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Is There A Connection Between Gluten And Hashimoto’s Disease?
Hormones play crucial roles in the human body, aiding in the functionality of all bodily systems.
These substances, often referred to as messengers in the body, are produced by a number of glands that form part of the human body’s endocrine system.
Each hormone has specific functions to serve in the body and, ultimately, they work together to ensure the body stays healthy, the digestive system works properly, the brain functions at an optimal level, the immune system is able to fight against foreign substances, and more1.
The Thyroid is considered to be one of the most important parts of the endocrine system. The gland produced two hormones that are collectively referred to as Thyroid hormones – consisting of thyroxine and triiodothyronine.
These hormones are produced in response to Thyroid stimulating hormone, which is secreted into the bloodstream by the pituitary gland.
Thyroid disorders can be hazardous to a person’s overall health, since every cell in the body contains Thyroid hormone receptors, and relies on these hormones for optimal function. Thyroid issues are more prevalent amongst the female population, affecting around 5% of all women.
While still problematic in some men, the global prevalence of Thyroid disorders amongst men is around 0.5%2. There are numerous disorders and health ailments that may affect Thyroid function – in some cases, only causing a temporary problem, and in other cases longer-term health issues.
Hashimoto’s disease is a type of autoimmune response where antibodies are sent to attack Thyroid tissue, even though the Thyroid gland does not contain pathogenic material.
This leads to an inflammatory response within the gland’s tissue, ultimately causing the affected patient to experience a reduction in the secretion of Thyroid hormones.
When Thyroid hormone secretion into the bloodstream is adversely affected, the body is affected at a cellular level. Numerous topics have been linked to Hashimoto’s disease and a Thyroid gland that produces an insignificant amount of Thyroid hormones.
Today, we want to take a closer look at how Gluten, Celiac disease and Hashimoto’s disease all have certain aspects in common that patients with Thyroid issues need to take into consideration.
Gluten And Celiac Disease
Gluten has become quite a popular topic. Walk into a local health store and you’ll be presented with numerous foods that are marked as being gluten-free.
Gluten is one of the many substances found in food that is generally considered to be unhealthy. In some people, a sensitivity to gluten may become obvious, causing them to suffer a variety of symptoms after they have consumed any type of food that contains this substance.
In others, no apparent symptoms may become present after the consumption of gluten-rich foods, even when a gluten sensitivity does exist.
According to data from NPD’s Dieting Monitor3, approximately 30% of adults in the United States either completely avoids including gluten in their daily diet, or at least limits their daily intake of gluten products.
Celiac disease is considered to be a very common condition in the general population, and is directly related to the body’s ability to digest gluten. Up to 1% of the worldwide population is affected by the condition.
It has also been found that celiac disease shares a connection with certain types of ailments. Individuals with another type of autoimmune disease, as well as those who are diabetic, for example, have a significantly higher risk of developing Celiac disease4.
The diagnosis of Celiac disease currently serves as a complication to the healthcare industry, primarily due to the fact that the disease affects people in different ways. Celiac disease can develop in both children and adults, and there are over 200 different symptoms5 that can be caused by the development of this disease.
Many of these symptoms may mimic other diseases; thus the most obvious test for a diagnosis may not always be aimed at Celiac disease or testing for gluten sensitivities.
One particular problem being faced with the misdiagnosis of Celiac disease is the fact that the immune system continuously attacks the villi found in the lining of the intestines6. The villi are responsible for assisting with the absorption of nutrients from food sources that a person consumes. When the immune system attacks the villi, malabsorption can develop as a possible complication.
Gluten, Your Thyroid And Hashimoto’s Disease
In as much as 90% of cases where a patient is diagnosed with Hypothyroidism, the cause behind the condition can be pointed to an autoimmune condition known as Hashimoto’s disease.
Autoimmune reactions are quite common in the modern world, and occurs when the immune system starts to send antibodies to a particular area in the body, thinking that healthy bodily tissue is really pathogenic.
This causes these antibodies to attack the healthy tissue and, in turn, causes damage, often repetitively. With Hashimoto’s disease, the Thyroid gland is the target of the immune system’s antibodies.
When diagnosed with Hashimoto’s disease, most physicians will provide the patient with medication to help increase the concentration of Thyroid hormones in their body, which will usually consist of a daily pill that contains a synthetic Thyroid hormone called Levothyroxine.
Brand names may include Synthroid or Levothroid7. In most cases, no additional tests are conducted and no further advice is provided to the patient to help them ease the symptoms and further aid in reducing damage to their Thyroid gland.
What many patients and even physicians fail to realize is that, when a patient is diagnosed with Hypothyroidism and the cause is Hashimoto’s disease, the consumption of gluten products might aggravate the condition and lead to further complications. The connection comes into play when we look at what happens when the body has a sensitive reaction to the consumption of foods that contain gluten.
When gluten is consumed, in some patients, the immune system sees the substance as a pathogenic compound; thus causing the immune system to start attacking gluten.
This reaction of the immune system leads to a number of potential complications. The lining of the stomach is affected firstly, which can lead to the development of gastrointestinal symptoms.
In addition, the immune system may also start to attack other healthy tissue in the body – when Hashimoto’s disease exists together with a gluten sensitivity, it causes the autoimmune reaction that occurs with Hashimoto’s disease to become aggravated.
Diagnosing The Connection
As mentioned before, gluten is not a particular topic of interest for physicians when a patient is diagnosed with Hypothyroidism, even when they are also diagnosed with Hashimoto’s disease. Still, a connection has been identified – not only between gluten intolerance and Hashimoto’s disease, but also between gluten intolerance and many other types of autoimmune disease, including rheumatoid arthritis, systemic lupus erythematous and insulin-dependent diabetes. One study8 estimates that approximately 2% of patients with Hashimoto’s disease may also suffer from Celiac disease.
The key here is to understand that a simple blood test will not reveal all that is needed to provide a particular patient with more details about their condition.
When Hashimoto’s disease is suspected in a patient, it is important for a physician to assist the patient in determining the cause behind the autoimmune response and inflammation that has developed in their Thyroid gland. While treatment with synthetic Thyroid hormones can be beneficial in elevating Thyroid hormone levels in the patient’s body, this treatment approach will not target the cause behind the problem.
For a patient to truly understand whether gluten may be a contributing factor to the inflammation in their Thyroid gland, additional tests need to be conducted. One particularly important factor to note here is that a patient that has been tested negative for Celiac disease may still have a sensitivity to gluten. This condition is called non-celiac gluten sensitivity.
Thus, even when a patient does not suffer from Celiac disease, gluten may still wreak havoc on their gastrointestinal tract, their immune system and their Thyroid gland, especially when Hashimoto’s disease is present.
Since no specific biomarkers can be checked to diagnose non-celiac gluten sensitivity, a variety of tests may be necessary to provide a patient with a clearer overview of whether or not gluten is a particular problem in their Thyroid dysfunction.
It has been suggested that non-celiac gluten sensitivity is more prevalent amongst the worldwide prevalence than celiac-related gluten sensitivities9, but due to no biomarkers provided for the diagnosis and testing of non-celiac gluten sensitivity, accurate data is not available presently.
Adopting A Gluten-Free Lifestyle
An effective approach to reducing the effects that gluten might have on the Thyroid function and on Hashimoto’s disease would be to adopt a gluten-free lifestyle. While it might seem convenient to simply reduce gluten in your daily diet, it should be noted that this may still lead to inflammation and an autoimmune reaction by your immune system.
For this reason, cutting out gluten should be a primary concern. When switching to a gluten-free diet, patients with Hashimoto’s disease should realize that the inflammatory triggers that have been caused by years of gluten-filled eating will take time to “reverse”. Thus, positive results should not be expected to occur overnight, but with time and commitment to the new diet.
The first step to a gluten-free diet is to identify the particular food options that do contain gluten. This will help you avoid consuming gluten-rich food; thus reducing inflammatory triggers caused by gluten in your body.
Sometimes, gluten is found in foods that you would not normally expect to contain gluten, which makes reading the label of any consumable product you are planning to buy essential.
Wheat and the different wheat varieties on the market are rich sources of gluten, and should be avoided in your diet. Wheat varieties include spelt, wheatberries, graham, einkorn wheat, emmer, semolina, durum and farro. In addition to wheat, other particular grains that contain gluten include barley, rye, malt, brewer’s yeast, wheat starch and triticale10.
If we look at particular food choices, then you should ideally try to avoid pasta and noodles, breads, crackers, some cereals, granola, croutons and beer. Look on the label of any product you wish to buy and see if it lists “wheat”. In some cases, “wheat flour” may be listed as an ingredient. Some sauces and salad dressings also contain gluten.
The best way to ensure you always buy gluten-free foods would be to check labels for words like “gluten-free” and “contains no gluten”.
These products are free of gluten, which means you are safe to eat them, and they will not interfere with your Thyroid disorder. If you do enjoy bread and other baked options, then you should ideally try to make them yourself with a gluten-free flour option. Some examples of gluten-free flour include coconut flour, rice flour, oat flour and chickpea flour11 – there are many other options available on the market as well.
Thyroid hormones interact with every single cell in the human body, and contributes to a healthy metabolism.
Disorders affecting the Thyroid gland’s function can lead to adverse symptoms, including fatigue and weight gain, that may become problematic in a patient’s daily life.
Hashimoto’s disease is the most common cause of an underactive Thyroid in the majority of settings.
This autoimmune disorder can be affected by numerous factors. Research suggests that gluten may also be a culprit in the inflammatory responses that occur within the Thyroid gland, due to an autoimmune reaction.
Obtaining proper screenings for gluten sensitivities, even with Celiac disease is not present, can help a patient identify how gluten may be affecting their Thyroid, and help them understand the right lifestyle changes that need to be implemented for a healthier Thyroid.
1 Kimm Ann Zimmermann. Endocrine System: Facts, Functions and Diseases. LiveScience. 15 February 2018. https://www.livescience.com/26496-endocrine-system.html
2 Chapter 3: The Thyroid Gland. Endocrinology: An Integrated Approach. https://www.ncbi.nlm.nih.gov/books/NBK28/
3 Percentage of U.S. Adults Trying to Cut Down or Avoid Gluten in Their Diets Reaches New High in 2013, Reports NPD. The NPD Group, Inc. https://www.npd.com/wps/portal/npd/us/news/press-releases/percentage-of-us-adults-trying-to-cut-down-or-avoid-gluten-in-their-diets-reaches-new-high-in-2013-reports-npd/
4 Naiyana Gujral, Hugh J. Freeman and Alan B.R. Thomson. Celiac disease: Prevalence, diagnosis, pathogenesis and treatment. World Journal of Gastroenterology. 14 November 2012. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3496881/
5 Celiac Disease Symptoms. Celiac Disease Foundation. https://celiac.org/celiac-disease/understanding-celiac-disease-2/celiacdiseasesymptoms/
6 Celiac Disease (Gluten Intolerance). PubMed Health. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024528/
7 Hypothyroidism (underactive thyroid). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hypothyroidism/diagnosis-treatment/drc-20350289
8 Multiple Authors. Thyroid-related autoantibodies and celiac disease: a role for a gluten-free diet? U.S National Library of Medicine. September 2002. https://www.ncbi.nlm.nih.gov/pubmed/12192201
9 Multiple Authors. Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts’ Criteria. MDPI Nutrients. 18 June 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488826/
10 Sources of Gluten. Celiac Disease Foundation. https://celiac.org/live-gluten-free/glutenfreediet/sources-of-gluten/
11 Gluten Free Cake. NPR. https://www.npr.org/2014/03/20/291873792/test-kitchen-have-your-gluten-free-cake-and-love-eating-it-too