Celiac or Hashimoto?

[Glutton3]

Fellow Members,

 

I did a comprehensive blood test yesterday and turns out that my IGA-TtG is positive. I also have Anti Peroxidase Antibody - 38.7 kU/l (<34 is optimal) - an indicator of Hashimoto's - All other thyroid params are normal.

Doctors have long suspected I have Hashimoto's disease but never went for Celiac. I have a few questions:

 

1. Is it possible that Celiac might be causing Hashimoto's?

2. Is the IGA-TtG test enough to diagnose Celiac? Should I try a Gluten-free diet before getting an endoscopy?

3. Few insights/symptoms:

    a. I have anxiety and ADHD (both under medication).

    b. My mother and sister have anxiety, thyroid, depression and digestion issues.

    c. I have an irregular stool pattern (a mix of bleeding, constipation and diarrhoea, and infrequent severe stomach cramps).

  Apologies if the post is all over the place - I am just coming to terms and getting an understanding of what Celiac is. I am wondering how many of my issues are due to Celiac and how optimistic I should be about this.. I read about success stories where anxiety, depression, ADHD and thyroid symptoms improved after gluten-free for Celiac patients - giving me hope at the same time leaving me confused about which of my issues are genuine!

 

[trents]

Welcome to the forum, Glutton33!

Celiac doesn't cause Hashimoto's but there is a statistical correlation as there is between celiac disease and some other autoimmune diseases as well. Autoimmune diseases tend to cluster and my understanding is that this may be due to proximity of their genes in the genome.

The tTG-IGA is pretty specific for celiac disease. There are some other diseases, some medications and even the dairy protein casein (for some people) that can cause elevated tTG-IGA. Would you mind posting your score along with the reference range for negative vs. positive? Were any other celiac antibody tests run?

Do not start the gluten free diet before the endoscopy/biopsy! If you do, healing of the SB villi may occur and it will compromise the test results. Continue to eat regular amounts of gluten. The endoscopy/biopsy is the gold standard of celaic diagnosis.

If it turns out that you have celiac disease, your parents, siblings and your offspring should be tested, even if they are asymptomatic. Recent studies are pointing to an almost 50% chance that first degree relatives of those with active celiac disease will also have or will develop active celiac disease and half of those were asymptomatic.

[Glutton3]

Thanks Trents! Appreciate your response. 

[Glutton3]

@trents No other celiac tests were run. IgA TTG was only positive vs negative. IgA value is 1.54 g/l (0.9 - 4.5 Optimal)

[trents]

What "IGA value" do you refer to? The one you give numbers for seems to be within normal range. Is this total IGA? So you are saying there was no numerical value supplied for the tTG-IGA, just a "positive" notation? The tTG-IGA is just a slice of the total IGA.

[Glutton3]

Just now, trents said:

What "IGA value" do you refer to? The one you give numbers for seems to be within normal range. Is this total IGA? So you are saying there was no numerical value supplied for the tTG-IGA, just a "positive" notation? The tTG-IGA is just a slice of the total IGA.

That's correct - see below:

Immunoglobulin A (IgA) -  Result: 1.54 g/l - Range: 0.9 - 4.5 Optimal
Immunoglobulin G (IgG) -  Result: 14.34 g/l - Range: 6 - 16 Optimal
Immunoglobulin M (IgM) -  Result: 1.34 g/l - Range: 0.6 - 2.5 Optimal

Anti-Tissue Transglutaminase Antibodies (Coeliac Disease) - Result: Positive - Range: Positive Negative

 

 

[trents]

I see from the spelling of "Coeliac" on the report that you must be in the UK. It's too bad there isn't an actual numerical value given to the tTG_IGA. The higher the value the more likely it is that it is caused by celiac disease and not something else. Do you have a date yet for the endoscopy/biopsy? I note from other UK forum participants that these procedures are usually scheduled quite far out due to the stress on the national healthcare system.

Many or most of the health problems associated with celiac disease accrue from vitamin and mineral deficiencies. For those with celiac disease, consuming gluten creates inflammation of the small bowel lining or the "villi". Over time, this wears down the villi and greatly reduces the surface area for absorbing vitamins and minerals - and this is the area of the gut where essentially all nutrient absorption occurs. Of course, this is happening even though the celiac person may be eating quite well. It typically takes around two years for complete restoration of the villous lining once a truly gluten free diet is achieved. There is usually a significant learning curve involved in achieving a truly gluten free diet and studies show that most people who claim to be eating gluten free are actually only achieving a lower gluten diet. This is particularly true of those still eating out.

Edited January 6, 2023 by trents

[Scott Adams]

You may be interested in looking at some of the research summaries we've done on celiac disease and thyroid issues, including Hashimoto's disease:

https://www.celiac.com/celiac-disease/celiac-disease-amp-related-diseases-and-disorders/thyroid-pancreatic-disorders-and-celiac-disease/ 

[Wheatwacked]

On 1/6/2023 at 10:43 AM, Glutton3 said:

Is it possible that Celiac might be causing Hashimoto's?

Yes but Cause is a strong word.  Celiac causes malabsorption. You want to look at your iodine intake. Low vitamin D is a common factor in autoimmune diseases and higher levels of it may protect.

Low choline can cause gallstones, gall bladder disease, high homocysteine. It is needed for fat metabolism so could be the source of your  "mix of bleeding, constipation and diarrhoea, and infrequent severe stomach cramps"

The latest estimates is 40% of the first degree relatives of a person diagnosed celiac also have Celiac so your mom and sister show get checked. Their symptoms you described certainly fits Celiac disease.  Vitamin D deficiency can cause anxiety, depression, autoimmune diseases. As a non medical non professional I would say you are all in the same boat.

Hashimoto: Low D, low iodine. Even if TSH is in the low normal range.

Poor fat digestion: low choline.

Anxiety: could be low Lithium with low D

Depression: low D

Fatigue: B vitamins, especially Thiamine (B1), B3, B5, B6 and B12.

Vitamin D and Depression: Where is all the Sunshine?

Vitamin D and the Immune System

The Missing Link to Thyroid Fatigue

Iodine: Good or Bad for Thyroid Health?Why You Need Iodine for Hormones, Thyroid and More with Dr. David Brownstein

[knitty kitty]

@Glutton3,

I like this article, written by a doctor with Hashimoto's, explaining how Thiamine (Vitamin B 1) can manifest as Hashimoto's.

Thiamine is the vitamin that we can run out of quickly because we don't eat enough, can't absorb enough, or use up quickly like when we're stressed emotionally or physically.  

https://thyroidpharmacist.com/articles/thiamine-and-thyroid-fatigue/

Hope this helps!

[Glutton3]

Thank you so much @trents  @knitty kitty @Wheatwacked @Scott Adams for all the information!

 

@trents Absolutely right - I am from the UK and this diagnosis can take months and months due to NHS timelines. That's why I was thinking of skipping the biopsy. Rock and a hard place really - to wait means to destroy gut further..

@knitty kitty @Wheatwacked Going Gluten-free and supplementing with listed micronutrients seems to be a sensible approach?

[trents]

8 minutes ago, Glutton3 said:

Thank you so much @trents  @knitty kitty @Wheatwacked @Scott Adams for all the information!

 

@trents Absolutely right - I am from the UK and this diagnosis can take months and months due to NHS timelines. That's why I was thinking of skipping the biopsy. Rock and a hard place really - to wait means to destroy gut further..

@knitty kitty @Wheatwacked Going Gluten-free and supplementing with listed micronutrients seems to be a sensible approach?

Going gluten free with vitamin and mineral supplementation is certainly a logical option if you don't need the government subsidies to offset the cost of gluten-free food that an official diagnosis qualifies you for . . . and as long as you are a disciplined person. Many find that they need the psychological fortification in order not to rationalize and cheat on the diet.

[knitty kitty]

@Glutton3,

These articles are very informative...

Nutritional inadequacies of the gluten-free diet in both recently-diagnosed and long-term patients with coeliac disease

https://pubmed.ncbi.nlm.nih.gov/23198728/

And...

Gluten-Free Diet: Gaps and Needs for a Healthier Diet

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357014/

And...

Micronutrients Dietary Supplementation Advices for Celiac Patients on Long-Term Gluten-Free Diet with Good Compliance: A Review

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681258/#!po=45.2703

 

[Wheatwacked]

8 hours ago, Glutton3 said:

Going Gluten-free and supplementing with listed micronutrients seems to be a sensible approach?

Make it a family thing so you can all support one another. You won't regret it. The transition is difficult because it goes against cultural biases and gluten is added to processed foods because it is addictive and makes you want to eat more.  Load up on proteins, veggies especially leafy greens, and fruits.