Hashimotos and The Gluten Connection
By Dr. Justin Marchegiani
Hashimoto’s disease, Hashimoto’s thyroiditis is an autoimmunedisease, a disorder in which the immune system turns against the body’s own tissues. In people with Hashimoto’s, the immune system attacks the thyroid. The thryoid gland is located in the front of your neck. It makes hormones that control metabolism.
Did you know that up to 90% of thyroid conditions are autoimmune in nature? This is a really important concept to master because in the conventional medicine community whether someone’s thyroid condition is autoimmune or not the treatment doesn’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 Autoimmune Connection
Eating gluten can increase your body’s production of thyroid antibodies! Essentially when you’re increasing your thyroid antibodies because you are eating gluten, you are destroying your thyroid gland faster. As your thyroid tissue gets destroyed, your ability to produce more thyroid hormone also drops. The longer you’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 someone has Hashimoto’s, the better chance the person can keep their full functioning thyroid gland.
This is what I tell my patients who have an autoimmune thyroid condition. It’s also what I practice myself!
“Imagine every bite of gluten literally burning up a piece of your thyroid tissue that you will never get back!”
If you’re serious about having good thyroid function, it becomes a must for you to give up gluten. I always recommend patients get their thyroid antibodies checked before they ever think about splurging on gluten. Gluten free alternatives are not recommended until 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 it’s shown that you have to be off gluten for at least six months for your gluten antibodies to be undetectable. What this means is a little bit of gluten can go a long way in destroying your thyroid health!
Gluten is strongly connected with autoimmune thyroid conditions and celiac disease. Research has found that many patients were subclinical celiac have Hashimoto’s (an autoimmune thyroid condition). Researchers are also finding more people with sub-clinical 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 significant chance of 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 allowing food and bacteria into the bloodstream.
False Negative Lab Test For Hashimotos
Over 30% of the time lab work can be false negative for Hashimotos thyroiditis. I strongly recommend multiple antibody tests along with a thyroid palpation to rule out Hashimotos. I refer out patients for a thyroid ultra sound 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 are found via a standard lab reference range. For instance, TPO antibodies that are greater than 15 IU/ml would make me very suspicious of Hashimotos.
The true gold standard diagnosis is a tissue biopsy to detect Hashimotos. 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 Hashimotos diagnosis. It maybe an inconvenience in the short run, but a greater inconvenience is not having an optimally functioning thyroid gland.
Thyroid Treatment Options
What you’ll see when comparing the two options is the functional medicine treatment plan is far more in depth and actually address the underlying cause (physical, chemical and emotion stressors) of the disease.
The conventional treatments typically only treat the symptoms and doesn’t come anywhere close to fixing the root cause. The conventional treatments work really well with physicians that only have 3 to 5 minutes to treat a patient (the current insurance model). There isn’t an even enough time to talk about gluten, one of the prime simulators for an autoimmune thyroid condition.
Most patients have to step outside of the conventional insurance model to truly get well.
- Medications: Synthetic T4 most of the time (synthroid or levothyroxine), sometimes synthetic T3 (cytomel).
- Nutrition: Dietary interventions including an autoimmune paleo diet that is nutrient dense, anti-inflammatory and low in toxins. Addressing nutritional deficiencies such as zinc, magnesium and selenium. If you have an active autoimmune thyroid, it’s important to avoid taking iodine in the beginning. There’s a time and a place when it comes to Iodine… More on this topic later.
- Hormones: 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 that have an autoimmune thyroid also tend to have poor digestion. As thyroid function decreases, so does the body’s ability to make stomach acid. When stomach acid gets lower, it’s harder for us to break down proteins and minerals. As you can see, there’s a vicious cycle starting here. Without enough healthy proteins and minerals, it’s hard to have healthy thyroid function.
- Infections: There are a handful of infections in the scientific literature connected to Hashimoto’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. These patients also made changes addressing blood sugar stability as well as removing gluten from their diet. Look at the 95% drop in thyroid antibodies that occurred over a 1 year time frame.
How Does Molecular Mimicry Work?
There are amino acid sequences on these antigens (foreign particle) that are similar to other tissues in the body. Our immune system reads these antigens by the sequence of its surface proteins. It’s kind of like getting pulled over by a policemen that is out looking for a 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, chron’s, ulcerative colitis) or other nervous system tissue based on similarity and genetic predisposition.
There’s a good deal of research showing that autoimmune disease cannot occur without a leaky gut. This is why anyone with a chronic illness needs to have their 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 dairy products can cause the immune system to start attacking the pancreas. Casein can also cross react with gluten to! 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 diet may not recover fully. The consumption of other cross reactive foods outside of gluten can be enough to prevent your thyroid from healing.
If you need help making changes with your diet, lifestyle and hidden stressors to help get your thyroid back on track feel free and click here for a complimentary evaluation.