Gluten and Hashimoto’s - Would you rather be dead than not eat bread

If I had a dollar for every time someone asked me why it might be a good idea to be gluten-free with Hashimoto’s thyroiditis and hypothyroidism I’d have a lot of dollars. 

Then if I added in a dollar for every time a client told me their partner said the only people who should avoid gluten are those with coeliac, oh my goodness, I’d be rolling in the dollars!  

Let’s deep dive into the research around gluten and Hashimoto’s as of 2020.  While we’re here we also need to cover off if ‘gluten-free processed foods’ are a good swap for those with hypothyroidism. Let’s do this! 

Let’s talk to the Scientists first

A 2019 published study found removing gluten from women with Hashimoto’s hypothyroidism, who did not have coeliac disease, reduced thyroid antibodies and improved thyroid hormone levels (1).

I want you to really absorb that… a scientific study, published last year, on women with Hashimoto’s, improved their thyroid hormone levels and reduced their thyroid antibody levels, by just changing one thing -> they stopped eating gluten.

That’s it.

No medication, no crazy diets, no sitting under a lotus leaf meditating for 12 hours straight… they all just cut out gluten. Boom. #MicDrop

Why is that interesting if you have hypothyroidism caused by Hashimoto’s but you are medicated?  Well, less thyroid antibodies means less symptoms (2, 3). That means the lower your antibody number the more energy you have, the easier it is to manage your weight and the better mood you enjoy! 

Also even more exciting I reckon is that a gluten-free diet may prevent the worsening of Hashimoto’s and hypothyroid symptoms over time and the potential disease complications (4).  A long healthy life from one dietary change? Yes, please!

In fact, researchers in the field of autoimmunity are finding a gluten-free diet may be a good idea when any autoimmunity is present regardless of the specific disease (5).

What Is It About Gluten & Thyroids?

It appears gluten worsens inflammation, it causes the hyperpermeability of the gastrointestinal lining (leaky gut) and this has been implicated in the development of autoimmunity (1, 6).

So to be clear what is not being said is -> you only exclude gluten if you have coeliac disease.

Rather what researchers are saying is -> if your thyroid disorder is caused by Hashimoto’s thyroiditis you may experience a benefit in how you feel today and how your condition progresses into the future, if you choose to be gluten-free.

But My Loved One Says Being Gluten-Free Is BS

Ahhhh this ole hoary chestnut… Well, your partner needs to read some recent research.  Non-coeliac gluten sensitivity (NCGS) is a medical condition recognised in the scientific literature with symptoms ranging from gut issues that appear like irritable bowel syndrome plus also non-gut symptoms.  The non-gut symptoms are mainly but not exclusively neurological (7).

In fact, a research study into people with autoimmunity and non-coeliac gluten sensitivity (NCGS) found:

“there is a high prevalence of Hashimoto thyroiditis in patients with suspected NCGS” (7).

A 2017 review of Hashimoto’s hypothyroidism concluded a gluten-free diet may be of benefit for patients with Hashimoto’s even if they did not have coeliac disease (8). 

Can I Substitute In Gluten-Free Processed Foods?

When I first heard about the research links between gluten and Hashimoto’s around 15 years ago I simply swapped all my gluten-containing foods for similar processed gluten-free foods. Somehow I thought gluten-free processed foods were healthy.  Oh my, talk about epic fail.  Not only did I not feel any better for gluten-free cereal, gluten-free bread and gluten-free cakes and biscuits; I also stacked on the pounds quickly.

It seems I am not alone. It’s been reported in research when people substitute in gluten-free processed foods their weight increases substantially (9, 10).

I hear you….eeeeek!

Let’s make this scientific discovery real.  Swapping wheat bix for gluten-free wheat bix, a sandwich for gluten-free bread sandwich and pasta for gluten-free pasta on a daily basis is not recommended if you are concerned with weight. In my practice as a nutritionist and naturopath, and in my own body, I find gluten-free processed foods worsen energy levels, memory and cognition.

Could it be because gluten-free processed foods are so heavily processed and intensely sugared they may be inflammatory for those with autoimmune conditions like Hashimoto’s?

Does this mean I never have gluten-free processed foods anymore? Nope. I have a loaf of gluten-free bread in the freezer right now.  But I leave these highly processed choices as my “sometimes foods” for special occasions like hosting a friend’s baby shower. Every delicate finger sandwich and fairy cake my BFF requested for her gender reveal is made from gluten-free bread or a gluten-free flour substitute.

Could the gluten-free processed foods you’re eating be implicated in excess weight or difficult weight loss for you? 

Living life without gluten and not relying on gluten-free processed food alternatives means enjoying as many vegetables, nuts, seeds, legumes, red meat, white meat, poultry and healthy fats like avocado, olives, olive oil and coconut as you wish to consume.

Google your favourite recipes, for sure someone, has made them over gluten-free style.  Buy a whole foods, gluten-free cookbook like those written for paleo or autoimmune paleo (AIP) diets, or, search my website for inspiration. Living gluten-free may give those of us with Hashimoto’s the gift of more energy and less brain fog - what’s not to love? 

As one of my client’s said, “Sonia, I used to think I’d rather be dead than not eat bread. But actually going gluten-free has given me my life back.“

With love,
Sonia x

References:

1. Krysiak, R., Szkróbka, W., & Okopień, B. (2019). The Effect of Gluten-Free Diet on Thyroid Autoimmunity in Drug-Naïve Women with Hashimoto’s Thyroiditis: A Pilot Study. Experimental and Clinical Endocrinology & Diabetes, 127(07), 417-422.

2. Ott, J., Promberger, R., Kober, F., Neuhold, N., Tea, M., Huber, J. C., & Hermann, M. (2011).  Hashimoto's thyroiditis affects symptom load and quality of life unrelated to    hypothyroidism: A prospective case–control study in women undergoing thyroidectomy for benign goiter. Thyroid, 21(2), 161-167. doi:10.1089/thy.   2010.0191.

3. Müssig, K., Künle, A., Säuberlich, A. L., Weinert, C., Ethofer, T., Saur, R., ... & Leyhe, T. (2012). Thyroid peroxidase antibody positivity is associated with symptomatic distress in patients with Hashimoto’s thyroiditis. Brain, behavior, and immunity, 26(4), 559-563.

4. Liontiris, M. I., & Mazokopakis, E. E. (2017). A concise review of Hashimoto thyroiditis (HT) and the importance of iodine, selenium, vitamin D and gluten on the autoimmunity and dietary management of HT patients. Points that need more investigation. Hell J Nucl Med, 20(1), 51-56.

5. Lundin, K. E., & Wijmenga, C. (2015). Coeliac disease and autoimmune disease—genetic overlap and screening. Nature reviews Gastroenterology & hepatology, 12(9), 507.

6. Fasano, A. & Shea-Donohue. (2005). Mechanisms of Disease: the role of intestinal barrier function in the pathogenesis of gastrointestinal autoimmune diseases. Nature Clinical Practice: Gastroenterology and Hepatology, 2(9), 416-422. doi:10.1038/ncpgasthep0259

7. Volta, U., Bardella, M. T., Calabrò, A., Troncone, R., & Corazza, G. R. (2014). An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC medicine, 12(1), 85.

8. Abbott, R. D., Sadowski, A., & Alt, A. G. (2019). Efficacy of the Autoimmune Protocol Diet as Part of a Multi-disciplinary, Supported Lifestyle Intervention for Hashimoto’s Thyroiditis.Cureus 11(4): e4556 DOI: 10.7759/cureus.4556

9. Amirikian, K., Sansotta, N., Guandalini, S., & Jericho, H. (2019). Effects of the Gluten-free Diet on Body Mass Indexes in Pediatric Celiac Patients. Journal of pediatric gastroenterology and nutrition, 68(3), 360-363.

10. Theethira, T. G., & Dennis, M. (2015). Celiac disease and the gluten-free diet: consequences and recommendations for improvement. Digestive Diseases, 33(2), 175-182.