What about TSH and Anti-Thyroid Antibodies in Patients with Autoimmune Thyroiditis and Celiac Disease Using a Gluten-Free Diet? A Systematic Review

Abstract

The prevalence of celiac disease (CD) in patients with chronic autoimmune thyroiditis (CAIT) is estimated to be between 2 and 7.8%. A gluten-free diet (GFD) in patients with CD is suggested to have a beneficial effect on CAIT. Thus, the present systematic review was undertaken to achieve more robust evidence about the change in thyroid stimulating hormone (TSH) and thyroid-specific antibodies (T-Ab) levels obtained in CD patients following a GFD. A specific search strategy was planned. The last search was performed on March 2022. The following data were mainly searched for in order to be extracted: sample size, mean and/or median with standard deviation (SD), and error (SE), individually, of thyroid hormones and T-Ab at baseline and after GFD, and the duration of the study. The initial search retrieved 297 records and 6 articles met the inclusion criteria. In total, 50 patients with both CD and CAIT and 45 controls were reported. The effects of a GFD on the thyroid hormonal and immunological profile could be extracted only in a part of the studies. Two studies were case reports. A low risk of bias was observed. These findings advise further studies, ideally randomized, in order to better investigate the potential relationship between GFD and thyroid homeostasis. The level of evidence is not still sufficient to recommend GFD to patients with CAIT.

The Influence of Nutritional Intervention in the Treatment of Hashimoto’s Thyroiditis—A Systematic Review

“…Such symptoms often accompany Hashimoto’s disease [ 46 ]. According to a systematic review of a gluten-free diet on parameters in the course of Hashimoto’s thyroiditis, among the six included studies, no significant change in TSH was noted at any time [ 47 ]. In the case of anti-TPO and anti-TG, Krysiak et al [ 36 ] observed a lowering of the antibody level and, in study by Valentino [ 48 ], one patient had a significantly reduced anti-TPO after 18 months ( p < 0.001).…”

The relationship between thyroid and human-associated microbiota: A systematic review of reviews

“…A beneficial effect of gluten free diet has been proposed in patients with Hashimoto’s thyroiditis [ 115 ]: the rationale of this proposal came from the partially shared genetic background of these two autoimmune disorders and the frequent co-presence in the same subject. However, the combined results of the trials published on this topic does not justify the use of this elimination diet in patients with Hashimoto’s thyroiditis [ 116 ]. Furthermore, this diet, frequently characterized by low complex carbohydrate and fiber as well as a high saturated fatty acids and sugar intakes, is often accompanied by deficiencies in iron, calcium, magnesium, vitamin D, E and some of group B [ 117 ].…”

Gluten and Wheat in Women’s Health: Beyond the Gut

“…Indeed, as stated by the “leaky gut” theory [ 9 ], the increase in intestinal permeability, possibly triggered by gluten ingestion, leads to autoimmunity in predisposed patients. Chronic autoimmune thyroiditis (CAT) has a higher prevalence in females, and the coexistence of CD and CAT ranges between 2–7.8% [ 70 ]. Nevertheless, the general assessment of a link between the direct effect of gluten exposure and the development of autoimmune disorders is far from granted [ 71 ].…”