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    Gluten-Free Diet Likely Improves Neuropathic Pain in Patients with Gluten Neuropathy


    Jefferson Adams
    • A strict gluten-free diet might substantially reduce rates of peripheral neuropathic pain in patients with gluten neuropathy.

    Gluten-Free Diet Likely Improves Neuropathic Pain in Patients with Gluten Neuropathy
    Image Caption: Image: CC--Thanh Liêm

    Celiac.com 09/12/2018 - Many people with celiac disease develop peripheral neuropathy, also known as gluten neuropathy. A team of researchers recently set out to determine rates of neuropathic pain in patients with seemingly idiopathic peripheral neuropathy and gluten sensitivity, and to make note of any contributing factors. They included patients with positive antigliadin, endomysial, and/or transglutaminase antibodies, with or without enteropathy.

    The research team included P Zis, PG Sarrigiannis, DG Rao, and M Hadjivassiliou. They are affiliated with the Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Sheffield, South Yorkshire, UK.

    They invited all consecutive patients with gluten neuropathy attending a specialist gluten/neurology clinic to participate in the study. They used the DN4 questionnaire and the visual analog scale to assess pain levels. They used the Overall Neuropathy Limitations Scale to assess the severity of neuropathy, along with the Mental Health Index (MHI-5) to assess patients' general mental health status.

    A total of 33 out of 60 patients with gluten neuropathy showed neuropathic pain. The team found no significant differences between the painful, and the non-painful groups in terms of age, gender, neuropathy severity and neuropathy type. 

    Over half of patients with painless gluten neuropathy followed a strict gluten-free diet, compared with just 21.2% of those with painful neuropathy. Patients with painful gluten neuropathy also showed significantly worse MHI-5 scores. 

    After adjusting for age, gender and MHI-5 scores, multivariate analysis showed that, strict gluten-free diet lowered the odds of peripheral neuropathic pain by nearly 90%.

    Most patients with gluten neuropathy commonly have neuropathic pain, which is associated with poorer mental health status. 

    A strict gluten-free diet might substantially reduce rates of peripheral neuropathic pain in patients with gluten neuropathy.

    Read more at: J Neurol. 2018 Jul 21. doi: 10.1007/s00415-018-8978-5.PMID: 30032386

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    Agreed by my own personal experience.  It is one of many symptoms I am glad resolve with GFD, that can come back with if cc sneaks/slips in gluten-free diet.

    I have spent many hours and many sleepless nights due to gluten neuropathy as many other readers attest to as well.

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  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, and science. He previously served as Health News Examiner for Examiner.com, and provided 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 Dangerous Grains by James Braly, MD and Ron Hoggan, MA.

  • Related Articles

    Jefferson Adams
    Higher Rates of Peripheral Neuropathy in People with Celiac Disease and Inflammatory Bowel Disease
    Celiac.com 07/17/2012 - To follow up on reported associations between celiac disease and peripheral neuropathy, a research team recently conducted a study of peripheral neuropathic symptoms in celiac disease and inflammatory bowel disease.
    T.C. Shen, B. Lebwohl, H. Verma, N. Kumta, C. Tennyson, S. Lewis, E. Scherl, A. Swaminath, K.M. Capiak, D. DiGiacomo, B.P. Bosworth, T.H. Brannagan 3rd, and P.H. Green. They are affiliated with the Department of Medicine, Division of Digestive and Liver Diseases at Columbia University Medical Center in New York, NY.
    For their study, the team recruited patients celiac disease and/or inflammatory bowel disease from the gastroenterology clinics at a medical center and local support groups. The team recruited control subjects without celiac disease or inflammatory bowel disease from the staff of the medical center, and from relatives and attendees at support groups.
    Researchers had each participant complete a survey that used two validated peripheral neuropathy standards to define and characterize peripheral neuropathy.
    The team found that 38.9% of participants with celiac disease and 38.7% in the inflammatory bowel disease group (P = 0.97) met criteria for peripheral neuropathy compared with 20.5% in the control group (P < 0.001).
    Using multiple logistic regression, the researchers found that those with celiac disease had higher odds of peripheral neuropathy (odds ratio, 2.51; 95% confidence interval, 1.82-3.47), adjusted for age, gender, diabetes, vitamin B12 deficiency, and cancer history; as did those with inflammatory bowel disease (odds ratio, 2.78; 95% confidence interval, 1.85-4.18).
    The results showed that people with celiac disease and/or inflammatory bowel disease
    had higher rates of peripheral neuropathy than did the general population.
    Source:
    J Clin Neuromuscul Dis. 2012 Mar;13(3):137-45.

    Jefferson Adams
    Celiac.com 06/01/2015 - Earlier research on celiac disease and neuropathy has been hampered by the use of inpatient data, low study power, and lack of information on neuropathic characteristics.
    A team of researchers recently set out to accurately assess both relative and absolute risk of developing neuropathy in a nationwide population-based sample of patients with biopsy-verified celiac disease. The research team included Sujata P. Thawani, MD, MPH; Thomas H. Brannagan III, MD; Benjamin Lebwohl, MD, MS; Peter H. R. Green, MD; and Jonas F. Ludvigsson, MD, PhD.
    They are variously affiliated with the Peripheral Neuropathy Center at the Neurological Institute of Columbia University College of Physicians and Surgeons, the Celiac Disease Center in the Department of Medicine at Columbia University College of Physicians and Surgeons in New York, New York, with the Department of Medical Epidemiology and Biostatistics at the Karolinska Institutet in Stockholm, Sweden, and with the Department of Pediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden.
    For their study, the team collected data on small-intestinal biopsies conducted at Sweden’s 28 pathology departments from 1969 to 2008. They compared the risk of neuropathy in a total of 28 ,232 celiac disease patients, all with villous atrophy, Marsh 3, against results from 139, 473 age- and sex-matched non-celiac control subjects.
    They used Cox proportional hazards regression to estimate hazard ratios (HRs), and 95% confidence intervals (CIs), for neuropathy as defined by relevant International Classification of Diseases codes in the Swedish National Patient Register; including both inpatient and outpatient data.
    They found that patients with biopsy-verified celiac disease faced a 2.5 times higher risk of developing neuropathy (95% CI, 2.1-3.0; P < .001). Celiac patients also had an increased risk of developing chronic inflammatory demyelinating neuropathy (2.8; 1.6-5.1; P = .001), autonomic neuropathy (4.2; 1.4-12.3; P = .009), and mononeuritis multiplex (7.6; 1.8-32.4; P = .006).
    However, the team found no association between celiac disease and acute inflammatory demyelinating polyneuropathy (0.8; 0.3-2.1; P = .68).
    The team found a significantly increased risk of neuropathy in patients with celiac disease, and they are recommending that doctors screen patients with neuropathy for celiac disease.
    Source:
    JAMA Neurol. Published online May 11, 2015. doi:10.1001/jamaneurol.2015.0475

    Jefferson Adams
    Could a New Cannabis Patch Bring Relief from Celiac-Related Nerve Pain?
    Celiac.com 11/27/2017 - For centuries, physicians have used cannabis to treat numerous disorders. Modern research shows that various cannabis compounds can alleviate symptoms from numerous conditions, including neurological disorders, cancer, rheumatism, epilepsy, sexual disorders, pain, among others.
    Many people with celiac disease suffer from neuropathy, which causes nerve pain, among other symptoms. Neuropathy can be difficult to treat. Nerve pain is a debilitating symptom that can significantly impair a patient's quality of life. Could a new cannabis patch change that?
    Some researchers think so. One California-based company, Cannabis Science, is developing an innovative new medicinal patch specifically designed to treat nerve pain. In addition to celiac related neuropathy, the patch could be helpful in treating nerve pain from many illnesses including fibromyalgia, diabetes, and multiple sclerosis.
    The National Institute of Health estimates that over 5 million Americans suffer from fibromyalgia, which has no known cure, and is difficult to treat. With diabetes on the rise in the U.S., diabetic nerve pain is also on the rise.
    When placed on the patient's skin, the patch developed by Cannabis Science delivers a measured dose of high potency cannabidiol (CBD) extract. CBD is the second major cannabinoid in marijuana after THC, but CBD has no psychoactive effects, so it won't get people high.
    When the patch is applied, the CBD is first absorbed into the blood, then moves to the central nervous system, where it delivers pain relief.
    Numerous studies have documented CBD's “anti-inflammatory and pain-relieving properties. More recent studies have shown that CBD provides relief from many kinds of pain.
    In addition to nerve pain, CBD has been shown to relieve inflammatory pain. Some studies have shown CBD to be more effective than current medication in treating inflammatory pain, such as pain from arthritis.
    As researchers home in on the pain-relieving properties of cannabis, look for more treatments to be developed, including treatments that may helpful for peopl with celiac disease.
    Read more: cannatech.news

    Jefferson Adams
    Can A Gluten-Free Diet Help You Battle Nerve Pain?
    Celiac.com 03/12/2018 - People with celiac disease often experience nerve pain, with can lead to actual nerve damage. Sometimes, neuropathy can be one of the few physical symptoms of celiac disease. Previous studies have linked gluten sensitivity with nerve damage in the hands and feet, which can cause weakness, numbness and pain; a condition called gluten neuropathy.
    For some time, doctors have suspected that gluten may play a role in triggering neuropathy in celiac patients, and that a gluten-free diet may help to alleviate the problem.
    The study by Dr. Zis and his team included 60 people, averaging 70 years of age, who had been diagnosed with gluten neuropathy. More than half of these patients also reported neuropathy-related pain. The data showed that diet was definitely a factor in the presence and severity of neuropathy. Nearly sixty percent of the patients without pain were following a gluten-free diet, but just 21 percent of patients with pain were avoiding gluten. After adjusting for factors including age, sex and mental health, the team concluded that neuropathy patients who followed a gluten-free diet experienced 89 percent lower risk of pain.
    The team’s research supports the idea that gluten-free diet may help reduce nerve pain in some people with gluten sensitivity. The findings are important, says lead author Dr. Panagiotis Zis, of the University of Sheffield in the United Kingdom, because they indicate that “a relatively simple change in diet could help alleviate painful symptoms tied to gluten neuropathy.” 
    Dr. Zis and his colleagues plan to present their findings at the annual meeting of the American Academy of Neurology (AAN), this April in Los Angeles. 
    As research into gluten intolerance has progressed, more and more researchers have come to regard it as “a spectrum of disease as opposed to one easily defined disease," said neurologist Sami Saba, who was not involved in the new study. While just 1 percent of Americans have celiac disease, many more could conceivably have gluten sensitivity, which is “marked by immune-system antibodies to gluten in blood tests, or symptoms of gluten sensitivity even in the absence of antibodies,” Saba said.
    Dr. Zis emphasizes that the study showed a connection, but did not prove causation. It did not prove that gluten causes neuropathy in these patients. Further study is needed to confirm the team’s results, and to determine for certain that the pain relief they saw in patients was the result of a gluten-free diet.
    In the meantime, doctors should consider a gluten-free diet in patients with neuropathy, as it may help to alleviate their symptoms, and carries minimal risk.
    Source:
    usnews.com

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    • Maureen and Cyclinglady, Of the foods you listed. . .. I would focus on the Chocolate. Chocolate has Tyramine in it and it could/can cause rashes that  might be confused for DH. Sometimes Tyramine get's confused for/in high sulfite foods as triggers. Here is a great overview article on this topic. http://www.chicagotribune.com/lifestyles/health/sc-red-wine-headache-health-0608-20160525-story.html you might also have trouble with headaches if it tyramine is causing you your trouble. People who have trouble Tyramine might also have trouble with consuming cheeses. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738414/ As for the Milk causing/triggering your DH don't rule Adult onset dairy allergy. While rare it does occur in the literature/research when you search it out. I am including the research here in the hopes it might help you or someone else entitled "Adult onset of cow's milk protein allergy with small‐intestinal mucosal IgE mast cells" https://onlinelibrary.wiley.com/doi/10.1111/j.1398-9995.1996.tb04640.x It is generally thought most of grow out of a Milk Allergy at approx. 3 years old. But for some lucky one (I guess) we never do apparently.  (I speak for my friend on this board JMG).  He found out he was having trouble with dairy as an adult better never realized until about 6 months ago. With delayed onset allergies it is often hard to tell if it (allergen) is effecting us because we might not associate it with our dairy consumption because it might happen a day or two latter. See this WHFoods article about food allergens/sensitivies.  It is very long/exhaustive but it is very helpful if you have time to study it in more detail. http://www.whfoods.com/genpage.php?pfriendly=1&tname=faq&dbid=30 I will quote some key points for your information. Symptoms of Food Allergies "The most common symptoms for food allergies include vomiting, diarrhea, blood in stools, eczema, hives, skin rashes, wheezing and a runny nose. Symptoms can vary depending upon a number of variables including age, the type of allergen (antigen), and the amount of food consumed. It may be difficult to associate the symptoms of an allergic reaction to a particular food because the response time can be highly variable. For example, an allergic response to eating fish will usually occur within minutes after consumption in the form of a rash, hives or asthma or a combination of these symptoms. However, the symptoms of an allergic reaction to cow's milk may be delayed for 24 to 48 hours after consuming the milk; these symptoms may also be low-grade and last for several days. If this does not make diagnosis difficult enough, reactions to foods made from cow's milk may also vary depending on how it was produced and the portion of the milk to which you are allergic. Delayed allergic reactions to foods are difficult to identify without eliminating the food from your diet for at least several weeks and slowly reintroducing it while taking note of any physical, emotional or mental changes as it is being reintroduced." Here is their information on Tyramine's. Tyramine "Reactions to tyramine (an amino acid-like molecule) or phenylalanine (another amino acid-like molecule) can result from eating the following foods: Fermented cheeses Fermented Sausage Chocolate Sour Cream Red wine Avocado Beer Raspberries Yeast Picked Herring Symptoms of tyramine intolerance can include urticaria (hives), angioedema (localized swelling due to fluid retention), migraines, wheezing, and even asthma. In fact, some researchers suggest that as many as 20 percent of migraines are caused by food intolerance or allergy, and tyramine intolerance is one of the most common of these toxic food responses." Here is an old thread on tyramine and especially how it can trigger headaches. https://www.celiac.com/forums/topic/95457-headache-culprit-is-tyramine/ I would also suggest your research a low histamine food diet.  Rashes/hives etc. can be triggered my disregulaton of histamine in the body. The other thing in chocolate that might be causing your problems is Sulfites. Here is a website dedicated to a Sulftie allergy. http://www.allergy-details.com/sulfites/foods-contain-sulfites/ Chocolate bars are on their list of sulfite contaning foods but probably most noted in dried fruits and red wine. Knitty Kitty on this board knows alot about a sulfite allergy. I want to go back to the possible dairy allergy for a second as a possible trigger. . .because it has been established as connected to DH . . .it is just not well known. Here is current research (as I said earlier) most dairy allergies are studied in children but it does occur in approx. 10 pct of the GP unless your of Asian descent where it is much more common. https://www.ncbi.nlm.nih.gov/pubmed/29555204 quoting the new research from this year on children. "When CMP (Cow's Milk Protein) was re-introduced, anti-tTG increased, and returned to normal after the CMP was withdrawn again." and if adults can also (though rarely) it seem develop "Adult onset of cow's milk protein allergy with small‐intestinal mucosal IgE mast cells" (see research linked above) as the research shows  you should at least trial removing dairy from your diet if you haven't already and see if your DH doesn't come back when you re-introduce it. It just takes 15 or 20 years for medical doctor' to incorporate new research/thinking into clinical practice.  And note the research on this happening in adults is 20+ years old and as far I know doctor's . . . are not aware of this.  I know I wasn't until recently and I research things alot of to help myself and my friends. But I know you can't do what you don't know about.  So this is why I am trying to share what I learned so that other might be helped and this research might not  lay hidden another 20 years before doctor's and their Celiac/DH patients become aware of it. And if it helps you come back on the board and let us know so it can help others too! If it helps you it will/can help someone else! if they know it helped you then they will/can have hope it might help them too and why I share and research these things for others'. . . who don't know or don't have time to research this for themselves. I hope this is helpful but it is not medical advice. Good luck on your continued journey. I know this is a lot of information to digest at one time but I hope at least some of if it helpful and you at least have a better idea of what in your chocolate could be causing your DH (idiopathic) as the doctor's say (of an unknown cause mild) DH symptom's. Or at least it is not commonly known yet that Milk can also cause trigger (DH) in children and adults who have a Milk allergy undiagnosed. . .because we don't don't typically think  or associate it with adults like maybe we should if we are not of Asian descent. Maureen if this doesn't help you you might want to start a thread in the DH section of the forum. As always  2 Timothy 2: 7   “Consider what I say; and the Lord give thee understanding in all things” this included. Posterboy by the grace of God,
    • I hooe you can get some answers with your new GI doc.
    • Many of us deal with doctor issues and diagnosis, you got a really bad draw indeed. Most doctors dismiss Celiac as their is no money in the cure for them IE a gluten free diet and not medications.

      Keep up updated on your new doctor and testing, good to see you finally found one that listens and can help, I got through on doc #5 I think it was.
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