Today's post from celiac.org (see link below) looks again at the link between gluten intolerance (celiac disease) and nerve damage. It may help you decide to modify your diet somewhat but remember the jury is still, to some extent, out regarding this question. You need to remember also that a gluten free diet will not prevent neuropathy coming in the first place but is likely to make the symptoms easier to bear and that's an important factor when making any lifestyle choice decisions. After reading this you may find other articles on the subject (use the search button to the right of the blog) useful as a follow up.
Neuropathy Linked to Celiac DiseaseJune 1, 2015
A member of CDF’s Medical Advisory Board, Peter Green, MD, recently studied the relationship between celiac disease (CD) and neuropathy, along with the expert knowledge of doctors Thawani, Brannagan, Lebwohl, and Ludviggson. Neuropathy is a condition that weakens nerve cells and inhibits normal nerve function. Our nerves are used for communicating with the brain and sending messages or signals throughout the body.1 Neuropathy can affect different nerve types and is associated with several autoimmune diseases, including celiac disease.
According to the study performed between October 2006 and February 2008, celiac disease and neuropathy were mutually associated. This study followed 28,232 patients after a biopsy-verified celiac disease diagnosis. Validation of their CD diagnosis was confirmed with three tissue samples demonstrating villous atrophy (Marsh 3), which indicates damaged villi in the small intestine, and is indicative of celiac disease.2 Patients did not show neuropathic symptoms at the time of diagnosis.
Hazard ratios (HRs) – a measurement of an event occurring in an experimental case versus a controlled case – of neuropathy were identified and measured with statistical analysis in order to clearly identify the increased risk of neuropathy in CD patients.3 Separate studies were also done to look at other factors that increase a CD patient’s risk of neuropathy. For example, odds ratios (OR) of patients with neuropathy prior to their CD diagnosis were accounted for in order to determine the likelihood of developing celiac disease.4
Neuropathy and its Risk Factors
During the study, several factors that increase the risk of neuropathy were identified and categorized in order to obtain an accurate study of neuropathy after CD diagnosis. These factors include type 1 diabetes mellitus, autoimmune thyroid disease, rheumatic disorders, vitamin deficiency, pernicious anemia, and excessive alcohol consumption.5
Disorders like type 1 diabetes, autoimmune thyroid disease, rheumatoid arthritis, systemic lupus erythematosus, and Sjögren’s syndrome are linked to both neuropathy and CD.5 During the study, results were adjusted around these disorders to analyze the risk factor of neuropathy in CD patients minus the influence from such disorders.
Neuropathy is Most Common in Female CD Patients
After following patients for an average of 10 years following a CD diagnosis, the majority of patients who suffered from later neuropathy were, on average, 29 year old females. However, gender and age at CD diagnosis does not make a person more prone to neuropathy. Factors that increase the likelihood of neuropathy, such as type 1 diabetes and vitamin deficiency, did not play a significant role when estimating the risk of neuropathy after CD diagnosis. Researchers found that neuropathy is most prominent five years after diagnosis. The top three types of neuropathy that were seen in CD patients include: chronic inflammatory demyelinating neuropathy, autonomic neuropathy, and mononeuritis multiplex. On the other hand, acute inflammatory demyelinating neuropathy was not noted in any patients.2
Ask Your Physician Today
Neuropathy diagnosis most commonly occurs after CD diagnosis because physicians are aware of the strong correlation. A gluten-free diet does not prevent neuropathy from developing, but slows down the progression of neuropathic symptoms. The association between both conditions may be due to nutrient deficiencies, like a lack of vitamin B12. However, this has not been proven, as several studies have identified CD patients with later neuropathy that do not have vitamin deficiency. For this reason, it is recommended that future research use electrophysiological studies to learn more about the relationship between CD and neuropathy. Electrophysiological analysis helps physicians identify different types of neuropathies by distinguishing and identifying specific fiber patterns.6
Resources
1 Vinik, A. (2002). Neuropathy: New Concepts in Evaluation and Treatment. Southern Medical Journal, 95(1), 21-23.
2 Lebwohl, B., Murray, J., Rubio-Tapia, A., Green, P., & Ludvigsson, J. (2014). Predictors of Persistent Villous Atrophy in Coeliac Disease. Alimentary Pharmacology & Therapeutics, 39(5), 488-495.
3 Spruance, S. L., Reid, J. E., Grace, M., & Samore, M. (2004). Hazard Ratio in Clinical Trials. Antimicrobial Agents and Chemotherapy, 48(8), 2787–2792. doi:10.1128/AAC.48.8.2787-2792.2004
4 Szumilas, M. (2010). Explaining Odds Ratios. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 19(3), 227–229.
5 Thawani, S., Brannagan, T., Lebwohl, B., Green, P., & Ludvigsson, J. (2015). Risk of Neuropathy Among 28,232 Patients With Biopsy-Verified Celiac Disease. doi:10.1001/jamaneurol.2015.0475
6 Krarup, C. (2003). An update on electrophysiological studies in neuropathy. Current Opinion in Neurology, 16(5), 603-612.
https://celiac.org/blog/2015/06/01/neuropathy-linked-to-celiac-disease/
Today's short post from time.com (see link below), with links to expand your reading, centres on a new Swedish study that shows more evidence of the link between celiac disease and neuropathy. Basically, celiac disease is gluten intolerance and as you probably know, gluten intolerance is one of those buzz-word deficiencies that dominates health forums on the internet at the moment. There has long been an assumed link between celiac and neuropathy but it has been difficult to prove and many doctors dismiss it as patient-driven sickness association (mention one and popular opinion assumes the other). One thing is sure, many people with nerve damage who cut gluten out of their diet, see an improvement in their neuropathy symptoms. That said, taking on a gluten-free diet is no mean feat and for many people proves both 'boring' and difficult to maintain. You need to do your own research, try things out and make your own mind up. A first step would be getting screened for celiac disease but you may need to convince your doctor that that is a reasonable option.
Mandy Oaklander @mandyoaklander May 12, 2015
A new study on every celiac in Sweden
Celiac disease, an autoimmune disorder that causes intestinal damage when a person eats gluten, is still something of a medical mystery. But a new Swedish study adds another piece to the puzzle.
People with celiac disease have a 2.5-fold increased risk of developing neuropathy, or nerve damage, found a new study published in JAMA Neurology. In the new nationwide study, pediatrician Dr. Jonas F. Ludvigsson, professor of clinical epidemiology at Karolinska Institutet in Sweden, and his team wanted to look at the risk of developing neuropathy in a sample of people diagnosed with celiac disease. They gathered data from every person diagnosed with celiac disease in Sweden between 1969 and 2008—28,232 celiac sufferers in all. Each of them had been tested with a small-intestine biopsy.
(Most of them, interestingly, were women. About 60% of people with celiac disease are women; more females than males are diagnosed with autoimmune disorders, Ludvigsson says, for a reason researchers haven’t yet determined.)
For every celiac patient, Ludvigsson also found five people identical in age, sex, birth year and place of residence in Sweden as controls. He followed them for an average of 10 years to see who developed a diagnosis of neuropathy.
MORE: You Asked: Do I Have a Gluten Allergy?
The researchers found that having celiac disease was associated with a significant increased risk of developing nerve damage later. “It’s quite a high figure, compared to many other outcomes in celiac disease,” Ludvigsson says. Having a diagnosis is automatically a risk factor for getting a diagnosis for any other disease, he explains, since going to the doctor for one thing boosts the chances the doctor will find something else—a phenomenon known as surveillance bias. But the increase here is too high to merely be due to bias, he says. “There is a real association between celiac disease and neuropathy…we have precise risk estimates in a way we haven’t had before.”
Previous work has shown that in the U.S., 39% of people with celiac disease also had symptoms of neuropathy. About 1% of the population has celiac disease, and that number is similar in Sweden and the U.K.
“I think this paper could actually change clinical practice somewhat,” Ludvigsson says. When a neurologist diagnoses a patient with neuropathy but finds no obvious cause, he might consider screening that patient for celiac disease, Ludvigsson says. “Some of these patients will be diagnosed with celiac disease, will have a gluten-free diet and will actually feel better and be healthier.”
http://time.com/3854589/celiac-gluten-neuropathy/
Today's post from prevention.com (see link below) is another article looking at gluten free diets and what this exactly entails. The American FDA has done us a favour by stepping in to regulate the gluten 'industry' so that the term 'gluten free' genuinely means what it says. This of course doesn't mean that all countries are as well-regulated but it's a guide and when the FDA decides to act, the rest of the world generally follows soon after. That said, the hype that gluten-free is beneficial for the nervous system and neuropathy problems is exactly that - hype and nothing has been proved. There is no doubt however, that many people claim to have benefited from changing to gluten-free. It's not easy and can lead to a 'boring' diet but it may be worth doing the research and consulting your doctor to see if it's an option for you.
What The FDA's New "Gluten-Free" Label Really Means By Robin Hilmantel for Women's Health Published August 2014,
If you've been buying foods labeled "gluten-free," we have some good news and some bad news for you. The bad news: Nothing you've bought up until this point has had to adhere to a uniform standard of what it actually means to be "gluten-free." The good news? As of August 2, there's finally a definition to go along with the label.
MORE: Are Gluten-Free Diets Healthy?
Late last week, the FDA published a new regulation defining the term. To be considered "gluten-free," a product now must contain less than 20 parts per million of gluten. Products bearing the labels "free of gluten," "no gluten," and "without gluten" are also now required to meet this standard.
“Adherence to a gluten-free diet is the key to treating celiac disease, which can be very disruptive to everyday life,” FDA Commissioner Margaret A. Hamburg, M.D., said in a press release. “The FDA’s new ‘gluten-free’ definition will help people with this condition make food choices with confidence and allow them to better manage their health.”
MORE: Gluten-Free Foods That Make You Gain Weight
One word of warning: Food manufacturers have until August 2, 2015, to bring their products into compliance with this new criteria. Granted, some products on the market may already meet this standard (and items that have less than 20 parts per million of gluten aren't required to be listed as "gluten-free;" it's a voluntary label).
Even after companies are required to comply with the new ruling, they can still use the terms "made with no gluten-containing ingredients" or "not made with gluten-containing ingredients" on products that don't fit the definition of "gluten-free" (provided these other labels are true). The bottom line? Even with the new regulation, it's still a good idea to reach out to the company or restaurant making a food if you have any questions about how much gluten it might contain.
http://www.prevention.com/food/healthy-eating-tips/fda-changes-gluten-free-labeling
Today's post from techtimes.com (see link below) is the latest article linking gluten intolerance (celiac disease) to neuropathy. You may have read various articles from various sources, recommending reducing gluten in your diet if you have neuropathic problems. Quite often, dramatic results can be achieved when people exclude gluten from their food intake. However, it's by no means a universal truth and certainly not a scientific fact...yet. So what should you do? It's probably best to do as much research as possible via reliable sites on the question and discuss it carefully with your doctor (although most doctors aren't sure either). A gluten-free diet seems to have several benefits but is extremely difficult (and often boring!) to implement.
By James Maynard, Tech Times | May 12, 8:27 AM
Gluten Intolerance could be tied to nerve damage. Should you be worried?
Celiac disease appears to be linked to nerve damage known as neuropathy.
Researchers examined medical records of over 28,000 patients with celiac disease as well as 139,000 people who were never diagnosed with the disorder. They found that those patients with the condition were 2.5 times as likely as the control group to suffer from nerve damage.
Celiac disease, also known as gluten intolerance, is a digestive disorder that causes pain and discomfort to sufferers when they consume the protein composite. This autoimmune response can reduce the efficiency of food absorption and can damage the linings of small intestines. Roughly 1 percent of all Americans suffers from gluten intolerance, regardless of race or gender.
The idea that the two medical conditions could be linked goes back about five decades, although this new study is the most-detailed investigation yet done of the idea.
Despite the apparent strong correlation between neuropathy and celiac disease, the total numbers of patients still remains low enough that a definite correlation between the two conditions cannot be proven. Neuropathy was seen in 0.3 percent of patients in the control group and 0.7 percent of people with celiac disease. There was no apparent difference in the possible correlation of the two conditions detected between men and women.
"We found an increased risk of neuropathy in patients with CD [celiac disease] that persists after CD diagnosis. Although absolute risks for neuropathy are low, CD is a potentially treatable condition with a young age of onset. Our findings suggest that screening could be beneficial in patients with neuropathy," researchers wrote in an article detailing their study.
According to the National Foundation for Celiac Awareness, roughly 83 percent of people suffering from CD are not diagnosed, or their health care provider believes their symptoms are attributable to other causes. Patients can often wait between six and 10 years before they are properly diagnosed with the disorder. Celiac disease can also lead to other autoimmune diseases, neurological disorders, reduced bone density and even some forms of cancer. There are no known treatments for the condition, leaving patients with little choice except to remove gluten — which gives dough its elasticity — from their diets.
Neuropathy is a medical term used for many different forms of nerve damage, although it usually refers to nerves outside the central nervous system. Such damage can be brought on from a number of causes, including infection, physical trauma or chemical influences. Many forms can be treated through therapy and drugs.
Analysis of the possible association of celiac disease with neuropathy was profiled in the journal Jama Neurology.
http://www.techtimes.com/articles/52228/20150512/celiac-disease-linked-to-nerve-disease-in-neuropathy-patients-is-gluten-to-blame.htm
