WHY GOING GLUTEN-FREE MAY HELP WITH HASHIMOTO’S
When it comes to popular trends around gluten-free diets, it can be hard to separate the wheat from the chaff. Some health professionals think the avoidance of gluten could be beneficial to almost anyone. Others believe that unless you have Celiac disease, avoiding gluten isn't necessarily beneficial at all.
But what about when it comes to Hashimoto's?
For a start, it is not uncommon for someone with Hashimoto's to also have Celiac disease. Many people who have one autoimmune condition are predisposed to having others. So it is important to be screened for Celiac disease if you have been diagnosed with Hashimoto's. In the case of a positive diagnosis of Celiac, avoidance of gluten is essential. However, some data show that those with Hashimoto's who do not have Celiac may have an increased likelihood of sensitivity to gluten, which can have a significant impact on health as well. (1)
Let's dive into the particulars.
Consumption of gluten can create a condition in the gut known as intestinal permeability or "leaky gut." Typically, our gut lining functions as a type of filter, letting essential properties of the food we eat (think vitamins and minerals) enter the bloodstream to be used for various functions in the body. In the case of leaky gut, more and larger particles of the food we eat get through to the bloodstream. This influx of particles is problematic because if something gets through the intestinal barrier that is not supposed to be within the bloodstream, the body identifies it as foreign and mounts an immune system response against it. Antibodies are deployed by the body to attack the foreign invader. When this occurs consistently over time, it can result in systemic inflammation.
Your body is designed to withstand inflammation from time to time, as in the case of illness. For example, a virus enters the body. The body subsequently mounts an immune system attack. The virus is eradicated, and then the inflammation associated with the immune response cools down. If the body experiences what is known as chronic inflammation or sustained inflammation over time, as is common in Hashimoto's and Celiac or gluten sensitivity, it can be damaging to the body.
Why are people with Hashimoto's more susceptible to Celiac or gluten sensitivity?
Critical to understanding why gluten can be problematic for those with Hashimoto's is a discussion of the relationship between the antibodies for gluten (or anti-gliadin antibodies) and the thyroglobulin (Tg) and thyroid peroxidase (TPO) antibodies involved in Hashimoto's autoimmunity. It has been shown in some research that gluten antibodies and thyroid antibodies are structurally similar, and the body cannot differentiate between them.
This structural similarity or "molecular mimicry" can create confusion in the body that initiates an autoimmune response to gluten. (2) When the body has an autoimmune reaction to gluten, it results in an attack on the cells of the small intestine. Damage sustained by the small intestine cells can lead to digestive symptoms or malabsorption of essential nutrients. Among these are nutrients vital for thyroid health, such as selenium, iodine, and Vitamin D. Insufficiencies in these nutrients can disrupt efforts to heal Hashimoto's.
Because gluten sensitivity is common among those with Hashimoto's, it is recommended that those with the condition consider a gluten-free diet. Testing for Celiac or gluten sensitivity is an option, but often those with Hashimoto's find that their symptoms improve once they have eliminated gluten. Many people with Hashimoto's have found that their lab markers for autoimmunity, (the Tg and TPO antibodies mentioned above) improve with gluten elimination, as well. (3) Improvement of symptoms and lab markers can be just as indicative of an issue with gluten as a test can be. Assessing how you feel after eating gluten-free for a couple of weeks can be a very informative experiment to determine how gluten might be affecting you.
References
1. Hadizadeh RS, Abbasalizad FM, Mobasseri, M, Asghari JM. The relationship between thyroid hormones, antithyroid antibodies, anti-tissue transglutaminase and anti-gliadin antibodies in patients with hashimoto's thyroiditis. Acta Endocrinol (Buchar). 2017; 13(2): 174–179. doi: 10.4183/aeb.2017.174
2. Benvenga S, Guarneri, F. Molecular mimicry and autoimmune thyroid disease. Rev Endocr Metab Disord. 2016; 17(4), 485–498. doi:10.1007/s11154-016-9363-2
3. Sategna-Guidetti C, Volta U, Ciacci C, et al. Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an italian multicenter study. Am J Gastroenterol. 2001; 96(3), 751–757. doi:10.1111/j.1572-0241.2001.03617.x