By now, you’ve likely heard about gluten intolerance. The buzz word “gluten-free” is everywhere in the health world. But how impactful is gluten? For those with thyroid issues, it may be affecting you more than you realize.
Thyroid Conditions Are Fairly Common
About 20 million Americans are currently suffering from a form of thyroid disease. And roughly 60% don’t know it. Thyroid disorders are particularly common in women with one in eight females going on to develop a thyroid condition within her lifespan, and women are five to eight times more likely to have thyroid issues than men.
Your Thyroid Can Be Under or Over Performing
A malfunctioning thyroid can lead to either over or under-production of thyroid hormones. These hormones affect every organ system in your body.
Your heart, central nervous system, autonomic nervous system, bone, gastro-intestinal tract and metabolism all obey the orders of our thyroid hormones.
The Gluten Intolerance Link
Recent research links gluten intolerance and auto-immune issues, meaning if an auto-immune condition is the underlying cause of your thyroid disorder (in the case of Graves or Hashimotos), your relationship with gluten may be an exacerbating factor. This connection happens so often that some studies suggest gluten intolerance screening for anyone with auto-immune thyroid issues.
Auto-Immune Thyroid Issues
If you have an auto-immune thyroid issue, eliminating gluten can be a helpful piece to calming your overactive immune system, and reducing the attack on the thyroid.
Gluten-free diets can be tricky to maintain, but the results are worth the trouble. Your gluten intake may be the critical factor affecting the function (or auto-destruction) of your thyroid.
How Does Gluten Lead to Autoimmunity?
When you ignore food sensitivities, your gut often pays the price in inflammation. Over time, inflammatory foods (like gluten) can degrade the delicate lining of your small intestine, leading to permeability or “leaky gut”. When this happens, food particles are able to slip past the protective mucosal layer, between the cells lining the intestinal wall, and reach your bloodstream. The protein portion of gluten — called gliadin — is a common culprit.
Mistaken Identity
The immune system targets these proteins as foreign particles and begins to attack them. Unfortunately, gliadin protein molecules are strikingly similar to the molecules that make up the thyroid gland. Once antibodies to gliadin are created, they can mistakenly attack thyroid tissue. From that point on, you have an auto-immune response to gluten.
A Gluten Intolerance Can Be Hidden
Many people misinterpret gluten intolerance as a “digestive” issue only. But it can affect far more than just the digestive system. Antibodies triggered by this kind of gluten intolerance travel throughout the whole body: the joints, skin, respiratory tract and brain can all be affected. In fact, for some people affected, no digestive symptoms are seen at all. With a wide variety of possible symptoms, gluten sensitivity may take a lot of effort to uncover.
Other Grains Can Mimic Gluten
As if the situation wasn’t complex enough, once the antibodies for gluten have been created, they can mistakenly attack other proteins too. Certain grains, such as corn, oats and rice, are naturally gluten-free yet their proteins are so similar to gluten that they occasionally still elicit an immune response. A functional medicine/integrative practitioner can help you identify which foods may trigger your gluten sensitivity.
Casein Sensitivity May Also be an Issue
Lactose intolerance is much more common than gluten intolerance. However, the two often overlap. In one study in Italy, roughly 25% of people with lactose intolerance also had celiac disease, a digestive condition that is linked to gluten-related autoimmunity.
This means that for many people, going gluten-free won’t be enough to get to the root of their auto-immune symptoms. If an intolerance to casein (the main protein in dairy) may be at play, patients are often advised to adopt both a dairy-free and gluten-free diet during the elimination phase, with dairy being added back separately to assess casein sensitivity.
How We Test for Gluten Intolerance
There are multiple ways to test for food sensitivities and ascertain whether gluten intolerance may be playing a part in your thyroid issues.
Testing for Thyroid Antibodies in the Blood
Many hypothyroid patients have never been tested for thyroid antibodies. This is typically the first step, especially if the patient is reporting having normal TSH but still feeling a lot “thyroid” like symptoms. These can include fatigue, dry skin, hair loss, brittle nails, feeling cold and weight gain. If patients have thyroid antibodies present, it is usually my recommendation to avoid or greatly reduce gluten in the diet.
There are also other ways to uncover gluten sensitivity. You can do a food sensitivity panel or an elimination diet.
Running a food sensitivity panel is one way to start learning what is going on. Although these these do not always lead to a clear path of action other than the complete avoidance of the foods in question, these blood tests can be vital guideposts in the dark for tricky cases.
Instead of testing, I often encourage patients to do an anti-inflammatory diet. Hypo-allergenic diets may be the most powerful tool a naturopathic doctor can prescribe, but no bones about it: these diets can be very difficult and take a long time. The hidden benefit is that the nutrition plan you are on during the investigation eliminates the possible triggers, so you should start to feel better right away. This nutrition plan also helps to reduce inflammation, help with detoxification and heals the gut all important factors in promoting balance.
The health of your thyroid affects every cell in your body. If you suspect an autoimmune condition may be affecting how well you feel, please give us a call. As Naturopathic Practitioners, we have access to a wide array of investigative tools and lab tests to help you uncover what’s really going on – and come up with a tailored plan to help you feel like yourself again.
Resources:
Fatourechi V. Subclinical hypothyroidism: an update for primary care physicians. Mayo Clinic proceedings. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664572/. Published 2009.
General Information/Press Room. Published 2014. American Thyroid Association. https://www.thyroid.org/media-main/press-room/
Ojetti V; Nucera G;Migneco A; Gabrielli M; Lauritano C; Danese S; Zocco MA; Nista EC;Cammarota G;De Lorenzo A;Gasbarrini G;Gasbarrini A; High prevalence of celiac disease in patients with lactose intolerance. Digestion. https://pubmed.ncbi.nlm.nih.gov/15775678/. Published 2005.
Shahid MA. Physiology, Thyroid Hormone. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK500006/. Published May 18, 2020.