The Role of Gluten in the Development of Autoimmune Thyroid Diseases: A Narrative Review

Abstract

Context: In recent decades, adverse reactions to gluten have increased, collectively known as gluten-related disorders (GRDs). The most prominent GRD is celiac disease (CD), a T-cell-mediated autoimmune-like disorder of the small intestine triggered by the ingestion of gluten proteins in genetically predisposed individuals. Celiac disease is often associated with various autoimmune and idiopathic conditions, including autoimmune thyroid disorders (AITDs). Autoimmune thyroid disorders result from immune system dysregulation and lead to an assault on the thyroid gland. This study aims to examine the potential effect of gluten consumption on the development of AITDs. Evidence Acquisition: A narrative literature review was conducted using the Google Scholar, Scopus, and PubMed electronic databases to identify studies investigating the role of gluten in the development of AITDs. Keywords such as "Gluten," "Autoimmune thyroid disease," and "Gluten-free diet" were used. Results: The involvement of gluten in the pathogenesis of autoimmune diseases is mediated through various mechanisms. Gluten may contribute to the expansion and progression of AITDs through mechanisms such as dysbiosis, leaky gut, and cross-reactivity. There is evidence that adherence to a gluten-free diet (GFD) may positively impact patients with AITDs, supporting the importance of personalized dietary strategies to mitigate risks associated with gluten intake. Conclusions: The findings suggest that dietary management, particularly strict adherence to a GFD, may be beneficial for individuals with both CD and AITDs. Emerging evidence highlights the importance of personalized dietary strategies to mitigate the risks associated with gluten intake. A deeper understanding of the gut-thyroid axis could lead to the development of innovative approaches in the management of autoimmune disorders.