McCall McPhersonFounder, Modern Thyroid Clinic.

Can you ever have gluten cheat meals with Hashimotos? #hashimotos #hashimotosthyroiditis

25 Jun 2026 · 2 min

Watch on YouTube

1:41

In this educational video, McCall McPherson addresses whether individuals with Hashimoto's thyroiditis who follow a gluten‑free diet can occasionally indulge in gluten “cheat” meals. She first clarifies the difference between celiac disease—an autoimmune condition that requires strict lifelong gluten avoidance—and non‑celiac gluten sensitivity, which comprises the majority of people on gluten‑free diets. Using an analogy of inflammation as water filling a cup, McPherson explains that the body can tolerate a certain level of inflammatory triggers before symptoms erupt. She describes how patients at the Modern Thyroid Clinic often have their “cup” already full, so even a small gluten exposure can cause a flare. The therapeutic goal, therefore, is not to eliminate all inflammation but to lower the baseline level (the water height) by about 75% through long‑term gluten avoidance and other lifestyle measures. When baseline inflammation is sufficiently reduced, many non‑celiac individuals can handle occasional small amounts of gluten without triggering symptoms, whereas celiac patients (including McPherson herself) cannot. The talk emphasizes a delicate balance and individualized assessment for cheat meals.

Chapters

So you have Hashimoto's, you've been gluten-free for a really long time. Can you have a cheat meal every once in a while? Let's talk about the vast majority of people who go gluten-free, which are non-celiac gluten-sensitive people. Okay? Celiac's the autoimmune disease with gluten. That's different. So for gluten-intolerant people, honestly, yeah, most people can have a cheat meal every once in a while. I want you to think about inflammation as like water in a cup. Okay. And every bit of inflammation you get is a drop of water in that cup. And your body is meant to deal with the cup's height of inflammation before it erupts and overflows and creates symptoms, autoimmune disease. Okay. When people come to Modern Thyroid Clinic, most of the time their cup is completely full. So one little bit of gluten, one little bit of environmental exposure triggers this inappropriate eruption of overflow. The goal is not to get rid of all of the water in the cup. Inflammation is inevitable. We're all going to get exposed to it. The goal is to reduce the amount of water in the cup so that you can handle inevitable amounts of inflammation every day. So what people do a lot of the time over years of being gluten-free is they take that water level in the cup and they reduce it by 75%, right? So as long as it's low enough, you can handle a little bit of gluten here and there and Yeah, it drops a little bit of water into the cup, but it's not overflowing. You're not getting symptoms, you're not getting a flare. So you have to be delicate about it because again, that water changes the level all the time. But most people can tolerate gluten in small amounts after they've refrained from it for a long time, except celiacs. And those people like myself, sadly cannot.