INDEX
- Celiac and Thyroid
- Diagnosis and Exams
- Role of the Diet
- Monitoring
- Other articles on ‘Celiac disease’
Celiac and Thyroid
Is There a Correlation Between Celiac Disease and Thyroid Diseases?
Shutterstock
Celiac disease is often associated with autoimmune diseases , such as dermatitis herpetiformis, autoimmune gastritis , type I diabetes , psoriasis and some autoimmune thyroid disorders , such as Hashimoto’s thyroiditis and Graves’ disease .
Although it is certain that celiac people are more prone to suffer from thyroid diseases, it is difficult to provide precise percentages, given the discord between the various epidemiological data that prevent the exact relationships between the two diseases to be established.
Diagnosis and Exams
In general, it is estimated that a patient with celiac disease is three times more likely to suffer from ailments affecting the thyroid gland .
However, the cases of hypothyroidism and subclinical hyperthyroidism related to autoimmune thyroid diseases that escape some studies due to serological findings within the normal limits should be considered.
Although in these celiac patients the TSH and thyroxine ( T4 ) values are within the normal range, it is often possible to highlight a positivity to the dosage of anti-thyrooglobulin and anti-thyroxine antibodies , which testify to an increased risk of developing pictures of hypo- or hyperthyroidism associated with thyroid diseases. autoimmune.
It should also be emphasized that the association between celiac disease and autoimmune thyroid disease is not consequential ; this means that autoimmune thyroid diseases can be diagnosed both earlier and later than the finding of celiac disease.
Considering the link, albeit labile, between the two diseases, the opposite is also valid, namely the increased risk of celiac disease in patients with autoimmune thyroiditis compared to the general population.
Therefore, in these subjects there will be a higher percentage of positive test for Ab-anti-tTG ( anti-transglutaminase antibodies ) and EMA ( anti- endomysium antibodies ).
Role of the Diet
Some studies have observed that the prevalence of autoimmune thyroid disease in the celiac population is proportional to the duration of exposure to gluten ; in other words, the later the diagnosis, the greater the risk that celiac disease is associated with autoimmune thyroid disorders.
For the same reason, a gluten-free diet seems to be able to positively influence the course of these thyroid diseases, but there are also exceptions highlighted by numerous studies that express a contrary opinion on the matter.
Therefore, it is not yet clear whether and to what extent autoimmune thyroiditis in celiac patients depends on the duration and intensity of gluten exposure, and vice versa.
In the case of hypothyroidism associated with celiac disease, for example, it has been seen how a gluten-free diet allows in many cases to reduce the dosage of replacement therapy with L-thyroxine ; this effect could however be mostly due to the better intestinal absorption of the drug, resulting from the restoration of the normal structure and functionality of the enteric mucosa .
Monitoring
Celiac disease and periodic dosage of thyroid hormones
As explained in the article, a careful follow-up of patients with celiac disease is desirable, which includes the periodic dosage of thyroid hormones and TSH to investigate the functionality of the thyroid .
These investigations are particularly important for celiacs in whom the presence of antithyroid autoantibodies has already been detected.
