“I have hypothyroidism, and it is well controlled on levothyroxine (Synthroid),” explained a MyLupusTeam member. “I had a diverticulitis flare-up a couple of weeks ago and was put on antibiotics and metronidazole (Flagyl). I have no idea if this was related to lupus, but it was very painful and landed me in the ER.”

Lupus, hypothyroidism, and diverticulitis are unique medical conditions affecting different body systems. Lupus affects multiple organs, hypothyroidism involves the thyroid gland, and diverticulitis is an inflammation of the colon (large intestine). However, some shared risk factors and clinical features may connect these conditions.

Thyroid problems, especially hypothyroidism (underactive thyroid), are more common when you have lupus. Experts estimate 15 percent to 19 percent of people with lupus have hypothyroidism, compared to just 4.6 percent of the general population. In addition, hypothyroidism may raise your risk of diverticulosis by 2.4 times. When diverticulosis flares up, it’s called diverticulitis.

Underlying Causes of Disease

Lupus is an autoimmune disease in which the immune system attacks healthy organs. Studies show that having one autoimmune disease puts you at a higher risk for a second or third. Hypothyroidism can also be caused by autoimmune problems but isn’t always. Nonetheless, the most common type of hypothyroidism is the autoimmune condition, Hashimoto’s disease.

In Hashimoto’s, the immune system makes antibodies that attack the thyroid gland. As a result, it makes less thyroid hormone. Lupus and thyroid disease might have similar genetic or environmental factors that cause issues with the immune system. However, more research is needed to understand the connection.

In addition to hypothyroidism, people with lupus are more likely to have inflammatory bowel diseases like Crohn’s disease. Unfortunately, it can be difficult for healthcare providers to distinguish between lupus and other autoimmune disorders because the signs and symptoms may overlap. Tests can help identify any coexisting health conditions with lupus. Your provider may also refer you to other specialists to uncover the root of your symptoms.

One member explained, “I’ve had Crohn’s disease and diverticulitis for 26 years. I also have two small nodules on my thyroid. I have 10 specialists and was told to add an endocrinologist specializing in hormones like the thyroid.”

Diverticulitis and Inflammation

Diverticulitis is not an autoimmune disease but it has one main feature in common with autoimmune diseases — and that’s inflammation. Lupus flare-ups happen when the immune system goes into hyperdrive, causing an inflammatory spike that wreaks havoc on the body. In diverticulitis, weak spots or outpouchings of the intestines get infected and inflamed. Immunosuppressant medications for lupus can make these infections harder to fight off on your own.

Diverticulosis is a relatively common condition, regardless of whether you have lupus. Most people with diverticulosis don’t need to worry because they don’t have any symptoms. But a flare-up of diverticulitis requires medical attention and sometimes hospitalization.

Years ago, healthcare providers would advise people with diverticulosis to avoid certain high-fiber foods, like seeds and popcorn, because they believed that fiber particles could get stuck in the diverticular pouches, leading to diverticulitis. However, the current treatment recommendations are to maintain a high-fiber diet. During flare-ups, a temporary liquid diet may be advised. This dietary approach also benefits lupus and hypothyroidism by preventing excess weight gain, protecting against heart disease, and promoting a healthy immune system.

Managing Life With Other Health Conditions

Living with lupus is challenging. So if the thought of an additional diagnosis (or two) feels overwhelming, it may help to talk to all your healthcare providers about how you can best care for your health. If living with multiple health conditions is negatively affecting your mental health, you may want to seek support from a therapist or mental health counselor.

Talk With Others Who Understand

On MyLupusTeam, people share their experiences with lupus, get advice, and find support from others who understand.

Have you experienced changes to your digestive system or thyroid function since your lupus diagnosis? Let others know in the comments below.