Everything You Need To Know About Hashimoto’s Disease And Gluten

Hashimoto's disease, also commonly referred to as Hashimoto thyroiditis (HT), is an autoimmune disorder that often (though not always) leads to hypothyroidism. This is because, over time, as the thyroid gland experiences misdirected attacks from your immune system, it can lead to an underactive thyroid.

The difference between the two conditions is that hypothyroidism develops due to thyroid gland issues, and Hashimoto's develops due to your immune system incorrectly attacking your thyroid gland.

When this happens, your thyroid does not produce enough thyroid hormones for your body to function properly. Your doctor will likely prescribe a treatment that increases production to help control symptoms and severity.

Another relevant approach your doctor should discuss concerns your diet and, more specifically, gluten consumption.

How does gluten affect Hashimoto's?

If you have Hashimoto's thyroiditis, you also have increased levels of antibodies, such as thyroid peroxidase (TPO) and thyroglobulin (TG). These contribute to the symptoms you may experience. When you lower those antibody levels, research¹ has found that you also reduce the severity of HT symptoms.

Although research has presented mixed results, a potential solution to reducing antibodies and lessening the severity of symptoms is to follow a gluten-free diet (GFD).

The same research above concluded that Hashimoto’s patients would benefit from removing lactose and gluten from their diet. This is because lactose can interfere with levothyroxine (a commonly prescribed hormone replacement for Hashimoto’s disease and hypothyroidism), and the proteins in gluten can interact with thyroid antigens.

Other studies have found that a gluten-free diet can benefit people with autoimmune thyroid disease (ATD) since it reduces inflammation and decreases antibody levels.² However, the topic has not been studied enough to demonstrate a strong connection.

Can gluten make Hashimoto’s disease symptoms worse? Potentially.

The potential problem with consuming gluten when you have Hashimoto's disease is that it contains a protein (gliadin) that resembles an enzyme of your thyroid (transglutaminase).

So, if you have gluten sensitivity or celiac disease, this can cause your immune system to attack your thyroid mistakenly. Over time, these attacks can lead to an underactive thyroid, resulting in many symptoms associated with hypothyroidism.

Even among non-celiac patients, gluten has been linked³ to promoting inflammation, producing interactions from the immune system, and being toxic to living cells.

How are celiac disease and autoimmune diseases related?

Celiac disease, which causes an immune reaction to gluten, is autoimmune. What’s more, patients with this condition are more susceptible to developing another autoimmune disease.

The risk of developing an additional autoimmune disease is about 25% among autoimmune patients.⁴

Thyroid conditions such as Hashimoto's and Grave's disease have been strongly linked⁵ to celiac disease, with those with either condition at a higher risk of developing celiac disease. The prevalence of celiac disease among people who have an autoimmune thyroid disorder such as Hashimoto's is between 2 and 5%.

What are the best diets for Hashimoto's? 

First and foremost, any diet or nutritional strategy is not an alternative to medication for treating Hashimoto's, and it will not reverse the impact HT has had on you. However, a high-quality diet and positive lifestyle changes can alleviate symptoms and contribute to better management and control of your disease.

The Autoimmune Protocol (AIP) Diet

The Autoimmune Protocol (AIP) diet was created in part for people with autoimmune diseases. The goal of the diet is to consume foods that help reduce pain and inflammation, and it also aims to improve other symptoms of an autoimmune disorder.

It can be beneficial to follow the AIP diet⁶ if you have Hashimoto’s disease. However, before making any substantial changes,  you should consult your doctor for more insight and advice.

Gluten-free diet

The gluten-free diet is also often considered one of the best diets for individuals with Hashimoto's disease.

According to a study² that included 34 women with autoimmune thyroiditis, a gluten-free diet resulted in clinical benefits.

What to eat on a gluten-free diet

According to research,⁷ the following foods are in the 'Diet4Hashi' protocol

• Vegetables

• Foods rich in calcium — milk, cheese, etc.

• Fruits 

• Whole grains — buckwheat, wholemeal, rye bread, etc. 

• Zinc-rich animal foods — eggs and meat.

• Selenium-rich animal foods — fish and other seafood.

• Nuts and seeds.

More specifically, the following are important parts of your gluten-free diet if you have Hashimoto's.

Fish

Fish, like salmon and sardines, provide your body with a great balance of omega-3 and omega-6 fatty acids.

You'll want to eat fish on your gluten-free diet because those fatty acids have been associated with reduced inflammation.⁸

Since Hashimoto's can cause your thyroid gland to be inflamed, eating fish regularly can be beneficial.

Foods high in fiber and probiotics

It's common for people with Hashimoto’s disease to experience some digestive changes⁹ due to their condition. To help manage this, it is recommended to eat foods high in fiber and probiotics.

Some high-fiber foods include lentils, beans, berries, and seeds. As for foods with a good source of probiotics, try kefir, kimchi, kombucha, natto, sauerkraut, and other fermented veggies.

Fruits and vegetables

Fruits and vegetables are essential nutrition sources for any diet. With Hashimoto's and a gluten-free diet, the benefit of eating more fruits and vegetables includes more vitamins, minerals, and antioxidants. This means reduced inflammation and a boost in nutrients and antioxidants known for combating free-radical damage.¹⁰ 

What to avoid on a gluten-free diet 

Just as there are foods you will want to ensure you're eating, there are also some foods you should avoid when possible. According to one study,⁷ it could help to reduce your intake of:

• Sweets, sugar, and honey

• Sweetened beverages and energy drinks 

• Fast food 

• Soybean and millet — millet groats, seeds, milk, etc. 

• Alcohol

With Hashimoto's, you should avoid the following in your gluten-free diet:

Dairy

Most dairy products are safe to consume because they're naturally gluten-free (although you should check for additives such as malt and thickeners). However, with Hashimoto's, dairy may have the same effect on people as gluten does.

The AIP diet⁶ does exclude foods that are considered potentially harmful — dairy is one of them, as well as coffee, alcohol, food additives, refined sugars, and legumes.

Another reason to avoid dairy is that there may be a link between Hashimoto's thyroiditis and being lactose intolerant. Although not every person will be or become lactose intolerant, one study¹¹ did note that out of 83 women with Hashimoto’s thyroiditis, 75.9% were diagnosed with lactose intolerance.

Some raw cruciferous vegetables

Although vegetables like kale, broccoli, and brussels sprout are gluten-free, they aren't good for people with Hashimoto’s disease if eaten raw in large amounts. This is because they contain goitrogens, which may interfere with thyroid hormone production.¹²

On the other hand, another study¹³ reported that cruciferous vegetables were suitable for people with Hashimoto’s disease when consumed in moderation.

It is worth noting that eating cruciferous vegetables would not lead to problems with thyroid hormone production unless eaten in excess.

The lowdown

Although following a gluten-free diet will not cure or act as an alternative treatment to medication, it can help relieve and manage the symptoms of Hashimoto's disease.

Gluten has been found to contain proteins that interact with thyroid antigens, and if included in your diet, your Hashimoto’s symptoms may worsen or, at a minimum, not get better.

Still, discuss your diet and any potential changes with your doctor beforehand. Every person is different, and your doctor will know which diet and foods will benefit you most.