The Effects of Gluten on the Brain and Nervous System

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Most of the articles about gluten and celiac disease I’ve came across in the media have focused on symptoms related to digestion, such as abdominal pain and bloating after eating gluten, and damage to the small intestine. The bulk of the gluten-related discussions on the celiac forums I’ve perused concern questions and answers regarding the diagnosis of celiac disease and tips for following the gluten free diet. There have been several papers published over the last few years about the neurologic effects of gluten exposure for those with celiac disease and non-celiac gluten sensitivity. I do not believe that they have gotten the attention that they deserve in the media or on the forums. I am especially interested in this area as over the last few months I have developed a peripheral neuropathy (nerve damage) related to having celiac disease.

Dr. Hadjivassiliou is one of the leading researchers on neurologic problems related to gluten exposure. Although I have no idea how to pronounce his name, I can tell you that he is on faculty in the Department of Neurology at Royal Hallamshire Hospital in Sheffield, United Kingdom. My favorite paper of Dr. Hadjivassiliou’s is a review article titled, “Gluten sensitivity: from gut to brain,” which was published in the Lancet, a major medical journal, in 2010. In this paper, gluten sensitivity refers to both celiac disease and non-celiac gluten sensitivity. Some of the key points of this paper include the following:

• Most patients with neurologic symptoms related to gluten do not have gastrointestinal symptoms.

• Ataxia (a problem with balance and coordination) and peripheral neuropathy (nerve damage) are the most common neurologic symptoms related to gluten. Up to 25% of celiac patients on a gluten free diet will develop a peripheral neuropathy at some point.

• Patients with neurologic symptoms often have celiac “autoantibodies” on blood testing, usually anti-gliadin (AGA) antibodies and/or tissue transglutaminase (TTG) antibodies. Many patients with these antibodies have non-celiac gluten sensitivity, meaning that they have high celiac antibody levels and symptoms, but no evidence of villous blunting (seen in celiac disease) on small bowel biopsy.

• The average age of onset of gluten ataxia is 53 years and for the gluten-related peripheral neuropathy is 55 years.

• Brain MRI findings can include cerebellar atrophy (loss of volume) and/or white matter lesions which may mimic those seen in multiple sclerosis.

• Neurologic symptoms often improve on a strict gluten free diet but may never resolve completely.

Gluten sensitivity has also been associated with seizures, dementia, and migraines. Obviously, further research on the effects of gluten on the brain and nervous system is needed. I’ve came across many people on the celiac forums who have psychiatric symptoms related to gluten exposure as well, although this has not been well-studied.

It seems especially frightening that many people who develop neurologic problems, like me, do so when they are already on the gluten free diet. This is a reminder that even small traces of gluten can cause serious damage to those of us who are gluten sensitive. If you have any family members or friends who develop ataxia or a peripheral neuropathy of an unknown cause, I urge you to recommend an evaluation for celiac disease and non-celiac gluten sensitivity.

For further reading on the this topic I would suggest the following links:

1. “Brain Abnormalities Common in Celiac Disease Patients,” by P. Harrison, published in Medscape Neurology News on September 10, 2012.

2. Dr. Hadjivassiliou’s Lancet Neurology article, “Gluten Sensitivity: From Gut to Brain,” published in March 2010.

3. Living Without Magazine article, “Gluten Attack: Ataxia,” found in the Feb/Mar 2011 issue.

3 thoughts on “The Effects of Gluten on the Brain and Nervous System

  1. Laurie

    I was diagnosed with Celiac in 1968 and been on a Gluten Free Diet for almost 45 years. In the last few years I became aware of some tingling in my lower legs. This has intensified in the last month and has become a major problem because it’s difficult for me to sit still and sleep without discomfort. I was diagnosed with peripheral neuropathy, but the doctor could not determine cause.

    I doubted that Celiac could cause my problem because I have been so carefully gluten free for so many years, but I decided to check the internet this morning to see if there could be a connection between my Celiac and these symptoms and came across your article.

    Do you have any more information on this connection, including what I could possibly do to alleviate the symptoms? I do the obvious, but it does not help.

    1. Jess Post author

      Hi Laurie,
      I am sorry to hear about what you are going through and I am glad that you found my page. I wrote all about my experiences with a celiac-induced peripheral neuropathy in September 2013 ( At the end of the post I include some resources and references about peripheral neuropathy and celiac disease. The relationship between the two problems is being increasingly recognized and up to 60% of celiacs develop some type of neurologic complication at some point.
      In my case the neuropathy did resolve (it was the result of traces of gluten contamination in a “no gluten ingredients” spaghetti sauce that I thought was safe). It has recurred two times from gluten cross-contamination. However, based on my conversations with others with a celiac-induced neuropathy, it can take a long time to go away. Has your neurologist ruled out other problems that can cause a peripheral neuropathy, such as diabetes, lyme disease, vitamin B12 deficiency, etc.?

  2. Heather

    Thank you for focusing on the neurological implications of celiac disease. I’m a musician (pianist) and was diagnosed with Celiac in 2008 at the age of 35 after having had symptoms since childhood. The pianistic problems that arose from this included many common instrument-related injuries including carpal tunnel, tendonitis, and focal dystonia. The physical symptoms included pain in various fingers, weakness in the hand and fingers, tingling in finger-tips, and typical trigger point pain experiences. The problems were visible in a lack of structural integrity in various parts of my body, for example the right shoulder sagged visibly lower than the left, the hands had lost structure and appeared to be “wasting away”, and it was impossible to maintain the structural bridge of knuckles visible on the back of the hand. Since celiac disease was diagnosed and treated, most of the symptoms affecting my general health have subsided. The pianistic symptoms have proven to be the most difficult to resolve, perhaps leading to an indication of damage within the central nervous system. Chronic pain is still present. I read Dr. Hadjivassiliou’s article on Gluten Ataxia, and wondered if a mild form of this might be at play in my case. It had seemed to me that simple elements in piano technique were becoming more and more difficult for me to grasp. I had the feeling of having to practice much more than my colleagues in order to maintain a professional level, this over-practicing in turn was a classic Catch-22 which only aggravated problems. There was an uncomfortable feeling of not being in control of my hands, not sensing their intricacy, and “making-do” with pianistic tools that seemed (and were) increasingly inadequate for the tasks they were asked to do. It seemed like the body was becoming less and less able to incorporate complex movement sequences, and it seemed like I had to rely on an “act of will-power” to do anything that should have been more or less automatic.

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