The American Journal of Medicine had an intriguing article about people with difficult-to-regulate thyroid disease.
Researchers at the University of Vermont studied patients with hypothyroidism (low-functioning thyroid) who were on thyroid replacement therapy. In many people it is easy to dial in the proper thyroid hormone regimen, but in some this can be very difficult.
When the Vermont researchers looked at this latter group they discovered a large number had previously undiagnosed celiac disease.
Since celiac disease alters absorption of nutrients it can also lead to poor absorption of medications.
Once the celiac disease was treated, the patients’ thyroid condition came under smooth control.
A recent article in the Journal of Pediatric Medicine has this interesting title: “The Complexity of Celiac Disease”.
The reason for the title surfaced when the researchers were testing the validity of the standard approach to diagnosing celiac disease. The current gold standard for diagnosis consists of having a positive blood test and having an intestinal biopsy that shows villous atrophy (shortening of the absorptive “cilia” in the gut).
This study was conducted in Finland where this disease is quite common. In the study group of patients who had a positive blood test but a normal biopsy, half went on a gluten-free diet, and half continued to eat gluten.
After a year the gluten avoiders not only felt better, but their blood tests had become negative. The group that ate gluten continued to have symptoms and most of them developed a positive result on a repeat biopsy.
Their editorial conclusion was that a positive blood test warrants at least a trial of gluten-free diet.