I often hear people express the belief that gluten sensitivity is a fad, this is not true. Rates of gluten intolerance have risen dramatically in the past decades due to many factors of industrialisation.

There also strong links between gluten sensitivity, celiac disease, autoimmune conditions and especially Hashimoto’s hypothyroidism.

People with Hashimoto’s hypothyroidism are genetically more prone to gluten sensitivity and celiac disease but unfortunately many cases are missed because the testing used to identify gluten sensitivity and celiac disease is limited as it only looks for one type of wheat protein, alpha- gliadin (gluten). The reality is that people can react to multiple compounds in wheat and any test should look at immune reactivity to these different compounds.

Celiac disease differs from gluten sensitivity because it involves a specific gene type expression which promotes an aggressive immune system response. This aggressive response can not only damage someone intestinal lining but cause systemic inflammation, leading to malabsorption syndromes and serious health complications. Celiac disease is also a trigger point for people to go on and develop Hashimoto’s and other autoimmune conditions.

Whilst gluten sensitivity does not trigger such an aggressive response it does play a role in triggering and exacerbating Hashimoto’s and therefore everyone with Hashimoto’s should be screened not only for celiac disease but also gluten sensitivity. If these tests are positive that person should follow a strict gluten free diet.

There are many different forms of food intolerance testing available but the only one you should consider is ELISA testing, the one we use in clinic is from the Cyrex Laboratory (www.clyrexlabs.com Array 3 Wheat Gluten Proteome Reactivity & Autoimmunity).

For some people with autoimmune conditions just coming off gluten is not enough as they are continuing to eat other foods that are known to be cross reactive with gluten, such as other grains and dairy. This cross reactivity with other foods is often why when some people try a gluten free diet, it doesn’t make any difference for them. For them a stricter exclusion is required to see any benefits.

Many people often ask me if “I can eat gluten again?”. Normally the answer is “no” especially if the person has celiac disease but this is often the case for those who have gluten sensitivity as well, because once the body starts to produce antibodies to gluten it becomes a lifelong problem. This is especially true for those with Hashimoto’s and other autoimmune conditions.

These are some of the concepts I look at when helping someone with an autoimmune condition or low thyroid function. It is not the only factor, environmental factors and other lifestyle, diet and nutrition interventions can all be used to develop a personalised plan based each individual’s unique situation and needs.