If you have Hashimoto’s Disease, you may have wondered if a Gluten-free diet could help you. My experience was positive, but I wanted to share a more in-depth analysis from a professional dietitian. Dietician Tiffany Torok, MA, RDN, weighs in on Hashimoto’s Thyroid Disease and the Gluten-Free Diet in this fascinating article. Let’s dive in!
What is Hashimoto’s Thyroid Disease?
Hashimoto’s disease, also known as Hashimoto’s thyroiditis, is one of two autoimmune thyroid
disorders that can accompany celiac disease or be present on their own. These autoimmune
conditions affect the thyroid gland, a butterfly-shaped gland that wraps around the base of the front side of the neck. This gland produces thyroid hormones that regulate how fast or slow our body’s metabolism functions. In Hashimoto’s thyroiditis, thyroid hormone levels are low, so the thyroid function is considered underactive, and the metabolism is slower.
The other autoimmune thyroid disease, Grave’s Disease, is associated with an overactive thyroid. Thyroid autoimmunity is frequently associated with celiac disease and other autoimmune diseases such as rheumatoid arthritis, Addison’s disease, or type 1 diabetes. Although some people are born with a form of hypothyroid called congenital hypothyroid, Hashimoto’s disease is the most common cause of hypothyroidism
Hashimoto’s and Celiac: How Are They Related
Both Hashimoto’s and celiac disease are autoimmune conditions that are rooted in genetics but have environmental triggers. The genetic predisposition to developing certain autoimmune
diseases is why we see them “run in families.”
However, just because someone has the family traits of autoimmunity doesn’t necessarily mean they will develop the disease over their lifetime. This is where environmental factors come into play. Some environmental factors, such as being in a pro-inflammatory state due to chronic stress or having excessive body fat, can cause oxidative stress, which can activate an autoimmune disease.
Additionally, there is a term called molecular mimicry, which means that the body may recognize a benign molecule such as gluten as a foreign invader such as bacteria or viruses because it has a similar molecular structure.
What is Celiac Disease?
Celiac disease, also known as coeliac disease in Europe, is an incurable autoimmune disease that occurs in genetically susceptible individuals.
It is estimated that approximately 1% of the general population in the United States has celiac disease. The only treatment for celiac disease thus far is lifelong adherence to a strict gluten-free diet, avoiding cross-contact.
To diagnose celiac disease, a gastroenterologist performs an upper endoscopy where they take a small sample of tissue from the small intestine and look for signs of damage from an autoimmune attack, and a blood test for tissue transglutaminase and endomysial antibodies confirms the diagnosis.
To read more about celiac disease and its treatment, click here:
How Many People With Celiac Have Hashimoto’s?
Research suggests that up to one-third of individuals with celiac disease or their first-degree
relatives have a form of autoimmune thyroid disease, with Hashimoto’s being the most common form of autoimmune thyroiditis (Ashok et al., 2022).
Can a Gluten-Free Diet Help Hashimoto’s Thyroid Symptoms and Other Autoimmune Diseases?
Following a gluten-free diet as an adjunct therapy for Hashimoto’s or other autoimmune diseases remains confusingly controversial. For every study that finds efficacy, another study refutes the results. Due to the molecular mimicry (the body recognizes gluten as a foreign invader) mentioned above, gluten ‘may’ elicit an autoimmune response other than the intestinal response in celiac disease.
Additionally, it is thought that due to the clustering of autoimmune diseases or more than one autoimmune disease becoming active in the same person, perhaps gluten is the culprit.(Passali, et. al,. 2020).
However, especially with autoimmune thyroiditis, patients must use caution when following a gluten-free diet because a gluten-free diet is naturally low in iron, and iron is a vital micronutrient for thyroid health.
If you explore a gluten-free diet, work with a professional dietitian who can help you craft a healthy eating plan.
Basics of a Gluten-Free Diet?
Hashimotos Gluten-Free Diet Essentials
- All fresh fruits and vegetables
- Unprocessed fish, meat, and poultry.
- Please read the label for lunch meats or other processed meats like bacon or sausage, as they might be processed with cross-contact or gluten.
- Minimally processed dairy products such as milk, yogurt, and *cheeses. Note- Some cheeses are seeded with a grain product to produce mold, which may contain gluten, such as blue cheese or camembert, so use caution when eating these types of cheese.
- Unprocessed or minimally processed eggs, beans, legumes, and soybeans
- Naturally gluten-free grains free from cross-contact, including buckwheat, millet, tapioca, amaranth, quinoa, rice, corn, and *oats.
- Read more about oats and the gluten-free diet: https://delectablefoodlife.com/are-oats-gluten-free-or-not-lets-find-out
Six Ideas To Help Hashimoto’s Disease
- Mediterranean diet – this way of eating has been shown to reduce overall inflammation in the body largely in part because of its high omega-3 fatty acids and inclusion of whole gluten-free grains. To learn more about a gluten-free approach to the Mediterranean diet, read this article:https://delectablefoodlife.com/how-to-start-a-mediterranean-diet/
- Anti-inflammatory diet – absent in red meat and dairy and rich in whole grains, fruits, and vegetables, this diet focuses on naturally anti-inflammatory foods. The Mediterranean diet is the most well-researched diet of this kind and takes a functional medicine approach to treating autoimmune thyroiditis or any inflammatory condition.
- Selenium – although research is still lacking on its role in treating Hashimoto’s thyroiditis, studies have found a link between selenium deficiency and Hashimoto’s disease. Foods naturally high in selenium and anti-inflammatory include nuts, seafood, and whole cereal grains.
- Vitamin D – this powerful antioxidant is commonly low in many people diagnosed with autoimmune diseases, and supplementing with Vitamin D can help reduce the body’s inflammation. Additionally, vitamin D is crucial for the immune system to function correctly because it aids in differentiating lymphocytic cells, which is often one of the problems that lead to an autoimmune disorder (Starchi, et. al., 2021).
- Iron is necessary for thyroid hormone production, and iron deficiency compromises thyroid health (Starchi, et. al., 2021). Although the richest source of iron is red meat, which is pro-inflammatory, plenty of anti-inflammatory iron-rich foods can be eaten, such as blackstrap molasses, whole grains, dark leafy greens, and beans.
- Iodine – like iron, much of the thyroid metabolism relies on iodine to function correctly. Most people obtain enough iodine in their diets because table salt is fortified with iodine; however, you can also find iodine naturally occurring in anti-inflammatory foods such as seafood, seaweed, chicken, and eggs.
Nutrient Dense vs. Calorie Dense Diet for Thyroid Disease
NUTRIENT-DENSE NOT CALORIE-DENSE One important point to remember when eating for an underactive thyroid disease is that your body’s metabolism is not running as fast as it should be, or probably used to run. This can cause people to overeat, which leads to more inflammation.
FOCUS ON LESS PROCESSED FOOD
That’s why focusing on less processed and fried foods and more fresh or healthfully prepared foods.
Whether you have Hashimoto’s thyroiditis, grave’s disease, celiac disease, or non-celiac gluten
sensitivity, a goal of care should be to reduce your body’s overall inflammation.
TIPS– Eating a gluten-free diet, which incorporates foods rich in selenium, iron, vitamin D, and iodine, can help keep your thyroid healthy and your body’s inflammation low
- Weetman, A.P. An update on the pathogenesis of Hashimoto’s thyroiditis. J Endocrinol Invest
44, 883–890 (2021). https://doi.org/10.1007/s40618-020-01477-1
- Starchl C, Scherkl M, Amrein K. Celiac Disease and the Thyroid: Highlighting the Roles of
Vitamin D and Iron. Nutrients. 2021; 13(6):1755. https://doi.org/10.3390/nu13061755
- Ashok T, Patni N, Fatima M, Lamis A, Siddiqui S. Celiac Disease and Autoimmune Thyroid
Disease: The Two Peas in a Pod. Cureus. (June 2023). 14(6)e26243.
- Klubo-Gwiezdzinska, J, Wartofsky, L. Hashimoto thyroiditis: an evidence-based guide to
etiology, diagnosis, and treatment. Polish Archives of Internal Medicine (2022). 132(3).
- Passali M, Josefsen K, Frederiksen JL, Antvorskov JC. Current Evidence on the Efficacy of
Gluten-Free Diets in Multiple Sclerosis, Psoriasis, Type 1 Diabetes and Autoimmune Thyroid
Diseases. Nutrients. 2020; 12(8):2316. https://doi.org/10.3390/nu12082316