Adopt a strict gluten-free diet if you have Hashimoto’s or elevated thyroid antibodies
Ekberg explains that Hashimoto’s is the most common thyroid disorder in the West, driven by molecular mimicry between gliadin (a fragment of gluten) and thyroid peroxidase (TPO). The standard TSH test misses the underlying autoimmunity, so he strongly urges testing TPO and TG antibodies. He cites clinical observation: when patients with elevated antibodies adopt a gluten-free diet, their antibody levels consistently fall, confirming the mechanism. Importantly, he stresses that this is not about celiac disease or digestive symptoms; the autoimmune reaction is systemic and often silent. Even people who feel fine may be chipping away at thyroid tissue every time they consume gluten. Therefore, for those with positive antibodies, gluten avoidance is non-negotiable.
Gliadin peptides share structural homology with thyroid peroxidase (TPO). When the immune system encounters gliadin, it produces antibodies that also target TPO and the thyroid cells containing it. This is a type 4 hypersensitivity. Additionally, gluten can increase intestinal permeability (leaky gut), allowing more gliadin and other antigens into circulation, amplifying the autoimmune loop. The result is a chronic, low-grade destruction of thyroid tissue, eventually leading to hypothyroidism.
gluten contains a little piece called gliadin. And this gliadin is very similar structurally to an enzyme you have in the thyroid called thyroid peroxidase.

