The gluten-thyroid connection

July 18, 2010 in Food & Nutrition, Thyroid Disorders | 49 comments

wheatIn the first article in this series, I showed that hypothyroidism is an autoimmune disease in 90% of cases. In this article we’re going to discuss the connection between autoimmune thyroid disease (AITD) and gluten intolerance.

Several studies show a strong link between AITD (both Hashimoto’s and Graves’) and gluten intolerance. [1, 2, 3, 4, 5] The link is so well-established that researchers suggest all people with AITD be screened for gluten intolerance, and vice versa.

What explains the connection? It’s a case of mistaken identity. The molecular structure of gliadin, the protein portion of gluten, closely resembles that of the thyroid gland. When gliadin breaches the protective barrier of the gut, and enters the bloodstream, the immune system tags it for destruction. These antibodies to gliadin also cause the body to attack thyroid tissue. This means if you have AITD and you eat foods containing gluten, your immune system will attack your thyroid.

Even worse, the immune response to gluten can last up to 6 months each time you eat it. This explains why it is critical to eliminate gluten completely from your diet if you have AITD. There’s no “80/20″ rule when it comes to gluten. Being “mostly” gluten-free isn’t going to cut it. If you’re gluten intolerant, you have to be 100% gluten-free to prevent immune destruction of your thyroid.

So how do you find out if you’re gluten intolerant? Unfortunately, standard lab tests aren’t very accurate. They test for antibodies to gluten in the bloodstream. But antibodies in the blood will only be found in cases where the gut has become so permeable that gluten can pass through. This is a relatively advanced stage of disease. Blood tests will miss the many milder cases of gluten intolerance that haven’t yet progressed to that stage.

Stool analysis is far more sensitive, because it detects antibodies produced in the digestive tract that aren’t yet escaping into the bloodstream. Using this method at Entero Lab, Dr. Kenneth Fine, a pioneer in the field, has found that up to 35% of Americans are gluten intolerant.

In addition to the stool analysis, Dr. Fine’s lab uses a cheek swab to test for the genes connected with gluten intolerance and celiac disease. People with HLA DQ genes are more likely than the general population to have autoimmune disease, celiac disease and gluten intolerance. Dr. Fine’s research shows that more than 80% of Americans have one of these gene types.

When I first read Dr. Fine’s research, I was astounded by the implications. It suggests that 1 in 3 Americans are gluten intolerant, and that 8 in 10 are genetically predisposed to gluten intolerance. This is nothing short of a public health catastrophe in a nation where the #1 source of calories is refined flour. But while most are at least aware of the dangers of sugar, trans-fat and other unhealthy foods, fewer than 1 in 8 people with celiac disease are aware of their condition. I would guess that an even lower proportion of people are aware they are gluten intolerant.

One reason gluten intolerance goes undetected in so many cases is that both doctors and patients mistakenly believe it only causes digestive problems. But gluten intolerance can also present with inflammation in the joints, skin, respiratory tract and brain – without any obvious gut symptoms.

As much improved as Dr. Fine’s methods are, they aren’t perfect. In some patients with autoimmune disease, their immune system is so worn out they can no longer produce many antibodies.

Hashmioto’s, the most common autoimmune thyroid condition, is primarily a Th1 dominant condition. I’ll explain what this means in further detail in a future article. For now, what you need to understand is that in Th1-dominant conditions, the Th2 system is suppressed. The Th2 system is the part of the immune system responsible for producing antibodies. When the Th2 system is severely depressed, the body’s ability to produce antibodies is impaired. The levels may be so low that they won’t show up on a test. So, even if you have gluten intolerance, your test for gluten antibodies may be falsely negative if you have Th1-dominant Hashimoto’s.

This is why I recommend that you avoid gluten if you have AITD, regardless of whether tests show an active antibody response. This is especially true if you have one of the genes (HLA DQ1,2, or 3) that predisposes you to developing gluten intolerance. In my opinion continuing to eat gluten when you have a confirmed autoimmune condition simply isn’t worth risking the immune destruction it could cause.

In fact, the more I learn about gluten and its effects on the body, the more I think we’d all probably be better off not eating it. Mark Sisson has written extensively about the dangers of gluten and gluten-containing grains, so head over there and have a look if this is new to you. The short version: foods that contain gluten (both whole grains and flours) contain substances that inhibit nutrient absorption, damage our intestinal lining, and – as I’ve described in this article – activate a potentially destructive autoimmune response. What’s more, there are no nutrients in gluten-containing foods that you can’t get more easily and efficiently from foods that don’t contain gluten.

The good news is that if you have AITD and are gluten intolerant removing gluten completely from your diet will dramatically improve your health. It’s not easy, but it’s worth it.

{ 49 comments… read them below or add one }

Nat July 19, 2010 at 9:43 am

I took gluten out of my diet back in February of this year at the recommendation of a doctor.  I must admit that I spent the first three months or so fantasizing about donuts.  However, I feel so much better that I have no intentions of adding gluten back to my diet.   Within a couple of months the strange swelling zit like things that used to appear all over my body finally went away (Oh, the money I wasted on acne cleansing products!  Grrrr!).  I stopped having horrible issues with my digestive system.  Eventually, the joints in my knees even began to bend once again.
Just about every woman in my family is on some sort of medication for thyroid issues.  I’m eager to share this blog and many of the links with them!
At first, removing gluten is not easy.  You will have to memorize a rather long list of things other than just wheat that you’ll need to avoid (I know when I’ve made a mistake because I’ll  have stomach cramps the next day and the spots all over my body come back).  Here’s a link to a rather extensive list of common ingredients that are not gluten free:
BUT not consuming gluten does eventually become much easier as you work towards making it a habit.  The key, for me personally, to avoiding gluten seems to be planning ahead.  Going to a summer BBQ?  Don’t forget to bring your own gluten free bun!  Thinking of joining friend for dinner?  You’ll need to contact the restaurant and discuss the gluten free options on their menu (If they don’t know what you’re talking about, pick another restaurant!).  About to drop an item in your grocery cart at the grocery store?  Read the label carefully first!
What’s been especially helpful to me are other gluten free folks’ blogs.  These are full of tips and recipes that your gut will truly appreciate.  Not eating gluten doesn’t mean you’ll never have bread or brownies again.  It just means you’ll learn to prepare these things for yourself with non wheat flours that you’ve probably never heard of.
It can also possibly mean the end to a lot of physical ailments :)


Charlotta Rexmark July 19, 2010 at 10:20 am

Thank you for an extremely interesting series of articles! It’s really hitting home.
I was diagnosed with gluten intolerance in 2001 after almost 10 years of digestive problems (amongst other things). My stomach got better and for a couple of years I thought I was recovering. In 2003 other types of symptoms (like chronic motion sickness) started to be a real problem and in 2005 I started suffering from exhaustion and from there on it just got worse. In januari this year I got diagnosed with hypothyroidism type 2. My blood test for antibodies came back negative and my T3-, T4- and TSH-levels were all good.
After reading your latest article I wonder how this ads up. Shouldn’t I’ve gotten better after 2001 when I started on a strict non-gluten diet (I’m still on it)? Instead that’s when I started getting really sick!
Btw I can mention that I turned down the offer of thyroid hormones and instead I depend on my homeopath and other clever people to help me try and build up my health again in a natural way. I hope that to be the better way to do things, and I am feeling much better since a couple of month but still there’s a long way to go.
Best regards
Charlotta Rexmark, Sweden


Chris Kresser July 19, 2010 at 11:17 am


I doubt removing gluten made you more sick. It’s more probable that the timing was a coincidence.

With thyroid hormone resistance, it’s important to figure out the cause and correct it. Typically chronic stress, high cortisol or homocysteine or genetic factors are involved. Treatment would involve reducing those factors and taking steps to improve receptor site sensitivity. I’ll discuss what these would be in a future article. Also, it’s probably best not to rule out thyroid hormone replacement if you have continued symptoms.


Susan July 19, 2010 at 10:21 am

Excellent post! In my experience as an herbalist, if gluten is removed from the diet, then the iodine becomes not so much of an issue. Thanks again for the great series, and anticipating more!


Dawna July 19, 2010 at 11:44 am

Awesome article!
Gluten is addicting and evil. One has to be very cautious about purchasing prepared or processed foods because it is in almost all of it. I just tell my patients to avoid processed foods all together.
One thing that I noticed is that it is very hard to get people off gluten. I can tell them over and over again to stay away from it but each week when I ask them about their diet and if it has changed or not, the answer is always no! They don’t want to give up their pizza, beer, bread, or processed food! Even when I tell them they can buy gluten free products they still seem to buy gluten products. Maybe I need to start using scare tactics and show them pictures of gluten intolerant guts and brains or before and after pictures.


Jamie July 19, 2010 at 11:56 am

Thanks for another great article Chris.  It is interesting with Dr Fine’s work that he found that 100% of infants tested had antibodies to gluten.  One has to wonder whether the ‘tolerance’ seen thereafter nothing more than a slow weakening and destruction of the immune response?  If you haven’t got enough troops to repel an invading army, does that mean you are becoming more tolerant of them?


Eva July 19, 2010 at 12:06 pm

If I am reading this correctly, the process seems to be that first, if you eat gluten and are predisposed to problems with it (like many are), then you begin to have antibodies to gluten in the gut.  Then eventually, probs in the gut from the gluten will lead to some gluten getting into the bloodstream.  Then the body will create antibodies to the gluten in the bloodstream.  And then the body may (or will) accidently mistake thyroid tissue for glutin, since they look similar to the antibody, and then your body will start to attack your thyroid.  THis will go on for a bit until finally, poor thyroid function will start to manifest physical symptoms of illness. 

If I am getting this correctly, it brings up a few questions.  Can thyroid function recover/regrow over time if antibody attack is halted?  Of course, this may be difficult if the antibody attack is fully developed because, as Charlotta mentioned, it’s easy to make an occasional mistaken intake of gluten.  If antibodies persist for 6 months (I would not be surprised if this number is an underestimate), then only 2 mistakes a year will make for an ongoing attack on the thyroid.  

So perhaps the other trick is to avoid gluten as much as possible before the problem reaches critical, such that the process never reaches the point of thyroid attack in the first place. I do wonder if for many people, if they only ate a little bit of gluten instead of the mass hoards that SAD eaters usually consume, then the gut and body in general would not reach the point of hypersensitivity for so many people.  Another issue is that those eating so called healthy whole grains might be at greater risk for problems.  


Eva July 19, 2010 at 12:30 pm

OK, more questions.  If you follow this link:
it talks about gliadin also resembling intestinal tissue.  Attacks on gliadin then result in damage to intestines, thus starting the cycle that lets the gliadin into the blood stream, at least for those with immune response to gliadin.  So anyway, later in the article on that link, they then talk about testing for antibodies direct against the intestinal tissue!  So sounds like to me that at some point, the body starts to target not only the gliadin, with collateral damage to the intestine, but ALSO starts making antibodies directly against the intestinal tissue itself!  Obviously, although you can stop eating gluten, you are not going to stop having intestine (hopefully), so what if the body does not stop making antibodies against the intestine? Hopefully, without the stimulus of the gliadin, they body’s immune response will come down but do we know if it will and under what circumstances.  The same issue is probably also important for thyroid.  In some poeple, does the body start making antibodies directly against the thyroid at some point as it apparently does for the intestine?   At some point, do you get to the point of no return for some people even if they eliminate all gluten?    


Chris Kresser July 19, 2010 at 12:32 pm


Yes, you’ve got it.

And yes, thyroid function can recover to some degree when the underlying autoimmunity is dampened.  However, it’s important to understand that once the autoimmune process begins, it can’t be fully reversed.  The body doesn’t forget.  Once it produces antibodies to a tissue, that tissue will always be tagged for attack.  This cellular memory is what makes our immune systems are so expert at fighting off pathogens, but it works against us in the case of autoimmune disease.

The key is to avoid triggers (like gluten, iodine and others) that ramp up antibody production and thus increase the autoimmune response, and to regulate the immune system and bring it back into relative balance.  I’ll be discussing the basics of this in an upcoming post, but this is something that’s best done under the supervision of a knowledgeable practitioner.


Chris Kresser July 19, 2010 at 12:35 pm

This paper that I linked to in my article suggests that gliadin antibody production may decrease to undetectable levels after six months on a gluten free diet.  This doesn’t mean celiac has been cured, because eating gluten would immediately ramp up antibody production again.  But it does mean the immune response has been dampened significantly.



Jacob July 19, 2010 at 12:52 pm

Jimmy Moore just put up his podcast interview with Dr. Khaarrzian.


Chris Kresser July 19, 2010 at 1:01 pm

Thanks, Jacob. I didn’t even realize Jimmy had interviewed him.


helen July 19, 2010 at 3:29 pm

Thanks for the great articles on what is such a common, complex condition that can affect the whole body! I am one of those with Hashimoto’s struggling with seeming ineffectiveness of thyroid hormones to remove the symptoms after a few weeks of them seeming to work each time the dose is raised, plus cycling symptoms and flare-ups so it is all a journey of discovery. I’ve been trying gluten-free on and off for a few months as challenge diet to see if I can sense any effects, but they are unclear, apart from an extremely sore thyroid for 2-3 days 3-4 days after stopping the gluten each time – must be telling its story! I’m just a bit confused in your explanation of detecting antibodies to the gliadin and the role of gut permeability. The gut needs to be permeable at some stage for the gliadin molecules to enter the bloodstream, right? And then this is the mechanism by which the body mounts an antibody attack as these protein molecules are not where they are supposed to be? This would then be the process by which the antibodies could attack thyroid tissue? If the gut has not become permeable anywhere, and the person is not a coeliac then how would they develop gluten intolerance? Is gut impermeability and presence in the bloodstream key for developing gluten intolerance? How does this tie in with the lab method for measuring gliadin antibodies from the gut in the stool? Just a little confused…


Chris Kresser July 19, 2010 at 5:36 pm

You can’t do an “on and off” gluten-free diet and expect results. As I said in the article, you must be 100% gluten free for a significant length of time to receive the full benefit of eliminating gluten.

Gluten intolerance develops in the gut. The gut doesn’t have to be permeable for that to happen. The gut does have to be permeable, however, for the antibodies to leak through the gut wall and into the bloodstream, where they can be detected on a blood test. Celiac is just an extreme form of gluten intolerance. You don’t have to be celiac to produce antibodies to gliadin. Celiacs will also often have antibodies to transglutaminase, an enzyme in the intestines, and endomysium, a msucle sheath.


Lisa July 19, 2010 at 4:16 pm

My daughter (she is 7) was diagnosed with Graves disease last year.  We have struggled mightily in trying to get her thyroid under control.  It is so volatile and appeared to be unresponsive to treatment.  I finally decided to get a second opinion after having some doubts with our pediatric endocrinologist.  The new doctor ran 9 vials of blood and found the presence of some antibodies in her system which could possibly indicate Celiac Disease.  Sure enough, after consulting with a pediatric gastroenterologist and a biopsy having been done, my daughter has Celiac Disease as well.  Totally explains why her thyroid never came under control.  While controlling her diet is extremely hard (mostly because I am new to this)… I am thankful that its just diet that needs to be reformed to help her out.  Thanks for an awesome article.


Eva July 19, 2010 at 4:53 pm

I noticed in the linked study it said: ” In these two celiac patients, the serologic markers became undetectable 6 months after beginning a gluten-free diet. However, thyroid autoantibodies did not positively correlate with dietary habits.”  Does that mean that although gliadin antibodies were no longer detectable after 6 months, thyroid antibodies were still there, ie did not correlate with diet?  The link does not let me see the whole study, just the synopsis, and it is only n=2 for celiacs, but if that is what it is saying, sounds like once the body starts making thyroid antibodies, it tends to keep making them, even if the gliadin is no longer fueling the fire.  Not good.  Either that or n=2 is not enough subjects for statistical significance and that is what they are saying by ”not positively correlated,” ie did not reach statistical significance.   


Chris Kresser July 19, 2010 at 5:20 pm

It means that removing gluten doesn’t eliminate antibodies to thyroid. Keep in mind, however, that antibody levels aren’t necessarily a measure of severity in autoimmune thyroid disease. As I mentioned in the article, low antibody levels aren’t always a good thing, because that may indicate a severely depressed Th2 system. In that case, we might expect to see antibody levels actually rise as we address their immune imbalance and they improve. On the other hand, high antibody levels doesn’t necessarily mean severe tissue destruction. Antibodies themselves don’t destroy tissue – they just tag it for destruction.

I think it’s best not to worry too much about the antibody levels and instead to focus on clinical symptoms as a measure of progress.


Chris Kresser July 19, 2010 at 5:38 pm


To clarify my last reply, gluten doesn’t exist naturally in the body. The reason the gliadin antibodies disappeared in those patients is because they weren’t eating gluten anymore. Thyroid tissue, however, is still there and the so the body will continue producing antibodies to it.


Venessa July 19, 2010 at 9:54 pm

Thank you thank you thank you THANK YOU! I have been trying to say what you are saying in these pages for YEARS but did have the knowledge, or confidence, or the right WORDS to say it with. MY BODY knew it though. My body knew that something wasn’t right with the medication that I was taking for my thyroid, but I didn’t have any other way of saying it except for ‘something doesn’t feel right’.
I am right behind you, going back to school to become more educated in these areas so that I can first heal myself, and then help others. THANK YOU AGAIN! xo


helen July 20, 2010 at 2:37 am

Thanks for the explanation, so useful to know more. Does the gut need to be impermeable somewhere for the antibodies to interact with the thyroid? Once you have antibodies to gliadin or transglutaminase in your gut, by what mechanism can this then lead to interactions with the thyroid?


Chris Kresser July 20, 2010 at 8:20 am

Molecular mimicry mechanisms with gliadin have been postulated for autoimmune thyroid conditions. The antibodies produced against gluten appear to stimulate B-cell production tagging of the thyroid tissue. But that doesn’t mean gluten intolerance is the sole trigger of autoimmune thyroid by any means. Your body is capable of producing antibodies to thyroid tissue without the influence of gluten.


Marley July 20, 2010 at 3:11 am

Hi Chris,
This is bit of the subject, but do you think there are any problems with  eating combinations of foods? ie. meat and dairy, meat and eggs etc. I have read a few things about not eating certain foods with others but havent found any scientific research to support this.
Also, I am unable to eat fish oil as I am allergic to fish and found it gave me problems. Do you think taking ground flaxseed is a of any benefit to try and get omega 3? we have a good source of organic pasture fed beef and eggs so hopefully this will help the omega3/6 ratio.
Thanks for all the great info! the acupuncture studies are going well- learning electroacupuncture and some TCM stuff this week


Chris Kresser July 20, 2010 at 8:18 am

The omega-3s in meat and dairy probably aren’t enough if you have an inflammatory condition. I’d look into algae oil for DHA at least. I’m not sure if you’d be allergic to that or not, but it would be a better choice than flax.

I don’t think there’s a problem with combining meat and dairy and meat and eggs – unless you notice there is for you. If it causes problems, it’s a sign of dysbiosis and you should investigate the cause (i.e. H. pylori, bacterial overgrowth, etc.)


Mario July 20, 2010 at 5:28 am

“The key is to avoid triggers (like gluten, iodine and others) that ramp up antibody production and thus increase the autoimmune response, and to regulate the immune system and bring it back into relative balance.”

The problem that I see with Dr. K (from what I read from his book) and yours articles so far, is that they address only a small part of the problem. Gluten is a very well know problem with Hashi and many other autoimmune diseases, ok. But hardly is the only problem. What about fluoride, chloride, bromide, bisphenol-A, mercury, and the many other contaminants that are well know endocrine disruptors and all make hashimoto worse? What to do about them? Do you and/or Dr. K thinks that only avoiding gluten, eating a paleo diet and regulating our immune system are enough?

“As I mentioned in the article, low antibody levels aren’t always a good thing, because that may indicate a severely depressed Th2 system.”

Chris, can you provide any reference for this? Thanks!


Chris Kresser July 20, 2010 at 8:16 am


It may be that fluoride, chloride, bromide and BPA toxicity need to be addressed in certain patients. But most practitioners (myself included) using Dr. K’s methods aren’t doing this explicitly, and are seeing dramatic results. BTW, Dr. K believes that hormone replacement is necessary in those with significant tissue destruction and persistently high TSH levels. Thyroid hormone is too important for proper physiological function to ignore. I’ll be addressing this in a future article.

Here’s a paper showing that Th1 dominance suppresses the Th2 system and reduces Th2-mediated antibody production to near zero.


Mario July 20, 2010 at 9:12 am

I was looking for a paper that showed Th1 dominance and antibody supression on AITD, not in general. But, anyway, searching on Pubmed, I came across this interesting paper, that showed that a high iodine intake produced lymphocyte proliferation, higher NK cells activity and Th1/Th2 imbalance on mice. But in rats with high iodine + selenium there is no difference in relation with the group that did not took iodine.


Mario July 20, 2010 at 9:12 am

Sorry, forget the link:


Chris Kresser July 20, 2010 at 11:05 am

Mario, this paper shows that increasing levels of Th1 IFN decrease levels of Th2 iL-4 in Hashimoto’s, and that Th1 dominance is positively correlated with disease severity.

This paper shows a similar trend in Graves’ opthalmopathy.  As Th1 cytokines rise, Th2 cytokines fall.  Th2 cytokines are necessary for antibody production.


Mario July 20, 2010 at 11:14 am

Thanks, I had already found these papers.
But, any comment on the study that I linked above, where a high intake of iodine did not cause a immune flare if selenium was taken together?


Chris Kresser July 20, 2010 at 11:19 am

Certainly worth consideration amongst all of the other studies on both sides.


Mario July 20, 2010 at 12:19 pm

Some other interestings studies about selenium and iodine:
On your post about iodine, you cited a studies from Brazil, Sri Lanka, Turkey, China, Greece, and Azerbaijan that showed a increase in Hashimoto when iodine was added to salt. The question is: do these countries have a sufficient selenium intake?
Greece: selenium status is one of the lowest of the Europe (
Brazil: the study was done in Sao Paulo, city were most brazilian japanese live. Brazilian japanese have significant lower levels of Se than japanese living in Japan (
China: Minerals as calcium, zinc, selenium, kalium and vitamins as vitamin A, B1, B2 were insufficient (

Turkey: Selenium status of Turkish children is found to be lower than that found in the literature (
Turkey: Turkey is one of those countries where iodine deficiency (ID) is widespread, Se levels are marginal (

Sri Lanka: This study has shown for the first time that significant proportions of the Sri Lankan female population may be Se deficient (
Azerbaijan: no studies found.


Chris Kresser July 20, 2010 at 12:31 pm

Excellent detective work, Mario. After my exam I’ll review these studies and revisit the topic.

Selenium is pretty amazing. I don’t know if you saw my series on EFAs & fish/fish oil, but selenium completely protects against the effects of mercury in seafood by binding to it and creating a new compound that can’t be utilized by the body. Interesting that it may have a similar effect with iodine.


Mario July 20, 2010 at 1:13 pm

Thanks, Chris. I’m as skeptic as you, after reading a lot of positive stories on iodine group and experience the same with me and my wife (which, by the way, is a m.d.), I can’t believe that iodine could have such a deleterious effect.
Yes, I have read your series on EFA & fish/fish oil. I was taking fish oil, but stopped and increased sea food (cod, shrimp and crab mostly). It’s so much more tastier!
Yes, selenium is pretty amazing. It is showed to reduce thyroid antibodies ( and is low in Hashimoto patients (, this study found that hsCRP is considerably lower in persons with high serum selenium!).
But, make no mistake. Selenium supplementation with iodine deficience is not good (
Last thing: thank god I don’t live in USA, where bromide levels are the highest in the world. So, make no mistake, don’t underestimate bromide. It is a powerfull endocrine disruptor and iodine + selenium are protective against it (here a study not from Brownstein nor Abraham:


Tamra July 21, 2010 at 9:13 am

Chris, I truly appreciate your insightful articles and your willingness to educate the public about this debilitating auto-immune disease. I have found much resistance (sometimes hostile) among certain Hashi patients who would rather call my dietary changes drastic or crazy. To some people, turning their backs on common sense certainly requires less conviction than bypassing the funnel cake stand.
I have Hashimoto’s, and when I quit gluten this February, the antibody attacks and swelling stopped. I’ve also cut my thyroid hormone dependence by over 1/4. Now, I only get these attacks when I have a stressful situation or when I eat something that stimulates my TH2 pathways.
For those Hashis who have tried the GF diet, just remember that eating a piece of yeasty, sugary GF cake every day can be equally as harmful to the gut. I’ve found that cow milk, soy and corn can also cause my gut to swell.
Hashis must also remember that proper nutrition (especially avoiding processed, fried foods) and exercise is paramount in managing this disease.
:) Tamra


Chris Kresser July 21, 2010 at 9:17 am


You bring up a great point, and I was thinking of doing a follow-up post on it.  A lot of GF products on the market are highly processed and full of junk.  Just because something is GF, that doesn’t mean it’s healthy.  In a future article on blood sugar and thyroid, I’ll explain why a low-carb diet free of refined carbohydrates (including refined GF carbs) is the best choice for people suffering from thyroid disorders (and everyone else, for that matter.)


Cheryl July 31, 2010 at 12:39 pm

Chris- I’ve recently discovered, by accident, that gluten is creating havoc in me.  In Nat’s comments of 7/19, she states that she “knows when she’s made a mistake cuz the next day she has stomach cramps and the spots come back all over her body.”  I have these brown spots which began a few years ago, and the majority of them are under my arms and inner thigh areas.  I’ve been told that they are blood sugar related.  Can you share more about these spots?  Will they go away with correcting my food intake?  I’m very new to the GF concept, but I know this is where I need to focus.


Teri August 2, 2010 at 9:40 am

Wow. What a great discussion. I’m thrilled to have found your site Chris! I’m a gluten-free cooking writer and have had a recent email conversation with a reader about several gluten-free grains and starches (tapioca, aka. cassava root, millet, teff, sorghum and soy) which may have goitrogenic effect on the thyroid gland. I am just embarking on a search to learn more about this potential effect.
PubMed search results for “cyanogenic glucosides in cassava, millet, sorghum” and “goitrogens in cassava, millet and sorghum” turn up little (very little, like a mouse study and old studies done in the Sahara and Nigeria, where populations consume large amounts of millet and cassava.)
Chris, do you have insight into the potential thyroid-suppressive effects of any of the above mentioned gluten-free flours? As someone with non-celiac gluten sensivity (diagnosed through Dr. Fine’s Enterolab,) Hashimoto’s hypothyroidism and casein intolerance, I am increasingly convinced to adopt a Paleo diet, avoiding gluten-free grains in the process of seeking real health.
Thanks again for your enlightening work.


Chris Kresser August 2, 2010 at 10:11 am


I don’t believe dietary goitrogens are significant contributors to thyroid dysfunction – although environmental goitrogens are. I will probably write about this in a future article.

That said, as you well know there are many who believe grains aren’t a good idea because the anti-nutrients they contain. The only grain I eat these days is in the form of very occasional sourdough buckwheat crepes – and buckwheat isn’t technically a grain.


Teri August 2, 2010 at 10:24 pm

Thanks for your comments Chris and I’m glad to hear your suggestion about eating buckwheat. For anyone beginning a gluten-free diet, buckwheat is actually an herb (Fagopyrum esculentum ), not a grain at all. And it has some amazing nutritional properties compared to the basic line-up of gluten-free flours (rice, sorghum, millet, tapioca, cornstarch, potato starch.)
Two substances in buckwheat are being studied (I think at Cornell?) for their positive effects on blood glucose regulation – “D-Chiro-Inosito” and “fagopyritols.”
But I’m wondering why you don’t believe dietary goitrogens have a significant effect on thyroid dysfunction? In populations with iodine def with diets high in grains like millet, goiters and thyroid disease are epidemic. Do you mean dietary goitrogens don’t significantly affect thyroid function in populations with adequate iodine status?
I’ll look forward to reading your article (which I hope will discuss halogens and thyroid dysfunction.) Thanks again Chris.


Peter August 26, 2010 at 5:52 am

Excellent article and follow up conversation.
Selenium can be measured functionally using a lymphocyte proliferation assay (spectracell labs does a good job with this).  Additionally reverse T3 can be measured as a marker for selenium deficiency as it is required to convert T4.
Looking forward to the next article.
All the best,


Kerry September 9, 2010 at 2:18 pm

Great Article!  I was diagnosed with hypothyroid 18 months ago.  I have lots of joint pain/muscle aches.  That has been my biggest symptom (I have obvious ones too) & docs keep looking at me like I have 10 eyes.  The symptoms come & go & I can’t seem to regulate my thyroid (even when I stay on the same dose for a long time).  I’m wondering if something else is making my thyroid fluctuate (ie. gluten) & I know that the joint pain / muscle aches are common in gluten sensitivity.  I was tested for celiac & it came back negative.  I took an immuno blood lab test & wheat was a +1.  So, I’m wondering if I really do have it & whether it’s worth going off gluten for 6 months.  Any thoughts?


Chris Kresser September 9, 2010 at 2:30 pm

I suggest all people with hypothyroidism (and probably just all people in general) should be off gluten forever.


Lynda September 12, 2010 at 8:58 pm

Thank you so much for answering questions on this forum!


Liza September 17, 2010 at 10:59 pm

thanks for the great info! I was  diagnosed  6 weeks ago w/ gluten, dairy and corn intolerance/allergies, low Vit D, hypothyroid, overactive adrenals, and low protein levels. I’ve been gluten and dairy free since the diagnosis, and mostly corn free except where corn by-products occasionally slip in (e.g. dextrose.), and am on thyroid supplements. I feel better than i have in years!  lots more energy, skin rashes are clearing up, depression is lifting.    I loved reading your posts about the interrelationship of these conditions– i was wondering if there was a link.
And i’m curious about the grain connection.  I’m a botanist, and know that most of the common grains (all?) (rice, millet, wheat, ancient wheats, corn, teff, etc.) are all fruit (seeds) of  plants that are botanically grasses, and are more broadly classified as monocots –a group of plants that includes lilies, orchids and grasses.  Buckwheat is in a completely different classification–it’s a dicot, or broad-leaved plant.  Is it something about monocots that makes them harder to digest or more likely to cause an immune response?  i’m thinking about other plants that we eat, and almost everything I can think of is a dicot. (coconut being another exception–it’s a monocot–as is ginger, lemongrass, and turmeric.) Just curious as to whether you have any thoughts on this, or know of any research about it.
Anyway, i’ll definitely be sharing links to your site with friends and family members.  thanks for the great articles and detective work with putting all this together.


Chris Kresser September 18, 2010 at 7:56 am

I think buckwheat is well-tolerated in most people. I eat it myself, usually in the form of buckwheat crepes (recipe). I’m not aware of any specific research suggesting dicots are better absorbed than monocots. Please let me know if you find any!


Eris de Suzerain February 15, 2011 at 3:04 pm

I read the information in the studies you referenced. Of those, only one indicated an unusually high prevelance of celiac in Graves and Hashimoto sufferers. The last referenced the high level of thyroid disease in celiac sufferers, not the high rate of celiac in thyroid disease sufferers. The overwhelming consensus seems to be that those who have celiac should be monitored for autoimmune thyroid conditions – not vice versa. Granted, getting tested is easy, and might as well – but the leaping to the conclusion that there is a strong correlation based on these studies is a bit much and makes me skeptical.


Eris de Suzerain February 15, 2011 at 3:05 pm

I must add that two of the studies you referenced indicated a 3-5% rate of celiac in those with autoimmune thyroid diseases – hardly compelling.


Gluten Intolerance April 7, 2011 at 3:29 am

Thanks for the effort creating this blog. I saw almost girl have thyroid, is it through that only girl has the biggest possibility to attack by thyroid? Maintaining gluten – free foods would not be perfectly safe. There are lots of diseases from now on, like Celiac Disease, Hashimoto and this hypothyroidism.


Gluten Intolerance April 7, 2011 at 3:29 am

Thanks for the effort creating this blog. I saw almost girl have thyroid, is it through that only girl has the biggest possibility to attack by thyroid? Maintaining gluten – free foods would not be perfectly safe. There are lots of diseases from now on, like Celiac Disease, Hashimoto and this hypothyroidism.


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