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Category: Science


Consider Gluten Sensitivity in Children with Psychosis

Hardly a day goes by without someone telling me a story about a miraculous improvement in some form of medical condition when a person decided to eliminate gluten from his or her diet. No doubt, most would find it fairly easy to accept the notion that some people may have improvement from, for example, gastrointestinal issue by going gluten-free. To be sure, it’s pretty well accepted these days that some people with chronic headaches may improve on a gluten-free diet as well.

But the idea that a psychiatric issue might be related to gluten sensitivity seems a little bit more difficult for people to generally accept. Nonetheless, we are seeing ever more frequent citations in well-respected medical journals that clearly make this connection.

In a recent report, published in the journal Nutrients, Italian researchers described the case of a 14-year-old girl who was evaluated because of psychotic episodes. Her medical history was in fact quite unremarkable. At age 12 she developed an illness characterized by a fever with irritability, headache, and difficulties with concentration. Over the next month the symptoms worsened and she began having sleep difficulties as well as changes in her behavior. Her school performance deteriorated. Ultimately, she began having aggressive hallucinations.

Her medical evaluation was extensive and included a wide panel of blood tests, a magnetic resonance scan of the brain, and an EEG.

She began experiencing severe abdominal pain that corresponded with her confusion, as well as paranoid thinking. She then began experiencing significant weight loss, and at that point a dietitian recommended a gluten-free diet. Almost immediately, all of her symptoms abated.

As you will note in the report, her physicians wanted to confirm that her issues were related to gluten sensitivity. They devised a way to reintroduce gluten into her diet in a double-blinded way, meaning that neither she nor the physicians knew when she was consuming gluten or not. This evaluation clearly confirmed that her symptomatology was absolutely related to sensitivity to gluten.

She subsequently was taken off of all gluten and all of her symptoms basically vanished. This allowed the physicians to discontinue antipsychotic medication that she had been prescribed. Her mild iron abnormality, as demonstrated by her blood test, normalized thereafter as well.

The authors concluded their study by indicating that determining the cause of psychosis in a child is very challenging and that we as clinicians should consider non-celiac gluten sensitivity as a possible cause moving forward. To be clear, this is not to say that gluten sensitivity is the cause of all psychiatric issues in children, but to completely ignore it as a possibility may deprive the child of a simple intervention that could virtually cure a devastating psychiatric situation.

  • Greg

    Dr. Perlmutter mentioned in his book Brain Maker a website/place that he recommends to have certain tests done – blood tests or other. I do not have access to that audiobook anymore. Does anyone know or remember what that reference was? Thank you for any help.

  • jaylala

    This article rings so true to my son, he was diagnosed with Failure to Thrive in 1998. We hand fed him until he was 6 1/2. He had serious allergies to things, brain fog, extreme shyness, cried very easily like his mom. At age 15 he started to experience phobias, anger without cause, things were happening in his head. We started working on helping him with his thinking, that helped a little. Then we decided to test him for celiac. As well as testing me, his mom. Our test were very revealing! I have a celiac gene and as the world describes, a Gluten sensitive gene and severe damage to the intestines. He has a two (different from each other), Gluten sensitive genes and serious damage to the intestines. Dr. Fine’s Enterolab, defined his combination as more serious then Celiac. We believe it to be so. As soon as we took him off Modern Wheat Gluten ( all gluten) the mind issues just vanished! There is bi-polar on my dad’s side and i carry a gene, I believe to be connected. I do not have Bipolar but now realize that I have been undiagnosed Celiac since starting school when our diet changed to sandwiches everyday. I pray for all the children with this difficulty and pray that these issues will be addressed and understood better before they are adults like my sister who has bi-polar and thinks she is fine.

  • Thank you Dr. Perlmutter for writing about this – what amazing results! It’s so unfortunate that medications are always the first approach when dietary changes like gluten removal can have such a profound impact. I see it in my practice on a daily basis and it’s truly wonderful.

    Hats off to the dietitian! Now we just need more practitioners in the mental health field to be open to this. And for those with anxiety and depression to know it is possible. Too often I hear “my anxiety (or depression) is too severe, there is no way food (or a nutrient) could possibly make a difference.”

  • Helen Elliott

    It is great that the role of gluten sensitivity in mental health is getting wider recognition because it has to be worth exploring rather than the expense and side effects of a life-time of medication. I work in adult mental health and welcome anything that encourages people to consider this and give it a try.

    • David Perlmutter

      I agree Helen. Could be the solution some are looking for.

  • Diane

    My 10-year-old grandson has been diagnosed with PANDAS. Dr. Perlmutter, could you advise me as to which probiotics would be more likely to help this particular disorder?

  • Hallie TAIT

    After suffering from depression and panic attacks for many years along with hashimoto’s disease (more recently diagnosed), I tried going gluten free. The withdrawal for me was quite intense with severe fatigue for 5 weeks then one morning I woke up and felt like a huge black cloud had been taken out of my head. My depression was completely gone and while I am still prone to very mild anxiety, I havent experienced a full blown panic attack since. Giving up gluten has been the single most important step in my recovery from both mental illness and thryoid disease. I can’t emphasise enough how great the change has been. I totally agree with Helen that diet changes totally need to be explored before potentially dangerous medications are given out willy nilly.

    • Helen Elliott

      Well done it’s great that you persevered with going gluten free during the withdrawal period and are now reaping the rewards. This deserves to be widely shared to encourage others that it has to be worth at least giving it a try before going down the medication route with all the costs (financial, physical and mental) both to the person taking them and our health systems around the world.

  • Stephanie Artist Hass

    My son was hospitalized for an anaphylactic reaction to a viral infection. A few months after his hospitalization, he developed another mild cold and then very suddenly his mental health began to deteriorate. He experienced insomnia, auditory and visual hallucinations, dilated pupils, aggression, confusion as well as developed neurological symptoms such as stereopathies and poor motor/gate function. He had thorough work ups performed by three reputable neurologists. All tests were negative. We were then referred to psychology where we were offered anti psychotic medication. Before we could embark on that path I decided we would try eliminating gluten and dairy from his diet. Within two weeks we noticed a change. Within four months he no longer experienced insomnia. His only lingering symptom was stereopathy. I decided to give him a high dose of B12. After six months on the diet elimination and three days on the b vitamin supplement all of his symptoms have abated. Symptoms will return upon digestion of even a small amount of gluten and persist for up to three days. Our neurologist who we saw at the Mayo Clinic said that there is not enough science out there to understand the mechanisms behind it nor do they know what biomarkers to look for to identify who may benefit from a gluten free diet.

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