Whether a Gluten-Free Diet Should Be Recommended in Chronic Autoimmune Thyroiditis or Not?—A 12-Month Follow-Up

Abstract

Elimination diets have recently become extremely popular among people with autoimmune diseases. A gluten-free diet is indicated in celiac disease (CD), but some studies show its effectiveness in cases of autoimmunity. The aim of this study was to assess whether the use of a gluten-free diet is also effective in patients with chronic autoimmune thyroid disease (cAITD), which is the most common thyroid autoimmune pathology associated with chronic inflammation, over-reactivity of the immune system, auto-destruction of thyrocytes and hypothyroidism. The final analysis of the study included 62 Caucasian women randomized into a control group (CG: n = 31) and an experimental group on a gluten-free diet (GFDG: n = 31), were subject to a 12-month follow-up, during which the concentrations of thyrotropin (TSH), free triiodothyronine (fT3), free thyroxine (fT4), anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies were assessed at baseline and after 3, 6 and 12 months. During the 12-month follow-up between the CG and the GFDG, no differences were found in anti-TPO and anti-TG antibodies, fT3 or fT4 levels, except a significant reduction in TSH levels in the GFDG. Additionally, performed analysis between individual appointments presented no significant differences in changes in the median concentrations of anti-TPO, anti-TG or fT3, but confirmed a significant decrease in TSH and showed accessory an increase in fT4 after 12 months in GFDG. Statistical analyses performed separately for both groups indicated a constant reduction of anti-TG concentrations in the GFDG. In conclusion, a GFD may be administered in cAITD after ruling out celiac disease, but it is necessary to perform more studies to assess if cAITD patients achieve the benefits of following a GFD. Patients with cAITD should be offered proper nutrition education combined with a healthy lifestyle promotion.

Metabolic Characteristics of Hashimoto’s Thyroiditis Patients and the Role of Microelements and Diet in the Disease Management—An Overview

“…The control group’s diet contained gluten, and the study group was on a gluten-free diet for 12 months. During follow-up, there was a significant reduction in TSH levels in the study group [ 151 ]. Only a few studies suggest that gluten elimination may be helpful for some HT patients.…”

Does a gluten-free diet affect the course of Hashimoto's disease? - the review of the literature

“…In contrast, antithyroid antibody levels did not improve. [1] Due to the presence of randomization, the larger group of subjects, the longer duration of the study, and the verification that the patients do not have coexisting celiac disease, it can be concluded that the 2021 study appears to be the most authoritative.…”

“…This is also important for the absorption of levothyroxine in the gut. [1] However, it is important to keep in mind the frequent co-occurrence of celiac disease in these patients. It is in these patients that dietary modification is warranted, as well as in patients with gluten sensitivity.…”

“…By destroying thyroid tissue, they cause a decrease in the number of hormones produced by the gland. [1] The level of antibodies is related to the severity of the symptoms of hypothyroidism present. The exact cause of the disease has not been fully elucidated.…”

“…Their common feature is lymphocytic infiltration in the involved organs and the presence of antibodies in the blood. [1] Proper thyroid function is also dependent on the proper composition of the intestinal microflora. Microorganisms affect the intestinal-liver circulation of iodine.…”