One of the world’s more common autoimmune diseases is Hashimoto’s Thyroiditis, named after Dr. Hakaru Hashimoto in 1912. This disease is characterized by the destruction and scarring of thyroid tissue due to lymphocytic infiltration. In addition, part of its etiology is the presence of antibodies to thyroid peroxidase and thyroglobulin. Conversely, celiac disease (CD) is also an autoimmune disease that destroys the gut lining and averts the absorption of multiple vitamins and promotes an exacerbated inflammatory response. Consequently, the connection between celiac disease and Hashimoto’s thyroiditis creates an overlap in the nutritional treatment.
Gut permeability: how celiac disease affects Hashimoto’s thyroiditis
The chronic inflammation present in celiac disease affects the villous structure integrity and destroys the gut lining. Henceforth, the absorption of multiple vitamins and trace minerals becomes affected by this phenomenon.
The importance of iodine in thyroid hormone maintenance, modulation, and synthesis has extensive literature regarding its function. Also, the role of appropriate selenium levels dictates the mechanisms behind thyroid gland health. These nutrients mentioned above become deficient in the presence of villous degradation and inflammation, increasing thyroid dysfunction and hormonal dysbalance.
The increased immnunosensitivity can explain the overlap of thyroid dysfunction and its association with celiac disease. Some of these associated conditions are:
- Autoimmune polyglandular syndrome.
- Antibodies that target both tissues.
- Selenium and iodine malabsorption.
In addition, it is recently recommended that patients diagnosed with autoimmune thyroid disease be screened for celiac disease. Furthermore, this test should screen for serum IgA and IgG gliadin antibodies, IgA transglutaminase antibodies, and serum endomysium antibodies.
Environmental factors: celiac and thyroid disease.
Regardless of the underlying genetic factors that can promote thyroid and celiac disease, environmental factors such as diet, being a female, and inflammation interact to complicate this condition. The interaction between gastrointestinal inflammation, gut permeability, microbiota changes, immune hyperreactivity, and environmental factors escalates these conditions’ acute reactions.
The overlap between thyroid disease and celiac disease can be associated with the incapacity to absorb a proper amount of antioxidants through the digestive tract. An increase of free radicals can destroy the cellular structure, gut lining, and thyroid tissue, inevitably complicating both situations. Some of the environmental contributors are:
- Smoking and excessive alcohol consumption.
- A high concentration of heavy metals (iron, copper, and zinc).
- Consumption of heavily processed foods.
- Fluctuating blood glucose levels.
- Mitochondrial dysfunction.
- Digestive issues like diarrhea preventing the absorption of antioxidant compounds.
A crucial part of the etiology of thyroid dysfunction is the hydrogen peroxidase that targets the thyroid gland, resulting in increased apoptosis. Nevertheless, the protective benefits of selenium supplementation on glutathione peroxidase function promote a proper recovery on antioxidant levels, reversing this complication.
Furthermore, studies report that patients diagnosed with Hashimoto’s disease have increased oxidative stress markers than their healthy counterparts. These results attributed a higher level of oxidative stress markers up to 60% in those patients with autoimmune disease.
Sadly, the thyroid gland and its hormones regulate metabolism, but the absorption of certain nutrients modulates them. This is why diet therapy in functional or orthomolecular medicine treatment is critical in improving these conditions.
Individual key players will dictate the nutritional treatment of each individual. However, it is essential to detect and make the patient aware of the following:
- Increased body fat results in elevated levels of inflammatory cytokines and oxidative stress markers. Therefore, fat mass reduction is a cornerstone of the dietary approach.
- The detection of celiac disease, intestinal permeability, and gluten intolerance will predict if the diet should be gluten-free oriented.
- Screening for nutrient deficiency should be part of the nutritional assessment. The results of such tests will determine the posterior dietary supplementation plan.
- Dietary fiber supplementation or ingestion is to be assessed. Adequate ingestion of dietary fiber is therapeutic since it improves heavy metal levels, modulates intestinal motility, and promotes detoxification.
How to diagnose gut permeability?
Functional medicine tests to treat. Genova diagnostics provides a wide array of digestive tests that provide great insight into what is causing or triggering a condition.
Orthomolecular or functional medicine seeks to treat upstream. Targeting subclinical deficiencies, oxidative stress, and exacerbated inflammatory responses that trigger autoinflammatory conditions, orthomolecular therapy promotes health through nutrient supplementation. Furthermore, testing is key to developing a proper treatment in the overlapping etiology shared by celiac disease and Hashimoto’s thyroiditis.
Reducing the intestinal permeability and inflammation caused by celiac disease is associated with increased absorption of anti-inflammatory and antioxidant nutritional compounds obtained by food. Creating a dietary therapy that fits the patient’s needs and supplements their nutritional deficiency will ensure a proper thyroid function. – Ana Paola Rodríguez Arciniega, MS.
Ihnatowicz, Paulina et al. “The importance of nutritional factors and dietary management of Hashimoto’s thyroiditis.” Annals of agricultural and environmental medicine: AAEM vol. 27,2 (2020): 184-193. doi:10.26444/aaem/112331
Liontiris, Michael I, and Elias E Mazokopakis. “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.” Hellenic journal of nuclear medicine vol. 20,1 (2017): 51-56. doi:10.1967/s002449910507
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Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
Licensed in Texas & New Mexico