People with celiac disease are more than twice as likely to suffer from nerve damage than the general population, according to a recently published study in the medical journal JAMA Neurology.
The association is so strong that the study authors suggest people with nerve damage should also be screened for celiac disorder in order to pinpoint potential treatment options, according to lead researcher Jonas Ludvigsson of the Swedish medical university Karolinska Institutet.
"The current guidelines suggest that patients with neuropathy [nerve pain] should be screened for type 1 diabetes and certain vitamin deficiencies,” Ludvigsson told The Huffington Post. "I believe that in patients with neuropathy and none of these conditions, celiac screening is appropriate."
Celiac disease is an autoimmune disorder that occurs in about 1 percent of the general population. When people with celiac disease eat foods with gluten, like wheat, barley and rye, the gluten attacks the small intestines. The damage prevents the body from properly absorbing nutrients from food, which can lead to several problem disorders: anemia, infertility, lactose intolerance, gall bladder malfunction and pancreatic disorders, according to the Celiac Disease Foundation.
Researchers analyzed medical records of over 28,000 patients with biopsy-confirmed celiac disease and then matched them with up to five other “control” patients who were the same age, sex and nationality. Then they followed up with all the study participants after a median of 10 years to see if they had developed nerve damage. They found that 0.7 percent of people with celiac disease had gone on to be diagnosed with nerve damage, while only 0.3 percent of the control participants had developed nerve damage over the decade. In other words, those with celiac disease had a 2.5-fold increased risk of developing certain kinds of nerve damage over a period of time as compared to the control population.
Most of the participants had developed non-specified neuropathy, or nerve damage. But researchers were also able to find an increased risk in a few specific nerve disorders. People with celiac disease had a higher risk of developing chronic inflammatory demyelinating neuropathy, which causes numbness and tingling in the extremities, mononeuritis multiplex, which causes pain and damage in one or more nerves outside of the brain and spinal cord, and autonomic neuropathy, which is damage to the nerves that affect involuntary bodily functions.
Celiac disease has been linked to nerve damage since 1966, when a small study of 16 participants established an association between the autoimmune disease and neurologic disorders. But this new study is notable in that it establishes a link between the two disorders with a nationwide, population-based study, which allowed Ludvigsson to come up with the more precise risk estimate (the 2.5 fold increase). It’s also the first to examine the link between celiac disease and specific types of nerve damage, according to the study authors.
Ludvigsson’s analysis didn’t examine why the two conditions are linked. He guessed that they could both be immune system disorders, as nerve damage is also tied to the autoimmune diseases type 1 diabetes, autoimmune thyroid disease and rheumatoid arthritis. But it could also be that the inflammation and malabsorption of nutrients caused by untreated celiac disease could be causing the nerve damage.
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