Hashimoto’s thyroiditis is an autoimmune disease that affects your thyroid, the small butterfly-shaped gland located in your neck. Your thyroid is important for many other functions in your body, including supporting a healthy metabolism.
Hashimoto’s symptoms can decrease quality of life, even if you are taking medication. Lifestyle factors, such as managing stress and changing your diet, have been shown to help alleviate some of the symptoms (1, 2).
Gluten-free diets have become popular among people with Hashimoto’s thyroiditis and other autoimmune diseases.
This article will further explore the relationship between gluten and a gluten-free diet and the symptoms of Hashimoto’s thyroiditis.
Gluten is a group of storage proteins, primarily glutenin and gliadin, found naturally in certain foods, such as wheat, barley, and rye. It is also sometimes used as an additive in processed foods to improve texture and flavor (3).
Hashimoto’s thyroiditis is an autoimmune disease that causes white blood cells and antibodies to attack the thyroid. The exact cause is unknown, but genetic, environmental, and epigenetic factors are thought to be involved (7, 8, 9).
The thyroid produces hormones called triiodothyronine (T3) and thyroxine (T4), which are important for the proper functioning of the metabolism. When the thyroid is attacked, these hormone levels become too low, often resulting in hypothyroidism or an underactive thyroid.
In developing countries, the biggest contributor to hypothyroidism is iodine deficiency. In countries where iodine is added to table salt to ensure adequate iodine intake, Hashimoto’s disease is the most common cause of hypothyroidism (ten, 11).
A doctor may suspect that you have Hashimoto’s disease if you have symptoms of hypothyroidism, such as (11):
- dry skin
- weight gain
- joint stiffness
- hair loss
- muscular weakness
- poor concentration
In order to make a diagnosis, a doctor will usually order a blood test to check thyroid levels and to check for the presence of specific antibodies – proteins made by the immune system that fight infections.
Blood tests in someone with Hashimoto’s disease usually show elevated levels of thyroid-stimulating hormone (TSH), which is responsible for the production of T3 and T4 by the thyroid. The body recognizes low levels of T3 and T4 and tries to repair them by producing excess TSH.
Hashimoto can exist without hypothyroidism, but over time thyroid levels can become low due to thyroid attack. For this reason, treatment for Hashimoto’s disease is often the same as that for hypothyroidism (14).
Hashimoto’s treatment usually involves lifelong medication that can help bring thyroid levels back to where they should be. However, research suggests that nearly a third of people taking thyroid medication still experience symptoms (ten, 14).
In Hashimoto’s thyroiditis, antibodies that attack the thyroid are present. It is thought that when a person with the disease eats gluten, these antibodies react because the protein structure of gluten is similar to the structure of the thyroid.
High antibody levels correlate with Hashimoto’s symptoms, so reducing antibody levels may help alleviate some of these symptoms (13).
A study in 34 women with Hashimoto’s disease found that a gluten-free diet reduced antibody levels, but more research is needed to confirm these findings (16).
There is some evidence that a gluten-free diet may be helpful for people with non-celiac autoimmune diseases as a whole, as it may help reduce inflammation, which may be largely responsible for many of the symptoms. that they feel (6, 17).
If you have an autoimmune disease, discuss the possibility of celiac disease with your doctor. Also, although the research is still mixed, you can try avoiding gluten to see if it makes a difference for you and your symptoms.
A diet focused on anti-inflammatory foods may be beneficial for someone with Hashimoto’s because it helps support a healthy immune system. Additionally, the minerals selenium and iron may help lower thyroid antibodies (9, 13, 21, 22, 23).
Here are some gluten-free foods to include in your diet if you have Hashimoto’s thyroiditis:
- Fruits: berries, grapes, cherries, pineapple
- Vegetables: broccoli, cauliflower, peppers, mushrooms, tomatoes, dark leafy greens like spinach and kale
- Healthy fats: avocado, extra virgin olive oil, nuts, fatty fish like salmon and mackerel
- Proteins: chicken, beef, turkey, tofu, dairy products such as Greek yogurt and low-fat cheese
- Selenium-rich foods: Brazil nuts, pork, eggs, bred rice
- Iron-rich foods: spinach, red meat, quinoa, tofu, legumes like beans and lentils
- Gluten-free cereals: certified gluten-free oats, brown rice, buckwheat, millet, amaranth
If you choose to eliminate gluten from your diet, you will want to avoid the following foods. Keep in mind that there are gluten-free varieties of some of these foods that would be safe substitutes:
- some dressings and condiments
- beer and some other alcoholic beverages
- baked goods
- packaged snack foods such as crackers, pretzels and some flavored potato chips
Since some gluten-containing foods may be more obvious than others, it’s important to check the ingredient label and avoid any foods that contain the following:
- oats (unless listed as gluten-free)
- beer yeast
People with autoimmune diseases such as Hashimoto’s are more likely to have celiac disease, a condition in which the immune system reacts to gluten. It is recommended that anyone with an autoimmune disease be screened for celiac disease (18, 19, 24, 25, 26).
A study of 53 women with autoimmune thyroid disease found that 9.3% of participants also had celiac disease, which is a much higher rate than in the general population (20).
Because there seems to be a correlation between celiac disease and autoimmune diseases, your doctor may recommend that you get tested for celiac disease, even if it’s just to rule it out.
If you test positive for celiac disease, you will need to follow a gluten-free diet, which may also help improve symptoms of other autoimmune diseases.
Hashimoto’s thyroiditis causes white blood cells and antibodies to attack the thyroid. It is one of the main causes of hypothyroidism. Avoiding gluten in the diet may help relieve some symptoms of Hashimoto.
Celiac disease, an autoimmune disease that causes the body to react to gluten, is more common in people with other autoimmune diseases, such as Hashimoto’s thyroiditis.
If you don’t have celiac disease, you may still see improvement in your Hashimoto’s symptoms by eliminating gluten, although research is mixed.
We recommend that you discuss methods of treating your Hashimoto’s symptoms with your doctor. If you choose to follow a gluten-free diet, a dietitian can help you implement these changes in a healthy way that works for you.