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celiac

Children, Gluten, Sleep Apnea and Headaches, Oh My!

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gluten sensitivity in children
duckman76 /Dollar Photo Club

Here’s the reality of human physiology; we will NEVER understand how complicated it is.   Gluten sensitivity’s effect on the brain falls under this category.

There’s no doubt that many of us has a grasp on small amounts of how the body works, but the big picture is just too big for any one of us to understand fully.  It’s kind of like–I can drive around here in Phoenix quite well and know where I’m at or at least how to get to where I need to go.  But drop my in Dubai without a map or GPS and I’m pretty much screwed (especially since my Arabic is a little rusty…).

That’s a pretty good analogy to the human body and its complexity.  The most that any of us can hope for is a glimpse of insight into how it works and how we, as physicians, can help patients heal and live full lives.

This is one of the reasons why my passion has always been normal physiology and how the lifestyles we are SUPPOSED to be living impact that.  I figure it’s easier to match how we are designed to live then to figure out the details of that process.  Sort of like recommending more vegetables in your diet (because it’s the right thing to do) instead of understanding how glucosinolates in broccoli assist detoxification of environmental contaminants.

Just to complicate things even more, every system in the human body communicates and interacts with every other system.  The connections between the gut and the brain are particularly strong.  This is why treatment for any “brain disorder” should always include a look at the gut.

While this relationship may seem a little strange at first glance, the reality is that the gut is considered the body’s “second brain” since its production of neurotransmitters is as heavy as the brain.  As an example, 2/3 of the body’s serotonin is produced in the gut NOT the brain.

To further complicate matters, your DNA codes for about 25,000 different genes that make all kinds of different proteins to make sure your body is working the way it is supposed to.  Just in case that sounds a little overwhelming, the bacteria in your gut, collectively, have about 3 MILLION genes, all equally capable of making proteins that effect your health and risk of disease.

With this as a background, we can now look at just how absolutely jaw-dropping amazing this particular study is.  It brings together so many of these concepts that it is going to make your head spin.  In this small study, researchers looked at 19 children who had newly diagnosed celiac disease confirmed through an intestinal biopsy and followed them for 6 months while on a gluten free diet.

In these children with gluten sensitivity, there were some disturbing findings:

  • 37% of the children had headaches that affected daily activities.
  • 32% demonstrated symptoms of obstructive sleep apnea.
  • 48% of the children had abnormalities on EEG (a test using electrodes to check brain activity).

These findings clearly indicate that gluten (essentially a gastrointestinal condition) was having very definite negative effects on the brain.  And make no mistake–these are serious conditions to be found in children.

Luckily, the researchers then found some amazing things that were affected by 6 months of a gluten free diet:

  • The headaches disappeared in 72% of children.
  • EEG abnormalities disappeared in 78% of the children.
  • ALL children no longer had symptoms of obstructive sleep apnea.

As I mentioned, this is a small study.  However, it does link to and support other studies that have found an increase in migraine headache in those with gluten sensitivity, which gives it more weight.  While many have called the gluten free diet a “fad” I think these naysayers have managed to miss much of the medical literature linking gluten with a long list of health problems.

Even better, this is a DIETARY change with no real downside or side effects.  It is an approach that truly gets to the root of the problem rather than just glazing over the symptoms with dangerous medications with a long list of side effects.

Also, while this study only evaluated biopsy-confirmed celiac disease, which is at the far end of the spectrum, you can bet that lesser degrees of sensitivity will also link to neurological damage.  It will just be more subtle.

 

When Wheat Allergies Cause Seizures

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There has been much increased awareness of the problems associated with wheat allergies. Celiac disease. Allergy to wheat. Gluten sensitivity. Whatever you call it, it’s here to stay. But exactly how far do the negative health effects run?  And can wheat allergy affect the brain?

Let’s start with the basics. Traditionally, celiac disease  was a condition where an allergy to the gluten containing grains (most commonly wheat, barley and rye, but also in trace amounts in oats) sets up an autoimmune reaction that destroys the villa of the small intestine. You may have heard that the total surface area of the small intestine is close to that of a tennis court because all of the villi increase the surface area.  Consider this shrinking to the size of a ping pong table and you get the idea. Nutrient malabsorption results and all kinds of bad things follow.

That was then…this is now…

Over time, we have come to understand that the scenario described above is the far end of a spectrum that starts with slight sensitivity that can only be picked up via stool sampling at specific labs (like www.enterolab.com). The real problem is that the inflammation set up by exposure to a common allergen such as gluten wreaks subtle havoc that compounds over the course of years and decades.  Celiac disease has been linked to:

  1. Type 1 diabetes
  2. Very strong association with all thyroid problems
  3. Osteoporosis, osteopenia and overall poor bone health

Before you begin to think this is new news, you need to understand that this was on the radar screen over a decade ago, if not longer. Strong concerns were noted with celiac disease in toddlers. 

But can something occurring in the gut actually affect something as far away as the brain?

The answer is a clear yes. Almost 20 years ago researchers where calling for evaluation of gluten sensitivity in any undiagnosed neurological disorder. This particular study demonstrates very strong links between epilepsy and celiac disease.  Those with the far spectrum of celiac disease (villus atrophy) had a 40% increased risk of developing epilepsy.

Two very important factors come to mind.

First, this is the far spectrum showing a 40% increase, but what about the entire range of the spectrum?  What if we looked in reverse to see how many epileptics had sensitivity to gluten?  We may be surprised at what we would find.

Second, the ketogenic diet has been shown to be an incredibly powerful therapy for seizure control for epileptics. Interestingly, researchers are not really sure how the diet works to control seizures, although some have speculated that the fat intake is key. But, on the ketogenic diet most grains are eliminated or cut back on severely. Could gluten really be the key?  Based on this study, it may very well be the link researchers have been looking for on the reason why the ketogenic diet works.