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Gluten Free Diet Should Be Considered For Everyone With Neurological And Psychiatric Symptoms

Brain dysfunction may be the only or major sign of gluten-related illness. Dr Mario Hadjivassiliou recently reported at the International Celiac Symposium that his neurology clinic was followed by more than 300 patients with gluten sensitivity presenting with various symptoms. In her clinic the most common gluten-related disorders of neurology are ataxia, a condition of balance impaired, now almost halfway. However peripheral neuropathy, myopathy, headache, and seizures are also neurological manifestations of gluten-related brain disorders.

Gluten ataxia, the most common cause of unexplained ataxia, is associated with intestinal disease in about one-third. There is usually no specific antibody in the blood diagnosis for celiac disease but high gliadin antibodies. Brain tissue examined after brain biopsy or autopsy was found to contain gliadin and / or transglutaminase deposits in the absence of antibodies in the blood.

About 60% of patients with gluten ataxia have narrowing of the cerebellum of their brain. They may also lose Purkinje brain cells that cannot be recovered. Brain MRI scans often reveal bright white spots in this area rather than the area where they occur in multiple sclerosis, a condition that may be mimicked by gluten injuries.

Gluten accounts for 34% of all unexplained sporadic axon neuropathies. Gluten-sensitive enteropathy is 10 times more common in these people. I recently treated a woman who for years has been diagnosed with such neuropathy even though she has never been tested for celiac disease. She came to me after I was diagnosed with her daughter's celiac disease. Although he does not meet the strict criteria for celiac disease, he has a key gene for celiac and has increased gliadin antibodies in his stool and blood. Increased intraepithelial lymphocytes were seen in duodenal biopsies but were insufficient to confirm celiac disease. But he does improve with a gluten free diet. Dr. Hadjivassiliou has personally confirmed to me via email that this neuropathy would be worse with continuous gluten intake but at best with a gluten-free diet although it may take several years to do so. Old symptoms cannot be completely reversed.

This makes it very important not to postpone gluten as a cause of neurological symptoms or to miss a diagnostic test or a gluten-free dietary institution. In my opinion a gluten free diet trial should be offered or considered for all neurological and psychiatric symptoms. However, I encourage anyone who considers such a diet to undergo adequate tests for celiac disease first because once a gluten free diet is started, the test may be false negative within 2-3 weeks of the diet. Although a negative test for celiac disease before limiting gluten, a gluten-free diet trial is recommended. About gluten and the brain Dr Hadjivassiliou was quoted as saying "there is a historical misconception that gluten sensitivity is purely a bowel disease ... in order to recognize the neurological effects, you have to appreciate that it is a systemic disorder." This is my personal and professional experience as a gastroenterologist who is a Food Allergy Specialist - Food Documents and cervical cancer specialist who is always associated with people around the world as a Food Doc.


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