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Celiac.com 09/01/2023 - Celiac disease, a chronic autoimmune disorder triggered by the consumption of gluten, has long been associated with gastrointestinal symptoms and malabsorption issues. However, a growing body of research has shed light on an often-overlooked aspect of celiac disease: its potential impact on mental health. The intricate relationship between the gut and the brain, known as the gut-brain axis, is garnering attention for its role in influencing both physical and mental well-being. As scientists delve deeper into the complexities of this connection, a compelling picture emerges—one that suggests that the health of the gut could play a pivotal role in shaping our mental state. In this article, we embark on a journey through the fascinating landscape of celiac disease and its intricate relationship with mental health. We'll explore the mechanisms that underlie the gut-brain axis and how they contribute to various mental health conditions. We'll delve into the scientific evidence that links celiac disease to conditions such as anxiety, depression, ADHD, autism spectrum disorders, schizophrenia, and bipolar disorder. Additionally, we'll examine how nutritional deficiencies stemming from untreated celiac disease may exacerbate these mental health issues. As we navigate this intricate web of connections, we'll address the question of whether a gluten-free diet—one that is central to managing celiac disease—could also hold the key to alleviating mental health symptoms in gluten sensitive individuals. The Gut-Brain Axis: Exploring the Connection The intricate interplay between the gut and the brain is a captivating area of scientific inquiry that has been gaining momentum in recent years. This communication network, known as the gut-brain axis, serves as a two-way highway along which information travels between these seemingly distant organs. The gut, often referred to as the "second brain," is home to a complex ecosystem of trillions of microorganisms, collectively known as the gut microbiota. These microorganisms play a pivotal role in maintaining the gut's health and influencing various bodily processes, including those related to mental well-being. The gut-brain axis operates through intricate signaling pathways that involve both direct and indirect communication. The vagus nerve, a long cranial nerve that connects the brain to the abdomen, acts as a vital conduit for this communication. In addition, a dynamic network of biochemical messengers, including neurotransmitters, hormones, and immune molecules, enables the gut and brain to send and receive messages. The gut microbiota, which includes a diverse range of bacteria, viruses, fungi, and other microorganisms, has emerged as a key player in shaping this communication. These microbes contribute to the production of neurotransmitters such as serotonin, dopamine, and gamma-aminobutyric acid (GABA), which are not only crucial for brain function but also have a profound impact on mood regulation. A growing body of research suggests that imbalances in the gut microbiota, often referred to as dysbiosis, may contribute to mental health disorders. Understanding the gut-brain axis offers a fresh perspective on the way physical and emotional health intersect. Factors that disrupt the balance of this delicate axis, such as chronic inflammation, stress, and dietary choices, can have far-reaching consequences for mental health. As researchers unravel the intricate threads of this connection, they are uncovering insights that may pave the way for innovative therapeutic approaches to address mental health conditions, particularly in individuals with underlying conditions such as celiac disease. Celiac Disease and Mental Health: A Complex Link As we journey deeper into the realm of celiac disease and its implications for mental health, we encounter a multifaceted connection that underscores the complexity of human physiology. Celiac disease, an autoimmune disorder triggered by the ingestion of gluten—a protein found in wheat, barley, and rye—has long been recognized for its impact on the gastrointestinal system. However, the story does not end there. A growing body of research suggests that the effects of celiac disease extend beyond the gut, reaching into the realm of mental health. While the exact mechanisms that link celiac disease to mental health conditions are still being unraveled, several factors contribute to this intricate relationship. One of the key elements is inflammation. Untreated celiac disease triggers an immune response that leads to chronic inflammation within the small intestine. This inflammation has the potential to extend beyond the gut, affecting other systems within the body—including the brain. This raises the intriguing possibility that the inflammation associated with celiac disease could play a role in the development or exacerbation of mental health issues. Moreover, the gut-brain axis comes into play once again. The gut microbiota, a collection of microorganisms residing in the gastrointestinal tract, plays a significant role in influencing both physical and mental health. Emerging research suggests that the gut microbiota of individuals with celiac disease may differ from those without the condition. This dysbiosis could potentially impact the production of neurotransmitters, such as serotonin, that are crucial for mood regulation. The prevalence of mental health issues among individuals with celiac disease adds another layer of complexity to the equation. Studies have shown that individuals with celiac disease are at an increased risk of conditions such as anxiety, depression, and attention disorders. While the exact causal relationship between celiac disease and these conditions remains under investigation, the implications are undeniable. Understanding the connections between celiac disease and mental health not only sheds light on the broader impact of the disorder but also offers new avenues for therapeutic interventions. Anxiety and Celiac Disease: Breaking Down the Ties Research has revealed a compelling link between celiac disease and anxiety disorders. While the exact mechanisms remain a subject of ongoing investigation, several factors contribute to this connection. One notable element is the role of inflammation. Untreated celiac disease triggers an immune response that leads to chronic inflammation in the small intestine. This inflammation may extend beyond the gut, affecting other areas of the body, including the brain. Inflammation is increasingly recognized as a potential contributor to anxiety, as it can disrupt neurotransmitter balance and neural pathways. In addition to inflammation, nutritional deficiencies resulting from malabsorption in celiac disease could exacerbate anxiety symptoms. Nutrients like B vitamins, particularly B12 and folate, are essential for maintaining optimal neurological function. Deficiencies in these vitamins have been linked to mood disorders, including anxiety. The gut's compromised ability to absorb these nutrients can hinder their availability to the brain, potentially amplifying feelings of anxiety. As for the impact of a gluten-free diet on anxiety, findings are promising but complex. Some individuals with celiac disease report a reduction in anxiety symptoms after adopting a gluten-free diet. However, the relationship is not one-size-fits-all. It's important to note that anxiety can stem from various factors, and while dietary changes might alleviate symptoms in some cases, they may not be a standalone solution for everyone. Seeking professional guidance from both medical and mental health experts is crucial for individuals with celiac disease experiencing anxiety. Depression and Celiac Disease: Searching for Clues Among the spectrum of mental health conditions, depression stands as a particularly intricate puzzle. Its origins are multifaceted, influenced by a combination of genetic, environmental, and physiological factors. As researchers delve into the complexities of depression, a new avenue of exploration emerges—one that involves the interplay between celiac disease and this mood disorder. Depression, characterized by persistent feelings of sadness, hopelessness, and a lack of interest in activities, affects millions of individuals worldwide. Interestingly, studies have shown a higher prevalence of depression among individuals with celiac disease compared to the general population. The question that naturally arises is whether there is a genuine connection between these two seemingly unrelated conditions. One avenue of investigation lies in the realm of serotonin, a neurotransmitter known for its role in regulating mood and emotions. An estimated 90% of serotonin is produced in the gastrointestinal tract, where the gut microbiota plays a significant role in its synthesis. Here, the gut-brain axis comes into play once again. Untreated celiac disease, with its potential to disrupt the balance of the gut microbiota, could potentially impact serotonin production and utilization. This disruption may contribute to the development or exacerbation of depressive symptoms. Moreover, nutritional deficiencies associated with celiac disease could play a role in the development of depression. Nutrients such as B vitamins, folate, and iron are essential for optimal neurological function. Malabsorption in celiac disease could lead to deficiencies in these nutrients, potentially affecting mood regulation. For instance, vitamin B12 deficiency has been linked to symptoms of depression, fatigue, and cognitive impairment—symptoms that often overlap with those of celiac disease. Could a gluten-free diet offer a ray of hope for individuals with celiac disease who also grapple with depression? While the research is ongoing and the results are variable, some individuals report improvements in their mood after adopting a gluten-free diet. This phenomenon raises intriguing possibilities regarding the connection between dietary choices and mental well-being. However, it's important to note that depression is a complex condition with diverse causes, and a gluten-free diet may not be a standalone solution for everyone. Consultation with medical and mental health professionals is essential for those considering dietary changes to manage their depression. Celiac Disease, ADHD, and Cognitive Function: Insights and Considerations Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects both children and adults, characterized by symptoms of inattention, hyperactivity, and impulsivity. While traditionally associated with behavioral and cognitive challenges, emerging research suggests a potential link between celiac disease and ADHD. The relationship between celiac disease and ADHD is complex and multifaceted. While definitive causality has not been established, studies have highlighted intriguing associations between the two conditions. Individuals with celiac disease seem to be at a higher risk of developing ADHD-like symptoms compared to the general population. Additionally, some research suggests that individuals with ADHD might have an increased prevalence of celiac disease. One plausible connection lies in the potential impact of untreated celiac disease on cognitive function. Nutritional deficiencies, often a consequence of malabsorption in celiac disease, can affect various aspects of cognitive performance. Nutrients like iron, zinc, and certain B vitamins are essential for optimal brain function. Deficiencies in these nutrients might contribute to attention difficulties and cognitive impairments often observed in individuals with ADHD. Furthermore, the gut-brain axis plays a role in shaping cognitive function and behavior. The gut microbiota, with its influence on neurotransmitter production and immune responses, could potentially impact the neural pathways associated with ADHD. Dysbiosis or imbalances in the gut microbiota might disrupt these pathways, contributing to the development or exacerbation of ADHD symptoms. Could adopting a gluten-free diet offer potential benefits for individuals with celiac disease who also experience ADHD-like symptoms? While the research is still unfolding, anecdotal evidence and some studies suggest that dietary changes might have positive effects on cognitive function and attention in individuals with celiac disease and ADHD. However, the outcomes vary, and the efficacy of a gluten-free diet for managing ADHD requires further investigation. It's essential for individuals to work closely with healthcare professionals when considering dietary interventions for managing ADHD symptoms. Autism Spectrum Disorders and Celiac Disease: An Evolving Understanding Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by a range of challenges in social interaction, communication, and behavior. While the exact causes of ASD remain elusive, researchers have been exploring potential links between celiac disease and autism, shedding light on intriguing intersections between the two. The relationship between celiac disease and ASD is a topic that continues to evolve. Studies investigating this connection have yielded mixed findings, with some suggesting a potential association and others failing to establish a clear link. Despite the ambiguity, there are notable overlaps in genetic and immunological factors between the two conditions, prompting researchers to delve deeper into the shared mechanisms. One avenue of exploration lies in the immune system's role in both celiac disease and ASD. Both conditions involve immune dysregulation and inflammation, suggesting that disruptions in the immune response could contribute to the development of both disorders. Shared genetic markers and pathways further underscore the potential connections between celiac disease and ASD. Additionally, nutritional deficiencies resulting from untreated celiac disease may play a role in the development of ASD symptoms. Nutrients like zinc, iron, and certain B vitamins are crucial for optimal neurological development. Deficiencies in these nutrients, which are common in individuals with celiac disease, could potentially impact brain development and function, potentially contributing to ASD symptoms. The question of whether a gluten-free diet could positively impact individuals with celiac disease and ASD remains a topic of interest. Some parents and caregivers have reported improvements in certain behaviors and symptoms in individuals with ASD after adopting a gluten-free diet. However, the results are variable, and the research landscape is complex. Rigorous scientific studies are needed to establish the potential benefits of dietary interventions for individuals with both celiac disease and ASD. Navigating the relationship between celiac disease and ASD requires a comprehensive approach that takes into account genetic, immunological, and nutritional factors. As researchers continue to explore this connection, individuals with celiac disease and caregivers of those with ASD are encouraged to collaborate with healthcare professionals to make informed decisions that consider the individual's unique needs and circumstances. Schizophrenia and Celiac Disease: Investigating the Intersection Schizophrenia, a complex and often debilitating mental health disorder, challenges our understanding of the intricate workings of the brain. Characterized by symptoms such as hallucinations, delusions, disorganized thinking, and impaired cognitive function, schizophrenia remains an enigma in the field of psychiatry. Recent research has sparked interest in the potential connections between celiac disease and schizophrenia, shedding light on an intersection that warrants further exploration. The relationship between celiac disease and schizophrenia is a topic of ongoing investigation, and while the evidence is limited, it presents intriguing insights into the possible links between immune dysregulation, inflammation, and brain function. Some studies suggest that individuals with celiac disease may be at a higher risk of developing schizophrenia-like symptoms compared to the general population. Furthermore, a shared genetic susceptibility between the two conditions raises the possibility of overlapping mechanisms. One avenue of inquiry involves the potential role of inflammation in both celiac disease and schizophrenia. Chronic inflammation, a hallmark of untreated celiac disease, has been proposed as a contributor to the development of schizophrenia symptoms. Immune molecules released during inflammation could impact neural circuits and neurotransmitter balance, potentially leading to the characteristic symptoms of schizophrenia. Moreover, the gut-brain axis comes into focus once again. The gut microbiota, with its influence on immune responses and neurotransmitter production, could play a role in shaping brain function and behavior. Alterations in the gut microbiota composition, often observed in individuals with celiac disease, may influence immune responses and inflammation, potentially contributing to the development or exacerbation of schizophrenia symptoms. As for the potential impact of a gluten-free diet on schizophrenia symptoms, the landscape is complex and the research is limited. Some case studies and anecdotal reports suggest that individuals with schizophrenia and celiac disease experienced improvements in their mental health after adopting a gluten-free diet. However, these outcomes are far from uniform, and more rigorous research is needed to establish the potential benefits of dietary interventions for managing schizophrenia. Understanding the potential connections between celiac disease and schizophrenia offers a fresh perspective on the intricate interplay between the immune system, inflammation, and brain function. As the scientific community continues to delve into this complex relationship, individuals with celiac disease and those with schizophrenia are encouraged to engage in open dialogues with healthcare professionals to make informed decisions that consider their unique circumstances. Bipolar Disorder and Celiac Disease: A Complex Interaction Bipolar Disorder, characterized by extreme shifts in mood, energy, and activity levels, presents a unique challenge in the realm of mental health. Individuals with bipolar disorder experience periods of elevated mood (mania) and periods of depression, often accompanied by changes in behavior and cognition. While the origins of bipolar disorder are multifaceted, researchers are uncovering potential connections between celiac disease and bipolar symptoms, shedding light on an intricate interplay that warrants exploration. The relationship between celiac disease and bipolar disorder is multifaceted and not fully understood. Studies exploring this connection have yielded mixed results, making it difficult to establish definitive causality. However, shared genetic factors and the potential impact of inflammation on brain function suggest potential links between the two conditions. One avenue of investigation involves the role of omega-3 fatty acids, essential nutrients with anti-inflammatory properties. Individuals with celiac disease are at risk of nutritional deficiencies, including deficiencies in omega-3 fatty acids. These deficiencies could potentially contribute to neuroinflammation and impact brain function, potentially exacerbating bipolar symptoms. Furthermore, the gut-brain axis enters the spotlight once again. The gut microbiota's influence on inflammation, neurotransmitter production, and immune responses makes it a key player in the relationship between celiac disease and bipolar disorder. Imbalances in the gut microbiota, often associated with celiac disease, could potentially contribute to immune dysregulation and impact mood regulation. The potential impact of a gluten-free diet on bipolar disorder symptoms remains a topic of interest. Some individuals with bipolar disorder and celiac disease have reported improvements in mood stability and overall well-being after adopting a gluten-free diet. However, the results are variable, and the research landscape is complex. Rigorous scientific studies are needed to establish the potential benefits of dietary interventions for individuals with both conditions. As researchers continue to explore the complex connections between celiac disease and bipolar disorder, individuals with celiac disease and those managing bipolar disorder are encouraged to engage in conversations with healthcare professionals. Understanding the potential impact of dietary choices and addressing nutritional deficiencies could hold promise in the realm of mental health, offering a comprehensive approach to managing bipolar disorder symptoms. The Impact of a Gluten-Free Diet on Mental Health As the intricate relationship between celiac disease and mental health unfolds, the question that looms large is whether a gluten-free diet—an essential component of managing celiac disease—could potentially have a positive impact on mental well-being. While the research is complex and the outcomes are variable, investigating the potential effects of a gluten-free diet on mental health conditions sheds light on a promising avenue of exploration. Anxiety and Depression: A Glimmer of Hope? For individuals with celiac disease who also experience anxiety and depression, the prospect of a gluten-free diet alleviating their symptoms is an intriguing one. While studies investigating the direct impact of a gluten-free diet on anxiety and depression are limited, some individuals report improvements in their mood and overall emotional well-being after adopting such a diet. The reasons behind these improvements are not fully understood, but they could stem from a combination of factors, including reduced inflammation and improvements in nutrient absorption. Attention and Cognitive Function: Enhancing Clarity? In the realm of attention disorders and cognitive function, the potential benefits of a gluten-free diet for individuals with celiac disease and ADHD remain under exploration. Anecdotal evidence suggests that some individuals experience improvements in attention and focus after adopting a gluten-free diet. However, rigorous scientific studies are needed to establish the efficacy of dietary interventions on cognitive function in individuals with ADHD. Autism Spectrum Disorders: Navigating Complexity For individuals with celiac disease and autism spectrum disorders, the potential impact of a gluten-free diet on symptoms remains a topic of debate. Some parents and caregivers report observed improvements in behavior and communication after removing gluten from the diet. However, the results are highly variable, and research findings have been mixed. It's crucial for individuals considering dietary changes to collaborate closely with healthcare professionals to make informed decisions that consider the individual's unique needs. Schizophrenia and Bipolar Disorder: A Bridge to Explore In the realm of severe mental health conditions like schizophrenia and bipolar disorder, the evidence regarding the impact of a gluten-free diet on symptoms is limited. While some case studies and anecdotal reports suggest potential benefits, the landscape is complex and the outcomes are far from uniform. The relationship between celiac disease, inflammation, and these conditions raises intriguing possibilities, but further research is needed to establish the potential role of dietary interventions. In the pursuit of understanding the impact of a gluten-free diet on mental health conditions, it's essential to approach dietary changes with caution. While the potential benefits are promising, it's important to recognize that dietary interventions are not a substitute for professional medical and mental health care. Consulting with healthcare providers who specialize in both celiac disease and mental health is crucial before making any significant changes to one's diet. Conclusion The intricate relationship between celiac disease and mental health unveils a captivating narrative that underscores the interconnectedness of the body and mind. As we navigate the complex landscape of the gut-brain axis, immune responses, and nutritional influences, a mosaic of connections emerges—highlighting the potential impact of celiac disease on a spectrum of mental health conditions. The gut-brain axis, a bidirectional communication network, serves as a bridge between the physical and emotional realms. The gut microbiota, immune responses, and inflammation play pivotal roles in shaping mental well-being. While the mechanisms are complex and multifaceted, the emerging research paints a compelling picture—one that invites us to consider new perspectives on mental health. From anxiety and depression to ADHD, autism spectrum disorders, schizophrenia, and bipolar disorder, each mental health condition weaves a unique thread in the tapestry of celiac disease's influence. Shared genetic factors, immune dysregulation, and nutritional deficiencies intermingle to create a symphony of interactions that challenge our understanding of the mind's intricate workings. As individuals with celiac disease and mental health conditions seek answers, it's essential to approach the journey with patience, curiosity, and a commitment to holistic well-being. While a gluten-free diet holds promise for some, it's not a panacea. Collaborating closely with healthcare professionals—those who specialize in both celiac disease and mental health—offers a comprehensive approach to addressing the nuanced connections between these realms. The exploration doesn't end here. As science continues to advance, our understanding of the gut-brain connection will deepen, unveiling new insights and potential interventions. The complexities of celiac disease's impact on mental health remind us of the intricate tapestry that makes us human—a tapestry woven with the threads of genetics, environment, biology, and experience. In the journey toward unraveling the gut-brain connection, we bridge the gap between the physical and emotional, gaining a deeper appreciation for the profound interplay that shapes our lives. As we move forward, let us continue to foster open dialogue, advance scientific inquiry, and empower individuals to make informed choices that honor both their physical health and mental well-being.

Celiac.com 03/27/2023 - Celiac disease, a chronic inflammatory disorder of the intestines, affects about 1% of the world's population. Celiac disease causes diarrhea, abdominal discomfort, bloating, flatulence, and, in rare cases, constipation in the digestive tract. Since the identification of gluten as the disease-causing antigen, celiac patients have been treated with a gluten-free diet, which usually eliminates symptoms and restores gut health, but which also has limitations for some patients. Celiac disease is also associated with numerous neurological and psychological manifestations. A recent article details findings from the most recent study, but here we try to provide more comprehensive information. Neurological Manifestations of Celiac Disease The neurological manifestations of celiac disease are varied and can include psychiatric and neurological symptoms such as ataxia, peripheral neuropathy, seizures, headaches, cognitive impairment, and myoclonus. The specific mechanisms of celiac disease's neurological effects are still being researched, but they may involve gluten-mediated pathogenesis that can lead to antibody cross-reactions, immune-complex deposition, direct neurotoxicity, or extreme vitamin or food deficiencies. A gluten-free diet can alleviate most celiac disease symptoms, except for cortical myoclonus and dementia, which may require immunosuppressive therapy. However, there is currently no consensus on whether serological or neurophysiological data can accurately predict or monitor celiac disease-related neurological involvement. Treatment for gluten-related neurological symptoms typically involves embarking on a strict gluten-free diet as soon as possible, which can have a positive therapeutic effect for most cases. Symptomatic management may also be required. Immunosuppression is only used in cases where a gluten-free diet alone has not been beneficial or for patients with refractory celiac disease. Peripheral Neuropathy and Gluten Ataxia Peripheral neuropathy and gluten ataxia are common in celiac patients, with up to 39% of patients experiencing gluten neuropathy. Gluten-free diets have been shown to improve neuropathy and ataxia. Gluten ataxia is an uncommon immune-mediated neurological disease that can be difficult to identify. The early signs of ataxia may be subtle, but worsen if left untreated. Patients with gluten ataxia may experience structural alterations in different parts of the brain, including the cerebellum and thalamus, and have larger lateral ventricles. Higher Epilepsy Risk Celiac disease increases the risk of epilepsy, especially in children and adolescents. The presence of villus atrophy on follow-up biopsies may reduce the risk of epilepsy but does not affect hospitalizations for epilepsy emergencies. Unexplained epilepsy should prompt celiac disease screening since early identification and therapy may increase the effectiveness of anti-epileptic drugs. Celiac patients also have a higher prevalence of migraines and tension headaches. The underlying relationship between celiac disease and headache involvement is still unknown, but adherence to a gluten-free diet can alleviate neurological symptoms. Celiac disease can also cause cognitive impairment, including memory loss, clouded thinking, personality shifts, and an inability to calculate. Nutrient deficiencies, systemic inflammation, and low brain serotonin levels have been suggested as possible reasons for this. Celiac disease has also been associated with Alzheimer's and vascular and fronto-temporal dementias. Neuropsychological assessments should be conducted in celiac disease patients to assess cognitive function. Psychiatric Manifestations of Celiac Disease Celiac disease is associated with depression, anxiety, eating disorders, autism spectrum disorder, attention deficit hyperactivity disorder (ADHD), bipolar disorder, schizophrenia, and mood disorders. The relationship between celiac disease and these psychiatric disorders is not well-known or established. Particular biological aspects as well as the effect of a gluten-free diet require additional research. Depression and Anxiety Celiac disease has been associated with various psychiatric disorders such as depression, anxiety, eating disorders, autism spectrum disorder, attention deficit hyperactivity disorder (ADHD), bipolar disorder, schizophrenia, and mood disorders. However, the relationship between these disorders and celiac disease remains unclear and requires further research. Research suggests that gastrointestinal disorders have a link with depression and anxiety due to prolonged pain and inflammation, affecting specific brain targets like the anterior cingulate cortex. Gastrointestinal disorder patients have reduced cognitive and mood status, leading to anxio-depressive phenotypes, even in the absence of clear evidence of threats. Children with celiac disease may experience anxiety and depressive symptoms, and pediatric patients with celiac disease should be frequently assessed for mental health issues, especially anxiety and sadness. Adults with celiac disease have reported experiencing anxiety and depression as well, particularly due to clinical illnesses and symptoms. Following a gluten-free diet may worsen symptoms like anxiety and fatigue, leading to a diminished quality of life. Therefore, clinicians must recognize the importance of promoting both dietary adherence and social and emotional well-being in celiac disease patients. Studies have shown that individuals with celiac disease experience low quality of life, anxiety, and depressive symptoms, and nutrition plays a crucial role in reducing these effects. However, the role of motivation in the quality of life and adherence remains unclear and requires further research. Eating Disorders Eating disorders may be a comorbidity with celiac disease (celiac disease) and the need for further investigation. celiac disease patients may experience disordered eating due to the disease itself or other factors such as food neophobia. It is crucial for gastroenterology clinicians to be aware of potential risks for eating disorders in celiac disease patients. The article notes that while numerous examples of eating disorders have been described in celiac disease patients, few epidemiological studies have investigated this potential link. One study found that patients with celiac disease had higher Eating Attitude Test scores than controls when testing individuals aged 13 and up, but no clear differences were seen between patients with celiac disease and controls when using other screening measures for ED. The article suggests that further investigations with larger samples and prospective designs are needed to corroborate these results. The article also discusses how celiac disease may cause food neophobia, which is linked to sensory aversions or fears of the negative effects of eating particular foods. This fear may be more severe in celiac disease patients than in non-celiac disease patients who choose to follow a gluten-free diet and can be linked to the possibility of having an unfavorable reaction to gluten-contaminated food products. The article emphasizes the importance of gastroenterology clinicians being aware of potential risks for eating disorders in celiac disease patients. It notes that eating disorders are defined by thoughts and actions linked to physical and/or psychological problems and that it is crucial to identify past, current, and potential risks for eating disorders in celiac disease patients. Autism Disorder Autism spectrum disorder is caused by a complex interplay of genetic and environmental factors, affecting individuals in diverse ways. Recent studies suggest that immune system dysfunction could contribute to the development of autism spectrum disorder in some people [55]. While some research suggests a connection between celiac disease, an autoimmune disorder triggered by gluten consumption that mainly affects the small intestine, and autism spectrum disorder, other studies have not found a significant association between the two conditions. Attention Deficit Hyperactivity Disorder (ADHD) Research has suggested a potential link between celiac disease and ADHD, with studies showing that celiac disease is overrepresented in ADHD patients, and a gluten-free diet improved ADHD symptoms in celiac disease patients. However, routine screening for ADHD in people with celiac disease or vice versa is not recommended. Cognitive problems similar to those seen in children with ADHD, such as a lack of focus or trouble paying attention, were linked to gluten-free diet noncompliance in childhood celiac disease, as were psychosomatic symptoms and antisocial behavior. Individuals with untreated celiac disease may be at risk for engaging in ADHD-like behavior, specifically inattention. Out of 23 studies, 13 found a favorable correlation between ADHD and celiac disease. Bipolar Disorder Bipolar Disorders refer to a group of serious and long-term mental health conditions that are characterized by manic and depressive episodes. Research has shown that people with bipolar disorder have higher levels of immunoglobulin G (IgG) antibodies against gliadin than those without a history of psychiatric illness. However, there is still a need for further investigation into the specific antibody response to gluten antigens in bipolar disorder. Close associations have also been observed between celiac disease and major depressive disorder, panic disorder, and bipolar disorder, leading to reduced quality of life. Therefore, early reporting of symptoms and screening for celiac disease is recommended, especially for those with a family history of the disease or essential symptoms. Schizophrenia Schizophrenia is a severe mental illness that increases the risk of premature death 2-4 times compared to the general population. Genetic and environmental factors, including drug abuse, especially involving cannabis, are associated with an increased risk of developing schizophrenia. Research suggests an association between schizophrenia and celiac disease, although a causal link has yet to be established. Although having elevated antibodies against gliadin is a common immunological abnormality between schizophrenia and celiac disease, most patients with schizophrenia who had elevated anti-gliadin antibodies (AGA) did not have celiac disease. However, there is evidence that a gluten-restricted diet may benefit schizophrenia patients with immunological gluten sensitivity. One treatment-resistant schizophrenia patient with immunological gluten sensitivity benefited from a gluten-restricted diet improvement in both mental and physical symptoms, as well as a reduction in the plasma quantitative level of AGA-IgG. Chronic inflammation, which is thought to increase due to gluten intolerance, may worsen the symptoms of schizophrenia and make it harder for patients to respond to treatment and absorb medications. Schizophrenia patients also have a higher rate of digestive and liver problems. While removing gluten from the diet may alleviate some symptoms, it is not recommended for all patients. Gluten intolerance is believed to increase chronic inflammation, exacerbating symptoms and reducing medication absorption. However, the available data on the link between celiac disease, gluten allergies, and schizophrenia are inconsistent, and a gluten-free diet is not recommended for people with psychosis and mood disorders without further research. Other Psychiatric Disorders Previous research has shown that people with celiac disease are more likely to suffer from neuropsychiatric disorders than the general population. So far, more than 60 non-human leukocyte antigen (HLA) genes have been linked to celiac disease by genome-wide association studies; of these, it is believed that 15% have a role in neurological health. Many common neuropsychiatric disorders include celiac disease as a primary predisposing factor. It's possible that the co-occurrence of diseases is in large part due to shared molecular networks and biological processes. To determine what causes these disorders, we need to look at the underlying molecular mechanisms. Celiac disease was associated with an increased risk of psychiatric problems in children, raising their lifetime risk by 1.4 times that of the general population. Celiac disease in children has been linked to an increased likelihood of developing psychosocial difficulties later in life, including depression, anxiety, eating disorders, antisocial behavior, attention deficit hyperactivity disorder, autism spectrum disorder, and intellectual disability. It was also more common to have been diagnosed with a mood, eating, or behavioral condition prior to the celiac disease diagnosis. In contrast, no elevated risk was found for any of the psychological diseases studied in the siblings of people with celiac disease. A cohort study included nearly 20,000 children with biopsy-verified celiac disease, pairing each patient with 5 reference child controls. Approximately 16.5% of celiac children were diagnosed with a psychological condition during a median follow-up of 12.3 years, compared to 14.1% of controls. Celiac disease in childhood increased the risk of psychiatric illness by 19% and this risk increases during maturity, in particular, mood, anxiety, eating, ADHD, and autism spectrum problems. There was no statistically significant increase in psychotic disorders, psychoactive substance use, behavioral disorders, personality disorders, suicide attempts, or suicides. Celiac disease increases the use of psychiatric medication. Psychological issues associated with celiac disease were also more prevalent. As a result, the attending physician should conduct routine surveillance of potential psychiatric symptoms in patients of all ages who have gluten-related diseases, including both children and adults. Conclusions In conclusion, celiac disease has been linked to numerous neurological and psychiatric conditions, including depression, anxiety, eating disorders, autism spectrum disorder, attention deficit hyperactivity disorder (ADHD), bipolar disorder, schizophrenia, and mood disorders. Clinicians should assess mental health factors when making a celiac disease diagnosis. Overall, the relationship between celiac disease and these neurological and psychiatric disorders is not well-known or established. More research is needed to understand the pathophysiology of celiac disease's neurological and psychiatric manifestations. Particular biological aspects as well as the effect of a gluten-free diet require additional research. Read more at Cureus.com

Celiac.com 07/06/2022 - More and more people are avoiding gluten and FODMAP food components (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) over concerns about their potential connection to celiac-like reactions in the gut. In recent years, gluten-free diets (GFD) and low-FODMAP diets (LFD) have become more popular across the globe. This is due to intolerances or allergies in some people, but also due to the direct influence of marketing movements or diet trends on eating choices. At the same time, understanding, diagnosing and treating neurological and psychiatric diseases is becoming more important in numerous countries. A number of researchers have started to examine FODMAPs for that reason. Because of this, the research team conducted a bibliographic systematic review to see if there is a pathophysiological relationship between consumption of gluten or FODMAPs and mental disorders. The research team included Egoitz Aranburu; Silvia Matias; Edurne Simón; Idoia Larretxi; Olaia Martínez; María Ángeles Bustamante; María del Pilar Fernández-Gil; and Jonatan Miranda. They are variously affiliated with the Gluten Analysis Laboratory of the University of the Basque Country, Department of Nutrition and Food Science, University of the Basque Country in Vitoria, Spain; the GLUTEN3S Research Group, Department of Nutrition and Food Science, University of the Basque Country in Vitoria, Spain; the Bioaraba, Nutrición y Seguridad Alimentaria, in Vitoria, Spain; and the Centro Integral de Atención a Mayores San Prudencio in Vitoria-Gasteiz, Spain. The team's review gathered data from clinical and randomized controlled trials, based on the PRISMA statement, published since 2012. Their analysis found that limiting or ruling out gluten or FODMAPs may improve symptoms such as depression, anxiety, or cognition deficiency, and to a lesser extent for schizophrenia and the autism spectrum. Nevertheless, further studies are needed to obtain completely reliable conclusions. Read more in Nutrients 2021, 13(6), 1894.

Celiac.com 01/27/2021 - The effects of celiac disease are typically gastrointestinal, though there have been rare cases where celiac disease can manifest with psychiatric symptoms and behavioral disturbances. In one recent case, a woman with untreated celiac disease experienced psychotic delusions when eating gluten. The delusions left her isolated from family and friends, and led to psychiatric treatment, diagnosis of celiac disease, and adoption of a gluten-free diet. After improving, accidental gluten consumption caused another break that led to a homicide attempt on her parents. In an unrelated matter, a team of researchers recently reported on the case of a 25-year-old man with a history of schizophrenia and autism spectrum disorder who was seen for behavioral disturbance after breaking into a neighboring house to eat food. The research team included Andrew K. Murphy, Joseph A. Norton, and Benjamin R. Pflederer. They are affiliated with the Department of Medicine at the University of Illinois College of Medicine in Peoria, Illinois. The male patient reported several months of diarrhea and fecal incontinence, and was severely malnourished on exam, despite eating sufficient food. These days, with better celiac awareness and testing, it's uncommon for patients to present with celiac crisis, which is marked by profuse diarrhea and severe metabolic/nutritional disturbances. Interestingly, behavioral disturbances, such as increased aggression or anxiety, are often the main manifestation of celiac disease in children, with gastrointestinal symptoms being milder or absent. A blood screen showed high tissue transglutaminase IgA antibody (TTG) and gliadin IgA levels, and celiac disease was confirmed by biopsy. The patient began a lactose-free and gluten-free diet, and received a short course of total parenteral nutrition (TPN) for nutritional resuscitation. He improved rapidly with this treatment, and his nutrition and behavior returned to baseline. This report of a case in which an adult with psychiatric comorbidities manifesting mainly as behavioral disturbances more common in children. Such patients can show highly atypical symptoms, and clinicians should watch carefully for such cases. Read more at: Am J Case Rep 2020; 21:e928337

Celiac.com 09/06/2019 (Originally published 04/05/2010) - I have a mental calendar that outlines some of the major contributors to the celiac community. It is a limited one, as I can not list all of the many thousands of contributors to our community. But I think I am aware of some of the most prominent of these, beginning with the discovery of the efficacy of the gluten free diet. In the 1930s, the most significant insight into celiac disease came from Dr. Willem Karel Dicke, a towering giant in the field of celiac research. His contribution of the gluten-free diet is the single most powerful contribution to the celiac community that has ever been made. Although others expressed insight into this condition, Dr. Dicke serves, in my mind, as the starting point for a modern understanding of celiac disease and gluten sensitivity. We cannot guess just how long it might have taken before some other pediatrician or gastroenterologist listened to the insightful comments of a concerned mother who had noticed that her child’s skin rash (possibly dermatitis herpetiformis) resolved when wheat was removed from the child’s diet. Please pause for a moment to think about this. Even seventy five years after Dr. Dicke’s discovery, would your physician, or your child’s pediatrician, investigate a nutritional theory you offered him or her? I think very highly of her, but I’m not sure that my physician would do so. The fact that Dr. Dicke listened that carefully to this concerned mother is the springboard that vaulted him to what I believe is the single greatest achievement in the history of celiac disease. By the 1950s, after Dr. Dicke’s thesis was published, the Crosby capsule was developed by Dr. William H. Crosby and was a major step forward for taking endoscopic biopsies from the small intestine. It may have been a mixed blessing though. While it identified some patients with severe, widespread villous atrophy, it likely missed most cases of celiac disease. During those early years, a gluten free diet was considered an extreme dietary measure and was usually not recommended unless celiac disease could be confirmed. Many physicians continue to see the diet in that light. Fortunately, that paradigm is changing, both through the improved quality and distribution of gluten free foods along with the trend of more and more health care professionals coming to realize some of the many benefits and the reduced burden of following a gluten free diet. In the 1960s, Dr. Curtis Dohan was the first to test the hypothesis that gluten might be a factor in schizophrenia – perhaps appreciating that LSD, taken by many Psychology and Psychiatry students at that time to mimic the experience of the schizophrenic, is refined from the mold that grows on gluten grains. He pointed to similarities between the indoles found in the urine of schizophrenics and those found in gluten grains. He went on to conduct research and publish his findings along these lines for more than two decades. His publications would prove prophetic even among those who had previously disparaged his work, as we now know that many schizophrenics mount immune responses to gluten that are usually quite dissimilar to those found in most celiac patients. Nonetheless, the evidence of gluten as a factor in schizophrenia has now been established by several different approaches conducted by several different groups. As Dr. Dohan was conducting his first research in this area, one of the most enduring and important figures in Twentieth Century celiac research entered the arena. Dr. Michael N. Marsh began his illustrious career in medicine with his graduation from the University of Leeds, School of Medicine in 1960. After a brief foray into obstetrics, he specialized in gastroenterology and dedicated most of the next 40 years to sub-specialty research on celiac disease. His work unveiled many facets of the immunological reactions to gluten inherent in celiac disease which provided a foundation for many subsequent advances in celiac research that followed. He developed the rectal challenge protocol which, although it continues to be experimental, is probably the best single test for identifying celiac disease and only celiac disease. As if that were not enough, he also developed the Marsh system to aid pathologists in categorizing the various forms of altered villous morphology that are consistent with celiac disease. Dr. Marsh’s retirement in 2000 was a loss to every celiac patient on the planet. Although he went on to publish another book about celiac disease and write and publish several more papers before he shifted to the pursuit of yet another doctoral degree (his fourth by North American standards). In 1984, Doctors Cooke and Holmes, contemporaries of Marsh, compiled a compelling medical textbook. Coeliac Disease may have been the first medical textbook devoted exclusively to celiac disease. It owns a special place in my heart because it is so well written that I found the information quite accessible even when I first began to explore the literature on celiac disease. These venerable gastroenterologists continued to conduct original research and thoughtful commentary both in the literature and at conferences. In the same decade, Dr. Martin Kagnoff was, I believe, the first to suggest that exposure to viral agents (specifically adenovirus 12) in addition to the predisposing HLA genetic markers, might be the key difference between those with the genetic predisposition who did and did not develop celiac disease. Several investigations have since explored exposure to other viral agents, with varying degrees of success. Also in the 1980s, both doctors Paul and Kozlowska each published separate accounts, in German and Polish respectively, of celiac children. About 70% of these youngsters showed signs and symptoms that are diagnostic for attention deficit disorders (ADD) but these criteria went away after six months to a year of strict compliance with a gluten-free diet. Again, in the 1980s, Dr. Vijay Kumar was an early pioneer in the development of antibody testing for celiac disease. Early in the 1990s, Dr. Carlo Catassi pioneered the use of endomysium antibody tests to conduct large screening studies for celiac disease among children throughout entire school districts in Italy. He first revealed high rates of celiac disease in Italy, of 1:250 (a startling number at that time) then in Sub-Saharan Africa where 5.6% of Saharawi children were shown to have celiac disease. These findings served as a template for similar work conducted in the USA. It was spearheaded by a group of researchers including Dr. Alessio Fasano, Dr. Peter Green, and several others at medical centers across the US. These same individuals have done wonders for celiac awareness in North America. Also in the 1990s, Dr. Kenneth Fine raised an early and strong voice in recognition of non-celiac gluten sensitivities. His voice continues to echo through the celiac and gluten sensitive community, as his laboratory continues to test for fecal antibodies against gluten. By the mid 1990s, Dr. Marios Hadjivassiliou had pioneered many facets of gluten-induced neurological disease, raising the alarm that more than half of neurological disease of unknown origin is associated with gluten sensitivity. And in 1997, Dr. A. De Santis and associates showed smoking-gun evidence on SPECT scans, that removal of gluten from the diet of at least one schizophrenic returned the patient to normal blood distribution in the brain, and normal behaviour. From the 1980s and continuing into today, Dr. Rodney Ford, a long time advocate of the gluten free diet for many associated conditions, first conceptualized the notion that celiac disease may begin as a neurological condition and only a subset of those whose nerves are injured by gluten will go on to develop villous atrophy. Further to the work of Hadjivassilou, Fine, Paul, Kozlowska, and Dohan, he has gone on to work on teasing out information from his patients and their records to show the gluten free diet can provide substantial academic and social benefits to these children. In the 1990s Dr. Joseph Murray added some startling examples to the long list of anecdotal reports of anomalous, overweight celiac patients. Near the end of that decade Dr. William Dickey investigated this issue and found that while 22% of one group of celiac patients were underweight, 34% were overweight, and the remainder fell somewhere in the normal range. Thus, only a minority of Dr. Dickey’s patients fit the malnourished and wasting stereotype often associated with celiac disease. His data demonstrate that the possibility of celiac disease should not be dismissed on the basis of body mass index when working with normal, overweight, and obese patients. No discussion of heroes of the celiac community would be complete without further mention of Dr. Alessio Fasano and his work. As previously mentioned, he has contributed enormously to celiac awareness. However he and his lab associates also discovered and characterized zonulin, a major mediating factor of intestinal permeability. He is also involved in the subsequent development of Larazotide, a drug that permits celiac patients to consume gluten with little or no adverse effects. Celiac awareness is growing rapidly in the US and Canada. Celiac and gluten sensitive patients have great cause for optimism as these many paths of research continue to open up. However, much of that work is not yet complete. Two people I know well have recently been diagnosed with pernicious anemia, yet neither of the attending physicians has even suggested testing for celiac disease. However, the future is full of promise for our children and their children. Enormous strides are being made in building awareness (celiac disease is commonly in the media now) and more and more physicians and patients are increasingly aware of celiac disease and it is being diagnosed much more frequently with every passing year. That’s where we’ve been. But where are we going? Has awareness built to critical mass where it will be self sustaining? It is hard to say. But so many of those diagnosed with celiac disease believe, as I do, that we should have been diagnosed much earlier, if only the doctors had listened to what we were telling them. We are understandably anxious to see this trend of overlooking celiac disease come to an end. Each of us, in our own way, continues to push celiac awareness and as long as this is happening, I think we can assume that the trend toward increasing celiac awareness will be self sustaining, at least in the short term. It may also be fair to suggest that through increasing celiac awareness and the resulting reduction in delays to diagnosis, there will be fewer celiac-related cancers and autoimmune diseases arising out of untreated celiac disease. Increased awareness is also making more gluten-free foods more widely available. And economies of scale should eventually bring down the price of these food items. In all, earlier diagnosis should lead to increased life expectancies and improved quality of life for younger generations of celiac patients. But those gains are only the tip of the iceberg. Increased rates of diagnosis should lead to fewer children struggling in school, greater general nutritional awareness. Larazotide or its derivatives will keep us safe when dining in risky places. More than half of neurological diseases of unknown origin may become preventable and more treatable. Some mental illnesses may prove to be more treatable on a gluten free diet. The current status of celiac awareness and available therapies gives good cause for optimism. The future is looking better too. 2009 saw a multi-author publication identifying non-celiac immune reactions in schizophrenic patients. Two years earlier, we saw a report by Anderson et al. that indicated higher rates of cancer and death among those with non-celiac gluten sensitivity than among those with celiac disease. The tide is turning. Non-celiac gluten sensitivity is clearly beginning to get some attention as a serious condition in its own right. This augurs well for increasing awareness of gluten sensitivity. Since this group forms 10 to 12 percent of the general population, and if studies of this sort continue to be conducted, we may soon see exponential gains in gluten free options. Perhaps a cultural shift away from gluten grains is a possibility. Both groups that conducted these investigations may someday be recognized as heroes for their willingness to investigate these questions. We may soon see a day when gluten free wheat is used to make bread that is safe to eat for all of us. That research has been under way in Germany for quite some time. Similar efforts are under way in the US. The future may also see the development of digestive enzymes that, when taken with gluten, will break the bonds that bind the harmful peptides in gluten. All of the above are very worthy goals. But there is a vastly greater benefit that is currently growing in our midst. There is a sense of connection and belonging that each of us feels when we encounter another person who also avoids gluten to improve or preserve their health. We are forging an international fellowship that knows no racial, economic, or social barrier. Our common bond is our shared journey through a gluten-infested labyrinth that shapes our food supply. And we feel a sense of affinity which may be one of Humanity’s most important needs. This sense of kinship arises in the context of support groups, listservs, commercial enterprises that serve our needs and day-to-day encounters in our communities. We are a growing fellowship of gluten avoiders.

Celiac.com 08/05/2019 - The relationship between mental health, gluten sensitivity, and celiac disease has not been well researched. Some studies have shown that people with schizophrenia and bipolar disorder have elevated levels of antibodies to gliadin. A team of researchers recently set out to examine longitudinally the levels of antibody reactivity to gliadin in acute mania. The sample included 60 individuals assessed during a hospital stay for acute mania, 39 at a 6-month follow-up, and a sample of 143 non-psychiatric control subjects. The research team included Faith Dickerson, Cassie Stallings, Andrea Origoni, Crystal Vaughan, Sunil Khushalani, and Robert Yolken. They are variously affiliated with the Stanley Research Program at Sheppard Pratt, Baltimore, MD, USA, and the Stanley Neurovirology Laboratory, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA. The team used enzyme immunoassay to measure antibodies to gliadin. They used regression models to analyze the relationship between the antibodies and the clinical progress of patients with mania. Using multivariate analyses, the team found that patients with mania had significantly higher levels of IgG antibodies to gliadin at baseline, but not other markers of celiac disease, compared with control subjects. At the six month follow-up, however, these levels did not differ substantially from those of control subjects. In patients with mania, elevated levels after six months were strongly associated with re-hospitalization in the 6-month follow-up period. Based on these results, the team concludes that the monitoring and control of gluten sensitivity could be helpful in managing individuals hospitalized with acute mania. Stay tuned for more on this and related stories. Source: Psychiatry Research. Volume 196, Issue 1, 30 March 2012, Pages 68-71.

04/22/2019 - A gluten-free diet can improve symptoms of schizophrenia in certain patients, new research suggests. In the small pilot study, Deanna L. Kelly, PharmD, professor of psychiatry, University of Maryland School of Medicine, Baltimore, and colleagues studied the effects a gluten-free diet in schizophrenia, especially in patients with elevated gluten antibodies. Kelly and her team set out to determine whether a gluten-free diet would improve psychiatric symptoms in this subgroup of patients with elevated AGA IgG. They found that schizophrenia patients with elevated gluten antibodies, specifically, elevated antigliadin antibodies (AGA IgG), who followed a gluten-free-diet for 5 weeks saw a greater reduction in negative symptoms compared counterparts on a non-gluten-free diet. "With a gluten-free diet, we do have the potential to improve psychiatric symptoms, particularly negative symptoms, which is a symptom domain with a high unmet clinical need," said lead investigator Deanna L. Kelly, PharmD, professor of psychiatry, University of Maryland School of Medicine, Baltimore. Currently, there are no good treatment options for negative symptoms of schizophrenia, "so this could be a treatment for people if they have these antigliadin antibodies," Kelly said. Nearly One-third of Schizophrenia Patients Gluten Intolerant Elevated AGA IgG may be present in about 30% of all patients with schizophrenia. The antigliadin antibody is not related to the antibodies seen in celiac disease, which affects roughly 1% of the overall population. Schizophrenia patients with elevated AGA IgG show substantially lower positive schizophrenia symptoms than those who test negative no AGA IgG. They also have higher levels of kynurenine, a metabolite of the amino acid L-tryptophan. Kynurenine has been linked to schizophrenia pathology, and to other conditions, Kelly noted. The tryptophan kynurenine pathway also has important links to neurotherapy. Strategies for treatment of schizophrenia are still largely "one-size-fits-all." The team's study began largely after a single 2-week gluten-free trial in two people with elevated AGA IgG and schizophrenia showed "robust symptom improvements, particularly in the domain of negative symptoms," so we wanted to do a feasibility study and enroll more patients," Kelly told reporters. The team's findings were presented at the first annual Congress of the Schizophrenia International Research Society (SIRS) 2019. Read more at Medscape Medical News

Celiac.com 11/25/2017 - We have long known that gluten intolerance, both celiac disease and gluten sensitivity, are highly associated with neurological symptoms. Migraines, ataxia (unstable gait), seizures, schizophrenia – the list is long. But a recent research study just published last month sheds some new light on exactly what the mechanism may be. Understanding why these debilitating symptoms occur as a result of a gluten intolerance will, hopefully, go a long way toward increased awareness among the lay public and clinicians alike. It is certainly true that too many millions of Americans suffer the effects of a gluten intolerance unknowingly. They only know that they feel unhealthy but have no idea that gluten is the culprit. The digestive tract is sometimes called the second brain. Some say that is because it is second in importance to the brain. After all, if the food that is consumed doesn't turn into fuel that can effectively feed the 10 trillion cells in the body, those cells will be unable to perform their job and keep the body healthy. In fact, poor digestion is absolutely linked to poor health and increased onset of degenerative disease. This article in Current Pain and Headache Reports looks at another possibility for naming the digestive tract the second brain, and it simply stems from anatomy. The digestive tract actually has a ‘mind of its own'; more correctly, it has a nervous system of its own, called the enteric nervous system. ‘Enteric' simply means having to do with the intestine. This nervous system, according to research, is very similar to the brain housed in the head in that it is bathed in similar chemicals (called neurotransmitters – which, interestingly enough, are mostly produced in the gut!). It sends and receives impulses and records experiences and is influenced by emotions. Some proof of the latter: Have you ever been nervous and had diarrhea? This particular study stated that experiencing ‘adverse events' created a state of hypervigilance (a state of being overly responsive - not a good thing) in the nervous system which was associated with migraines and IBS. Such ‘hypervigilance' was previously only associated with the central nervous system – the one attached to the brain in the head. This group of researchers suggests that the initiation of hypervigilance may very likely lie in the enteric nervous system also. What this means is that if the small intestine is genetically sensitive to gluten and gluten is ingested, it could set off a nervous system response that could create disabling diseases, such as migraines and IBS, but likely others as well. The take-away message is that it is truly critical to diagnose gluten intolerance as soon as possible. Once that hurdle is surmounted it then needs to be followed with a program of nutrition, lifestyle and diet that will ensure healing of the small intestine and a ‘calming' of the hypervigilant nervous system. You may sometimes hear this referred to as healing a leaky gut. Here at HealthNOW we often see this clinically in patients who seem intolerant to many different foods and can't seem to enjoy stable improvement of their symptoms, even after they eliminate gluten from their diet. The reason for this insufficient improvement is that a comprehensive follow-up program is missing – a program that addresses what we call the Secondary Effects of Gluten. This entails evaluating for any other food sensitivities, cross reactive foods, a tendency towards autoimmune disease, the presence of any infectious organisms, healing the leaky gut, balancing the probiotic population, and more. While increasing awareness of the presence of gluten intolerance is absolutely critical, neglecting the secondary effects, as mentioned above, can result in long-term ill health that is truly preventable. Have you experienced such symptoms? Have you removed gluten but are only partially healthier? I'd love to hear from you. To your good health.