I just read in the Goiter belt thread that many with PD also have thyroid disease. Do you know if there is actually a higher prevalence of thyroid disease in those with PD than in the general population? If so, it might be one more reason to consider gluten.
Anyone with Hashimoto's thyroiditis (Hashimoto's thyroid disease is autoimmune, and I think something like 95% of all hypothyroidism is Hashimoto's)... might want to take a closer look for gluten sensitivity... on the basis that there is also an increased association of thyroid disease and celiac disease. (Grave's disease, too.)
There is some newer researcher that suggests gluten sensitivity (and maybe casein sensitivity) may actually be a trigger for developing autoimmune thyroid disease and some other autoimmune diseases. Intestinal permeability is involved in this theory.
Quote:
There is, however, growing evidence that the loss of the intestinal barrier function typical of celiac disease could be responsible of the onset of other autoimmune disease. This concept implies that the autoimmune response can be theoretically stopped and perhaps reversed if the interplay between autoimmune predisposing genes and trigger(s) is prevented or eliminated by a prompt diagnosis and treatment.
Systemic autoimmune disorders in celiac disease.
PMID: 17053448 Nov 2006 Full text on Medscape
When the finely tuned trafficking of macromolecules is dysregulated in genetically susceptible individuals, both intestinal and extraintestinal autoimmune disorders can occur. This new paradigm subverts traditional theories underlying the development of autoimmunity, which are based on molecular mimicry and/or the bystander effect, and suggests that the autoimmune process can be arrested if the interplay between genes and environmental triggers is prevented by re-establishing intestinal barrier function.
Mechanisms of disease: the role of intestinal barrier function in the pathogenesis of gastrointestinal autoimmune diseases. PMID: 16265432 Sept 2005
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Quote:
From:
Emerging concepts in celiac disease by William Treem, MD
"The association of CD with autoimmune diseases, particularly Type 1 diabetes and autoimmune thyroid disease, has been widely reported with some investigators finding a ten-fold increase in patients with CD compared with the general population [68,69].Less clear is the link between CD and Sj๖gren syndrome, primary biliary cirrhosis, Addison disease, autoimmune chronic active hepatitis, cardiomyopathy, and peripheral neuropathy (not due to B-12 or vitamin E deficiency) [7073,74].
When both CD and autoimmune disease occur in a patient, CD is most often silent.The autoimmune disease is diagnosed first with the diagnosis of CD the result of serologic screening in this high-risk population. The question whether the early diagnosis and treatment of CD reduces the risk of developing other autoimmune diseases is still open to debate.There are several lines of evidence that support the notion that CD is a causative factor in the development of other autoimmune diseases. A recent study suggests that the prevalence of autoimmune diseases is closely related to the duration of gluten exposure and the age of initiation of a GFD with children diagnosed and treated before 2 years of age having little subsequent increased risk [75].Older children diagnosed with CD have a higher than expected frequency of organ-specific autoantibodies that tend to disappear after starting a GFD.Anecdotal reports suggest that socalled "celiac neuropathy", IgA nephropathy, juvenile rheumatoid arthritis, and autoimmune myocarditis will all improve when patients who have underlying CD are maintained on a strict GFD [73,74,76,77]. "
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Quote:
In a 1999 study, Ventura, et.al. found
that those diagnosed with celiac disease
between 2-4 years of age had a 10.5%
chance of developing an autoimmune
disorder.
Additional findings based on age at diagnosis
and chance of developing an
autoimmune condition are:
4 12 yrs of age 16.7%
12 20 yrs of age 27%
Over 20 yrs of age 34%
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Since gluten sensitivity can cause neurological disease
even without celiac disease it is important to have all the tests run,
especially the antigliadin antibodies which are often left out of celiac disease screening. There is more about testing in The Gluten File - Diagnostic Testing page.
If caught early enough, sometimes the thyroid antibodies have actually come down... and the thyroid disease reversible. This is not the norm as gluten sensitivity needs to be uncovered at the very onset of thyroid disease, before permanent damage has been done... but there are some isolated reports of thyroid disease remitting on a gluten free diet. This research is all relatively new, and ongoing.
http://thyroid.about.com/cs/latestresearch/a/celiac.htm
Quote:
Antibody screening for coeliac disease should be included in the work-up of patients with autoimmune thyroiditis
Coeliac disease in patients with autoimmune thyroiditis. PMID: 11549838
The greater frequency of thyroid disease among celiac disease patients justifies a thyroid functional assessment. In distinct cases, gluten withdrawal may single-handedly reverse the abnormality.
Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study. PMID: 11280546
On gluten-free diet an excellent clinical and histological response was recorded with an improvement of hypothyroidism and reduction of the thyroxine dosage. Our data suggest a significant high prevalence (3.3%) of CD in patients with ATD, in particular with Hashimoto's thyroiditis.
Prevalence of coeliac disease in patients with thyroid autoimmunity. PMID: 10461017
These results show that the prevalence of coeliac disease in patients with autoimmune thyroid diseases is significantly increased when compared with the general. We suggest a serological screening for coeliac disease in all patients with autoimmune thyroid disease measuring anti-endomysial antibodies, considering that early detection and treatment of coeliac disease are effective in preventing its complications.
Prevalence and early diagnosis of coeliac disease in autoimmune thyroid disorders.PMID: 10425571
After 18 months on gluten-free diet, the anti-thyroid antibodies titre decreased significantly, and we could discontinue thyroid substitutive therapy.
Unusual association of thyroiditis, Addison's disease, ovarian failure and celiac disease in a young woman. PMID: 10401714
Moreover, untreated patients with celiac disease have been found to have a higher than expected prevalence of organ-specific autoantibodies. In a prospective study of 90 patients with celiac disease, we found that the prevalence of diabetes and thyroid-related serum antibodies was 11.1% and 14.4%, respectively. Like antiendomysium autoantibodies, these organ-specific antibodies seem to be gluten-dependent and tend to disappear during a gluten-free diet.
Gluten-dependent diabetes-related and thyroid-related autoantibodies in patients with celiac disease. PMID: 10931424
A significant proportion of patients with Hashimoto's thyroiditis present signs of 'potential' CD and of activated mucosal T cell immunity. The gluten dependence of such findings remains to be ascertained.
Markers of potential coeliac disease in patients with Hashimoto's thyroiditis. PMID: 11916614
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