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  • Jefferson Adams
    Jefferson Adams

    Can a Gluten-Free Diet Help People with Bipolar Disorder?

    Reviewed and edited by a celiac disease expert.

    There’s growing evidence that autoimmune disorders and bipolar disorder are closely connected.

    Can a Gluten-Free Diet Help People with Bipolar Disorder? - Image: CC BY-SA 2.0-- Christiaan Tonnis
    Caption: Image: CC BY-SA 2.0-- Christiaan Tonnis

    Celiac.com 08/14/2019 - One question we get often is whether a gluten-free diet can help treat bipolar disorder. There’s growing evidence that autoimmune disorders and bipolar disorder are closely connected. 

    It's also true that celiac disease and bipolar disorder are linked. People with celiac disease are many times more likely to have bipolar disorder than those without celiac.



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    About 1% of the population has celiac disease. However, nearly 4.3% of celiacs are diagnosed with bipolar disorder, compared a 0.4% bipolar rate for the non-celiac control group.

    Having a mood disorder can have a major negative impact on quality of life in people with celiac disease. One study suggests that the negative impact on quality of life in people with celiac disease and bipolar disorder is second only to that of people with bipolar and MS.

    While there's been some study connecting gluten sensitivity and acute mania, there really hasn't been much research on a gluten-free diet for people with bipolar disorder. That means much of the information is anecdotal, and needs to be taken with a grain of salt.

    The topic thread on the Celiac.com forum contains robust commentary on the gluten-free diet and bipolar disorder.

    In his blog, Getting Older With Bipolar, George Hofmann shares his own experiences on being bipolar with celiac disease, and the benefits of a gluten-free diet.

    On going gluten-free, Hofmann says "I had gut problems for decades.  I thought it was normal to feel like crap after I ate.  Then I was diagnosed with celiac disease and my life completely changed. Please understand, though, that my bipolar disorder is still medically treated as it was before I knew I had celiac disease.  Removing gluten from my diet has not led to the removal of my psych meds...My bipolar disorder is not cured.  I just feel a lot better."

    Celiac disease increases immune activation, which many researchers think is an important factor in the onset of bipolar disorder.

    Many researchers suggest celiac disease screening for people with bipolar disorder who show some key symptoms or have a family history of celiac disease. Many of those same researchers suggest screening people with celiac disease for a mood disorders.

    To close, the current answer to the question whether a gluten-free diet can help treat bipolar disorder would be that there's a good amount of anecdotal evidence that a gluten-free diet can help to improve the general well-being of people with bipolar and other mood disorders.

    However, there's not much in the way of actual science to support those claims. Still, for people with bipolar disorder, there's likely not much of a downside to following a gluten-free diet, as long make sure you get adequate nutrition and fiber. As always, check with your doctor before adopting any treatment or change that may have an influence on your condition of symptoms. Also, consider getting tested for celiac disease.

    Read more at NIH


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    Huh, interesting. I recently started having stomach issues, about over a month. It's really been on/off for a little but I didn't think anything of it until it lasted a month straight. My doctor suspects that I have celiac disease. I'm trying an elimination process and so far it's been helping then she recommended eating gluten for a few weeks and doing test to confirm, but anywho. I'm bipolar so it's interesting to know that there's a common link between the two. It gives me hope that this is what I have, because I'd rather know than... not know I guess? Either way at least it'll help manage my bipolar a little as well.

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    Brittany, I too was like you. I got an endoscopy and colonoscopy done after two months of experiencing severe symptoms turns out I have celiac and Crohn’s. It’s been hard mentally dealing with bipolar disorder and two autoimmune diseases but makes me feel better there’s a reason for all of the pain! I would definitely recommend getting checked for celiac and even a gluten allergy. Even if it’s negative you should consider changing your diet, it may help!

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    I wonder how many people with gluten sensitivity also have MTHFR SNPs and problems with their methylation cycle?  Bipolar disorder is strongly linked to problems with methylation and the production of neurotransmitters.  Getting rid of folic acid consumption might be a great first step for those struggling with bipolar disorder.

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  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.


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  • Related Articles

    Jefferson Adams
    Celiac.com 01/09/2012 - Women with celiac disease face a higher risk for depression than the general population, even once they have adopted a gluten-free diet, according to U.S. researchers.
    A team of researchers recently used a Web-mediated survey to assess a range of physical, behavioral and emotional experiences in 177 U.S. adult women, who reported a physician-provided diagnosis of celiac disease.
    The team was led by Josh Smyth, professor of biobehavioral health and medicine at Pennsylvania State University, and included members from  Syracuse University and Drexel University.
    The survey gathered information about how closely people follow a gluten-free diet and assessed various symptoms of celiac disease from physical symptoms to the respondents' experience and management of stressful situations, along with charting symptoms of clinical depression and frequency of thoughts and behaviors associated with eating and body image.
    Perhaps unsurprisingly, many women with celiac disease suffer from disordered eating, given that the management of celiac disease requires careful attention to diet and food, Smyth said.
    "What we don't know is what leads to what and under what circumstances," Smyth said. "It's likely that the disease, stress, weight, shape and eating issues, and depression are interconnected."
    The findings are forthcoming in the journal of Chronic Illness.
    Source:
    http://www.upi.com/Health_News/2011/12/28/Celiac-ups-depression-risk-for-women/UPI-75401325131984/#ixzz1iQynze9k.


    Jefferson Adams
    Celiac.com 05/29/2014 - Many people with celiac disease report symptoms of depression, which usually subside upon treatment with a gluten-free diet. But a new study out of Australia suggests that gluten can cause depression in people with non-celiac gluten-sensitivity.
    Current evidence shows that many patients with self-reported non-celiac gluten sensitivity (NCGS) continue to have gastrointestinal symptoms on a gluten-free diet, but say that avoiding gluten makes them feel ‘better'. So, why do people with non-celiac gluten sensitivity seem to feel better on a gluten-free diet, even if they still have gastrointestinal symptoms? A team of researchers wanted to know if this might be due to gluten’s effects on the mental state of those with NCGS, and not necessarily because of gastrointestinal symptoms.
    The research team included S. L. Peters, J. R. Biesiekierski, G. W. Yelland, J. G. Muir, and P. R. Gibson. They are affiliated with the Department of Gastroenterology, Central Clinical School of Monash University at The Alfred Hospital in Melbourne, the Department of Gastroenterology at the Eastern Health Clinical School of Monash University in Box Hill, and the School of Health Sciences at RMIT University in Bundoora, Victoria, Australia.
    For their double-blind cross-over study, they looked at 17 women and five men, aged 24–62 years. All participants suffered from irritable bowel syndrome, but not from celiac disease, and their symptoms were controlled on a gluten-free diet. The team gave the participants one of three random dietary challenges over 3 days, followed by a minimum 3-day washout before moving to the next diet. All participants got all three diets over the course of the study.
    For each phase, the team supplemented the challenge gluten-free food with gluten, (16 g/day), whey (16 g/day) or nothing at all (placebo). The team assessed mental state as determined by the Spielberger State Trait Personality Inventory (STPI), cortisol secretion and gastrointestinal symptoms.
    They found that gluten ingestion was associated with higher overall STPI state depression scores compared to placebo [M = 2.03, 95% CI (0.55–3.51), P = 0.010], but not whey [M = 1.48, 95% CI (−0.14 to 3.10), P = 0.07]. They found no differences for other STPI state indices or for any STPI trait measures, and they saw no difference in cortisol secretion between challenges. Gastrointestinal symptoms were similar for each dietary challenge.
    Short-term exposure to gluten specifically induced current feelings of depression with no effect on other indices or on emotional disposition. Moreover, the team saw no gluten-specific trigger of gastrointestinal symptoms. Such findings might explain why patients with non-coeliac gluten sensitivity feel better on a gluten-free diet despite the continuation of gastrointestinal symptoms.
    Source:
    Aliment Pharmacol Ther. 2014;39(10):1104-1112.


    Jefferson Adams
    Celiac.com 06/23/2016 - Digestive Disease Week 2016 took place in San Diego from May 21-24. Among the presentations given was one that stood out for its obvious health impacts. That presentation was given by Jonathan Cordova, DO, pediatric gastroenterologist at the University of Chicago Medical Center. His presentation tied celiac disease to major depressive disorder in adolescents, and stated that most adolescents with celiac disease have symptoms consistent with the disorder.
    Dr. Cordova said that "...interim analysis does suggest that a majority of adolescents living with celiac disease may have symptoms consistent with major depressive disorder," and that the depression has a negative impact on their quality of life, "but does not appear to be associated with their celiac disease state." That is, the depression does not seem to be impacted by how well their celiac disease is doing. Healthy gut and gluten-free diet, or unhealthy gut, with symptoms, it doesn't seem to matter. The depression levels seem about the same whatever the case.
    A number of recent studies indicate that depression and anxiety are the main reasons people with celiac disease report decreased quality of life, Dr. Cordova and his colleagues wrote. But, most of these studies were done on adults, almost none used adolescents, and adolescents may be more susceptible to depression.
    The research team was able to connect celiac disease with mental health disorders in adolescents by administering questionnaires to adolescents and their parents. Average age of adolescents was 14.6 years at the time of survey and 11.2 years at the time of diagnosis.
    The researchers found no correlation between celiac disease and depression, anxiety, ADHD, age at survey, quality of life, age at diagnosis or length of time on a gluten free diet. However, the majority of adolescents and parental reports screened positive for major depressive disorder.
    Interestingly, a parent's perception of the state of their child's celiac disease impacted their perception of depression in their child.
    Dr. Cordova says that "the data suggests that early screening for depression in any adolescent with celiac disease is crucial to help optimize behavioral health,"
    Dr. Cordova's team plans to follow these patients into young adulthood, and aims to re-screen them again in 5 years.
    Reference: 
    Cordova J, et al. Abstract #844. Presented at: Digestive Disease Week; May 21-24, 2016; San Diego


    Jefferson Adams
    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.


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