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A 24-year-old active duty military man, undergoing treatment for recurrent <jats:italic>Clostridiumdifficile<\/jats:italic> infection, presented for clinical evaluation and was found to have a thyroid stimulating hormone level of 0.003\u2009mg\/dL. Further labs revealed a normal T4, elevated T3 at 5.0\u2009pg\/mL and elevated C reactive protein at 3.69\u2009mg\/L. The patient was followed with monthly labs and the abnormal thyroid stimulating hormone and triiodothyronine levels resolved after the completion of his <jats:italic>C. difficile<\/jats:italic> treatment. While subacute thyroiditis has historically been due to viral causes, rarely do we see this condition associated with an intestinal bacterial source.<\/jats:p>","DOI":"10.1136\/bcr-2018-226711","type":"journal-article","created":{"date-parts":[[2018,12,19]],"date-time":"2018-12-19T05:44:17Z","timestamp":1545198257000},"page":"e226711","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["<i>Clostridium difficile<\/i> colitis in the setting of subacute thyroiditis: the chicken or the egg"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3102-9423","authenticated-orcid":false,"suffix":"Jr","given":"Jacob","family":"Mathew","sequence":"first","affiliation":[{"name":"Department of Aviation Medicine, Evans US Army Hospital, Fort Carson, Colorado, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,12,18]]},"reference":[{"key":"2025082623083036000_11.1.e226711.1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1136\/pmj.77.903.29","article-title":"Subclinical thyrotoxicosis","volume":"77","author":"Al-Abadi","year":"2001","journal-title":"Postgrad Med J"},{"key":"2025082623083036000_11.1.e226711.2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-1591"},{"key":"2025082623083036000_11.1.e226711.3","unstructured":"Jameson JL , Mandel SJ , Weetman AP , et al Disorders of the Thyroid Gland. 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