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The connection between gluten and thyroid issues

By now, you’ve likely heard about gluten intolerance. The buzzword “gluten-free” is everywhere in the health world. But how impactful is gluten? For those with thyroid issues, it may be affecting you more than you realize.

Thyroid conditions are fairly common

About 20 million Americans are currently suffering from a form of thyroid disease. And roughly 60% don’t know it. Thyroid disorders are particularly common in women with one in eight females going on to develop a thyroid condition within her lifespan, and women are five to eight times more likely to have thyroid issues than men.

Your thyroid can be under or over performing

A malfunctioning thyroid can lead to either over or under production of thyroid hormones. These hormones—called T3 and T4—affect every organ system in your body. 

Your heart, central nervous system, autonomic nervous system, bone, gastrointestinal tract and metabolism all obey the orders of our thyroid hormones.

A holistic approach

Whether the issue is hyperthyroidism, hypothyroidism, Grave’s disease or Hashimoto’s thyroiditis, the symptoms of thyroid issues can vary in severity from moderate to life changing. That’s why functional medicine nurse practitioners take a holistic approach to tackle thyroid issues from all angles—and that includes nutrition.

The gluten intolerance link

Recent research links gluten intolerance and auto-immune issues, meaning if an auto-immune condition is the underlying cause of your thyroid disorder, your relationship with gluten may be an exacerbating factor. This connection happens so often that some studies suggest gluten intolerance screening for anyone with auto-immune thyroid issues.

Autoimmune thyroid issues

If you have an autoimmune thyroid issue, eliminating gluten entirely is critical to fully understanding your condition. Even eating small amounts can cause immune reactions lasting up to six months, so complete elimination is needed in order to notice any difference in your symptoms. 

Gluten-free diets can be tricky to maintain, but the results are worth the trouble. Your gluten intake may be the critical factor affecting the function (or auto-destruction) of your thyroid.

How does gluten lead to autoimmunity?

When you ignore food sensitivities, your gut often pays the price in inflammation. Over time, inflammatory foods (like gluten) can degrade the delicate lining of your small intestine, leading to permeability or “leaky gut.” When this happens, food particles are able to slip past the protective mucosal layer, between the cells lining the intestinal wall, and reach your bloodstream. The protein portion of gluten—called gliadin —is a common culprit.

Mistaken identity

The immune system targets these proteins as foreign particles and begins to attack them. Unfortunately, gliadin protein molecules are strikingly similar to the molecules that make up the thyroid gland. Once antibodies to gliadin are created, they can mistakenly attack thyroid tissue. From that point on, you have an autoimmune response to gluten.

A gluten intolerance can be hidden

Many people misinterpret gluten intolerance as a “digestive” issue only. But it can affect far more than just the digestive system. Antibodies triggered by this kind of gluten intolerance travel throughout the whole body: the joints, skin, respiratory tract and brain can all be affected. In fact, for some people affected, no digestive symptoms are seen at all. With a wide variety of possible symptoms, gluten sensitivity may take a lot of effort to uncover.

Other grains can mimic gluten

As if the situation wasn’t complex enough, once the antibodies for gluten have been created, they can mistakenly attack other proteins too. Certain grains, such as corn, oats and rice, are naturally gluten-free yet their proteins are so similar to gluten that they occasionally still elicit an immune response. A functional medicine nurse practitioner can help you identify which foods may trigger your gluten sensitivity. 

Dairy/casein sensitivity may also be an issue

Lactose intolerance is much more common than gluten intolerance. However, the two often overlap. In one study in Italy, roughly 25% of people with lactose intolerance also had celiac disease, a digestive condition that is linked to gluten-related autoimmunity. 

This means that for many people, going gluten-free won’t be enough to get to the root of their autoimmune symptoms. If an intolerance to casein (the main protein in dairy) may be at play, patients are often advised to adopt both a dairy-free and gluten-free diet during the elimination phase, with dairy being added back separately to assess casein sensitivity.

Testing for food sensitivities 

Running a food sensitivity panel is one way to start learning what is going on. These blood tests can be vital guideposts in the dark for tricky cases. We may order the ALCAT blood test to measure food/immune reactions through stimulation of white blood cells after exposure to various foods and chemicals including gluten, gliadin, casein and whey. 

Creating a benchmark

Your functional medicine nurse practitioner may advise running a food sensitivity panel before you begin an elimination diet so that you have a benchmark to work with. While eliminating gluten and dairy are the most common requests, you may be asked to remove one or more other foods based on the results of your food sensitivity panel so that other potential problem foods don’t interfere with the success of your elimination phase.

The gluten challenge 

Hypoallergenic diets may be the most powerful tool a functional medicine nurse practitioner can prescribe, but no bones about it: these diets can be very difficult and take a long time. The hidden benefit is that the diet you are on during the investigation eliminates your possible triggers, so you should start to feel better right away, even as you uncover the details of your sensitivity.

Luckily, when it comes to autoimmune conditions, removing dairy and gluten are often the main dietary requirements and there are many alternative foods available.

Randi Mann, WHNP-BC, NCMP, APNP, is a woman’s hormone expert and the owner of Wise Woman Wellness LLC, an innovative wellness and hormone care center at 1480 Swan Road, De Pere. Mann is the author of the eBook: A Guide to Gluten and Going Gluten Free. She is a board-certified Women’s Health Nurse Practitioner and NAMS Certified Menopause Practitioner, one of a handful in Wisconsin and less than 1600 worldwide to achieve this distinction. She combines the best of conventional, functional and integrative medicine to help women with female, thyroid and adrenal hormone issues to live healthier, more abundant, joy-filled lives using a blend of compassion, cutting edge science, practical guidance and humor. Contact her at 920-339-5252 or via the Internet at Join the introductory virtual seminar, “End Hormone Havoc – Crazy Hormones Cause Fatigue, Weight Gain and Brain Fog and How to Fix Them!”, offered monthly, to learn about specialized thyroid, adrenal and female hormone testing and customized, bioidentical hormone treatments to achieve lifelong optimal hormone balance, increased vitality and longevity.

Sources: Fatourechi V. Subclinical hypothyroidism: an update for primary care physicians. Mayo Clinic proceedings. Published 2009. 

General Information/Press Room. Published 2014. American Thyroid Association.

Ojetti V; Nucera G;Migneco A; Gabrielli M; Lauritano C; Danese S; Zocco MA; Nista EC;Cammarota G;De Lorenzo A;Gasbarrini G;Gasbarrini A; High prevalence of celiac disease in patients with lactose intolerance. Digestion. Published 2005. 

Shahid MA. Physiology, Thyroid Hormone. StatPearls. Published May 18, 2020.

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