Hashimoto’s and Gluten – Get the Facts

Is anything more controversial than gluten these days? If you have Hashimoto’s, you may be wondering if you need to bid bread goodbye! 

Research shows there is a link between Hashimoto’s thyroiditis and gluten intolerance. In fact, people who are allergic to gluten, called Celiac Disease (CD), are more likely to have Hashimoto’s than those without CD. 

To understand whether going gluten-free is beneficial for Hashimoto’s, it’s important to know what gluten and CD are. 

In this article, I’ll go over what gluten and CD is, share the research on Hashimoto’s and gluten, a final conclusion on whether you should go gluten-free or not, and share some resources on navigating a gluten-free diet! 

What is gluten? 

Gluten is a protein complex, made up of the proteins gliadin and glutenin, found in grains like wheat, rye, barley, and triticale (a hybrid of wheat and rye). 

Some food products that contain gluten because they contain wheat, rye, barley, or triticale include (this list is not exhaustive): 

• Bread
• Pasta
• Cereals
• Baked goods
• Malted barley flour
• Malted milk and milkshakes
• Malt extract
• Malt syrup
• Malt flavoring
• Malt vinegar
• Beer
• Oats*

*While oats do not contain gluten themselves, they can often be contaminated by gluten during processing.

The most severe type of allergy to gluten occurs in an autoimmune disease called Celiac Disease (CD). Let’s talk about that next. 

What is Celiac Disease?

Gluten can cause the immune system to attack the gut lining. As a result of this attack, the gut lining can become damaged, which can disrupt nutrient absorption and cause symptoms like bloating, abdominal pain, chronic diarrhea, fatigue, weight loss, osteoporosis, etc (1). People with CD must absolutely avoid all forms of gluten in their diet.

While it is a common misconception that people suffering from celiac disease have digestive symptoms, such as diarrhea, CD can also be silent, with no obvious symptoms or signs. But if you have CD, your immune system can still be attacking your gut and causing damage. It’s thought that 80% of people with CD remain undiagnosed (2). 

What is the overlap between Hashimoto’s and gluten?

Research shows that there is a high rate of Hashimoto’s and Celiac Disease occurring at the same time. One in five people with CD also have Hashimoto’s (3, 4). 

Because of this, I recommend that people who have Hashimoto’s also be screened for CD. You can learn more about how CD is diagnosed here. 

If CD has been ruled out, checking for gluten sensitivity is important. People who don’t have CD, but do have gluten or wheat sensitivity are also more likely to have Hashimoto’s (5).  

Currently, there are no tests for gluten sensitivity. The best way to test whether you have gluten sensitivity is through an elimination diet. Here’s how to do an elimination diet in brief (but it can be very helpful to work with a registered dietitian for support in this process). 

Avoid eating any source of gluten for a few weeks. If you see improvements in digestive or other symptoms, reintroduce gluten to see if your symptoms come back. If you see symptoms coming back, you likely are gluten sensitive and need to go gluten-free. If you don’t experience any symptoms again, then you likely can tolerate gluten and should be okay to keep gluten in your diet (6). 

So, should you go gluten-free if you have Hashimoto’s? 

The short answer is yes. 

According to several studies, a gluten-free diet can reduce thyroid antibodies (which are usually high in Hashimoto’s), increase vitamin D levels, and slightly increase the number of thyroid hormones. This is the case, especially in individuals with CD or gluten sensitivity (7, 8). 

A gluten-free diet can positively impact Hashimoto’s by (9):

• Increasing vitamin D levels, which then has a positive impact on thyroid function
• Increasing absorption of nutrients that are important for thyroid function, like selenium, copper, zinc, and iodine 
• Reducing inflammation in the body, which can calm the immune system and lower thyroid antibodies

According to a meta-analysis study done in 2017, people with Hashimoto’s, regardless of whether they have CD or not, could benefit from a low-gluten diet (10).

According to a 2022 review, a gluten-free diet is more likely to be beneficial for those with Hashimoto’s and CD or gluten sensitivity (11). 

What is the Risk of Not Going Gluten-Free?

Continuing to eat gluten can hinder keeping Hashimoto’s in remission. The research shows that gluten consumption increases thyroid antibodies, which means it can push your immune system to keep attacking your thyroid gland. 

While maintaining a gluten-free lifestyle can be beneficial, it is also difficult. 

Tips for a Gluten-Free Lifestyle

The Celiac Disease Foundation has many resources for leading a gluten-free lifestyle, including gluten-free meal plans and recipes. You can check out some of their resources here. 

Going gluten-free can be overwhelming. Working with a registered dietitian can make it easier. 

One wayI help clients eliminate gluten is to find gluten-free substitutes for their usual foods without overburdening their gut with irritants and additives. While easier than ever these days, it still presents a big burden when getting started. 

It has surprised my clients to learn that without reading food labels, it can be hard to truly know if a food contains gluten or not. In a recent conversation with a client, she remarked that maybe egg noodles would be a good substitute for regular noodles, only to find out that they’re made from wheat! 

As a registered dietitian, I have the skills and tools to help you navigate a gluten-free diet and get relief from Hashimoto’s symptoms, like fatigue, constipation, cold intolerance, or hair loss. If you’re ready to chat, book your free consultation right here. 

Summary 

Avoiding gluten can be helpful in reducing Hashimoto’s antibodies and improving thyroid function, especially if you have Celiac Disease or gluten sensitivity. However, going on a gluten-free diet can be overwhelming and challenging. Consider working with a registered dietitian to help you get started! If you’re ready to chat, book your free consultation right here.