Your Thyroid Gland
Before discussing the link between gluten and autoimmune thyroid disease, let’s first cover some fundamentals about the thyroid gland.
The thyroid gland is a butterfly-shaped organ located in the front of the neck, just below the Adam’s apple. It consists of two lobes, one on each side of the windpipe, connected by a bridge called the isthmus. The hormones produced by the thyroid gland play a crucial role in regulating various metabolic processes in the body.
Functions of the Thyroid Gland
The primary function of the thyroid gland is to synthesize and release thyroid hormones—triiodothyronine (T3) and thyroxine (T4). These hormones contain iodine and are essential for regulating several body functions.
Metabolic Regulation: Thyroid hormones influence the rate at which cells convert nutrients into energy. They help regulate metabolism, affecting processes such as energy expenditure, cell maintenance, and tissue repair.
Metabolism of Nutrients: Thyroid hormones affect the metabolism of carbohydrates, fats, and proteins. They help regulate the breakdown, utilization, and storage of these nutrients, contributing to overall energy balance.
Development and Growth: Thyroid hormones are vital for normal growth and development, particularly in infants and children. They play essential roles in brain development, bone growth, and maturation of various tissues and organs.
Regulation of Body Temperature: Thyroid hormones help regulate body temperature by influencing heat production and heat dissipation. Imbalances in thyroid hormone can contribute to cold intolerance or excessive sweating.
Heart Function: Thyroid hormones have significant effects on the cardiovascular system. They influence heart rate, cardiac output, and blood pressure, helping to maintain proper cardiovascular function. Imbalances in thyroid hormone levels can lead to heart rhythm abnormalities and other cardiac issues.
Now that we have a clearer understanding of the thyroid gland and its function, let’s dive into the autoimmune thyroid diseases.
What Is Autoimmune Thyroid Disease?
There are two main types of autoimmune thyroid disease – Hashimoto’s thyroiditis, and Grave’s disease.
Hashimoto’s disease is characterized by chronic inflammation of the thyroid gland caused by an autoimmune reaction. This condition results in the thyroid gland failing to produce enough thyroid hormones (hypothyroidism). Some of the most common symptoms of low thyroid function are fatigue, weight gain, joint pain, dry skin, hair loss, sensitivity to cold, and depression. Treatment typically involves hormone replacement therapy to restore thyroid hormone levels and manage symptoms.
Graves’ disease is characterized by the overproduction of thyroid hormones. In this condition, the body produces autoimmune antibodies that stimulate the thyroid to produce excessive amounts of thyroid hormones. This overstimulation leads to hyperthyroidism. Grave’s often results in symptoms such as rapid heartbeat, weight loss, tremors, anxiety, and heat intolerance. Graves’ disease can also cause eye problems, such as bulging eyes and vision changes, known as Graves’ ophthalmopathy. Treatment options may include medications to regulate thyroid function, radioactive iodine therapy, or in some cases, surgery to remove part or all of the thyroid gland.
The Role of Gluten in Autoimmune Thyroid Diseases (AITD)?
Multiple research studies demonstrate that a gluten free diet can improve thyroid function, reduce autoimmune antibody production, and reduce symptoms those with both Hashimoto’s thyroiditis and Grave’s disease. A breakdown of these research finding are listed below.
Celiac, Gluten Sensitivity & Hashimoto’s
One study in the American Journal of Gastroenterology looked specifically at the prevalence of thyroid impairment among adult patients with newly diagnosed celiac disease. It found that there is a greater frequency of thyroid disease among celiac disease patients, enough to justify a thyroid functional assessment for newly diagnosed celiac disease patients.
Another study evaluated the genetic component to celiac disease and thyroid autoimmunity. It found that first-degree relatives of patients with celiac disease have a three-fold higher risk of developing autoimmune thyroid disorders and associated thyroid dysfunction. This means that if you have celiac disease, it may be worthwhile for your parents, children and siblings to be screened for both celiac disease and thyroid autoimmune disease.
Due to the increased awareness around Non Celiac Gluten Sensitivity (NCGS), some studies have attempted to identify whether there is an increased prevalence of thyroid dysfunction among individuals with NCGS as well. A review of literature published in the American Journal of Gastroenterology found promising evidence that a link may exist – particularly in those with Hashimoto’s thyroiditis developing NCGS.
Another study compared individuals with celiac disease and non-celiac wheat sensitivity and found that similar proportions of individuals with non-celiac wheat sensitivity and celiac disease (29% in both cases) developed an autoimmune disease (predominantly Hashimoto’s thyroiditis).
Gluten Free Diets Lead to Improvements in Hashimoto’s
A major meta analysis published in the journal, Frontiers in Endocrinology, found that gluten free diets not only improved antibody levels, but also improved TSH and T4 values in patients with Hashimoto’s.
One study looked at the effect of a gluten free diet on a group of women diagnosed with Hashimoto’s thyroiditis. The study split the group of women into those who followed a gluten free diet and those who ate gluten. The participants who followed a gluten free diet had reduced thyroid antibody levels.
Another study evaluated children aged 1-12 with celiac disease and concluded that compliance with a gluten free diet can help reduce incidence of autoimmune thyroiditis and also maintain a healthy thyroid in existing celiac disease patients.
Another topic of interest with respect to thyroid dysfunction is the symptom of obesity in those (particularly women) with Hashimoto’s thyroiditis. One study attempted to take the evaluation of a gluten free diet on autoimmune hypothyroid a step further and compared weight loss in a group of women with Hashimoto’s thyroiditis who followed a standard calorie reduction diet with a group of women with Hashimoto’s thyroiditis who followed a standard calorie reduction diet and a gluten free diet. After six months, body fat content was statistically significantly lower in the group of women on the gluten free diet than in the control group of only a calorie reducing diet.
Gluten Free Diet and Grave’s Disease
A major analysis published in The Journal of Clinical Endocrinology & Metabolism found that patients with gluten induced celiac disease were at higher risk for developing Grave’s disease.
A number of studies have acknowledged that a gluten free diet likely benefits those with Grave’s hyperthyroid as well, and that there is enough evidence to warrant further research. One case review is particularly compelling. It followed a 37-year-old woman with Graves’ disease as well as thyrotoxicosis (excess circulating thyroid hormones in the bloodstream) that was not responsive to medical management. She tested positive for celiac disease, and after initiation of a gluten free diet, her thyrotoxicosis responded to medical management and thyroid health stabilized.
What Can You Do If You Have Been Diagnosed with Autoimmune Thyroid Disease?
Bottom line…celiac disease and non celiac gluten sensitivity are linked to both Hashimoto’s and Grave’s disease. Research shows that a gluten free diet can bring many of these patients improvements. If you have been diagnosed with an autoimmune thyroid disease, and have not considered a gluten free diet, it is definitely worth investigating. Ask your doctor to test you for gluten sensitivity to confirm whether a gluten free diet is right for your thyroid.