Hashimoto’s and Gluten! The Autoimmune Connection…
By Dr. Justin Marchegiani
Most people are not aware of the strong connection between Hashimoto’s and gluten! With over 30 million people with undiagnosed thyroid conditions, we need solutions that address the underlying cause of these low thyroid symptoms!
Low Thyroid Symptoms
- Weight gain
- Cold extremities or low body temperature
- Brittle or peeling fingernails
- Chronic bowel issues or constipation
- Abnormally high cholesterol levels
- Thinning hair or eyebrows
- Depression or anxiety
- Gluten intolerance/sensitivity (may show no GI symptoms)
Did you know that up to 90% of thyroid conditions are autoimmune in nature?Â This is a really important concept to masterÂ because in the conventional-medicine community, whether someoneâ€™s thyroid condition is autoimmune or not, the treatment doesnâ€™t change. I know, this makes me want to pull my hair out, too! I have an autoimmune thyroid condition myself, and knowing whether or not your thyroid condition is autoimmune can make all the difference in the world.
Gluten and the Autoimmune Connection
Eating gluten can increase your bodyâ€™s production of thyroid antibodies! Essentially, when you increase your thyroid antibodies by eating gluten,Â you destroy your thyroid gland faster. As the thyroid tissue gets destroyed, your ability to produce more thyroid hormone also drops. The longer youâ€™ve had an autoimmune thyroid condition, the greater chance you will need some type of thyroid hormone intervention in the future. The sooner we can intervene when you have Hashimotoâ€™s, the better chance you can keep your fully functioning thyroid gland.
This is what I tell my patients who have an autoimmune thyroid condition (itâ€™s also what I practice myself):
â€œImagine every bite of gluten literally burning up a piece of your thyroid tissue that you will never get back!â€
If youâ€™re serious about having good thyroid function, it becomes a must for you to give up gluten. I always recommend patients get their thyroid antibodiesÂ checkedÂ beforeÂ they think about splurging on gluten. Gluten-free alternatives are not recommended untilÂ the patient gets healthy again. I have seen many patients get their thyroid antibodies down to undetectable levels following the functional-medicine strategies mentioned in this blog post.
With some sensitive individuals, itâ€™sÂ shown that they have to be off gluten for at least six months for their gluten antibodies to be undetectable. What this means is a little bit of gluten can go a long way in destroying thyroid health!
Gluten is strongly connected with autoimmune thyroid conditionsÂ and celiac disease. Research has found that many patients with subclinical celiac have Hashimotoâ€™s (an autoimmune thyroid condition).Â Researchers are also finding more people with subclinical celiac disease. There are many reasons why this is so. Many of the dietary and environmental stressors are causing a phenomenon known as leaky gut. Leaky gut is when the gastrointestinal tight junctions open slightly and allow undigested food particles (antigens) to make their way into the bloodstream.
Many people who have an autoimmune thyroid condition have a significantÂ chance ofÂ having a second autoimmune condition. This is known as polyglandular autoimmune syndrome, and it is closely connected with gluten. Gluten stimulates the compounds on zonulin, which acts as a zipper, unzipping the tight junctions and allowing food and bacteria into the bloodstream.
False-Negative Lab Test for Hashimoto’s
Over 30% of the time, lab work can be false negative for Hashimoto’s thyroiditis.Â I strongly recommend multiple antibody tests along with a thyroid palpation to rule out Hashimoto’s. I refer patients for a thyroid ultrasound if any swelling or nodules are detected on palpation.
In functional medicine we use more sensitive lab ranges that can help us pick up potential problems before they areÂ found via a standard lab reference range. For instance, thyroid peroxidase (TPO) antibodies that are greater than 15 IU/ml would make me very suspicious of Hashimoto’s.
The true gold standard diagnosis is a tissue biopsy to detect Hashimoto’s. I try to avoid this type of diagnostic method due to its invasive and inflammatory nature. Following the above recommendations can be enough to get you the answers you need.
When in doubt, cut gluten out of your diet anyway! There is a small chance of slipping through the cracks regarding a Hashimoto’s diagnosis. It may be an inconvenience in the short run, but a greater inconvenience is not having an optimally functioning thyroid gland.
Thyroid TreatmentÂ Options
What youâ€™ll see when comparing the two options is that the functional-medicine treatment planÂ isÂ far more in depth and actually addresses the underlying cause (physical, chemical, and emotional stressors) of the disease.
The conventional treatments typically only treat the symptoms and donâ€™tÂ come anywhere close to fixing the root cause. The conventionalÂ treatments work really wellÂ with physicians who only have three to five minutes to treat a patient (the current insurance model). This doesn’t leave enough time to talk about gluten, one of the prime stimulators for an autoimmune thyroid condition.
Most patients have to step outside of the conventional insurance model to truly get well. The bullet points below outline conventional and functional treatment plans.
- Medications: Synthetic T4 most of the time (Synthroid or levothyroxine), and sometimes synthetic T3 (Cytomel).
- Nutrition: Dietary interventions include an autoimmune Paleo diet that is nutrient dense, anti-inflammatory, and low in toxins. Nutritional deficiencies are addressed, such as zinc, magnesium, and selenium. If you have an active autoimmune thyroid, itâ€™s important to avoid taking iodine in the beginning. Thereâ€™s a time and a place when it comes to iodineâ€¦More on this topic later.
- Hormones:Â When an autoimmune thyroid condition is present, there tends to be some level of adrenal fatigue or female hormone imbalance as well. Running blood or salivary testing to assess the function of the other hormonal systems is very important!
- Digestion: Patients who have an autoimmune thyroid also tend to have poor digestion. As thyroid function decreases,Â so does the bodyâ€™s ability to make stomach acid. When stomach acid gets lower, itâ€™s harder for us to break down proteins and minerals. As you can see, thereâ€™s a vicious cycle starting here. Without enough healthy proteins and minerals, itâ€™s hard to have healthy thyroid function.
- Infections:Â There are a handful of infections in the scientific literature connected to Hashimotoâ€™s. A few include H. pylori, Yersinia, Epstein-Barr, and Lyme disease. Clinically speaking, when we remove these infections, antibodies drop, and patients begin to feel better.
Below is an example of a patient who had infections that were removed, like the ones above. This patient also made changes addressing blood-sugar stability as well as removing gluten from the diet. Look at the 95% drop in thyroid antibodies that occurred over a one-year time frame.
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There are amino acid sequences on these antigens (foreign particles)Â that are similar to other tissues in the body. Our immune system reads these antigensÂ by the sequence of their surface proteins. Itâ€™s kind of like getting pulled over by a policeman that is out looking for aÂ similar make and model of the car you drive because a suspected criminal was seen driving that same car earlier that day.
Foods like gluten can easily cause your immune system to start attacking the thyroid gland, brain, intestinal tract (celiac, Crohnâ€™s, ulcerative colitis), or other nervous-system tissue based on similarity and genetic predisposition.
Thereâ€™s a good deal ofÂ research showing that autoimmune disease cannot occur without a leaky gut. This is why anyone with a chronic illness needs to have his or her gut checked.
Gluten and Cross-Reactivity
When these proteins have a similar shape to other proteins, cross-reactivity can occur. These proteins have the ability to bind into other receptor sites, just like with casein and gluten. As you can see by the picture below, the shape of the antigen can be enough to confuse the immune system.
Foods like casein from dairyÂ products can cause the immune system to start attacking the pancreas. Casein can also cross-react with gluten, too! Cross-reaction is where the immune system starts responding to other proteins as if they are gluten. This is the reason why some people who only remove some grains from their dietÂ may not recover fully. The consumption of other cross-reactive foods outside of gluten can be enough to prevent your thyroidÂ from healing.
If you need help making changes to your diet, lifestyle, and hidden stressors that will help get your thyroid back on track, click here for a complimentary evaluation.Â