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Gluten Sensitivity and Coeliac Disease: Associated Neurological and Psychological Manifestations Manifestations

by learningdiscoveries on July 24, 2012

Most people are unaware that Gluten Sensitivity (GS) and Coeliac Disease (CD) can manifest as neurological and psychological conditions in addition to gastrointestinal symptoms.

So what is gluten and is it attacking your brain?

Gluten is a protein that is found in grains like wheat, barley, oats, rye and spelt. It is therefore present in foods that contain these grains such as breads and cereals to name the basic few. These breads and cereals are the most commonly eaten food in western countries. Contrary to popular belief that breads and cereals must make up the majority of a diet as portrayed by the food pyramids, recent research shows that there can be major side effects to the consumption of gluten.

There are two distinct consequences of intolerance to gluten- Coeliac Disease (CD) and Gluten Sensitivity(GS). Coeliac Disease is a well researched, well defined autoimmune condition that occurs when individuals who have a genetic predisposition to gluten intolerance continue to eat gluten-containing products and thus their own immune system begins to attack their normal, healthy body tissue. A bowel biposy was considered the gold standard to test for CD but other tests are now sometimes used instead or in conjunction with a biopsy. Originally thought to be primarily a childhood ailment , doctors are now discovering that CD can even appear for the first time in adults. If not managed properly, coeliac disease can have significant effects on the overall health of a person.

Gluten Sensitivity on the other hand, is not autoimmune and therefore distinct from CD. the name given to any reaction to gluten consumption in individuals wherein Coeliac Disease and other allergies like wheat allergy have been ruled out (1).

The manifestations of Gluten Intolerances include both neurological and psychological. A neurological condition known as ‘Gluten Ataxia’ occurs when the consumption of gluten affects the portion of the brain at the back known as the ‘cerebellum’ which plays an important role in the motor control of an individual (2) . Subsequently, individuals that suffer from Gluten Ataxia show symptoms of poor muscle movement and coordination, a loss of balance, and the degradation of other complex movements (2).A study was conducted on patients who suffered from Gluten Ataxia wherein they were prescribed a gluten free diet for one year. After the trial period, patients displayed a significant relief of symptoms (3).

Epilepsy is another neurological condition which is known to be associated with seizures. Celiac Disease has also been shown to correlate with seizure activity with 0.8-6% of patients suffering from Celiac Disease also showing symptoms of seizures (4). Furthermore, a study examined patients who had had seizures and currently experiences problems with vision i.e. blurriness etc. All the patients examined were found to have Celiac Disease (5). Subsequently, all the patients were administered a carefully prepared gluten-free diet and upon following the diet, symptoms were reduced (5).

The psychological manifestations of Gluten Sensitivity and Celiac Disease include Schizophrenia, ADHD, and Depression. Research has shown that there is a higher incidence of major depressive disorder, dysthymic disorder and adjustment disorder in individuals who suffer from Gluten Sensitivity and Celiac Disease (6). A study found that in the elderly population, individuals who suffered from Gluten Sensitivity were two times more likely to suffer from depression at some point than individuals who did not suffer from Gluten Sensitivity (7).

Results from other research also shows that there is a possible association between Gluten Sensitivity and ADHD. Individuals who suffered from Gluten Sensitivity showed symptoms of ADHD compared to the general populace. These individuals were then presented with a six month gluten free diet plan that they adhered to. After the trial, 74% of participants were found to exhibit reduced symptoms (8).

The occurrence and rate of recovery from Schizophrenia has been repeatedly linked to Gluten Sensitivity. Early research showed that a diet free of dairy and gluten rapidly decreased symptoms of schizophrenia (9).Studies have also shown more rapid improvements in the symptoms of schizophrenic patients when they were administered a strict gluten-free diet whilst a case study of a schizophrenic woman who after following a similar gluten-free diet for an entire year discontinued her use of antipsychotic drugs consequently (10).

Gluten Intolerance is not only associated with the above discussed psychological phenomena, but has relations with other manifestations such as Autism and Anxiety. Different types of anxiety including panic disorders and social phobia have been associated with Gluten Sensitivity (6, 11).

Interestingly, it is the drug-like effect of Gluten that causes many of the behaviors that we collectively use to diagnose for Autism Spectrum Disorders. A theory known as the ‘Opioid Excess Theory’ suggests that if proteins that we consume particularly from dairy and gluten products are not digested properly, the proteins break down (2). These broken down elements, can (in some individuals with a genetic predisposition) then manage to exit through the intestinal wall into our blood where they eventually circulate to the brain, crossing the protective layer known as the Blood Brain Barrier, and interact with opioid receptors wherein the body believes it to be a morphine-like substance (2). This morphine-like effect is associated with many symptoms of the Autistic Spectrum Disorder including lack of eye contact, a need for self-stimulation and a disfigured threshold of pain in the individual.

When individuals consume gluten for lengthy periods of time, the experience can be likened to a drug (opiate) addiction wherein the drug itself – in this case, the Gluten – causes the cravings and it itself is responsible for the problems that the individual experiences (2). It is this drug-addiction like effect that is responsible for the ‘withdrawal’ symptoms some individuals who being a gluten-free diet may experience (2). Thus, the initial stages of the gluten-free diet may seem to have no positive effect on the individual, but, one must consider the action of Gluten itself on the brain as a drug-like substance and continue the gluten-free diet so that withdrawal symptoms may gradually fade and the neurological and psychological manifestations associated with Gluten Sensitivity and Celiac Disease may decrease in their strength or occurrence.

In Conclusion, recent research has shown the many associations between Gluten Sensitivity/Celiac Disease and a number of neurological and psychological manifestations. Those who suffer from Gluten Sensitivity or Celiac Disease have an increased risk of neurological manifestations such as Gluten Ataxia which has implications for fine and gross motor movement as well as displaying symptoms of seizures typically associated with Epilepsy. Furthermore, there are numerous psychological manifestations associated with Gluten Sensitivity and Celiac Disease including Depression, Anxiety, ADHD and of particular concern- Schizophrenia. It is a theory that Gluten may act as a morphine-like substance in that in causes a condition very much like when an individual is addicted to opiates, but in this case- to more gluten containing food. The withdrawal symptoms that are presented immediately after the commencement of a Gluten-free diet are only natural and should not be confused with being ‘negative effects’ of the diet itself.

1. Verdu EF, Armstrong D, Murray JA. Between celiac disease and irritable bowel syndrome: The ‘No Man’s Land’ of Gluten Sensitivity. The American Journal of Gastroenterology . 2009;104(6):1587-1594
2. Whiteley P, Shattock P. Biochemical aspects in autism spectrum disorders: updating the opioid-excess theory and presenting new opportunities for biomedical intervention. Expert Opinion on Therepeutic Targets. 2002; 6(2): 175 – 183
3. Hadjivassiliou M, Kandler RH, Chattopadhyay AK, Davis-Jones AG, Jarratt JA, Sanders DS, et al. Dietary remedies of gluten neuropathy. Muscle and Nerve .2006, 34:762-766
4. Morris JS, Ajdukiewiez AB, Read AE: Neurological disorders and adult coeliac disease. Gut. 1970; 11:549-554.
5. Pfaender M, D’Souza WJ, Trost N, Litewka L, Naine M, Cook M: Visual Disturbances representing occipital lobe epilepsy in patients with cerebral calcifications and coeliac disease: A case series. Journal of Neurology, Neurosurgery and Psychiatry . 2004; 75:1623-1625
6. Carta MG, Hardoy MC, Boi MF, Mariotti S, Carpiniello B, Usai P: Association between panic disorder, major depressive disorder and celiac disease: A possible role of thyroid autoimmunity. Journal of Psychosomatic Research . 2002;53:789-793
7. Ruuskanen A, Kaukinen K, Collin P, Huhtala H, Valve R, Maki M, et al.: Positive serum antigliadin antibodies with celiac disease in the elderly population: Does it matter? Scandinavian Journal of Gastroenterology. 2010; 45:1197-1202
8. Niederhofer H, Pittschieler K: A preliminary investigation of ADHD symptoms in persons with Celiac Disease. Journal of Attention Disorders. 2002;10:200-204
9. Dohan FC, Grasberger JC, Lowell FM, Johnston HT, Jr., Arbegast AW: Relapsed schizophrenics: More rapid improvement on a milk and cereal-free diet. British Journal of Psychiatry . 1969;115:595-596
10. De Santis A, Addolorato G, Romito A, Caputo S, Giordano A, Gambassi G, et al.:Schizophrenic symptoms and SPECT abnormalities in a coeliac patient: Regression after a gluten-free diet. Journal of Internal Medicine . 1997;242: 421-423
11. Addolorato G, Mirijello A, D’Angelo C, Leggio L, Ferrulli A, Vonghia L, et al.: Social phobia coeliac disease. Scandinavian Journal of Gastroenterology. 2008;43:410-415

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Rosemary Boon

Registered Psychologist

M.A. (Psych),
Grad. Dip. Ed. Studies (Sch. Counsel),
Grad Dip. Ed. B Sc, Dip. Nut.
MAPS, AACNEM, ATMS, ISNR, ANSA.

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