Some research suggests that people with celiac disease may have higher rates of thyroid disease, including hypothyroidism, than the general population. People with thyroid disease may also have higher rates of celiac disease.
Hypothyroidism is an underactive thyroid gland. In hypothyroidism, the thyroid gland does not make enough thyroid hormone to support body functions.
Celiac disease is a chronic digestive disease involving small intestine inflammation and impaired nutrient absorption.
These conditions share some symptoms, and it is possible for a person to have both conditions.
A 2020 study of 288 people with untreated celiac disease and 200 control subjects in Iran suggests a strong association between thyroid disease and celiac disease.
In the study, thyroid disease rates were four times higher in people with celiac disease than in those without. The researchers observed hypothyroidism in 30 people with celiac disease and hyperthyroidism in 9.
They suggest that thyroid disease was more likely to affect females and younger participants.
A 2017 review suggests that the prevalence of autoimmune thyroiditis may be higher among people with celiac disease and vice versa.
The authors suggest that the rate of hypothyroidism and Hashimoto’s thyroiditis, a common type of autoimmune thyroid disease, are higher among adults with celiac disease than children.
A 2022 study found that rates of thyroid disease among people with celiac disease were twice as high than in people without celiac disease, and most cases of thyroid disease involved hypothyroidism.
The study authors concluded that people with celiac disease appear to have a higher risk of thyroid disease and recommended that they receive regular screening to assess their thyroid function.
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The authors suggest that these conditions may share a genetic link. Genes that may be involved in both conditions include:
- human leukocyte antigen (HLA)
- cytotoxic T-lymphocyte-associated antigen (CTLA)
- interleukin (IL)
- interferon (IFN)
A 2017 review suggests the following factors may also play a role in the shared association between these conditions:
- Shared autoantibodies: Autoantibodies are proteins that the immune system makes. These proteins target and attack the body’s tissues. Hypothyroidism and celiac disease may share certain autoantibodies.
- Shared immune pathways: Autoimmune thyroid disease and celiac disease may both involve:
- chronic inflammation
- immune cells infiltrating and damaging the target organs
- the release of similar types of cytokines — proteins that help control the growth and activity of other immune system cells
- Problems with the gut microbiota: Problems with the gut microbiota may affect the small intestine and influence thyroid function.
More research is necessary to understand what may cause the association between thyroid disease, including hypothyroidism, and celiac disease.
A 2017 review suggests that symptoms of undiagnosed celiac disease may differ in people with thyroid disease. The review authors also state that symptoms of both conditions can overlap and may include:
Other celiac disease symptoms
People with celiac disease experience symptoms after eating gluten. Symptoms
Digestive symptoms may be more common in children than adults, and symptoms typically resolve if someone avoids gluten.
Other hypothyroidism symptoms
Symptoms of hypothyroidism may also vary from person to person and develop slowly over
Common symptoms of hypothyroidism include:
To diagnose celiac disease, doctors
To diagnose hypothyroidism, doctors will use blood tests to measure the levels of certain hormones and antibodies, such as thyroid-stimulating hormone.
If blood tests indicate thyroid disease, a doctor
If someone receives a diagnosis of either of these conditions, their doctor may recommend screening for the other. However, there are no consensus-based recommendations on how often to screen for celiac in people with hypothyroidism or vice versa.
Treatment for celiac disease
People with celiac disease may also need to attend regular follow-up appointments with their doctor or dietitian to assess symptoms and adjust their diet.
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Doctors usually prescribe levothyroxine in pill form. However, if someone has celiac disease or another digestive issue that affects their ability to absorb medication, their doctor may prescribe levothyroxine liquid or softgel capsules.
People will usually need a blood test around
Each time a doctor adjusts the dosage, the person will need a follow-up blood test. Once they reach the optimal dosage, their doctor will repeat the blood test in 6 months and then again at yearly intervals.
Can people with celiac disease take levothyroxine?
People with celiac disease can typically take levothyroxine, but doctors may prescribe liquid or gel forms of the medication to help with absorption. They should also remain on a gluten-free diet to increase the chance of absorption.
In an older 2016 case study, a 33-year-old female was taking levothyroxine to treat Hashimoto’s thyroiditis, but her symptoms continued despite regular medication.
Blood tests and investigations of the small intestine confirmed that she had celiac disease. The doctors concluded that the celiac disease had caused intestinal malabsorption, adversely affecting her absorption of levothyroxine.
When she began a gluten-free diet, her symptoms improved, and her thyroid hormones remained stable.
People should speak with their doctor if they have celiac disease and need to start taking levothyroxine. Their doctor may suggest adjustments to their diet to increase the chance of absorbing the medication properly.
People with celiac disease must follow a gluten-free diet for life, while those with hypothyroidism must take levothyroxine for life.
Both conditions also require regular monitoring to ensure that the symptoms do not worsen and to help prevent complications.
With treatment, people with celiac disease, hypothyroidism, or both are usually able to maintain their quality of life as long as they continue to take their medications as their doctor advises.
People should contact a doctor if they develop symptoms of celiac disease or hypothyroidism or if they have one of these conditions and would like to discuss screening for the other.
People should also see a doctor if they are taking levothyroxine for hypothyroidism and experience a continuation or worsening of symptoms.
This may indicate that their doctor needs to adjust their levothyroxine dosage. It may also indicate that another underlying issue, such as celiac disease, is interfering with their body’s ability to absorb the medication.
Some research suggests that people with celiac disease have higher rates of thyroid disease and vice versa. This may be due to the conditions sharing certain genes, autoantibodies, or other features.
Hypothyroidism and celiac disease may also share certain symptoms, including fatigue, depression, and hair loss. This may make it difficult for a person to recognize when they have both conditions.
If someone has a diagnosis of hypothyroidism and celiac disease, their doctor may make changes to their treatment plan to ensure they can successfully manage both conditions.