Gut Microbiota in Graves’ Disease: Microbial Signatures and Diagnostic Potential Original paper
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Giorgos Aristotelous
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Giorgos Aristotelous
Read MoreGiorgos — BSc, MSc. Giorgos is an exercise scientist whose training and professional practice sit at the intersection of human performance, clinical health, and emerging microbiome science. He holds a BSc in Sports Science & Physical Education from Aristotle University (2012) and an MSc in Exercise & Health from Democritus University (2016), where his graduate work explored physiological adaptations to training across the lifespan. Now in his 15th year of practice, Giorgos pairs evidence-based coaching (ACSM-CPT, NSCA, USA Weightlifting) with a research-driven interest in how physical activity, body composition, and musculoskeletal integrity shape—and are shaped by—host–microbiome dynamics.
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Kimberly Eyer
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Kimberly Eyer
Read MoreKimberly Eyer, a Registered Nurse with 30 years of nursing experience across diverse settings, including Home Health, ICU, Operating Room Nursing, and Research. Her roles have encompassed Operating Room Nurse, RN First Assistant, and Acting Director of a Same Day Surgery Center. Her specialty areas include Adult Cardiac Surgery, Congenital Cardiac Surgery, Vascular Surgery, and Neurosurgery.
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Autoimmune Diseases
Autoimmune Diseases
Autoimmune disease is when the immune system mistakenly attacks the body's tissues, often linked to imbalances in the microbiome, which can disrupt immune regulation and contribute to disease development.
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Graves Disease
Graves Disease
OverviewGraves’ Disease (GD) affects approximately 0.5% of the population, predominantly women. First-line treatment options—antithyroid medications, radioactive iodine, and surgery— often result in significant side effects, incomplete remissions, and frequent relapses. Further, current first-line treatment options focus on symptoms management, and reflect an inadequate understanding of the etiology of the condition. However, recent research reveals a […]
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Giorgos Aristotelous
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Researched by:
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Giorgos Aristotelous
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Giorgos Aristotelous
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Fact-checked by:
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Kimberly Eyer
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Kimberly Eyer
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Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Giorgos Aristotelous
What was studied?
This original research article investigated the gut microbiota composition and its metabolic functions in patients with Graves’ disease (GD), an autoimmune thyroid disorder. The study aimed to uncover specific microbial signatures associated with GD, explore correlations between gut microbiota and thyroid function, and evaluate the potential of microbiome profiles as non-invasive diagnostic tools for GD. Using high-throughput 16S rRNA sequencing of fecal samples, the authors compared the microbial diversity, abundance, and structure between untreated GD patients and matched healthy controls. They further analyzed the relationships between specific bacterial genera, thyroid autoantibody levels, and predicted metabolic pathway involvement, with an emphasis on the identification of microbiome-based biomarkers for GD. The focus keyphrase “gut microbiota in Graves’ disease” is central to this investigation, as the study provides new insights into how gut microbial alterations may contribute to the pathogenesis and potential diagnosis of GD.
Who was studied?
The study cohort comprised 45 untreated patients with Graves’ disease (12 males, 33 females; median age 37, range 16–65 years) and 59 healthy controls (22 males, 37 females; median age 43, range 22–71 years), all recruited from the Shanghai Tenth People’s Hospital. Controls were matched for age and sex, confirmed to be free of thyroid disease by clinical and laboratory assessment, and none had received antibiotics, probiotics, or prebiotics for at least one month prior to sampling. Subjects with malignancies, gastrointestinal, or other endocrine diseases were excluded. Fecal samples, collected after an overnight fast, were stored at -80°C until analysis. Detailed clinical data, including thyroid function tests (FT3, FT4, TT3, TT4, TSH) and thyroid autoantibodies (TGAB, TPOAB, TMAB, TRAB), were obtained for all participants to facilitate correlation analyses between microbiota and disease phenotypes.
Most important findings
The study revealed a marked reduction in alpha diversity (species richness and evenness) of the gut microbiome in GD patients compared with healthy controls, indicating a less robust and potentially dysbiotic microbial community. At the phylum level, GD patients exhibited significantly lower Firmicutes and higher Bacteroidetes proportions. Notably, at the genus level, GD patients had elevated levels of Bacteroides and Lactobacillus, while beneficial butyrate-producing genera such as Blautia, [Eubacterium]_hallii_group, Anaerostipes, Collinsella, Dorea, unclassified Peptostreptococcaceae, and [Ruminococcus]_torques_group were significantly depleted. Lactobacillus levels were particularly increased in GD patients with concurrent Hashimoto’s thyroiditis, suggesting a role in broader autoimmune thyroid disease (AITD) pathogenesis.
Correlation analyses demonstrated that Blautia levels positively correlated with thyroid autoantibodies (TPOAB, TMAB), while Bacteroides showed inverse associations, and Dorea was negatively correlated with TPOAB. Functional predictions implicated Blautia in key metabolic pathways (lipid, amino acid, and carbohydrate metabolism), hinting that its depletion may disrupt intestinal homeostasis and immune regulation. A diagnostic model using nine genera distinguished GD patients from controls with high accuracy (AUC=0.81). Collectively, the findings support a model where microbial dysbiosis—characterized by loss of butyrate producers and expansion of potentially pathogenic taxa—may impair intestinal barrier integrity, promote systemic inflammation, and trigger or exacerbate thyroid autoimmunity.
Key implications
This study underscores the significant role of gut microbiota in the pathogenesis and potential non-invasive diagnosis of Graves’ disease. The identified microbial signatures—particularly the depletion of butyrate-producing genera and enrichment of Bacteroides and Lactobacillus—may contribute to immune dysregulation and thyroid dysfunction through alterations in intestinal permeability and pro-inflammatory signaling. The strong association between specific genera and thyroid autoantibody levels suggests that microbiota-driven immune mechanisms could be central to GD onset and progression. The diagnostic model based on microbial markers offers a promising, non-invasive adjunct for GD detection. These results open avenues for microbiome-based therapeutic interventions and precision diagnostics in AITD, but further studies are necessary to clarify causality, elucidate underlying mechanisms, and validate these biomarkers in larger, diverse populations.