Gluten and the Brain
We believe that food allergy is a common cause of mental illness. Allergy to
proteins from cows milk, hens eggs and wheat are the three most common problems.
One idea is that antibodies generated by gluten proteins can attack the brain.
This immune mistake is generally known as molecular mimicry. A second idea is
that gluten proteins or peptides generated from them during digestion can act
directly on the brain. A third idea is that your brain is affected by immune
responses in other parts of your body. All immune activity sends signals to the
brain to change behavior and to recruit a range of defensive responses.
Disturbances to brain function vary from routine effects such as sleepiness,
fogginess, and brief episodes of confusion to symptoms of major mental or
neurological illness. For example, people with celiac disease suffer for many
years before the diagnosis is made. They often state that they never feel well.
Most of these patients will report episodes of fatigue with cognitive
dysfunction; difficulty concentrating, mental "fogginess", recent memory
dropouts. They complain of mood liability and are often tearful and irritable.
They return to normal when they no longer eat problem foods.
We have recognized that Gluten-related diseases involve the absorption of
complete proteins such as gliadin or its peptide-fragments. Anti-protein
antibodies circulate in the blood and form immune-complexes, combining antibody
with food protein. Immune complexes provoke the release of mediators which may
cause multiple disturbances in all body systems and tissue damage. These
circulating problems influence brain function in a variety of undesirable ways.
A family history of "psychiatric problems" is more common in patients with
celiac disease. Schizophrenia has been associated with gluten intolerance. The
diagnosis, schizophrenia, describes a variety of differing individuals who
belong to complex group of brain-disordered people often with a chronic or
relapsing disease that leads to dementia. The schizophrenic process distorts
sensing, feeling, remembering, deciding, and acting. It is unlikely that
schizophrenia is a single disease with a single cause. The milder, but similar
brain dysfunctions observed with gluten allergy suggests that food allergy
may play a role in schizophrenia, with gluten proteins as a set of triggering
antigens. Many years ago, Dohan advocated a gluten-schizophrenia link.
" Many diseases are caused by genetically-deficient utilization of specific
food substances. Perhaps the best studied example is phenyketonuria... far more
common disorders, for example, atherosclerosis, and coronary heart disease, are
strongly suspected of being due to genetically defective utilization of certain
food constituents. " Similarly, considerable evidence indicates that the major
cause of schizophrenia is the inborn inability to process certain digestion
products of some food proteins, especially cereal grain glutens..."
Among Dr. Dohan's interesting ideas was a "Gluten tolerance test". Such a
test has not yet been developed, but is the sort of evaluation method that NP
advocates in general. A gluten tolerance test could be initiated with routine
evaluations before and after ingestion of grain foods. More sophisticated
versions would measure gluten proteins and derived peptides in the blood, and
would track the path of these molecules into organs, especially the brain.
Finally the impact of these molecules would be evaluated by monitoring the
function of the target organ in real time. I have been eager to do real-time
monitoring of brain activity in gluten-sensitive patients. These patients report
changes in their energy, mood, cognitive abilities and emotions which no
researcher to date has documented objectively. The problem of adverse brain
effects of molecules derived from food is a major under-recognized phenomenon of
nutrition and molecular pathophysiology. Research in the next 10-20 years will,
I am convinced, reveal a great deal about the extent, mechanisms, and importance
of this consequence of eating problematic foods to our mental status.
Recommendations: The Alpha Nutrition Program is
gluten-free and is recommended as the diet revision strategy for anyone with
diagnosed celiac disease, or any person with symptoms suggestive of gluten
Some Examples of Gluten caused Brain Disease
Gluten-Free Diet in Patients with Gluten Sensitivity and Cerebellar Ataxia
Sponsored by National Institute of Neurological Disorders and Stroke (NINDS)
Study Details: In many patients with cerebellar ataxia, the etiology is
unknown. Sensitivity to gluten (wheat protein) has been suggested as a cause for
cerebellar ataxia even in the absence of malabsorption symptoms or intestinal
pathology. However, the prevalence of gluten sensitivity in patients presenting
with cerebellar ataxia is unknown and the effect of gluten-free diet on gluten
sensitivity-associated cerebellar ataxia has not been systematically studied.
The aim of this project is: 1) To identify gluten sensitive cerebellar ataxia
patients attending the Human Motor Control Clinic at the NIH using tests for
celiac disease antibodies as a screening method. 2) To conduct open-label
controlled clinical trial to assess the efficacy of gluten-free diet in the
patients identified using a detailed cerebellar ataxia scale as an objective
Neurological diseases associated with celiac disease
Hagen_EM; Gjerde_IO; Vedeler_C; Hovdenak_N
Tidsskr Nor Laegeforen, 2000 00, 120: 4, 439-42 J. Neurol Sci 1982
Abstract: During the period from May 1997 to October 1998, eight patients
with coeliac disease or dermatitis herpetiformis and neurological disorders were
admitted to the Department of Neurology, University Hospital of Bergen. The most
frequent conditions were polyneuropathy (seven patients) and spinocerebellar
ataxia (three patients). Other conditions were lower motor neuron disease,
myelopathy, epilepsy and encephalopathy. The patients used various degrees of
gluten-free diet at the time of admission. It remains unclear whether there is a
shared common pathogenetic mechanism or the neurological disorder is a
complication to the coeliac disease. Both vitamin depletion and immunological
mechanisms may cause neurological disorder. Neurological manifestations may
occur before the gastrointestinal symptoms. With reference to our patients and
available literature we discuss prevalence, clinical picture, pathogenesis,
treatment and prognosis. Neurologists, gastroenterologists and general
practitioners should be aware that coeliac disease can cause neurological
diseases, especially polyneuropathy, cerebellar ataxia and encephalopathy.
Degeneration of the central nervous system associated with celiac disease.
Kinney HC, Burger PC, Hurwitz BJ, Hijmans JC, Grant JP. Eur Neurol
The following report describes a 57-year-old man with celiac disease who
developed a progressive and fatal neurologic disorder despite intensive medical
and nutritional care. The clinical and pathological CNS findings in this patient
are compared with those of 9 previously reported patients with well documented
celiac disease in whom a progressive CNS disorder was carefully studied both
pre-and postmortem. An entity of CNS degeneration associated with celiac disease
appears to emerge from the study of these 10 cases. This disorder affects
predominantly the cerebellum, deep gray masses, certain brain stem nuclei, and
spinal cord; its cause and pathogenesis are unknown.
Coeliac disease presenting with neurological disorders.
Luostarinen L, Pirttila T, Collin P. Neuropathol Appl Neurobiol 2000
It is well known that coeliac disease may be associated with various
neurological manifestations. We have had a high index of suspicion of coeliac
disease during recent years in our neurological clinic. As a result 10 (7%) out
of 144 of our new coeliac patients were detected because of neurological
symptoms. The most common neurological manifestations were neuropathy, memory
impairment and cerebellar ataxia. In these patient groups screening for coeliac
disease with serological antibody tests helps to find patients who may suffer
from this disease.
The neurology and neuropathology of coeliac disease. Wills AJ.
A number of neurological syndromes have been described in association with
coeliac disease. These include disorders of the central nervous system
encompassing epilepsy, myoclonus, ataxia, internuclear opthalmoplegia,
multifocal leukoencephalopathy and dementia. Most of these associated conditions
show a poor response to gluten restriction. Peripheral neuropathies, of axonal
and demyelinating types, have also been reported and may respond to elimination
of gluten from the diet. The mechanism underlying these processes remains
obscure but may be immunological or related to trace vitamin deficiencies.
Controversially, it has also been claimed that occult coeliac disease accounts
for a substantial proportion of patients with neurological dysfunction of
unknown cause. Some authorities recommend that cryptogenic ataxias and
neuropathies should be routinely screened for the presence of gluten-sensitivity
but this remains contentious and has not been universally accepted. This review
will attempt to review the clinical and pathological findings in this condition
and speculate on pathogenesis and directions for future research.