The Important Connection between Gluten and Autoimmunity

For varying reasons, going gluten free is pretty commonplace these days. It’s rare that you come across a menu at a restaurant or a product in the grocery store that doesn’t reference gluten in one way or another. That’s because many of us are adopting some form of a gluten free or gluten-reduced diet for the sake of our health, hoping that it lessens our brain fog, improves our constipation, or just helps us to feel less puffy and bloated. Yet, when it comes to those of us with autoimmune conditions, going gluten free might be more of a requirement than a suggestion, according to the growing body of evidence.

Although there is a wide spectrum of autoimmune disorders, they all share the same pattern: the body’s immune system flags its own healthy cells and tissues as pathogens and, therefore, attacks them. Some of the more common autoimmune diseases are Celiac Disease, Crohn’s Disease, Lupus, Hashimoto’s Thyroiditis, type 1 diabetes, Rheumatoid Arthritis and Multiple Sclerosis, but there are many many more. With the rates of autoimmunity rising steadily over the past several decades, it’s important to consider the development of such disorders but, also, the food and nutrient triggers that may exacerbate the body’s autoimmune response. 

One study by Lerner et al. analyzed 83 different scientific publications that addressed gluten removal and non-gluten-dependent autoimmune disorders in the past 6 decades. They found that an entirely gluten-free diet was beneficial in 66 out of 83 of the studies and that autoimmune thyroiditis, which includes both Hashimoto’s and Grave’s Disease, was the most responsive condition to gluten removal by far (1). 

Gluten and Thyroid Conditions

A pilot study reported that a gluten-free diet reduced thyroid antibodies in women with Hashimoto’s after just 6 months (2). Another retrospective study looked at 131 patients diagnosed with nonceliac wheat sensitivity (NCWS) and uncovered that 29% of these people eventually developed an autoimmune disorder, the main one being Hashimoto’s (3). 

This is likely due to a concept called molecular mimicry, which occurs when the body produces antibodies to something that is similar in structure to what the body is programmed to attack. In the case of gluten and Hashimoto’s, the physical shape of a gluten protein and the thyroid tissue are extremely similar, causing the body to mistakenly attack the thyroid instead of gluten protein. 

Therefore, by eliminating gluten from the diet, you can avoid this autoimmune response and also lower your thyroid antibodies. In fact, one meta-analysis found that avoiding gluten reduced the levels of thyroglobulin antibodies (TgAb) and thyroid peroxidase antibodies (TPOAb) while also lowering thyroid stimulating hormone (TSH) and increasing free T4, or free thyroxine (4). 

One important note here is that if you do in fact have an autoimmune condition, or suspect that you have one, you must COMPLETELY remove gluten for your diet for a total of 6 months before you make any conclusions about its effect on your body or running any lab tests. While it may be tempting to flirt with gluten a bit, eating it here and there, you will have to restart the (6 month) clock every time you do this. That’s because the goal during this elimination period is to not introduce a single gluten protein into your body, as to not trigger any immune response and get an accurate reading if you decide to get your antibodies tested from your doctor. 

Other Ways That Gluten Can Exacerbate Autoimmunity:

• It can increase intestinal permeability. In other words, it can create gaps in the tight junctions between the epithelial cells that line the walls of your colon, making it easy for molecules to pass through when they shouldn’t and leading to a host of issues. This concept is also known as leaky gut, which you may be familiar with.

• It can alter the gut microbiome. It does this by reducing the numbers of beneficial bacteria and aiding in the overgrowth of harmful bacteria

• It’s more difficult for enzymes to break gluten down than other proteins that we consume. Gluten has a complex structure as it’s composed of 2 main protein groups: glutenins and gliadins. This elastic network is what gives glutinous dough its stretchy quality but makes it more resistant to complete digestion. That is, we can partially digest gluten but aren’t able to ever fully break it down. That’s why when gliadin remains undigested it can cause a number of issues for people with autoimmunity (namely those with Celiac Disease).

• It can cause oxidative stress and inflammation. Gluten peptides, specifically gliadin, can induce the production of proinflammatory cytokines and enzymes such as cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS). These lead to an increase in reactive oxygen species (ROS) and nitric oxide (NO) metabolites, which cause oxidative stress on the body. 

• It is often high in glyphosate, which is a known toxicant that can irritate and inflame the gut, as well as cause intestinal permeability.

For more information on autoimmunity, particularly Hashimoto’s thyroiditis, chronic illness and how nutrition can help improve these conditions, listen to our 2 hour long episode with Fiona Smith, a Nutritional Therapy Practitioner on What’s the Juice podcast.