This article is part of a special report on Thyroid Disorders. To see the other articles in this series, click here.
In the first article in this series, I showed that hypothyroidism is an autoimmune disease in 90% of cases. In this article we’re going to discuss the connection between autoimmune thyroid disease (AITD) and gluten intolerance.
Several studies show a strong link between AITD (both Hashimoto’s and Graves’) and gluten intolerance. [1, 2, 3, 4, 5] The link is so well-established that researchers suggest all people with AITD be screened for gluten intolerance, and vice versa.
What explains the connection? It’s a case of mistaken identity.
These antibodies to gliadin also cause the body to attack thyroid tissue. This means if you have AITD and you eat foods containing gluten, your immune system will attack your thyroid.
Even worse, the immune response to gluten can last up to 6 months each time you eat it. This explains why it is critical to eliminate gluten completely from your diet if you have AITD. There’s no “80/20” rule when it comes to gluten. Being “mostly” gluten-free isn’t going to cut it. If you’re gluten intolerant, you have to be 100% gluten-free to prevent immune destruction of your thyroid.
So how do you find out if you’re gluten intolerant? Unfortunately, standard lab tests aren’t very accurate. They test for antibodies to gluten in the bloodstream. But antibodies in the blood will only be found in cases where the gut has become so permeable that gluten can pass through. This is a relatively advanced stage of disease. Blood tests will miss the many milder cases of gluten intolerance that haven’t yet progressed to that stage.
Stool analysis is far more sensitive, because it detects antibodies produced in the digestive tract that aren’t yet escaping into the bloodstream. Using this method at Entero Lab, Dr. Kenneth Fine, a pioneer in the field, has found that up to 35% of Americans are gluten intolerant.
In addition to the stool analysis, Dr. Fine’s lab uses a cheek swab to test for the genes connected with gluten intolerance and celiac disease. People with HLA DQ genes are more likely than the general population to have autoimmune disease, celiac disease and gluten intolerance. Dr. Fine’s research shows that more than 80% of Americans have one of these gene types.
When I first read Dr. Fine’s research, I was astounded by the implications. It suggests that 1 in 3 Americans are gluten intolerant, and that 8 in 10 are genetically predisposed to gluten intolerance. This is nothing short of a public health catastrophe in a nation where the #1 source of calories is refined flour. But while most are at least aware of the dangers of sugar, trans-fat and other unhealthy foods, fewer than 1 in 8 people with celiac disease are aware of their condition. I would guess that an even lower proportion of people are aware they are gluten intolerant.
As much improved as Dr. Fine’s methods are, they aren’t perfect. In some patients with autoimmune disease, their immune system is so worn out they can no longer produce many antibodies.
Hashmioto’s, the most common autoimmune thyroid condition, is primarily a Th1 dominant condition. I’ll explain what this means in further detail in a future article. For now, what you need to understand is that in Th1-dominant conditions, the Th2 system is suppressed. The Th2 system is the part of the immune system responsible for producing antibodies. When the Th2 system is severely depressed, the body’s ability to produce antibodies is impaired. The levels may be so low that they won’t show up on a test. So, even if you have gluten intolerance, your test for gluten antibodies may be falsely negative if you have Th1-dominant Hashimoto’s.
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This is why I recommend that you avoid gluten if you have AITD, regardless of whether tests show an active antibody response. This is especially true if you have one of the genes (HLA DQ1,2, or 3) that predisposes you to developing gluten intolerance. In my opinion continuing to eat gluten when you have a confirmed autoimmune condition simply isn’t worth risking the immune destruction it could cause.
In fact, the more I learn about gluten and its effects on the body, the more I think we’d all probably be better off not eating it. Mark Sisson has written extensively about the dangers of gluten and gluten-containing grains, so head over there and have a look if this is new to you.
The good news is that if you have AITD and are gluten intolerant, removing gluten completely from your diet will dramatically improve your health. It’s not easy, but it’s worth it.
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Mario, this paper shows that increasing levels of Th1 IFN decrease levels of Th2 iL-4 in Hashimoto’s, and that Th1 dominance is positively correlated with disease severity.
This paper shows a similar trend in Graves’ opthalmopathy. As Th1 cytokines rise, Th2 cytokines fall. Th2 cytokines are necessary for antibody production.
Sorry, forget the link:
I was looking for a paper that showed Th1 dominance and antibody supression on AITD, not in general. But, anyway, searching on Pubmed, I came across this interesting paper, that showed that a high iodine intake produced lymphocyte proliferation, higher NK cells activity and Th1/Th2 imbalance on mice. But in rats with high iodine + selenium there is no difference in relation with the group that did not took iodine.
“The key is to avoid triggers (like gluten, iodine and others) that ramp up antibody production and thus increase the autoimmune response, and to regulate the immune system and bring it back into relative balance.”
The problem that I see with Dr. K (from what I read from his book) and yours articles so far, is that they address only a small part of the problem. Gluten is a very well know problem with Hashi and many other autoimmune diseases, ok. But hardly is the only problem. What about fluoride, chloride, bromide, bisphenol-A, mercury, and the many other contaminants that are well know endocrine disruptors and all make hashimoto worse? What to do about them? Do you and/or Dr. K thinks that only avoiding gluten, eating a paleo diet and regulating our immune system are enough?
“As I mentioned in the article, low antibody levels aren’t always a good thing, because that may indicate a severely depressed Th2 system.”
Chris, can you provide any reference for this? Thanks!
It may be that fluoride, chloride, bromide and BPA toxicity need to be addressed in certain patients. But most practitioners (myself included) using Dr. K’s methods aren’t doing this explicitly, and are seeing dramatic results. BTW, Dr. K believes that hormone replacement is necessary in those with significant tissue destruction and persistently high TSH levels. Thyroid hormone is too important for proper physiological function to ignore. I’ll be addressing this in a future article.
Here’s a paper showing that Th1 dominance suppresses the Th2 system and reduces Th2-mediated antibody production to near zero.
This is bit of the subject, but do you think there are any problems with eating combinations of foods? ie. meat and dairy, meat and eggs etc. I have read a few things about not eating certain foods with others but havent found any scientific research to support this.
Also, I am unable to eat fish oil as I am allergic to fish and found it gave me problems. Do you think taking ground flaxseed is a of any benefit to try and get omega 3? we have a good source of organic pasture fed beef and eggs so hopefully this will help the omega3/6 ratio.
Thanks for all the great info! the acupuncture studies are going well- learning electroacupuncture and some TCM stuff this week
The omega-3s in meat and dairy probably aren’t enough if you have an inflammatory condition. I’d look into algae oil for DHA at least. I’m not sure if you’d be allergic to that or not, but it would be a better choice than flax.
I don’t think there’s a problem with combining meat and dairy and meat and eggs – unless you notice there is for you. If it causes problems, it’s a sign of dysbiosis and you should investigate the cause (i.e. H. pylori, bacterial overgrowth, etc.)
Thanks for the explanation, so useful to know more. Does the gut need to be impermeable somewhere for the antibodies to interact with the thyroid? Once you have antibodies to gliadin or transglutaminase in your gut, by what mechanism can this then lead to interactions with the thyroid?
Molecular mimicry mechanisms with gliadin have been postulated for autoimmune thyroid conditions. The antibodies produced against gluten appear to stimulate B-cell production tagging of the thyroid tissue. But that doesn’t mean gluten intolerance is the sole trigger of autoimmune thyroid by any means. Your body is capable of producing antibodies to thyroid tissue without the influence of gluten.
Thank you thank you thank you THANK YOU! I have been trying to say what you are saying in these pages for YEARS but did have the knowledge, or confidence, or the right WORDS to say it with. MY BODY knew it though. My body knew that something wasn’t right with the medication that I was taking for my thyroid, but I didn’t have any other way of saying it except for ‘something doesn’t feel right’.
I am right behind you, going back to school to become more educated in these areas so that I can first heal myself, and then help others. THANK YOU AGAIN! xo
I noticed in the linked study it said: ” In these two celiac patients, the serologic markers became undetectable 6 months after beginning a gluten-free diet. However, thyroid autoantibodies did not positively correlate with dietary habits.” Does that mean that although gliadin antibodies were no longer detectable after 6 months, thyroid antibodies were still there, ie did not correlate with diet? The link does not let me see the whole study, just the synopsis, and it is only n=2 for celiacs, but if that is what it is saying, sounds like once the body starts making thyroid antibodies, it tends to keep making them, even if the gliadin is no longer fueling the fire. Not good. Either that or n=2 is not enough subjects for statistical significance and that is what they are saying by “not positively correlated,” ie did not reach statistical significance.
It means that removing gluten doesn’t eliminate antibodies to thyroid. Keep in mind, however, that antibody levels aren’t necessarily a measure of severity in autoimmune thyroid disease. As I mentioned in the article, low antibody levels aren’t always a good thing, because that may indicate a severely depressed Th2 system. In that case, we might expect to see antibody levels actually rise as we address their immune imbalance and they improve. On the other hand, high antibody levels doesn’t necessarily mean severe tissue destruction. Antibodies themselves don’t destroy tissue – they just tag it for destruction.
I think it’s best not to worry too much about the antibody levels and instead to focus on clinical symptoms as a measure of progress.
i’m familiar with these issues- i am gluten-free and grain free already, so maybe it is a mute point, but i am wondering how to really know if you are hypothyroid and then if it is hashimotos….
i was on thyroid meds for years because of low thyroid symptoms and positive response to the medication, Armour Thyroid. I went off of them about 2 years ago and my blood tests are about the same. the blood tests seem unreliable and the “normal” range doesn’t seem like it is high enough to really be healthy. my doctors insist on only testing TSH so i have had limited info and it’s never been addressed whether is was hashimotos…
To clarify my last reply, gluten doesn’t exist naturally in the body. The reason the gliadin antibodies disappeared in those patients is because they weren’t eating gluten anymore. Thyroid tissue, however, is still there and the so the body will continue producing antibodies to it.
My daughter (she is 7) was diagnosed with Graves disease last year. We have struggled mightily in trying to get her thyroid under control. It is so volatile and appeared to be unresponsive to treatment. I finally decided to get a second opinion after having some doubts with our pediatric endocrinologist. The new doctor ran 9 vials of blood and found the presence of some antibodies in her system which could possibly indicate Celiac Disease. Sure enough, after consulting with a pediatric gastroenterologist and a biopsy having been done, my daughter has Celiac Disease as well. Totally explains why her thyroid never came under control. While controlling her diet is extremely hard (mostly because I am new to this)… I am thankful that its just diet that needs to be reformed to help her out. Thanks for an awesome article.
Hi Lisa, my daughter was 10 when she was diagnosed with Graves. I have not talked with anyone else with a child with Graves. I know this is an old post but how is she doing now? We are 3 years into this journey.
Thanks for the great articles on what is such a common, complex condition that can affect the whole body! I am one of those with Hashimoto’s struggling with seeming ineffectiveness of thyroid hormones to remove the symptoms after a few weeks of them seeming to work each time the dose is raised, plus cycling symptoms and flare-ups so it is all a journey of discovery. I’ve been trying gluten-free on and off for a few months as challenge diet to see if I can sense any effects, but they are unclear, apart from an extremely sore thyroid for 2-3 days 3-4 days after stopping the gluten each time – must be telling its story! I’m just a bit confused in your explanation of detecting antibodies to the gliadin and the role of gut permeability. The gut needs to be permeable at some stage for the gliadin molecules to enter the bloodstream, right? And then this is the mechanism by which the body mounts an antibody attack as these protein molecules are not where they are supposed to be? This would then be the process by which the antibodies could attack thyroid tissue? If the gut has not become permeable anywhere, and the person is not a coeliac then how would they develop gluten intolerance? Is gut impermeability and presence in the bloodstream key for developing gluten intolerance? How does this tie in with the lab method for measuring gliadin antibodies from the gut in the stool? Just a little confused…
You can’t do an “on and off” gluten-free diet and expect results. As I said in the article, you must be 100% gluten free for a significant length of time to receive the full benefit of eliminating gluten.
Gluten intolerance develops in the gut. The gut doesn’t have to be permeable for that to happen. The gut does have to be permeable, however, for the antibodies to leak through the gut wall and into the bloodstream, where they can be detected on a blood test. Celiac is just an extreme form of gluten intolerance. You don’t have to be celiac to produce antibodies to gliadin. Celiacs will also often have antibodies to transglutaminase, an enzyme in the intestines, and endomysium, a msucle sheath.
Wow. Really? Eighteen years ago I had major surgery to remove part of my colon, due to near obstruction. Fast forward eight years and I found out I am a celiac. I have practically no muscle tone in my abdomen, despite being muscular everywhere else. My tummy protrudes above the scar line. Are you saying that the lack of muscle tone could be, in part, due to antibodies to the muscle sheath in that area?
I am to start physical therapy soon, as my organs are not positioned optimally for aging. Ackk.
Thanks for the interesting article and everyone’s ideas. Great exchange!
Jimmy Moore just put up his podcast interview with Dr. Khaarrzian.
Thanks, Jacob. I didn’t even realize Jimmy had interviewed him.
This paper that I linked to in my article suggests that gliadin antibody production may decrease to undetectable levels after six months on a gluten free diet. This doesn’t mean celiac has been cured, because eating gluten would immediately ramp up antibody production again. But it does mean the immune response has been dampened significantly.
Yes, you’ve got it.
And yes, thyroid function can recover to some degree when the underlying autoimmunity is dampened. However, it’s important to understand that once the autoimmune process begins, it can’t be fully reversed. The body doesn’t forget. Once it produces antibodies to a tissue, that tissue will always be tagged for attack. This cellular memory is what makes our immune systems are so expert at fighting off pathogens, but it works against us in the case of autoimmune disease.
The key is to avoid triggers (like gluten, iodine and others) that ramp up antibody production and thus increase the autoimmune response, and to regulate the immune system and bring it back into relative balance. I’ll be discussing the basics of this in an upcoming post, but this is something that’s best done under the supervision of a knowledgeable practitioner.
I have a 12 year old that was just diagnosed with Hashimoto’s. Her antibody level was 1,886 . She was started on a low dose of levoxyl (.5) and I immediately put her (and myself) on a GF diet. I would like to know if there is a chance that she can get off her meds if her antibody level returns to normal being GF. I have had Hashimotos since I was a young teenager. I have been in and out of endos all across this country and I had never heard of the gluten connection. I wish I had done my homework much earlier.
There’s a chance, but I usually don’t recommend it. The implications of not having enough thyroid hormone are more significant than the potential side effects or complications of the medication. They key is to address the immune imbalance that characterizes Hashimoto’s – that should reduce the required dose of medication.
After being diagnosed with Hashimotos I was placed on a relatively high dose of synthroid (.112mcg). I tried losing weight and was never successful over several years. I made a 10lb – 1 year weight loss goal and started to cut out all carbs and refined sugars. After about 2 months, I just decided to make this “diet” a lifestyle change. I have been gluten free for about 6 months! During this diet, I started feeling really sick because I became over medicated on the dose of sythroid I had been taking for years. I visited my doctor who told me that I was healing myself and this healing led me to be overmedicated ( I no longer needed the large dose I was on and adjusted me to .50mcg). Because of this gluten free diet, I lost 27 lbs in 6 months and dropped the amount of my synthroid dose by more than half.
If you are going gluten free, I recommend you communicate often with your doctor because your levels will change and you will want your doctor to adjust your medication accordingly (so you don’t start feeling hyperthyroid!).
Going gluten free has been an answer to my weight loss, my foggy thinking, my stomach issues, body aches and so much more. I can’t tell you how this has saved my life.
Also make sure to have your vitamin D levels checked too.
There are lots of website you can visit to help start you on your gluten free journey – and you are worth it!
I had gone gluten free (it has only been about 4 months for me so far) and I take Lugol’s iodine, selenium, magnesium, himalayan salt, vit C, vit D3 and eat lots of naturally fermented foods. I also did a 10 day Candida cleanse with oil of oregano – absolutely life-changing for me!
Although my thyroid was struggling and labs were not great, it seems to be now at the point where I don’t need actually feel any difference whether or not I take my NatureThroid (I was only on a half grain dose), so I’m hoping I’ve averted disaster.
I think many of these issues stem from dysbiosis, often after a dose of antibiotics. I know exactly when it all started for me. Then GMOs and gluten cause further damage to our now-susceptible intestine, give us a leaky gut, which then leads to malabsorption, causes us to absorb bits we shouldn’t (and then get an immune reaction to them and terrible inflammation) and allows parasites, candida and other opportunists to get in there and wreak havoc. If a gluten intolerance goes unchecked you can end up with more and more intolerances…lectins, salicylates etc., and then things get very tricky.
Do whatever you can to regain healthy intestinal flora (and I don’t mean eating commercial yogurts like Activia), and your body will have the best chance at recovery. Seek organic, non-GMO foods, never take antibiotics unless absolute last, last resort. Eat cultured real food like sauerkraut or kim chee (best of all, make it yourself)…get Candida in check if it has run amok. You will certainly feel the benefits.
I am suffering TERRIBLY with HASHIMOTOS, Celiac, Candida…..and asthma !!! Please share the Candida diet that worked for you !!! I juice daily, NEVER consume gluten, and still do not feel well. Have been to doctors all over the U.S. ……to no avail. Any info will be appreciated !!! ~blessings~
I felt a huge difference after I eliminated grains and sugar from my diet. I eat a low carb diet avoiding processed and GMO food. I eat meat, fish, poultry, vegetables (except potatoes), some fruit, nuts, etc. The grains that affect me the worse are wheat, corn, and oats. If I eat anything with gluten (even a small amount from cross-contamination), I get a severe headache, joint and muscle pain, fatigue, brain fog, IBS, acid reflux, etc. The symptoms last 5 days. If I eat corn my fibromyalgia, arthritis, eczema, and allergies come back. Oats affect me similar to wheat.
Can you post your latest TSH, Free T4 and Free T3 test results?
Hello everyone! I’m new tothis site but have suffered from so things for about 25yrs!! From what I’ve learned, gluten free is good but adding Corn free is better! It also has been “altered” in the last 20 years without much info!! So its abit more challenging but for those who truley suffer and don’t see any or great results from gluten alone its really worth a shot!! And healthy too! Even hybrid wheat,corn are not “True” real products its impossilbe to get the REAL corn like we grew up on (20 yrs ago) sickening to know that people geneticly altered what was once good for us and know even then knowing its making people sick–all to make money. My health issues include autoimmune disease, IBS, chronic ulcers,skin ulcers,severe fatigue,connetive tissue disorder,chronic. Very lov Fe (iron storage, need IV boost) chronic pain,FM, MS, symptoms of Lupus,Addisons and porphyria unable to DX yet,and more. I’m labelled “an exteremly complex patient” for 15+ yrs now. Super frustrating!!! But I will never give up,I and we have to try to improve our quality of life!! So add Corn free and even lower sugar intake- won’t know till we try! Best of luck to all!
I hope you get this. Discuss the following with a Doctor and a Vegan Dietician First. Thanks!
Almost every single condition you mentioned, can be caused by undiagnosed food allergies and intolerances that you have been eating for too long, which in turn, caused much intestinal damage and leaky gut syndrome. Coeliac, being an auto-immune disorder, has been known to be the reason for many other health issues. Some people have seen a reversal of some of their symptoms when they have removed certain foods completely out of their diet. I elaborate below.
To heal the gut,
1. Get B12 levels recorded, and I would record other key vitamins as well – you want the actual numbers, not just “normal range” versus below normal range. Get tested 3 months later for B12 (and if number have gone down, then increase your B12 sources.)
2. I would remove all cross-reactors to gluten from the diet for a period of 6 months. And I would instead, substitute Vegetables, green smoothies (using as little calcium containing liquid as possible, but instead use fruit and water) for better Iron absorption. And, I would eat more of a Vegan diet, but if not allergic, I would add fish to be sure that you were getting the B12. See below for what I would do if it were me.
Coeliac: Cross-reactors to Gluten have caused issues in some Coeliac people.
Cross-reactor free diet Excludes (for at least 6 months, as that is how long a tiny bit of gluten attacks the body for): All grains and foods in the cereal family (including ancient versions of corn and rice), buckwheat family, amaranth family (includes quinoa), Hemp, chocolates, dairy, soy, yeast, egg, potato, cassein, whey and coffee bean and salt with iodine (as the iodine is made on corn). One list adds Tomato as a cross-reactor, but another list doesn’t.
Nightshade Free diet Excludes (to reduce inflamation, pain and ulcers): Brinjal, Cayenne, Capsicum, Eggplant, Ground Cherry, Banana Pepper, Bell Pepper, Chili Pepper, Green Pepper, Red Pepper, Sweet Pepper, Paprika, Pimento (the red insert found in olives, not the spice), Potato, Tabasco, Thorn Apple, Tobacco, Tomato.
Chronic Fatigue: Increase vegetables in your diet. Kale, Spinach, Broccoli are very good, as is Beet roots. Beet roots have a good source of iron as well. Some people have had great success when they have gone Vegan with a balanced diet. I would still add Fish, if tolerated. Or, I would see a registered dietician who is very well versed on Vegan diet with food allergies. and intolerances. Also, I would go Vegan Plus Fish (if not allergic to fish).
Allowed sources of certain nutrients that may otherwise be lacking:
Iodine: Add Himalayan Crystal Salt (500 mcg of natural iodine per 1 gram).
Strawberries = 13 mcg (we need 150 mcg)
Protein: Nuts, Fish, Legumes, Chia Seeds
Ginger: This has been know to decrease inflamation.
Green Smoothies: Kale, Swiss Chard, Spinach, Beet Roots with Peaches (Iron rich smoothie with Vitamin C, especially if made with low-calcium liquid.)
Stage 2: 6 months later. – get retested for B12 and other vitamins and minerals you got tested for originally, and see if your absorption has improved. If so, then….
– Add Soy (if tolerated – if not tolerated, then make sure you are getting all the essential proteins, and add cross-reactor of your choice).
If symptoms that have left you, do not return, then you can leave this item in your diet. If you experience more pain, gut ache, pain in the joints, then I would take this food item back out of your diet permanently.
– I would add an item NOT in the cross-reactor to gluten list every two weeks.
Stage 3: 9 months later. Get your vitamins and minerals retested. This is to be sure that Soy is not causing Leaky Gut issues.
After this, I would continue adding 1 new item from either list. However, with the Cross-reactor list, I would suggest getting retested every so often to be sure that leaky gut isn’t coming back, but you might be able to extend the testing to every 6 months.
Lastly, if you do not tolerate soy or fish, then a dietician who is familiar with the vegan diet may be useful. Why Vegan? Its has been proven to reverse diabetes. not damage organs, improve vitamin and mineral amounts in diet, and has reversed in some people many symptoms they were previously having – but NOT in all. It can not reverse a dead pancreas, for example.
I hope this helps you.
Make sure you strain your juice, as fibers are indigestible. If you have indigested food in your gut, you’ll only be feeding your candida!
My candida diet was:
no sugars, starches or carbs except sprouted kasha, quinoa, millet & amaranth, no fruit except one apple per day. Plenty of vegetables and proteins. No ferments or mushrooms. This is similar to Paul Pitchford’s C diet and was recommended to me by an acupuncturist. It worked well. I intend to go GF for awhile now to heal my thyroid.
Wow, this sounds just like me… I am doing a plan called Trim Healthy Mama and have cut out *most gluten, but starting feeling very bad after losing about 15 lbs, and come to find out my 175 dose of Synthroid is too much and I am now “hyper” levels. I know previously that I was Vit D deficient (probably still am). So now we go back to the drawing board on my dose of Synthroid.
Do you feel/see and difference in either or both of your health? If so, how long on a G diet until you noticed any difference?
I have hashimoto’s and lately it’s been really acting up, I have been put on cytomel (T3) and some of my symptoms are improving while others are just getting worse… for example, my hair will not stop falling out and sometimes my i can’t really think, to the point where it’s hard to construct a sentence, i’ts really scary!
I am almost 9 months gluten free now, and I have noticed no difference. 🙁
My hair is still falling out. And I still have fatigue and brain fog all of the time. I had testing. I know I am gluten intolerant, but being off of it is not the miracle cure I was hoping for. My symptoms still persist.
Check your iron and ferritin levels. I am gluten intolerant, a discovery I made in my 30s after about 24 years of sufferng from many symptoms including a skin disorder (for 24 years doctors treated me for acne with topical treatments and antibiotics) and eventual hair loss. I informed my doctors (ENT, allergist, primary care physician, and GI-celiac specialist) and naturopath of my because none of them were able to help me here or in Canada where I’m from. Why couldn’t doctors help me? No one ever asked what I was eating.
I realized that the problem was not external, what I was putting on my skin, therefore it had to be internal, what I was putting in my body. I bought 30 books, searched Google day and night, and began seeing a naturopath in NYC for elucidation.
Find yourself a good naturopath who will likely have extensive training in holistic nutrition. My naturopath sent me to my primary care doctor to have several bloodtests performed including for iron, ferritin, Zinc, and vitamin D levels and to check my thyroid function. She was right about everything-all of my results were out of balance and I had almost no iron stores (ferritin) in my body.
After one year on a gf diet, seven months of iron supplements and eating iron-rich meats, and two years of vitamin D treatment-I first took 2 courses of prescription-strength pills then supplements, I feel like a new person. I am no longer lethargy, or sleepy. My skin, which was always in a state of healing, but sores would never actually heal for years on end, actually healed after two months being gf (July-Sept 2013); my dermatologist was amazed. My constant runny nose and sinus issues have subsided, although my seasonal allergies continue, my stomach is no longer in knots, and I simply feel better than I ever have.
I am not convinced that the negative blood and skin allergy tests for gluten containing grains are accurate because they were negative for fish and seafood which I have not been able to eat for 32 years, an allergy which has sent me to the emergency room with a swollen eye and causes me respiratory issues at the scent of seafood cooked or being cooked. I tested negative for HLA DQ2 and DQ8, but again, I wonder if the absence of these genes can lead to a definitive conclusion that one does not have celiac because dermatologists believed that I did based on my skin condition and other factors.
I wish you luck in finding solutions that work for you. Give up gluten and you will find many wonderful alternatives. It was difficult because I grew up eating fresh bread, cakes, and pastries from my grandmother’s bakery and my parents’ and aunt’s kitchen. I realized that I was essentially addicted to wheat and I could not give it up despite all my suffering until faced with losing my hair, which as I woman I refused to do. Vanity saved my hair and my health.
Please check out the “Stop The Thyroid Madness” website, which explains why T3 or T4 alone is not enough for many people suffering hypothyroidism. You should ask for natural thyroid, such as NatureThroid or Armour Thyroid, which has both T3 and T4. If your doctor is not open to prescribing you this, keep searching for a doctor who will…many integrative doctors are more open minded about this.
get off the artificial hormones! demand that your prescription be changed to a naturally desiccated hormone like armour thyroid. synthroid is artificial t-4. supposedly t-4 will cause the body to make t-3, but often that does not happen. then they put you on artificial t-3 which is a dangerous drug! it also completely ignores t-1 and t-2, because not enough is known about these 2 and it is assumed thy are not important. i got into a shouting match with my now former primary care practitioner, but i got my script changed and i feel much better. i also found a new dr. many dr.’s are not even aware of the existence of armour thyroid anymore and if they are they will tell you it is going to be pulled from the market. this is false info fed to them from the makers of synthroid. natural desiccated thyroid is still the treatment of choice in canada and europe where drug companies do not make obscene profits pushing unsafe drugs.
Totally agree… I could not take Armour for the longest time because the T3 was like a shock to my system when I tried to switch. I was taking levoxyl and switching seemed impossible because it appeared that Armour made me feel really bad. The doctor that prescribed it was stopping the Levoxyl and starting me on a low dose of Armour and working up to find the ultimate dosage that was right for me. It was just that after only 2 days of being on too low a dose I felt worse than ever. My hair would start to fall out and I would jump back to the Levoxyl when really started to feel bad.
Ultimately what we did was start me on time release T3 at a dosage of 12.5 mcg and we upped the dosage 12.5 mcgs every 10 days. We did not stop or lower Levoxyl when we added the new T3. At day 70 we were at 87.5 mcg of TR T3, I was still taking 150 mcg of Levoxyl. I felt pretty darn good and barely noticed the T3 in time release form hitting my system throughout the day. There were no signs of Hyperthyroidism… we kept an eye on the Free T3 range and the Free T4 NOT the TSH which had fallen obviously. We were dosing to treat the symptoms not adhere to any TSH level.
Finally I made the switch to Armour and stopped the Levoxyl all together. I could tell my cells had gotten use to the higher levels of T3 and it was no longer this massive shock to my system. Since Armour has 37.5 mcg of T4 per grain we attempted to translated that to the dosage I was taking of Levoxyl. I started Armour at 4 grains which was a full grain higher than I’d ever taken before. I did feel a surge of electricity type of feeling but that quickly passed and within a week or so my body excepted the new dosage.
I felt like getting something my body had been missing for almost 8 years. It was not perfect but so much better than synthetic T4 alone AND better than synthetic T4 mixed with cytomel. We tested free T3 and free T4 every 30 days and upped the dosage to get into the high range of normal on both. The ultimate dosage for me is 5 grains with NO hyper symptoms. I feel great and look like a new person. Its amazing what some T3 will do to lax skin especially on your face.
I tried and tried to switch Armour for years but gave up because of starting on too low a dose and blaming the resulting severe hypo symptoms on Armour and not the dosage. Not to mention slamming your already stressed body and adrenals with T3 when you are not prepared for it! I wish I’d started it from the beginning instead of the synthetics!!
Get your life back and switch to Armour. Think you already feel fine on synthetic? Guess what? Those anti-depressants you’re on and that statin you need to take? Those are because your thyroid is NOT alright most likely.
I know this is an old post…I was diagnosed with Hashimotos when I was 15 (30 years ago). I was never told about the connection between gluten and thyroid either…I had to have a total thyroid removal a few years ago.
My daughter is 15. Did you notice something in your daughter that led you to having her tested?
Yes, I did notice changes. She kept gaining weight despite being on a healthy diet. We spent one summer in Europe with my husband’s work and she gained 10-15 pounds to our 5. Her face became fuller and rounder also. Her doctors all had an antiquated way of looking at her symptoms and thought since she was growing taller, that she could not be suffering from a thyroid problem. Also, that same Fall, her cousin who was 15 at the time had an elevated TSH. My daughter was diagnosed with Hashimotos in early September of 2011. We went gluten free within two weeks. I am now beginning to believe that her problem was Celiac all along. The two diseases are very closely linked and a celiac diagnosis is more consistent with symptoms she struggled with as a younger child. We have found a doctor finally that is helping us with her autoimmunity and she says that children with celiac tend to be over weight due to the changes in wheat processing in the last 20 years. She was only maybe 5-15 pounds overweight at any given time, however the weight divide between healthy and where she is seems to be growing on a gf diet. She is also going through puberty so that could have some effect on the weight. Her diet absolutely does not account for her entire weight gain. She is currently on a doctor prescribed protocol to help her lower her antibodies. Since we did not test for celiac before going gluten free, we do not want to stress her immune system at this time to put her back on gluten for the biopsy. We are moving forward believing that celliac was the issue that caused this cascade of other problems. If anybody has had similar issues with their children, I would be grateful to hear about them.
I’m not sure where you are located but I go to the most awesome dr in Portland OR and YES it is possible to not take meds. I got diagnosed with Hashimoto 3 yrs ago and she has been treating my immune system, not just my thyroid and my number is now less than .5!!! I have a very strict diet but it is SO WORTH IT!!! After eating gf, corn free, oat free for 5 yrs now I have found so many other things I love that I rarely feel deprived. I would love a bowl of oatmeal now and then:) But the risk is not even a chance I would take! I did a weight loss program this last year and lost 63 lbs and got to my goal of 135 lb and when I am done with stabilization in a few weeks I will be going strictly Paleo. ( I quit dairy during my program in June and it has helped IMMENSELY with fatigue I still had!) I haven’t felt this good in 13 yrs since I got married and got pg. So YES keep looking for your sweet 12 yr old and yourself! There is hope I PROMISE!!! You have made me see it is past time to get my 4 children tested for the same allergies as I have – I would be devastated if my 12 yr old got Hashi:-( Best of luck to you! here is my email if you are wanting anymore info on my dr. – jmierandco (at) gmail (dot) com.
What test number are you talking about with a result less than .5? Antibodies? What is the range of normal?
I would also like to get your doctor’s name. Thanks.
@Janna who is your doctor? I am in the Portland area 🙂
OK, more questions. If you follow this link:
it talks about gliadin also resembling intestinal tissue. Attacks on gliadin then result in damage to intestines, thus starting the cycle that lets the gliadin into the blood stream, at least for those with immune response to gliadin. So anyway, later in the article on that link, they then talk about testing for antibodies direct against the intestinal tissue! So sounds like to me that at some point, the body starts to target not only the gliadin, with collateral damage to the intestine, but ALSO starts making antibodies directly against the intestinal tissue itself! Obviously, although you can stop eating gluten, you are not going to stop having intestine (hopefully), so what if the body does not stop making antibodies against the intestine? Hopefully, without the stimulus of the gliadin, they body’s immune response will come down but do we know if it will and under what circumstances. The same issue is probably also important for thyroid. In some poeple, does the body start making antibodies directly against the thyroid at some point as it apparently does for the intestine? At some point, do you get to the point of no return for some people even if they eliminate all gluten?
If I am reading this correctly, the process seems to be that first, if you eat gluten and are predisposed to problems with it (like many are), then you begin to have antibodies to gluten in the gut. Then eventually, probs in the gut from the gluten will lead to some gluten getting into the bloodstream. Then the body will create antibodies to the gluten in the bloodstream. And then the body may (or will) accidently mistake thyroid tissue for glutin, since they look similar to the antibody, and then your body will start to attack your thyroid. THis will go on for a bit until finally, poor thyroid function will start to manifest physical symptoms of illness.
If I am getting this correctly, it brings up a few questions. Can thyroid function recover/regrow over time if antibody attack is halted? Of course, this may be difficult if the antibody attack is fully developed because, as Charlotta mentioned, it’s easy to make an occasional mistaken intake of gluten. If antibodies persist for 6 months (I would not be surprised if this number is an underestimate), then only 2 mistakes a year will make for an ongoing attack on the thyroid.
So perhaps the other trick is to avoid gluten as much as possible before the problem reaches critical, such that the process never reaches the point of thyroid attack in the first place. I do wonder if for many people, if they only ate a little bit of gluten instead of the mass hoards that SAD eaters usually consume, then the gut and body in general would not reach the point of hypersensitivity for so many people. Another issue is that those eating so called healthy whole grains might be at greater risk for problems.
Thanks for another great article Chris. It is interesting with Dr Fine’s work that he found that 100% of infants tested had antibodies to gluten. One has to wonder whether the ‘tolerance’ seen thereafter nothing more than a slow weakening and destruction of the immune response? If you haven’t got enough troops to repel an invading army, does that mean you are becoming more tolerant of them?
Gluten is addicting and evil. One has to be very cautious about purchasing prepared or processed foods because it is in almost all of it. I just tell my patients to avoid processed foods all together.
One thing that I noticed is that it is very hard to get people off gluten. I can tell them over and over again to stay away from it but each week when I ask them about their diet and if it has changed or not, the answer is always no! They don’t want to give up their pizza, beer, bread, or processed food! Even when I tell them they can buy gluten free products they still seem to buy gluten products. Maybe I need to start using scare tactics and show them pictures of gluten intolerant guts and brains or before and after pictures.
Do you have any pictures?
I would like to see those pictures 🙂
Hmm…maybe google coelic enteropathy and select for images.
How sad 🙁 Because real whole wheat bread is SO lovely.
I’ve tried before to give up gluten, but end up feeling as though my stomach is digesting itself 🙁
I’m trying again — with a hgh protein and animal fat diet and minimal carbohydrates and sugar. I’d hoped that the increased animal fats would solve my skin issues, but no joy so far. Wheat should be easier to give up now I’ve dropped bread. (Ow, ow ow. Poor me 🙁
I would challenge you to a blind taste test to tell the difference between Udi’s version of gluten free “whole wheat” bread and real whole wheat bread. Then I’d have a taste test with Glutino pretzels and real pretzels… Glutino is better! Even my friends says so.
I’m not sure what and where you’re eating but all the restaurants I frequent do a gluten free pasta exchange that is almost exactly the same taste as regular pasta. There is no reason to “drop” anything or to feel like you’re missing out by cutting gluten… in fact, its seems certain that its psychological that you miss it at all.
I am in Rural Australia and I’m eating at home — home prepared meals. When it comes to ‘bread’ I preferr to make my own from stine ground wholemeal flour and bakers yeast. NO contamination with soy, barley, vinegar, sugar, malt. I do not like mixed ingredient of so many commercialy produced products. I am highly allergic to flax seed, intolerant of soy. I dislike maize.
The price of commercial ‘gluten free’ breads puts me off. I so far stick to rice — when I get the gnawing pain in my belly, I eat a plain rice cake. Rice pasta is tasteless, so I’ll stick to plain rice instead.
I have been gluten free for several years now and only recently discovered also sensitive to corn (even starch) so many foods that are “gluten free” have corn. For pasta, we recently found at a restaurant they were using Asian noodles made from rice. They are wonderful and will give you your “fix” of pasta without causing issues. Asian markets also have tapioca noodles that can be used in soups and stir-fry.
Many years ago, i gave up wheat/gluten products because it made me “sleepy, lethargic, depressed”, and used corn as a replacement for the wheat/gluten. I ate a lot of corn products and became corn-sensitive (makes my joints hurt). So i switched to rice products, amd ate a lot of rice products as a substitute for wheat/gluten. Now i am getting reactions to rice, and found out most rice grown everywhere (except Thailand and a few other countries) have high levels of naturally ocurring ARSENIC (its in the soil)!! Most of the commercially bought gluten free products, especially breads and baked goods, are made with rice as the flour substitute. I guess that means only home-made for me now. Hope this info helps someone else (especially the tip about arsenic in rice).
Glutino pretzles have 420 MG of sodium and most Gluten free foods are made from GMO Corn
Glutino products have Non GMO Corn and Too Much Sodium
Yes, many of the gluten free pastas are made with corn, which can be GMO. Check the packaging. If it doesn’t say Non GMO, assume it is.
When I’m in a hurry, I prepare a quick Bob’s Mills basic bread mix. It’s awesome. Slices very nicely and is a softer bread. I will have a slice of sprouted bread on occasion. It doesn’t affect me, really.
Has anyone tried the Namaste products – they are awesome!
Just want you to know that if have celiac disease, NO amount of gluten is acceptable. Just because you don’t FEEL any negative reaction after eating sprouted bread, does not mean it is not damaging your internal organs. There are approximately 300 symptoms for CD, and some people have NO symptoms at all.
They are typically diagnosed after experiencing unexplained anemia.
Excellent post! In my experience as an herbalist, if gluten is removed from the diet, then the iodine becomes not so much of an issue. Thanks again for the great series, and anticipating more!
Thank you for an extremely interesting series of articles! It’s really hitting home.
I was diagnosed with gluten intolerance in 2001 after almost 10 years of digestive problems (amongst other things). My stomach got better and for a couple of years I thought I was recovering. In 2003 other types of symptoms (like chronic motion sickness) started to be a real problem and in 2005 I started suffering from exhaustion and from there on it just got worse. In januari this year I got diagnosed with hypothyroidism type 2. My blood test for antibodies came back negative and my T3-, T4- and TSH-levels were all good.
After reading your latest article I wonder how this ads up. Shouldn’t I’ve gotten better after 2001 when I started on a strict non-gluten diet (I’m still on it)? Instead that’s when I started getting really sick!
Btw I can mention that I turned down the offer of thyroid hormones and instead I depend on my homeopath and other clever people to help me try and build up my health again in a natural way. I hope that to be the better way to do things, and I am feeling much better since a couple of month but still there’s a long way to go.
Charlotta Rexmark, Sweden
I doubt removing gluten made you more sick. It’s more probable that the timing was a coincidence.
With thyroid hormone resistance, it’s important to figure out the cause and correct it. Typically chronic stress, high cortisol or homocysteine or genetic factors are involved. Treatment would involve reducing those factors and taking steps to improve receptor site sensitivity. I’ll discuss what these would be in a future article. Also, it’s probably best not to rule out thyroid hormone replacement if you have continued symptoms.
Few people look at oxalate intake. Some people “get healthy” and add in too much oxalate in their
gluten-free substitutions. See lowoxalate.info for more information on this. 🙂
I went GF and had some problems clear up. Recurrent eczema and GI issues, specifically.
But I didn’t have more healing until I wend low oxalate. 🙂
Adding paleo-style has been even better.
@Toni – my eczema and gastrointestinal problems completely disappeared as well, along with no more gout attacks (even though I stopped allopurinol entirely after 1 month), migraines, allergies, and incessant heartburn. I’m like a new person, and it feels GREAT! Been GF and eating according to The Paleo Solution for right at two years. Dropped over 50 pounds in 3 months when I first started. My doctor is amazed.
Chris I dong’t have a thyroid but I’m always hypo? Can eating gluten still cause this? Or cause same response like hashis ?this has been going in 13 years with no answered. T3 cytomel has helped a little but any advice is so appreciated.
You say you are hypo because your TSH is reading high? When you have no thyroid you cannot be treated by TSH numbers, but need to target your T4 numbers.
Some of us are genetically not able to convert T4 to T3. Free T3 needs to be targeted not T4 in this case. This woman would probably feel much better with time release T3 since cytomel burns off so quickly.
What if your thyroid is attacking your own thyroid. I have half thyroid and for a year have been telling my dr. That I started to get horrible symptoms with nature thyroid but he was happy with my numbers. Until I found another dr and he tells me that I have symptoms of over med. says my thyroid is attack my thyroid but it is not autoimmune it is in a very low range. So what is going on.
If you are having problems with a low thyroid function, you may want to check into your pater, if it’s from a public supply. My town treats the water with fluoride and it has had devistating effects on my health. I stopped drinking the water over a year ago, but within 2 weeks most of my more obvious symptoms disappeared.
sorry…I should have pro-read my reply.
*check into your WATER supply.
I have just read that the rtificial sweetener ‘sucralose’ (brand name Splenda) has been iimpliicated in migraines and skin racshes in a significant mumber of people.
So, IF you are adding artificail sweeteners to your ‘gluten free’ diet, itmight be then that are causing your problems.
Do you have a link or citation for the Splenda info? I’ve been trying to get my daughter (migraines/IBS/lactose and gluten intolerant/allergies) to stop drinking it, and would love some research to back me up.
Mostly what I’ve read is anecdotal — certainly not authoritative but worth bearing in mind.
The research articles I’ve seen on Google Scholar are mostly related to absorption in the short term.
However, this is one article which makes me think that sucralose (aka Splenda) is best totally avoided:
Personally I’d cut out all artificial sweeteners. When you reduce your sugar intake after a while you will find ‘sweetened’ foods, even with sucrose. sickly sweet.
While looking for this I also found out why Stevia is banned in the US — and should not be used by women who want a family — it causes infertility in women.
Stevia isn’t banned in U.S. And you may want to check sources re it’s effects on women. I’m not sure up ur comment is accurate. Most naturalist docs I know recommend it. And you can grow your own. It a plant and good alternative to sweeteners or sugar. Moderation is key in everything.
I read recently Stevia has a beneficial effect on glycogen levels as opposed to artificial sweeteners. My concern is the stuff they use to pad it out. The concentration of stevia in products appears to be very slight. Is it possible to get pure organic stevia? I shall google. ps, yes it is.
I took gluten out of my diet back in February of this year at the recommendation of a doctor. I must admit that I spent the first three months or so fantasizing about donuts. However, I feel so much better that I have no intentions of adding gluten back to my diet. Within a couple of months the strange swelling zit like things that used to appear all over my body finally went away (Oh, the money I wasted on acne cleansing products! Grrrr!). I stopped having horrible issues with my digestive system. Eventually, the joints in my knees even began to bend once again.
Just about every woman in my family is on some sort of medication for thyroid issues. I’m eager to share this blog and many of the links with them!
At first, removing gluten is not easy. You will have to memorize a rather long list of things other than just wheat that you’ll need to avoid (I know when I’ve made a mistake because I’ll have stomach cramps the next day and the spots all over my body come back). Here’s a link to a rather extensive list of common ingredients that are not gluten free: http://www.celiac.com/articles/182/1/Unsafe-Gluten-Free-Food-List-Unsafe-Ingredients/Page1.html.
BUT not consuming gluten does eventually become much easier as you work towards making it a habit. The key, for me personally, to avoiding gluten seems to be planning ahead. Going to a summer BBQ? Don’t forget to bring your own gluten free bun! Thinking of joining friend for dinner? You’ll need to contact the restaurant and discuss the gluten free options on their menu (If they don’t know what you’re talking about, pick another restaurant!). About to drop an item in your grocery cart at the grocery store? Read the label carefully first!
What’s been especially helpful to me are other gluten free folks’ blogs. These are full of tips and recipes that your gut will truly appreciate. Not eating gluten doesn’t mean you’ll never have bread or brownies again. It just means you’ll learn to prepare these things for yourself with non wheat flours that you’ve probably never heard of.
It can also possibly mean the end to a lot of physical ailments 🙂
I avoid all products containing gluten. Ocassionally I will have a “moment” and slip…then relalize why it is I can’t have it in the first place! Sooo not worth it. I feel so much better without it and am symptom free when I follow the strict diet. It took me a while to pin point what it was but now that I know my health is sooo much better and I no longer have to rely on medicine for it….which was quite costly.
Thanks for the details. I never knew all those things were related! And after struggling with blood poisoning from a bad surgeon, I’ve struggled with my immune system. This answers all the questions the Dr’s haven’t been able to. I’ve actually found it pretty easy to ignore gluten-full foods. I’ve ALWAYS had stomach cramps from pancakes and waffles, biscuits and gravy, etc. No wonder! I’ll be able to rebuild my immune system knowing ALL the things to avoid! Thank you so much for sharing! 🙂
I’ve been reading about mercury and the thyroid. I was thinking back about the time when in the 8th grade I was diagnosed with an under-active thyroid. Around that same time I had been walking around blind not wearing my contacts. It turned out that the reason the contacts bothered me so much was that the contact solution had thimerosal in it. I was told I was allergic to it (not that it is a poison and I should sue the company) at the time and I switched to another solution and was fine. I’m not sure how long I had been using this solution, but probably a couple of years. Not surprisingly, I became very nearsighted.
It was around this time that I also was found to be hypo-thyroid. I would come home from school and go right to bed and wake up for school the next day. My mother thinks she remembers my T4 and T3 being low, but TSH being normal. I also had a few amalgam fillings which I’m sure didn’t help. I suspect that mercury poisoning caused my thyroid disorder. I wonder if chelation (http://www.earthtym.net/ref-merc-thy-01.htm), is too late to recover my thyroid function since I have been taking Synthroid for approximately 30 years.
I can so identify about the doughnut thing!! I dream of doughnuts flying in my sleep Also I really miss having a sandwich or a hamburger! Have not found any bread that suites me. It is the texture and not really the taste. I miss light and fluffy things.
If you’re okay with ‘safe starches,’ you could try tapioca bread! I know a lot of people like the chebe bread mixes. Tara Grant (primalgirl) has a ‘magic dough’ recipe that I know she’s used for hamburger buns before.
Try Three Bakers Bread, I spent a lot of money on expensive gluten free bread and took one bite and threw the loaves away immediately. They make breads and rolls and they are the best I have found yet. Oh, and pizza too! Enjoy!
Ooh! Ooh! Ditto Jody’s recommendation! Seven Ancient Grains Bread made by Three Bakers is a real treat. The slices are small, but the bread is light with a very nice texture and makes great sandwiches.
Gloria I know your post was 2013 and now 2019 (how time flys!) So hope you and others have found great bread. If not here is my great breadcake recipe – 5 mins to prepare (no yeast) and most of that is the weighing of ingredients
Preheat oven 175c
Boil kettle ready
I’m English you’ll have to convert measurements
115g organic almond flour
12g organic psyllium husk
1/2 teasp bicarbonate of soda
grind in a little healthy salt eg pink himalayan
5 very heap teasp of flaxseed (fresh grind in nutribullet or coffee grinder)
Egg whites – from healthy pasteured hens or ducks
I use 3 duck egg whites if using hen’s, use 4 v large
Teasp of cider vinegar
actually boiling water
It is the reaction between bicarb, acid from vinegar and the alkili bicarb which makes the bread rise. So once mixing ingredients get in the oven asap now is not the time to answer the phone!
Mix the egg white and vinegar with a fork, whisking lightly until a little frothy
Add to dry ingredients and stir quickly with a knife
(stiff porridge look)
boil kettle again
Add approx 160ml of boiling water and mix/beat with a knife until water mixed in and glutinous /stretchy(will look like sloppier porridge)
with a tablespoon/large spoon
spoon 4 equal mounds onto stainless baking tray. about 1 ” thick. You will notice mixture will move /stretch with spoon
Bake in the oven for 50 mins
after 50 mins you can turn the oven out/ open the door have a look but can leave in cooling oven for 10-20 mins
Remove from tin with a fish slice or similar
The nicest bread you could eat
Best place to store is the oven on a tray (nice and dry)
I eat one a day always warm up the next day for freshness
Can cut in half for sandwiches
Lovely hot to dip in olive oil
I add rosemary to the dry ingredients (optional)
Thanks for your comments about gluten. I’ve got Grave’s disease and my knee really gets stiff and I’m thinking this is what I need to do, get gluten out of my system. Can my Endocrinologist check for this?
Why not just try eliminating it for a couple of months and see if there’s any improvement? And then adding it back in to see if symptoms return? Simple, easy. I’ve done it several times and always get joint pains back as well as tiredness and clouded, irritable mind. Nothing to lose etc.