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Brain And Neurological Problems Affect Almost Half Of Celiacs Even With A Gluten Free Diet

There is reasonable evidence of neurologic problems in celiac disease (CD), and regular neurologic screening should be performed even in those patients who are well treated with a gluten-free diet. Peripheral neuropathy is present in almost half of CD patients. Previously, neurologic complications of celiac disease were reported to be as high as 36%, or more than a third. Many patients have some unexplained neurological problem that the patient or their doctor is unaware of, and some patients have multiple problems. Unfortunately, since brain imaging is not routinely performed or recommended for newly diagnosed people, we don’t really know how high these numbers really are. Even more alarming, we’re still learning about people who don’t meet the diagnostic criteria for celiac disease but are found to have gluten-related neurological problems that respond to a gluten-free diet.

Many neurological problems are present in undiagnosed and untreated celiac disease, including neuropathy, balance problems (ataxia), seizures, MS-like symptoms, headaches, memory disturbances, depression and anxiety, difficulty concentrating (ADD /ADHD), schizophrenia, dementia, muscle weakness, developmental delays in children, autism (Asperger’s syndrome). The sad truth is that even on a strict gluten-free diet, many patients experience delayed diagnosis, leading to delayed treatment and poor response. The average delay in diagnosis in adults is eleven to thirteen years. British neurologist Dr. Hadjivassiliou, who is considered a world expert on gluten-related neurological problems, communicated with me via email and wrote that the response to a gluten-free diet can take five years, and if the neurological condition does not change at all for a long time Too likely to recover.

Symptoms of neuropathy are paresthesias (numbness) or paresthesias (burning, tingling, heaviness, “pins and needles”). Many of my patients also describe their skin being so irritated that they don’t like the air blowing on them or their children or a spouse against their skin. Some people admit to having a “bug-crawling” feeling on their skin, which is known in medical terms as helminthiasis, but most doctors rarely ask or give it much thought. Strange muscle movements under the skin, which some call “pockets of worms” Medically known as fasciculations are also common but ignored by many doctors. My wife is a celiac doctor and she was in These occurred during an EMG (electromyography, which records muscle activity by placing needle electrodes into the muscle) to an older neurologist. Despite observing that these occur visually and the monitor showing “static noise,” But neurologists consider them “normal.”

Many people with celiac disease also have what radiologists and neurologists call “UBOs” on brain MRIs. These unrecognizable bright objects (think UFOs) are white spots that appear on brain images. When they are found in certain locations in the brain, they are highly suggestive of multiple sclerosis (multiple scarred spots in the brain). However, although many people with CD have MS-like symptoms, and these symptoms often begin early in response to a gluten-free diet, UBOs seen on brain MRI are often not in areas typical of MS. Instead, they are commonly found in areas of the brain associated with migraines or difficulty with balance (ataxia).

Even without obvious bowel symptoms, some children have strange seizure problems. A typical specific syndrome associated with epilepsy in children and adults has calcifications in the brain that can be detected by CT scan or MRI. Epilepsy is well documented, but research is so confusing that there is not a good consensus on risk and recommended screening for all children with epilepsy.

I have personally and professionally observed all the neurologic complications of celiac disease, most of which I have also noted sensitivity in patients for whom I cannot confirm CD but who I believe have objective signs of gluten and/or genetic risk. I have patients with MS-like symptoms, chronic unexplained neuropathy, headaches, difficulty concentrating, autistic behaviors, and developmental delays who respond to a gluten-free diet, but if they follow their doctor’s advice, they stay This “restrictive, expensive, difficult to follow” diet should only be “imposed” on those diagnosed with celiac disease.

If you have neurological problems, get tested for celiac disease before starting a gluten-free diet. If you test negative for CD, make sure they do a complete HLA DQ genetics test for you, including high risk white blood cell patterns DQ2 and DQ8 for celiac disease, and blood tests including IgG and IgA gliadin antibodies . If your blood tests, including gliadin IgA and IgG antibodies, are negative or normal, consider a stool test for gliadin antibodies in your stool ($99, http://www.enterolab.com).

Although often overlooked or missed, evidence continues to accumulate that gluten is toxic to the brains of some people, even if they don’t have CD. If you do have celiac disease, chances are you already have neurological problems and may be at risk despite being on a gluten-free diet. Borrowing from the old anti-drug ad “Here’s your brain on drugs”, maybe we should say “It’s your brain on gluten”. Regardless of your test results, if you have unexplained or unresponsive neurological problems, consider trying a gluten-free diet after you have completed the test. You owe it to your brain. Like my seven year old son said to a friend of ours, “Maybe you should cut gluten off”.

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