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    Nerve Disease and Celiac Disease


    Scott Adams

    Nerve Disease and Celiac Disease


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    Celiac.com 02/08/1996 - The article was based on a study published in the same weeks Lancet which was conducted by Dr. Marios Hadjivassiliou and colleagues at the Royal Hallamshire Hospital in Sheffield, England. Dr. Hadjivassiliou tested patients with various undiagnosed neurological symptoms and found that 57% of them tested positive to gluten sensitivity. Specifically, they tested positive for gliadin antibodies, which means they have gluten sensitivity and not necessarily celiac disease. Sixteen percent of the patients were found to have full blown celiac disease, which is far higher than the estimated .004% level found in the normal population. Five percent of the patients with previously diagnosed neurological disorders such as Parkinsons disease were found to have the gliadin antibodies present compared to 12% of a healthy control group.

    According Dr. Hadjivassilious theory, many neurological ailments could be caused when the anti-gliadin antibodies mistakenly attack neural tissue and destroy it. The fact that some celiac patients with neural damage never fully heal helps to support Dr. Hadjivassilious theory, because neural tissue repairs itself very slowly, if at all. Further, Dr. Hadjivassiliou states in the article that celiac disease seems to be much more common than was previously thought (1 in 250 people). When one includes the people who test positive for the gliadin antibody (this means they have gluten-sensitivity and are not necessarily celiacs), the amount could be much higher than 1 in 250. Based on his study, Dr. Hadjivassiliou recommends that patients who exhibit any type of neural disorders be tested for gluten sensitivity and celiac disease.

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  • About Me

    In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease. In 1998 I founded The Gluten-Free Mall, Your Special Diet Superstore!, and I am the co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

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  • Related Articles

    Jefferson Adams
    Celiac.com 10/28/2010 - A team of researchers recently found that gluten sensitivity can play a role in triggering a certain type of neurologic dysfunction, called sensory ganglionopathy, and that the condition may respond to a strict gluten-free diet.
    The team conducted a retrospective observational case study on 409 patients with different types of peripheral neuropathies, including seventeen patients with sensory ganglionopathy and gluten sensitivity.
    The research team was made up of M. Hadjivassiliou, MD, D.G. Rao, MD, S.B. Wharton, PhD, D.S. Sanders, MD, R.A. Grünewald, DPhil, and A.G.B. Davies-Jones, MD. They are affiliated variously with the Departments of Neurology, Neurophysiology, Neuropathology, and Gastroenterology at Royal Hallamshire Hospital in Sheffield, UK.
    Neurological issues are common in people with celiac disease and gluten-sensitivity. On eof the most common neurological issues in these people is called peripheral neuropathy. The most common type of neuropathy seen in people with gluten sensitivity is sensorimotor axonal.
    The team reviewed data on 409 patients with different types of peripheral neuropathies. All of these patients had been followed for a number of years in dedicated gluten sensitivity/neurology and neuropathy clinics.
    Fifty-three of these patients (13%) showed clinical and neurophysiologic evidence of sensory ganglionopathy. Seventeen of these fifty-three patients (32%) showed positive blood screens for gluten sensitivity.
    The median age of those with gluten sensitivity was 67 years, with symptom onset starting at 58 years on average.
    Seven of those with positive blood screen evidence gluten sensitivity showed enteropathy upon biopsy. Fifteen patients went on a gluten-free diet, resulting in stabilization of the neuropathy in eleven of the fifteen.
    The remaining four patients did not follow the gluten-free diet and their conditions worsened, as did the two patients who declined dietary treatment. Autopsy tissue from three patients showed inflammation in the dorsal root ganglia with degeneration of the posterior columns of the spinal cord.
    These results led the team to conclude that sensory ganglionopathy can result from gluten sensitivity and may respond positively to a strict gluten-free diet.
    Source:

    Neurology 2010;75:1003–1008

    Jefferson Adams
    Celiac.com 09/29/2014 - Can a gluten-free diet lead to dramatic improvement of Parkinsonian symptoms in patients with celiac disease?
    In the January issue of the the Journal of Neurology, researchers Vincenzo Di Lazzaro, Fioravante Capone, Giovanni Cammarota, Daniela Di Giuda, and Federico Ranieri report on the case of a man who saw a dramatic improvement of Parkinsonian symptoms after gluten-free diet.
    The researchers are affiliated with the Department of Neurosciences at the Institute of Neurology, Campus Bio-Medico University in Rome, Italy.
    This case is interesting because it supports a growing body of research that indicates that, in some cases, gluten toxicity might adversely impact the nervous system, producing symptoms identical to classical Parkinson’s disease.
    The man in question was a 75-year-old Parkinson’s disease patient with silent celiac disease saw major improvements in his symptoms after a 3-month long gluten-free diet.
    Noting the positive results in this patient, and the fact that celiac disease often manifests with only neurological symptoms, even in older patients, the researchers are calling for a deeper exploration to determine if there are higher rates of celiac disease in people afflicted with Parkinson’s disease, or the related multi-factorial neurodegenerative condition known as Parkinsonism.
    Source:
     J Neurol. 2014 Feb;261(2):443-5. doi: 10.1007/s00415-014-7245-7. Epub 2014 Jan 25.

    Jefferson Adams
    Celiac.com 04/23/2015 - It's well-known that many people with celiac disease experience neuropathy and other nerve disorders. Now, a team of Israeli researchers are cautiously proposing a link between gluten reactions and ALS.
    The research team, from the Tel Aviv Medical Center, believes that the gluten sensitivity seen in people with celiac disease might have a connection with ALS, or amyotrophic lateral sclerosis. Their study linking tissue transglutaminase 6 antibodies to ALS is the first study to document a connection between ALS and antibodies to a particular enzyme. Also known as Lou Gehrig's disease, ALS is a progressive disease that attacks nerve cells and pathways in the brain and spinal cord, eventually causing paralysis.
    In the study, researcher Vivian Drory and her team found antibodies to an enzyme produced in the brain, called tissue transglutaminase 6 (TG6), in 23 out of 150 patients with ALS, but in only five of 115 healthy volunteer subjects. Furthermore, ALS patients showed higher concentrations of those antibodies.
    It's well documented that people with celiac disease produce antibodies to another transglutaminase, TG2, when they eat gluten, a protein in wheat, barley and rye. Interestingly, nearly half (45%) of patients with celiac disease also produce antibodies to TG6, even when they have no neurological symptoms.
    Droury's team set out to evaluate the prevalence of celiac disease-related antibodies and HLA antigen alleles, as well as TG6 antibodies, in patients with ALS and healthy individuals serving as controls to determine whether a neurologic presentation of a gluten-related disorder mimicking ALS might occur in some patients.
    They conducted a case-control study in an ALS tertiary center, where they measured serum levels of total IgA antibodies, IgA antibodies to transglutaminase 2 (TG2) and endomysium, along with IgA and IgG antibodies to deamidated gliadine peptide and TG6 and performed HLA antigen genotyping in 150 consecutive patients with ALS and 115 healthy volunteers of similar age and sex.
    Study subjects did not have any known autoimmune or gastroenterologic disorder, and none was receiving any immunomodulatory medications.
    The team found that ALS patients with antibodies to TG6 showed the classic picture of ALS and the typical rate of disease progression. The volunteers with antibodies to TG6 showed no signs of any disease.
    All patients and control group participants were seronegative to IgA antibodies to TG2, endomysium, and deamidated gliadine peptide. Twenty-three patients (15.3%) were seropositive to TG6 IgA antibodies as opposed to only 5 controls (4.3%) (P = .004). The patients seropositive for TG6 showed a classic picture of ALS, similar to that of seronegative patients.
    The team tested fifty patients and 20 controls for celiac disease-specific HLA antigen alleles; 13 of 22 TG6 IgA seropositive individuals (59.1%) tested seropositive for celiac disease-related alleles compared with 8 (28.6%) of the 28 seronegative individuals (P = .04).
    Average levels of IgA antibodies to TG6 were 29.3 (30.1) in patients and 21.0 (27.4) in controls (P = .02; normal, <26). Average levels of IgA antibodies to TG2 were 1.78 (0.73) in patients and 1.58 (0.68) in controls (normal, <10). In a subset of study participants, mean levels of deamidated gliadin peptide autoantibodies were 7.46 (6.92) in patients and 6.08 (3.90) in controls (normal, <16).
    None of the ALS patients or volunteers had the antibodies to TG2 that are commonly associated with celiac disease, but the ALS patients were more likely to show the genetic mutations that put them at risk for celiac disease.
    Drory said her team has begun to study TG6 antibody levels in patients newly diagnosed with ALS, and they will be testing the effects of a gluten-free diet in some of those that test positive. However, theirs is just one report, and Drory expects it will be at least a couple of years before the team has any solid results. Her team is also inviting further input from other centers, and study of their data.
    In the meantime, she warns ALS patients against adopting a gluten-free diet without "clear evidence of antibodies," because any imbalance of diet might prove harmful. It's also worth remembering that an association is not the same as a cause. At least one earlier study concluded that there was no association between TG6 antibodies and either neurological disease or gluten itself.
    The possibility of a link between celiac disease and a degenerative nerve disease like ALS is interesting, to say the least. The findings of this team will likely invite more examination of any connection between gluten reactions and nerve disorders, so stay tuned for any follow-up news.
    Source:
    JAMA Neurol. 2015 Apr 13. doi: 10.1001/jamaneurol.2015.48.

    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

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    Bakery On Main started in the small bakery of a natural foods market on Main Street in Glastonbury, Connecticut. Founder Michael Smulders listened when his customers with Celiac Disease would mention the lack of good tasting, gluten-free options available to them. Upon learning this, he believed that nobody should have to suffer due to any kind of food allergy or dietary need. From then on, his mission became creating delicious and fearlessly unique gluten-free products that were clean and great tasting, while still being safe for his Celiac customers!
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    Celiac.com 06/19/2018 - Could baking soda help reduce the inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease? Scientists at the Medical College of Georgia at Augusta University say that a daily dose of baking soda may in fact help reduce inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease.
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    Jefferson Adams
    Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown.  To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. 
    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
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    Overall global prevalence of celiac disease was 1.4% in 275,818 individuals, based on positive blood tests for anti-tissue transglutaminase and/or anti-endomysial antibodies. The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% in 138,792 individuals. That means that numerous people with celiac disease potentially remain undiagnosed.
    Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults.
    This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. 
    This review demonstrates a need for more comprehensive population-based studies of celiac disease in numerous countries.  The 1.4% rate indicates that there are 91.2 million people worldwide with celiac disease, and 3.9 million are in the U.S.A.
    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.