Should Hashimoto’s Thyroid Patients Avoid Gluten?

Hashimoto's thyroiditis is an autoimmune disease in which your body's immune system attacks your thyroid. Avoiding gluten isn't currently a recommendation for people with Hashimoto's, but if you wish to avoid gluten to see if it improves your thyroid disease symptoms, there's probably no harm in doing so.

If you have a diagnosis of Hashimoto’s disease, you might have heard of the link between Hashimoto’s and gluten. There are many misunderstandings about gluten — especially when it comes to the conflicting information about gluten and human health.

Should people with Hashimoto’s avoid gluten? Learn more about the link between thyroid disorders and diet in the following guide.

Hashimoto’s thyroiditis is an autoimmune disease in which your body’s immune system attacks your thyroid — a gland located in your neck that controls many aspects of your metabolism, energy, and mood. Over time, your immune system will destroy your thyroid’s ability to produce enough of the thyroid hormones needed to sustain specific bodily functions. 

You’re at risk for developing Hashimoto’s if you’re female or middle-aged or if you have preexisting autoimmune conditions. Anybody can develop this disease, though. If you have symptoms, it’s a good idea to ask your doctor for a blood test that can easily detect whether or not there’s something wrong with your thyroid.

Hashimoto’s progresses over time, and it's possible to continue to experience uncomfortable symptoms despite taking synthetic thyroid hormone medication. Many people notice flare-ups of their disease when they are very stressed, sick, or not getting adequate nutrition. Some people change their diet as they try to make their immune systems more stable. Usually, Hashimoto's causes the following symptoms of hypothyroidism:

• Weight gain
• Fatigue that isn’t explained by overactivity or lack of sleep
• Feeling cold all the time (or much colder than others around you)
• Depression
• Body aches in your muscles and joints
• A puffy-looking face
• Swelling at the base of your neck where your thyroid is

You might also notice strange symptoms that seem like the opposite of your typical symptoms. During flare-ups of Hashimoto’s, your thyroid might respond to the immune system attack by producing more thyroid hormone. This overload of thyroid hormones can result in the following symptoms:

• Feeling too hot or sweating
• A fast heartbeat
• Weight loss 
• Panic or anxiety
• Swelling around your eyes

Hashimoto’s progresses over time. Many people believe that eating a healthy diet will slow the activity of this disease. While there isn’t much research to indicate that people with Hashimoto’s should avoid specific foods, there are a few connections between this thyroid condition and gluten.

The autoimmune connection

Many people with thyroid disease also have celiac disease, which is an autoimmune reaction triggered by gluten (a protein in wheat). It’s common to have more than one autoimmune condition. Celiac disease and Hashimoto’s frequently occur together: In fact, 26% of patients with celiac disease also have an autoimmune thyroid condition. 

Though there isn't yet research to back this idea, some people think that Hashimoto’s patients might experience flare-ups after eating gluten because of the close relationship between thyroid disorders and celiac disease. These people avoid gluten in hopes of alleviating thyroid and slowing down the progression of Hashimoto’s.

The inflammation connection

A quick internet search will reveal that many people — whether they're in the health care field or not — believe that gluten is “inflammatory.” This is true if you have celiac disease. In fact, avoiding gluten is the only treatment that alleviates symptoms for celiac patients. 

But there currently isn’t any conclusive research indicating that gluten causes inflammation in thyroid patients. Experts recommend a plant-based or anti-inflammatory diet that focuses on fruits and vegetables, whole grains, and fish to decrease the effects of autoimmune inflammation.

Avoiding gluten isn’t currently a recommendation for people with Hashimoto’s. But if you wish to avoid gluten to see if it improves your thyroid disease symptoms, there’s probably no harm in doing so. Be cautious about the following points before you start your gluten-free diet.

Get tested for celiac disease before cutting out gluten

Hashimoto’s and celiac frequently occur together. If you have celiac disease, it might be overlooked in the Hashimoto’s diagnostic process. Your doctor might attribute all of your symptoms to thyroid disease. In short, if you’re a Hashimoto’s patient who feels better when you don’t eat gluten, you could be treating a hidden case of celiac disease.

People avoid gluten for many reasons. Some have celiac disease or a wheat allergy — which is a different condition than celiac disease — while others simply don’t feel well when they eat wheat. If you suspect a gluten intolerance or you wish to cut gluten out of your diet, it’s important to first determine whether or not you have celiac disease. The blood test for celiac disease is not accurate if you’ve already stopped eating gluten. For accurate results, there needs to be enough gluten in your diet for your immune system to produce antibodies to it. 

Make sure you meet your nutritional needs with a gluten-free diet

Gluten itself does not provide nutrition, and there’s no harm in removing it from your diet. But there’s a good chance that many of your daily nutrients — like fiber, B vitamins, magnesium, and iron — come from the wheat in your diet. It won’t hurt you to cut out wheat if you replace these nutrients with other sources to make sure that you don’t develop a deficiency on the gluten-free diet.

If you've tested negative for celiac disease and you wish to continue eating gluten, research indicates that this is probably fine. A 2022 review of relevant literature concluded that there isn’t enough evidence to prescribe a gluten-free diet for Hashimoto’s patients. The exception to this rule is that if a Hashimoto’s patient also has celiac disease, they should adopt a lifelong gluten-free diet.

Remember to ask your doctor about getting tested for celiac disease if you are unsure about whether or not you have this autoimmune condition in addition to Hashimoto’s. In the meantime, the current science indicates that there’s no need for you to avoid gluten as a Hashimoto’s-only patient. If you do wish to avoid gluten, make sure you adopt a healthy eating pattern that features healthy sources of nutrients you might otherwise miss.