Hashimoto's and Celiac Disease: What Is the Connection?

When you have Hashimoto's, you may start looking at food differently, especially if you're dealing with bloating, changes in bowel habits, or fatigue that doesn't seem to go away.

Perhaps you don't have obvious digestive symptoms at all, but you've been feeling unwell for a long time. Then you come across information about the connection between Hashimoto's and celiac disease.

That connection is real. Celiac disease is more common in people with autoimmune thyroid disease than in people without it.

But that doesn't mean everyone with Hashimoto's has celiac disease. And it certainly doesn't mean you automatically need to follow a gluten-free diet after receiving a Hashimoto's diagnosis.

Understanding the difference is important, especially if you have ongoing symptoms and are considering removing gluten from your diet.

What Is the Connection Between Hashimoto's and Celiac Disease?

Hashimoto's and celiac disease are both autoimmune conditions, but they affect different parts of the body.

In Hashimoto's, the immune system attacks the thyroid gland. Over time, this can damage the thyroid and reduce its ability to produce thyroid hormones.

In celiac disease, the immune system reacts to gluten in genetically susceptible people. Gluten is a group of proteins found in wheat, barley, and rye.

When someone with celiac disease eats gluten, an inflammatory reaction can damage the lining of the small intestine and interfere with nutrient absorption.

These are two separate conditions, but they occur together more often than would be expected by chance.

People with one autoimmune condition have an increased likelihood of developing another. Shared genetic and immune-related factors may help explain this connection.

However, Hashimoto's doesn't directly cause celiac disease, and celiac disease doesn't automatically cause Hashimoto's.

Are People With Hashimoto's More Likely to Have Celiac Disease?

Yes. People with autoimmune thyroid conditions have a higher risk of celiac disease.

That's why healthcare professionals may consider celiac testing in certain situations, particularly when symptoms or other medical findings suggest the condition.

However, an increased risk doesn't mean most people with Hashimoto's have celiac disease.

A Hashimoto's diagnosis alone isn't proof that gluten is causing your symptoms.

It does mean that persistent or unexplained symptoms deserve appropriate attention.

Do You Need to Avoid Gluten if You Have Hashimoto's?

Not automatically.

If you have confirmed celiac disease, a strict lifelong gluten-free diet is necessary. Even small amounts of gluten can trigger an immune response and damage the small intestine.

If you have Hashimoto's without celiac disease, there is no general medical recommendation that you must completely avoid gluten because of your thyroid condition.

Some people notice that they feel better after changing their diet. That experience is worth taking seriously.

But feeling better without gluten isn't the same as having a confirmed diagnosis of celiac disease.

That's why investigating possible medical causes before eliminating gluten can be important.

Why Is Gluten Discussed So Often With Hashimoto's?

Many symptoms experienced by people with Hashimoto's also occur with other conditions.

Fatigue, bloating, changes in bowel habits, brain fog, and a general feeling of being unwell are not specific to one diagnosis.

When you learn that Hashimoto's and celiac disease occur together more often, it's understandable to wonder whether gluten could be responsible.

But bloating doesn't automatically mean you have celiac disease. And fatigue alone isn't evidence that gluten is causing your symptoms.

Even if you feel better after removing bread or pasta, that improvement doesn't establish a celiac disease diagnosis.

Specific medical testing is needed.

What Exactly Is Celiac Disease?

Celiac disease is an autoimmune condition in which the immune system reacts to gluten.

In people with celiac disease, eating gluten can trigger inflammation in the small intestine. This may damage the intestinal villi, which help the body absorb nutrients.

As a result, nutrient absorption can become impaired.

Celiac disease isn't the same as a wheat allergy.

It also isn't automatically the same as experiencing digestive discomfort after eating bread or other gluten-containing foods.

A diagnosis requires appropriate medical evaluation.

What Are the Symptoms of Celiac Disease?

Celiac disease can cause a wide range of symptoms.

Some people mainly experience digestive problems, including diarrhea, constipation, abdominal pain, or bloating.

Others may notice fatigue, anemia, unexplained weight changes, or deficiencies in certain nutrients.

Symptoms outside the digestive system can also occur.

Not everyone with celiac disease experiences the typical combination of abdominal pain and diarrhea.

This can make the condition harder to recognize, especially if you already have Hashimoto's and have become accustomed to certain ongoing symptoms.

Can You Have Celiac Disease Without Digestive Symptoms?

Yes. Celiac disease can occur without obvious gastrointestinal symptoms.

In some people, it's discovered during investigations for anemia, nutrient deficiencies, or other medical concerns.

You cannot rule out celiac disease simply because you don't have abdominal pain or diarrhea.

If you have Hashimoto's and unexplained symptoms or abnormal test results, discuss whether celiac testing may be appropriate with your healthcare professional.

How Is Celiac Disease Diagnosed?

Testing for celiac disease usually begins with blood tests for specific antibodies.

A commonly used test measures tissue transglutaminase IgA antibodies, often called tTG-IgA.

Total IgA may also be measured because IgA deficiency can affect the reliability of certain antibody tests.

Depending on the results, your age, and your medical circumstances, additional testing may be needed to confirm the diagnosis.

In adults, this may include an examination of the small intestine with biopsies.

Your healthcare professional will determine which tests are appropriate.

One point is particularly important: **don't start a gluten-free diet before your celiac disease testing has been completed.**

Why Should You Keep Eating Gluten Before a Celiac Test?

Celiac testing looks for evidence of the body's reaction to gluten.

If you've already removed gluten from your diet for an extended period, antibody levels may decrease and the intestinal lining may begin to heal.

This can make blood tests and intestinal investigations less reliable.

If you suspect celiac disease, discuss testing with your healthcare professional before removing gluten.

If you're already following a gluten-free diet, don't start eating large amounts of gluten again on your own to test yourself.

Your healthcare professional can advise you on the appropriate next steps.

Can You Test Yourself by Trying a Gluten-Free Diet?

Not reliably.

You may notice changes in bloating, fatigue, or other symptoms when you stop eating gluten-containing foods.

But this isn't a diagnostic test for celiac disease.

When you remove bread, pasta, cookies, and other foods, you often change more than just your gluten intake.

You may also eat fewer processed foods or replace them with rice, potatoes, vegetables, and other ingredients.

That's why feeling better without gluten doesn't prove that gluten itself was the cause.

Can Celiac Disease Affect Levothyroxine Absorption?

Yes, it can.

Untreated celiac disease may damage the lining of the small intestine and interfere with nutrient absorption.

In some people, it can also reduce the absorption of levothyroxine.

This may become relevant if your thyroid levels are difficult to stabilize despite taking your medication consistently, or if you appear to need a relatively high levothyroxine dose.

That doesn't prove you have celiac disease.

Thyroid levels can fluctuate for several reasons, including medication timing and interactions with food, supplements, or other medicines.

However, when other signs of celiac disease are present, it's worth discussing this possibility with your healthcare professional.

What Happens to Levothyroxine When Celiac Disease Is Treated?

For confirmed celiac disease, treatment involves following a strict gluten-free diet.

As the intestinal lining heals, nutrient absorption may improve. Levothyroxine absorption may change as well.

If you take thyroid medication, it's important to continue monitoring TSH and, when appropriate, FT4 according to your healthcare professional's advice.

Never adjust your levothyroxine dose on your own because you've started eating gluten-free.

Your healthcare professional can determine whether any change is needed.

What if You Feel Better Without Gluten?

If certain foods seem to affect how you feel, that information matters.

But it doesn't automatically mean you have celiac disease.

There are other possible explanations for symptoms after eating wheat or gluten-containing foods.

When symptoms persist, identifying the actual cause is usually more helpful than continuing to eliminate additional foods without a clear reason.

This can help prevent unnecessary dietary restrictions.

Hashimoto's Doesn't Mean You Need to Eliminate Everything

Living with Hashimoto's can sometimes make nutrition feel like a complicated puzzle.

You may read advice telling you to avoid gluten, dairy, sugar, or soy.

Before long, the list of foods you believe you shouldn't eat becomes increasingly long.

But Hashimoto's doesn't automatically mean you need a strict elimination diet.

Celiac disease is different. In that case, a gluten-free diet is medically necessary.

It's important to distinguish between a confirmed medical condition and removing foods without a clear medical reason.

When Should You Discuss Celiac Disease With Your Doctor?

It may be worth discussing celiac disease if you have Hashimoto's alongside persistent or unexplained symptoms.

These might include long-term diarrhea, recurring abdominal pain, bloating, anemia, nutrient deficiencies, unexplained fatigue, or weight changes.

A family history of celiac disease may also be relevant.

Difficulty stabilizing thyroid levels despite consistent medication use can be another reason to review possible contributing factors.

Your healthcare professional can assess whether celiac blood tests or further investigations are appropriate.

Hashimoto's and Celiac Disease: What Should You Remember?

Hashimoto's and celiac disease are two different autoimmune conditions that occur together more often than in people without autoimmune thyroid disease.

But having Hashimoto's doesn't automatically mean you have celiac disease.

And you don't need to follow a gluten-free diet simply because you've been diagnosed with Hashimoto's.

If celiac disease is confirmed, a strict gluten-free diet is essential.

If you suspect celiac disease, speak with your healthcare professional about testing before removing gluten from your diet.

Sometimes taking better care of yourself doesn't begin with eliminating more foods. It begins with understanding what's actually causing your symptoms.