Can I Eat Gluten If I Have Hashimotos?
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 advise their patients, “Oh, you have an autoimmune disease; you can never eat gluten again.” These sorts of fear-mongering tactics 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 (HT) is one of these autoimmune conditions brought up quite frequently regarding avoiding gluten consumption. HT is an autoimmune condition where your immune system starts targeting 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 can control their autoimmunity before it gets that severe. Nutrition and lifestyle behaviors have a huge role in how your autoimmunity plays out, but what do we know about gluten's role in Hashimoto’s? Will cutting it out for a few weeks be enough? Or do I need to be gluten-free forever? What about gluten 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. You need to bond amino acids together in order to make proteins. Why should we care? 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 get rid of it.” The immune system could be attacking specifically 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).
What do you notice? There’s an “L” instead of a “T” for the second letter.
The only difference is one letter — one amino acid. Our immune system sees this as “close enough” and targets 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 produce thyroid hormones. If you have Hashimoto’s, your TPO antibodies will likely be 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 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 Celiacs and HT. In fact, autoimmune thyroid disorders — Hashimoto’s & Graves — are the most common co-presenting autoimmune disease with celiac. If you have Celiac, then it’s not uncommon to have thyroid autoimmunity. But what do we know about gluten consumption in those with Hashimoto’s?
In a new study, two groups of women with autoimmunity and normal thyroid function were divided into those that went on a gluten-free diet for six 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 consider antibody levels of 700 pretty high, and the reduction amount is clinically insignificant.
That isn’t to say that going gluten-free wasn’t effective; the reduction in antibodies of 25% versus none is still a huge difference! There’s just more to autoimmunity than going gluten-free. There’s good research on 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 patients get when they eliminate gluten.
I believe much of this results from all the newly adoopted behaviors when going gluten-free: eating out less, less processed foods, more nutrient dense foods, etc.
Suppose you personally experience benefits from reducing/cutting out gluten — That should be your number one answer right there. But, I believe it’s unfair for healthcare providers to claim that “you can never eat gluten again” just because you felt better cutting it out.
Let me paint you two different scenarios.
Scenario 1: You return from work after getting yelled at by your boss, getting cut off in traffic, and almost running 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 decide to take your family to the local donut shop to celebrate. You’re very relaxed and calm, enjoying time with your family, and decide to consume several donuts.
Now, which situation do you think will make your autoimmunity worse? I’d say the first one. Which one may actually improve it by deciding to engage in activities with family? I’d argue scenario 2 until the cows come home…and we’re in southern Florida.
Everything is context-dependent. Don’t be afraid to have that occasional ”treat”. Don’t myopically focus on your diet while neglecting time with your 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 alterations so you can work on the health of your gut. Once you improve your gut health, the goal should be to handle the most diverse diet possible.
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.
