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Is Gluten Sensitivity a Neurological Disease?

Celiac.com 08/13/2009 - In the latest issue of the journal Medical Hypotheses, Dr. Rodney Philip Kinvig Ford of the Children’s Gastroenterology and Allergy Clinic in Christchurch, New Zealand, offers up a compelling hypothesis regarding celiac disease and gluten sensitivity, which asserts that the broad array of associated symptoms are more fully explained using a neurological perspective, than using a digestive/nutritional perspective.

For Dr. Ford, the idea that celiac disease is exclusively an auto-immune condition, and that nutritional mal-absorption is the main cause of related problems, is simply not borne out by the body of clinical data.

Dr. Ford accepts that celiac disease may itself be largely an auto-immune disorder. However, he believes that the broad array of problems associated with gluten intolerance are best explained by looking at the neurological aspects of intolerance to gluten, indeed, treating it as a neurological condition.

That's because gluten intolerance can affect up to up to 10% of the population, and that intolerance to gluten has largely neurological manifestations. That is, up to 10% of the population tests positive for elevated antibodies for gluten, even with no bowel damage.

Under Dr. Ford's hypothesis, neurological causes, rather than gut damage and nutritional deficiency, best explain
the myriad symptoms experienced by sufferers of celiac disease and gluten-sensitivity.

Under Dr. Ford hypothesis, if gluten is the assumed cause of harm, then exposure to gluten in sensitive individuals may cause neurological harm through a combination of cross-reacting antibodies, immune complex disease and direct toxicity.

It's certainly true that a number of celiac patients experience neurological symptoms, often associated with autonomic nervous system malfunction.

Such neurological symptoms can even show up in celiac patients who are otherwise well nourished. Moreover, gluten-sensitivity can be associated with neurological symptoms in patients who have no mucosal gut damage--that is, patients who are clinically free of celiac disease.

Dr. Ford argues that gluten exposure can cause neurological harm through a combination of cross-reacting antibodies, immune complex disease and direct toxicity. These nervous system affects include: dis-regulation of the autonomic nervous system, cerebella ataxia, hypotonia, developmental delay, learning disorders, depression, migraine, and headache. He calls such neurologically-driven sensitivity to gluten ‘‘The Gluten Syndrome."

Hypothesis: Gluten causes symptoms, in both celiac disease and non-celiac gluten-sensitivity, by its adverse actions on the nervous system.

Many celiac patients experience neurological symptoms, frequently associated with malfunction of the autonomic nervous system. These neurological symptoms can present in celiac patients who are well nourished. The crucial point, however, is that gluten-sensitivity can also be associated with neurological symptoms in patients who do not have any mucosal gut damage (that is, without celiac disease).

Gluten can cause neurological harm through a combination of cross-reacting antibodies, immune complex disease and direct toxicity. These nervous system affects include: dis-regulation of the autonomic nervous system, cerebella ataxia, hypotonia, developmental delay, learning disorders, depression, migraine, and headache.
If gluten is the putative harmful agent, then there is no requirement to invoke gut damage and nutritional deficiency to explain the myriad symptoms experienced by sufferers of celiac disease and
gluten-sensitivity. This he calls: ‘‘The Gluten Syndrome."

To support his hypothesis, Dr. Ford cites a study of 921 children carried out at his gastroenterology and allergy clinic. All children were screened for celiac disease via IgG-gliadinantibody (InovaDiagnostics) and tissue trans-glutaminase (tTG); and 190 had a small bowel biopsy. Results showed 724 with high IgG-gliadin levels (>14 units): mean age 5.3 years, s.d. 3.8.

In a key part of the, all children, whatever the biopsy results, were offered a gluten-free diet.

Results fell into three distinct categories:
(a) Definite celiac disease was revealed in 31 patients (4.3%), via histologic diagnosis. 94% of these patients reported improvement on a gluten-free diet.

(b) Possible celiac was revealed in 48 patients (6.6%), who had elevated tTG antibodies, but normal gut histology: 75% of these patients reported improvement on a gluten-free diet.

(c) Not-celiacs, n=644 (89.1%), with normal tTG antibodies and no evidence of gut damage: 53% reported improvement gluten-free.

Note that last category: More than half of people without celiac disease reported improvement on a gluten-free diet. What's up with that? Well, those are the people Dr. Ford suspects suffer from "gluten syndrome."

The parents of apparently ‘‘asymptomatic” children were interviewed as part of a population study to identify those with celiac disease. They found many children who had positive tests for gliadin antibodies also had irritability, lethargy, abdominal distension, gas, and poor weight gains.  A high proportion of children with gastro-intestinal, allergy, and neurological conditions have elevated IgG-gliadin antibodies.

The three groups all shared similar clinical features. In the respective groups, 71%, 65%, and 51% of patients reported behavior issues, such as tiredness, lethargy, irritability, sleep disturbance, while 16%, 15%, and 24% reported gastric reflux. Dr. Ford believes these symptoms are likely to be neurologically driven by gluten-sensitivity.

Celiac patients completed a questionnaire regarding the presence of neurological symptoms. Those reporting any neurological manifestations were compared with a control group: celiac patients had more neurological disorders (51.4%) in comparison with controls (19.9%). These conditions included: hypotonia, developmental delay, learning disorders, attention deficit hyperactivity disorder, migraine, headache, and cerebella ataxia.

For Dr. Ford, not only is it significant that such high numbers of people with celiac disease report neurological issues, but it is also significant that the majority of 'non-celiac' patients report improvement on a gluten-free diet.

These patients are likely candidates for what he calls 'gluten syndrome.' These children can likely be spotted via screening for high IgG-gliadin levels.

Dr. Ford believes the next step is to test this hypothesis in a double-blind study.

Certainly, the idea that a whole category of non-celiac gluten-sensitivity exists is intriguing, as is the idea that a neurological take on celiac-disease and gluten-sensitivty might might provide a better or improved understanding of those who suffer from these conditions.

Medical Hypotheses 73 (2009) 438–440

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12 Responses:

 
Glenn Ribotsky
Rating: ratingfullratingfullratingfullratingemptyratingempty Unrated
said this on
14 Aug 2009 4:14:18 AM PST
This is news?

While any increased dissemination of the idea that gluten sensitivity can have primarily neurological manifestations is welcome, the idea is hardly new or revolutionary, if one is familiar with the work of Drs. Hadjivassiliou, Chin, Latov, Fasano, and numerous others who can be looked up in Pub Med or google Scholar.

 
admin
( Author)
said this on
18 Aug 2009 11:32:33 AM PST
Why so angry Glenn? Additional perspectives are good, and the more articles about this the better...right?

 
admin
( Author)
said this on
18 Aug 2009 11:32:46 AM PST
Why so angry Glenn? Additional perspectives are good, and the more articles about this the better...right?

 
Stephen
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said this on
14 Aug 2009 8:46:53 AM PST
High IgG Values point to a Delayed Gluten Allergy.

I wonder if these same Individuals had High IgE Levels to Gluten.

I wonder what the Total IgE "Allergy Status" is in theses individuals > my hunch is that it is high for Enviro also.

A High IgG / Delayed Presence will initially translate to Neutro manifest and Gut Damage later .. if not at all.

 
Brent Bielema
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said this on
31 Aug 2009 9:33:39 PM PST
Vaccines can also cause neurological disease -- so could this be behind some of the celiac cases? I also read a recent article by Jeffrey Smith about GMO foods, which said that they may cause allergies to non-GMO foods. It's amazing the human body can still function under all these onslaughts!

 
Jim
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said this on
01 Sep 2009 7:42:32 AM PST
I've always wondered this because gluten causes so many neurological issues...

 
Michelle
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said this on
01 Sep 2009 9:03:23 AM PST
I have celiac and have been on a gluten free diet for more than five years. I have been going to Physical Therapy for over a year now for problems with my muscles and nerve pain. The doctor's don't know what's wrong. Interesting to think it may have to do with my celiac.

 
Pam
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said this on
08 Sep 2009 9:06:53 AM PST
I have had many of the same problems you're describing. I also have severe migraines. It would be interesting to know if the celiac has caused this damage or not. Only been on the diet for a year. I also have a son with autism who has seen some improvement in behavior on this diet.

 
Jeff Adams
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said this on
13 Jan 2010 12:52:06 PM PST
Check out the very latest article with a part about gluten-free diets not seeming to help many of the common neurological problems associated with celiac disease...

 
Mike Pilkington
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said this on
21 Jan 2013 8:29:14 PM PST
You all make it so complicated. We all know:
What you eat controls your digestion
What you eat controls your energy
What you eat controls your heart rate...
AND I AM LIVING PROOF
What I eat prevents my Atrial Fibrillation (chronic heart seizures)
What I eat stops my neuropathy pain.

HOW MUCH SIMPLER CAN IT GET THAN THAT?

 
Mike Pilkington
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said this on
21 Jan 2013 8:33:40 PM PST
Jeff Adams,

The gluten-free diet is not helping the neurological because the poor absorption problem (gluten disease issue) still exists.

If they were to eat gluten again, both the neurological and digestive will escalate. If they not eat gluten, I would not expect improvement because the digestive disorders still exist simply because they cannot eat gluten.

 
Susan Mayans
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said this on
26 Apr 2013 8:50:42 PM PST
I have been gluten free for 28 years and 2 years ago, I developed ataxia. I have all over neuropathies and atrial fibrillation. I am very strict about being gluten-free and it didn't prevent or alleviate my symptoms.




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