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      Frequently Asked Questions About Celiac Disease   09/30/2015

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Strokes And Tia's (Transient Ischemic Attacks)
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New research suggests a link between celiac disease and strokes and TIA's (transient ischemic attacks).

El Moutawakil B; Chourkani N; Sibai M; Moutaouakil F; Rafai M; Bourezgui M; Slassi I

Celiac disease and ischemic stroke, Revue Neurologique [Paris] 2009 Nov; Vol. 165 (11), pp. 962-6.

Neurological manifestations of celiac disease are various. An association with ischemic stroke is not common and has not been well documented. We report two cases. OBSERVATIONS: The first patient had experienced several transient ischemic strokes in the past 2 years and then had an acute ischemic stroke involving the territory of the right posterior cerebral artery. Investigations revealed celiac disease with no other recognizable etiology. The clinical course was marked by persistent visual aftereffects, but no new vascular event. The second patient had been followed since 1998 for celiac disease confirmed by pathology and serology tests. She was on a gluten-free diet. The patient had an ischemic stroke involving the territory of the left middle cerebral artery. Apart from a positive serology for celiac disease and iron deficiency anemia, the etiological work-up was negative. DISCUSSION: The mechanisms of vascular involvement in celiac disease are controversial. The most widely incriminated factor is autoimmune central nervous system vasculitis, in which tissue transglutaminase, the main auto-antigen contributing to maintaining the integrity of endothelium tissue, plays a major role. Other mechanisms are still debated, mainly vitamin deficiency. CONCLUSION: Being a potentially treatable cause of ischemic stroke, celiac disease must be considered as a potential etiology of stroke of unknown cause, particularly in young patients, and even without gastrointestinal manifestations.

Lohi S, Maki M, Rissanen H, Knekt P, Reunanen A, Kaukinen K.

Prognosis of unrecognized coeliac disease as regards mortality: A population-based cohort study.

Ann Med. 2009 Jun 23:1-8.

Background and aim. Clinically diagnosed coeliac disease patients carry an increased risk of mortality. As coeliac disease is markedly underdiagnosed, we aimed to quantify the risk of mortality in subjects with unrecognized and thus untreated coeliac disease. Method. Blood samples from 6,987 Finnish adults were drawn in 1978-80, and sera were tested for immunoglobulin A (IgA)-class tissue transglutaminase antibodies (Eu-tTG) in 2001. Positive sera were further analysed for endomysial (EMA) and tissue transglutaminase antibodies by another test (Celikey tTG). EMA- and Celikey tTG-positive cases were compared to negatives as regards mortality in up to 28 years of surveillance, yielding a total follow-up of 147,646 person years. Dates and causes of death were extracted from the nation-wide database. Results. Altogether 74 (1.1%) of the participants were EMA- and 204 (2.9%) Celikey tTG-positive. The age- and sex-adjusted relative risk of overall mortality was not increased in either EMA (0.78, 95% CI 0.52-1.18) or Celikey tTG (1.19, 95% CI 0.99-1.42) -positive subjects. However, antibody-positive cases evinced a tendency to die from lymphoma, stroke, and diseases of the respiratory system. Conclusions. The prognosis of unrecognized coeliac disease was good as regards overall mortality, which does not support screening of asymptomatic coeliac disease cases.

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Why do I keep seeing celiac as being the possible causitive origin of so many present day maladies? Just thinking out loud here....

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When I had a TIA last fall I wanted to know if it was related to my newly diagnosed gluten intolerance. I found these articles and ran them by my GP, neurologist, and gastroenterologist (a celiac disease specialist). Each of them took the information seriously. Of course, this hardly proves gluten intolerance was the cause of my TIA. But given the utter lack of any other possibilities, I now have a powerful incentive to remain gluten-free

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So the second person was gluten free and still had the stroke??

I had a stroke in Nov. at 25 years old, had a WHOLE work up done. Nothing was found, but I pushed for Celiac testing and found that I most likely do indeed have Celiac and for sure a gluten intolerance. I also was found to have the gene linked with neurological side effects. My neurologist thinks it was most likely the cause of my stroke.

Just made me nervous that the second person was off gluten, guess that just proves how careful you need to be in avoiding gluten.

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I would wonder if perhaps the celaic is a secondary immunilogical problem and that the primary problem is the root of both the stroke & the celiacs in that second person.

My daughter had a stroke at birth. We are still searching for answers.

:(

Just made me nervous that the second person was off gluten, guess that just proves how careful you need to be in avoiding gluten.

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Why do I keep seeing celiac as being the possible causitive origin of so many present day maladies? Just thinking out loud here....

Most likely because untreated Celiac Disease produces extreme inflammation all over the body. Inflammation is responsible for the initiation of many disease processes.

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I had an unexplained mini stroke too a few years ago, although I am sure it was caused by taking max dose of Advil for 6 days in a row from very painful neck-back.It turns out Advil thickens the blood and so strongly, that it negates even strong blood thinners. As I researched, I found one more possible link -migraines. On the other hand people with migraines are more likely to take many painkillers.

Maybe gluten added to the mix?

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OMG???

 

I had TWO TIAs!!!! Nov 2004 and Jan 2005 however it was following a DVT and they found I had a PFO (small hole in my heart) and THAT was deemed the cause and I had the hole closed.

 

This is all starting to be too much to take in...and all blamed on bad eating habits and even when I was eating better it was just deemed I must be lying since I was still over weight. I am so over being brushed off by medical professionals because of my weight I once saw a pulmonologists for shortness of breathe and he said "I knew your problem as soon as I saw your chart said you weighed 350lbs" I said well doctor I once weighed over 500lbs and never had this problem, so now what??? Grrrrrrrrrrrrrrrrrr.

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Wow, Ive been reading through the forums for info and stumbled upon this. When I began to have celiac symptoms, I had the weirdest black out in the middle of the night along with passing out, anxiety and other odd symptoms- went the ER and  blood work indicated a clot. Since that particular time, I could no longer consume gluten, it was like a switch had turned on and I was no longer able to eat wheat etc. Each time Ive been accidentally glutened, I have a similar but less severe response.  

 

I wonder if I had a transient ischemic attack due to gluten? This makes me feel like Im not crazy after all! 

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Welcome to the forum! :) No, you are not crazy!

 

I had a TIA that was directly related to gluten. The gluten caused severe chronic headaches (and I was a person who wasn't prone to frequent headaches and had no history of migraines before my gluten challenge) and the headaches led to the TIA. I had numbness on my right side and speech difficulties. I went to the ER and they diagnosed it as a TIA and told me that it meant that I had an elevated risk for stroke.

 

After I quit the gluten, I saw my doctor and he told me that he didn't think that further neurological tests were needed and that staying away from gluten was the best treatment. He was right--as soon as I stopped the gluten (which was immediately after my trip to the ER) my headaches started improving. After a few days, I felt completely normal and I have never had any recurrence. 

 

That episode though absolutely cemented the fact that I will never be doing a gluten trial again. It's just not worth the risk of having a full blown stroke!

 

I wish that I had more concrete information on the risk of TIA/stroke while on a gluten free diet for those who had gluten related ones previously.

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I wonder if something like this is what happened to my cousin. When she was in grade 5, she started getting really bad migraines. One time in class she got one, and then her speech started slurring and one side of her face got all droopy. She was taken to hospital but they didn't find anything. It happened a second time too.

My cousin has never been tested for celiac but I suspect she could have it. She says she's tired all the time, and sometimes she gets stomachaches after eating certain things. One time she got stomach pain after pizza and she blamed it on too much cheese on the pizza. She's in grade 8 now.

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My sister was a coeliac, diagnosed 18 years ago at the age of 30. She had been gluten free as much as possible over that time but was recently involved in a study where she was required to consume gluten and record the results. This caused severe cramping, diarrhoea and vomiting. She eventually, on the day of the test, had a major stroke in the PONS area of the brain and died 13 days later. I would be interested in collecting as much research as possible to do with links between consumption of gluten of diagnosed coeliacs and strokes or, as this post has, stroke and undiagnosed coeliacs.  Her death will be the subject of a coroner's report some time this year. Any links to research can be sent directly to jeff@bilbyweb.com.au

With thanks in anticipation.

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