Endocrine Abstracts

Hashimoto’s thyroiditis is an autoimmune condition characterized by the infiltration of lymphocytes into the thyroid gland, resulting in the subsequent production of antibodies directed against thyroglobulin and thyroid peroxidase. This pathology is the primary etiology of hypothyroidism in developing countries. Recently, researchers have focused on studying the inflammatory potential of gluten, not only in the intestinal context, where it can act as a trigger for dysbiosis but also systemically, with the ability to influence the production of pro-inflammatory cytokines by T cells. However, there is controversy regarding individuals without gluten intolerance or celiac disease concerning the inflammatory potential of gluten and whether there is any benefit in its exclusion from the diet. This article aims to conduct a comprehensive literature review covering the last six years, based on records available on the PubMed platform, to clarify the relevance of implementing a gluten-free diet in patients diagnosed with Hashimoto’s thyroiditis who do not have concomitant celiac disease. The keywords "Hashimoto thyroiditis gluten" were used, covering the publication period between 2018 and 2023, identifying 34 scientific articles. Excluded were those not directly related to the research topic or duplicated, resulting in the inclusion of 14 works, comprising literature reviews, meta-analyses, case reports, and original articles. As a conclusion, there was no evidence of symptom improvement or antibody reduction with the introduction of a gluten-free diet in patients without celiac disease or gluten intolerance. However, it is important to note that patients with autoimmune diseases, such as Hashimoto’s thyroiditis, are statistically more susceptible to developing food intolerances. Thus, a significant number of patients with Hashimoto’s thyroiditis may have undiagnosed celiac disease or gluten intolerance and would benefit from gluten removal from their diet. Nevertheless, gluten withdrawal for the rest of the population without indications tends to result in increased caloric intake, higher consumption of processed foods, reduced fiber intake, and approximately a 30% increase in food expenses. Therefore, it is concluded that the addition of a gluten-free diet is not beneficial for patients without a diagnosis of celiac disease or gluten intolerance. However, in patients with autoimmune diseases, such as Hashimoto’s thyroiditis, investigating even asymptomatic food intolerances is essential due to their higher prevalence in this population.