Celiac disease is linked to numerous other conditions. So many in fact that it's hard to keep them all straight! To better understand the connection between celiac and other conditions, we've called upon celiac expert and author Ron Hoggan. Ron is such a fabulous expert that we've split his interview up into two parts, so check back next week to see even more wonderful advice.
Enjoy this wonderful insight and if you think of more questions, submit them anytime to email@example.com. All of the questions you see answered below were submitted by readers just like you!Question 1. Celiac disease is connected to many other conditions. Can you tell us how many it's linked to and what some of the most common diseases are?
Answer from Ron: Contemporary medical research has linked celiac disease to more than 200 other conditions and that number continues to rise. Each year, medical and scientific research uncovers new connections with ailments not previously recognized in association with celiac disease. Broadly speaking, these conditions include those arising out of nutrient deficiencies, various forms of autoimmunity, and a number of other conditions that are not so easily categorized.
There is little debate about the causal connection between celiac disease and illnesses arising out of the many associated nutrient deficiencies. Mineral deficiencies are very common in untreated celiac disease and they usually resolve quite quickly after beginning a gluten free diet. Yet such conditions are often misunderstood. For instance, I know one person who was receiving iron injections for several years before she moved to a different city. Her new doctor did some more testing which led to her diagnosis of pernicious anemia, a condition caused by vitamin B12 deficiency. This should have suggested testing for celiac disease, yet the question was never raised by her new physician. In this case, vitamin B12 supplements were prescribed and the patient was sent on her way.
Similarly, women who deliver children with spina bifida should also be tested for celiac disease, as spina bifida is associated with inadequate maternal folate which is another B vitamin. Although the connection between folate deficiency and spina bifida has long been recognized, and folate supplementation is a standard prenatal recommendation, the mothers of such infants are rarely investigated for celiac disease. Both pernicious anemia and spina bifida are potentially catastrophic illnesses that impose enormous individual, familial, and social costs. Yet these are only two of many such vitamin deficiency illnesses that can arise in the context of undiagnosed or untreated celiac disease and these conditions are only rarely investigated for celiac disease.Similarly, one type of heart disease, pericarditis, is sometimes seen in connection with celiac disease. Such patients often recover fully on a gluten free diet combined with steroid medications. In some cases only the diet is needed.
More commonly, the rates of type 1 diabetes and autoimmune thyroid disease (Graves and Hashimoto's) are significantly increased among newly diagnosed and untreated celiac patients. Because the auto-antibodies associated with type 1 diabetes and autoimmune thyroid disease have been shown to diminish on a gluten-free diet, there is a clear suggestion that gluten may be at least a contributing cause of such cases of autoimmunity. Relatedly, the work of Canadian researcher, Fraser Scott, has shown a clear connection between some cases of type 1 diabetes and gluten. I have often wondered why these patients are not routinely offered a gluten free diet. The potential for reversal of this debilitating condition, especially if dietary intervention occurs early in the disease process, is enormous. Emerging research using islet cell transplants might open the path to a genuine cure for this otherwise life-long illness.
While autoimmune and vitamin deficiency diseases are the most common result of undiagnosed (and hence, untreated) celiac disease, deficiencies in various minerals are also common among celiac patients. This is because the location in the small intestine where we absorb most of our minerals is also where gluten often does most of its damage. On a personal level, I struggled with low iron levels for more than a decade after beginning a gluten free diet. I also struggled with weakening bones. Yet there are relatively easy answers to these problems if one does some investigation. (See: Get the Iron Edge by Ron Hoggan, Ed. D. available at www.celiachometest.com) In most cases, nutrient deficiency diseases are reversed quite quickly by a gluten free diet but some require added measures to compensate for gluten-induced intestinal damage.
There are conflicting opinions about the many neurological conditions associated with untreated celiac disease. Some investigators argue that these neurological conditions arise out of nutrient deficiencies. Others assert that autoimmunity drives much of this broad range of neurological illnesses and symptoms. Still others point to additional facets of untreated celiac disease that may contribute to these many conditions. The symptoms of these gluten-associated neurological conditions range from seizures, to the robot-like gait of those suffering from cerebellar ataxia, to tremors, peripheral neuropathies, impaired vision, damage to the myelin sheath on nerves similar to that seen in multiple sclerosis, altered cognitive function and a host of additional psychiatric conditions.
One such condition, according to several research articles published in medical journals, is attention deficit disorder. This disorder is found in a majority of children with newly diagnosed or untreated celiac disease. After 6 to 12 months on a strict gluten free diet, these children experience complete recovery from their deficits in attention. Yet, after 20 years of classroom teaching, and having participated in many such assessments, I have never encountered a single case where a child being evaluated or treated for a diagnosis of an attention deficit disorder has been investigated for celiac disease as part of this process. By tacit agreement, physicians and teachers participate in a process that almost invariably leads to prescription of stimulants or other powerful, mind-altering drugs. However, an unknown portion of these children might well benefit, to a much greater extent, from a gluten free diet. These drugs make children more manageable without providing them with significant long-term career and educational benefits. The gluten-free diet, on the other hand, offers a return to normalcy as learners and participants in the education system.