Multiple Sclerosis and Celiac Disease EP040

According to the University of Chicago Celiac Disease Center, 10% of MS patients also suffer from celiac disease. Studies conducted in Italy and Spain uncovered a significant increased prevalence of celiac disease in first-degree relatives of MS patients, 18% and 32% respectively. Additional research has identified situations in which celiac disease mimicked other neurological disorders such as MS and ALS.

With evidence like that, it is definitely worth it to further explore the relationship between MS and celiac disease. Today, the Gluten Free RN investigates whether MS and celiac disease are similar, related, or perhaps the same thing, as she shares case studies from the literature and her own experience.

Nadine discusses the story of Dr. Terry Wahls, explaining how she was able to resolve her symptoms of MS with a variation of a Paleo diet. She outlines the analogous symptoms of MS and celiac cerebellar ataxia, the neurological damage caused by gluten, and how malabsorption of nutrients caused by intestinal damage can extend to medication. Listen and learn how Nadine and others have resolved symptoms of MS and other neurological disorders on a gluten-free diet!

What's Discussed:

Nadine's MS scare

• Bouts with falling, dragging feet
• Numbness, tingling (neuropathy)
• Symptoms disappeared after adopting gluten-free diet
• Takes two to three years to resolve neurological symptoms

Dr. Terry Wahls' story

• Diagnosed with MS, confined to wheelchair
• Continued to research condition
• Adopted version of Paleo diet
• Now walks without cane, rides bike again
• Conducts seminars to share how healed mitochondria

The commonalities between celiac disease and MS

• Both autoimmune issues
• Studies necessary to determine if conditions are similar, related, or the same

How celiac disease affects the body

• Triggered by ingestion of gluten
• Causes villous atrophy, cryptic hyperplasia in small intestines, damage to immune system
• Primarily neurological disorder

The symptoms of celiac cerebellar ataxia

• Poor balance
• Hard to distinguish where body is in space
• Trip, stumble or fall
• Related to vision

The multi-organ manifestations of celiac disease in the central nervous system

• White matter lesions
• Inflammatory cerebral spinal fluid syndrome
• Sinus venous thrombosis
• Epilepsy, seizure disorders
• Cerebellar pontine atrophy
• Encephalopathy
• Myelopathy
• Dementia
• Gluten ataxia
• Migraines, headaches
• Depression, anxiety
• Cerebellar ataxia

Nadine's patient who wasn't responding to MS medication

• Nadine recommended celiac testing
• Panel negative, but gene carrier
• Already adopted gluten-free diet
• Fewer medications necessary
• Hope to decrease, discontinue meds
• Malabsorption issues extend to medications, could stem from undiagnosed celiac disease

The 2014 study in Vienna regarding celiac disease and MS

• Concluded that celiac disease may mimic MS
• Celiac disease may be present despite absence of anti-gliadin antibodies
• If patient history indicates gastrointestinal issues, celiac disease should be considered even if CSF and MRI findings suggest MS

The new evidence around seronegativity in celiac disease

• Most labs only test for tissue transglutaminase 2
• Transglutaminase 6 is specific for neurological damage caused by gluten

The 2014 Italian study of the genetic overlap between celiac disease and MS

• Sites significant increased prevalence of celiac disease in MS first-degree relatives (18%)
• Recommends celiac testing in MS patients who aren't responding to MS treatment or present with ataxia

The association between MS and celiac disease as reported by the University of Chicago Celiac Disease Center

• Approximately 10% of those who have MS also have celiac disease

The genes that indicate a predisposition to celiac disease

• HLA-DQ2
• HLA-DQ8

The 2013 Iranian case study of a celiac patient diagnosed with MS

• 37-year-old woman with history of chronic abdominal pain
• Diagnosed with celiac disease, adopted gluten-free diet
• Became ataxic, met with neurologist
• MRI indicated multiple sclerosis
• Nadine argues that patient likely re-exposed to gluten

How gluten acts as a neurotoxin

• Pastor exposed to gluten in cookies had acute neurological event
• Shaking, tremors (similar to stroke)

The 2007 Oxford case study of celiac disease mimicking ALS

• 44-year-old man with progressive right-sided spastic hemiparesis (muscle wasting)
• Remote family history of celiac disease
• Strict gluten-free diet resolved most symptoms

Why patients with neurological symptoms should be tested for celiac disease

• The anti-gliadin antibody is excellent biomarker for gluten sensitivity

Why it is acceptable to adopt a gluten-free diet if your antibody test is negative for celiac disease

The Paleo diet Nadine suggests for celiac and gluten-sensitive patients

• Gluten-, dairy-free
• Whole food
• Low carb, super-good high fat

The increased prevalence of celiac disease in MS patients revealed in a 2011 study

• Increased prevalence found in eight of 72 MS patients (11.1%)
• Also in first-degree relatives (13/126 or 32%)
• Advises increased efforts aimed at early detection and dietary treatment

The fundamentals of MS

• Chronic disease of unknown etiology
• T-cell mediated antibody response
• Leads to demyelination of central nervous system
• Associated with autoimmunity (body attacking itself)
• Damage to enteric nervous system can lead to constipation

How to conduct your own research around celiac disease and neurological disorders

• Celiac researcher Dr. Marios Hadjivassiliou

How long it takes to heal on a gluten-free diet

• Villous atrophy heals in six months to one year
• Neurological damage takes two to four years

The nutrients a celiac patient is missing that contribute to neurological issues

• B vitamins
• Trace amounts of copper
• Magnesium
• Zinc

The autoimmune symptoms Nadine resolved/reversed with a gluten-free diet

• MS symptoms
• Graves' disease
• Positive ANA panel

Why it's important for celiac patients to work with educated practitioners who understand functional medicine

Resources:

Dr. Terry Wahls' TED Talk

The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principle by Terry Wahls MD

"Celiac Disease with Cerebral and Peripheral Nerve Involvement Mimicking Multiple Sclerosis" in the Journal of Medicine and Life

"Celiac Disease in Multiple Sclerosis: A Controversial Issue" in the International Journal of Neurology and Neurotherapy

University of Chicago Celiac Disease Center MS Info

"Multiple Sclerosis or Neurological Manifestations of Celiac Disease" in Advanced Biomedical Research

"A Case of Celiac Disease Mimicking Amyotrophic Lateral Sclerosis" in Nature Clinical Practice Neurology

"Prevalence of Celiac Disease in Multiple Sclerosis" in BMC Neurology

"A Case of Concurrent Multiple Sclerosis and Celiac Disease" in Govaresh

"Neurological Disorders in Adult Celiac Disease" in the Canadian Journal of Gastroenterology

"A Case of Multiple Sclerosis and Celiac Disease" in Case Reports in Neurological Medicine

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Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism