Table of Contents

• How does gluten affect women with Hashimoto’s?
• Hidden sources of gluten
  • Gluten-containing grains + their derivatives
  • Common foods with gluten
  • Foods that may contain gluten
  • Distilled beverages + vinegar
  • Gluten-free flour alternatives
• Healing Hashimoto’s symptoms with a gluten-free diet

How Does Gluten Affect Women with Hashimoto’s?

A gluten-free diet is a lifestyle change suggested to many women with Hashimoto’s to alleviate symptoms. To understand the correlation between an autoimmune disease like Hashimoto’s and a gluten-free diet, we have to understand the Hashimoto woman’s reaction to gluten on a cellular level. When we consume gluten, our DNA is programmed to release specific enzymes to digest gluten. This is significant for those with Hashimoto’s because the section of our DNA for gluten digesting enzyme is adjacent to the section of DNA responsible for producing immune cells called macrophages. Research shows the overconsumption of gluten in women with Hashimoto’s permanently turns on the switch for both the digestive enzyme and the inflammation-causing macrophages. 

The inflammation caused by gluten occurs systematically on both a genetic and environmental level within the body of a Hashimoto’s woman. It’s important to make the distinction here between Celiac disease and gluten sensitivity. Celiac disease is a genetic autoimmune disease in which the immune system antibodies attack the intestines.

Here are some surprising statistics released by Northwestern Medicine: 

• Celiac disease is found in 1% of the population. 
• Gluten sensitivity is found in individuals with similar symptoms to celiac carriers but they do not have the same severity in repercussions when gluten is consumed. 
• Gluten sensitivity affects 6% of the population, and it has a wide variance of possible symptoms from person to person. 

It is also possible your gluten sensitivity is a result of gliadin intolerance. Gliadin and glutenin are the two main proteins of gluten. An allergy to gliadin occurs when the body cannot properly break down the protein resulting in inflammation, irritation, and symptoms of irritable bowel syndrome. When the gliadin crosses the gut’s protective barrier into the bloodstream, your immune system flags the protein for destruction causing the inflammation. 

If these symptoms and bodily reactions are sounding quite familiar, an elimination diet could be your next best step to confirm your sensitivities. An elimination diet is simply the process of removing ingredients or food groups from your diet for a short period of time before reintroducing the potential irritant back into your digestive system. The idea is to watch your body’s reaction to the reintroduction of the food item or ingredient to determine if you do indeed have a sensitivity. Think of it as a science experiment of sorts. Stool analysis is another option for detecting the antibodies wreaking havoc on your digestive system. Some labs also offer cheek swabs to test for the presence of gluten-intolerant genes.

I recommend testing yourself for gluten sensitivity with the elimination diet or labs because symptoms of gluten intolerance are often written off in conventional medicine as digestive issues. Now, let’s get into the dos and don’ts of having a gluten-sensitive digestive system.

Hidden Sources of Gluten in your Diet

The Celiac Foundation released these helpful lists of foods to watch out for when you’re avoiding gluten in your diet. 

Gluten-Containing Grains + Their Derivatives

• Wheat, varieties + derivatives of wheat (such as wheatberries, durum, emmer, semolina, spelt, farina, farro, graham, KAMUT® Khorasan wheat, einkorn wheat) 
• Rye 
• Barley 
• Triticale 
• Malt in various forms (including malted barley flour, malted milk or milkshakes, malt extract, malt syrup, malt flavoring, malt vinegar) 
• Brewer’s yeast 
• Wheat starch.

Common Foods with Gluten

• Pasta: ravioli, dumplings, couscous, and gnocchi
• Noodles: ramen, udon, soba, chow mein, and egg noodles 
• Bread and Pastries: croissants, pita, naan, bagels, flatbreads, cornbread, potato bread, muffins, donuts, rolls
• Crackers: pretzels, goldfish, graham crackers
• Baked Goods: cakes, cookies, pie crusts, brownies
• Cereal & Granola: corn flakes and rice puffs (often contain malt extract/flavoring), granola made with regular oats (not gluten-free oats)
• Breakfast Foods: pancakes, waffles, french toast, crepes, and biscuits
• Breading & Coating Mixes: panko breadcrumbs
• Croutons: stuffings, dressings
• Sauces & Gravies (many use wheat flour as a thickener), traditional soy sauce, cream sauces made with a roux
• Flour tortillas
• Beer: (unless explicitly gluten-free) and any malt beverages

Foods That MAY Contain Gluten

• Energy bars/granola bars
• French fries 
• Potato chips 
• Processed lunch meats 
• Candy, soups 
• Multi-grain or “artisan” tortilla chips 
• Salad dressings and marinades 
• Starch or dextrin 
• Brown rice syrup 
• Meat substitutes made with seitan (wheat gluten) 
• Soy sauce 
• Self-basting poultry 
• Pre-seasoned meats 
• Cheesecake filling  
• Eggs served at restaurants (some restaurants put pancake batter in their scrambled eggs and omelets)

Distilled Beverages + Vinegar

Watch out for beverages with added color or flavorings like dessert wines and beverages made from barley malt like bottled wine coolers.

Gluten-Free Flour Alternatives

• Amaranth flour 
• Arrowroot flour 
• Banana flour 
• Brown rice flour 
• Buckwheat flour 
• Chia flour 
• Chickpea flour 
• Coconut flour 
• Coffee flour 
• Hemp flour 
• Lupin flour 
• Maize flour 
• Millet flour 
• Oat flour 
• Potato flour 
• Potato starch flour 
• Quinoa flour 
• Sorghum flour 
• Soya flour 
• Tapioca flour 
• Teff flour 
• White rice flour

Healing Hashimoto’s Symptoms with a Gluten-free Diet 

To explore the connection between a gluten-free diet and healing Hashimoto’s symptoms, we must explore the concept of gut dysbiosis. Gut dysbiosis is an imbalance of the microbes that live in your gastrointestinal tract. According to research from Endocrine Web, eating gluten can trigger gut dysbiosis, especially for those with autoimmune disorders like Hashimoto’s. Many gut dysbiosis symptoms— such as fatigue, sluggishness, constipation, unexplained weight gain, irregular periods, anxiety, depression, abnormal thyroid levels, and memory lapses— perfectly parallel the symptoms seen in women with Hashimoto’s. 

Beyond the healing of symptoms, Arcadia University and PubMed.gov have both released studies stating a gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease.

Removing gluten from my diet was a big game-changer in terms of how I felt day-to-day. I experienced an increase in energy and a decrease in brain fog. Beyond just having more energy, I had more steady energy throughout the day. I used to use the morning croissant and coffee as a stimulant to make up for a lack of sleep and burning the candle at both ends running a business, a team, and a family in NYC. Now, I still get a headache within 20 minutes if I get “gluten-ed” without knowing it. In my Thyroid Strong course, we interview functional medicine doctor experts to bring clarity on what to eat to lose weight with Hashimoto’s and reduce inflammation in the body. Click the link below to learn more about changing the way you feel from the inside out!

Happy healing, 

 Dr. Emily Kiberd

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