Celiac aka Gluten Intolerance and your Thyroid

Let’s start with a definition:

CELIAC DISEASE: Celiac disease (CD), also called Celiac Sprue or Glu­ten Into­le­rance, appears to be a gene­ti­cally inhe­ri­ted disor­der which sets off an autoim­mune attack in the body. In other words, if you have it, you pro­bably have ances­tors or family mem­bers with it, too. This attack cau­ses an atrophy damage in the small intes­tine, and that, in turn, results in poor absorp­tion of nutrients in the food you eat, which can lead to mal­nu­tri­tion and other mala­dies. Some indi­vi­duals can have CD less seve­rely than others.

What cau­ses CD to show its face: Stress can cause Celiac to reveal itself, and eating cer­tain types of sto­rage pro­tein, aka glu­ten, can set off the autoim­mune res­ponse. Those glu­tens are found in wheat, rye, bar­ley and even oats, as well as other rela­ted grain pro­ducts. The Celiac gene­tic ten­dency can also be trig­ge­red by oral thrush, vagi­nal infec­tions and intes­ti­nal Can­di­dia­sis, all which con­tain the same pro­tein sequence as wheat gluten.

Some patients find them­sel­ves with mani­fes­ta­tions of Celiac Disease after the birth of a baby; others after an infec­tion or sur­gery. It’s all over the map.

Who has it: The Celiac Sprue Asso­cia­tion web­site sta­tes that up to 1 in 133 have CD, and only 3% of those have been diag­no­sed! Other esti­ma­tes are around 1 in 2000. There is also evi­dence that peo­ple of Irish or Swe­dish des­cent have the highest inci­dence. It is much more pre­va­lent in ligh­ter skin­ned indi­vi­duals than in dar­ker skin and in Asians. And many thy­roid patients have it.

What are the symp­toms of Celiac: Symp­toms of Celiac inc­lude bloa­ting, muscle cramps, smelly gas, and diarrhea, and you can also have cons­ti­pa­tion, weight loss, ane­mia, chro­nic fati­gue, weak­ness, or pre­ma­ture osteo­po­ro­sis and even bone pain. You can also have pro­jec­tive vomi­ting, migraine hea­daches, tin­gling of hands or dif­fi­culty wal­king. If the autoim­mune attack star­ted early in one’s childhood, it can result in a short sta­ture, plus ena­mel pro­blems on the teeth. Lac­tose into­le­rance can be com­mon with many who have CD.

It is not uncom­mon to be mis­diag­no­sed with irri­ta­ble bowel syn­drome, spas­tic colon, and Crohn’s disease. CD also affects the cen­tral ner­vous sys­tem and can be simi­lar to symp­toms of Mul­ti­ple Scle­ro­sis. You will have CD your entire life, and it can wax and wane.

Are there non-GI symp­toms of Celiac: Fati­gue and weak­ness, Vitamin/mineral defi­cien­cies, Hea­daches (inc­lu­ding migrai­nes), Joint/bone pain, Depres­sion, irri­ta­bi­lity, list­less­ness, mood disor­ders, “Fuzzy brain” or an ina­bi­lity to con­cen­trate, infer­ti­lity, spon­ta­neous abor­tions, intrau­te­rine growth retar­da­tion (infer­ti­lity inci­dence as high as 10%), Abnor­mal mens­trual cyc­les, Den­tal ena­mel defi­cien­cies and irre­gu­la­ri­ties, Sei­zu­res, Ata­xia (bad balance), Nerve damage (periphe­ral neu­ro­pathy), Res­pi­ra­tory pro­blems (inc­lu­ding asthma and bronchial), Can­ker sores (apthous ulcers), Lac­tose into­le­rance, Eczema/psoriasis (skin con­di­tions –not to be con­fu­sed with der­ma­ti­tis her­pe­ti­for­mis, a dead givea­way for Celiac), Rosa­cea (a skin disor­der), Acne, Hashimoto’s disease, Sjogren’s syn­drome, lupus erythe­ma­to­sus, and other autoim­mune disor­ders, Early onset osteo­po­ro­sis, Hair loss (alo­pe­cia), Brui­sing easily,
Low blood sugar (hypogly­ce­mia), Muscle cram­ping, Nose­bleeds, Swe­lling and inflam­ma­tion, Night blind­ness.   (The lat­ter symp­toms cour­tesy of realthyroidhelp.com and “hypothyroidceliac”.)

How is it con­fir­med in the doctor’s office: Three key tests inc­lude the anti-endomysium anti­body (lgA EMA) and anti-gliadin anti­body (lgA & IgG), and tis­sue trans­glu­ta­mi­nase (tTG IgA) or anti-reticulin. A gas­troen­te­ro­lo­gist can also take a small intes­tine tis­sue biopsy, if necessary.

Also strongly recom­men­ded is the stool test from Enterolab.com, since the above can fail to show it in some patients.

How do I treat my Celiac: By a total gluten-free diet, which means eli­mi­na­ting any food pro­ducts con­tai­ning wheat, rye, bar­ley and even oats, the lat­ter which can have tra­ces of wheat on them. But you have to be care­ful, because even other pro­ducts can have glu­ten, inc­lu­ding soy sauce from your favo­rite Chi­nese food res­tau­rant and many pro­ces­sed foods. Believe it or not, some cos­me­tics con­tain glu­ten, as well as some hou­sehold clea­ners. Once you eli­mi­nate glu­ten from your diet, give the remo­val of Celiac symp­toms time. There are some medi­ca­tions you can talk to your doc­tor about to help con­trol it, such as Dap­sone. But you may have to start low for your body to deal with the side effects of the med.

Joseph Murray, MD, PhD, who has been one of the lea­ding US phy­si­cians in the diag­no­sis of Celiac disease plus Der­ma­ti­tis Her­pe­ti­for­mis, sta­tes that the damage done to your intes­ti­nes with CD came be rever­sed in most cases by avoi­ding the glu­ten. (Janie won­ders if being on desic­ca­ted thy­roid like Armour, which pro­mo­tes a stron­ger immune sys­tem, can help pro­mote that hea­ling when glu­ten is avoi­ded, as well, as com­pa­red to those who are on thy­ro­xine or who are undiag­no­sed due to their doctor’s over-reliance on the TSH range.)

Why is Celiac Disease men­tio­ned on this thy­roid web­site: Because autoim­mune disea­ses can go hand in hand, and there are a per­cen­tage of Hashimoto’s patients who also have Celiac! Con­ver­sely, those with Celiac have a higher risk of having hypothy­roid (besi­des dia­be­tes or rheu­ma­toid arth­ri­tis). Esti­ma­tes are that 10 – 14% of hypothy­roids have Celiac, and it might be higher. It is pro­po­sed that if Celiacs con­trol their disease by avoi­ding glu­tens, they can either stop a thy­roid autoim­mune attack, or pre­vent it from occurring!

Another impor­tant rea­son to men­tion Celiac in rela­tionship to thy­roid disease: when you are under­trea­ted due to being on thy­ro­xine meds like Synth­roid, Levoxyl, Eltro­xin, etc, or if you are undiag­no­sed due to a doctor’s over-reliance on the TSH range, your immune sys­tem is com­pro­mi­sed, and that can lead to the very con­di­tions which can trig­ger the autoim­mune res­ponse, inc­lu­ding oral thrush, vagi­nal infec­tions or intes­ti­nal Can­di­dia­sis. These three can also deve­lop due to an adre­nal insufficiency.

Can there be other disor­ders that go along with Celiac: Der­ma­ti­tis Her­pe­ti­for­mis (DH) can often go hand-in-hand as a mani­fes­ta­tion of Celiac. DH is a chro­nic and extre­mely itchy skin con­di­tion which is mani­fes­ted by red bumps which can erupt into blis­ters, and those are mostly found on your elbows, knees, back, but­tocks and even the scalp, though they can occa­sio­nally be found elsewhere on your body. Many patients with DH see it start when they are young adults. Like Celiac, it is con­tro­lled by avoi­ding glu­ten in your diet. Iodine in your diet can make it worse, accor­ding to some sour­ces, so if you are sup­ple­men­ting with iodine, you might want to pay att­ten­tion if it’s affec­ting you or not.

Is there a dif­fe­rence bet­ween the terms ‘Celiac’ and ‘Glu­ten Into­le­rance’: Celiac disease refers to a dama­ged intes­ti­nal mucosa brought about by a inhe­ri­ted gene, and avoi­ding glu­tens can help con­trol the disease. It is pro­po­sed that others can have a sen­si­ti­vity to glu­ten without damage to the intes­ti­nes, and this could be simply called Glu­ten Intolerance.

Check out the Celiac Sprue Asso­cia­tion web­site where you can also get reci­pes to learn how to cook without wheat and rela­ted products.

Click here to read an exce­llent over­view of Celiac by Dr Joseph Murray, one of the lea­ding US phy­si­cians in the diag­no­sis of celiac disease (CD) and der­ma­ti­tis her­pe­ti­for­mis (DH)

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