Celiac disease and thyroid: what link is there?
Celiac disease is an autoimmune disease caused by gluten intolerance, or more precisely by the body's reaction to prolamin, a protein found in wheat and other common cereals, such as barley, rye, oats, spelled.
Their consumption causes an inflammatory reaction that mainly manifests itself with diarrhea, abdominal cramps, swelling and growth retardation, and is capable of causing damage to the intestinal mucosa (atrophy of the villi). Symptoms may sometimes not be present, complicating the identification of the disease, but it is estimated that one in 100 people suffer from it in Italy, with 10,000 new cases every year. A recent Italian study, The New Epidemiology of Celiac Disease - Journal of Pedriatic Gastroenterology and Nutrition, highlighted how celiac disease has registered an increase of about 5 times worldwide in the last 25 years, both in areas historically most affected for their diet rich in gluten-containing cereals (Europe and USA), and in others, where until now it was less frequent among the population thanks to the high consumption of rice (Asia).
In addition to an improvement and greater ease of access to diagnostic services that make it possible to detect more and more new cases, it seems that this spread is also attributable to the introduction of wheat crops in new areas and, above all, to a change in models food in children.
Celiac disease and hypothyroidism
Celiac disease seems in some way related to other autoimmune diseases, in particular thyroid diseases: even if there are no precise data about it, statistically celiac disease patients are still more prone to Hashimoto's thyroiditis and Basedow's disease.
What is certain, in any case, is that hypothyroid patients who have gluten intolerance and who follow hormone replacement therapy with levothyroxine, can see the therapeutic result compromised due to intestinal malabsorption.
The choice of the most suitable formulation of the synthetic thyroid hormone is decisive in these cases for the well-being of the patient: the new liquid formulations of levothyroxine in single-dose oral solution or in soft capsules, for example, compared to traditional tablets, guarantee the optimal therapeutic result in all conditions, thanks to a more stable and reproducible absorption and a lower variability of concentration of the active ingredient in the blood.
The gluten-free diet
Today the only effective therapy for celiac disease consists in the exclusion from the diet of any food containing even minimal amounts of gluten. Naturally, therefore, pasta, bread, pizza, biscuits, snacks and snacks, up to a wide range of foods that may contain small traces.
The complete exclusion of gluten from the diet is therefore not easy to implement and there is a risk of accidental contamination, due to the processing processes of the food industry: in this regard, the list of allowed foods, published on the website of the Italian Celiac Association , it is very complete and, in some ways, surprising, including cold cuts, ice creams, sauces, instant coffee and many other "unsuspected" products among the foods at risk.
Please note that the set of regulations, known as "Codex Alimentarius", developed by a specific FAO Commission, establish that a food product, in order to be defined as "gluten-free" must contain less than 20 mg / kg. From this point of view, it is good to clarify that a gluten-free diet inevitably conditions daily habits such as shopping or eating out, but it should by no means be considered "punitive", as celiacs still have many carbohydrates available as a source of carbohydrates. gluten-free grains (rice and corn) or other vegetables such as potatoes.
In collaboration with Il Portale della Salute
