The Gluten Conundrum: Does It Cause Nerve Damage Or Not?

Today's post from verywellhealth.com (see link below) discusses one of the most controversial and at the same time, vague, potential causes of neuropathy and that is gluten intolerance. I get more mails concerning gluten than almost anything else on the blog and that is because even the experts can't seem to make up their minds if it can cause nerve damage or not. This article fills in a few of the gaps and more importantly, acknowledges that this is not an exact science. The jury is still pretty much out. So neuropathy patients have to become their own guinea pigs and do the research and test themselves by reducing gluten in their diet to see if this applies to them as individuals. Of course, gluten intolerance (Celiac disease) is a proven condition but tying that to nerve damage remains to be proved conclusively. If you're worried, or are thinking about taking the difficult road (cutting gluten out of your diet) then this article may be useful to you but in all honesty, you need to do your own research, as well as discussing it with your doctor (or qualified nutritionist/ neurologist...preferably all three!) Gluten free products are to be found in every supermarket these days, so you can try modifying your diet to see if that helps your neuropathy symptoms but as with so many things surrounding neuropathy...there are no guarantees.

 

What Is the Connection of Gluten and Neuropathy?
 By Jane Anderson | Reviewed by Emmy Ludwig, MD
Updated April 30, 2018


Celiac disease or gluten sensitivity may cause nerve damage  

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Did you ever let your foot fall asleep and suffer first from numbness and then from a tingling, pins-and-needles sensation while it "awakened"? People with peripheral neuropathy suffer from those types of sensations — numbness and painful tingling — all the time. And there's growing evidence that peripheral neuropathy is linked with celiac disease and gluten sensitivity.


About 10% of people newly diagnosed with celiac disease suffer from an associated neurological condition, usually peripheral neuropathy (which is quite common) or gluten ataxia (which is rarer), studies show.

Meanwhile, non-celiac gluten sensitivity is a newly-recognized condition that's not universally accepted, and there haven't been any studies looking at peripheral neuropathy as a medical condition that's associated with it. However, physicians who are performing research on this topic say tingling and numbness in the extremities represents one of the most common gluten sensitivity symptoms.

Peripheral Neuropathy Involves Nerve Damage

The tingling, numbness, and pain of peripheral neuropathy generally stem from nerve damage in your hands and feet. The nerve damage — and the symptoms — generally start in your longest nerves, which is why you'll probably notice symptoms first in your feet and possibly your hands.

The weird sensations (sometimes your feet or hands can feel cold, or hot, or like someone's jabbing them with a sharp instrument) usually start at the farthest point and work inward, up your legs and your arms. You can have just one nerve affected or multiple nerves.

Diabetes is the number one cause of peripheral neuropathy since up to half of all diabetics will experience nerve damage.


However, autoimmune conditions (celiac disease is autoimmune in nature) also have been linked with peripheral neuropathy.

Peripheral Neuropathy Gluten-Related in Some Cases

In some cases, peripheral neuropathy does seem to be related to gluten consumption — specifically, to the anti-gluten antibodies some people produce in response to gluten consumption.

In one study, researchers screened 215 patients with axonal neuropathy, a form of peripheral neuropathy involving damage to your axons, or bunches of nerves. A total of 140 of these had "idiopathic neuropathy," meaning there was no apparent medical reason for their peripheral neuropathy.

The researchers tested those 140 people for antibodies to gluten using two celiac disease blood tests, the AGA-IgA test, and the AGA-IgG test. Although these tests are not thought to be very specific to celiac disease, they can detect if your body views gluten as an invader and is generating antibodies against the protein.

Thirty-four percent of those tested — 47 people — had high antibodies to gluten in one or both of those tests, compared with a 12% rate of high antibodies to gluten in the overall population. Those test results could indicate that the people had gluten sensitivity since some experts are recommending the AGA-IgA and the AGA-IgG as gluten sensitivity tests.


The researchers also performed endoscopies and biopsies on those people in the study suspected to have celiac disease and found that 9% of those in the "unexplained neuropathy" group actually had celiac. The celiac disease genes — i.e., HLA-DQ2 and HLA-DQ8 — were found in 80% of all peripheral neuropathy patients.

Peripheral Neuropathy Key Symptom of Celiac and Gluten Sensitivity

Peripheral neuropathy actually is one of the most common non-digestive symptoms of celiac disease, according to the University of Chicago Celiac Disease Center. In fact, it's possible to have no noticeable gastrointestinal symptoms of celiac disease, but instead to have mainly peripheral neuropathy and other neurological symptoms.

Neurological symptoms such as peripheral neuropathy, migraine, and brain fog are even more common in non-celiac gluten sensitivity, according to Harvard Medical School's Dr. Alessio Fasano, one of the lead researchers in the field of gluten sensitivity. Dr. Fasano says up to 30% of people he's diagnosed with gluten sensitivity have neurological symptoms ... a much larger percentage than people with neurological symptoms in celiac disease.

If you have peripheral neuropathy and you're diagnosed with celiac or gluten sensitivity, you may be able to improve or even resolve your symptoms by following the gluten-free diet — some studies have found the diet helps. However, other studies have found that "neurologic manifestations," including peripheral neuropathy, may continue or even develop after diagnosis, indicating that there may be a related inflammatory process involved.

The University of Chicago recommends that people with peripheral neuropathy induced by celiac disease make sure to consult with their physicians about discontinuing drugs that might cause peripheral neuropathy. The practitioners there also recommend that celiacs with peripheral neuropathy make lifestyle changes to reduce their pain, including avoiding long periods of standing or walking, wearing loose shoes (in some cases, insurance might cover special therapeutic shoes), and soaking their feet in ice water to ease pain and tingling.

Physicians also may be able to prescribe medication that can ease some of the discomforts of peripheral neuropathy, especially if it doesn't seem to respond to the gluten-free diet. Meanwhile, people with peripheral neuropathy, whether or not it appears to be related to celiac disease or gluten sensitivity, should make sure to be extra careful when they walk or move around since the lack of sensation in their feet could lead to a risk of falls.

Sources:

Chin R. et al. Peripheral Neuropathy and Celiac Disease. Current Treatment Options in Neurology. 2005 Jan;7(1):43-48.

Hadjivassiliou M. et al. Neuropathy Associated With Gluten Sensitivity. Journal of Neurology, Neurosurgery, and Psychiatry. 2006 Nov;77(11):1262-6. Epub 2006 Jul 11.

Rigamonti A. et al. Celiac Disease Presenting With Motor Neuropathy: Effect of Gluten-Free Diet. Muscle & Nerve. 2007 May;35(5):675-7.

University of Chicago Center for Peripheral Neuropathy. Types of Peripheral Neuropathy - Inflammatory - Celiac Disease.

Zelnik N. et al. Range of Neurologic Disorders in Patients With Celiac Disease. Pediatrics. 2004 Jun;113(6):1672-6.

https://www.verywellhealth.com/gluten-and-neuropathy-562315