Your thyroid is a tiny butterfly-shaped gland that sits at the base of your neck and is part of the endocrine system. Your thyroid gland produces hormones that tell your cells whether they need to slow down or speed up, helping regulate your energy levels, metabolism, and other key body functions.
Any dysfunction, disorder, or condition that causes the thyroid gland to underact or overact can have far-reaching symptoms and health consequences. They are collectively called thyroid conditions. Today, thyroid conditions affect approximately 20 million people in the U.S. alone. Additionally, over 12 percent of Americans will develop a thyroid condition at some point in their lives, according to the American Thyroid Association (ATA).
Recent medical research shows there is an established connection between the conditions of the thyroid and celiac disease. Moreover, celiac disease has several symptoms in common with certain thyroid conditions, most notably autoimmune thyroid disease. In some cases, certain thyroid conditions have been misdiagnosed as celiac disease, and vice versa. This can leave you being treated for the wrong condition, all while suffering unknowingly from the other.
In this article, we dig into the link between celiac disease and thyroid conditions. But first, let’s take a closer look at the basics.
What are Thyroid Conditions?
Thyroid condition is any anomaly or dysfunction in which the thyroid gland secretes either too little or too much thyroid hormone. It afflicts people of all races, ages, and walks of life. About 20 million Americans aged 12 and above suffer from some form of the thyroid condition. Unfortunately, women are at a five to eight times greater risk of developing a thyroid condition than men, according to the ATA.
A thyroid gland is said to be overactive when it produces too much hormone, a condition which is referred medically to as hyperthyroidism. With hyperthyroidism, the body consumes more energy than it should.
Individuals with an overactive thyroid often experience symptoms that may include anxiety, heat sensitivity, vision issues, insomnia (and other sleep complications), tremors, weight loss, lighter menstrual periods, weak muscles, mood swings, high blood pressure, heart palpitations (or elevated heartbeat), or irritability, just to mention a few. Graves’ disease is the most common thyroid condition and an autoimmune disorder that causes hyperthyroidism, affecting 7 in every 10 people with an overactive thyroid. With this condition, your own immune system mistakenly attacks your thyroid gland, forcing it to release more hormone.
An underactive thyroid, on the other hand, secretes too little hormone, which means your body consumes less energy than it should. This is medically known as hypothyroidism. If you have hypothyroidism, you may experience symptoms that include dry skin, weight gain, depression, fatigue, memory problems, bloating, constipation, difficulty processing information, hoarse voice, and slow heart rate. In many cases, people with hypothyroidism may have an enlarged thyroid gland, or what’s called goiter in medical terms. On rare occasions, it may lead to coma, although most cases are mild. Damage from chemotherapy (or other forms of radiation treatments), surgical removal of the thyroid gland may cause hypothyroidism. However, Hashimoto’s thyroiditis (better known as Hashimoto’s disease) is the leading cause of hypothyroidism.
As we’ve mentioned, Grave’s disease and Hashimoto’s thyroiditis are the most common culprits for hyperthyroidism and hypothyroidism respectively. They are both autoimmune disorders in which the immune system launches a reactive attack on the thyroid gland.
Let’s take a quick look at these two top thyroid conditions.
Hashimoto’s disease is an autoimmune condition in which your body erroneously launches an immune system attack on the thyroid gland. This not only causes inflammation but also gradually destroys the thyroid gland, rendering it unable to produce enough hormones. This thyroid condition is sometimes called autoimmune thyroiditis or chronic lymphocytic thyroiditis.
Unsurprisingly, Hashimoto’s thyroiditis is the #1 cause of hypothyroidism in the US where it affects nearly 14 million people, according to the American Association of Clinical Endocrinologists. While it can strike at any age, Hashimoto’s disease is most common among women between 30 and 50 years of age, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Hashimoto’s disease can stay largely asymptomatic and stable for several years. And when symptoms do show, they are typically mild. These symptoms include depression, constipation, thinning hair, dry skin, fatigue, sensitivity to cold, lack of coordination, heavy menstrual periods, goiter, and sometimes weight gain. In severe cases, dizziness, muscle cramps, clinical depression, extreme hair loss, sudden weight gain, yellowish skin (jaundice), and nausea are common. Some people may not even display obvious symptoms of the condition. As you may have noticed, most of these symptoms are also non-specific and often mimic symptoms of gastrointestinal conditions and other autoimmune disorders, including celiac disease. This is also one of the top reasons to get tested for celiac disease before you make the next move, such as seek treatment.
Grave’s disease is also an autoimmune thyroid disorder. It’s named after Robert J. Graves, a renowned doctor who first described the condition in the mid-1830s. In Grave’s disease, the immune system mistakenly also attacks your thyroid gland, causing it to become overactive. Unlike Hashimoto’s disease, Grave’s disease triggers the thyroid gland to produce too much of the hormone that regulates metabolism. Grave’s disease is the prominent cause of hyperthyroidism, forcing body processes and systems to go on overdrive. Grave’s disease affects about one in every 200 Americans. While it affects everyone, it’s much more common in women aged between 20 and 30.
The most common symptoms include vision problems, bulging eyes, irregular menstrual cycle, diarrhea, sleeping problems, excessive sweating, heart arrhythmia, hand tremors, fatigue, irritability, and anxiety.
What’s the Link between Thyroid Conditions and Celiac Disease?
Research studies have shown that people with autoimmune thyroid conditions – most notably Grave’s disease and Hashimoto’s disease – are at a higher risk of developing celiac disease than the general population. The converse is also true – celiac patients are more likely to suffer from autoimmune hypothyroidism and hyperthyroidism. There are several reasons and facts that help explain this strong connection between celiac disease and thyroid conditions.
Link: A Genetic Link
The most common explanation has to do with a shared genetic predisposition. This means that there seems to be a genetic connection between thyroid conditions (particularly autoimmune thyroid disease, AITD) and celiac disease.
More specifically, scientists have discovered that specific genes such as PTPN22, the HLA genes, and CTLA-4 are found in both celiac disease and autoimmune endocrine diseases.
In addition, gene variants like DR4-DQ8 and DR3-DQ2 that put you at a higher risk of getting Grave’s disease, Hashimoto’s disease, and other AITDs are the very same genes that genetically predispose you to celiac sprue.
Link: Risk of Other Autoimmune Disorder
Most autoimmune disorders go hand in hand. While the relationship isn’t exactly clear, it is highly likely that autoimmune thyroid disease and celiac disease are common together because they are both autoimmune disorders. That doesn’t mean that autoimmune disorders cause each other. It means only that they usually occur together.
As a result, people with celiac disease are more likely to develop other autoimmune disorders, including type 1 diabetes, autoimmune hepatitis, Sjögren’s syndrome, lupus, rheumatoid arthritis, Addison’s disease, Grave’s disease, and Hashimoto’s disease. This relational risk usually increases the older you get.
And this has been confirmed by several clinical studies. For instance, in one 2016 study published in the journal Autoimmunity Reviews, scientists found that a large portion of individuals with autoimmune thyroid disorder (ATID) also had other autoimmune disorders, especially celiac disease.
Link: Common Symptoms
People with celiac disease generally exhibit symptoms that include constipation, excess gas, bloating, headaches, fatigue, irritability, depression, and weight loss. Other symptoms more common in older adults with celiac disease include low bone density (osteoporosis), a skin rash, acid reflux, iron-deficiency anemia, and more. If left untreated, severe celiac disease can significantly affect your gums and teeth, as well as cause infertility, miscarriage, and pre-term birth.
As you may have concluded, celiac disease shares some specific symptoms with both types of autoimmune thyroid disease, Grave’s disease, and Hashimoto’s disease. So, if you have hyperthyroidism or hypothyroidism, your symptoms may have much in common with celiac disease. These symptoms include fatigue, weight loss, irritability, depression, bloating, constipation, and headaches.
Link: Presence of Antibodies
Antibodies are present in people with celiac disease and thyroid conditions, which may help explain the connection between them. About 20 percent of people with celiac disease have type 1 diabetes and/or thyroid antibodies. Moreover, approximately 98 percent of celiac patients have tTG IgA antibodies in their blood.
In autoimmune thyroid disease, on the other hand, about 4 percent and 8 percent of adults and children respectively have tTG IgA antibodies in their blood. That translates to 2-5 percent in the general population.
Treating Celiac Disease and Thyroid Conditions
Overlap in celiac disease and autoimmune thyroid conditions can result in misdiagnosis. That’s why getting regularly tested for celiac disease is your best shot. There’s no shortcut to treating celiac disease (in fact, there’s no known cure) but maintaining a completely gluten-free diet is an important first step. Still, if you are diagnosed with both celiac disease and a thyroid condition, you should get your thyroid checked every 6 months. This is especially true in the first year after you embrace a gluten-free diet.
One complication of celiac disease’s damage to your small intestine is that it becomes difficult for your intestine to properly absorb thyroid medication. The good news is that as soon as your celiac disease is managed, you can absorb your thyroid meds without an issue. Do you think you have celiac disease? Check out our celiac disease screening test that can be taken in the comfort of your own home.