Having a healthy microbiota is essential for the immune system’s proper function. In addition, gut health is a crucial mediator for thyroid function, as intestinal diseases commonly overlap with thyroid conditions. Indeed, conditions such as Hashimoto’s thyroiditis (HT) and Graves’ disease (GD) commonly coexist with Celiac Disease (CD) and Non-celiac wheat sensitivity (NCWS). Furthermore, these conditions can be linked to the common root causes: Intestinal permeability and dysbiosis. 

The role of microbiota and thyroid health:

Intestinal bacteria have coexisted in a perfect balance with humans throughout centuries. Indeed, this symbiotic dependence plays an essential role in determining the health or disease of the patient. Furthermore, many factors tend to influence these conditions; birth delivery and breastfeeding can affect the diversity of bacterial strains at a young age. 

In addition, dietary intake, fiber, genetics, environment, diseases, and the constant use of antibiotics may determine our bacterial diversity and growth. Consequently, an impaired bacterial can impact the synthesis of many vitamins such as vitamin K, folic acid, vitamin B2. B3, B5, B6, B7, and B12. Ultimately, reduced synthesis of these vitamins will result in impaired immune response and deranged metabolic functions.

How does gut health influences immune reactions:

Gut microbiota is a crucial influencer of the innate and adaptive immune system, as it is fundamental for gut-associated lymphatic tissue (GALT). Indeed, GALT is an essential factor in developing tolerance to self-antigens, as it modulates its toll-like receptors in the intestinal mucosa.

Furthermore, dietary fiber and the short-chain fatty acids (SCFA) derived by microbial metabolism positively correlate with the number of regulatory T-cells. Consequently, these mediators improve immune tolerance and reduce inflammation, explicitly lowering the concentration of proinflammatory Th-17 cells. Additionally, a higher concentration of SCFA is correlated to stronger intercellular tight junctions, which result in lower pathogen translocation.

Vitamin deficiency, immunity, and gut health

A growing number of research studies describe the cross-reaction between autoimmune conditions like Celiac Disease (CD) and autoimmune thyroid disease. Indeed, in CD’s physiopathology, gluten triggers a chronic inflammatory response, leading to villous alteration, digestive enzyme deficiency, and deprivation of brush-border proteins. 

Consequently, the enzymatic deficiency affects iron absorption, decreasing heme-dependent thyroid peroxidase (TPO). Furthermore, this produces a chain reaction that leads to dysregulation of triiodothyronine (T3) and thyroxine (T4).

Also, lower folate, Vitamin D, vitamin B12, zinc, and magnesium levels are common in patients with CD. The role of these vitamins on immune system regulation is pivotal, and it is considered the common denominator to explain the coexistence of CD, Hashimoto’s Thyroiditis, and Graves disease. 

Clinical applications

Vitamin supplementation has been featured in a large number of studies with the aim of treating autoimmune conditions. 

Vitamin D supplementation is linked to immunoregulatory properties, primarily because Vitamin D receptors are expressed by immune cells like lymphocytes and antigen-presenting macrophages. In addition, immune cells are capable of vitamin D synthesis and promote the differentiation of naive T-cells. 

How can I choose the right supplement for me?

Nowadays, we have vitamin shops that carry a wide variety of supplements and products. Choosing the right supplement can be easy if we know what we should be looking for, and this guide can help you understand how you should select your supplements.

Autoimmune diseases are difficult conditions to manage and control. The medical-nutritional treatment of these conditions relies on an in-depth assessment, including micronutrient deficiency tests, comprehensive gastrointestinal labs, and a symptoms questionnaire. Following this assessment, nutritional intervention is crucial to replenish vitamin deficiencies with supplementation. In addition, treating the gut is essential to ensure vitamin absorption and symptom improvement. – Ana Paola Rodríguez Arciniega, MS

Bibliography

Starchl, Christina et al. “Celiac Disease, and the Thyroid: Highlighting the Roles of Vitamin D and Iron.” Nutrients vol. 13,6 1755. 21 May. 2021, doi:10.3390/nu13061755

Knezevic, Jovana et al. “Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function?.” Nutrients vol. 12,6 1769. 12 Jun. 2020, doi:10.3390/nu12061769

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