Gluten intolerance and celiac disease are caused by a permanent intolerance to gluten, and are associated with many autoimmune disorders including rheumatoid arthritis and lupus. Numerous research studies have also demonstrated an association between celiac disease and various cognitive and psychiatric disorders, including schizophrenia.
One study investigated whether gluten intake is a risk factor in causing cerebral impairment in a group of patients with celiac disease.1 Cerebral function, of course, is responsible for all conscious mental activity, including thinking, speaking, purposeful movement, and remembering and reasoning.
The patients’ brains were imaged using single-photon emission computed tomography (SPECT). SPECT imaging allows researchers and laboratories to investigate brain metabolism, based on assessing the amount of blood flow to specific regions.
Seventy-one percent (24 of 34) patients with celiac disease) showed abnormal cerebral perfusion. The more significant deficiencies were localized in the frontal cortex. Importantly, more significant abnormalities were found in patients on an unrestricted diet, compared to those on a gluten-free diet.
The study’s authors concluded that, at least in the frontal cortex, brain function abnormalities may be improved by a gluten-free diet.
In another study investigating the relationship between cognitive impairment and celiac disease2, the authors identified a trend of frontal-subcortical impairment. A small sample of 13 patients were evaluated - these patients all had progressive cognitive decline which began within two years of symptomatic onset or severe symptomatic exacerbation of celiac disease.
The most common neurologic/psychiatric findings were personality changes, loss of memory, and confusion.
Gluten withdrawal enabled three of 13 patients to improve or stabilize cognitively. The authors stress the importance of treatment - specifically, gluten withdrawal - given the possible association between celiac disease and progressive cognitive impairment.
In a remarkable case study3, physicians used SPECT to demonstrate reduced circulation to the left frontal region of the brain in a 33-year-old patient with schizophrenia. The patient had presented with symptoms suggestive of celiac disease, and intestinal biopsy confirmed typical findings. The patient was started on a gluten-free diet, which resulted in a normalization of the SPECT findings and a disappearance of psychiatric symptoms.
The authors stress this was the first case (1997) of SPECT-documented cortical abnormalities disappearing following a gluten-free diet.
For individuals with celiac disease, a recent review article4 stresses the importance of continuing on a gluten-free diet for life. Part of the challenge of maintaining such a food plan is ensuring sufficient nutrition and sufficient intake of all necessary vitamins and minerals. The review affirms that a gluten-free diet is a complex undertaking and patients need comprehensive education in balanced nutrition.
Many excellent web sites offer recipes for gluten-free foods. One of the best is elana’s pantry – a wonderful resource providing delicious easy-to-prepare recipes and a wealth of related information supporting the gluten-free life.
1Usai P, et al: Frontal cortical perfusion abnormalities related to gluten intake and associated autoimmune disease in adult celiac disease. Dig Liver Dis 36(8):513-518, 2004
2Hu WT, et al: Cognitive impairment and celiac disease. Arch Neurol 63(10):1440-1446, 2006
3De Santis A, et al: Schizophrenic symptoms and SPECT abnormalities in a celiac patient. Regression after a gluten-free diet. J Intern Med 242(5):421-423, 1997
4Niewinski MM: Advances in celiac disease and gluten-free diet. J Am Diet Assoc 104(4):661-672, 2008
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Thanks for the informative article. Celiac Disease is still a relatively unknown condition, and in my case as well as in most cases, diagnosis does not come until adulthood after years of suffering. There needs to be better education in the medical community in order to have children diagnosed properly. This would have saved so much pain! Plus, the lifestyle change is enormous. It is comparable to being diabetic. A gluten free diet is not easy to adhere to. I found this book helpful: glutenfreeenterprises.com as it has recipes and also mentions restaurants with gluten free menu items. If celiac disease was better known, perhaps more places would cater to a gluten free diet.
My son has been suffering from auditory/visual hallucinations for as far back as he can remember. At age 12 he was diagnosed with schizoaffective disorder. He was seen by numerous family practice doctors, neurologists and psychiatrists, to no avail. Now, at age 18, thanks to a dedicated and knowledgeable doctor, he was recently tested for Celiac disease. Testing showed that he carries a double gene for Celiac and the initial allergy testing shows that he is highly allergic to gluten, dairy, egg and corn. After starting his gluten free diet his visual hallucinations have decreased by half and the auditory hallucinations have quieted a bit also. We hope that with a more complete allergy panel workup and the additional time necessary for his stomach to heal, that the hallucinations will disappear completely, or at least subside enough so that he will be able to lead a somewhat normal life. It continues to be shown that Celiac disease can be the underlying cause for symptoms of mental illness. How many more children like mine will be misdiagnosed and suffer needlessly for years due to close minded or misinformed doctors? Studies like these are much needed in the mental health fields. Rather than medications to mask the symptoms, let’s test for the underlying cause and save the suffering of so many.
At the end of this article, the author states that taking on a gluten-free diet can be quite an undertaking. I wanted to point out that it is only a challenge to those people that are uneducated on alternative sources of grains. It is actually easier to get the vitamins and minerals you need when you are on a gluten free diet because you can absorb better due to your gut not being as inflamed as it was when consuming gluten. There are are numerous sources of alternative grains to be utilized. The problem is that the wheat industry has had the power, leading the pubic to not have any idea of other sources of grains. USA should be growing many different types of grains anyway.