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A question for the thyroid experts out there: Can removal of gluten create new symptoms through a disruption of the previous balance of thyroid antibodies (specifically TSBAb, TSAb, and TPOAb)?

Answered on August 19, 2014
Created November 10, 2012 at 6:27 PM

First off, I have a confession to make. For a long time I???ve been a bit annoyed by how often paleohackers blame random symptoms on a malfunctioning thyroid. It seems like every time someone has an unexplained or mysterious complaint, people are quick to jump in and insist that it sounds like a ???thyroid issue.??? However, as fate would have it, I???m now starting to think that I have a ???thyroid issue.??? So my apologies for my previous skepticism. I went gluten free (but not yet paleo) two years ago, and I had a bizarre reaction that I???ve never been quite able to explain. After only two days gluten-free, I felt astounding ??? absolutely wonderful! Digestive symptoms (mostly painful bloating) and other symptoms (fatigue, brain fog, hair shedding) completely disappeared, and I felt great physically, cognitively, and emotionally.

For about ten days.

Then I suddenly developed some alarming symptoms ??? a shakiness, some heart palpitations, about five pounds of weight loss (which was very unwelcome), anxiety, a return of hair shedding, and more frequent and loose stools.

I went to my doctor almost immediately and he ran some tests, including TSH (which came back at .9 versus my reading of 2.5 a year prior). Symptoms have waxed and waned even since trying various forms of the paleo diet (autoimmune protocol, very low carb, no starch, yes starch, etc.) The low-FODMAP diet fixed the loose stools pretty impressively, but I still have problems with anxiety, somewhat elevated heart rate (resting rate is frequently 80-90), and over the past few months, occasional trouble falling asleep (one night I actually laid in bed for 8 hours before just getting up and going to work - ugh). This is a marked contrast to my gluten days in which I frequently fell asleep on the couch right after dinner, exhausted, not wanting to do dishes, not even wanting to drag myself upstairs to my bed. Generally I feel much better and certainly more energetic than those days, but the new symptoms are disturbing.

I find a lot of my current symptoms to be in line with those of Graves??? Disease (elevated pulse, insomnia, anxiety, trouble maintaining a healthy weight, hair shedding, dry / irritated eyes, occasional shakiness, and a pre-FODMAP tendency toward frequent / loose stools). However, I???ve always been confused as to how going gluten free could have possibly caused this.

Then recently I read an article on the different TSH receptor antibodies present in Hashimoto???s Thyroiditis and Graves??? Disease (http://www.hindawi.com/journals/jtr/2012/182176/#B13). It is my understanding that patients with these diseases frequently have a mix of both types of TSH receptor antibodies (TRAb): TSH Stimulation Blocking Antibodies (TSBAb) and Thyroid Stimulating Antibodies (TSAb). From what I understand, the balance between these types of antibodies can shift over time due to unknown reasons. Could the removal of gluten cause a shift in the percentage of these two antibody types? For example, if someone had a fairly equal percentage of both antibodies and the removal of gluten dramatically reduced the TSBAb number without equally reducing the amount of TSAb, couldn???t this theoretically shift someone from a bit of a Hashimoto???s picture to a Graves??? picture? Or to complicate things further, could going gluten free reduce the TPO antibodies associated with Hashimoto???s and unmask (symptomatically) a predominance of TSAb in the TRAb mix?

I doubt I was hypothyroid before removing gluten, although I do have an aunt with Hashimoto???s (who was very thin like me when she was younger), a sister who was once told she was on the high end of the TSH normal range, and a mom who once had a TSH of .2 and was medicated for heart palpitations. While I definitely don???t plan to add gluten back in an attempt to ???balance out my antibodies,??? (haha) if full-out hyperthyroid Graves??? Disease were to develop over time due to a new (hypothetical) predominance of TSAb on my gluten-free diet, that is certainly not something to take lightly (and is potentially deadly).

My TSH readings are always in the normal range (although it has been a year since my last test), but I get the feeling that researchers have not completely separated out which ???thyroid symptoms??? are due to excess/deficient thyroid production and which are due to the effects of thyroid antibodies on various body tissues. It is possible, for example, to have Euthyroid Graves??? Disease in which the symptoms of Graves??? Ophthalmology are present in the context of normal thyroid hormone levels (http://www.ncbi.nlm.nih.gov/pubmed/7595176). It is my understanding that the binding of circulating antibodies to the TSH receptors in the ocular tissue causes inflammation even if the binding of those antibodies to TSH receptors on the thyroid itself does not result in abnormal thyroid hormone production. Given that there are TSH receptors in many body tissues, not just ocular and thyroid tissues, (http://www.jci.org/articles/view/16234/table/1) I suspect symptoms of thyroid disease are not always the result of improper thyroid hormone levels and might be caused by the antibodies binding to tissues as in Euthyroid Graves??? Disease. Therefore, I???m not convinced that my normal TSH readings put me in the clear from thyroid disease.

I???m going to make an appointment to see my doctor for more thorough thyroid testing, but in the mean time, I wanted to throw this idea out there for those who might have more information, either personal experiences along these lines or links to related research.

Ff5307d657eb7bbcc526dc7cf1ddd7fd

(460)

on November 11, 2012
at 02:33 AM

Thanks for your input, ElisaOS. Quick question for you (since you brought it up) - do you have any research studies on the relationship between zinc and copper status and thyroid hormone production? I know the ithyroid website talks about copper supplementation being good for people with hyperthyroidism, but I have trouble finding this in the medical literature. Do you remember where you heard / read that zinc improves thyroid hormone production? I did cut out iodized salt, which I was still consuming in decent amounts.

Ff5307d657eb7bbcc526dc7cf1ddd7fd

(460)

on November 11, 2012
at 02:25 AM

Yeah, I realize that this is all speculation and I'll never know exactly what my situation was prior to going gluten free. I'll hopefully have more thorough thyroid testing soon. I agree these symptoms could be due to many different diseases. How would one test for adrenal issues? Just basic cortisol tests or are there other tests that point to adrenal issues? I don't know too much about adrenal issues. My realization that my family history included thyroid problems led me to look in this direction.

A0d4481f4b568e4edc7d8c72102dcfc1

on November 10, 2012
at 06:46 PM

It is impossible to tell what your symptoms could have been from without labs. TSH is worthless, so is your doctor telling you it is normal. You need to have free t3, t4, and antibodies tested to see what is going on. Also, a lot of your symptoms sound adrenal related. Have you ever had that checked out?

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886436139cec4c2fbf30d26a40a0fc06

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on November 11, 2012
at 02:25 AM

If at all possible, do get tested and appropriately treated.

I'll tell you what I think, without knowing much, as a sufferer of Hashimoto's.

Sometimes, people with Hashimoto's go hyper before going hypo. It happened to me. So if you do have antithyroid antibodies, you might have some of that going on.

But -- I believe that the current medical knowledge is that grain reduction does resolve a lot of the antibody situation. HOWEVER -- if you are a grain-free, organ-eating paleo eater, you no longer have phytic acid preventing absorption of Zinc and your Iodine status may have improved too. Both of those could help your body to make more thyroid hormone -- help that you may not need right now.

I, however, have no medical training in autoimmunity. I have suffered from Hashi's for 12 years diagnosed, probably 20 years undiagnosed. And I personally wish that I could go back in time and go grain free. Because a conventional diet did nothing to help.

Ff5307d657eb7bbcc526dc7cf1ddd7fd

(460)

on November 11, 2012
at 02:33 AM

Thanks for your input, ElisaOS. Quick question for you (since you brought it up) - do you have any research studies on the relationship between zinc and copper status and thyroid hormone production? I know the ithyroid website talks about copper supplementation being good for people with hyperthyroidism, but I have trouble finding this in the medical literature. Do you remember where you heard / read that zinc improves thyroid hormone production? I did cut out iodized salt, which I was still consuming in decent amounts.

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