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Gastroenterology

When One Becomes Many: Associated Conditions

At a Glance

Patients with autoimmune gastritis (AIG) have a higher risk of developing other autoimmune diseases, such as Hashimoto's thyroiditis, Type 1 diabetes, and Celiac disease. Doctors strongly recommend proactive screening for these conditions, even before symptoms appear.

If you have been diagnosed with Autoimmune Gastritis (AIG), it is important to know that this condition rarely travels alone. In the medical world, the presence of multiple autoimmune diseases in one person is known as polyautoimmunity [1][2].

Think of your immune system as a security team that has accidentally been programmed with a “glitch.” If the team is mistakenly attacking your stomach, there is a higher chance they might also target other organs [2]. This shared vulnerability is often due to an autoimmune tautology—common genetic and immunological “blueprints” that make some people more susceptible to autoimmune attacks in general [2][3].

The “Autoimmune Neighbors”

Certain conditions are more likely to appear alongside AIG. These are often grouped together because they share similar genetic risk factors, such as specific HLA (Human Leukocyte Antigen) alleles [4][5].

  • Autoimmune Thyroid Disease: This is the most common companion to AIG [6]. Conditions like Hashimoto’s thyroiditis (which causes an underactive thyroid) or Graves’ disease (overactive thyroid) are frequently found in AIG patients [2][7].
  • Type 1 Diabetes Mellitus (T1DM): There is a strong link between AIG and T1DM [6]. When these occur together with thyroid disease, it is sometimes called Autoimmune Polyglandular Syndrome (APS) [8].
  • Vitiligo: This is an autoimmune condition where the immune system attacks the pigment-producing cells in the skin, resulting in white patches [8].
  • Celiac Disease: Some patients with AIG also have Celiac disease, where the immune system reacts to gluten [9]. Both can cause iron deficiency, which can make a diagnosis tricky [10].

Why Active Screening Matters

The presence of another autoimmune disorder can actually be a predictor that early-stage AIG will progress to a more severe form [11]. Because many of these “neighboring” conditions can have subtle symptoms, doctors recommend active screening—testing you even if you don’t feel sick yet [9][12].

If you have AIG, your medical team should ideally look for:

  1. Thyroid Markers: Blood tests like TSH (Thyroid Stimulating Hormone) and TPO antibodies to ensure your thyroid is functioning correctly [7].
  2. Blood Sugar Levels: Checking your HbA1c or fasting glucose to screen for early signs of Type 1 Diabetes [8].
  3. Nutrient Levels: Continued monitoring of iron and B12, as other autoimmune conditions like Celiac can worsen these deficiencies [10][9].

Empowering Your Care

You are the best advocate for your own health. If you haven’t been screened for these associated conditions, it is reasonable to bring them up with your doctor. Polyautoimmunity isn’t about “looking for trouble”—it’s about ensuring that your entire immune system is being managed so you can stay as healthy as possible [1][9].

Associated Condition Body Part Targeted Common Symptoms
Hashimoto’s Thyroid Gland Fatigue, weight gain, feeling cold.
Type 1 Diabetes Pancreas Excessive thirst, frequent urination.
Vitiligo Skin Pigment White patches on skin or hair.
Celiac Disease Small Intestine Bloating, diarrhea, weight loss.

Common questions in this guide

Why do I have multiple autoimmune conditions with autoimmune gastritis?
Autoimmune diseases often occur together due to shared genetic and immunological vulnerabilities, a concept called polyautoimmunity. If your immune system mistakenly attacks your stomach, it is more likely to mistakenly target other organs as well.
What other autoimmune conditions are most commonly linked to AIG?
Autoimmune thyroid diseases, like Hashimoto's and Graves' disease, are the most common companions to AIG. Other frequently associated conditions include Type 1 Diabetes, Vitiligo, and Celiac Disease.
Should I be screened for Hashimoto's if I have autoimmune gastritis?
Yes, doctors recommend active screening for thyroid function if you have AIG. This typically involves blood tests to check your TSH levels and TPO antibodies to ensure your thyroid is working correctly.
How are Celiac disease and autoimmune gastritis related?
Both conditions are autoimmune disorders that can occur together and cause severe iron deficiency. Because their symptoms and nutritional impacts overlap, doctors often recommend screening for Celiac disease if you are diagnosed with AIG.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Given my AIG diagnosis, should we perform a baseline screening for Hashimoto's thyroiditis by checking my TSH and TPO antibodies?
  2. 2.Are there specific signs of Type 1 Diabetes I should be monitoring for, and should we check my HbA1c or fasting glucose?
  3. 3.Should I be screened for Celiac Disease, particularly since I already have iron absorption issues?
  4. 4.Since I have one autoimmune condition, what is the likelihood that I will develop another in the future, and how often should we re-evaluate?
  5. 5.Do you recommend a referral to an endocrinologist to screen for autoimmune polyglandular syndrome?

Questions For You

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References

References (12)
  1. 1

    Low Pepsinogen I/II Ratio and High Gastrin-17 Levels Typify Chronic Atrophic Autoimmune Gastritis Patients With Gastric Neuroendocrine Tumors.

    Magris R, De Re V, Maiero S, et al.

    Clinical and translational gastroenterology 2020; (11(9)):e00238 doi:10.14309/ctg.0000000000000238.

    PMID: 33094954
  2. 2

    Alterations in SLC4A2, SLC26A7 and SLC26A9 Drive Acid-Base Imbalance in Gastric Neuroendocrine Tumors and Uncover a Novel Mechanism for a Co-Occurring Polyautoimmune Scenario.

    Calvete O, Reyes J, Valdés-Socin H, et al.

    Cells 2021; (10(12)) doi:10.3390/cells10123500.

    PMID: 34944008
  3. 3

    Unravelling the Shared Genetic Mechanisms Underlying 18 Autoimmune Diseases Using a Systems Approach.

    Gokuladhas S, Schierding W, Golovina E, et al.

    Frontiers in immunology 2021; (12()):693142 doi:10.3389/fimmu.2021.693142.

    PMID: 34484189
  4. 4

    Genome-wide association study identifies five risk loci for pernicious anemia.

    Laisk T, Lepamets M, Koel M, et al.

    Nature communications 2021; (12(1)):3761 doi:10.1038/s41467-021-24051-6.

    PMID: 34145262
  5. 5

    Gender-sex differences in autoimmune atrophic gastritis.

    Lahner E, Dilaghi E, Cingolani S, et al.

    Translational research : the journal of laboratory and clinical medicine 2022; (248()):1-10 doi:10.1016/j.trsl.2022.04.006.

    PMID: 35470008
  6. 6

    A Retrospective Study on Clinical Features of Autoimmune Gastritis: Impact of Age, Sex, and Autoimmune Thyroid Disease in China.

    Wang X, Lu CJ, Ding Y, et al.

    Gut and liver 2025; (19(4)):528-535 doi:10.5009/gnl240448.

    PMID: 39943807
  7. 7

    Evaluation of adult celiac disease from a tertiary reference center: a retrospective analysis.

    Binicier OB, Tosun F

    Revista da Associacao Medica Brasileira (1992) 2020; (66(1)):55-60 doi:10.1590/1806-9282.66.1.55.

    PMID: 32130382
  8. 8

    Thyro-entero-gastric autoimmunity: Pathophysiology and implications for patient management.

    Lahner E, Conti L, Cicone F, et al.

    Best practice & research. Clinical endocrinology & metabolism 2020; (34(1)):101373 doi:10.1016/j.beem.2019.101373.

    PMID: 31864909
  9. 9

    Pediatric autoimmune gastritis: clinical correlates and histologic features.

    Kulak O, Gurram B, Montgomery EA, Park JY

    Human pathology 2021; (116()):31-38 doi:10.1016/j.humpath.2021.07.002.

    PMID: 34284050
  10. 10

    Autoimmune gastritis.

    Kulnigg-Dabsch S

    Wiener medizinische Wochenschrift (1946) 2016; (166(13-14)):424-430 doi:10.1007/s10354-016-0515-5.

    PMID: 27671008
  11. 11

    Time course and risk factors of evolution from potential to overt autoimmune gastritis.

    Lenti MV, Miceli E, Vanoli A, et al.

    Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 2022; (54(5)):642-644 doi:10.1016/j.dld.2021.10.001.

    PMID: 34732311
  12. 12

    Polyautoimmunity in autoimmune gastritis.

    Kalkan Ç, Soykan I

    European journal of internal medicine 2016; (31()):79-83.

    PMID: 27085391

This page provides educational information about conditions associated with autoimmune gastritis. It is not a substitute for professional medical advice, diagnosis, or proactive screening from your healthcare provider.

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