Category: Science

Gluten Sensitivity is a Neurological Illness

Gluten Sensitivity Doesn’t Only Involve the Gut

Recently, Australian researchers published a report in the journal Gastroenterology that purported to argue against the clinical entity known as non-celiac gluten sensitivity. In their research, the claim was made that because there were no biomarkers for gluten sensitivity correlated with introduction of gluten into the diet and no clear cut correlation of gluten exposure to gastrointestinal symptoms in their small study, the existence of gluten sensitivity as a clinical entity should be doubted.

The researchers evaluated the clinical parameter of “gastrointestinal distress,” in a mere 37 subjects. What’s troubling about this report is that it completely misses the point. As I have stated on multiple occasions, gluten sensitivity is frequently an extra-intestinal disease that may have no impact on the gut whatsoever.

As Dr. Marios Hadjivassiliou pointed out 12 years ago in his landmark publication, Gluten sensitivity as a neurological illness, gluten sensitivity may relate to a number of neurological conditions in the absence of gastrointestinal involvement. As this same author has stated more recently in a report appearing in Practical Neurology: 

Neurological manifestations of gluten sensitivity are a scientific fact, not a theological issue. Whilst the debate continues, we owe it to our patients to screen them effectively for gluten sensitivity with the simple widely available antigliadin antibody test so that we do not in the meantime deprive them of a harmless but potentially effective treatment in the form of a gluten-free diet.

As a practicing physician who has witnessed first hand the life changing effects of a gluten-free diet in individuals who have suffered from any number of physical ailments for literally decades, media attention to this study serves only to compromise the health of those who need this information the most.

  • barbara carroll

    It is strange how ‘the anointed’ can ignore the facts. The ‘roar of the crowds’ will prove what you are saying, that life changing effects of a gluten-free (and even grain-free) diet will improve people’s lives and and lead to better health and less chronic disease. Thanks for all you do to help us all lead healthy lives.

  • TechnoTriticale

    As always, the first thing to read in any alleged nutrition report is the funding disclosure, in this case:
    “This study was supported by George Weston Foods …”
    who are a major supplier of packaged foods in Australia, and several of the images on their site prominently feature wheat-based products. There is no chance they would fund a study that unambiguously details the effects of consuming gluten-bearing grains.

    You will also have heard about the other recent trial that tried to reverse a prior finding of non-celiac gluten sensitivity. They may not have intended to have poor design, confounding factors, unsupported conclusions, all leading to wild press claims about the implications for eating wheat, but that was the result.

    • Designer Girl

      There are a lot of technical holes in how this study was conducted. The funding, yes, is critical as it taints the results!
      But what scientist conducts a study with only 37 subjects? Statistically, there isn’t enough data to prove anything one way or the other.
      The subjects all had IBS, irritable bowel syndrome, so, therefore, this study could only possibly report results on the effects of gluten on IBS, not other gluten-related symptoms.
      The subjects were on their diets for only 2 weeks…not enough time for many people’s bodies to clean out, heal, and adjust to the lack of gluten. From my family’s experience (celiac and gluten sensitivity), most of us didn’t see significant, noticeable results until the 3rd week, and the most results came 5-6 weeks into a GF-diet.
      I’m sure if I had been one of the subjects, I wouldn’t have reported much improvement or change in just 2 weeks, either!

    • MarcusK

      The fact that the control group was given whey protein also blurs the results of the study since it is common that people with gluten sensitivity also have sensitivities for milk-based proteins.

      I agree full with what TechnoTriticale and Designer Girl state: look who
      funded the study and you know why it is such a bad study. Especially
      the extremely short time of the study makes it worthless.

  • MarcusK

    Yesterday I read a blog by Richard Nicoley (http://freetheanimal.com/2014/05/resistant-problems-ignorance.html) where he explained how he got rid of gluten intolerance, chronic salmonella and high bloodsugar by taking soil-based probiotics for 10 weeks. Very interesting indeed. The blog does not have scientific evidence that gluten are digested by the probiotics in the gut but it is obvious that the probiotics play a major role.

    Dr Perlmutter, I recommend reading the blog and other material about soil-based probiotics, e.g. http://drbganimalpharm.blogspot.nl/search?q=depression since soil-based probiotics might be an alternative treatment for many patients.

    Best regards,
    Marcus Kool

  • Ian Nigh

    U. Of Chicago’s Celiac Disease Center has this to say about the AGA test:

    “AGA are anti-food protein antibodies; as such, they are not indicative of any autoimmune reactions. They appear only if the patient has been eating gluten, but–and this is the point–they are not linked to any detectable adverse reaction to gluten. In other words, they can appear in individuals who eat gluten as a response to it touching the gut, but do not necessarily correlate with any clinical expressions.

    Thus, patients with true non-celiac gluten sensitivity, patients with IBS and no gluten sensitivity, as well as individuals who are totally healthy (perhaps a bit less commonly, but not significantly so) may all have positive (or negative) AGA.

    AGA should not be relied upon to prove or disprove the diagnosis of celiac disease or non-celiac gluten sensitivity.”

    • Kerri

      does that mean the only real way to test is the elimination diet?
      My 5 yr old twins were tested by their Dr. for antibodies and said they were not Celiac, but we still are dealing with anemia, low weight gain, and digestive issues.

      • Kelly

        Can I interject and suggest removing dairy – especially from cows. Made a Hugh! difference for me. Include yogurt – see if that helps

        • Anna Patty

          Yes true, but grass fed was a different story for many of us we were ok. And yogurt has many fillers so watch the filler/other ingredients that can do just as much harm as glutens.

          • David Perlmutter

            Yes, and many flavored yogurts can be exceptionally high in sugar.

          • Tonka

            The only dairy I take in is cottage cheese. I have 1/2 a cup each morning with my breakfast. I cannot handle most dairy, but for some reason cottage cheese does not affect me. Not sure why. Other dairy products seems to cause mucus in my nose and throat that is bothersome and causes me to clear my throat for up to two hours after consuming. Very strange. Yogurts causes me extreme heartburn. Probably the sugars they put in it.

    • Ann Petersen

      Hi Ian, When I was homeless and having trouble using my brain well, the professor of the “Mind and Metabolism” class (physiological psychology) told me that I ought to read the book, “Dangerous Grains” by James Braly M.D. and Ron Hoggan M.A. I bought the book and devoured it. I got very excited about the chapter on mental illness and pestered my doctor to test me for gluten sensitivity/celiac disease. The test result was that I was over 200 points above normal in one AGA indicator the IgG. That doctor the same general response as the one that you quote above. I didn’t trust his opinion so I hunted down Ron Hoggan, a fellow Canadian. He ended up calling me (on his dime) at the shelter and we talked for 45 minutes. Later, I asked him to reiterate what he’d told me on the phone so that I could quote him in a school paper. This is what he said, “Many doctors say that the AGA test results are “non-specific” and conclude that a gluten-free diet isn’t necessary. I believe that’s a mistake. The antibodies are signaling an important health issue. Your body is obviously mounting an immune response to gluten so I wouldn’t eat it if I were you. The presence of anti-gliadin antibodies in the bloodstream indicates that gliadin is reaching the bloodstream. In a healthy body, that shouldn’t be happening. While a positive AGA test is non-specific (meaning that it doesn’t point to any specific disease) it’s been shown to be associated with a variety of autoimmune diseases, increased cancer rates, a wide range of neurological and psychiatric ailments, as well as early mortality. Even though AGA is not diagnostic for any particular illness, those who test positive for any class of AGA would likely benefit from a gluten free diet.” I went GF (a hard feat when homeless) and regained the use of my brain along with an even temperament! Ron Hoggan later came down and spoke at my senior project for Prescott College. I put on a seminar on mental illness among the homeless and natural healing. He was AWESOME! There has since been a study that found my exact AGA profile in bipolar diseased people. (Elevated IgG but normal readings for all the other indicators) I was diagnosed as bipolar in 1979. Had five hospitalizations for manic episodes. Met a maverick doctor in 1986 and used the candida diet (mostly GF by default), rebuilding good gut flora, an anti-fungal medication and excercise to normalize. Haven’t been manic since but didn’t know specifically about the gluten until I became homeless from eating crap from the foodbank. (Had lost my job). So there you have it. Mainstream medicine doesn’t always know what’s going on!!!

  • Mindy

    From the age of 18, I spent 25 years having expensive and inconclusive testing and medication for heart palpitations, chest pain and other CARDIAC symptoms along with a diagnosis of fibromyalgia. After another inconclusive nuclear stress test, the cardiologist told me that he didn’t think anything was seriously wrong but that I may want to consider a heart catherization. I went to Dr. Paul Hobaica who suggested some lifestyle changes including getting more exercise. (Other doctors had suggested limited exercise and lots of meds) He was promoting a boot camp so I gave it a try. The trainers introduced a paleo diet. Within 4 weeks, my heart palipations and chest pain were greatly improved. I eventually added some grains, but not wheat. 4 years later, I rarely have cardiac symptoms, joint or muscle pain, and am able to be very active. I no longer spend my free time and money on useless medications and testing and can enjoy life. I have great respect for the medical community and hope to see them embrace the benefits appropriate dietary suggestions for their patients prior to subjecting them to a lifetime of pharmaceuticals.

  • Binah

    It is such a relief to hear you, as a doctor, confirm what I figured out a few years ago based on intuition alone. I kept saying to my family almost those exact words: gluten is affecting my nervous system and causing inflammation throughout my whole body, but not affecting my digestive system (as dramatically at least). I have a friend who said gluten made her feel suicidal and I thought that was genius to make the connection between a food and a psychological disturbance, and it helped me to not feel so crazy. Your words come as a relief, confirming that I am not crazy after all! I’ve been gluten free for at least a year and feel like a different person. I am now taking it further and eliminating grains, sugar and carbs. I am also in school to become a dietician so I can help others find their way to better health. Thank you Dr, Perlmutter for shining the light on this life changing discovery.

    • David Perlmutter

      Thank you for those very kind words Binah.

    • Virginia

      I recently started a ketone diet.
      I have fibromyalgia, etc etc..
      Point is that after reducing carbs to under 25a day…after a week
      ALL MY INFLAMMATION IS GONE IN MY WHOLE BODY!!
      I couldn’t have imagined and would have thought a doctor a quack
      If they would have told me that sugar was causing my inflammation that I was eating
      Motrin for and was considering having my Lyrica increased.
      Now,I STILL have fibromyalgia, it didn’t have any effect on that…
      But the inflammation in my body is gone! 🙂 🙂

  • cynthia sidner

    As a physiologist and nutrition consultant I have observed that many clients resolve a variety of symptoms by eliminating gluten, and usually casein, from their diets. The standard blood test (IgA to gliadin) will often be negative. However, a much more sensitive test is offered by Enterolab. This is a stool test which will measure IgA antibodies in the stool to gliadin, casein, soy, eggs, and many other foods. Since the IgA to these foods is made in the gut, it is understandable that the stool is the appropriate place to look. Dr. Kenneth Fine (head of the lab) explains that this IgA antibody will spill into the blood when there is a considerable degree of poor gut barrier function (aka: ‘leaky gut’). Of course, as undigested food proteins are entering the blood, there can be additional food reactions which can trigger a myriad of symptoms. This test can be ordered on-line, without a doctor’s prescript.

  • Sandra Clagett

    This is excellent! Too many times we’re told if it doesn’t affect the “gut”, you’re not gluten sensitive. My husband and I have been gluten free for one year and the medical changes are impressive; from arthritis, skin rashes, loss of hair, bowel problems to low platelets. I can’t say enough about this diet. The “gut” is just part of the overall picture.

  • Frank Luv2ski

    Thank you for the blog post and the eye-opening book. My wife’s doctor was unable (or would not) send in for the Cyrex 3 array test so she got all your recommended tests except the Cyrex 3. The deamidated gliadin came out as 2.9 result vs. range of 0-19. Is it OK to interpret this as not sensitive to gluten?

  • Tonka

    Gluten sensitivity is real. I suffer not only from intestinal issues, but skin and other issues not even having to do with digestion. When I cut out grains, my life is pain free and my mind is clear. I would rather listen to my own body than to listen to those that try to deny and put down people and what they are going through.

  • Tom

    I am a junior doctor in the UK currently rotating through acute psychiatry. Prior to this job, wheat-derived ill-health had already become something of an interest to me in the context of obesity. It has been fascinating to learn about the pyschiatric implications of wheat in the medical literature, and I was delighted to realise that I’m in the same area of the country as Dr. Marios Hadjivassiliou! The link between wheat and schizophrenia for example makes me fantasize about how easy it would be to just put our patients on a GFD. Sadly, given the amount of ignorance, I feel pretty isolated with my thoughts.

    • Poto300

      Hi Tom, I am in the uk also and have now had to revert to seeing a functional medicine doctor privately to help me address issues with my 5 year (one aspect of which relates to issues with gluten). It is amazing that you are open to potential issues with wheat and gluten. You just have to have the courage to stand up and be part of the change that needs to take place within the uk medical establishment. Don’t give up on educating your peers. Best of luck.

    • Rosie

      I can only speak as a Junior Anthropologist (studied, but not degree’d and still studying!)… there is one theory on the disappearance of the Anasazi, the Ancients of the Southwest (America). It pertains to a diet almost exclusively of corn (maize) and the effects of that diet on their mental (& physical) health. It is one of many theories, so not conclusive but corn would have been their wheat and they did rely heavily on it. (Study by Michele Ernandes, University of Palermo, Italy). To quote author Craig Childs ( House of Rain), “It has long been known that too much corn can alter brain chemistry and lead to a variety of malnutrition diseases…..lacks two key amino acids…. ” the conclusion of the theory is that the malnutrition brought on by the sole corn diet was responsible for altering serotonin levels and ultimately, creating a sleep deprevation-like state. That state results in OCD behaviors, aggression and an ectastic state. this, too, is an unpopular theory, but that does not mean it is untrue.

      • Rosie

        P.S. My studies were in ethnobotany (aka archeobotany) which is a cross-study between anthropology & botany…. that is why this whole paleo, wheat, etc…. thing is so interesting to me, both academically and personally, as am type II diabetic with high trigclyerides…. and have been very successfully in bringing numbers down with relinquishing grains and reducing other carbs.

  • Deborah Rodvik

    I have read some of Dr. perlmutter’s critics arguments. I have not read any that have convincing scientific merit. It’s sad how hard it is to get some individuals to accept ideas that are so absolutely logical.

  • Deb P.

    I have noticed an increase in bladder sensitivity and urgency with gluten consumption. The condition ceases when gluten is removed. I haven’t seen this subject addressed on this website (am I just not seeing it?) Anyway, I’m curious whether this could be a neurological issue, a bladder issue or a combination of the two?

    • Yvonne Forsman

      Deb, you may be onto something! I worked for 6 yrs at an airport and ate dry noodle soups b/c it was easy to bring to work, add water and microwave. I ended up with a bladder disease called Interstitial Cystitis. I am now disabled.

      • Myron

        Yvonne – strongly suggest you acquire DMSO (Dimethylsulfoxide), a liquid, combine it equally with Aloe Vera juice and drink it at least once per day, although twice would be better. 1 cc of each in a small glass of water or unsweetened apple juice. It tastes kind of awful and gives your body a peculiar smell, but it is a powerful anti-inflammatory and will heal an astonishing range of problems. I’ll bet you have other problems as well and most would also likely benefit from this routine. You could safely double or triple this dose to get faster results. I am currently using it as part of my anti-prostate cancer regime. Interstitial cystitis is the only thing it is approved for by the FDA, but it is effective for a wide range of things. Google for it.

  • David Balbi

    Dr Perlmutter, do you have an affiliate program that would allow me to promote your products and earn money?

    • David Perlmutter

      Not at this time David, but many thanks for your interest.

  • Anne Crawford

    Is it true if you have osteoporosis you definitely have celiac disease too?

    • MarcusK

      Dear Anne, I suggest you to look at a video of Dr John Bergman on YouTube with the awesome description “Learn what causes Osteoporosis, how to prevent it, and how to reverse it!!!”: https://www.youtube.com/watch?v=vjnBcNsjp8A

      Dr Bergman is like Dr Perlmutter one of my favorites.

      • Anne Crawford

        Thank you so much for introducing me to Dr. Bergman. Such informative information some I’m already doing but some I’ll be starting immediately!

  • Jean Marie Smith

    I want to thank you, Dr. Perlmutter, for I believe that you have saved my life. Concerned that I was headed down the same path as my mother, who has three auto-immune issues(Peripheral Neuropathy, Rheumatoid Arthritis, Myasthenia Gravis); I embarked on a quest to discover what could be causing my peripheral neuropathy and stop it before I ended up with RA and Myasthenia Gravis. I had read your articles about gluten and the health problems associated with it and went to my doctor to discuss what I had learned. She said it would be a good idea for me to go gluten free and see if my symptoms lessoned. I was so excited to hear about your book, Grain Brain. I bought it and read it cover to cover; so much of it sounded familiar to me. My bad cholesterol was trending up, along with my weight and blood pressure. My numbness and tingling was getting worse. I made the changes to my diet that you recommended. I’ve been gluten free since August 2013. In ten months time, my blood pressure has gone back to the normal range, my bad cholesterol has dropped from 133 to 124, I’ve lost 12 pounds, and the numbness and tingling is less noticeable. I no longer have night-time carbohydrate cravings that made me feel like an addict. That’s what gluten did to me– it made me an addict and was robbing me of my health. I am so grateful to you for opening my eyes to the adverse health consequences of gluten.

    • David Perlmutter

      Thank you for sharing this Jean.

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  • Glen Fritz

    I had debilitating MS-like neurological symptoms that started as chronic fatigue syndrome/fibromyalgia. I had very litte GI difficulty. Going gluten free saved my life. The caveat is that I did not respond entirely until I also eliminated rice and corn, which have their own forms of inflammatory gluten.

    • David Perlmutter

      Good to hear you found the diet and lifestyle that worked for you Glen.

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  • Joe Texan

    I do not want to give people wrong information and I have a question. My understanding is that Vitamin D hormone is the precursor for all other hormones such as seritonin, epinephrine, etc., and that Vitamin D is produced when sunlight hits cholesterol molecules in the skin. Is that correct?

    • David Perlmutter

      Joe: I very much appreciate your contributions to this community, so I hope my answer will not offend, but that information is actually incorrect!

      • Joe Texan

        Not at all doc. I read that in a functional medicine book, but I will have to re-check my source.

  • Mary

    I was reading a report that a B12 deficiency that actually showed up on lab tests was not diagnosed in over 10 years by 3 physicians in different specialties. A DC Fixed the B12 deficiency that solved several physical problems that seemed unrelated.
    If Pharma doesn’t make it, chances are most physicians will be unaware of the real problem.

  • Sherry

    OK I believe this is true and I have thought that it is probably a problem for myself and family. Chronic stomach issues and headaches and a lot of other stuff. So how do I start to figure this all out?

  • Suze

    Since off gluten for just three weeks now, my son-in-law’s Tourette’s has improved 95% This is amazing! We are thrilled by his progress!

    • David Perlmutter

      A wonderful success story! Here’s to continued improvement.

  • Natalie

    My friend’s 13 year old daughter had glandular fever for 6 months, 3 years ago she has now been diagnosed with ME or Chronic Fatigue Syndrome and everyone is telling her it isn’t the gut. Does anyone have any information about links with the gut and these diseases please?

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