For every gluten sensitive patient with the symptoms of classic celiac disease, there are 8 cases with no GI symptoms.(1, 2)
Celiac disease is a multi-system disorder. Believing that it involves solely the small intestine is a common misconception. (3) While the gluten protein may start by damaging the small bowel, the effects do not stop there.
At the time of this writing, there are strong, research-backed correlations between celiac disease and neurological illness. The most studied include:
- Peripheral neuropathies
- Numbness or tingling in the hands and feet
- A balance disturbance
- Epileptic seizures
- Brain atrophy and dementia
This article explores common neurologic illness that is strongly associated with gluten-related allergies and sensitivities.
A brief introduction to your nervous system
Your nervous system is composed of two distinct systems:
- The central nervous system (CNS) (4)
- This consists of your brain and spinal cord.
- The peripheral nervous system (PNS) (5)
- The PNS consists of all the nerves and ganglia outside of the brain and spinal cord.
- Think of the PNS as a highway that connects information to and from the brain and spine (CNS).
Nerves that transmit signals from the brain are called motor or efferent nerves, while those nerves that transmit information from the body to the CNS are called sensory or afferent nerves.
Millions of sensory receptors detect stimuli, changes that occur inside and outside the body. On the outside, they monitor such things as temperature, light, and sound from our environment. Inside the body, the internal environment, receptors detect variations in pressure, pH, carbon dioxide concentration, and the levels of various electrolytes. All of this gathered information is called sensory input.
Sensory input is converted into electrical signals called nerve impulses that are transmitted to the brain. There, the signals are brought together to create sensations, to produce thoughts, or to add to memory; decisions are made each moment based on the sensory input.
Based on the sensory input and integration, the nervous system responds by sending signals to muscles, causing them to contract, or to glands, causing them to produce secretions. Muscles and glands are called effectors because they cause an effect in response to directions from the nervous system.
It is your nervous system that maintains your balance. Nerve fibers are continually assessing the position of our limbs in relation to our environment. This calculation occurs behind the scenes, so to speak. Though it is through the excitement of specific motor nerves (and inhibition of others) that keeps us standing straight.
As you can see, a proper functioning nervous system is absolutely integral to health. Unfortunately, the gluten protein can disrupt this system in a multitude of ways.
Gluten and peripheral neuropathy
Peripheral neuropathy is a general term used to describe a condition that affects the nerves in the body’s extremities (peripheries). The most common manifestation is altered sensation(s) in the hands and feet. Carpal tunnel syndrome is a type of peripheral neuropathy. As is the altered sensations often found in the feet of diabetics. (6)
The common causes of peripheral neuropathy include:
- Infection (Lyme disease, shingles)
- Vitamin deficiency
- Chemotherapy drugs
In celiac disease, it is often the sensory nerves that are affected. Motor nerves generally remain intact. This means that those suffering from celiac disease or gluten sensitivity are more likely to notice “pins and needles” sensations in the hands/feet than they are to lose control of the muscles in their hands/feet.
About 10% of those suffering from peripheral neuropathies with an unknown cause have an undiagnosed celiac disease. (7) Peripheral neuropathy is the second most common manifestation of gluten sensitivity. (8)
If you’ve been diagnosed with peripheral neuropathy, yet all your lab tests come back within normal ranges, gluten could be the cause. I’d recommend testing your body’s reaction to gluten with a functional medicine practitioner. If there are no practitioners nearby, try following a strict gluten-free diet for 60 days.
Ataxia is a neurological sign consisting of lack of voluntary coordination of muscle movements. Ataxia is a non-specific clinical manifestation implying dysfunction of the parts of the nervous system that coordinate movement, such as the cerebellum. (9) Those suffering from ataxia will often mention unsteadiness, exaggerated movements, and falling easily.
A number of studies have shown that between 9-15% of patients with ataxia of unknown cause have celiac disease. (10, 11, 12, 13) Ataxia is one of the most common neurological manifestations of celiac disease. It is worth noting, those with gluten ataxia will often be free from any of the common GI symptoms found in celiac disease.
At the time of this writing, researchers are unsure of the exact cause of gluten ataxia. Current theories suggest that antibodies our body creates to the gluten/gliadin protein may be toxic to our brain (especially the cerebellum). (14) Other theories suggest that nutrient deficiencies (vitamin E) caused by celiac disease are to blame. (15)
As ataxia is a debilitating disorder, starting a gluten-free diet should be done ASAP. Please note that gluten ataxia can also occur in those without celiac disease. To see if the gluten protein is causing ataxia, strict adherence to a gluten-free diet needs to be done for 90-days. Should gluten be contributing to ataxia, a noticeable improvement will occur within this time.
Gluten and epilepsy/seizures
Epilepsy is a chronic neurological disorder that is characterized by recurrent, unprovoked seizures. Seizures are disturbances in the electrical activity of the brain. Brain cells either excite or inhibit (stop) other brain cells from sending messages. Usually, there is a balance of cells that excite and those that can stop these messages. However, when a seizure occurs, there may be too much or too little activity, causing an imbalance between exciting and stopping activity. The chemical changes can lead to surges of electrical activity that cause seizures. (16)
More than two million Canadians have epilepsy. Each day, an average of 42 Canadians (15,500/year) learn they have epilepsy. (17) Epilepsy is the second most common neurological disorder. Second only to strokes.
Epilepsy is a syndrome; meaning that there is a group of symptoms that must occur in order to be diagnosed with epilepsy. The hallmark symptom is seizures. The type of epilepsy you have is based on the type of seizures you exhibit. Epilepsy is divided into four categories:
- Generalized epilepsy
- Focal epilepsy
- Generalized and focal epilepsy
- Unknown if generalized or focal epilepsy
Generalized epilepsy is diagnosed when seizures occur on both sides of the brain. In generalized epilepsy, grand mal or petit mal seizures are the most common. Focal epilepsy is diagnosed when the seizure occurs on one side of the brain. The other two types of epilepsy are diagnosed if there is a combination of both generalized and focal seizures, or if the seizure cannot be classified.
In those with celiac disease, the incidence of epilepsy ranges from 3-5%. Nearly 10x the risk of the general population. (18,19) In general, children are at greater risk of suffering celiac-related seizures.
In children, celiac disease has been shown to create calcium deposits near the occipital or rear aspect of the brain. These calcium deposits are thought to be caused by an autoimmune process that is triggered by celiac disease. (20) Should you or your child suffer from seizures, screening for celiac disease and gluten sensitivity should be considered.
Gluten and migraines
A migraine is a primary headache disorder characterized by recurrent headaches that are moderate to severe. (21) Migraines typically begin at puberty and mostly affect those between the ages of 35 and 45 years. The exact cause of migraine headaches is poorly understood. There is thought to be both a genetic and environmental component. (22) Though no migraine genes have been identified.
One study looked at the connection between celiac disease and migraines. In this study, 4% of migraine patients (versus only 0.4% in the control group) had silent celiac disease. (23) Meaning, their particular presentation of celiac disease did not involve abdominal discomfort, diarrhea, and/or bloating. Instead, in these patients, celiac disease manifested as migraine headaches. In this same study, all those with silent celiac disease had drastic improvements in their migraines after following a gluten-free diet.
So, should you be suffering from migraines, adopting a gluten-free diet is the perfect initial step. I outline how do start a gluten-free diet in this post.
Should you go gluten-free?
Well, if you have an illness affecting your nerves like the ones discussed in the article, adopting a gluten-free diet is a great idea. If you have a family history of celiac disease, the likelihood gluten is contributing to your illness is even higher.
The gluten-free diet is cost-effective, you can do it yourself, there is little to no risk, and the potential upside huge. I recommend going gluten-free for a minimum 60 days (90 days if you have ataxia). During this period, you need to be incredibly strict. Absolutely no sources of wheat or gluten can be in your diet. For a thorough investigation of all the foods gluten hides in, please see this post.
Remember, if you test negative for celiac disease that does not mean you don’t react to gluten. Non-celiac gluten sensitivity can be just as damaging to your nerves.
Don’t get discouraged if nothing changes after two months on a gluten-free diet. Nerves are notoriously slow at healing. It may take months before you notice an improvement. In order to be confident gluten is not affecting your nerves, I strongly recommend working with a functional medicine practitioner who can run lab tests that determine your body’s reaction to gluten.
Now, I want to hear from you!
Did going gluten-free help you?
How long did it take for you to notice an improvement?
Looking for more information? Check out our other blog posts about gluten.
Also published on Medium.