I have had no less than three people ask me this week if they should cut gluten because of Hashimoto’s. Deserves a post, no?
Yes…but not yet.
THE LONG ANSWER
The Connection between Hashimoto’s and Gluten
If you are interested enough to be reading this article, you probably already know Hashimoto’s is an autoimmune hypothyroidism. People with one autoimmune disease are vulnerable to other autoimmune diseases. (I know, that’s the worst) One of these autoimmune diseases that is of particular interest to me due to the nutritional entanglements with Hashimoto’s is celiac disease. In true nutrition nerd form, I got a little carried away with researching all this, but I will cut out as much of the non-essentials as I can and try to get to the point.
When people are first diagnosed with celiac disease, they typically have high amount of serum anti-tissue transglutaminase (tTG) antibodies in their blood (I swear that is an essential). A bit of time on the gluten-free diet will clear this up, but if it has taken a a while to get a celiac diagnosis, then the antibodies can be circulating through the body long enough to do damage to the thyroid. Cue autoimmune thyroid disease (told you it was an essential).
There are several other symptoms of celiac that aren’t gut related- weight loss, fatigue, hair loss, depression/anxiety, joint pain, miscarriage/infertility/missed periods …do any of these sound familiar? Exactly- they are also the symptoms for thyroid diseases. So, if you go to the doctor with these symptoms, the first obvious would be to check your thyroid. They check it, your antibodies are high- bam, you have a diagnosis. Treatment for thyroid disease often takes sometime to hammer out the details of dosage, so immediate improvement is hoped for but not completely expected. But, what if all this time, you also have underlying celiac disease? This means correcting the thyroid disease isn’t just an issue of tinkering with the dosage of meds but also of diagnosing celiac and cutting out gluten.
What To Do About It
FIRST- ask to be checked for celiac disease. If you have not been tested for celiac disease- get tested BEFORE you start cutting out gluten. The markers in your blood that give you the celiac disease diagnosis are only there if you are still eating gluten. I know when you eat gluten you feel rubbish, but if you cut the gluten first, you’ll never know if you have the disease. Why does it matter if you have it or not if you feel better without gluten? Let me tell you why in this article.
If you are diagnosed with celiac disease, cutting gluten is a no-brainer. The gluten-free diet will decrease the tTGs attacking the thyroid as well as allow your gut to heal and do it’s job in increasing absorption of nutrients and medications- either way, your doctor may need to reduce your thyroid meds. Great, right?
If you are not diagnosed with celiac disease, there is still a chance of a non-celiac gluten intolerance. Even though there isn’t hard and fast research linking Hashimoto’s to non-celiac gluten sensitivity (mainly because it’s hard to research something that doesn’t have a diagnostic test), many clinicians will tell you when they see Hashimoto’s, they recommend a gluten-free diet trial regardless what the celiac panel results, and often their patients feel much better. It doesn’t hurt to give it a trial, right? One thing to consider, though, many over-processed gluten free products are VERY dense in calories. If you are having weight issues, be mindful you are choosing whole to lightly processed foods. Here’s an article for more tips.
Further Reading/Resources… Elfström P, Montgomery SM, Kämpe O, Ekbom A, Ludvigsson JF. Risk of thyroid disease in individuals with celiac disease. J Clin Endocrinol Metab. 2008;93(10):3915-3921 // Ch’ng CL, Jones MK, Kingham JGC. Celiac disease and autoimmune thyroid disease. Clin Med Res. 2007;5(3):184-192 // Duntas L. Does celiac disease trigger autoimmune thyroiditis? Nat Rev Endocrinol. 2009;5(4):190-191 // Naiyer AJ, Shah J, Hernandez L, et al. Tissue transglutaminase antibodies in individuals with celiac disease bind to thyroid follicles and extracellular matrix and may contribute to thyroid dysfunction. Thyroid. 2008;18(11):1171-1178