This paper demonstrates that gluten-free diets with Hashimoto's may have an influence on vitamin D uptake. Just a thing to be aware of.
Gluten-free diet attenuates the impact of exogenous vitamin D on thyroid autoimmunity in young women with autoimmune thyroiditis: a pilot study
October 2022 Scandinavian Journal of Clinical and Laboratory Investigation
DOI: 10.1080/00365513.2022.2129434
Robert Krysiak, Karolina Kowalcze, Bogusław Okopień
Abstract
Although both exogenous vitamin D and a gluten-free diet were found to reduce thyroid antibody titers, no study investigated interactions between gluten intake and vitamin D status in patients with autoimmune thyroid disorders. The aim of the present study was to assess whether the gluten-free diet determines the effect of vitamin D treatment on thyroid autoimmunity and thyroid function in young women with autoimmune (Hashimoto’s) thyroiditis. The study compared two groups of euthyroid premenopausal women with this disorder, matched for thyroid antibody titers: 31 women with non-celiac gluten sensitivity complying for at least 12 months with the gluten-free diet and 31 unaffected sisters of women with non-celiac gluten sensitivity remaining without any dietary intervention. Plasma titers of thyroid peroxidase and thyroglobulin antibodies, as well as plasma concentrations of thyrotropin, free thyroid hormones, prolactin, 25-hydroxyvitamin D and high-sensitive C-reactive protein were measured at entry and after a six-month follow-up. Moreover, at both time points, the structure parameters of thyroid homeostasis were assessed. Although exogenous vitamin D decreased titers of thyroid peroxidase and thyroglobulin antibodies and increased 25-hydroxyvitamin D levels in each treatment group, this effect was less pronounced in patients on the gluten-free diet than in patients not following any dietary recommendations. Only in the latter group of patients, vitamin D increased SPINA-GT. Treatment-induced changes in thyroid peroxidase and thyroglobulin antibodies correlated with the impact of treatment on 25-hydroxyvitamin D levels. The obtained results suggest that gluten-free diet may impair beneficial effects of exogenous vitamin D in individuals with Hashimoto’s thyroiditis.
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diogenes
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Dose of D3 should be based on current level with the aim of reaching the level recommended by the Vit D Society, Vit D Council and Grassroots Health which is 100-125nmol/L, and Grassroots Health's recent blog post recommends at least 125nmol/L.
You can work out what dose you need here, if your unit of measurement is nmol/L you need to calculate it into ng/ml and you do this by dividing nmol/L result by 2.5 to give ng/ml:
Thank you Susie, k2 gives me palpitations. I had to stop taking it. I strughle with magnesium as i take my ndt 3x day. Hard to find time when magnesium wont interfere with thyroid meds.
In april my d3 was 72nmol/l. Range (50-200)
If i take more than 2000 d3 i cant sleep.
Its difficult to get everything in balance.
But i have been wondering if re introduction of gluten may help.
So i guess i could take magnesium at 5pm. I will set my phone alarm. It may well help my sleep too. Thanks 😊
This is interesting. I have been gluten free for some years and was diagnosed with osteoporosis a year ago just by chance when I fell off a ladder and fractured my radius. I need to up my vitamin D then. Thanks for your post.
Do you also take D3's important cofactors - magnesium and Vit K2-MK7. The K2-MK7 directs calcium to bones and teeth where it is needed, very important.
What's your current Vit D level and how much D3 do you take? Magnesium is needed so that the body can convert D3 into it's usable form.
Hi SeasiseSusie. I take a Vit D3/ Calcium combo (Calcichew) prescribed by the Consultant Rheumatologist. I do have magnesium supplements, but to be honest, I'm not very good at taking supplements regularly. I've read that you have to take them all separately and at different times, so with that and the thyroid meds, I often only take the vitamin D and calcium. My GP won't do a full vitamin test, and barely agrees to a thyroid test at no more than once a year. I have managed to coerce the phlebotomist to do Ft3 as well, so testing without the expense of doing it privately is not an option for me unfortunately. I take NDT, and that is really too expensive for me, so I try limit other supplements where possible.
I suggest that you do some reading about Vit K2-MK7 and it's importance for bones and osteoporosis and then decide whether or not it's a good idea not to take it. Here are a couple of articles for starters:
Dark rye, buckwheat, pumpkin and sunflower seeds are all better sources of magnesium than wheat, though I have now chosen to cease baking (and eating the loaves!), due to pre-diabetes. I experienced regular leg cramping when consuming the good sources, but don't now. More greens doing the job?
Is this a case of causation based on association? How were they able to prove this?
Also, sample sizes of 31 females in each group isn’t exactly a large sample size. Also, we don’t know the degree to which a GF diet impairs exogenous Vitamin D.
Everyone, this is an interesting study but as always I wouldn’t just jump the gun and start taking more Vitamin D based on a single study.
Totally agree. There are a lot of variables that the scientists haven't controlled and as such careful consideration needs to be given to any 'conclusions' that are drawn. Some people may make themselves quite ill if they make incorrect assumptions about their own treatment or diet based on one study ike this. I am very wary of 'scientific' studies that are put out to the public.
I think we just need to put things into context rather than be wary. Because it’s these studies that help society progress. Critical analysis skills and an open mind are required.
This also sounds like a one off and small study. I personally like reading systematic reviews as they critically review a number of similar studies before making conclusions.
I have been gluten free for 4 years now and my level of vitamin D is top of the range around 125. I don't take a specific supplement of vitamin D apart from a small amout that will be in the silica supplement I take daily.
My diet is very good with lots of fish mainly oily type, one egg daily, homemade yoghurt daily and mild Gouda so I am getting a fair bit from my diet. (also lots of vegetables and small amounts of fruit plus a couple of oatcakes daily and low carb granola for breakfast). In the winter I do sometimes just take 1000 mcg of vitamin D3 which comes in dropper form from Nutri Advanced.
Vitamin K2 is synthesized in the gut from fermented fibres and I also have a very good level of this from a stool test I did with Biomesight which also give recommendations as to specific foods an individual needs to maximise their microbiome.
Thank you for posting this, diogenes. I'd like to make sure I understand the possible implications.
From the abstract:
Although exogenous vitamin D decreased titers of thyroid peroxidase and thyroglobulin antibodies and increased 25-hydroxyvitamin D levels in each treatment group, this effect was less pronounced in patients on the gluten-free diet than in patients not following any dietary recommendations. Only in the latter group of patients, vitamin D increased SPINA-GT.
and
The obtained results suggest that gluten-free diet may impair beneficial effects of exogenous vitamin D in individuals with Hashimoto’s thyroiditis.
To my mind, there's arguably a difference between saying
- people on GF diets may need to increase their vitamin D3 intake to achieve desired serum levels in order to receive beneficial effects
and saying
- a GF diet may impair beneficial effects of exogenous vitamin D
If you see what I mean. Hopefully not putting too fine a point on this. This may be to do with the effect on SPINA-GT, which is beyond my ken. So my question is, as long as someone with AIT who is GF maintains desirable serum levels of vitamin D3, do they obtain the same beneficial effects of the exogenous D3 as someone who is not GF?
Just curious here…is it possible that subjects that were gluten free already had damage to their intestines and as a result, didn’t absorb the vitamin D as well? I ask this because I had severe anemia for over 30 years with a ferritin of 2 no matter how much iron supplements I took and even did iron injections. Nothing worked to raise my iron and magnesium levels until I went on a gluten free diet for 6 months and then raised my T3. Heal your gut, heal your absorption. Something else to consider is you need magnesium to absorb vitamin D which it doesn’t seem this study considered - maybe it’s on the full study report? Another thing to consider is absorption is affected by sodium levels which are affected by thyroid adrenal issues. Without sufficient sodium, you will have poor absorption of all nutrients. Vitamin D is also the precursor to other hormones and if you’re deficient, your vitamin D levels will be converted to these other hormones and perhaps this is why there is less on blood work?
I guess point is that there could be multiple factors affecting your Vitamin D levels
It is a probably a good idea that everyone consider this study within their own personal history. I personally don’t think it would be a good idea for me to come off a GF diet.
I take digestive enzymes to help. My daughter is the same with low levels of stomach acid, tho didn't know it applied to me, too! Anything I can do to address this, other than by digestive enzymes? In all my 73 yrs I have never had such a number of blood tests, never. Did ask the nurse as she took vial after vial, if it would be quicker to take a pint!! As a result of keeping far from the GP surgery, many issues never addressed! I carried on regardless!
I'm not sure that digestive enzymes increase stomach acid levels:
The majority of digestive enzymes are made by the pancreas. Pancreatic juice contains several digestive enzymes, as well as bicarbonate to neutralize the acid from your stomach. The enzymes work in the small intestine to break down the food so it can be absorbed 2.Apr 1, 2016
You could try increasing your salt intake, and check on your B12 level. If either of these are low, your stomach acid will be low. But the main cause in hypos is low FT3.
If all else fails, you could try Apple Cider Vinegar. I've never tried this myself, but I believe you take one teaspoon of ACV in water, and drink with a straw, about twenty mins before every meal. Or, you can find Betain HCL supplements on Amazon which will help.
So in my case a coeliac for last decade … struggled to maintain good vitamin D it’s dropped to 56, 50 being “adequate” by nhs standards although we know probably with autoimmune disorders we probably need higher levels to feel well.
As SlowDragon mentioned I do believe magnesium, especially in my case might be a missing link, as for gf diet being short of magnesium I couldn’t say, although many whole grains are taken out of our diet which could be part of the problem.
I think we coeliacs and similar with digest disorders generally struggle to absorb, convert and maintain various levels of nutrients regardless of having a good diet or control conditions.
I thought I was having enough magnesium with daily nuts, seeds, oats (gf) and banana in my porridge, various leafy veg, legumes and brown basmati regularly in my diet not cooking things too much and keeping well away from the white based starches which are of little nutritional value.
I’m aware over cooking of veg, alcohol and some other conditions can cause depletion of magnesium as well as diuretics. Then there’s anti nutrients like lectins (there’s others) and people with digestive problems can be affected by these but majority of people are ok.
I was told by dietitian when diagnosed, Fibre, Vitamin Bs and Calcium are the main problem for coeliacs (on gf diet) although this was a decade ago, and many additives have been added in to some foods now to improve this area, as far as I’m aware it’s still not a regulation to fortify gf flour like wheat based flours and cereals are in U.K. think this was being looked at.
I take Better you spray D3 3000 with K2 daily, although in summer only took occasionally, so clearly I need to take all year round, and maybe higher dose.
So I feel we probably need enough Magnesium to convert vitamin D and seems to be the magic mineral that helps deliver and balance a few areas
Being only in abstract we can't tell what dose of vitamin D was given to the research subjects.
The very first test I had done of vitamin D (that I know the results of) was in 2013. I had never taken thyroid hormones at that point, nor was I eating gluten-free.
My first result (tested by the NHS) was 69 nmol/L and at the time I believed this was only a smidgen below optimal.
I started taking 1000 iU vitamin D per day because I thought that was ample.
My next test was 6 months later (tested by Blue Horizon) and my results dropped. It was 54.5. nmol/L. By this time I had started taking thyroid hormones, but was still eating gluten.
I have never managed to explain this to myself. My vitamin D level wasn't great but wasn't bad. I started supplementing and it dropped. Why?
Note that I was getting plenty of sunshine at that time because I was walking my dog twice a day.
I have discovered since 2013 that I need to supplement about 2000 iU of vitamin D just to barely maintain my level, and 3000 iU per day will raise it very slowly. So, if I need to raise my level I take 4000 iU.
The fact that doctors suggest a dose of 400 iU or 10 mcg per day to raise levels still astonishes me.
Note for anyone interested... If you want to convert from iU to mcg for vitamin D or vice versa, this link will do it for you :
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