Is gluten messing with your thyroid?

Let’s face it: Gluten, a group of proteins found in wheat, catches some serious heat for a wide variety of symptoms and ailments these days. In some cases, rightly so. And in other cases, there’s more hype than truth. But what about gluten and thyroid issues? Is there a connection?

Here’s the deal: Many thyroid issues fall under the autoimmune umbrella, which essentially means the body’s immune system attacks its own tissues (in this case, the thyroid), explains Karly Powell, ND, a registered naturopathic doctor at the Strata Integrated Wellness Spa at Garden of the Gods in Colorado Springs.

While research on gluten and the thyroid (and gluten intolerance in general) is still ongoing, one predominant belief is that gluten can be a trigger for the immune response against the thyroid in people who are already predispositioned to be sensitive to gluten. As you might imagine, this can lead to a whole host of unpleasant symptoms. So, how can you tell if gluten is playing a role in your thyroid function?

Keep reading to see exactly how gluten affects your thyroid.

The thyroid’s role in the body

The thyroid is a structure that mainly produces the hormone T4, and it has a pretty foundational role. “The thyroid is active in literally every cell in your body, and it’s the main regulator of your metabolism,” says Powell. “Almost every biochemical process in your cell is somewhat dependent on thyroid hormones being normal, so when the thyroid is not working normally, we tend to see really sluggish cellular function.”

This can manifest as fatigue, weight gain, hair loss, brittle nails, constipation, and more–your cellular functions essentially slow down without normal levels of thyroid hormones, explains Powell.

If you’re experiencing these symptoms, blood tests can be used to diagnose and monitor thyroid problems pretty definitively. “The most standard test that’s done is the TSH test, and that’s the signal from your brain to your thyroid to make more thyroid hormones,” says Powell. “I also like to look at the output of the thyroid hormone, so mostly the T4 and the T3.” (T3 is most active form of thyroid hormone, and the conversion from T4 to T3 mainly happens in the cell, although the thyroid produces a small amount.)

Whether gluten is influencing these issues, though, is another question.

The gluten-thyroid connection

“From a research perspective, we’re still in our infancy, but the area where we do have a lot of research on is the connection between thyroid and gluten within people with celiac disease,” explains Powell.

A refresher: Celiac disease is an autoimmune disease where gluten triggers a major immune response in the digestive tract. So while its not inherently attacking the thyroid, research does show that people who have one autoimmune disease are at a higher risk for another one (like an autoimmune thyroid condition). “If you have celiac disease, you have about a three times increased risk compared to someone who doesn’t have celiac disease of having thyroid disease,” says Powell.

Granted, the connection is slightly murkier when it comes to people who have non-celiac gluten sensitivity. “[But] clinically, I absolutely see that there’s a connection there,” says Powell. “And often, when I’m working with patients who have thyroid disease, we’re really looking at what the inflammatory triggers in their system are.” Gluten is one of these potential triggers.

How to tell if gluten is triggering thyroid dysfunction

1. Try a gluten elimination diet

Powell considers this the gold standard among testing options. “There’s some pretty good evidence that it takes up to three months to completely clear gluten from your system, so to really do a full elimination diet, it’s going to mean cutting gluten out as strictly as possible for three months and then reintroducing it back into your diet and seeing if you have any symptoms that change,” she says.

If you’re working with a doctor, along the way they may monitor your thyroid function with blood tests. If your labs change during or after your elimination diet, that can be an indicator that gluten is a trigger.

2. Consider food sensitivity testing

There are also food sensitivity tests available (although they’re not always as reliable as an elimination diet). “The type of testing that I do is looking at what happens to your white blood cells when you’re exposed to gluten, or whatever food we’re testing for,” says Powell. “Do you have an inflammatory response?”

This platform is called the ALCAT test. “It’s got about 90 percent sensitivity and specificity, so it’s going to have a 10 percent rate of false negatives or false positives. In the food sensitivity world, that’s pretty good,” says Powell. The test that looks at IgG antibodies is also a common option. (That one’s only about 60 to 80 percent accurate, says Powell.)

3. Ask your doctor about testing for celiac disease

If there’s a concern that you may have celiac disease, there’s a blood test that can test for it (although an official diagnosis is usually made by doing a biopsy via an endoscopy). There’s a catch here, though: “In order to test for celiac disease, someone needs to be actively consuming gluten,” says Powell. So if celiac disease is on the table, you definitely shouldn’t start an elimination diet.

If you have a thyroid disease, it’s pretty unlikely that gluten is the sole culprit. But if it does trigger symptoms in you (and you don’t have full-blown celiac disease), cutting back on gluten can be helpful. There are better ways to do this than others. “[Some people] fall into the trap of thinking, OK, normally I’d eat bread, and tortillas and cereal, so I’m just going to find a gluten-free bread, a gluten-free tortilla, and a gluten-free cereal,” says Powell. “Instead, I like to have people think about how they can incorporate more whole grains into their diet. Quinoa, oats, rice, millet—those are all naturally gluten-free grains, so you’re going to get a higher nutritional quality from those [than processed options].”

And hey, ultimately, focusing on eating more whole foods and grains is generally a good idea for most people—whether you’ve got issues with gluten and your thyroid or not.

If you’re cutting out gluten, here are some pitfalls you’ll want to avoid, plus a recipe for Middle Eastern pizza to try.