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.
Like what you’re reading? Get my free newsletter, recipes, eBooks, product recommendations, and more!
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.
Better supplementation. Fewer supplements.
Close the nutrient gap to feel and perform your best.
A daily stack of supplements designed to meet your most critical needs.
Great article and comments. Four years back bloodtest showed TSH of 15, started on 0.25 levoxythyroxine, stopped it everytime within few days, on GF diet since last 4 days, already the pain of insects biting thyroid is much reduced, haziness reduced, had some vertigo symptoms one year back, left ear closure for months, trying to explore more food alternatives and recipes in GF free vegan by choice diet, will try to stop dairy for a while after month or so, maybe vit D deficient as being in sun helps, had a food poisoning episode ten years back with fever for a days and gas, stomach cramps, bloating for months thereafter, it may have started from here, although the hypothyroidism symptoms fit in since childhood, tooth filling 30 years back, maybe mercury like someone mentioned a few comments back
Is thyroid and gluten problem connected in any way to pesticides?
While a connection to pesticides hasn’t been established, a recent paper correlated increased use of “Round-up Herbicide” with increased incidence of Celiac disease. The possible mechanism, The Glyphosate in Roundup, used in drying the wheat, erodes the lining of the intestines, causing leaky guy syndrome and undigested proteins entering the bloodstream, triggering an autoimmune response. The same mechanism could be responsible for triggering the immune system in Hashimotos (and Celiac patients are 3x more likely to have Hashimotos than the rest of the population)
I meant to include a link to that paper (included in this Mother Earth New Report on the Report)
http://www.motherearthnews.com/real-food/gluten-intolerance-from-roundup-herbicide-zw0z1402zkin.aspx#axzz37Jd9EABm
I wish I had read this even just last year. I was diagnosed with Hashimoto’s about 8 years ago but prior to diagnosis self diagnosed I couldn’t eat gluten when I lost a lot of weight in a matter of months (I’d been told to avoid wheat before losing the weight as the gluten test was negative). My gluten blood test always comes back negative but I have read that in some cases, future tests become positive. Due to this, I decided to reintroduce gluten last year to get an official diagnosis. Plus, I could get food on prescription, as GF food is expensive. Sadly, the test still came back negative and my sysmptoms were worse than I remembered them being. I now have severe joint pain even though I only reintroduced it for about 2 months but on reading this blog, realise that eating gluten caused an autoimmune response which has probably increased the likelihood that I have rheumatoid arthritis – something that I was being tested for due ot the joint pain experienced when my throid wasn’t balanced. It’s a shame that most doctors are ignorant of this, as people’s health is being put at risk due to ignorance. Also, had I been aware of this when I first went to see my GP which lead to being tested for celiac, I potentially could be completely healthy, as the autoimmune response might not have occurred. Who knows???
Thank you so much for the information! I was diagnosed last year with AITD. It was difficult to cut gluten at the beginning. I too always dreamed about cookies and doughnuts. But after a few months gluten free diet, I feel a lot better. My blood test showed the improvement.
I changed from my endocrinologist to a holistic doctor specializing in thyroid disorders when I started taking more of an active approach in my health care. My first doctor didn’t like that. My new doctor does (and yes, she’s an MD as well as holistic). After testing and finding I do NOT have Hashimoto’s, but still hypo-thyroid, we looked into diet for my weight issues. I’ve lead a plant based, whole foods dietary lifestyle, Forks Over Knives, for 2 years now and am very active in training hard for Spartan Races.
When my weight began to increase and I went from a size 6 to a size 12 in six months, we investigated our options. My doctor had me do a Cyrex Laboratories Array 3 test where I had a result of 1.65 (well out of range) for Transglutaminase-6 IgG. All other gluten test results in this array are well within normal. When my weight didn’t decrease but continued to slowly gain, I investigated further and found information about something called cross reactivity. Cyrex Array 4 test showed an off the charts cross reactivity to corn, and less reactive although still disconcerting reaction to oats. I also tested for the need to remove teff, sorghum, millet, and hemp.
Now, many, if not most, gluten free pre-made items are corn flour based. That is important to understand. Corn starch is in everything, as is corn syrup. Baking soda contains corn starch, for an example.
All of this is to say that it may not just be gluten that we have an issue with. My body thinks the above grains are gluten, ie cross reactivity. If you’re still having issues, talk to you doctor about this possibility. I’ve eliminated all of the above from my diet and I’ve lost 10 pounds in 2 months. It isn’t coming off fast, but it is coming off. That tells me my body is able to focus on health now that its not being forced to try to deal with the attacks of gluten and cross reactivity to other grains. And I feel better.
Below are some web sites that talk about gluten and its effects on everything from type 1 diabetes to schizophrenia. Its a lot of information that can be overwhelming. Nutritionally Yours explains the different Cyrex tests and what they’re used to test. Metametrix has a stool profile test that was highly beneficial to me in identifying some issues as well.
My goal to follow Hypocrates philosophy to truly ‘Let food be thy medicine” is paying off. I hope it will for you as well.
http://www.ncbi.nlm.nih.gov/pubmed/18825674
http://schizophreniabulletin.oxfordjournals.org/content/early/2012/04/19/schbul.sbs064.full.html
http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/83671
http://dfwceliac.org/memberarea/Why_am_I_not_getting_better.pdf
http://www.nutritionallyyours.net/services_gluten.html
http://arizonaadvancedmedicine.com/gluten-sensitivity-celiac-disease-wheat-allergy-and-cancer/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2111403/
Hi Carrol,
Thanks for your comment and links. It’s great to hear that you are getting better through changes in diet!
I noticed you mentioned that you are on a plant based diet and I just wanted to make sure that you are aware of the effects of soy and the vegetables in the cruciferous family (cabbages, kale, broccoli, cauliflower etc). The cruciferous veggies shouldn’t be eaten raw as they are goitrogenic and can be a factor in hypothyroidism. Same for unfermented soy. Since the vegetarian and vegan diets tend to be high in those foods, I thought I’d mention it because I have seen some people that were hypothyroid without hashis and it turned out it may have been because of their high intake of soy and cruciferous veggies. Cooking removes most of the goitrogenic properties of the cruciferous veggies, so they are ok cooked. Fermentation helps with soy, but still be carefull with it. Most soy in North america is GMO and there have been links found with GM foods and celiac disease, so the only soy we should really eat is organic and fermented. You may already know this, but for you or anyone else reading this, I just thought I’d mention it. There’s lots of info online about these issues for more details. Good luck and best wishes!
Liz,
Thanks so much for your reply! I truly appreciate your information.
Yes, I understand about the cruciferous veggies and only eat them steamed or fully cooked. I know about the soy issue as well, and only eat tofu once or twice a year. I don’t typically use soy sauce because it has gluten in it. Instead, I use Bragg’s Liquid Aminos when I need it in a recipe, as it is organic, gluten free, and certified non-GMO soybeans. I also stay away from soy products because my mother is a two time breast cancer survivor whose cancers were both estrogen driven. Soy is an estrogen containing plant.
The only veggie I eat raw in the above mentioned is Kale, as I juice it for my after workout recovery drink. My doctor said the benefits outweigh the goiterogenic properties.
I do my best to stay away from GMO’s as they are truly terrifying. I’m more than a little worried about the use of GMO bugs in Europe, that they’ll make their way here. Those people never learn, often at our expense.
I’ve become greatly interested in indoor urban gardens that produce organic veggies through hydroponics. I’m a city councilman and we have several abandoned buildings in our area that were once factories. I have contacts who know a great deal about water and fish and would know what I’d need to research to be able to see if this was feasible in our area. It would be invaluable to have organic veggies with NO carbon footprint that would be sustainable. It is a dream at present, but it is one that reaches out toward a healthy future not only for those who are gluten sensitive AND cross reactive, like me, but for anyone who wants to reach for better health.
Also, I found a great site called Gluten Free Vegan Girl that is wonderful!!!! Give her a try!
Can anyone give me a citation for the claim that gliandin protein resembles thyroid tissue?
Hi!
I haven’t been diagnosed with Hashimoto’s, but that’s what I think I have. I have so many of the symptoms, most disturbing being puffiness in my feet, hands and especially face! I hate it. And I have a double chin, even though I’m skinny.
So please, somebody tell me how long does it take to have a normal face? I don’t wanna be a doughy-face!
I’ve beem 100% gluten free for almost 6 months now. Although I’ve glutened myself a few times, quite badly in Christmas (3½ months ago) and then eaten in friends’ homes etc. so can’t be 100% sure there has been no cc.
But please, give me some hope, am I ever gonna get rid of this dough-face and get a firm, good-looking face?
Teija,
First and foremost, I’m sure your “doughy” face is beautiful and fits well on your skinny body. Unfortunately some skinny people just have a double chin…usually it’s genetic.
Second, If you have an AITD just being gluten free is not going to be enough. You need to see an Endocrinologist and have a TPO and TSH/T4 test done to determine if you have an AITD or thyroid condition so that you can start treating it properly, along with cutting out gluten.
Over the last few years I have spoken with people who have under active thyroid who have complained about acid reflux type symptoms. Because I have both these I started to think that thyroid and gluten intolerance were connected. Thank you for the confirmation. Now I want to see if lactos is also connect.
Also, when I look at the body type, and perhaps someone is looking at gene heredity there will be a connection.
I am not a researcher, just an observer.
I am
Hypothyroidism causes weakness in all small muscle groups…. perhaps this applies as well to the esophageal sphincter muscle?
Hypothyroid diagnosis – 4/2009; endoscopy results – 7/2009 (benign stomach polyps, biopsy results confirmed Celiac disease); 34 year history of IBS, eczema, and GERD. I cannot tolerate oatmeal unless it is gluten free and I avoid soy. Post gluten and soy free diet, my health is improving.
I’m wondering if my thyroid is at risk.
I have multiple food allergies (true IgE mediated allergies) to gluten, wheat, barley, rye, eggs and some others. I’ve also been diagnosed with Eosinophilic Esophagitis. I’ve complained for years of being increasingly tired and feeling worn out and depressed. I instinctively ‘feel’ that something is chemically wrong inside but can’t get doctors to get past prescribing anti-depressants.
My allergy blood tests included TSH which was 1.17, which I’m learning is within lab ranges but below the functional level. I’m considering going back to my allergist and demanding a more in-depth thyroid screening.
Every article I’ve read linking food allergies and thyroid problems discuss celiac disease and gluten intolerance and how antibodies may actually attack the thyroid. Does that mean just antibodies related to celiac disease and intolerance such as IgA and IgG attack the thyroid or do true-allergy IgE antibodies also attack it?
Not sure if this subject has been covered or not, so I apologize ahead of time if it has. If you have Hashimotos for many years and thyroid minimal to none does it matter if you are gluten free or not? Since your thyroid is probably destroyed, anyway?
How does real sourdough bread compare when dealing with gluten intolerance and/or thyroid issues? Should it be avoided as well?
Hi Chris! I have hypothyroid disease and wheat intolerance, and I am trying to track down the source of the claim that “The molecular structure of gliadin, the protein portion of gluten, closely resembles that of the thyroid gland.” The thyroid gland obviously has more than one “molecular structure,” so can you say which part of the thyroid gland it is that gliadin closely resembles? And do you have any diagrams showing the similarity of the molecules? Or, if you could just tell me where *you* are getting this info, I would appreciate it very much. I see this claim mentioned a lot among thyroid patients, but no one can tell me its source, or what research backs it.
I would really like to track this down, because it is something that patients talk about a lot and we would really like some definitive answers. Thanks!
Hi, I’m in the UK and was diagnosed with autoimmune hashimotos under active thyroid (with goitres) 13 years ago and have been taking levothyroxine ever since. I have also suffered with a problem with my throat for the same amount of time – feeling a tightening/ swelling/bubbling feeling when I eat/ drink certain foods. I have never managed to work out exactly what it is that causes the reaction as sometimes its instant – ie to orange juice/ cake/ wine/ tea, other times its a build up over the day & I can’t pin point the cause. However, I have often wondered whether its a lactose or gluten intolerance. Reading this I’m now very interested in the connection between my AITD & gluten but can anyone tell me whether the gluten would still be affecting me if my condition is being treated? So many articles I read seem to be about untreated thyroid disease I always wonder if I need to worry about the issues related to it once you are being treated as the medication is replacing the function of the thyroid. I really would appreciate your thoughts/ advice.
Have you seen a link between Hashimotos hypothyroidism + gluten = infertility issues? I have a very brittle thyroid while trying to do IVF with recurrent implantation failure and I am wondering if going gluten free would assist.
If so, I’d like to read some of the literature.
Hi Erika,
I hope you you have had successful IVF or had a baby by now. Did you try going gluten free or something else? May be it could help me and other future readers who are facing the same issues. I have read that Hashimoto’s cause infertility issues as it can interfere in conceiving as well as there is a very high risk of miscarriage. I am currently facing these issues. I was never able to conceive on a normal diet while trying for over a year. Normal diet means no processed food only home cooked food. But then I started gluten and dairy free diet since almost 2-3 months and I was able to conceive but miscarried as my TSH went high 🙁 (from 2 to 6). So I think there is some connection it wont hurt going gluten free for some time.
I’ve been on GAPS for about a year now and only recently have found alot of people saying that they have gotten Thyroid issues from being on GAPS and I’ve done research that says that we need some carbs other then veggies! So is its really harmful to stay off grains and starches? As I feel better staying off them and was going to permanently.
I am so frustrated!! I was diagnosed with hypothyroidism almost 5 years ago and was put on levothyroxine. I didn’t seem to have any issues the last few years, but fast forward to a few months ago. I have gained about 10 lbs very quickly (which for me is HUGE) and have been exhausted for no reason (my main 2 symptoms from 5 years ago when I realized I had thyroid problems).
I just went to my dr to be tested and had a FULL panel of tests done, and they have come back to me and said the tests are all NORMAL!
I’m so frustrated and don’t know what could possibly be causing these issues. I have been fine for a few years, I eat healthy, I’m very into weight lifting for exercise, and I’m only 25.
I guess I just need some advice as far as what to do next. I was thinking I might try gluten free, but don’t know if it would help at all. Is it possible to have normal thyroid tests but still have a need to go gluten free?? Maybe I need to try a homeopathic doctor or herbalist? Any thoughts would be greatly appreciated!!!!
My daughter and I both have Hashis and have been gluten free for 2 1/2 years. During this time my daughter’s antibodies dropped from 1800 to 364. After some testing, we discovered that she was currently manufacturing antibodies to most gluten free gains – brown rice, teff, tapioca …. you name it! It was a who’s who list of the gf grain family. We have now been grain free since October and I just got her antibody test back and her levels have risen again. They are now up in the 800’s. She is eating meat and fruits and veggies and some dairy. She had zero issues with dairy as discovered through her Cyrex testing. Her tsh is elevated also. Up from 3.99 to 6.89 and her hair is falling out. Can flooding hormones in a teenage body cause this havoc? If not, what can it be? She takes a cereal bowl of supplements to support her thyroid each day. Please help! Thank you in advance!
A few months ago, I tried the Gluten-Free diet for about a week and then I had a new lab test with my doctor. I normally have high triglycerides but this time they were actually at normal levels. I think going gluten-free may have helped with that. I am starting back up with going gluten-free again and I am going to see if it helps me feel better. I am so tired of feeling tired even though I take my thyroid medicine.
Here’s my story:
I gained 20 pounds in two months. I had 4 months of infertility. I knew I had thyroid problems but I didn’t think it was serious and didn’t recognize the warning signs because I’ve always been very appreciative of sleep. Lol.
I went on a health binge. I knew that the only time I’ve ever been able to lose weight through my entire 24 years of life was to cut the bread. So I did and I took my synthroid and got pregnant. After that, I stopped, thinking “The job is done. I have cravings.” But I was totally miserable! Sick, tired, depressed, you name it. Bowel problems like crazy!
At my first prenatal appointment (7 weeks), my tsh was 121 and I had gestational diabetes already. My endocrinologist asked me how I was alive. He bumped my synthroid from 25 mcg to 100 mcg.
Second prenatal (still not eating the way I should and still feeling like crap), I had taken all my pills but my tsh was still too high. My sugar readings were all over the place. The doc bumped me up again to 125 mcg, not telling me – maybe you should try a dietary approach. He did send me to a dietician, but for diabetes. Not for thyroid. She encouraged bran cereal, whole wheat bread, etc…
After that appointment, I got tired of being miserable. I was a week into my second trimester when I decided I needed to make a change. I swapped bread for iodine rich foods to boost thyroid function. I stopped eating raw, cruciferous vegetables that hinder iodine absorption (I was a major kale lover. But I don’t eat it anymore – at all).
The biggest struggle, as we all know, was the bread. I live in a rural area. When someone says “I have celiac” or “I can’t eat gluten”, people think you’re “blowing smoke up their ass” for a lack of better terminology. Our grocery stores have 1 teeny tiny area devoted to GFree foods because it’s so uncommon or undiagnosed here. The possibilities for us are limited unless we order stuff online. Let me say, $5 for a loaf of GFree bread is NOT worth it. It’s the worst gluten free product made.
I’m not completely GFree. I’m still learning. I do not eat anything containing wheat, barley, or rye on the label, but I’m still learning the big terms for “contains gluten” – like maltodextrin, etc… But I don’t seem to have an issue with those things (or some cross contamination) because my tsh levels the last two check ups have both decreased!! My last tsh level was 0.87! I’m still on 125 mcg of synthroid and I imagine that will be decreased soon.
I have so much energy and my attitude is astounding. I don’t have intestinal issues and most of my acid reflux and nausea stopped (can’t expect all of it to go since the baby will press into my organs). I actually want to be around people and out of my pajamas. Through this ride, I’ve lost 12 pounds and kept it off. Right now, I’m 24 weeks pregnant, showing, and my scale hasn’t moved further than 170 (which is great since I started out overweight at 182).
I plan on keeping this up post-preggo (with the exception of one last donut after birth) to see how far I can go with this and how good it will be on my body.
I just wish the rest of society would catch on and do it. It would make this challenge easier on all of us.
Chris,
Can you explain how this all factors in to pregnancy?
I was diagnosed with Hashimoto’s 7 years ago, and have been taking thyroid medication (previously lexothyroxine, currently synthroid) for several years. My doctor just upped my dosage a little bit, to get my levels to the optimal range for pregnancy (as I understand that keeping the levels at the right spot is critical for fetal development). I am just now learning about this connection between gluten and Hashimoto’s, so am considering cutting gluten. However, I also plan to start trying to get pregnant in the next couple of months. I am worried about doing those things at the same time – if I cut gluten, and then my thyroid begins healing and all of a sudden my thyroid medication dosage is too high, this could be a risk to the baby (and we do not want to wait years longer before trying to get pregnant, as then I will have age to worry about on top of it).
Can you shed some light as to whether now is a good time to make this diet change, or if it would be better to wait until after pregnancy to do it??