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The Gluten, Gut, and Thyroid Connection

Science Based

Written by Amy Myers, MD

Thyroid function is a topic I hold near to my heart. During medical school, I was diagnosed with Graves’ disease. Conventional medicine presented me with three options: take a medication known as propylthiouracil (PTU), use radioactive iodine to ablate (blow up) my thyroid; or have my thyroid surgically removed. There was never a discussion of alternative treatments or the root cause of why my thyroid became out of whack. 

I have since made it my mission to help those facing thyroid disease reverse their conditions and return to optimal health through functional medicine principles. The two most common types of thyroid dysfunction are Hashimoto’s and, as I mentioned above Graves’. The culprit behind these two conditions is often an autoimmune disease, a condition in which your body confuses your own tissues with outside invaders and begins attacking itself. 

The question is, how does it lead to thyroid disease? The answer is multi-part, and as I explain in my book, The Thyroid Connection, it all begins in the gut, because the gut is the gateway to health. In this article, we will uncover the gluten and thyroid connection and the thyroid and gut health connection. You will learn how both can lead to autoimmune and non-autoimmune thyroid disease. First, let’s dive into the autoimmune connection. 

The Autoimmune Connection

Hashimoto’s and Graves’ disease are both autoimmune in nature. They cause your immune system to make antibodies that attack your thyroid gland, in turn, affecting your levels of thyroid hormones.1 Thyroid hormones control how your body uses energy and affect nearly every organ. People with Graves’ disease have hyperthyroidism, meaning they produce too much thyroid hormone. Those with Hashimoto’s disease have hypothyroidism or an underactive thyroid gland that does not produce enough hormones.

An estimated 20 million Americans have some form of thyroid disease, with 60% unaware of their condition.2 Shockingly, those that are aware often don’t know that their condition is autoimmune-related. This is because most conventional doctors fail to check for thyroid antibodies in blood tests. At your next physical, I recommend asking your doctor to check your thyroid antibodies with your blood panel. 

If most thyroid dysfunction is caused by autoimmunity, what causes the autoimmunity in the first place? The answer is complex; however, without a doubt, one of the biggest contributing factors is gluten. Gluten wreaks havoc on your gut, increases inflammation, and can directly cause your immune system to attack your thyroid. This is not a myth! Let’s dive into this connection further.

Gluten, Leaky Gut, and Autoimmune Thyroid Disease

Today, we no longer eat the same wheat that previous generations harvested. Instead, we are consuming a hybridized grain that is drought-resistant, bug-resistant, and faster-growing. These hybridized grains have new proteins not found in original wheat plants. These “new proteins” are part of the problem that has led to increased system inflammation and intolerance of gluten.

In patients I treated in my functional medicine clinic, gluten was one of the main contributors to leaky gut. When you eat gluten-containing food, your body produces zonulin, a chemical that signals the tight junctions of the intestinal walls to open up and remain open. This is known as leaky gut. Leaky gut can also be caused or made worse by gut infections such as Candida overgrowth or SIBO, medications such as antibiotics, steroids, birth control pills, or a high-stress lifestyle. 

Think of your gut as a drawbridge. Your gut is naturally semi-permeable to let teeny-tiny boats (micronutrients) pass through your intestinal wall and into your bloodstream. It’s how you absorb your food. Certain external factors, including food, infections, toxins, and stress, can break apart the tight junctions in your intestinal wall, leaving the drawbridge open.

Once this happens, you have a leaky gut. When your gut is leaky, much larger boats that were never meant to get through (toxins, microbes, and undigested food particles) can escape into your bloodstream. Your immune system marks these “foreign invaders” as pathogens and attacks them.

Symptoms occur as a result of your body’s immune response to these invaders. This puts you on the path to developing Hashimoto’s disease, for example, or another autoimmune disease, thanks to a phenomenon called molecular mimicry.

Molecular Mimicry, A Case of Mistaken Identity

Every time your body is exposed to a dangerous outside invader, your immune system memorizes its structure, specifically its protein sequence, so that it can develop the perfect defense to that pathogen and recognize it in the future.

But, the immune system’s recognition system isn’t perfect; as long as a molecule’s structure and protein sequences are similar enough, the immune system can be fooled into attacking look-a-like molecules that are actually your body’s tissue, causing autoimmune disease. Unfortunately for the thyroid, it has two common doppelgangers that put it at risk for rogue autoimmune attacks: gluten and casein (a protein found in dairy), both of which are likely rampant in your bloodstream now, thanks to your leaky gut.

It could be pulled straight from a scene in a classic old movie, the thyroid shouts indignantly, “I didn’t do anything, I swear! You’ve got the wrong guy!” and the antibodies cynically retort, “Sure buddy, sure,” before binding to your thyroid tissue to neutralize the “threat.” In the case of autoimmune hypothyroidism (Hashimoto’s disease), your immune system’s attacks diminish thyroid functionality, so your metabolic processes slow down. In autoimmune hyperthyroidism (Graves’ disease), the antibodies act like Thyroid Stimulating Hormone, causing your thyroid to overproduce its hormones and sending your metabolism into overdrive.

Gluten and Thyroid

Gluten and casein are the most common hypothesized causes of molecular mimicry-induced autoimmune thyroid disease. These can affect your thyroid and gut health. The peptide sequences of foods such as milk and wheat are similar to those of human molecules. This similarity can result in cross-reactivity that leads to autoimmune disorders.3 

Even in patients with non-autoimmune thyroid disease, the molecular mimicry phenomenon still impacts thyroid and gut health function. This is why I recommend that all of my patients with thyroid disease eliminate gluten from their diets, even if they are not autoimmune.

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Food Consumption 

Contaminated food or water containing the bacteria Yersinia enterocolitica is another common contributor. Researchers have documented this to cause Grave’s disease due to its reactivity with the TSH receptor. 4 Additionally, certain foods can cause immune reactions and the formation of antigen-antibody complexes. Some foods even act directly on the thyroid gland, making it harder to absorb iodine, which is necessary for proper functioning.5 

How to Prevent Autoimmune Thyroid Caused by Leaky Gut and Molecular Mimicry

Although a diet heavy in gluten can set you on a dangerous path toward autoimmune thyroid disease. Now that you know more about the thyroid and gut health connection, you can begin to take steps to diminish the negative effects. To reverse, start by implementing the Four Pillars of The Myers Way®.

Pillar I: Heal Your Gut

Your gut is the foundation of your whole body’s health because 80% of your immune system is located there. Without a healthy gut, you can’t have a healthy immune system. Without a healthy immune system, you’re open to infections, inflammation, and autoimmune disease. When your gut loses the ability to discriminate between the good and the bad bacteria, you have a leaky gut.

When your gut is leaky, things like toxins, microbes, undigested food particles, and more can escape from your intestines and travel throughout your body via your bloodstream. Your immune system marks these “foreign invaders” as pathogens and attacks them. The constant onslaught of inflammation from your immune system causes a widespread immune response throughout your body.

Pillar II: Get Rid of Gluten, Grains, and Legumes

Leaky gut puts you on the Autoimmune Spectrum®, which is why healing your gut is the first pillar of The Myers Way®. Once you’ve healed your gut, it’s time to make lifestyle and diet changes to put you on the path toward optimal health. One of the best ways to do that is through diet and eliminating foods that are causing inflammation and damage to your intestinal tract: Gluten, grains, and legumes! 

Pillar III: Tame the Toxins

For many people, 80% of healing occurs while simultaneously addressing Pillar I and Pillar II of The Myers Way®. If you haven’t seen a full reversal of your symptoms after following Pillar I and II, we need to dig deeper.

Pillar III addresses and reduces your exposure to toxins, a poison or any substance that’s dangerous to the human body. That includes things you know are a problem such as heavy metals like lead, mercury, and cadmium, industrial chemicals and pollutants, and pesticides. 

However, toxins lurk in common products you may not think of as being toxic, such as home cleaning products, body products, and even makeup. 

Pillar IV: Heal Your Infections and Relieve Your Stress

When I saw a patient in my clinic who has not experienced full reversal of their symptoms after simultaneously addressing Pillar I and II, I knew we had more work to do. Once Pillar III was addressed, and I determined that toxins weren’t the issue or were taken care of, I turned to the next piece of the puzzle: underlying infections and stress. Some infections associated with autoimmune disease are caused by viruses. Some common culprits I saw in my clinic were:

Herpes simplex (HSV): This is the virus that gives you cold sores and/or genital herpes. It’s very common: about 90% of Americans have one or both types of HSV, although they might not show symptoms. 

Epstein-Barr (EBV): EBV is the virus that causes infectious mononucleosis. 95% of all US adults contract this virus by age 40. You’ve likely had mono at some point, even if you don’t remember, because it’s often misdiagnosed as the flu or strep throat. EBV is the infection that has been studied the most extensively in connection with autoimmune disease, and it has been strongly correlated with multiple sclerosis (MS), chronic fatigue syndrome (CFS), lupus, fibromyalgia, Graves’ disease, and Sjögren’s syndrome

When a patient isn’t getting better on the first pillars of The Myers Way®, I always consider the possibility that they could have another bacterial infection: Lyme disease, which is caused by a bacteria called Spirochaetes. It shares many similarities to autoimmune diseases. Many people are misdiagnosed with autoimmune disease or another inflammatory condition, like chronic fatigue syndrome, when the underlying issue is actually Lyme. 

Viruses like EBV and HSV don’t leave your system. When your immune system is healthy, it keeps the viruses in check, but when it is suppressed by stress or illness, the infection can become active once again. Once the virus is active, the inflammatory immune response damages tissue, which then causes more inflammation and a stronger response from the immune system. Autoimmune disease develops from that chronic state of inflammation.

How to Heal the Damage Caused by Gluten

You can reverse the symptoms of Graves’ disease and other thyroid conditions. If you have thyroid dysfunction, I recommend breaking up with gluten once and for all. After eliminating gluten, your gut can begin to heal, and your inflammation will decrease. Slowly, your body will eventually stop its rogue attacks on your thyroid. 

In addition to eating a gluten-free diet, I recommend using functional medicine’s 4R approach to heal your leaky gut. 

Remove the bad – Get rid of things that negatively affect the environment of the GI tract, such as inflammatory and toxic foods, and intestinal infections such as yeast overgrowth and SIBO.  

Restore what’s missing — Adding digestive enzymes and HCL to your daily regimen will help support optimal digestion and nutrient absorption, as well as assist your body’s intestinal repair and inflammation responses. 

Reinoculate with healthy bacteria — Restore beneficial bacteria with probiotics to re-establish a healthy balance of good bacteria to heal your gut. 

Repair the gut — Provide nutrients necessary to help the gut repair itself. L-glutamine is an amino acid that will support gut lining. Drinking bone broth or collagen will also help to heal your gut, as will supplementing with omega-3s, zinc, and herbs such as slippery elm and aloe vera

In my book, The Thyroid Connection, I dive deeper into other root causes that can disrupt your thyroid function. I also discuss optimal hormone levels, how to work with your doctor to ensure you get the right diagnosis, and to help you understand which labs to inquire about. Most importantly, I offer a step-by-step, 28-day plan with recipes, meal plans, supplements, and stress-reducing techniques to restore your thyroid function and live a more vibrant life.

The Final Word

There is no shortage of information when it comes to the thyroid and gut health connection. Whether you have Hashimoto’s, Graves’, or any of the hundreds of other autoimmune diseases, there are ways to reverse your diagnosis and take back your life. 

In my New York Times Bestsellers, The Autoimmune Solution and The Thyroid Connection you will learn how to address the true underlying causes of your symptoms. Using my simple yet proven dietary and lifestyle changes, it’s possible to reverse your symptoms. Through this comprehensive reset, you will regain your energy and feel like yourself again!

Article Sources

  1. Hashimoto's Disease. Leonard Wartofsky, M.D., M.A.C.P.. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. 2021.
  2. Prevalence and Impact of Thyroid Disease. American Thyroid Association.
  3. Molecular mimicry as a mechanism for food immune reactivities and autoimmunity. Aristo Vojdani. Altern Ther Health Med. 2015.
  4. Thyrotrophin (TSH) binding sites on Yersinia enterocolitica recognized by immunoglobulins from humans with Graves' disease. P Heyma, L C Harrison, R Robins-Browne. Clin Exp Immunol. 1986.
  5. Iodine. Office of Dietary Supplements. 2022.