Nothing over the past decade has been more demonized than this item. Everyone from Harvard researchers to the front desk clerk at your local grocery store knows about it. It’s some of the most generic health advice you can receive: “Oh you have X problem, just stop eating gluten.” “You have Y symptoms, have you tried cutting gluten out of your diet?” Even some healthcare practitioners will advise their patients, “Oh you have an autoimmune disease, you can never eat gluten again.” It’s these sorts of fear-mongering tactics that leave people afraid of food, afraid to go out with friends because there might be some gluten in the salad dressing, and afraid to have a piece of cake at their child’s birthday party. It can consume so much of one’s life, almost to the point where your health starts to suffer at the expense of pursuing what you think is healthy, not eating gluten.

Hashimoto’s thyroiditis is one of these autoimmune conditions that is brought up quite frequently in regards to avoiding gluten consumption. Hashimoto’s is an autoimmune condition where your immune system starts attacking your thyroid gland, thinking it’s a foreign invader. For some, the thyroid can become so damaged that it no longer produces optimal levels of thyroid hormone, while others are able to get control of their autoimmunity before it gets that severe. Lifestyle, and diet particularly, has a huge role in how your autoimmunity plays out, but what do we know about the role gluten plays in Hashimoto’s? Will cutting it out for a few weeks be enough? Or do I need to be gluten-free forever? What is it about gluten that can be so problematic for those with Hashimoto’s?

Gluten’s Potential Role in Hashimoto’s

Gluten is a protein found in wheat, barley, and rye. Proteins are made up of a particular combination of 20 different amino acids. In other words, you need to bond amino acids together in order to make proteins. Our thyroid gland is also made up of amino acids and proteins. For some people, eating gluten causes an inflammatory response, basically the immune system’s version of saying “Hey we don’t like this protein so we might have to attack it.” What the immune system could be attacking specifically is the amino acid sequence of gluten (A-T-P-L). Parts of our thyroid gland look very similar to this amino acid sequence (A-L-P-L). The only thing that’s different is one letter, one amino acid. Our immune system sees this as “close enough” and decides to attack everything that looks like gluten when we eat it. Sorry thyroid gland, you look a lot like gluten.

Researchers examined a part of wheat known as Wheat-Germ Agglutinin (WGA), and measured the immune response to WGA. They found that antibodies to WGA had “strong reactions…with TPO” (1). TPO (thyroid peroxidase) is an enzyme in the thyroid gland that helps with the production of thyroid hormones. If you have Hashimoto’s, you’ve likely had your TPO antibodies tested to help confirm the diagnosis (see image below).

Contrary to the previous point, another study (with similar researchers) found that out of 204 different food proteins (including wheat), NONE OF THEM REACTED WITH TPO. The researchers remarked, “our study found that none of the 204 foods tested demonstrated any immune reactive response to these key target sites [TPO] associated with Graves’ and Hashimoto’s disease” (2).

It’s important to highlight that both of the previous studies I mentioned were done in labs or in vitro, and were not tested directly in living humans.

Human Data

I think it’s safe to say that for those with celiac disease, giving up gluten is one of your best bets. We also know that there is some association between celiac disease and Hashimoto’s, in fact, autoimmune thyroid disorders are the most common co-presenting autoimmune disease with celiac, but what do we know about gluten consumption in those with Hashimoto’s?

In a new study, 2 groups of women with autoimmunity and normal thyroid function were divided into those that went on a gluten-free diet for 6 months and those that consumed a gluten-containing diet. What they found was quite interesting: the women on the gluten-free diet saw a nearly 25% reduction in their autoimmune levels (3). While the women eating gluten saw no change. A couple of things to note from this study: 1) They did not track clinical symptoms, so we don’t know if the reduction in antibodies happened alongside an improvement in symptoms. 2) The average reduction in antibodies still resulted in levels around 700 (check the image above to see that anything above 9 is flagged as high). I’d still consider antibody levels of 700 to be pretty high, and the reduction amount to be clinically not very significant.

That isn’t to say that going gluten-free wasn’t effective; the reduction in antibodies of 25% versus none at all (for those who ate gluten) is still a huge difference! There’s just more to autoimmunity than going gluten-free. There’s good research for using supplemental selenium and vitamin D to help with Hashimoto’s.

Personal Experience is Important.

If you ask any Naturopath, Chiropractor, or even some Nutritionists and medical doctors, they will tell you how much better some of their patients get when they eliminate gluten. I believe much of this has to do with consuming less processed foods when going gluten-free (although you can still find gluten-free muffins and cookies anywhere). If you personally experience benefits from reducing/cutting out gluten then that should be your number one answer right there, but I believe it’s unfair for health care providers to make the bold claim of “you can never eat gluten again.”

Let me paint you two different scenarios. Scenario 1, you return from work after getting yelled at by your boss, you got cut off in traffic, and almost ran out of gas on the way home. You decide to eat an entire box of donuts out of frustration. Scenario 2, you’re at your child’s 5th birthday party and you decide to take your family to the local donut shop to celebrate. You’re very relaxed, calm, enjoying time with your family, and decide to consume several donuts. Now, which situation do you think is going to make your autoimmunity worse? Which one may actually improve it by deciding to engage in activities with family?

Everything is context-dependent. Don’t be afraid to have that occasional ”treat”. Don’t myopically focus on your diet while neglecting time with family. Remember that other lifestyle factors such as sleep, exercise, and stress management can play a huge role in autoimmunity, but also keep in mind that some situations may require short-term dietary restrictions so you can work on the health of your gut. The goal is to handle a diet with a wide variety of foods.

As always, Trust in Your Gut.

Disclaimer: The contents of this article are for educational purposes only, and are not intended to diagnose or treat any condition. Do not apply any of this information without first speaking with your doctor.

References

Vojdani A, Afar D, Vojdani E. Reaction of Lectin-Specific Antibody with Human Tissue: Possible Contributions to Autoimmunity. Jour Immunology Research. 2020 ID 1438957: 1–16.

Kharrazian D, Herbert M, Vojdani A. Immunological Reactivity Using Monoclonal and Polyclonal Antibodies of Autoimmune Thyroid Target Sites with Dietary Proteins. Journal of Thyroid Research. 2017 ID: 4354723: 1–13.

Krysiak R, Szkróbka W, Okopień B. The Effect of Gluten-Free Diet on Thyroid Autoimmunity in Drug-Naïve Women with Hashimoto’s Thyroiditis: A Pilot Study. Exp Clin Endocrinol Diabetes. 2019 Jul;127(7):417–422. DOI: 10.1055/a-0653–7108. Epub 2018 Jul 30. PMID: 30060266.