It is estimated that approximately 90 percent of hypothyroidism in the United States is caused by an autoimmune condition. In these cases of autoimmune hypothyroidism, known as Hashimoto’s, antibodies attack the thyroid, resulting in thyroid tissue destruction. There is evidence showing gluten plays a significant role in driving the antibody attack against your thyroid.
Gluten tricks your body into attacking itself.
The protein portion of gluten, known as gliadin, enters the bloodstream through the gut in those with sensitivities or intestinal permeability (leaky gut). Your immune system recognizes this protein as non-self and creates antibodies against gliadin. In a process known as molecular mimicry, gliadin closely resembles the thyroid gland, leading the gliadin antibodies to mistakenly attack the thyroid. So, your body’s response every time you eat gluten is to make antibodies to the gliadin molecule – antibodies that then attack your thyroid.
If you have Hashimoto's, you are producing thyroid antibodies. If you have thyroid antibodies and are eating gluten, you are driving your body to attack your thyroid.
What if I’ve tested negative for gluten antibodies?
Unfortunately, testing for gluten antibodies isn’t always accurate in Hashimoto’s. Hashimoto’s is most commonly a Th1-driven response (Th1 is a type of T cell that fights infections), which can lead to suppression of Th2, the aspect of the immune system that is responsible for antibody production. If your antibodies are depressed, your gluten antibody test may reflect a false negative.
While an elimination diet can help you determine which foods are not well tolerated in your diet, I do not recommend the reintroduction of gluten to test for intolerance in Hashimoto’s because of the how quickly it can drive autoimmunity and cause tissue destruction.
Think you can cheat?
The idea that you can eat gluten-free the majority of the time and have some “cheat” days is false. The reality is that eating gluten just once can result in an immune response that lasts up to 6 months. Because these antibodies are destructive to the thyroid and other tissues in the body, including the brain and joints, I recommend all of my autoimmune thyroid patients completely avoid gluten in their diet.
Hypothyroid? Quit Gluten with These 5 Tools
- Know where gluten hides. Aside from foods, gluten can also be found in your vitamins, herbal teas, make-up, shampoo, envelope adhesion and over-the-counter drugs. Look for dextrin on your supplement and medication labels. It is a filer that is often wheat derived. In my office, I only carry gluten free supplements to help patients avoid potential gluten ingestion.
- Read labels. Gluten is found in soy sauce, imitation crab, meatballs and soups, to name a few. It is also found in many vegetarian products.
- Don’t be afraid to ask when you are eating out. Ask for clarification on menu items. Not everyone knows what contains gluten so be specific, asking about breadcrumbs and flour as a thickening agent, for example.
- When in doubt, skip it. If you aren’t sure, it is best to just avoid foods that might be contaminated with gluten.
- Remember BROWS: Barley, Rye, Oats, Wheat and Spelt all contain gluten.
What should you do if you suspect you have hypothyroidism?
- Unexplained weight gain
- Cold intolerance
- Hair loss
- Dry hair or brittle nails
- Dry skin
- Irregular and/or heavy menses
- Brain Fog
- Low mood or depression
- Joint or muscle pain
- Weak muscles
- Elevated cholesterol
If you are experiencing symptoms of hypothyroidism, you should have comprehensive blood testing done to determine the health of the thyroid. As a Naturopathic Physician, I look for patterns that reveal a poor functioning thyroid and work with my patients to prevent disease whenever possible. To do this, I look at more than just TSH, which is only one piece of the thyroid picture. In addition to TSH I recommend free T3, free T4, Reverse T3, Anti-Thyroid Peroxidase and Anti-Thyroglobulin antibodies as part of a patient’s screening labs. I also believe that patients should be heard and that their symptoms should also be strongly considered along with lab findings.
But my doctor said my thyroid antibodies were negative.
Unfortunately, thyroid antibodies are not always detected in Hashimoto's. Sometimes the body isn't producing sufficient amounts of B cells (the ones that make antibodies) in order for a lab test to show elevated antibody levels. And other times, people just never test positive for antibodies, although they have the condition. How do we know they have Hashimoto's? Because despite being negative for thyroid antibodies, their biopsy and other immune markers are all consistent with the diagnosis.
The bottom line is that if you have been diagnosed with hypothyroidism, the odds are that you have an autoimmune condition. And autoimmunity doesn't stop at just one tissue. Once your immune system has lost tolerance for your thyroid, it is much more likely to lose tolerance to other tissues. Or in other words, if you have one autoimmune disease, you are much more likely to develop another.
The Hashimoto’s Celiac Connection
There is a strong link between autoimmune thyroid conditions and celiac disease. If you have tested positive for thyroid antibodies or suspect your have Hashimoto's and have yet to eliminate gluten, you should consider having celiac testing performed to rule out this condition.
And if you have been diagnosed with celiac disease, you should be aware that you are at higher risk of developing a second autoimmune disease.
Eliminated gluten can help you reduce the damage to your thyroid and improve your overall health. I have had many of my patients reduce their antibody levels and symptoms by adopting diligent dietary practices that included gluten elimination.
If you are struggling with symptoms and have yet to find the root cause, please consider scheduling a complimentary 10 minute phone visit to learn more about how I can help you reclaim your health.