We've heard it a thousand times. Make sure that you check your child's TSH every year because people with Down Syndrome have a tendency towards low thyroid function. So you diligently take your child to get his or her TSH (thyroid stimulating hormone) levels checked every six months or year and your pediatrician monitors those levels closely for any signs that your child might need thyroid support. While this is absolutely necessary, do you find yourself wanting to do more? Maybe you've thought about preventing thyroid disease more than just monitoring it?

The old saying "an ounce of prevention is worth a pound of cure", although cliche, couldn't be more true, especially in this case. Since people with Down Syndrome are more prone to low thyroid function, what can we do as parents to ensure they stay as healthy as possible? One of the most powerful ways to positively impact your child's health is by making simple dietary changes. By avoiding certain foods like gluten, you can help maximize your child's thyroid function.

What is Gluten?

Gluten is a mixture of two proteins: glutenin and gliadin. These two proteins are responsible for that delightful chewy texture in breads and other backed goods. While gluten can make foods more appealing, it has another less known and potentially harmful effect on the human body.

The cells of the intestines are connected to one another through tight junctions. These spaces are very selective in what they allow into the bloodstream. Therefore they add a layer of protection for your body when you eat.

The gliadin portion of gluten, helps to open up these tight junctions through another protein made by the body [1]. Zonulin is the protein your body makes that widens your cells' tight junctions. When your tight junctions aren't as tight as they should be, bigger food particles can enter into your bloodstream that shouldn't be there.

When your body sees these large foreign food particles, it makes your immune system more alert. Your body starts to attack these particles as if they are viruses or bacteria. So how does eating gluten harm the thyroid? When gliadin gets into the bloodstream, your body will attack it, thinking it is a foreign enemy. Gliadin is similar in structure to an enzyme in your body called transglutaminase, which helps to make chemical bonds in the body [2].

This similarity confuses the immune system into attacking not only gliadin but also thyroid tissue which has high amounts of transglutaminase [3]. The immune system attack on the thyroid leads to less functional thyroid cells and ultimately to hypothyroidism.

Gluten and Down syndrome Diet

This whole process can be avoided simply by avoiding gluten in your diet.

Avoiding gluten can be done by removing foods like breads, crackers, cakes, cookies, and wheat products. Careful consideration must be made because certain products like ketchup and sauces may have gluten in them as an ingredient.

By actively removing and keeping gluten out of the diet of people with Down Syndrome, you can positively impact the health of the thyroid and reduce the effects of hypothyroidism on your child.

Though it may seem hard initially, with a little planning and diligence you can remove gluten from your diet and put your child in a position to have optimal thyroid health.

References

1. Hollon, Justin et al. "Effect Of Gliadin On Permeability Of Intestinal Biopsy Explants From Celiac Disease Patients And Patients With Non-Celiac Gluten Sensitivity". Nutrients 7.3 (2015): 1565-1576. Web.

2. Griffin M1, Casadio R, Bergamini CM. Transglutaminases: nature’s biological glues.Biochem J. 2002 Dec 1;368(Pt 2):377-96

3. Naiyer AJ1, Shah J, Hernandez L, Kim SY, Ciaccio EJ, Cheng J, Manavalan S, Bhagat G, Green PH. Tissue transglutaminase antibodies in individuals with celiac disease bind to thyroid follicles and extracellular matrix and may contribute to thyroid dysfunction. Thyroid. 2008 Nov;18(11):1171-8. doi: 10.1089/thy.2008.0110.