The Effect of Gluten-Free Diet on Thyroid Autoimmunity in Drug-Naïve Women with Hashimoto’s Thyroiditis: A Pilot Study

Krysiak, Robert; Szkróbka, Witold; Okopień, Bogusław

doi:10.1055/a-0653-7108

Cited by 68 publications

(79 citation statements)

References 30 publications

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“…A group of HT patients with positive transglutaminase antibodies and no symptoms of celiac disease were divided, receiving gluten-free vs. gluten-containing diets. The former group, but not the second one, experienced a reduction in antibody titers and an increase in VitD levels [116]. However, the possibility of VitD deficiency being exclusively a consequence of AID seems unlikely, given that this relationship has been found in several studies, independently of factors such as age, body mass index, thyroid function tests (i.e., presence of hyper-, hypo-, or euthyroidism) and the presence or absence of other AIDs.…”

Section: What Is the Nature Of The Relationship Between Vitamin D Levmentioning

confidence: 82%

Vitamin D and Autoimmune Thyroid Disease—Cause, Consequence, or a Vicious Cycle?

Vieira¹,

Rodrigues

Paiva³

2020

Nutrients

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Vitamin D is a steroid hormone traditionally connected to phosphocalcium metabolism. The discovery of pleiotropic expression of its receptor and of the enzymes involved in its metabolism has led to the exploration of the other roles of this vitamin. The influence of vitamin D on autoimmune disease—namely, on autoimmune thyroid disease—has been widely studied. Most of the existing data support a relationship between vitamin D deficiency and a greater tendency for development and/or higher titers of antibodies linked to Hashimoto’s thyroiditis, Graves’ disease, and/or postpartum thyroiditis. However, there have also been some reports contradicting such relationships, thus making it difficult to establish a unanimous conclusion. Even if the existence of an association between vitamin D and autoimmune thyroid disease is assumed, it is still unclear whether it reflects a pathological mechanism, a causal relationship, or a consequence of the autoimmune process. The relationship between vitamin D’s polymorphisms and this group of diseases has also been the subject of study, often with divergent results. This text presents a review of the recent literature on the relationship between vitamin D and autoimmune thyroid disease, providing an analysis of the likely involved mechanisms. Our thesis is that, due to its immunoregulatory role, vitamin D plays a minor role in conjunction with myriad other factors. In some cases, a vicious cycle is generated, thus contributing to the deficiency and aggravating the autoimmune process.

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Section: What Is the Nature Of The Relationship Between Vitamin D Levmentioning

confidence: 82%

Vitamin D and Autoimmune Thyroid Disease—Cause, Consequence, or a Vicious Cycle?

Vieira¹,

Rodrigues

Paiva³

2020

Nutrients

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“…As dietary habits may play a role in HT disease development [13][14][15] , we performed a set of analyses to detect food groups that: (a) differ between HT patients and controls and (b) may be associated with clinical aspects of HT. We found animal fat, processed meat and nuts, as more frequently consumed food groups in HT patients than in controls.…”

Section: Discussionmentioning

confidence: 99%

Differences in food consumption between patients with Hashimoto’s thyroiditis and healthy individuals

Kaličanin

Brčić

Ljubetić

et al. 2020

Sci Rep

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Food is considered as important environmental factor that plays a role in development of Hashimoto's thyroiditis (HT). The goal of our study was to identify food groups, assessed by food frequency questionnaire, that differ in consumption frequency between 491 patients with HT and 433 controls. We also analysed association of food groups with the wealth of HT-related clinical traits and symptoms. We found significantly increased consumption of animal fat (OR 1.55, p < 0.0001) and processed meat (OR 1.16, p = 0.0012) in HT cases, whereas controls consumed significantly more frequently red meat (OR 0.80, p < 0.0001), non-alcoholic beverages (OR 0.82, p < 0.0001), whole grains (OR 0.82, p < 0.0001) and plant oil (OR 0.87, p < 0.0001). We also observed association of plant oil consumption with increased triiodothyronine levels in HT patients (β = 0.07, p < 0.0001), and, association of olive oil consumption with decreased systolic blood pressure (β = − 0.16, p = 0.001) in HT patients on levothyroxine (LT4) therapy. Analysis of food consumption between HT patients with and without LT4 therapy suggest that patients do not tend to modify their diet upon HT diagnosis in our population. Our study may be of relevance to nutritionists, nutritional therapists and clinicians involved in developing dietary recommendations for HT patients. Environmental factors, in addition to genetic factors, play important role in Hashimoto's thyroiditis (HT) development 1. HT is a chronic autoimmune thyroid disorder (AITD) characterized by the production of thyroid autoantibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) 2. Other main characteristics of HT include infiltration of lymphocytes and ruination of thyroid tissue, which usually leads to hypothyroidism 3. This disease predominantly affects female population and is considered as one of the most frequent endocrine disorders 4. The estimated incidence of HT is 350/100,000 for females and 80/100,000 per year for males 5. It is most often diagnosed in women between the age of 30 and 60 6. High iodine intake (median urinary iodine concentration ≥ 300 μg/L) 7 , especially in areas with sufficient iodine supply, is one of the most known factors that increase the incidence of HT 8. Also, low vitamin D levels (below 30 ng/mL) 9 and low selenium intake (bellow 40 µg/day) 10 are proposed to be risk factors for HT development, albeit a role of these factors in HT still needs to be confirmed. Conversely, alcohol intake was proposed to decrease the risk for HT 11. Other dietary factors are also considered as potential environmental modifiers of the clinical appearance of HT 12-15. A diet low in gluten has been recently proposed to have beneficial effects on the disease course in a study of 34 women with HT 13. Another study of 83 patients with HT indicated that restriction of lactose intake in lactose-intolerant HT patients resulted with decreased thyroid-stimulating hormone (TSH) levels 14. However, the current knowledge of this topic is scarce and only the following two studies ...

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“…In the previous year, Polish scientists published results of a study [1] in which participated 34 women aged 20-45, with newly-diagnosed Hashimoto's thyroiditis and the presence of anti-tissue transglutaminase antibodies without clinical symptoms of coeliac disease. The subjects had not previously adopted a gluten-free diet.…”

Section: Elimination Of Glutenmentioning

confidence: 99%

“…Hashimoto (HT) disease is one of the most frequently occurring autoimmune diseases, characterized by lymphocytic infiltration, destruction and scarring of thyroid tissue and the presence of antibodies to thyroid peroxidase and thyroglobulin [1]. The name "Hashimoto's disease" comes from the name of the Japanese surgeon Dr. Hakaru Hashimoto, who in 1912 described four cases of this disease.…”

Section: Introductionmentioning

confidence: 99%

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The importance of nutritional factors and dietary management of Hashimoto’s thyroiditis

Ihnatowicz¹,

Drywień²,

Wątor³

et al. 2020

Ann Agric Environ Med.

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Hashimoto (HT) is an autoimmune disease in which destruction of the thyroid occurs as a result of lymphocyte infiltration. It is caused by an increased level of titers of antibody against thyroid peroxidase (TPO) and thyroglobulin (TG). Because of that,in HT patients, changes are observed in the level and metabolism of thyroid hormones, which leads to unspecified physical and psychological symptoms. A high level of antibodies attacking thyroid antigens has been positively correlated with the symptoms. From the etiological point of view, the most important are genetic factors; however, environmental factors are necessary to provoke the immune system to attack until the process is over. Scientists indicate specified stress, toxification, microbiota dysbiosis and under-or over-nutrition, to name only a few. Dietotherapy of Hashimoto's is based on the proper nourishment of the body and regulation of the immune system by an anti-inflammatory diet. Observational and controlled trials have shown frequent nutrition deficiencies in HT patients. In literature, there is evidence for selenium, potassium, iodine, copper, magnesium, zinc, iron, vitamin A, C, D and B. The role of the proper level of protein intake, dietary fibre and unsaturated fatty acids, especially the n-3 family, has been indicated. HT patients should often eliminate lactose because of intolerance and interactions with levothyroxine and gluten because of possible interactions of gliadin with thyroid antigens. The article describes the nutrition factors of HT patients, and share nutrition recommendations for diet therapy.

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The Effect of Gluten-Free Diet on Thyroid Autoimmunity in Drug-Naïve Women with Hashimoto’s Thyroiditis: A Pilot Study

Abstract: The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease.

Cited by 68 publications

References 30 publications

Vitamin D and Autoimmune Thyroid Disease—Cause, Consequence, or a Vicious Cycle?

Vitamin D and Autoimmune Thyroid Disease—Cause, Consequence, or a Vicious Cycle?

Differences in food consumption between patients with Hashimoto’s thyroiditis and healthy individuals

The importance of nutritional factors and dietary management of Hashimoto’s thyroiditis

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