Probiotics and Prebiotics in Subclinical Hypothyroidism of Pregnancy with Small Intestinal Bacterial Overgrowth

Probiotics Antimicrob Proteins. 2024 Apr;16(2):579-588. doi: 10.1007/s12602-023-10068-4. Epub 2023 Apr 10.


Evaluating efficacy of probiotics combined with prebiotics in small intestinal bacterial overgrowth (SIBO) in subclinical hypothyroidism (SCH) in the second trimester. We collected data from 78 pregnant women with SCH (SCH group) and 74 normal pregnant women (control group) in second trimester, compare the differences in high sensitivity C-reactive protein (hsCRP), result of lactulose methane-hydrogen breath test and gastrointestinal symptoms assessed by GSRS scale between two groups. In SCH group, 32 patients with SIBO were selected as intervention group. Treatment with probiotics + prebiotics for 21 days; The differences of lipid metabolism, hsCRP, thyroid function level, methane-hydrogen breath test results and GSRS scores before and after treatment were compared to evaluate the therapeutic effect. (1) The positive rate of SIBO and methane, hsCRP levels in SCH group were higher than those in control group (P < 0.05), the total score of GSRS scale, mean score of indigestion syndrome, and constipation syndrome in SCH group were higher (P < 0.05). (2) The mean abundance of hydrogen and methane were higher in SCH group. (3) After treatment, serum levels of thyrotropin(TSH), total cholesterol(TC), triglyceride(TG), low-density lipoprotein (LDL), and hsCRP in intervention group were decreased, and high-density lipoprotein (HDL) was increased compared with before treatment (P < 0.05). (4) After treatment, methane positive rate, total score of GSRS scale, mean score of diarrhea syndrome, dyspepsia syndrome, and constipation syndrome were decreased (P < 0.05). (5) The average abundance of methane and hydrogen were lower. Probiotics combined with prebiotics are effective in the treatment of SIBO in pregnant SCH patients.Clinical Trial Registration Number: ChiCTR1900026326.

Keywords: Prebiotics; Probiotics; Small intestinal bacterial overgrowth; Subclinical hypothyroidism during pregnancy; Treatment.

Publication types

  • Clinical Trial

MeSH terms

  • C-Reactive Protein / metabolism
  • Constipation
  • Female
  • Humans
  • Hydrogen / metabolism
  • Hypothyroidism* / drug therapy
  • Hypothyroidism* / metabolism
  • Intestine, Small / microbiology
  • Methane / metabolism
  • Prebiotics
  • Pregnancy
  • Probiotics* / therapeutic use


  • C-Reactive Protein
  • Hydrogen
  • Methane
  • Prebiotics