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Celiac and the Thyroid

 

Jump to: Hashimoto's Disease | Graves' Disease | Do You Have Celiac?

Celiac and Thyroid

The thyroid, a butterfly-shaped gland, located at the base of the neck, bears the enormous responsibility of regulating hormones that control some of the body’s most essential functions – most notably, metabolism. For those with celiac disease, the risk of developing a condition that can affect the thyroid and compromise their overall health is significantly increased.

thyroid scanIt is common knowledge that individuals with celiac disease are at an increased risk of developing additional autoimmune disorders, but did you know the thyroid gland is particularly affected by autoimmune diseases, too?

In fact, people with celiac disease are nearly four times more likely to develop an autoimmune thyroid condition, the most common types being Hashimoto’s disease and Graves' disease.

Currently, about 20 million Americans have some form of thyroid disease. People of all ages and races can get thyroid disease. However, women are five to eight times more likely than men to have thyroid problems.

And, while scientists have yet to identify the exact cause of these diseases, many suspect that genetics and immunological triggers may both be partially to blame. Celiac disease and autoimmune thyroid disorders share a common genetic predisposition, which may explain the higher incidence of thyroid autoimmune disorders among celiacs than in the general population.

Before we cover specific conditions, let’s go over a few definitions:

  • Hypothyroidism, or underactive thyroid, occurs when there is a decrease in thyroid production.
  • Hyperthyroidism, or overactive thyroid, occurs when there is an increase in thyroid production.

Hashimoto's Disease

What is it? Who gets it?

Hashimoto’s disease, a form of hypothyroidism caused by an autoimmune reaction, is by far the most common type of thyroid disease. The condition is seven times more likely to affect women than men, and frequently runs in families.

During the progression of the disease, the thyroid gland is subject to an antibody attack, causing it to become inflamed and enlarged. As the gland enlarges, it begins to under-function, causing thyroid hormone deficiencies within the body.

If left untreated, individuals with Hashimoto’s disease can develop heart problems, birth defects and mental health issues such as depression.

What are the symptoms?

Common symptoms of hypothyroidism include:Celiac and the Thyroid handout

o  Fatigue

o  Depression

o  Muscle cramps

o  Constipation

o  Weight gain

o  Low body temperature

o  Dry skin

o  Dry/Brittle hair or hair loss

o  Swollen/enlarged thyroid gland

How is it diagnosed?

Hashimoto’s can be diagnosed easily through a simple blood test. Your doctor will measure the amount of thyroid hormones (TSH) in the blood to determine whether or not you have the condition.

Can it be treated?

The standard treatment for Hashimoto’s is synthetic thyroid hormone supplements, with Levothroid, Levoxyl, and Synthroid being the most common. Your doctor will gauge the right dosage of medication based on hormone levels in the blood. Taken orally and daily, these medications will gradually resolve symptoms once the right dosage is determined.

There is little evidence that a gluten-free diet can help treat hypothyroidism. However, those newly diagnosed with celiac disease are sometimes able to decrease the dosage of their thyroid hormone supplements after their small intestine heals and their body’s ability to absorb nutrients improves.

Sources:

o  Blumer, Ian, MD, Crowe, Shelia, MD. Celiac Disease for Dummies, Wiley & Sons, 2010.

o  Green Peter H.R, Jones R. Celiac Disease: A Hidden Epidemic. HarperCollins, NY, 2010

o  WomensHealth.Gov. Hashimoto’s Disease. Reviewed May 18th, 2010 http://www.womenshealth.gov/publications/our-publications/fact-sheet/hashimoto-disease.cfm

Graves' Disease

What is it?

Graves' disease is the most common cause of hyperthyroidism. Like Hashimoto’s disease, Graves' is caused by an autoimmune response, which causes antibodies to attack the thyroid gland. However, unlike hypothyroidism, the antibody attack causes an increase in thyroid hormone production. When the thyroid produces too much hormone, the body uses energy faster than it should.

Those with Graves' disease can also suffer from other conditions, such as heart disorders, pregnancy complications, osteoporosis, and even a life-threatening condition called Thyroid Storm. A rare complication, Thyroid Storm causes a sudden and drastic increase in hormones that can cause fever, profuse sweating, disorientation or confusion, severe low blood pressure and even coma.
 

What are the symptoms?

Patients with Graves' may experience one or more of the following symptoms:

o  Muscle weakness

o  Weight loss

o  Overheating/Excess sweating

o  Diarrhea/Frequent bowel movements

o  Tremors in hands or fingers

o  Difficulty sleeping

o  Irritability

o  Anxiety

o  Rapid or irregular heartbeat

o  Change in menstrual cycles

o  Erectile dysfunction or reduced libido

o  Bulging eyes

o  Thick, red skin, usually on the shins or tops of the feet (Graves' dermopathy) - a relatively uncommon manifestation

How is it diagnosed?

A Graves' diagnosis can be confirmed via blood test. Like diagnosing Hashimoto’s Disease, your doctor will examine thyroid hormone levels (TSH) in the blood to determine whether or not you have Graves'.

A thyroid scan may also be used to diagnose Graves'. This diagnostic technique requires the patient to drink a small amount of radioactive iodine, and the physician then measures the amount of iodine the thyroid gland takes up. This is examined using a specialized camera.

Can it be treated?

Radioactive iodine therapy may be used to treat Graves' disease. Drinking iodine helps to destroy overactive thyroid cells and balance thyroid levels. This treatment may cause neck pain and swelling, as well as decreased testosterone levels, all of which are temporary. It is important to note that although the iodine does destroy thyroid cells, it does not harm surrounding organs and tissues. This treatment is not recommended for pregnant or nursing women.

Thyroid hormone suppressing medications, such as propylthiouracil and methimazole (Tapazole) can also be used to treat Graves'. Similar to radioactive iodine therapy, these medications take time to suppress the elevated thyroid levels. Even if remission occurs, physicians still recommend regular evaluation and continual drug therapy since relapse is common.

Sometimes, doctors may recommend surgery to remove all or part of the thyroid gland. When the thyroid gland is removed completely, the procedure is known as a thyroidectomy. Following the procedure, patients are put on thyroid hormone supplements similar to those with Hashimoto’s disease.

Sources:

o  Blumer, Ian, MD, Crowe, Shelia, MD. Celiac Disease for Dummies, Wiley & Sons, 2010.

o  Green Peter H.R, Jones R. Celiac Disease: A Hidden Epidemic. HarperCollins, NY, 2010

o  Mayo Clinic. Graves' Disease. Reviewed July 7th, 2011.  http://www.mayoclinic.com/health/graves-disease/DS00181

Do You Have Celiac?

Thyroid disease is often diagnosed before celiac disease. As autoimmune thyroid conditions are more readily recognized and diagnosed by physicians, NFCA encourages patients with these conditions to get tested for celiac disease in an effort to thwart any further health complications.

Take the Celiac Symptoms Checklist

 
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    Complete our celiac disease symptoms checklist today to find out if you are at risk of having celiac disease or non-celiac gluten sensitivity ('gluten sensitivity').  We can help improve your quality of life!
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