• By Kimberly Beauchamp, ND

Gluten Sensitivity Beyond the Gut

A new report published in the Lancet Neurology may change the way people think about gluten sensitivity. Celiac disease, an intestinal gluten sensitivity, is well known. But mounting evidence now links gluten sensitivity with problems in the nervous system (neurological disorders)—even in people without intestinal symptoms.

Gluten is a protein found in grains, including wheat, barley, rye, spelt, and sometimes oats. When people with celiac disease eat gluten-containing foods, an immune reaction takes place in their intestines, causing damage to intestinal cells and interfering with nutrient absorption. Common symptoms of celiac disease are bloating, cramping, diarrhea, foul-smelling stools, and tingling or numbness in parts of the body.

Mounting evidence now links gluten sensitivity with problems in the nervous system—even in people without intestinal symptoms

Sensitivities beyond celiac

“Celiac disease is only one aspect of a range of possible manifestations of gluten sensitivity. In some individuals, gluten sensitivity is shown to manifest solely with neurological dysfunction,” the authors of the new report explain.

Neurological disorders that might be tied to a gluten sensitivity include a lack of muscle coordination leading to instability (ataxia), tingling and numbness (neuropathies), and migraine-like headaches (encephalopathy). The authors go on to say that the tests that help to establish a diagnosis of celiac disease may not reliably show if a person has a gluten sensitivity that affects only their nervous system. For this reason, they suggest other tests that may help uncover a hidden gluten sensitivity in people suffering from certain neurological disorders.

The report’s authors recommend, “To improve diagnosis rates, the perception of physicians that gluten sensitivity is solely a disease of the gut must be changed.”

If you think you have a gluten sensitivity

• Get medical support. Identifying and treating a gluten sensitivity can help you avoid serious complications.
• Be proactive. Ask your doctor if he or she is familiar with the tests that are useful for identifying different types of gluten sensitivities, or if he or she can refer you to someone who is.
• Pay attention. If you think your symptoms might be related to gluten, consider a six-week gluten-free diet trial. If you’re going in for lab work, though, eat your normal diet so your test will gauge your regular reactions.

Living with a gluten sensitivity

Gluten sensitivity is in the spotlight, so there’s never been an easier time to go gluten-free. New food packaging requirements mandate that gluten-free foods be accurately labeled, and gluten-free cookbooks abound on bookstore shelves. Ask your grocer whether they can recommend books, recipes, and other resources to help.

(Lancet Neurol 2010;9:318–30)