31 replies to this topic

[landslide]

I forgot to ask: have you ever heard of anyone having non-Hashimoto's thyroid problems which resolve on a gluten-free diet? The reason I'm asking is because Hashimoto's seems to be the case in the celiac thyroid connection but from the blood tests, it looks like I don't have Hashi's. The reason I'm having a biopsy is to find out whether or not I have some kind of inflammation of the thyroid. If that's the case, I'll have a bit more to work with and there'd be less speculation involved. However, whether it's Hashi's, non-Hashi's or something else, I guess I should still try going gluten-free, correct nutritional deficiencies and hope for the best, eh?

[GFinDC]

I think gluten is your most likely culprit, since celiac runs in your family. People with celiac also tend to get other auto-immune diseases, especially if they don't follow the diet. It might eb interesting for you to make list of the other auto-immune diseases in your family. It might lead you to a guess about which side the celiac genes are on. If they aren't o both that is. If you search on "celiac associated condition" or "celiac related condition" you can find lists of the other auto-immune diseases that are more common in celiacs.

It sure sounds like celiac could be the problem to me.

[landslide]

As I said, I hope gluten is the culprit as that would make it easy for me to fix everything, but my point was that there is no indication that my problems are auto-immune related, or is there? I mean, I tested negative for celiac, I have no thyroid antibodies (TPO, TR, TG) and diabetes test was negative. The only disease (of any kind) in the family I know of is one case of celiac which my brother has, but nothing else that I know of. Then again, celiac and thyroid problems are vastly underdiagnosed, so there might be hidden cases in my family...

[landslide]

After reading on Wikipedia about Celiac disease I came across the miscellaneous section which covers certain related conditions. I think I have four of the six conditions listed:

IgA deficiency - 0.9 g/L [0,9-4,5] in one test and 0.83 g/L [0.88-4.5] in another
Infertility - semen analysis showed low motility and sperm count
Hyposplenism - unsure about this one, but my thrombocyte count is low
Abnormal liver function tests - bilirubin has always been high and AST has occasionally been elevated, haptoglobin was abnormal in one test as well, 1 mg/dL (2.4-19)

http://en.wikipedia.org/wiki/Celiac_disease#Miscellaneous

This is in addition to all the other symptoms I've mentioned in previous posts. Now, the big question is whether or not this would be applicable in my case...

[landslide]

I had an abdomen ultrasound today and the preliminary results were ok - nothing out of the ordinary. I specifically asked them to image my adrenals to make sure they look ok which they apparently did. I hope ultrasound images are a lot easier for docs to interpret than blood tests as I've had my share of you're-in-range-there's-nothing-wrong-with-you-crap. Up next is another brain MRI (last one was done seven years ago) and thyroid ultrasound.

On a sidenote: how much of an issue would cross-contamination be for someone like me? I just read through the Gluten-For-Beginners-list and was shocked at how careful one needs to be. I've been using the same toaster, collander, frying pan, tupperware etc but I'm going to replace all that today. Assuming I've been cross-contaminated this whole time, I might as well call this day 1 of being gluten-free, not day 70. Damn it!

[GFinDC]

Hi Landslide,


CC is a serious issue. Think about how your immune system reacts to germs. Once you become immune to something the germs get killed off by your immune cells. After you are all better your immune system relaxes. But if another germ of the same kind gets in your system the immune system perks up and starts fighting again. It doesn't matter if it is a tiny little microscopic germ, the immune system can't afford to let little things go. If it did we wouldn't last very long.

So, yeah, cc from a toaster or anything is bad news.

[Skylark]

I forgot to ask: have you ever heard of anyone having non-Hashimoto's thyroid problems which resolve on a gluten-free diet? The reason I'm asking is because Hashimoto's seems to be the case in the celiac thyroid connection but from the blood tests, it looks like I don't have Hashi's. The reason I'm having a biopsy is to find out whether or not I have some kind of inflammation of the thyroid. If that's the case, I'll have a bit more to work with and there'd be less speculation involved. However, whether it's Hashi's, non-Hashi's or something else, I guess I should still try going gluten-free, correct nutritional deficiencies and hope for the best, eh?

Sometimes I wonder about malabsorption of iodine or selenium in non-Hashi's hypothyroidism.

[landslide]

Hi Landslide,


CC is a serious issue. Think about how your immune system reacts to germs. Once you become immune to something the germs get killed off by your immune cells. After you are all better your immune system relaxes. But if another germ of the same kind gets in your system the immune system perks up and starts fighting again. It doesn't matter if it is a tiny little microscopic germ, the immune system can't afford to let little things go. If it did we wouldn't last very long.

So, yeah, cc from a toaster or anything is bad news.

I see, I'm beginning to realise that my gluten-free trial is going to be a lot more difficult than I initally thought. The problem with cross-contamination for me is that I don't have full-blown celiac, so assuming I have gluten sensitivity (which I don't know for sure) and get cross-contaminatied, the symptoms might be very subtle or not noticeable at all except in the form of weak iron, hemoglobin, platelets in blood tests. Working with this amount of unknown factors i.e not knowing if I even have gluten sensitivity and not knowing if I'm being cross-contaminated is really going to be a challenge...

Anyway, I've gotten rid of my plastic colander, toaster, all pots, pans, tupperware and cutting boards. I'm curious about some things though:

1. It should be ok to keep a non-wired, steel colander, provided that I wash it carefully, right?
2. At work, I bring a lunch box and heat it up in the microwave, how can I avoid cross-contamination there? Maybe if I keep the lid on on the lunch box while it's being heated - would that do the trick?

Sometimes I wonder about malabsorption of iodine or selenium in non-Hashi's hypothyroidism.

I think you're on to something. Have you read this study? http://www.scielosp....nrm=iso&tlng=en
It refers to selenium malabsorption in celiac disease so I'm not sure if it would be applicable to non-celiacs, but interesting nonetheless. As far as my own thyroid status is concerned, I'll know more once I've had the ultrasound/biopsy - I believe Hashi's is possible without detectable antibodies in the blood, so we'll see.

[Skylark]

I think you're on to something. Have you read this study? http://www.scielosp....nrm=iso&tlng=en
It refers to selenium malabsorption in celiac disease so I'm not sure if it would be applicable to non-celiacs, but interesting nonetheless. As far as my own thyroid status is concerned, I'll know more once I've had the ultrasound/biopsy - I believe Hashi's is possible without detectable antibodies in the blood, so we'll see.

That is extremely relevant. Gliadin has been shown to trigger overproduction of IL-15 in people with non-celiac gluten intolerance as well as celiacs. It seems to be an innate effect on the immune system, requiring no antibodies at all. Overproduction of IL-15 is the first step in the development of celiac, but in some folks the extra IL-15 seems to be enough to cause malabsorption and some degree of inflammation on its own. If excess IL-15 can cause thyroid inflammation, that may be the link we've been looking for between gluten sensitivity and thyroid disease.

As far as the kitchen, I kept my old aluminum colander, just washing it very carefully. I don't worry about the microwave at work as long as my food is in a dish. I do not use the toaster oven. I'm not sure why you got rid of pots and pans. Were they scratched teflon? Otherwise they wash up fine. Tupperware without scratches is fine too. Agreed cutting boards should go as they're always scratched up. It's also really hard to de-gluten a toaster.

[landslide]

That is extremely relevant. Gliadin has been shown to trigger overproduction of IL-15 in people with non-celiac gluten intolerance as well as celiacs. It seems to be an innate effect on the immune system, requiring no antibodies at all. Overproduction of IL-15 is the first step in the development of celiac, but in some folks the extra IL-15 seems to be enough to cause malabsorption and some degree of inflammation on its own. If excess IL-15 can cause thyroid inflammation, that may be the link we've been looking for between gluten sensitivity and thyroid disease.

I see, very interesting! The innate immunity you're referring to, I suppose it's the same as Dr Fasano mentions in the link below? "Their immune reactions were different, too [compared to Celiacs]. In the gluten-sensitive group, the response came from innate immunity, a primitive system with which the body sets up barriers to repel invaders."
http://online.wsj.com/article/SB10001424052748704893604576200393522456636.html

As far as the kitchen, I kept my old aluminum colander, just washing it very carefully. I don't worry about the microwave at work as long as my food is in a dish. I do not use the toaster oven. I'm not sure why you got rid of pots and pans. Were they scratched teflon? Otherwise they wash up fine. Tupperware without scratches is fine too. Agreed cutting boards should go as they're always scratched up. It's also really hard to de-gluten a toaster.

Thanks for the info. Yes, pots and pans were all scratched teflon so they had to go, same thing with my tupperware.

[Skylark]

I see, very interesting! The innate immunity you're referring to, I suppose it's the same as Dr Fasano mentions in the link below? "Their immune reactions were different, too [compared to Celiacs]. In the gluten-sensitive group, the response came from innate immunity, a primitive system with which the body sets up barriers to repel invaders."
http://online.wsj.com/article/SB10001424052748704893604576200393522456636.html

Yes, that's the study. The role of an innate IL-15 response as the first step in celiac is also pretty well documented. The model is gluten -> IL-15 through innate immunity -> interferon-gamma and NK cells -> inflammation and apoptosis of epithelial cells -> abnormal antigen presentation of gliadin by DQ2 or DQ8 -> anti-gliadin antibodies -> recruitment of CD8+ cells to the intestine to "kill" the gluten -> (insert uncertain mystery step) -> TTG antibodies -> celiac.

Thing is, it's looking more and more like just the IL-15 is enough to cause some folks a heap of trouble. Some research suggests that the loss of intestinal integrity is more a result of the innate immunity than autoimmunity.

Scratched teflon is bad news anyway. Sounds like it was time for nice, fresh pots.

[landslide]

Yes, that's the study. The role of an innate IL-15 response as the first step in celiac is also pretty well documented. The model is gluten -> IL-15 through innate immunity -> interferon-gamma and NK cells -> inflammation and apoptosis of epithelial cells -> abnormal antigen presentation of gliadin by DQ2 or DQ8 -> anti-gliadin antibodies -> recruitment of CD8+ cells to the intestine to "kill" the gluten -> (insert uncertain mystery step) -> TTG antibodies -> celiac.

Thing is, it's looking more and more like just the IL-15 is enough to cause some folks a heap of trouble. Some research suggests that the loss of intestinal integrity is more a result of the innate immunity than autoimmunity.

Scratched teflon is bad news anyway. Sounds like it was time for nice, fresh pots.

Ok, very interesting model! If it's true that IL-15 is enough to cause problems, that would explain why some of my symptoms (IgA deficiency, elevated liver enzymes, subfertility, low platelet count, borderline anemia etc) point to celiac disease although I don't have elevated gluten antibodies.

[landslide]

Had an MRI with a contrast agent yesterday and everything was fine. Not that I was expecting anything else but it's always nice to know my pituitary is ok.

I have a thyroid ultrasound tomorrow. I also asked my doc to schedule a testicle ultrasound - might as well cover all bases while I'm at it.

[landslide]

Had a thyroid ultrasound today which came back normal. I wonder if a biopsy is needed if the ultrasound didn't show anything? I could get one if I want to, but there's obviously a risk associated with it... Any advice?

[Skylark]

I'm glad to hear everything is checking out OK. The time I had nodules on my thyroid, I was not referred for biopsy after a non-worrying thyroid ultrasound. You'll have to go with the advice of your doctors though.