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Celiac Disease and the Thyroid Gland

If you have Celiac Disease, it is important that you know a bit about your thyroid gland, as you are at a high risk of autoimmune thyroid disease. Experts estimate that between 8 and 12% of people with Celiac Disease have, or will eventually develop, problems with their thyroid gland. Conversely, between 3 and 5% of people with autoimmune thyroid disease will develop Celiac Disease. I was diagnosed with Hashimoto’s Disease (hypothyroidism) in 2003, seven years before my Celiac diagnosis.

The thyroid gland is a butterfly-shaped gland that is present in the neck region, just under the region of the “Adam’s apple,” which is made up of two lobes (see diagram).

Illu_thyroid_parathyroid

Our thyroid glands secrete hormones that regulate metabolism, play a role in the growth and development of our bones and muscles, and impact brain and heart function. Thyroid gland dysfunction can lead to a rapid decline in health. Prior to my diagnosis with Hashimoto’s Disease, I had a 4 to 6 month history of overwhelming fatigue, dry skin, puffiness around my eyes, hair thinning, mental sluggishness, and feeling cold all of the time. I was about to scan and put in a photo of myself in the weeks leading up to my diagnosis, but I look so atrocious that I did not want to scare any of you. It is available upon request!

In Hashimoto’s Disease, the body makes auto-antibodies which lead to thyroid inflammation and destruction, which in turn causes the the thyroid to be under-active (also called hypothyroidism). Hashimoto’s is the most common autoimmune thyroid disease that is associated with Celiac Disease. Common symptoms associated with hypothyroidism include lethargy, depression, muscle cramps, constipation, dry skin, cold intolerance, and/or weight gain. The treatment for hypothyroidism is to take synthetic thyroid hormone, which is called levothyroxine. The brand name for levothyroxine is Synthyroid.

If you are started on levothyroxine, it is important to have your thyroid hormone levels checked frequently, so that your dose can be adjusted as needed. Pregnancy, the postpartum period, lactation, menopause, and other events associated with hormonal changes can also effect the thyroid gland, so it is important to have your thyroid hormone levels monitored closely during these times.

Once I went gluten free, my levothyroxine dose decreased from 150 mcg/day to 125 mcg/day. From the reading that I have done, this is not unusual, and many Celiacs experience a need for less thyroid hormone once off of gluten. However, it is very unusual for hypothyroidism to ever totally resolve. This means that if you are diagnosed with Hashimoto’s Disease, you should anticipate being on thyroid hormone replacement therapy for the rest of your life.

A few other things which I have learned about levothyroxine: 1. Make sure to take it on an empty stomach (I take mine first thing in the morning, about 30 to 45 minutes before breakfast), 2. To take separately from vitamin and mineral supplements, as some can interfere with its absorption, and 3. Make sure that the levothyroxine which you are taking is gluten free.  I have been taking generic levothyroxine manufactured by Lannett since October 2012 without any issues. www.glutenfreedrugs.com is a great resource to check out the GF status of drugs and supplements.

Grave’s Disease is the most common cause of hyperthyroidism, or overactive thyroid. In this disease, auto-antibodies stimulate the thyroid gland to produce an excess of hormones. Hyperthyroid symptoms are the opposite of those seen in Hashimoto’s Disease and include weight loss, elevated body temperature, irritability, tremors, heart palpitations, and insomnia. Treatment options for Grave’s Disease include antithyroid medications, radioactive iodine, and surgery. For more on Grave’s Disease, please see the following link (taken from the womenshealth.gov website).

The main test used to screen for thyroid problems and monitor thyroid function is called a TSH (short for thyroid stimulating hormone). In hypothyroidism, the TSH is too high, and in hyperthyroidism, the TSH is too low. In most cases test results should be available within 24 hours of having blood drawn. T4 and T3 levels are also monitored closely during diagnosis and treatment.

My hypothyroid symptoms improved dramatically within one week of starting on Synthroid after my diagnosis with Hashimoto’s Disease. I urge you to have your TSH checked if you or a loved one are experiencing any unusual symptoms which may be due to thyroid dysfunction.

The bottom line is that if you have Celiac Disease, you need to have your thyroid function monitored, and if you have autoimmune thyroid disease, you should strongly consider being screened for Celiac Disease, especially if any concerning symptoms develop.

For more information, please check out the following links:

1. Celiac Disease and Autoimmune Thyroid Disease. Ch’ng, C., et al. Clin Med Res. 2007; 5(3): 184-192.

2. “Celiac Disease, Thyroid Disease Often Found Together. Two Autoimmune Disorders Could Share Common Trigger.” By Jane Anderson, About.com Guide; updated January 19, 2012.

3. “Celiac and the Thyroid.” NFCA website: www.celiaccentral.org. Accessed 04/23/2013.

4. Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study. Sategna-Guidetti C, Volta U, Ciacci C, Usai P, Carlino A, De Franceschi L, Camera A, Pelli A, Brossa C. Am J Gastroenterol. 2001 Mar;96(3):751-7. See link.

6 thoughts on “Celiac Disease and the Thyroid Gland

  1. Mary Bradigan

    Good heads up on the connection between thyroid disease and Celiac Disease. A few important things to keep in mind: many thyroid patients do not have celiac but are gluten sensitive, which will make the thyroid disease near impossible to treat until you are gluten free; many thyroid patients do not do well with standard synthetic thyroid hormone-if you still don’t feel well and your doctor says you are fine-look for a doctor that will try another form of medication; autoimmune disease is complicated and may take a multidisciplinary approach in order to feel well. Thanks for your work!!

    1. Jess Post author

      Hi Mary,
      Thank you so much for reading and for all of your advice for other readers. In terms of alternatives to synthetic thyroid hormone, are you alluding to porcine based hormones, such as Armour, or other therapies?
      Thank you also for bringing up the link between non celiac gluten sensitivity (NCGS) and thyroid disease. It is frustrating that there have not been any large scale studies looking at the incidence of autoimmune diseases in those with gluten sensitivity, but I guess that it is partially due to the fact that NCGS is such a “new” diagnosis. I am optimistic that, with time, there will be increased awareness of NCGS (and that necessary screening for other autoimmune diseases will be performed in those with gluten sensitivity).
      Jess

  2. Curt Kittelson

    I have NCGS and have been GF for 17 months (also dairy free, soy free). I appreciate the blog post and the response by Mary. My prostate was removed in June 2011, margins came back not good. Have declined radiation and instead have made numerous lifestyle changes, diet being a major one. Every 6 months my PSA is checked and undetectable has been the word. Over the past few blood tests though, my thyroid numbers have been a little high. First one, lets wait and see. Second one, we need to watch this. This last one, I was told, time to see someone. I have put it off until the next “PSA test cycle” comes around to give me time to research, learn and understand. I thought it would be easy. Not so much. I am pleased I found your site.

    1. Jess Post author

      Hi Curt,
      It is great to hear that your PSA is undetectable.
      Until my Celiac diagnosis in 2010, I did not appreciate the impact of nutrition on my health. I wish that I knew 10 years ago what I now know. It is inspiring that you are doing your own research into how to manage your health. Please keep me updated and feel free to ask questions (I am learning new info about being gluten free every day!) Also, I am soy free too and very, very dairy light these days…
      Jess

  3. Marnie T

    Hi,

    Thank you for your great website.

    I am curious about what you think concerning my TSH lab values. The same lab in which the following tests were done accepted the normal TSH values as .5 to 5.

    In 2006, my TSH was 1.35. On April 20, 2011, it was 1.85. The last time it was tested on January 27, 2012, it was 3.58. Is it normal for the values to go up this much in a less than ninth month period? Since then, I have gained 15 pounds and have not changed my diet or exercise program.

    Thank you,

    Marnie

    1. Jess Post author

      Hi Marnie,
      It is nice to hear from you.
      I am in a tricky situation on this page, as I am unable to give out true medical advice.
      I have been on levothyroxine since I was 26 and have had my TSH checked at least every 12 months since then.
      My TSH has fluctuated between about 0.5 to 4 at various times, which I’ve often attributed to pregnancy and hormones. Have you had it checked more recently than 2012?
      I personally know that once I go above 2.5 that I start to feel hypothyroid, so I work with my doctors and aim to have it between 1 and 2.
      I am sorry that I cannot give you a better answer.
      Jess

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