Friday, January 20, 2012

Gluten Ataxia

Gluten Ataxia

Ataxia, a destructive and only partially reversible neurological condition, can develop in some gluten intolerant individuals who may be genetically susceptible to this kind of neurological damage.
Living Without, the wonderful magazine devoted to the gluten-free lifestyle, has a very timely and well-written articlein their February-March 2011 issue. According to the article, which centered on the extensive clinical work, published in peer-reviewed journals, of neurologist Marios Hadjivassiliou, MD, gluten can cause a number of serious neurological problems in susceptible individuals, including but not limited to:
* Dizziness
* Loss of balance
* Loss of coordination, especially walking, as well as movements of the arms, legs, hands, feet and fingers
* "Pins and needles" sensation, pain, or numbness, in extremities, or peripheral neuropathy
* Inability to concentrate
* Loss of control of optical muscles
* Inability to hold hands steady
* Inability to distinguish exact locations of objects
* Difficulty speaking and/or writing
* Difficulty swallowing
* In advanced stages, difficulty breathing
Ataxia can occur in anyone, gluten sensitive or not. In those individuals who are gluten sensitive, the condition may be caused by the body's reaction to gluten, and this condition is referred to as gluten ataxia. In that case, its progression may be stopped by removing exposure to gluten.
A strict gluten-free diet frequently reduces symptoms. Because the mechanism is not fully understood, it is imperative that those suffering from gluten ataxia avoid gluten in all its forms, even more so than for those with celiac disease. Each exposure to gluten reduces the level of brain function and increases impairment, which does not fully reverse.

This gluten-mediated condition can manifest in persons who have no classical symptoms of gluten intolerance, such as the typical gastro-intestinal dysfunctions like steatorrhea, malabsorption, or leaky gut syndrome. These patients may not present with any symptom that would lead to a diagnosis of celiac disease.
The fact that "asymptomatic" persons present with gluten-mediated neurological dysfunction demands a new standard for diagnosing gluten intolerance. Ten percent of the population tests positive for anti-gliadin antibodies but does not have celiac disease. The conclusion the medical community arrived at was that ten percent of the "healthy" population had these antibodies.
While no definitive conclusion can be reached without further testing, the belief that the ten percent in question is "healthy" must be re-evaluated. These individuals may be at risk for non-celiac gluten-mediated diseases and dysfunctions.

If you have symptoms, but have been told you are not celiac, you may still be gluten intolerant. You need to do a gluten challenge to determine if ending your exposure to gluten allows improvement of your symptoms. Remember, neurological damage can take months to heal, so be sure to give your body adequate time to repair itself. A gluten challenge for neuropathy or ataxia should last four to six months before reintroduction of gluten and observations of symptoms.

Work with your health-care provider, a nutritionist or other medical professional if you need help evaluating the changes you may experience during your challenge.

Included below are resources for you to read - and a few to download, if you choose. Many are written by Dr. Marios Hadjivassiliou, the neurologist who first published about the relationship between some forms of ataxia and gluten intolerance.

Gluten Ataxia, Article published in Cerebellum, 2008;7(3):494-8.

Autoantibodies in gluten ataxia recognize a novel neuronal transglutaminase

Gluten Ataxia in Perspecitve, published in Brain (2003) 126 (3): 685-691.

Gluten Ataxia 2-page downloadable article by Dr. Hadjivassiliou

Gluten Sensitivity: From Gut to Brain downloadable article

Gluten Sensitivity: Time to Move From Gut to Brain