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Celiac Disease and Hashimoto’s
Gliadin, a gluten protein
Many people who suffer from Hashimoto’s are aware that there may be problems caused by eating gluten and related proteins.
However, because of misinformation and the inconvenience of going gluten free, many people ignore these warnings or don’t think this really applies to them.
I have had a number of people write me and tell me during consultations that they need to see “peer reviewed studies” about gluten and Hashimoto’s before they are going to commit to going gluten free.
In this post we examine a boat load of research on this subject and we seek to demonstrate, once and for all, why eating gluten is not a luxury you and your thyroid (and lots of other important parts of your body – like your brain) can afford.
Celiac Disease is an Autoimmune Disorder
According to the Celiac Support Association “Celiac disease, also known as celiac sprue or gluten-sensitive enteropathy, is a genetically linked autoimmune disorder that can affect both children and adults…”
Yes, celiac disease is an autoimmune disease. It’s not just a food allergy or sensitivity.
What do we know about autoimmune disease?
When you have one, it’s easy to get others.
Like Hashimoto’s, for example.
To read more about this, check out my previous post that looks into this in depth.
“…In people with celiac disease, eating certain types of grain-based products sets off an immune mediated response that causes measurable damage to the small intestine.”
Another key point. I and many other specialists in this field believe that the small intestine is ground zero for autoimmune diseases of all kinds.
This damage to the small intestines has systemic consequences.
These include the immune system, the endocrine system, the nervous system and the brain. This is no small matter (pun intended).
“…This, in turn, interferes with the small intestine’s ability to absorb nutrients in food, leading to malnutrition and a variety of other complications.”
Yes, the other complications include an inability to convert and absorb thyroid hormone, major deficiencies in important vitamins and minerals like iodine, iron, selenium, magnesium and vitamins like B, D and plenty more.
Pretty much guaranteeing hypothyroidism and thyroid gland dysfunction.
“…The offending amino acid sequences are collectively called “gluten” and are found in wheat, barley, rye, and to a lesser extent, oats* (WBRO). Related proteins are found in triticale, spelt, and Kamut.”
Indeed, these “offending amino acid sequences” are not just found in these grains, they are found in many foods like dairy, soy, coffee, corn, potatoes, and lots more.
The reality is gluten may just be the tip of the iceberg and going gluten free may not be enough to effectively treat autoimmune disease.
Some people do not get better by only going gluten free. This is not because they don’t have a problem with gluten.
There are many other foods that have a similar amino acid sequence to gluten and these may also be a problem.
Because it is these amino acid sequences that the immune system attacks and that resemble our own tissues. (To learn more about this, check out this previous post).
Celiac Disease Creates Antibodies that Attack Tissue Transglutaminase
Tissue transglutaminase is an enzyme that repairs damage in the body. People with celiac disease often make antibodies that attack this enzyme.
Well, studies have shown that people with transglutaminase and gliadin antibodies also have a much higher levels of TPO and TgAB antibodies.
A Major Link Between Celiac Antibodies and Thyroid Antibodies and Autoimmunity
Celiac Disease and autoimmune thyroid disorders share a common genetic link, namely, the DQ2 allele.
This is a subtype of a region of cells called the HLA (or Human Leucocyte Antigen) System.
There is a region on cells located on some of our genes called the HLA. Many of these are located on chromosome 6 (for those of you keeping count).
Mutations or defects of HLA have been linked to many different autoimmune diseases.
Exactly what happens is not known, there are numerous theories, but the end result is that our own tissue gets attacked and destroyed by the immune system.
With Celiac disease and autoimmune thyroid diseases we see an increase in both types of antibodies that lead to attack on these tissues.
Collin et al found 5.4% of 335 adult celiac patients, of whom 83% complied with a gluten-free diet, had autoimmune thyroid disease (autoimmune hypothyroidism or Graves’ disease).
Counsell et al found that 14% (15 out of 107) of celiac patients had thyroid disorders (3.7% hyperthyroid and 10.3% hypothyroid).
The same authors also noted a high prevalence of thyroglobulin antibodies (11%) and thyroid microsomal (TPO) antibodies (15%) in their CD patients.
Likewise, Velluzzi et al found the prevalence of thyroid peroxidase antibodies to be higher in CD (29.7%, 14 out of 47 patients) than in healthy controls (9.6%).
“Yes, But I Was Tested For Gluten Antibodies and The Tests Were Negative”
This is another area of misinformation. Most doctors test for 2-4 gluten antibodies.
Current testing for Gluten-Reactivity and Celiac disease (CD) includes serum IgG and IgA against gliadin and tissue transglutaminase-2 (tTG2).
These antibodies are measured against minor components of a wheat protein called alpha-gliadin.
Here’s the thing, wheat consists of multiple proteins and peptides including, alpha-gliadin, omega-gliadin, glutenin, gluteomorphin, prodynorphin, and agglutinins.
And there are many we still do not know about.
And the important thing to understand is that any of these antigens can cause an immune response.
So, even if you tested negative to celiac, you could still have gluten sensitivity or silent celiac disease because you may not have tested for the right thing.
Which Came First, The Gluten or the Autoimmunity?
This is a really interesting question that is controversial and no one really knows.
But, here’s what we do know.
Autoimmunity doesn’t just happen for no reason. It is the result of a perfect storm of factors.
You need the genetic predisposition (like the HLA DQ2 allele mentioned above), you need exposure to some antigen (Often Yersenia, Epstein Barr, Coxsackie, Lyme disease or some other pathogen), these produce antibodies and somehow you get the breakdown of mucosal IgA and tight junction proteins.
Ground zero is the intestinal mucosa.
One theory is that gluten, which is sticky and invasive (like a thief who can get into anywhere it wants), gets into the intestines, into the spaces between the intestines (the tight junctions) and eventually into the bloodstream.
Then the immune system kicks in.
Antigen presenting cells like macrophages (those Pac man cells that munch the bad guys) start attacking and they stimulate the T helper cells.
These are either TH-1 or Th-2 (check out this previous post that describes this works with Hashimoto’s in detail) and these lead to pro-inflammatory immune cells and proteins, more antibodies, cross reactions – generally, all hell breaking loose.
And, finally as this plays out and is repeated over and over again every time you eat a piece of bread, a pastry, some cake, a doughnut, etc. you are unknowingly pushing your body further and further into autoimmunity.
Your immune system is so juiced it doesn’t know which way is up and eventually, you loose self tolerance.
And loss of self tolerance means the immune system starts attacking your own tissue.
Another problem caused by gluten is that it makes thyroid hormone less effective.
Celiac Disease Has A Major Impact on Thyroid Hormone Absorption
An interesting study published by the American Thyroid Association found “…This study examined 68 patients with Hashimoto’s thyroiditis alone and 35 patients with Hashimoto’s thyroiditis and celiac disease.
The average dose of levothyroxine needed to treat patients with Hashimoto’s thyroiditis alone was lower than the average dose required to treat patients with Hashimoto’s and celiac disease.
When the patients with celiac disease went on a gluten-free diet while staying on the same dose of thyroxine, their TSH level decreased, indicating that their absorption of thyroxine had improved.”
We see this clinically all the time.
When patients go gluten free, they often must reduce their dosage of thyroid replacement hormone because it starts to work so much better.
Well, thyroid hormone produced by your thyroid and thyroid replacement hormone have the same structure.
Gluten prevents thyroid hormone produced by your thyroid from being absorbed, as well.
Is There Evidence That Gluten Leads Directly To Destruction of the Thyroid?
One idea that is often discussed in this context is something called molecular mimicry.
This is what happens when the immune system identifies certain proteins or protein fragments (amino acid sequences) and then attacks everything that has that amino acid sequence.
With autoimmunity, when the immune system attacks a virus like Epstein Barr, for example, it activates certain kinds of B cells.
These differentiate into plasma cells and one theory is that these may also stimulate anti-self B cells.
These are present in normal people and are there because our immune system constantly gets rid of old dead cells from our body.
But somehow these viral fragments cause other immune proteins called complement to stick to our own tissue and when they accumulate the immune system starts attacking that living tissue as well.
Viruses may also down regulate the T suppressor cells that call off the attack and this keeps the carnage going.
This is what happens to the thyroid. Thyroid cells get attacked as does the enzyme thyroid peroxidase and the protein thyroglobulin.
There is plenty of evidence that gluten is involved with firing up autoimmunity, but I could not find any actual research to support the claim that gliadin proteins closely resemble thyroid tissue (which is something that many bloggers in this area repeat).
There is no question exposure to gluten leads to autoimmunity, destruction of the small intestine, systemic inflammation and destruction of the thyroid.
But whether this type of molecular mimicry is at play is not clear. (I invite any readers to show me this actual research.)
However, at the end of the day, this hardly matters. There are so many other reasons not to eat gluten. And here’s another really big one.
Gluten Causes Neurodegeneration in Your Brain
Another really good reason to stay far away from gluten is that it has been linked to destruction of the brain, especially the cerebellum.
The brain is profoundly impacted by Hashimoto’s.
Check out this video (SAVE YOUR BRAIN (FROM HASHIMOTO’S) to learn more.
This is the reason why the second most common symptom for people with Hashimoto’s is brain fog and memory issues. (The most common symptom is fatigue.)
A condition of advanced neurodegeneration that results from Hashimoto’s is called Hashimoto’s Encephalopathy.
This destroys parts of the brain in much the same way that Alzheimer’s does.
And this is caused by autoimmunity in the brain.
One area of the brain that can be impacted is the cerebellum. And a common symptom of impairment to the cerebellum is ataxia.
Ataxia is uncoordinated movement is due to a muscle control problem.
It leads to a jerky, unsteady, to-and-fro motion of the middle of the body (trunk) and an unsteady gait (walking style). It can also affect the limbs.
You can test this by doing the DUI test. Close your eyes and imagine you are walking on a tight rope, put one foot in front of the other.
If you lose your balance or fall over, this may indicate some impairment of the cerebellum.
Guess what else causes ataxia?
Gluten.
In fact, a study from Brain a Journal of Neurology, 2003 found “Gluten ataxia is therefore the single most common cause of sporadic idiopathic ataxia.”
The most common cause of ataxia that has no known explanation.
So when you combine Hashimoto’s with brain autoimmunity and gluten, you have a recipe for really bad things.
And Wait There’s More
The final pièce de résistance of this post is something that is related to gluten but adds a whole other layer of badness.
That is glyphosate or Monsanto’s marquee product Roundup.
Glyphosate is sprayed on wheat and many other grain crops just before harvesting to make them dry out more uniformly.
Well, it turns out that this chemical also does a number on the small intestine, may be responsible all by itself for the destruction of the intestinal lining and the initiation of a host of diseases.
Fish exposed to glyphosate develop digestive problems that are a lot like celiac disease.
Celiac disease is associated with imbalances in gut bacteria that can be fully explained by the known effects of glyphosate on gut bacteria.
Characteristics of celiac disease point to impairment in many cytochrome P450 enzymes, which are involved with detoxifying environmental toxins, activating vitamin D3, catabolizing vitamin A, and maintaining bile acid production and sulfate supplies to the gut.
Glyphosate is known to inhibit cytochrome P450 enzymes.
Deficiencies in iron, cobalt, molybdenum, copper and other rare metals associated with celiac disease can be attributed to glyphosate’s strong ability to chelate these elements.
Deficiencies in tryptophan, tyrosine, methionine and selenomethionine associated with celiac disease match glyphosate’s known depletion of these amino acids.
Celiac disease patients have an increased risk to non-Hodgkin’s lymphoma, which has also been implicated in glyphosate exposure.
So Let’s Review:
Here are 5 reasons to never touch gluten as long as you live that are supported by about 30 peer review studies listed below.
1. Celiac Disease is an Autoimmune Disease with striking similarities to Autoimmune Thyroid Disease.
2. People with Celiac, and Gluten Sensitivity have higher levels of thyroid antibodies and visa versa.
3. Gluten can destroy your small intestines and cause deficiencies in important nutrients, vitamins, and minerals absolutely necessary for proper thyroid function.
4. Gluten and Celiac Disease block the absorption of thyroid hormone.
5. Gluten can cause neurodegeneration in your brain.
And a Bonus
6. Commercial wheat also has lots of glyphosate, a chemical that can make all of what we have just mentioned a whole lot worse.
Bottom Line
In life we must always make decisions based on risk and benefit.
The risk of the destruction that gluten can cause in people with Hashimoto’s so far outweighs the benefit that it is really no contest.
References:
http://www.csaceliacs.org/celiac_disease_defined.jsp
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2111403/ Celiac Disease and Autoimmune thyroid disease
http://www.ncbi.nlm.nih.gov/pubmed/18176874 North Italian prevelance of CD in autoimmune thyroid
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC96126/: CD and autoimmune endocrinopathies
http://www.eje-online.org/content/130/2/137.abstract Autoimmune thyroid disorders and celiac disease
http://www.ncbi.nlm.nih.gov/pubmed/15244201 Antigliadin antibodies in celiac disease
http://www.ncbi.nlm.nih.gov/pubmed/9872614 Autoimmune thyroid diseases and celiac disease
http://www.ncbi.nlm.nih.gov/pubmed/12919165 Risk factors of thyroid autoimmunity
http://www.ncbi.nlm.nih.gov/pubmed/11768252 Autoimmune thyroid disease in celiac patients
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725235/ Celiac disease and autoimmunity: excellent overview
http://cvi.asm.org/content/8/4/678.full Celiac related autoimmune endocrinopathies
http://www.direct-ms.org/pdf/LeakyGutMS/Fasano%20Celiac%20other%20autoimmune%20disease.pdf Systemic Autoimmune disease and celiac
http://en.wikipedia.org/wiki/Anti-transglutaminase_antibodies EMA and transglutaminase antibodies
http://www.thyroid.org/patient-thyroid-information/ct-for-patients/vol-5-issue-6/vol-5-issue-6-p-3-4/ The effect of celiac disease on levothyroxine dosage
http://www.nature.com/cmi/journal/v8/n2/full/cmi201065a.html Antibodies in Celiac disease, implications beyond diagnosis
http://www.wjgnet.com/1007-9327/13/1715.asp Dutch study of patients with Hashimoto’s and Celiac disease
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730948/ Celiac disease and autoimmunity in the gut and elsewhere
http://jeffreydachmd.com/2014/01/hashimotos-thyroid-disease-molecular-mimicry/
http://www.todaysdietitian.com/newarchives/110310p52.shtml Research connects Celiac and Hashimoto’s
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1808742/ Gliadin, TPO and other antibodies in latent autoimmune diabetes patients
https://www.enterolab.com/StaticPages/EarlyDiagnosis.aspx Before the Villi Are Gone
http://en.wikipedia.org/wiki/Human_leukocyte_antigen Define HLA
http://thyroidbook.com/eating-gluten-increases-need-thyroid-hormones/
http://www.hindawi.com/journals/ijad/2011/865432/ Transglutaminase enzyme involved in Alzheimer’s
http://www.csaceliacs.org/celiac_disease_defined.jsp
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077662/ Hashimoto’s Encepheopathy and Cerebellar Ataxia
http://www.ncbi.nlm.nih.gov/pubmed/12566288 Gluten Ataxia
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945755/ Glyphosate, pathways to modern disease: Celiac sprue and gluten intolerance
https://www.cyrexlabs.com/Portals/0/Docs/ClinicalApplications/ClinicalAppArray3.pdf
“Why Isn’t My Brain Working”, Dr. Datis Kharrazian, 2013 Elephant Press
About the Author Marc Ryan
So now, not only is it my profession, it’s my passion, and it’s personal. I’ve been joking with people lately saying it’s a blessing and a curse. A blessing because I really get it, and a curse because I really got it! ?
