In this episode, Dr. Eric Osansky dives into the often-debated topic of gluten and grains—and their impact on thyroid health, especially in those with Graves’ disease and Hashimoto’s. While many people understand the need to avoid gluten, there’s still a lot of confusion around whether gluten-free grains are truly safe during the healing process.
Dr. Eric explains why gluten is a common trigger for autoimmune conditions, touching on mechanisms like increased intestinal permeability (leaky gut), immune activation, and molecular mimicry. He also breaks down the bigger picture of grains as a whole, including how compounds like phytates, lectins, and even mold exposure can interfere with gut healing—even when gluten isn’t present. You’ll also hear his perspective on controversial topics like sourdough bread, eating gluten in other countries, and whether glyphosate is to blame.
He wraps up by emphasizing a practical, balanced approach: while some people may tolerate certain grains, removing both gluten and grains—at least temporarily—can significantly improve your chances of restoring gut health and achieving remission. If you want a clearer, more balanced understanding of gluten, grains, and thyroid autoimmunity, you’ll get a lot out of this episode.
Click Here to listen to it on the Save My Thyroid podcast
Dr. Eric Osansky:
In this episode,I am going to talk about yet another controversial topic when it comes to thyroid health. That is gluten and grains. If you have been diagnosed with Graves’ or Hashimoto’s or even a non-autoimmune thyroid condition, there is a very good chance you have heard that you should avoid gluten, and maybe even all grains. At the same time, you have maybe come across information saying that whole grains can be healthy, and not everyone needs to eliminate them. There is no wonder why there is a lot of confusion.
I can’t tell you how many people I speak with who ask, “Do I really need to go gluten-free?” or “Are all grains bad for my health?” The truth is the answer isn’t completely black and white. In this episode, I will break this down for you. I will briefly talk about what gluten is; why it can be a problem for those with thyroid autoimmunity, including Graves’ and Hashimoto’s; and I will also discuss the concerns with grains as a whole.
Most importantly, I want to bring some balance to the conversation. While gluten can be a trigger for many people, it’s also important to understand that there is not one single diet that fits everyone perfectly. If you have been wondering whether gluten and grains might be affecting your health, or you have already made dietary changes but are not sure if you’re doing the right things, this episode will help to give you some clarity.
Part of the problem is that different practitioners will say different things. Some practitioners will say that you should avoid gluten completely. I would say that’s probably most, at least natural health care practitioners, especially when it comes to different autoimmune conditions. More functional medicine practitioners- I use natural healthcare practitioners and functional medicine practitioners interchangeably. Either way, most will agree that you should avoid gluten while healing. Some will say to avoid gluten permanently.
Grains, a little more controversial. Some will say that it’s perfectly fine, even if you have an autoimmune condition, to follow a diet like the Mediterranean Diet, which does allow grains. When most say you can eat grains, they mean gluten-free grains. As I mentioned earlier, there is no one size fits all.
Is it possible to heal from Graves’ and Hashimoto’s if you continue to eat gluten? The choice is, especially with grains, there are people who could get away witheating grains, especially gluten-free grains, and still heal. Grains, even gluten-free grains, can be harsh on the gut. That’s a big reason why it’s a good idea to take a break from grains. It doesn’t mean it’s impossible to heal while eating gluten-free grains, but it can be more difficult.
Rather than go through three months of trying to do things naturally to restore your health, then when you hit a roadblock, if you’re eating grains, you won’t know for sure if it’s related to the grains, but just to play it safe, I would say to avoid grains, if you’re still eating grains at that point.
Usually, I try to encourage people to avoid grains initially right from the start. If someone is eating grains, you might heal. There are people I’ve worked with over the years who continue to eat grains. I have some people I work with over the years, people from Asia, where grains are a staple in their diet, especially white rice. They give up all grains except white rice. There have been people who heal while they eat white rice. There have been people who don’t heal when they eat white rice. Sometimes, we don’t know if it’s because they’re still eating white rice or if they’re eating other types of grains.
There’s quinoa, which is more of a pseudo grain. There is oats, which you need to be careful with because they can be cross-contaminated.
The answer is yes, it is possible in some cases to heal if you continue to eat grains. Same thing with other foods that are excluded. We could say the same thing with nightshades, which are excluded from an AIP diet.
Gluten is different. I would argue there are some people who might be able to heal if they get exposed to some gluten. If you’re eating gluten day in, day out, it would be more difficult. Again, there are some people who even a small amount of gluten could prevent them from healing. I am not just talking about those with Celiac.
One other thing I want to mention in the beginning here is I do eat some grains on a wellness basis. Many of you know I have been in remission since 2009. While I was trying to restore my health when I was dealing with Graves’, I did avoid grains.
I can’t say I eat grains on a daily basis. When I eat grains, it’s typically gluten-free grains. Still, I would say a few times per month is usually when I eat grains. My guess is if I ate them more frequently, like a few times a week, it still would be okay. I just prefer not to eat them that frequently.
I wanted to let you know that in many cases, arguably even most cases, you will be able to reintroduce gluten-free grains.
As a reminder, there is the triad of autoimmunity, where there are three components necessary for autoimmunity to develop. I have discussed this before. One is a genetic predisposition. Two is exposure to one or more environmental triggers. Three is that increased intestinal permeability, which is also known as a leaky gut.
Food, such as gluten, can be a potential trigger and can also affect that permeability of the gut. I wouldn’t say that grains necessarily can be a trigger, depending on the grain.
One grain I hadn’t mentioned yet is corn. I’ll talk more about it, but corn can be problematic. On the other hand, I haven’t heard of quinoa or gluten-free oats being a trigger. Due to certain compounds, they could be harsher on the gut. Even if they’re not causing a leaky gut, if you already have aleaky gut, it might make gut healing more challenging.
Let’s briefly talk about what gluten is. Gluten is a protein found in certain foods such as wheat, barley, rye, spelt. One of the main proteins is gliadin, which you can test for in the blood, stool, or saliva.
As I mentioned earlier, you need to be careful even with some gluten-free grains, like oats. Oats are commonly cross-contaminated with gluten. I’m not recommending to eat oats, but if you were to do so, you’d want to make sure not just that they are gluten-free but ideally certified gluten-free.
If you really want to go into great detail with gluten, I would recommend reading my books. I definitely go into greater detail in my book The Hyperthyroid Healing Diet. I also talk about it, for those with hypothyroidism, in my book Hashimoto’s Triggers. I honestly don’t have a lot of podcast episodes on gluten. This is why I decided to do this particular episode. If you visit my website, NaturalEndocrineSolutions.com, I have some articles and blog posts on gluten and likely grains, too. It’s been a while since I wrote those articles.
Let’s talk about some of the top concerns about gluten. We’ll talk more about grains in general, too. First of all, gluten sensitivity is common. Once again, I am not talking about Celiac. If you have Celiac, that’s an autoimmune reaction to gluten. If you have Celiac, you really do need to avoid gluten permanently, even if you don’t experience any symptoms.
There’s what’s called silent Celiac, which means that some people with Celiac will feel okay when eating gluten, but that doesn’t mean it’s not doing damage to the intestinal barrier and continuing to perpetuate the autoimmune response.
Most people with Celiac do have obvious symptoms. Usually GI symptoms. You might not have GI symptoms, but you might have brain-based symptoms, skin conditions related to gluten exposure. The pointis, even if you have done a test for Celiac, and it was negative, it doesn’t mean you can’t have a non-Celiac gluten sensitivity.
Also something that’s important to mention is if you have done any type of gluten-related testing, you would have needed to be consuming gluten for that test to be accurate. I mention this because every now and then, there will be someone who does a Celiac test or different type of test for gluten, maybe even just gliadin. They have been gluten-free for a few months.
If you have been gluten-free, you are not producing the antibodies, like gliadin. You wouldn’t be producing gliadin antibodies or transglutaminase, which is on a Celiac panel. If you have been gluten-free for 2-3 months, you don’t have any antibodies. That doesn’t mean that you’re not reacting to gluten if it comes back negative. It could be a true negative, but it could also be a false negative.
That being said, I am not suggesting that if you are gluten-free, and you have been gluten-free for a few months, to eat gluten and test. I don’t recommend that. First of all, if you did that, you still would have to wait a little bit. It takes some time for antibodies to develop. Even if you decided to eat gluten and then do a Celiac test or another type of gluten sensitivity test, you would still want to wait a few weeks for antibodies to develop. I don’t recommend to eat gluten just for the sake of testing.
Regardless of what the test shows, I will recommend to avoid gluten because it’s not just about the sensitivity. Gluten can increase intestinal permeability. I believe it’s a 2015 study that showed that gluten can cause a leaky gut in everyone. Something to keep in mind.
Even if you are not experiencing any symptoms, not only can you have a gluten sensitivity, but you could also have a leaky gut related to gluten. I mentioned that increase in intestinal permeability is part of that triad of autoimmunity.
If you are dealing with Graves’ or Hashimoto’s, and you are trying to heal and also eating gluten, especially on a regular basis, it will be difficult to heal the gut. As I also mentioned, even if you are eating gluten occasionally while healing, it might prevent your gut from healing.
Another reason to avoid gluten is it could cause activation of the immune system. There is also something called molecular mimicry. This is more controversial, where you could have a similarity between the gluten proteins and the thyroid tissue, which could lead to immune reactivity. This is one way that gluten might be a trigger.
I heard this first from Dr. Datis Kharrazian, who is brilliant. He had written one book on Hashimoto’s, which has been out since 2010. In 2016, he released his brain-based book. A lot of knowledge. He was the first one who mentioned that. He doesn’t just bring things up; he does a lot of research. I think there is some validity to this. Still more of a theory than a fact.
As I mentioned, even if molecular mimicry is not an issue, you still have to deal with the leaky gut component.
I mentioned you can’t always rely on symptoms. The lack of digestive symptoms doesn’t rule out a problem with gluten. I also mentioned the limitations with testing, especially if you are not eating gluten. Also, the test could be pretty basic. You might do a test for gliadin, but there are many other proteins associated with gluten.
If you decide to do a test, I hesitate because I can’t say I recommend this test to a lot of people, but Cyrex Labs has their Array #3, which is a more comprehensive gluten sensitivity test. I believe the Wheat Zoomer is pretty similar. Those are two options you have compared to doing a blood test, which is very basic. You could do a Celiac panel, which looks at transglutaminase and antibodies. Still nothing compared to Cyrex Labs, which has about two dozen markers related to gluten sensitivity.
I don’t commonly test for it because it’s expensive. I’m going to recommend to avoid gluten regardless. These tests aren’t perfect. Even if someone comes back negative, I won’t say, “It looks great. Eat all the gluten you want.”
Maybe in the future, they might be able to eat gluten. That’s a reason to test for it. Once someone heals, they might choose to reintroduce gluten because everything was negative. That’s up to the person. There are some people who continuously avoid gluten permanently even after healing, even if they don’t have Celiac. Some people want to reintroduce gluten in the future, so they will do a test just to see if they have a problem with gluten.
If I am working with them, they might say, “I want to do a comprehensive test for gluten.” It’s rare, but sometimes that will happen. They will see that if it’s negative, I still will encourage them to avoid gluten while healing. After healing, they might decide to reintroduce gluten because they had a negative Array #3.
I also often get asked questions, “Is it okay to eat sourdough bread?Is it okay to eat ancient grains, like Ezekiel bread?” Sourdough bread has a fermentation process that breaks down gluten. Some earlier studies suggested that people with Celiac might be able to eat sourdough. Later studies showed that wasn’t the case.
I would say don’t eat sourdough or ancient grains, like Ezekiel bread, while healing. In the future, maybe. I’m not saying there are people who can’t on a wellness basis eat sourdough or Ezekiel bread, healthier types of wheat.
Another question I’ll get every now and then is the problem with glyphosate and not gluten. For those who are not familiar with glyphosate, I do have other episodes on it. Glyphosate is the active ingredient in the herbicide Roundup.
The reason why this is brought up is there are people who can eat wheat in other countries. They might have problems in the U.S., but if they go to Italy, they don’t have a problem. They can eat pasta and pizza there.
I think glyphosate without question can be a problem. I did have Dr. Tom O’Brien on the podcast (episode 204), and when I did the interview with him, which was in 2025, he said the wheat in the U.S. is higher in FODMAPs than in other countries. At the time, he lived in Italy, and I think he still does.
He is a gluten expert, and he said it’s not necessarily related to the glyphosate, which I’m not so sure. Maybe it’s both. Maybe it’s a FODMAP problem and a glyphosate problem.
Let’s put it this way. If you’re visiting a different country, like in Europe, I will recommend to avoid gluten, but that’s up to you. I haven’t yet been to Italy, but when I visit Italy one day, I am pretty sure I will be eating regular pasta and pizza at least once. I likely won’t go overboard.
I will admit that I don’t feel bad when I eat gluten, but that doesn’t mean if I go to Italy, and I am eating pizza and pasta, that it isn’t affecting permeability of the gut. I will do it anyway in all likelihood. Just want to be up front about that.
There are people I work with who tell me the same thing. They’re going to Italy for the first time, or for the first time in a long time, and they really want to try the pasta and pizza. I tell them it’s ultimately up to them. I can’t tell them it won’t have any consequences, but I understand if they decide to eat it.
Let’s talk about grains in general. Not all grains are equal. You have grains that include gluten. I mentioned wheat, barley, rye, spelt. There are gluten-free grains. Oats should be gluten-free, but there is cross-contamination. I will talk more about corn later. There are pseudograins like buckwheat, quinoa, and rice.
You have to be careful with rice. If you go out to eat and order rice, it very well might include gluten. If you make your own rice, you can make sure it’s gluten-free.
If someone is going to eat grains while trying to heal, I would say to make sure they are gluten-free.
Potential concerns with grains. I mentioned the impact they could have on the gut. Maybe not always causing the leaky gut but making it more difficult for your gut to heal due to the compounds such as phytates and lectins.
Another issue with grains is mold. Mold is common in grains. A lot of grains are moldy.
Grains can sometimes affect blood sugar in a negative way. That is more the refined grains. I would recommend avoiding refined grains, refined sugars.
A really good resource is an older book by Dr. Peter Osborne, No Grain, No Pain. If you want to learn more about the concerns with grains, I would recommend reading this book.
When it comes to grains that people sometimes tolerate, if you have that mindset, “I’m just not going to 100% give up grains,” maybe it’s also because you’re vegan/vegetarian, and your diet is really restrictive. You can’t follow a strict AIP or a paleo diet.
Certain types of rice, such as white basmati rice, which is based off of Dr. Steven Gundry’s Plant Paradoxdiet. Some people can eat quinoa or buckwheat. Some people can even eat certified gluten-free oats. You are taking a risk that you might hit a roadblock in your recovery. It does depend on your gut health.
It also arguably depends on your stage of healing. If you’re eating grains right from the start, compared to maybe following a more restrictive diet for a few months and then later on reintroducing grains, that would be preferable.
I want to spend a minute or two talking about corn. If you’re going to eat gluten-free grains, I would definitely avoid corn. Most corn is genetically modified, at least in the U.S. Even if you get certified organic corn, it won’t be genetically modified.
There are other concerns though. Mold is still a big concern. Some studies show that corn can have a similar effect as gluten. Even if you’re avoiding gluten, you could have issues with corn.
It goes beyond food sensitivity testing. We’re not just talking about sensitivities. I know I mentioned that earlier, but some people might still get confused. They might run a food sensitivity test, like an IgG test. If they see corn as positive and gluten as positive and other things as positive, they will avoid those foods. If they see that these are negative, they might think it’s safe to eat these foods.
Maybe you’re not having an immune reaction to these foods. Again, this doesn’t mean they can’t affect the permeability of the gut. Not to mention that not all food sensitivity tests are accurate. You can get false negatives and false positives. If you do a test, and corn, wheat, rice are negative, maybe these are true negatives, but they are not perfect.
Years ago, prior to being diagnosed with Graves’, I was eating a lot more whole grains. Probably moreso bread. Bread is a favorite of a lot of people. I wasn’t eating gluten-free bread. When I went through chiropractic school, this was in the ‘90s, and they weren’t recommending gluten-free at that time. I fell under that trap and was eating so-called whole, healthy grains.
It’s not just about the impact on the gut. Who knows if that played a role over the years in the development of my Graves’ condition. I don’t think that’s the first thing that comes to mind. it’s about some of the other reasons that I mentioned, too, to potentially avoid grains.
I would say at the very least, avoid it during healing. Avoid both gluten and grains during healing. At the very least, gluten. If you eat some gluten-free grains during healing, maybe you’ll be okay. Ideally, I would say to avoid gluten and even gluten-free grains during the healing process to help support the gut. With gluten, it could potentially be not just aleaky gut trigger but a direct trigger potentially.
As far as long-term, can you reintroduce gluten and grains? It depends on the person. If someone has Celiac, you really do want to avoid gluten permanently. Most people who have Celiac know this. I don’t have to get into detail.
If you have a known gluten sensitivity, let’s say you do some type of test, whether it’s the Cyrex Labs Array #3 or another test, and it shows that you have a gluten sensitivity. Not Celiac, but a non-Celiac gluten sensitivity. You might still need to avoid gluten long-term. Maybe when healing the gut, you might be able to tolerate gluten again. That goes for other foods you might be sensitive to as well. Definitely would be more cautious.
If you’re like me, and you haven’t had any negative symptoms with gluten, just keep in mind it could affect your gut. I can’t say that I haven’t had any gluten exposure since restoring my health back in 2009. As of recording this, it’s been over 16 years.
For the most part, I try to avoid gluten, but I haven’t been perfect. If I go out to eat, I can’t say there hasn’t been any cross-contamination. I feel fine, but that doesn’t mean it’s not affecting my gut in a negative way. Hopefully, I’ll never relapse with Graves’, but if I do, I can’t say that this might not be an issue. My guess would be not because it’s not like I’m doing this commonly. In some people, even small amounts could be a problem.
Ultimately, it’s up to you if you choose to reintroduce gluten in the future. Some people might choose to reintroduce it in the form of healthy types of gluten such as sourdough bread or ancient grains.
When it comes to grains, especially gluten-free grains, I would say I still try to minimize exposure to corn. I do like some popcorn every now and then, I won’t lie. Overall, I can’t say I eat corn much. I don’t eat a lot of grains, but I do eat them sometimes, moreso rice and quinoa. They are the two more common ones. Rice most of the time.
It also is up to you how frequently you eat them. I probably wouldn’t eat them every day when you’re in a state of wellness. Who am I to say? Everybody is different. Maybe you could get away with eating them on a day in, day out basis.
I would make sure you are fully healed, that your thyroid numbers look good. If you have Graves’ or Hashimoto’s, your antibodies ideally are within an optimal range. If you have digestive symptoms, you want those to resolve. You want to know for sure or be pretty confident that you’re healed.
This might be an argument for leaky gut testing. I had a previous podcast episode where I talked about different types of functional medicine testing. I mentioned how I am not a big fan of testing for a leaky gut because most people who I work with have a leaky gut. I know that from doing more frequent testing in the past.
One argument for doing leaky gut testing is you have a baseline, and you can always retest. You could do that even without a baseline. Let’s say your thyroid panel—your TSH, your T4, and T3—are all within the optimalrange. Your antibodies are negative. You’re not having gut symptoms.
On top of that, you could do a leaky gut test, like Cyrex Labs Array #2. Array #3 is the gluten test. Array #2 is the leaky gut test. There are other markers, too. They are not perfect, but you could always do that to see if your gut has been healed.
One other thing I’ll say is it’s not just for Graves’ and Hashimoto’s. Even if I am working with someone who has toxic multinodular goiteror subclinical hyperthyroidism or any type of non-autoimmune thyroid condition, I will still recommend to avoid gluten. Ideally, to avoid grains as well. Definitely to avoid gluten and other potentially inflammatory foods. I say “potentially…” With gluten, we can say sourdough bread or Ezekiel bread are not inflammatory. Still, they can potentially have that same negative affect on the gut.
I get a lot of questions when it comes to gluten. In all my books, I talk about gluten. I talk about grains in the hyperthyroid healing diet book. I probably do in my other books, articles, and blog posts, too. I was doing some searching, and I didn’t have a solo episode where I go into detail about gluten and grains.
I think most people know and understand why it’s a good idea to avoid gluten. Not everybody understands why it’s a good idea to avoid grains. Maybe you could eat some grains and still heal. That ultimately is up to you. If you really are trying to go all out, I would say not only take a break from gluten but also take a break from grains while healing.
Hopefully, you found this information to be valuable. Of course, I look forward to catching you in the next episode.
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Gluten and grains. I mentioned when I visit Italy in the future, I definitely will be eating regular pizza and pasta, not gluten-free pizza and pasta. That being said, if I went to Italy when I was dealing with Graves’, I am not sure. My guess is I probably would have strayed. I would have done my best not to put myself in a position to go to Europe during that time. When I dealt with Graves’ I didn’t do much traveling.
Obviously, people have plans. You don’t plan to get Graves’ or Hashimoto’s or non-autoimmune thyroid conditions. It definitely is possible, and it does happen where someone already has plans to go outside of the country. It doesn’t have to be out of the country. We’re focusing here because some think that if you go out of the country, it’s okay to eat the wheat in Italy and other areas. I mentioned I wouldn’t because it’s different.
Is it more of a FODMAP problem or a glyphosate problem? I’m not sure. But I would try your best to avoid gluten as well as grains.
I also spoke about sourdough bread. Is it okay to eat sourdough bread? I mentioned not only sourdough bread but Ezekiel bread, like ancient grains. When healing, I would do everything you can to avoid gluten. That includes sourdough and Ezekiel. Once you restore your health, that’s up to you.
There are people who while restoring their health say they will reintroduce gluten, but then they change their mind. They don’t introduce gluten in the future. Something I wouldn’t worry about now. Assuming you’re not already in remission, that you’re looking to heal, take a break from sourdough. Take a break from ancient grains. Take a break from white rice, which I’ll chat about a little bit next.
On a level one diet, for those who have read The Hyperthyroid Healing Diet, white basmati rice is allowed. That is based on Dr. Steven Gundry’s Plant Paradox diet. Can you get away with eating rice? Maybe. What’s the big deal of taking a break from grains for a few months? That’s my perspective. Same thing with gluten. It’s not a big deal to take a break for a number of months while restoring your health. Even if it’s a year or a year and a half. I get it. It’s a long time. You can do it. A lot of people I have worked with have done it. I did it when I dealt with Graves’. You definitely can do it.
There are worse things you can have than white rice. Even though it is allowed on a level one diet, I usually still encourage people to avoid grains. If you’re vegan/vegetarian, I understand it is more challenging. It is still not impossible to avoid grains. Is it difficult? Yeah. Not impossible.
Is it okay to have gluten-free oats? The answer is up to you. You can do whatever you want. I can’t stop you. If you’re following an AIP or paleo diet, you would want to avoid all grains, which includes oats.
I did mention if you do happen to eat oats, make sure they are gluten-free because oats are commonly cross-contaminated with gluten. On top of that, make sure they are certified gluten-free. If they’re not certified, then you are taking the company’s word that they’re gluten-free. You want that certification.
Testing for gluten sensitivity. I mentioned how I don’t do comprehensive testing for gluten, like the Array #3 or the Wheat Zoomer. I don’t think I mentioned that I do recommend a Celiac panel when I work with someone who is currently eating gluten.
If someone has been avoiding for gluten, especially for a few months, it’s a waste to do any type of gluten-related test, even a test for gliadin. If someone is currently eating gluten, I will recommend to stop eating gluten. But before doing that, I would recommend to do a Celiac panel. If you want to go beyond that, that’s up to you.
I also briefly spoke about mold in grains. I have a chapter in The Hyperthyroid Healing Diet, “Mold in Food.” It is an issue. Obviously, it’s not just grains where you have to worry about mold. Nuts are a concern as well. Nuts are excluded from AIP, but it’s not just because of mold; it’s about compounds in the nuts, even though nuts are allowed on a regular paleo diet, whereas grains are not allowed on a regular paleo diet.
It’s not just about the phytates and lectins in grains. I guess it’s more phytates in grains. Grains could definitely be harsher on the gut and prevent your gut from healing, but mold is also something to be concerned about.
As I also mentioned, there is a really good book, No Grain, No Pain, by Dr. Peter Osborne. You might want to check that out.
That is it. Thank you so much again for tuning in. Hope you found it to be valuable. Look forward to catching you in the next episode.
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