Hashi's and T3 - can a gluten-free diet help when on T3?

[bristolboy]

I have Hashi's. I've been on Levo for about 9 years but about 3 years ago my symptoms flared up (before then I was subclinical with no symptoms). Endos have not helped, so my aim was to try to get T3 added to my Levo. But before going down that route, I decided to try going gluten-free. So I have been 100% GF for the last 4 months, with no obvious improvement in my symptoms. Since re-introducing a little gluten last week I have had bloating and wind.

Whilst being GF I have been successful in getting T3 prescribed privately - but I have not started taking the T3 yet.

I'm interested to know whether, once I start on T3 and assuming it works for me, would staying 100% GF forever help with thyroid symptoms, or would it just make life a bit more comfortable (ie less bloating etc)? Am I right in thinking that if I wasn't GF then my immune system would just continue merrily attacking my thyroid (and reducing its T3 output) - but why would that matter if my prescribed T3 was keeping me well, albeit presumably with dose increases as my thyroid withered? Basically, once on T3 and it works, I'm hoping being GF can then just be an option for me if I want to feel more comfortable digestion-wise.

greygoose and SlowDragon : SeasideSusie suggested I tag the Hashi's experts

[SlowDragon Administrator]

Well it's a good question

I have been gluten free for almost 4 years and on T3 for almost 2 years. I am extremely careful to be absolutely gluten free.

Gluten intolerance confirmed by endoscopy. Effectively coeliac (though NHS DNA test says probably not coeliac)

When I have been inadvertently glutened, eating out, I still get symptoms. Principle one being terrible joint pain. Never had any gut symptoms.

As it's taken decades to get well, I am not going to risk reintroducing gluten, even as temporary experiment

I have been able to reduce levels of vitamin supplements slightly. Is that because gut is healing because of gluten free diet, or because of T3, or a mix of both.....who knows

But the difference in my energy levels and ability to now live completely normal life, since the addition of T3 has been truly astonishing

I wear a Fitbit to show, despite suppressed TSH, I am not over medicated. Resting pulse 53-55. I walk at least 10,000 steps a day. Often much more

Before T3, could barely manage 1000 steps

[bristolboy in reply to SlowDragon]

I'm really pleased you've done so well - eventually. I can see why you wouldn't want to risk reintroducing gluten!!

As you'll see from MaisieGray's response below, I may have been a little premature in expecting results so soon. I shall persevere - but I shall still start on T3 as soon as I return from dragging myself around Portugal for the next week or so

I'm crossing everything and hoping that I respond to T3 as well as you have done. Thanks, Nick.

[SlowDragon Administrator in reply to bristolboy]

I only noticed an improvement in brain fog after about a year gluten free

Just became aware looking for words etc wasn't as difficult.

[bristolboy in reply to SlowDragon]

So the improvement in brain fog would have been before you started on T3? Once you started on T3 did that further improve the brain fog - or did it just massively help your energy levels? And how long after starting T3 did you notice the improvement/s?

And it looks like I'm being too impatient with the gluten free - probably need to give it longer!

[SlowDragon Administrator in reply to bristolboy]

Yes brain fog definitely improved before T3 added.

I did supplement a lot of vitamins. It fact it was the low vitamin levels that made me consider gluten might be a problem.

I never had no obvious gut symptoms, just fatigue and legs that wouldn't work for more than 10 minutes. If I pushed on through fatigue joint pain would be terrible

When T3 was added, it gave immediate significant improvements. Just 6 days later I walked to supermarket at back (20 mins each way). Astonishing.

So impressive I did DIO2 gene test. Confirmed as Heterozygous DIO2. Helped persuade NHS to fund

[jimh111]

Your abdominal bloating could be gluten sensitivity or perhaps IBS aggravated by gluten (or bread). I believe hypothyroidism is one cause of IBS (often undiagnosed hypothyroidism). Hypothyroidism can lead to pseudo-allergy, you get symptoms similar to allergy as long as you are hypo. You can try introducing the L-T3, if you recover you could then try reintroducing the gluten after a few months, this would give an indication of whether you are truly intolerant of gluten or your intolerance is a consequence of hypothyroidism. I would also take a magnesium supplement as hypothyroidism leads to intracellular magnesium deficieny (no blood test for it) and low magnesium causes a sensation of abdominal bloating.

[bristolboy in reply to jimh111]

Hello jimh111, yes, I'd heard about pseudo-allergy - I assume that's molecular mimicry? Fingers crossed the T3 works - then it will be interesting to try reintroducing gluten as you suggest. I already take 200mg of Magnesium Glycinate per day, so hope that is enough? Nick.

[jimh111 in reply to bristolboy]

I don't think it's anything like molecular mimicry, more likely complex effects of hypothyroidism. You could try a bit more magnesium, particulary when / if you recognise the onset of abdominal bloating ibshypo.com/index.php/magne... . Ultimately, it's not a matter of taking enough magnesium but eliminating any causes of deficiency. I found the best approach was to (rightly or wrongly) assume you have deficiency and then eliminate any potential causes. By this process you can rule out magnesium deficiency.

[bristolboy in reply to jimh111]

Hmm, sorry, I misunderstood you (easily done given my current level of fog!). That link made interesting reading. I'll certainly consider more magnesium when bloating seems imminent.

[jimh111 in reply to bristolboy]

Although not the ultimate solution I found it a very useful technique, you can crush a tablet in your teeth and hold it under your tongue for a little while before swallowing. I found I could abort an IBS attack this way. Once I was diagnosed and treated for hypothyroidism I never had IBS again apart from once when I got diarrhoea from a dodgy meal in Thailand. Bloating followed for a few days, I assume the loss of electrolytes included magnesium loss which recovered quite quickly.

[bristolboy in reply to jimh111]

My fingers are well and truly crossed for the T3 working!!

[MaisieGray]

"So I have been 100% GF for the last 4 months, with no obvious improvement in my symptoms"

The immune response to gluten can last up to 6 months, and your negative response to reintroducing gluten may infer that your body had acclimatised itself to living with the effects of consuming gluten, and/or the damage caused to your gut is not yet sufficiently advanced to be consciously noticed by you, rather than that it wasn't affecting you. Also, one reason gluten intolerance goes undetected is the wrong belief that it only causes digestive problems, when it can also present with inflammation in the joints, skin, respiratory tract and brain, without any obvious gut symptoms. So if you were judging improvement based only on the continued presence of say bloating etc, you might have missed other more subtle improvements.

"Am I right in thinking that if I wasn't GF then my immune system would just continue merrily attacking my thyroid"

That wrongly presupposes that eliminating gluten stops the autoimmune attack on the thyroid; that there is no damage taking place to the thyroid independent of the effects of gluten - or more accurately, of gliadin, the protein portion of gluten, that resembles that of the thyroid gland; and that gluten's only damaging effect is to the thyroid rather than that it can also damage the intestinal lining and inhibit nutrient absorption. Dr Falano's research in 2012 I think, found that when gluten reaches the small intestine, it triggers the release of zonulin, a chemical that signals the tight junctions of the intestinal wall to open up, creating intestinal permeability, aka leaky gut. So the fall out, quite literally, is poor uptake of anything passing through the GI tract and thence poor nutrition and presumably poor absorption of meds too. The other effect is the release of gut microbes, toxins, and partially digested food particles into the bloodstream which the immune system marks as dangerous invaders and creates inflammation to get rid of them ........

[bristolboy in reply to MaisieGray]

I don't think I suffered from any of the more subtle symptoms (inflammation of joints etc) prior to going gluten free. As you say, I probably haven't allowed long enough to get the gluten out of my system. Someone I know with Hashi's went gluten free a few weeks before I did, and they reported some improvements in brain fog almost immediately (it was they who prompted me to go gluten free) - but the other day told me that the benefits had worn off and they were back to square one. They wondered whether it might have been the placebo effect that generated their so-called improvements?

The leaky gut alone would be sufficient reason to continue gluten free after starting T3, to ensure the T3 gets absorbed properly - good point.

[islandlady91]

Hi, I am hypo and gf also. First, I take natural dessicated thyroid and it helps me much more than Levo. It has all the thyroid hormones rather than just T4. Also, you may need to get your iron and B vitamins as well as vit D checked. Iron issues can cause a lot of problems for people with hashii’s or hypo. As for gluten free, that alone won’t help your hashi, but definitely help you feel better. I just quit gluten about 1 ½ years ago because i was having horrible stomach pain. GF helped a lot and when I cheat, I do pay a price for it. Sometimes there are other foods that can create issues as well, but from my reading and groups I am involved in, iron, malfunctioning adrenal glands can be big issues in not feeling well. I would get all 4 iron labs done if I were you. If your iron is high or low, that can definitely cause issues and T3 would be a help. Also, it is definitely recommended for people with hashi or hypo to be gluten free.

[greygoose]

I don't think I can add anything to the excellent replies you've already had.

[bristolboy in reply to greygoose]

No worries, greygoose. I've got plenty to think about now