Hashimoto’s and Celiac Disease are both autoimmune diseases. Hashimoto’s causes an attack on the thyroid and celiac disease causes damage to the gut.
Hashimoto’s and Celiac Disease can commonly occur in the same individual. This is because when you have one autoimmune disease you can be at higher risk for developing another. Diet can be used to treat or support both conditions and a dietitian specialized in both can be helpful as you navigate them.
Below, we’ll discuss more about the relationship between the two conditions and what you can do about them.
Before we get into the relationship between celiac and hashimoto’s, we need to understand what celiac disease is.
Celiac is a serious autoimmune disease that occurs in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine. When people with celiac disease eat gluten (a protein found in wheat, rye, barley, and contaminated foods like oats), their body mounts an immune response that attacks the small intestine.
These attacks lead to damage to the villi, small fingerlike projections that line the small intestine, that promote nutrient absorption. When the villi get damaged, nutrients cannot be absorbed properly into the body.
This inflammatory response to gluten and related nutrient deficiencies can cause a wide variety of symptoms in people with celiac. From bloating, headaches, constipation, joint pain, bone health complications, infertility, weight gain, weight loss, and more.
This can start at any age, and occur in any body, as long as someone is eating gluten and has the celiac genes. If left untreated, celiac disease can lead to additional serious health problems.
Additionally, before we start hashing out the connection between celiac and Hashimoto’s, we need to know what Hashimoto’s is too.
Hashimoto’s is an autoimmune condition in which the body attacks the hormone-producing cells of the thyroid. This leads to hypothyroid, a condition in which the thyroid is underperforming. Hashimoto’s also causes the accumulation of white blood cells in the thyroid gland, damaging the thyroid.
Hashimoto thyroiditis affects 1 to 2 percent of people in the United States. The condition is the most common cause of thyroid underactivity (hypothyroidism) in the United States.
When we look at the relationship between Hashimoto’s and celiac disease, one of the biggest connections is the overlapping symptoms of each condition. Hashimoto’s can cause symptoms like:
As you can see, often, many symptoms associated with celiac can be associated with Hashimoto’s making difficult to know if someone has Hashimoto’s and celiac or just one or the other. More on that in a minute.
Now that we know more about Hashimoto’s and celiac disease, we can discuss the connection between the two. When you have one autoimmune condition, you are at risk for developing other autoimmune conditions because your body is primed for attack. This includes the risk of developing Hashimoto’s on top of celiac (or vice versa).
It’s important that you have a doctor who’s able to properly diagnose both conditions as there are many factors that can complicate it. Most people with celiac disease have elevated tTG IgA antibodies in their blood. This is the immune response people measure that’s associated with celiac. However, on some occasions, tTG IgA antibodies have also been recorded in people with autoimmune thyroid disease. So the same antibodies that attack the gut can also attack the thyroid.
If you’re not feeling better but celiac follow-up testing is improving, be sure that doctors are monitoring for other autoimmune diseases with celiac that match your symptoms as well. In the case of Hashimoto’s, you’d be looking for the symptoms that overlap to see if screening for Hashimoto’s is in order.
Of course, if you have any questions or concerns about your healthcare, treatment, and monitoring, talk to your doctor. This post, nor any other resource I provide is meant to substitute 1:1 care and attention from your doctor who is most aware of your unique circumstances and case.
Symptoms that Hashimoto’s and celiac disease can have in common include:
If you’re staying gluten-free and your follow-up testing has normalized, but you’re still struggling with these other symptoms, it might be time to explore other causes with your doctor in addition to celiac. Causes like perhaps a thyroid condition such as Hashimoto’s disease.
Should you suspect that you have both Hashimoto’s and celiac disease, you’ll want to talk to your doctor about being screened and tested for Hashimoto’s. Generally, screening and testing for Hashimoto’s includes a thyroid panel.
The thyroid panel is a blood test that measures TSH, Free T3, and Free T4 which indicate thyroid hormone levels. Hashimoto’s would make these levels low. The doctor would also test thyroid antibodies through a TPO test to see if your thyroid is under autoimmune attack.
Once the results come back you will want to sit down with your doctor to see how to proceed from there.
Following a gluten-free diet can ease symptoms of Hashimoto’s and Celiac disease if you have been diagnosed with both conditions. This may be because if you calm down the body’s celiac autoimmune reaction you may be decreasing the overall autoimmune reaction.
Improving the celiac by healing the gut may help Hashimoto’s because it will enable you to absorb more nutrients. These nutrients, particularly iodine and selenium, are needed for the thyroid to function well.
Some medications may be used for Hashimotos, one of which is Levothyroxine. However, some brands of Levothyroxine can contain gluten. Your doctor will discuss with you what they would recommend for your treatment and your pharmacist will help you ensure your medications are gluten-free.
If you’re not sure how to check prescribed medications for gluten, and your pharmacist is unsure too, this is something I cover in the Celiac Crash Course. A self-paced course that teaches you how to make avoiding gluten and cross-contact feel routine. In this course, not only do I teach you how to check medications for gluten, but I give you a handout to give to your pharmacist to help them check too. Check it out here.
Diet is also a component of support for these diseases. Eating a balanced gluten-free diet with a variety of fruits, vegetables, gluten-free whole grains, and fiber can help. Enjoying a balance of macronutrients (carbs, fat, and protein) can help too. I walk you through a very simple method of doing this in my Celiac Nutrition Course, including nutrients to keep your eye on for celiac. Check out the course here.
Iodine is a necessary nutrient to make thyroid hormones. It is rare, but if you’re not getting enough in your diet then you can eat seaweed and iodized salt. In some cases, a diet with a lot of iodine could worsen dermatitis herpetiformis (DH) with celiac. So discuss with your healthcare team if this is something you need to pay attention to.
There is varying research to support other diet modifications like avoiding lactose, dairy, following certain elimination diets, etc., however, I would be sure to discuss these modifications with a dietitian to make sure they are right for you. Balancing a gluten-free diet for all the nutrients you need can be hard, the more restrictions you add, the harder it can get so making sure you actually need to avoid other foods is essential. A 1:1 session with a dietitian who is very familiar with both conditions can help.
Hashimoto’s and Celiac Disease share some commonalities including symptoms and antibodies. Sadly, if you have one you are at greater risk for the other. Fortunately, there are treatments for both.
It is important to note that not everyone with celiac disease will develop Hashimoto’s thyroiditis, and vice versa. However, if you have been diagnosed with one autoimmune disorder, it is important to be aware of the potential for developing others and to discuss any concerns with your healthcare provider.