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The Association Between Gluten and the Development of Hashimoto‘s Disease.

Discussion in 'Doctors Cafe' started by Hazem wahb, Sep 19, 2019.

  1. Hazem wahb

    Hazem wahb Young Member

    Aug 17, 2019
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    Many Epidemiological Studies have recognized Recently A steady increase in the occurrence of diverse Autoimmune endocrine disorders, such as : autoimmune thyroid disease “AITD”.

    AITD occurs due to many different factors including genetic and enviromental factors like: smoking and alcohol, they have significant effects, both for aggravating the disease and protective as well. There are two types of AITD, Hashimoto‘s disease and Graves‘disease and both of these have strong correlations in age groups above 45-50 years.

    In Hashimoto‘s and Graves‘s disease there are elevated levels of antibodies which circulating against the thyroid proteins especially thyroid oxidase, thyroglobulin and TSH Receptor, In addition of these factors, Genes Play a major role in the onset of AITD, like the thyroid-specific genes,TSH Receptor, thytoglobulin and also many immune-regulatory genes.

    We will talk about these two Diseases and Explain How does Gluten Affects on the onset development of them.

    Hashimoto‘s disease and Gluten

    Hashimoto‘s disease affects more than 14 million individuals in United states and is preponderant in Females.

    The Connection between HT disease and gluten is a mistaken identity, But How ?

    The problem here lies in the close symmetry between the molecular structure of gliadin which is the protein portion of gluten and that of the thyroid gland.

    When glaidin enters the bloodstream after breaching the protective barrier of the gut, the immune system gets ready to destroy it in addition to these produced antibodies to gliadin make the body attack thyroid tissue, This explains why if you have AITD your immune system will attack your thyroid after eating Gluten containing Food.

    But the problematic issue here is that the immune system can respond to gluten for a long period of time may last up to 6 months each time you eat gluten, this is why make it a must to eliminate gluten entirely from your diet if you have AITD.

    And being not 100% gluten-free isn‘t going to cut it. So, if you are intolerant to gluten you have to eat 100% gluten-free food to prevent immune destruction of your thyroid gland.

    Thyroid replacement therapy has long been the major and the only medical treatment of Hashimoto‘s disease; however, Research published recently supports the vital role of nutritional approaches.

    This case report shows that How a 34-old-year-female with HT disease has successfully managed for only 5 months without thyroid replacement therapy through following a specific type of free-Gluten Diet.

    The patient was told and advised to go on a specific type of diet rich in phytonutrients like berries, avoid sensitive foods like: gluten and soy; and consume quality fats, filtered water and fermented food, Nutritional supplementations were used also.

    As it is Known that Hashimoto‘s disease is often accompanied by celiac disease

    Celiac disease and Hashimoto‘s disease

    Celiac disease is a small inflammatory disease in the intestine with autoimmune features that is triggered and maintained by the ingestion of the storage proteins like : Gluten of wheat, barley, and rye

    Untill now , the only known effective and Fruitful treatment for celiac disease is a strict gluten-free diet for life. We reviewed the literature to evaluate the maximal limit for gluten content in food, which would be safe for patients with celiac disease. Patients with CD should limit their daily gluten intake to no more than 10-50 mg. Most health entities define gluten-free products as containing less than 20 parts per million gluten.

    Sharing a common genetic background can largely explain the close relationship between celiac disease and glandular autoimmunity .Further, between 10-30% of patients with celiac disease are thyroid and/or type1 diabetes antibody positive, and about 5-7% of patients with autoimmune thyroid disease, type 1 diabetes, and/or polyglandular autoimmunity are IgA anti tissue transglutaminase antibody positive.

    However, Gluten can‘t reverse glandular autoimmunity, its early institution may delay or even prevent its first manifestations.

    In other words, Celiac disease patients have an increased risk of thyroid autoimmune disorders when compared to non-celiac controls on normal gluten-containing diet.

    While gluten ingestion is responsible for the signs and symptoms of celiac disease, it is unknown what factors are associated with initial onset of the disease. So, In a study conducted recently aimed to examine whether the timing of gluten exposure in infants was associated with the development of celiac disease autoimmunity (CDA).

    Study conducted on 1560 children from 1994-2004 at considerably increased risk for celiac disease or type 1 diabetes, The mean follow-up was 4.8 years.

    51 children developed Celiac Disease Autoimmunity (CDA). Results and Findings showed that children exposed to foods containing barley, wheat, or rye (gluten-containing foods) in the first 3 months of life had a 5-fold increased risk of Celiac Disease Autoimmunity compared with children exposed to gluten-containing foods at 4 to 6 months.

    Children not exposed to gluten until the 7th month or later had a marginally increased risk of CDA in comparison with those who exposed at 4 to 6 months.

    Another Strong Evidence shows that Gluten is a very strong contributor in the onset of Hashimoto‘s disease.

    In a recently published research about How Gluten-Free-Diet affects positively on Hashimoto‘s disease.

    The objective of that study was to investigate whether a diet free from gluten affects thyroid autoimmunity, hypothalamic-pituitary-thyroid axis activity and thyroid function tests in females with HT disease.

    The study was conducted on 34 women with autoimmune thyroiditis, they divided into 2 groups:

    Group A and Group B, n:16,18 in each group respectively. The patients belonging to the first one compiled with the gluten-free diet for 6 months, while the group B patients remained without any dietary treatment.

    The findings of that study after completing the study protocol by all patients was :

    In group B which not treated by any dietary treatments, serum thyrotropin and free thyroid hormones levels, serum 25-hydroxyvitamin D levels and the calculated indices remain at the similar levels as well.

    The thyroid antibody titers reduced in gluten-free-diet, as well as slightly increased 25-hydroxyvitamin D levels.

    The conclusion of that study suggests that the gluten-free-diet may have clinical benefits to women with autoimmune thyroid disease.

    Graves‘ disease and Gluten

    Graves-Basedow disease (GD) is one the main autoimmune thyroid diseases that affect in pediatric age. GD is characterized by the production of anti-thyroid antibodies, by an infiltration of autoreactive B and T lymphocytes into the thyroid parenchyma and by alterations in thyroid function (hyperthyroidism in Graves‘ disease, normal function or subclinical hypothyroidism in Hashimoto‘s disease with possible evolution towards manifest hypothyroidism).

    According to a study published recently

    The correlation between autoimmune thyroid disorders (AITD) and celiac disease (CD) is well known, however, most of the literature concentrates on hypothyroidism and celiac disease.

    a case of a 37-year-old woman with Graves' disease (GD) with thyrotoxicosis that was not responsive to medical management. The screening for celiac autoimmunity (CA) was positive. After initiation of a gluten-free diet the patient's thyrotoxicosis responded to medical management. She was given radioiodine therapy and is currently hypothyroid on a stable dose of thyroxine.

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