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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Liz…
Thanks so much for that generous update…
I cannot follow much of what you relate (due to my ignorance about thyroid levels), but I thought to add this:
You may be stressing your endocrine system, still, by the carbohydrate load in your diet. Avoiding gluten is a terrific first step, but potential leptin and adrenal dysregulation due to high glycemic loads can provoke an assault on normal thyroid function.
As you know, every day gluten free seems like an age. Three months seems an eternity. But one can’t feel the past, so much–only the future. Prime yourself for practicing a lifestyle not just remaining on a diet. I say that it is a practice because how you manage your diet six months from now will seem so much more refined (then) than it is now.
Brace yourself for a 1-3 year challenge and head into the wind. It requires tacking, but you will make it.
Robert,
Thanks for the encouraging words. Somedays being gluten-free seems pretty easy, but some days when I’m tired and there’s nothing to eat in the fridge, it’s frustrating not being able to go out and buy something easy. I’ve always been big on cooking from scratch, but I did have some take-out solutions before that I can no longer count on, but all in all it doesn’t seem too bad and I can imagine it gets easier with time.
You said its a 1-3 year challenge, what do you mean by that? My conclusion from going gluten-free and seeing my thyroid numbers improve made me conclude that I should be gluten-free for life if I don’t want my thyroid to get worse or possibly develop other auto-immune health problems. Are you referring to it getting easier in 1-3 years?
You also mention the possibility of a high glycemic load….how do I know if my diet has a healthy level of carbs? Since going gluten-free I have only replaced some of the carbs with gluten-free alternatives e.g quinoa and simply cut the rest (I have also cut sugar intake drastically), so overall my diet is lower carb than the ever before, but how do I know what’s optimal? Chris also mentions you need carbs for T4 to T3 conversion.
Liz, Hi…
Well, about the 1-3 year bit… This is not my imagination–I looked into what one can expect, in the way of an improvement via a gluten free diet in the case of IgA (is that the right way?) indication and discovered that (say, in the case of a classic marker like dermatitis herpetiformis) the immuno response to GSE (not just celiac) is extremely persistent and, therefore, so are the symptoms. http://dermatology.cdlib.org/111/reviews/herpetiformis/barankin.html
That link addresses “IgA deposits”, which are white blood cell depositories. Now (and I dislike discussing personal symptoms) I have had classic GSE related skin symptoms for more than TWENTY YEARS and didn’t comprehend the connection to anything until the past (almost) year. I had a persistent rash on my back, itchy raised welt-like scales beneath the hair on my head (though not egregious) and extremely dry, patchy redness on my elbows and knees. Well, the rash on my back is beginning to evaporate–perfect, smooth skin (astonishing) is beginning to reclaim the affected area on my back, my elbows and knees are smooth and supple (again, for the first time in memory) and my scalp is beginning (only) to make a comeback (much less itchy).
Now, if this were, indeed, dermatitis herpetiformis, then one is faced w/ the fact that GSE is approaching late stage, and there is, likely, much more–at least–sub-clinical pathology (or asymptomatic conditions) with which to deal.
I will not fight the doctor on the carb conversion issue. But I will say that it is truly difficult to become ketogenic in a deep sense–one is either over-consuming protein, or some such thing. As for how might one discover one’s status as trending toward a ketogenic bias, then you could consider Bayer Ketostix (available for about $15.00 at any mainline drugstore), which is a ballpark way of measuring one’s degree of excess keytones in the urine. (And, please, a trained professional will be wincing at the use of my language and the way in which I frame this discussion–I am just trying to get something across.) The sticks themselves are not perfect and do generate false positives–you can search for, and find, discussions on this topic, also.
Okay, now I would suggest, strongly, purchasing Nora T. Gedgaudas’s book, “Primal Body, Primal Mind”, for competent narrative on these issues. I would also encourage you to install Amazon’s “Kindle for the PC (Windows)” if you do not have a Kindle (I do not) and start w/ Primal Body as soon as you think that you can. (Her chapter on gluten is excellent.) Please also consider my link (of sometime ago), above, to her 3-hour radio interview on Coast to Coast AM.
Anyway, all this is a small (given the world at large) but huge (given our personal lives and aspirations) issue…
Nice to hear from you… R.
And a clarification…
The 1-3 year time frame is a period during which a rigorously pursued GFD would expect to produce alleviation of GSE symptoms. It is not intended to indicate a period of time after which one can return to a normal diet (unfortunately).
Also, there were several sites that supported that particular time frame (though they were a bit difficult to find–and a couple indicated the time period included drug therapy).
R.
Just my two cents but celiac and any condition that causes gut inflammation including food allergies will cause magnesium deficiency (as well as B vitamin issues) and that alone will cause severe skin problems. Other symptoms can be exaggerated startle reflex, anxiety, and a host of other problems. Conditions that often have magnesium deficiency as a symptom include autism and schizophrenia leading some to believe that radical diet changes can be used to ameliorate those conditions.
I was so magnesium deficient that I couldn’t restore levels orally… I had to have IV’s. I know now that it was all these undiagnosed food allergies; some brought on by hypothyroidism.
Just thought I’d give anyone who is subscribing to this comment thread an update on my gluten-free diet and the effect on my thyroid so far….I have been gluten-free since first posting here in late January. I also eat 1-2 brazil nuts a day, take 2000IU of Vitamin D, take a host of Dr. Willson’s Adrenal Support Supplements for some adrenal fatigue and a Vit B complex. I also tried taking Zinc as well which is important, but my stomach got super irritated on it. The Adrenal Suport Supplements contain a bit of Zinc and I’m hoping that’s enough. I also eat mostly organic and try to avoid most harmful ingredients. My approach is a combination of gluten-free, the approach recommended by Dr. Alexander Haskell on Hope for Hashimotos, who is another amazing doctor spreading the word, and the approach on healthwyze to cure hypothyroidism naturally (they don’t mention going gluten-free which I think is super important, but have a lot of other great advice). For the past month now I have been getting hyper symptoms and have had to decrease my Natural Dessicated Thyroid Horomone dosage three times (From 4 x 30mg, to 3.5, to 3). I just got my first blood test results since starting this and found my TSH was at 0.01 and my T4 and T3 were both well above normal range. I have been feeling hyper symptoms again and with these results will be dropping another 0.5 pills, so down to 2.5 pills or 1.25 grains. I am incredibly encouraged by these results and I think this gluten-free diet and supplementation is really working! I am still not feeling pre-hashi’s ‘normal’, but now it’s because of the hyper symptoms. Anways, I just wanted to share so as to encourage anyone who is on the fence about trying the gluten-free diet to do it! I still don’t know for sure if I am recovering or just having a thyroid flare up, but it’s been over a month now and I keep lowering the dose and still needing less, so I think it looks more like recovering than flaring up. I will post again in the coming months to let you all know how things are going. I know I am super grateful to those who shared their stories and encouraged me to try this diet and supplementation and I just want to help keep on spreading the word! Thank to Chris again for sheding more light on the gluten-thyroid connection! It’s thanks to people like you that share their knowledge on the internet that more people have found out about this. Please continue your great work!
Does taking gluten/casein digestive enzymes before meals containing gluten/casein ‘fix’ the guts inability to break down the protein?
If the genetic varient that prediposes you to gluten intolerance is simply a low enzymes issue then it seems like it would be an option to a difficult gluten free diet, no?
Nope, it doesn’t fix the problem.
Since that is the shortest answer you’ve ever given anyone in this comment area so I feel its ok to ask a follow up question on the subject. Why wouldn’t it help if after quelling the gut inflammation by going gluten free for over 6 months then supplementing this gluten enzyme and reintroducing the protein slowly into the diet? The large undigested protein wouldn’t have a chance to inflame the gut and enter the bloodstream if it is broken down with the aid of digestive enzyme especially in the theoretical absence of a damaged permeable gut lining. Am I seeing the whole gluten intolerance thing too simplistically? Have you tried supplementing this particular digestive enzyme with patients?
The Hashi/Gluten connection has nothing to do with digestive enzymes and everything to do with the auto-immune response.
If you are consuming gluten, you are flooding your body with protein molecules that your immune system recognizes as foreign invaders to be killed. For Hashi’s patients, those foreign invaders are marked on our thyroids and thus the thyroid is the target of the attack.
Eating a “difficult gluten-free diet” is very simple when the alternative to have cancer. Is getting cancer worth eating grains? Nope. It’s a really simple choice. There is no cheating. Either you are eating to save your life or you are contributing to your own mortality. Which many people chose to do.
Once your gut becomes permeable the large unbroken-down molecules pass in to the blood stream where the immune system targets them is my understanding. If those proteins never make it to the blood stream then there would be no attack. My question is simply if these proteins are broken down to a non-irritating level by supplemented enzymes how can these huge whole gluten proteins make it into the blood stream?
When I was under-treated with thyroid hormone for my hashi’s I showed stool anti-bodies against soy and casein as well as gluten. As soon as I reach a decent level of thyroid hormone the two food ‘allergies’ (soy, casein) cleared up spontaneously leading me to believe that digestive enzymes were disrupted in my previous hypothyroid state.
Cancer is hardly the alternative to going gluten free. That seems a little extreme. I will say you will have a host of mysterious physical problems that the current medical establishment will attempt to mask with drugs however… and that is certainly no way to live.
I agree….but it is so hard to walk by those Italian fresh-baked rolls!
But I suffer when I cheat.
So gluten free AND stress free are my goals.
I hvve Graves Disease, have had radioactive iodine tx several years ago and take Synthroid. I have some dairy intolerance, increased irritablity and mild panic attacks. My levels are normal per MD. Should I try gluten free? I started doing this but haven’t cut it out entirely. I did give up coffee as was recommended. I am new to this and any advice would be helpful. Thank you!
I am subscribing to comments to continue learning from you all. Need to have more time to digest the article for better understanding. Thank you Chris; and Robert, I am heading to those links right now. 🙂
WARNING: After that you will never look upon things the same way… R.
Thank you all for the super information!
I have no insurance and really cannot afford the expensive tests or alternative physicians. I’m left to my own devices so I greatly appreciate all the free information indeed.
I was diagnosed with Hashi many years ago, placed on low dose Levithyroxyn. I didnt notice any difference, no diet was ever mentioned by any doctors I went to (no surprise). I recently started feeling all typical symptoms getting worse. I’m on day 2 of going GF and adding a Iodine Plus2 supplement and am very excited to see what will happen.
Does anyone have any suggestions about how to best detox from gluten and soy (I thought I was doing good by going vegan).
Thank you again,
Joanna
Hi Chris,
How is it possible, in your opinion, for someone with hypothyroidism who has been on the Paleo diet for over a year, to have their TSH levels increase? Prior to starting Paleo, I had HDL cholesterol of 58, LDL of 116, TSH of 2.99. Now HDL is 84, LDL is 153 and TSH is 5.24. Could I be Leptin resistant? Why else would my thyroid still be out of whack when I haven’t touched gluten in so long? I had hip arthroscopy 11 weeks ago (labs were drawn about a month ago) so could that be contributing to the problem? I do eat cheese occasionally and put heavy cream in my coffee, but no other dairy, and no grains whatsoever. Also, could the gluten from grain-fed beef wreak as much havoc as eating grains by themselves. I’m at a loss as to what I’m doing wrong, but I’m convinced that my thyroid problem is hindering my hip recovery. Dr. Kruse recommended CT and upping my Synthroid dose to 105 (from 88). What do you think? Thanks so much!
Two main possibilities: you’re not eating enough carbohydrate (which is required for T4 to T3 conversion), or it has nothing to do with the Paleo diet and the increase in TSH is merely coincidental with starting the Paleo diet. If you have Hashimoto’s, and you aren’t specifically addressing the immune dysregulation, and increase in TSH over time wouldn’t be unexpected.
Upped my Armour dosage to 120mg/day for the last two weeks. Going to get my levels checked next week. Should I take my Armour the morning of my bloodwork? Should I ask them to test for Hashi’s? Thanks!
Question to those with knowledge regarding food sensitivities. I recently got an enterolabs test done mainly for gluten. I’ve been getting severe diarrhea after most of my hard workouts over the last 2 years. + energy levels have been really wacky lately. I noticed when I don’t eat my usual oatmeal and sandwich for lunch it isn’t so bad.
My results were
Fecal Anti-gliadin IgA 61 Units (Normal Range is less than 10 Units)
Fecal Anti-casein (cow’s milk) IgA 14 Units (Normal Range is less than 10 Units)
Fecal Anti-ovalbumin (chicken egg) IgA 10 Units (Normal Range is less than 10 Units)
Fecal Anti-soy IgA 31 Units (Normal Range is less than 10 Units
My biggest question is could my obvious gluten issues skew the results for the egg/casein antigens. I heavily rely on eggs for breakfast throughout the week and don’t want to eliminate them as Dr Fine suggested.
Hi Chris, Thank-you for your wonderful web-site. I have just been tested for gluten intolerance and my test was abnormal. My Mother had Celiac and it was never treated successfully back in the 1950’s and 60’s. At that time the Dr’s thought that she had tropical spru which she got while in Bali in the late 1930’s. I am a F 62. I have eaten gluten all my life, mostly whlie living and growing up in Europe and the UK. I am waiting now to get an Endoscopy to see if I have Celiac. My symptoms have been Alleriges, vertigo, and sinus. Constepation, etc. I’m now thinking that my problem is Thyroid. I will pass your Web-site on to my Doctor who practices intergrated medicine. In West Marin. For the past 20 years I have been working as Street Artist on Beach st. in SF. I usually get several hours of sunlight a day. However, in August I had a bad accident and had to stop work for 6 months. That’s when the symptoms started. My guess is that I am used to getting allot of Vitamin D, from sunlight. I am now on a Vitamin d supplement. So I ‘m sure that there’s a connection between Vitamin D, Gluten, and Thyroid. I look forward to your comments. Sorry for the Type O’s. VT.
Hi Chris
Thank you for all your help on your website
If you can answer any of the following I would be very grateful.
I have recently collected my results from my doctors.
Serum free T4 level=10.8 Pmol/L
Serum TSH 7.87 mu/L high
TPO Ab’s may be found in association with autoimmune thyroid disease
Thyroid auto antibodies>1000 iu/mL High Throperoxidase antibodies (serum)
`I’m not sure what they all mean! or what is ‘normal’
I have worked out by searching many websites for information, that I have hashimotos.
I am reading “Why Do I have Thyroid Symptoms? When my lab tests are normal by Datis Kharrazian
(i followed the link from your website)
In the book Dr Datis states that there are “six patterns of hypothyroidism” then lists the test required
to establish them.
Do you know where I can get these tests done in the UK? or can they be done via post?
My friend is a nutritionalist and has recommended I have ‘the york test” I have given up gluten and think I would be better spending my money on test specifically related to Hashimoto
Thanks again for all your help
Hello, I’m interested in knowing more about this statement:
The molecular structure of gliadin, the protein portion of gluten, closely resembles that of the thyroid gland.
Would you have a reference where I might find out more? Thanks!
Me too. Very keen to have some reference. Maybe I can try googling it under the term “molecular mimicry”.
Replying to myself! Yes, I found stuff on molecular mimicry done in the late 1990’s that explains the mechanism so google it. Basically viruses trigger an autoimmune response (antibodies) that target a specific organ whose amino acid sequence resembles the virus’s. And particular foods with the same amino acid sequence then aggravate the antibody attack as well because they have the same amino acid sequence. Unbelievable but true! So in my case some virus – influenza probably – rarked things up and the thyroid got targeted and wheat aggravates it. For MS people it can be wheat, dairy and beans. ?EBV, ?rotavirus being the possible troublemakers. New Zealand scientists discovered juvenile development of type I diabetes after immunisation – I think it was polio. Certainly there are studies recommending that siblings of these children should not be immunised.
I’d like anyone to point me at one scientific study that demonstrates molecular mimicry relating to Hashimoto’s. I looked in vain. It appears some speculation (which might someday be proved true) has gone around and now everyone in quoting the information but no real evidence at all exists at this time. Please prove me wrong, as I’m fascinated.
I found that information on MS-Direct. There were a lot of studies on molecular mimicry done in the late 1990’s. I’m wondering if Dr Terry Wahls mentions it in her 2 books.
oops, Direct-ms actually.
I have both type 1 diabetes (diagnosed at age 10½ in 1995) and Hashimoto’s thyroiditis (officially diagnosed in 2010, though I showed occasional hypothyroid test results as early as my teenage years). My Hashimoto’s is not currently at the level where my endocrinologist has advised me to take any medication like Synthroid yet, but I wonder how much of the time I am truly hypothyroid and how much of an effect this has on my brain and body response. I don’t seem to consistently have the energy that other twentysomethings have – I became more withdrawn in my teenage years, and that pattern has continued throughout my adult years. I have enough energy to exercise vigorously 2-3x a week and do well in school, but when I have to perform at even higher levels – like student teaching, or any other arena where multi-tasking rapidly is required (receptionist work, paralegal work, etc.), I lock up and get terrible brain fog, inflexibility, etc. Colleagues are constantly puzzled by this because they of course have no such difficulties coping, and so they assume I’m lazy or weird or whatever. I started selenium supplementation today, but I’ve never seriously considered giving up gluten completely despite reading stuff like this. I take it that gluten intolerance could possibly explain my troubles, but how does one go totally gluten-free? The stuff seems everywhere in the modern diet.
Khendra…
Without my repeating myself to the consternation of all here, would you please consider reviewing my posts above, for the relevant links I pasted, namely, to the book, Primal Body, Primal Mind, by Nora T. Gedgaudas, and to the interview of the author on Coast to Coast AM?
Oh yes, no soy either!
I was diagnosed with Hashimoto’s [with Graves’ antibodies too] last year. I read everything I could and went gluten, dairy and sugar free. I started with kombucha, kefir, and home-made probiotic yoghurt fermented for 24 hours to rid the lactose. I also took probiotic pearls as I read that these deliver the flora to the intestines intact – there seems some doubt that they will survive the acid in the stomach so I wanted to make sure they got there. I also took milk thistle to help detox, siberian ginseng, echinacea and rhodiola rosea. Oh, I went Paleo too, organic; coconut oil and flour, butter, no veg oil save for a little olive in dressings; plenty of salmon and sardines, fresh meat, grass reared and or free range as far as possible, no potatoes etc etc. Voila; my blood results returned to normal within 4 months. I still don’t feel QUITE right [lacking energy, sleep better but odd sleepless night, little resistance to stress] but am much better than I was. Antibodies were negligible too, last test. Another blood test next week and will report back if any different.
That’s inspiring. I need to make a note of all this.
I was diagnosed with Hashimotos 5 years ago and have been on levothyroxine ever since. Over the last year I have developed chronic fatigue, new persistent daily headache, fibromyalgia, anemia, vit d deficiency and hypoglycemia. It’s been a rough year. All with normal hormone levels. My antibody levels are just under 1,000. I tested negative for celiac and gluten intolerance. I’ve had CT, MRi, MRV, sleep studies & a battery of blood tests, all apparently normal (aside from low iron & vit d).
After reading this article I intend to go gluten free & hope it helps relieve some of my symptoms. I have also read that soy and dairy are foods that should be avoided for Hashi’s patients and am wondering what your thoughts are on this?
I’m hoping that cutting out gluten is enough, I am already a pescatarian (fish is the only meat I eat) for moral reasons I feel strongly about, so I am trying not to limit myself too much more if possible. You can imagine having chronic fatigue & hypoglycemia make special diets a bit of a challenge but I think cutting out gluten sounds worth it. Let me know if you think it would be worthwhile to cut out soy or dairy as well.
Thank you, Jessica
Soy, absolutely. Dairy for 30 days, then add it back in to see how you tolerate.
What’s the problem with soy? I know it’s discouraged for Hashi’s patients, but why?
Can you point us to any links/studies/research?
Phytic acid and estrogenic activity.
Since you eat only fish, you might want to get your mercury checked. There is a correlation between mercury poisoning and thyroid disfunction. From what I’ve read, a low constant amount will cause it to be hypo where a high amount of mercury will cause it to be hyper such as graves. If you do have high mercury, you’ll need chelation.
Ive been dealing with a thyriod condition for over 8 years and almost 2years ive been experincing aches and pain in my neck and shoulder which maybe a wasting syndrome that extremely is bothersome emotionally hurts my feelings . Can you please help me ease my pain I think the articles you’ve posted makes alot of sense to me.
Hi 😉 I have hashimotos for the last 10 years now and have recently been advised by my dr that I must cut gluten from my diet. I am a little overwhelmed by the information out there. Do I treat this like a severe allergy and worry about cross contamination etc ? Also I am scheduled to start a new job april 1 managing a pizza place – is the flour in the air something to worry about too? I am so stressed and confused – please help!!!
Hi, Everyone…
The last series of posts–esp. those of the Doctor–have been very helpful in starting a new perspective to this page–a bit more hard and fast test histories and symptom diaries would go a long way toward making sense of the pathology ambiguity surrounding, what could be, one of the most profound disease patterns or sets of our time.
Liz mentioned (as has the Doctor, of course) that the gluten allergenic reaction and the gluten autoimmune response are two different things. (I will reference a great Wikipedia article–that, no doubt, others here have already found–that explains some of this: http://en.wikipedia.org/wiki/Gluten_sensitivity .) What I have a hard time separating are issues (such as) can one have both a sensitivity (which can be precursor to celiac disease?) and an allergenic response to gluten? If one is gluten free for an extended period of time (and is, say, an autoimmune candidate) will a single slice of bread begin the autoimmune path all over gain; i.e., does any level of antibody directed to a particular target completely reinvigorate the autoimmune reaction path so that all progress is lost? (The Doctor indicated that it was not an “80/20” thing.) How long does it take to quell the various gluten-inspired antibodies once they are activated? Do antibodies such as these ever truly disappear, go “dormant”, or dissipate to a degree that one could be deemed to possess a margin of resistance against them generating again? I’ll tell you that I don’t have a clue to any of this.
I also have not been able to discern, anywhere, a timeline for recovery of some of the typical symptoms from hypothyroidism to dermatitis (one site stated that, w/ a particular drug and w/ a gluten-free diet, the prognosis was serious relief after 1 – 3 years). I can throw in my bit here and state that, after about six months of a gluten-free effort (a pretty good attempt w/ a couple of slips during the holidays) my body temp. is approx. (at least) one-degree higher (now perfectly normal) and my heart rate has jumped 10 – 15 beats per min. That is just for starters, as all kinds of little things have improved to make me feel reborn (a bit).
Thanks for everyone’s efforts… R.
I have been gradually going gluten free and am pretty well compliant with it now. My antiTPO dropped from in the 800’s to 63 over this time. I have subclinical auto-immune thyroiditis. At the same time, the TSH dropped from 10 to just over 3. Having magnesium and 3 brazil nuts/day may have helped too.
Hi Honora,
Thanks for posting your results. It is inspiring stories like yours that got me to cut out gluten and hope that it’s possible to control hashi’s. May I ask if you have also been able to decrease your dose of thyroid meds, if you were taking them previously and how you have been feeling as your antibodies and tsh drops. Also, did you get tested anywhere for gluten intolerance and if so what were the results? Thanks so much and I’m so happy for you that you’ve had such great results!
Honora…
I am w/ Liz on this one… Could you also please post–for the benefit of all who read here–what “anti-TPO” is and what it indicates, as well as the approximate goal of your efforts (within the anti-TPO signature levels) and how long it took you to achieve your current levels?
I am completely in the dark about gluten antibodies, their persistence within the body, and what dietary relapse (or accident) does to these levels. This would be a v. good topic to discuss. This would be especially true for those of us w/o medical coverage.
In short, I believe anyone who reads this page would be very thankful for you (or anyone) contributing something along these lines.
Thanks so much, R.
TPO stands for thyroperoxidase, an enzyme involved in thyroid hormone production. If you have anti-TPO antibodies, that means your immune system is attacking your thyroid. That is autoimmune thyroid disease. It is most often Hashimoto’s, but it could be Graves’ or Ord’s as well.
Thank-you, so much, for the traction, Doctor… R.
Thanks, Liz and Robert. Well, my AITD is sub-clinical which means I think that I didn’t have any signs or symptoms (clinically euthyroid) though I do have a bit of a goitre as the ol’ thyroid tries to compensate for its poor effectiveness at producing T4 and T3. Weirdly enough, my reflexes are exaggerated and I’ve been more jumpy for quite a few years. I haven’t asked an expert why that would be so but I assume I simply don’t have hypothyroid symptoms because so far the T4 and T3 are in the normal range. I think the optimum is in the upper third of the range but my Total T4 is at the lower third (80nmol/L in the range for 55-140 but up from 70) and the Total T3 is 2.44 up from 1.89 (normal range 1.2-2.8 nmol/L) so that’s in the upper third which is great.
The doctors say that if my TSH gets up to 10, then I’ll need to be commenced on Thyroxin. To be at the mercy of a prescriber doesn’t sound like a good idea to me as I’m constantly reading of the dissatisfaction and misery this causes so many patients. Even getting my desired dose of Vitamin D3 was a struggle, first entailing changing my doctor and then 4 phonecalls. And this was despite having my Vit D3 levels measured 5 times in the last couple of years showing the pathetic rise on the usually prescribed dose.
I had the Enterolab gluten sensitivity on feces which also included anti-casein IgA testing and gene pane done by the American Red Cross. It was all normal except I had HLA DQ 2,1 (subtype 2,5) which indicated a predisposition to gluten sensitivity. Not surprising with my mainly Irish and Scottish descent. A recent anti Tissue Transglutaminase was negative as expected as coeliac enteropathy (gut damage) is a different disease process to gluten intolerance.
Basically, if my sister hadn’t spotted the ‘small, diffuse goitre”, I wouldn’t know that the TSH was up and I had positive thyroid antibodies (subclinical hypothyroidism). I wasn’t really eligible to see a thyroid specialist but I wangled it as they run the clinic a few metres from my workplace and they discharged me after a single consultation. I’m due to get more TFT’s and thyroid antibodies in March so will see how things go.
Hi Honora,
Thanks so much for following up! Funny, I’ve been jumpy too and never connected it to any of my other symptoms….my main symptoms are fatigue and anxiety and I just assumed that the jumpiness was just part of the anxiety and didn’t see it as a separate symptom. I wonder if anyone else has that?
I find that really interesting that your enterolab tests came back normal….including not having antibodies to gluten (just the gene predisposition) and yet the gluten-free diet seems to be working so well! I was going to get tested and I thought that if I had no antibodies to gluten then it meant going gluten-free couldn’t be the solution. So another curve ball. Your story has been incredibly eye-opening, I can’t thank you enough for posting, now I am going to continue going gluten-free regardless of what the tests show.
I hope your antibodies and tsh levels continue to improve and I hope you post again in March!
From what I have read, most “gluten antibody” blood tests only test for two specific proteins:
Gliadin-Transglutaminase IgG
Gliadin-Transglutaminase IgA
Cyrex Labs Wheat/Gluten Array tests for 22 other wheat/gluten proteins which may be the culprit.
Of the two above, only one was out of range for me.
Gliadin-Transglutaminase IgG: 2.52 (Ref Range: 0.4 – 1.6)
Gliadin-Transglutaminase IgA: 1.0 (Ref Range: 0.6 – 1.6)
With only two tests and a partial picture, a typical doctor might say that I’m not gluten intolerant.
However, with a fuller picture of the other 22 proteins, they would clearly see that I am above range for 18 of the 24 tested proteins – sometimes double and triple the top end of the reference range.
Get the full picture!
I wouldn’t recommend waiting until your TSH gets to 10 to begin treatment with thyroid hormone replacement, natural or pharmaceutical. TSH is a more sensitive indicator of thyroid hormone status, because it will respond to changes in cellular receptor sensitivity and transcription whereas T4 and T3 levels may not.
Maybe Honora lives in the UK? I wonder this because, when I lived in the UK, I was told by my GP that even though my TSH was well above the American limits (such that, in the US, medical treatment for hypothyroidism would have been started right away for me, given my test results), that in the UK they wouldn’t start any medical treatment until my TSH got to 10, and that I just had to tolerate all my symptoms and have my health get worse and worse over the years before they would do anything.
However, I think that in recent years in the UK they’ve lowered the lab result cut-off number down from 10 (though it is still not as low as the American one; I think it might be 5 now, but I’m not certain), so Honora might want to check into what the current NHS guidelines are. If she qualifies for medication under them, she can then either present the NHS information to her doctor, or switch to another NHS GP (which is not a big bureaucratic process anymore – and you do not have to provide your reason for changing).
[If she doesn’t live in the UK, nevermind!]
I’m in New Zealand. I’m now seeing a doctor recommended for thyroid management who prescribes WTE. We’re just trying a few things before we start on the WTE.
Just for comparison, as a 20 year Hashi’s patient, my labs which were run on 12/15/2011 had the following results (which were alarming. You’d think my immune system would have given up by now!)
antiTPO: 1251 (Ref Range: 0 – 34)
antiThyroglobulin: 2966 (Ref Range: 0 – 40)
Vitamin D: 19.3 (Ref Range: 30 – 100)
Free T4: 0.97 (Ref Range: 0.82 – 1.77)
Free T3: 2.0 (Ref Range: 2.0 – 4.4)
I’ve been grain-free for just about a month now. I retest my thyroid levels in another month, and my antibodies in 6 months. I’m very interested to see the results!
Stacey,
Sorry to hear your results are so alarming! I hope the grain -free diet works! Please let us all know how your thyroid and antibody levels respond after the grain-free diet. There are so few scientific studies tracking the progress of antibodies and symptoms of non-celiac people with other auto-immune diseases, and thyroid levels with thyroid autoimmune diseases,that it would be really great to start a place where we can do that.
Chris,
Maybe you could start a page where people going gluten or grain-free could show their results (improvement of symptoms, antibody levels, tsh and other thyroid indicators)? This could become a powerful tool to get more doctors to look into the gluten connection with their patients and convince other patients to give it a try! It’s not the same as a controlled study, but it could be very interesting!
Stacy: you’re antibodies are quite high and your T4 and T3 are on the very bottom of the range. This suggests the autoimmune process is still very active, and not under control. I’d recommend focusing your attention there. Best,
Stacy,
Thanks for adding in your results from the two labs…you actually answered a question that has been on my mind. I wanted to know if either test would catch a gluten intolerance or if I had to do both. It looks like both tests showed a gluten intolerance (even though your enterolab results only had one of the two out of range, I think that it is still significant), but the cyrex results make the gluten intolerance even more obvious. I as worried that the cyrex tests werent as sensitive since they aren’t stool tests, but from your results it sounds like that isnt a problem.
First of all thank for the information on your website, I have read quite a few of your articles with great interest and have already started on a completely gluten-free diet after my recent diagnosis of hashi’s. I am trying to understand the gluten-AITD connection and there is one thing that I still don’t understand. You wrote “These antibodies to gliadin also cause the body to attack thyroid tissue.” Initially I understood that as meaning that the same antibodies that my body is making against gluten are also going to work against my thyroid, but thinking back to my blood test, they are clearly two different antibodies. This article you linked to http://www.ncbi.nlm.nih.gov/m/pubmed/12192201/ confirms that, with the celiac patients’ gluten antibodies going down with a gluten free diet, but not their thyroid antibodies. If this is the case, why would eliminating gluten help control hashi’s? I understand it cannot be cured, but my understanding was that by decreasing the body’s production of thyroid anti-bodies the destruction of the thyroid could be slowed down or stop, allowing decrease in hormone replacement for some patients and an improvement in symptoms. If the antibodies don’t go down with gluten removal, how is any of this possible? By the way I understand that if the Th2 system is severely depressed, the system will not produced much antibodies at all, but I assume that happens at a very progressed stage of the disease, is that correct? For people that are still only slightly hypothyroid and at an early stage of the disease, shouldn’t a control of hashi’s be able to be measured with a decrease in thyroid antibodies? And if so, if a gluten free diet doesn’t decrease those antibodies, then doesn’t that mean going g/f won’t help? I really hope that there is a way to control hashi’s, so much so that I have already gone completely gluten free in a matter of days after getting my diagnosis and researching like mad, but these questions are now making me wonder…by the way I’m completely sold on gluten not being any good for anyone in general, I just want to understand how it can control hadhi’s better.
Thank you in advance for your response!
If I understand him correctly:
* the body reacts to gluten metabolites, and makes antibodies to attack this invader
* the antibodies against gluten metabolites also attack the thyroid (and sometimes other tissues, as well!)
* the immune system puts the thyroid (or muscle membranes, or guts) on its enemies list
* if you keep eating gluten, the problem continues to accelerate, like an avalanche
* If you stop eating gluten, you stop the first step in the cascade. You may not halt the whole avalanche. The immune system may still react to the thyroid (or whatever) as if it were the enemy, and keep producing antibodies to attack it. But even if it does, it won’t attack as energetically as it would if you continued to eat gluten.
Hi Ginny,
Thanks for your response. I’ve been really looking for a mechanism that would explain the gluten-thyroid connection. The chain of events you wrote all makes sense to me, except for the second point, which for me is that missing link in the gluten-thyroid connection that I’ve been trying to understand. The part that I still feel is unexplained is this: the antibodies against gluten (antigliadin and others) aren’t the same antibodies as thyroid peroxidase and thyroglobulin antibodies. I’m not a biologist, but from what I understand, the fact that we can measure the levels of each of these anti-bodies separately tells me that they are different molecules that are produced independantly. So when a person produces antibodies against gluten or one of it’s metabolites, going on a gluten-free diet lowers the production of those anti-bodies. The big question is how does that affect the levels of thyroid peroxidase and thyroglobulin antibodies? Maybe there is some link, but I just can’t find any explanation. One thought I had was that maybe the presence of gluten just irritates the immune system of a gluten intolerant person in general and then the immune system just overreacts to other things and depending on the person attacks random other tissue as well. So by removing gluten the irritant, it allows the immune system to calm down in general. Any ideas?
I have an 18 yr old daughter who has been suffering from terrible migraines for the past couple of years. Other symptoms have included: cramping in legs, nausea, dizziness, struggles to lose weight, insomnia, irregular cycles, and I can’t remember the rest offhand. She is never without pain from a headache! They’ve tested her thyroid and found it normal. Oh, and she was growing regularly as a child and then her height really seemed to stunt (she’s 5’2 but her growth patterns seemed to match mine exactly as a child but then stopped and I’m 5’6″).
I’m desperate to help her. I talked to her about going gluten-free. I’m wondering if this could help her even though she has no types of thyroid dx. I have crohns (I’m in remission), one daughter has IBS and then one of my son’s is ASD. Lots of gut issues in the family as you can see. My son is GFCFSF so I’m familiar of what to remove from the diet.
Thanks for any help!
My daughter had migraines and going off gluten cured them. She also did not grow as tall as she might. I wish we had caught it sooner. I think it would be an excellent idea to get your daughter tested for gluten intolerance.