Many people who are fairly well read about thyroid problems will know that the general advice is to go gluten free. This is for both hyper and hypothyroid, especially if one has autoimmune thyroid disease like Graves’ and Hashimoto’s thyroiditis. We will be talking mostly about Hashimoto’s when referring to autoimmune thyroid disorder.
Hashimoto’s is usually diagnosed by doing a thyroid antibody profile. The profile consists of Thyroid Peroxidase Antibody (TPO Ab) and Thyroglobulin Antibodies (TgAb). TPOAbs are present in nearly all (>90 %) patients, while TgAbs can be seen in approximately 80%. So a negative test does not necessarily mean that you don’t have Hashimoto's.
This test is not done that often in the NHS as it does not alter management in most instances. With functional medicine practitioners however, we treat most autoimmune diseases by attempting to decrease the body’s attempt to attack itself.
The problem with gluten is that the molecular structure of the protein component of it- gliadin- actually resembles the structure of the thyroid gland. When gluten/gliadin is eaten, it passes into the blood stream and the body tags it for destruction by the immune system antibodies. These same antibodies will then also attack the thyroid gland because of the resemblance to gliadin.
In people eating gluten regularly for example toast in the morning, sandwich for lunch and pasta for dinner, you can see how over time, this can cause a critical situation of your thyroid gland being constantly attacked a few times a day, every day for months or years on end. One frequent reason that despite ‘adequate’ T4 supplementation, those with Hashimoto’s simply don’t feel that well.
This is also the reason that desiccated thyroid like Armour, is not a good idea in autoimmune thyroid. The animal glandular tissue looks like thyroid tissue and is then attacked by the body which subsequently also attacks the thyroid gland at the same time. In these instances, I prefer using compounded thyroid T4 and T3 where relevant.
The take home message is that if you have thyroid problems and you’re not sure if you have autoimmune thyroiditis and your GP is not happy to test you for it, do try going completely gluten free for at least 3 weeks and see how you feel. Its well worth your time and effort.