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Celiac, Non-Celiac Gluten Sensitivity & Mental Health

A 2015 case report outlined the clinical course of a 14-year old girl who began to have complex hallucinations, including seeing people coming off of the screen to scare her, and gastrointestinal distress. She was tested for both celiac disease and wheat allergy, markers for both of which were negative.

Researchers completed a double-blind challenge test with alternating wheat and rice flour pills with a seven day wash out in-between. Upon intake of wheat flour, she experienced headache, halitosis, abdominal distension, mood disorders, fatigue, and poor concentration, and three episodes of severe hallucinations. While the young girl received the capsules with rice flour, she experienced no symptoms. (source)

This case study is an example of how significantly food sensitivities or intolerances can impact mental health and wellbeing.

What is GLUTEN? Gluten is a mixture of gliadins and glutenins, complex proteins that are not completely digestible by intestinal enzymes. In some people, these partially digested proteins can trigger immune responses. Gluten proteins are found in wheat, barley, rye & other ancient grains including freekeh, emmer and spelt (source).

Celiac Disease is well-established as a disease state which involves an auto-immune response to gluten. Celiac disease can present with symptoms of intestinal damage, malabsorption, brittle bones, bloating, nausea, weight loss, infertility, diarrhea, ataxia, and fatigue. ‘Non-celiac gluten sensitivity’ (NCGS) has become recognized as it’s own entity aside separate from Celiac disease, but with some symptom overlap.

Wheat is the most significant source of gluten proteins in the American Diet

What are some of the symptoms of ‘Non-Celiac Gluten Sensitivity’?

Bloating

Constipation

Diarrhea

Flatulence

Anxiety

Ataxia

Depression

Rash

Fatigue

Irritability

Peripheral Neuropathy

Connecting Non-Celiac Gluten Sensitivity & Mental Health

Did you notice ‘depression’ and ‘anxiety’ in that list?

One of the impacts of non-celiac gluten sensitivity is on mood and emotional wellbeing! Pretty wild, right?

As I’ve grown my private practice and provided community talks about anxiety, food & mood, I’ve started to uncover papers like this:

Celiac and non-celiac gluten sensitivity: a review on the association with schizophrenia and mood disorders
Neurologic and Psychiatric Manifestations of Celiac Disease and Gluten Sensitivity
Fibromyalgia and non-celiac gluten sensitivity: a description with remission of fibromyalgia

In fact, a growing body of evidence suggests that mood symptoms are associated with a spectrum of gluten-related disorders (source).

So much so, in fact, that three main diseases have been described in the spectrum of gluten-related neurologic manifestations: gluten ataxia, gluten neuropathy and gluten encephalopathy (source).

  • Gluten ataxia: Gluten ataxia has the strongest relationship with gluten-related disorders, demonstrating impaired coordination (gait/limb ataxia) and limb. It is thought that one of the phenomena that may cause the ataxia is necrosis of Purkinje cells, which regulate and coordinate motor movement (source; source).
  • Gluten neuropathy is a form of peripheral neuronal damage (source)
  • Gluten encephalopathy is a central nervous system disease-the most common symptom is migraine (source)
  • A variety of studies have explored the link between ingestion of gluten-containing food and the onset of neurologic and psychiatric disorders or symptoms such as peripheral neuropathy, schizophrenia, autism, depression, anxiety, and hallucinations (source).

How Does Food Impact Mood?

Interestingly, one of the ways that diet can influence mood is through inflammatory pathways. Inflammatory mediators & biomarkers including inflammatory cytokines and acute-phase proteins are elevated in a significant proportion of patients with major depressive disorder (MDD), bipolar disorder, anxiety disorders and post-traumatic stress disorder (PTSD).

Inflammation can impact parts of the brain including basal ganglia and cortical reward circuits as well as anxiety-related brain regions including amygdala, insula and anterior cingulate cortex, which may result from cytokine effects on monoamines and glutamate (source)

In susceptible individuals, the immune reactions to many foods including wheat and gluten seem to be sufficient to impact neurological and mental health in significant ways.

If you’re wondering if food could be influencing your symptoms, don’t go it alone! Partner with an Integrative Registered Dietitian who can help you to remove, replace & adjust variables in your diet to get you feeling better.

Do you want to learn more about non-celiac gluten sensitivity? Check out the ‘gluten-free living’ section of my ‘learn’ page.

Interested in hearing more about how my approach can help?

About Sarah Ferreira

Sarah Ferreira,MS,MPH,RD,CDN,CNSC,IFNCP,CHWC is a Registered Dietitian Nutritionist with complementary certification as an Integrative and Functional Nutrition Certified Practitioner and Certified Health and Wellness Coach. She is the owner of Mindfully Nourished Solutions, where she uses a whole-person, whole-food approach to explore the impact of nutrition on mood and cognition. Her individualized approach integrates an assessment of nutritional, genetic, environmental, and lifestyle factors into a collaborative nutrition care plan using cutting-edge research designed to facilitate meaningful and restorative changes based around client goals and priorities.

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