What are your food triggers?

Boost Health Survey results

We are what we eat. By the amount of sugar in what we eat we determine how many and which type of bacteria will populate our intestine. Bacteria living in our intestine can determine how healthy or sick we are, and they will work together with the immune system to help make the best possible defence against any virus or bacteria trying to attack us.

The human immune system is an elaborate network of human and bacterial cells and molecules that, in the ideal case, recognize, attack and destroy any harmful substances.

In the case of autoimmune disease, the body will recognize some foods as a harmful substance and try to destroy it. The food we eat might determine the number and the type of the immune cells attacking our own organs, and in case of Hashimoto’s, the primary but not the only organ is the thyroid gland.

How does that happen? The mechanism by which we lose tolerance toward food is the same mechanism by which we lose tolerance to our own proteins. This is because our own proteins share many similarities to food proteins.

Scientific literature is not fully decided on what foods cause such an immune response, so we asked you to tell us what foods cause yours:

Dairy causes flare-ups for 70% of you
Wheat sensitivity is present for 65% of you.
Soy causes flare-ups for 35% of you
Alcohol causes problems for 25% of you
Nuts-induced flare-ups happen to 15% of you
Fruit and vegetables are responsible for 10% of you having flare-ups
Meat causes 5% of you to flare-up
Sugar is the culprit for <5% of you having flare-ups
Caffeine is the cause of <5% of you experiencing flare-ups

What is the role of dairy and wheat in triggering flare-ups?

According to our survey, both dairy and wheat seem to be the major foods causing flare-ups. They are also the most well researched triggers of the flare-ups.

Part of dairy’s great nutritional value is the high protein content. Similarly, wheat has also a high protein content. Both dairy and wheat have a lot of proteins, as well a smaller protein-like molecules called peptides [1].

Milk contains over 400 different proteins, and some of these proteins resemble parts of our own proteins that are found on the surface of thyroid cells. This similarity between milk protein and our own protein is the cause of the flare-up. The most notorious cow milk protein, called albumin, is similar to certain proteins of our own body. This is not problem in itself, until the so-called oral tolerance is disturbed or faulty.

Faulty oral tolerance means that our immune system failed to recognize food we eat as harmless. It apparently happens over time, and it results in food allergy [2].

Wheat diet has been associated to several autoimmune disorders, most notably celiac disease (CD), which is associated to thyroid autoimmune disorders [3].

Most of you are indeed sensitive to cow milk (57% of you), with 7% of you being allergic to goat and sheep milk and 23% of you are allergic to all of the animal milk types.
Dairy allergy breakdown by the source (animal).

Soy and thyroid autoimmunity

Soy is a known food item interfering with hormonal effects in our body. It does so because it contains phytoestrogens. Phytoestrogens mimic estrogens, and through that most likely effect occurrence of flare-ups. Estrogen is one of the hormones present in people with (semi) regular menstrual cycles, and it acts on Hashimoto’s in at least three ways. First, estrogen decreases the available free T4 (thyroxine) in the body, thereby causing an increase in production of TSH and T4. Second, it causes growth and proliferation of thyroid cells and through that enlargement of the thyroid gland. Last, estrogen is also known to activate and intensify the immune response [4]. Research is still undecided on the last one, as there are studies showing there is no apparent increase in inflammation post soy [5].

However, effects from soy might come from the other sources too: iodine disbalance, as well as high salt content in case of soy sauce [6, 7].

Alcohol and Hashimoto’s

The relationship between alcohol consumption and autoimmune flare-ups is complex. In general alcohol causes tissue damage, and persistent inflammation, which attract immune cells and other molecules that are also present in the autoimmune disease [8, 9].

Alcohol consumption has been connected to autoimmune diseases, as one of the factors putting stress on the body and through that predisposing people to develop flare-ups [10]. However, the data is conflicting, with several studies having found that alcohol has a protective role [11].

Alcohol, if chronically used, blocks functioning of the thyroid gland by being toxic for thyroid cells and suppressing TSH production and through that also decreasing the amount of T3 and T4 in our bloodstream [12]. Another effect of alcohol is tampering with protein production in cells, and this changes the properties and the function of immune cells. This is how alcohol most likely changes function of our immune system and triggers Hashimoto’s flare-ups.

This is not the only effect of alcohol; it also interferes with the gut and intestine. Alcohol breaks down the cells in the intestine, and weakens the barrier between the intestine and the rest of the body. This is called leaky gut syndrome.

Alcohol sensitivity breakdown by alcohol type.

Nuts and allergies in Hashimoto’s

Nuts are a highly recommended food group to prevent many age-related diseases, however nut allergies are a significant medical problem, with peanut allergy as the most known example of a severe nut allergy [13, 14].

Research is very poor on the connection between nuts and autoimmune diseases. The mechanism through which nuts cause flare-ups might be similar to that of dairy and wheat: shared protein similarities.

Nut sensitivity breakdown by different types of nuts.

Does the flare up correspond to the amount of eaten food?

By ingesting larger amounts of the food person is allergic to (dangerous food), one can expect an increase in the intensity of flare-ups. For 4 in 10 of you the intensity or the duration of the flare-ups is dependent on the amount of the dangerous food you have eaten.

Even the smallest amount of dangerous food will probably cause the allergic reaction and the inflammation of the intestine. This initial reaction might be too mild to be noticed, but by increasing the amount of eaten dangerous food this becomes more apparent, and more severe, and it takes longer time for it to go away because larger areas of the body are affected.

If you are not sure if there is a connection between your flare-ups and the food you eat, but would like to test it: you can track it in Boost Health now. You can enter how much you adhered to your individual diet. With values from 1 (did not follow the diet at all) to 5 (fully followed the diet, 100%), you can enter values 2, 3 or 4, which are representing the smaller or bigger diet cheats, when you sneaked some dangerous food in between your strict diet routine.

You did not fill the food survey yet? No problem, it is still open. We will update results on our Facebook page regularly.

References

1. Vojdani A. A Potential Link between Environmental Triggers and Autoimmunity. Autoimmune Dis. 2014;2014:437231.

2. Pabst O, Mowat AM. Oral tolerance to food protein. Mucosal Immunol. 2012;5(3):232–9.

3. Ch’ng CL, Jones MK, Kingham JG. Celiac disease and autoimmune thyroid disease. Clin Med Res. 2007;5(3):184–92.

4. Jenkins DJ, Kendall CW, Connelly PW, Jackson CJ, Parker T, Faulkner D, et al. Effects of high- and low-isoflavone (phytoestrogen) soy foods on inflammatory biomarkers and proinflammatory cytokines in middle-aged men and women. Metabolism. 2002;51(7):919–24.

5. Maskarinec G, Steude JS, Franke AA, Cooney RV. Inflammatory markers in a 2-year soy intervention among premenopausal women. J Inflamm (Lond). 2009;6:9.

6. Doerge DR, Sheehan DM. Goitrogenic and estrogenic activity of soy isoflavones. Environ Health Perspect. 2002;110 Suppl 3:349–53.

7. Santin AP, Furlanetto TW. Role of estrogen in thyroid function and growth regulation. J Thyroid Res. 2011;2011:875125.

8. Curtis BJ, Zahs A, Kovacs EJ. Epigenetic targets for reversing immune defects caused by alcohol exposure. Alcohol Res. 2013;35(1):97–113.

9. Feghali CA, Wright TM. Cytokines in acute and chronic inflammation. Front Biosci. 1997;2:d12–26.

10. Manzel A, Muller DN, Hafler DA, Erdman SE, Linker RA, Kleinewietfeld M. Role of “Western diet” in inflammatory autoimmune diseases. Curr Allergy Asthma Rep. 2014;14(1):404.

11. Effraimidis G, Tijssen JG, Wiersinga WM. Alcohol consumption as a risk factor for autoimmune thyroid disease: a prospective study. Eur Thyroid J. 2012;1(2):99–104.

12. Balhara YP, Deb KS. Impact of alcohol use on thyroid function. Indian J Endocrinol Metab. 2013;17(4):580–7.

13. Martucci MA, Dreskin SC. Immunologic similarities between selected autoimmune diseases and peanut allergy: possible new therapeutic approaches. Curr Allergy Asthma Rep. 2011;11(4):334–9.

14. Grosso G, Estruch R. Nut consumption and age-related disease. Maturitas. 2016;84:11–6.