University of Life Sciences, Warsaw, Poland.
University of Agriculture, Kraków, Poland.
Ann Agric Environ Med. 2021 Dec 29;28(4):558-568. doi: 10.26444/aaem/136523. Epub 2021 May 28.
There is a growing interest in a gluten-free diet (GFD) in the management of various autoimmune diseases, including Hashimoto's thyroiditis (HT). Even medical professionals claim that gluten elimination may improve a patient's treatment. Some studies suggest a relationship between gluten intake and HT development or progression. The aim of the study was to analyze and describe available knowledge regarding the effect of gluten or a gluten-free diet on thyroid autoimmunity in HT with or without celiac disease.
Potentially applicable records were obtained through review and analysis of the PUBMED (MEDLINE) and Google Scholar database by using the following phrases: 'hypothyroidism gluten', 'Hashimoto gluten' and 'thyroiditis gluten'. If a record focused on the subject by title and abstrakt, the full paper was screened. Authors' scientific achievements and references of eligible records were screened for possibly omitted studies. The review was focused only on human studies.
Gluten exclusion might increase the risk of HT development because of the potential nutritional deficiencies related to the low quality of gluten-free products. Gluten intake from crops grown on selenium-depleted soil increases the risk of HT development. Only a few studies suggest that GFD would be beneficial for HT patients, even without the coexistence of CD. The strongest connection between gluten intake and thyroid destruction seems to be based on a mechanism of molecular mimicry between gut and thyroid tissue transglutaminase.
Studies conducted so far do not support the claim that HT patients should eliminate gluten from their diet. In view of the limited number of studies, with major limitations and ambiguous results, a gluten-free diet is not recommended.
越来越多的人对无麸质饮食（GFD）在各种自身免疫性疾病的治疗中感兴趣，包括桥本甲状腺炎（HT）。即使是医学专业人员也声称，消除麸质可能会改善患者的治疗效果。一些研究表明，摄入麸质与 HT 的发展或进展之间存在关联。本研究旨在分析和描述有关麸质或无麸质饮食对 HT 患者甲状腺自身免疫的影响的现有知识，无论这些患者是否患有乳糜泻。
通过对 PUBMED（MEDLINE）和 Google Scholar 数据库的回顾和分析，使用以下短语获取潜在适用的记录：“hypothyroidism gluten”、“Hashimoto gluten”和“thyroiditis gluten”。如果记录通过标题和摘要重点关注该主题，则会筛选全文。筛选合格记录的作者的科学成就和参考文献，以查找可能遗漏的研究。本综述仅关注人类研究。
由于无麸质产品质量较低而导致的潜在营养缺乏，无麸质饮食可能会增加 HT 发展的风险。在缺硒土壤中种植的作物中的麸质摄入会增加 HT 发展的风险。只有少数研究表明 GFD 对 HT 患者有益，即使不存在 CD 也是如此。麸质摄入与甲状腺破坏之间的最强关联似乎基于肠和甲状腺组织转谷氨酰胺酶之间的分子模拟机制。
迄今为止进行的研究不支持 HT 患者应从饮食中消除麸质的说法。鉴于研究数量有限，存在主要限制和模糊的结果，因此不建议采用无麸质饮食。
