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Following is a Medline abstract that Sue Goldstein posted to the list back
on 30 Aug 95. Recently I corresponded with a graduate student at Rutgers,
and she looked up the article. Following the abstract is her analysis, which
is quite interesting. Don Wiss.
 
 
Coeliac disease and autoimmune thyroid disease, Gut, 1994, June, Vol 35,
Pg. 844-6. Counsell, et al.
 
A well defined cohort of coeliac patients was studied prospectively to
assess the prevalence of coexisting thyroid disease and positive thyroid
autoantibodies. Comparison with epidemiological data on the prevalence of
coeliac disease in a neighboring area suggested that few adult coeliac
patients had been missed. Overall, 14% of the coeliac patients had thyroid
disease: 10.3% were hypothyroid and 3.7% hyperthyroid, both significantly
more than expected. There were significantly more coeliac disease patients
with thyroid autoantibodies than expected--11% had thyroglobulin antibodies
and 15% had thyroid microsomal antibodies. This association is clinically
important. Three patients are described in whom the coexistence of coeliac
disease and hypothyroidism led to diagnostic difficulties and delay of
treatment.
 
 
From: Lynda Callicotte <[log in to unmask]>
Date: 16 Nov 95
 
Autoimmune hypothyroidism is more common in coeliac patients than Graves
disease is. Around 10% of coeliacs had hypothyroidism and there was a high
incidence of anti-thyroid antibodies. Anti-thyroid antibodies, unlike Graves
antibodies, target the thyroid hormone itself and cause it to be destroyed
or to be ineffective. The doctors didn't know why coeliacs should be
predisposed to hypothyroidism, but they speculated that maybe the excessive
gut permeability results in greater than normal exposure to foreign antigens
that resemble thyroid hormone and can trigger an immune response to it. Most
coeliacs who had
hypothyroidism were elderly and probably had untreated coeliac disease for a
long time. The reason why hypothyroidism and coeliac result in diagnosic
complications is that some of the symptoms are the same. When one of the two
diseases is treated, but the symptoms don't all go away, the doctors are
confused. Hypothyroidism can also mask some symptoms of coeliac disease. For
instance, coeliacs often have diarrhea, but hypothyroidism can cause
constipation.