By now, you have 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% do not 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 — called T3 and T4 — 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.
A Holistic Approach
Whether the issue is hyperthyroidism, hypothyroidism, Grave’s disease, or Hashimoto’s thyroiditis, the symptoms of thyroid issues can vary in severity from moderate to life-changing. That is why natural health care practitioners take a holistic approach to tackle thyroid issues from all angles – and that includes nutrition.
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, 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 entirely is critical to fully understanding your condition. Even eating small amounts can cause immune reactions lasting up to six months, so complete elimination is needed to notice any difference in your symptoms.
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 can 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 like 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 was not 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.
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 will not 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 Antibodies in the Blood
Running a food sensitivity panel is one way to start learning what is going on. Although they are expensive to run, and 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.
IgA and IgG
Both IgA and IgG antibodies are tested. These antibodies are created in response to gluten particles in the bloodstream. IgA and IgG are delayed-response antibodies — they aren’t created immediately, making them a good indicator of a long-term sensitivity to gluten. However, a milder case of gluten sensitivity (when antibodies have not been created) may be missed, and false negatives can occur if a patient is currently avoiding gluten.
Creating a Benchmark
A food sensitivity panel before you begin an elimination diet is a good idea so that you have a benchmark to work with. While eliminating gluten and dairy are the most common requests, you may be asked to remove one or more other foods based on the results of your food sensitivity panel so that other potential problem foods do not interfere with the success of your elimination phase.
The Gluten Challenge
Hypo-allergenic diets may be a powerful tool when dealing with food sensitivities, but no bones about it: these diets can be very difficult and take a long time. The hidden benefit is that the diet you are on during the investigation eliminates your possible triggers, so you should start to feel better right away, even as you uncover the details of your sensitivity.
Luckily, when it comes to auto-immune conditions, removing dairy and gluten are often the main dietary requirements and there are many alternative foods available.
The Elimination Phase
For anywhere from two to six weeks, depending on your individual situation, you will remove all dairy and gluten from your diet. During this time, you will keep a close eye on your symptoms to see if they resolve or reduce dramatically. If symptoms do not resolve, you may be asked to remove additional foods: like eggs or soy.
The Challenge Phase
Once your symptoms resolve, you will reintroduce each food one at a time. Let us say dairy first. You will have dairy in every meal for three or four days while keeping note of any symptoms or sensitivity reactions. Then you will be instructed to stop eating dairy for three days.
If there are no reactions during elimination or in the final phase, a dairy sensitivity can be ruled out. At that point, you can safely add dairy back into your diet.
A Positive Result
Next, you will begin the challenge phase for gluten. Let us say you did have a symptom response to gluten. At that point, you would be instructed to eliminate gluten from your diet for another three to six months before attempting the challenge again. After a longer break, some food sensitivities are no longer as offensive.
If – on the other hand – your symptoms did return when you reintroduced gluten, your natural health practitioner may diagnose you with gluten intolerance.
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 so we can set you up with the right practitioner for you.
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.