Psychological morbidity of celiac disease: A review of the literature

1. Ludvigsson JF, Leffler DA, Bai JC, et al.
The Oslo definitions for coeliac disease and related terms. Gut
2013; 62: 43–52. [PMC free article] [PubMed] [Google Scholar]

2. Ludvigsson JF, Bai JC, Biagi F, et al.
Diagnosis and management of adult coeliac disease: Guidelines from the British Society of Gastroenterology. Gut
2014; 63: 1210–1228. [PMC free article] [PubMed] [Google Scholar]

3. Troncone R, Ivarsson A, Szajewska H, et al.
Review article: Future research on coeliac disease—a position report from the European multistakeholder platform on coeliac disease (CDEUSSA). Aliment Pharmacol Ther
2008; 27: 1030–1043. [PubMed] [Google Scholar]

4. Hallert C, Lohiniemi S.
Quality of life of celiac patients living on a gluten-free diet. Nutrition
1999; 15: 795–795. [PubMed] [Google Scholar]

5. Ciacci C, Iavarone A, Siniscalchi M, et al.
Psychological dimensions of celiac disease: Toward an integrated approach. Dig Dis Sci
2002; 47: 2082–2087. [PubMed] [Google Scholar]

6. Lee A, Newman JM.
Celiac diet: Its impact on quality of life. J Am Diet Assoc
2003; 103: 1533–1535. [PubMed] [Google Scholar]

7. De Rosa A, Troncone A, Vacca M, et al.
Characteristics and quality of illness behavior in celiac disease. Psychosomatics
2004; 45: 336–342. [PubMed] [Google Scholar]

8. Häuser W, Stallmach A, Caspary W, et al.
Predictors of reduced health-related quality of life in adults with coeliac disease. Aliment Pharmacol Ther
2007; 25: 569–578. [PubMed] [Google Scholar]

9. Hallert C, Grännö C, Grant C, et al.
Quality of life of adult coeliac patients treated for 10 years. Scand J Gastroenterol
1998; 33: 933–938. [PubMed] [Google Scholar]

10. Usai P, Minerba L, Marini B, et al.
Case control study on health-related quality of life in adult coeliac disease. Dig Liver Dis
2002; 34: 547–552. [PubMed] [Google Scholar]

11. Hallert C, Grännö C, Hulten S, et al.
Living with coeliac disease: Controlled study of the burden of illness. Scand J Gastroenterol
2002; 37: 39–42. [PubMed] [Google Scholar]

12. Hallert C, Sandlund O, Broqvist M.
Perceptions of health-related quality of life of men and women living with coeliac disease. Scand J Caring Sci
2003; 17: 301–307. [PubMed] [Google Scholar]

13. Ciacci C, D’Agate C, De Rosa A, et al.
Self-rated quality of life in celiac disease. Dig Dis Sci
2003; 48: 2216–2220. [PubMed] [Google Scholar]

14. Green PHR, Stavropoulos SN, Panagi SG, et al.
Characteristics of adult celiac disease in the USA: Results of a national survey. Am J Gastroenterol
2001; 96: 126–131. [PubMed] [Google Scholar]

15. Häuser W, Gold J, Stein J, et al.
Health-related quality of life in adult coeliac disease in Germany: Results of a national survey. Eur J Gastroenterol Hepatol
2006; 18: 747–754. [PubMed] [Google Scholar]

16. Roos S, Kärner A, Hallert C.
Psychological well-being of adult coeliac patients treated for 10 years. Dig Liver Dis
2006; 38: 177–180. [PubMed] [Google Scholar]

17. Zarkadas M, Dubois S, MacIsaac K, et al.
Living with coeliac disease and a gluten-free diet: A Canadian perspective. J Hum Nutr Diet
2013; 26: 10–23. [PubMed] [Google Scholar]

18. Jacobsson LR, Hallert C, Milberg A, et al.
Coeliac disease—women’s experiences in everyday life. J Clin Nurs
2012; 21: 3442–3450. [PubMed] [Google Scholar]

19. Byström IM, Hollén E, Fälth-Magnusson K, et al.
Health-related quality of life in children and adolescents with celiac disease: From the perspectives of children and parents. Gastroenterol Res Pract
2012; 2012: 986475–986475. [PMC free article] [PubMed] [Google Scholar]

20. Ford S, Howard R, Oyebode J.
Psychosocial aspects of coeliac disease: A cross-sectional survey of a UK population. Br J Health Psychol
2012; 17: 743–757. [PubMed] [Google Scholar]

21. Lee A, Ng D, Diamond B, et al.
Living with coeliac disease: Survey results from the USA. J Hum Nutr Diet
2012; 25: 233–238. [PubMed] [Google Scholar]

22. Roos S, Hellström I, Hallert C, et al.
Everyday life for women with celiac disease. Gastroenterol Nurs
2013; 36: 266–273. [PubMed] [Google Scholar]

23. Sainsbury K, Mullan B, Sharpe L.
Reduced quality of life in coeliac disease is more strongly associated with depression than gastrointestinal symptoms. J Psychosom Res
2013; 75: 135–141. [PubMed] [Google Scholar]

24. Aaronson N, Acquadro C, Alonso J, et al.
International quality of life assessment (IQOLA) project. Qual Life Res
1992; 1: 349–351. [PubMed] [Google Scholar]

25. Borgaonkar M, Irvine E.
Quality of life measurement in gastrointestinal and liver disorders. Gut
2000; 47: 444–454. [PMC free article] [PubMed] [Google Scholar]

26. Riddle DL, Lee KT, Stratford PW.
Use of SF-36 and SF-12 health status measures: A quantitative comparison for groups versus individual patients. Med Care
2001; 39: 867–878. [PubMed] [Google Scholar]

27. Eypasch E, Williams J, Wood-Dauphinee S, et al.
Gastrointestinal Quality of Life Index: Development, validation and application of a new instrument. Br J Surg
2005; 82: 216–222. [PubMed] [Google Scholar]

28. Rasmussen NA, Norholm V, Bech P.
The internal and external validity of the Psychological General Well-Being Schedule (PGWB). Quality of Life News Letter
1999; 22: 7–7. [Google Scholar]

29. van Doorn RK, Winkler LMF, Zwinderman KH, et al.
CDDUX: A disease-specific health-related quality-of-life questionnaire for children with celiac disease. J Pediatr Gastroenterol Nutr
2008; 47: 147–152. [PubMed] [Google Scholar]

30. Jordan NE, Li Y, Magrini D, et al.
Development and validation of a celiac disease quality of life instrument for North American children. J Pediatr Gastroenterol Nutr
2013; 57: 477–486. [PubMed] [Google Scholar]

31. Häuser W, Gold J, Stallmach A, et al.
Development and validation of the Celiac Disease Questionnaire (CDQ), a disease-specific health-related quality of life measure for adult patients with celiac disease. J Clin Gastroenterol
2007; 41: 157–166. [PubMed] [Google Scholar]

32. Dorn S, Hernandez L, Minaya M, et al.
The development and validation of a new coeliac disease quality of life survey (CD-QOL). Aliment Pharmacol Ther
2010; 31: 666–675. [PubMed] [Google Scholar]

33. Pouchot J, Despujol C, Malamut G, et al.
Validation of a French version of the Quality of Life “Celiac Disease Questionnaire”. PloS One
2014; 9: e96346–e96346. [PMC free article] [PubMed] [Google Scholar]

34. Zingone F, Iavarone A, Tortora R, et al.
The Italian translation of the Celiac Disease-specific Quality of Life Scale in celiac patients on gluten free diet. Dig Liver Dis
2013; 45: 115–118. [PubMed] [Google Scholar]

35. Casellas F, Rodrigo L, Molina-Infante J, et al.
Transcultural adaptation and validation of the Celiac Disease Quality of Life (CD-QOL) survey, a specific questionnaire to measure quality of life in patients with celiac disease. Rev Esp Enferm Dig
2013; 2013: 585–593. [PubMed] [Google Scholar]

36. Marchese A, Klersy C, Biagi F, et al.
Quality of life in coeliac patients: Italian validation of a coeliac questionnaire. Eur J Intern Med
2013; 24: 87–91. [PubMed] [Google Scholar]

37. Mustalahti K, Lohiniemi S, Collin P, et al.
Gluten-free diet and quality of life in patients with screen-detected celiac disease. Eff Clin Pract
2002; 5: 105–113. [PubMed] [Google Scholar]

38. Johnston SD, Rodgers C, Watson RGP.
Quality of life in screen-detected and typical coeliac disease and the effect of excluding dietary gluten. Eur J Gastroenterol Hepatol
2004; 16: 1281–1281. [PubMed] [Google Scholar]

39. Nachman F, Maurino E, Vázquez H, et al.
Quality of life in celiac disease patients: Prospective analysis on the importance of clinical severity at diagnosis and the impact of treatment. Dig Liver Dis
2009; 41: 15–25. [PubMed] [Google Scholar]

40. Vilppula A, Kaukinen K, Luostarinen L, et al.
Clinical benefit of gluten-free diet in screen-detected older celiac disease patients. BMC Gastroenterol
2011; 11: 136–136. [PMC free article] [PubMed] [Google Scholar]

41. Ukkola A, Mäki M, Kurppa K, et al.
Diet improves perception of health and well-being in symptomatic, but not asymptomatic, patients with celiac disease. Clin Gastroenterol Hepatol
2011; 9: 118–123. [PubMed] [Google Scholar]

42. Paavola A, Kurppa K, Ukkola A, et al.
Gastrointestinal symptoms and quality of life in screen-detected celiac disease. Dig Liver Dis
2012; 44: 814–818. [PubMed] [Google Scholar]

43. Kurppa K, Paavola A, Collin P, et al.
Benefits of a gluten-free diet for asymptomatic patients with serologic markers of celiac disease. Gastroenterology
2014; 147: 610–617.e1. [PubMed] [Google Scholar]

44. Nachman F, del Campo MP, González A, et al.
Long-term deterioration of quality of life in adult patients with celiac disease is associated with treatment noncompliance. Dig Liver Dis
2010; 42: 685–691. [PubMed] [Google Scholar]

45. Barratt SM, Leeds JS, Sanders DS.
Quality of life in coeliac disease is determined by perceived degree of difficulty adhering to a gluten-free diet, not the level of dietary adherence ultimately achieved. J Gastrointestin Liver Dis
2011; 20: 241–245. [PubMed] [Google Scholar]

46. Hopman E, Koopman H, Wit J, et al.
Dietary compliance and health-related quality of life in patients with coeliac disease. Eur J Gastroenterol Hepatol
2009; 21: 1056–1056. [PubMed] [Google Scholar]

47. Paarlahti P, Kurppa K, Ukkola A, et al.
Predictors of persistent symptoms and reduced quality of life in treated coeliac disease patients: A large cross-sectional study. BMC Gastroenterol
2013; 13: 75–75. [PMC free article] [PubMed] [Google Scholar]

48. Smith D, Gerdes L.
Meta-analysis on anxiety and depression in adult celiac disease. Acta Psychiatr Scand
2012; 125: 183–193. [PubMed] [Google Scholar]

49. Cannings-John R, Butler CC, Prout H, et al.
A case-control study of presentations in general practice before diagnosis of coeliac disease. British J Gen Pract
2007; 57: 636–642. [PMC free article] [PubMed] [Google Scholar]

50. Addolorato G, Stefanini G, Capristo E, et al.
Anxiety and depression in adult untreated celiac subjects and in patients affected by inflammatory bowel disease: A personality “trait” or a reactive illness?
Hepatogastroenterology
1996; 43: 1513–1513. [PubMed] [Google Scholar]

51. Addolorato G, Capristo E, Ghittoni G, et al.
Anxiety but not depression decreases in coeliac patients after one-year gluten-free diet: A longitudinal study. Scand J Gastroenterol
2001; 36: 502–506. [PubMed] [Google Scholar]

52. Häuser W, Janke KH, Klump B, et al.
Anxiety and depression in adult patients with celiac disease on a gluten-free diet. World J Gastroenterol
2010; 16: 2780–2780. [PMC free article] [PubMed] [Google Scholar]

53. Addolorato G, Mirijello A, D’Angelo C, et al.
Social phobia in coeliac disease. Scand J Gastroenterol
2008; 43: 410–415. [PubMed] [Google Scholar]

54. Taylor E, Dickson-Swift V, Anderson K.
Coeliac disease: The path to diagnosis and the reality of living with the disease. J Hum Nutr Diet
2013; 26: 340–348. [PubMed] [Google Scholar]

55. Morris JS, Ajdukiewicz A and Read A. Neurological disorders and adult coeliac disease. Gut 1970; 11: 549–554. [PMC free article] [PubMed]

56. Hallert C, Åstrøm J and Sedvall G. Psychic disturbances in adult coeliac disease. Scand J Gastroenterol 1982; 17: 25–28. [PubMed]

57. Zingone F, Siniscalchi M, Capone P, et al. The quality of sleep in patients with coeliac disease. Aliment Pharmacol Ther 2010; 32: 1031–1036. [PubMed]

58. Siniscalchi M, Iovino P, Tortora R, et al. Fatigue in adult coeliac disease. Aliment Pharmacol Ther 2005; 22: 489–494. [PubMed]

59. Addolorato G, De Lorenzi G, Abenavoli L, et al. Psychological support counselling improves gluten-free diet compliance in coeliac patients with affective disorders. Aliment Pharmacol Ther 2004; 20: 777–782. [PubMed]

60. Fera T, Cascio B, Angelini G, et al. Affective disorders and quality of life in adult coeliac disease patients on a gluten-free diet. Eur J Gastroenterol Hepatol 2003; 15: 1287–1292. [PubMed]

61. Van Hees NJ, Van der Does W and Giltay EJ. Coeliac disease, diet adherence and depressive symptoms. J Psychosom Res 2013; 74: 155–160. [PubMed]

62. Barratt SM, Leeds JS, Sanders DS. Factors influencing the type, timing and severity of symptomatic responses to dietary gluten in patients with biopsy-proven Coeliac disease. J Gastrointestin Liver Dis 2013; 22. [PubMed]

63. Kurppa K, Collin P, Mäki M, et al. Celiac disease and health-related quality of life. Expert Rev Gastroenterol Hepatol 2011; 5: 83–90. [PubMed]

64. Addolorato G, Giuda DD, Rossi GD, et al. Regional cerebral hypoperfusion in patients with celiac disease. Am J Med 2004; 116: 312–317. [PubMed]

65. Hallert C, Svensson M and Tholstrup J, et al. Clinical trial: B vitamins improve health in patients with coeliac disease living on a gluten-free diet. Aliment Pharmacol Ther 2009; 29: 811–816. [PubMed]

66. Ferretti A, Parisi P and Villa MP. The role of hyperhomocysteinemia in neurological features associated with coeliac disease. Med Hypotheses 2013; 81: 524–531. [PubMed]

67. Carta MG, Hardoy MC, Boi MF, et al. Association between panic disorder, major depressive disorder and celiac disease: a possible role of thyroid autoimmunity. J Psychosom Res 2002; 53: 789–793. [PubMed]

68. Garud S, Leffler D, Dennis M, et al. Interaction between psychiatric and autoimmune disorders in coeliac disease patients in the Northeastern United States. Aliment Pharmacol Ther 2009; 29: 898–905. [PMC free article] [PubMed]

69. Tsigos C and Chrousos GP. Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. J Psychosom Res 2002; 53: 865–871. [PubMed]

70. Ludvigsson JF, Reutfors J, Ösby U, et al. Coeliac disease and risk of mood disorders: a general population-based cohort study. J Affect Disord 2007; 99: 117–126. [PubMed]

71. Ciacci C, Iavarone A, Mazzacca G, et al. Depressive symptoms in adult coeliac disease. Scand J Gastroenterol 1998; 33: 247–250. [PubMed]

72. Sainsbury A, Sanders DS, Ford AC.
Prevalence of irritable bowel syndrome-type symptoms in patients with celiac disease: A meta-analysis. Clin Gastroenterol Hepatol
2013; 11: 359–365. [PubMed] [Google Scholar]

73. Barratt SM, Leeds JS, Robinson K, et al.
Reflux and irritable bowel syndrome are negative predictors of quality of life in coeliac disease and inflammatory bowel disease. Eur J Gastroenterol Hepatol
2011; 23: 159–159. [PubMed] [Google Scholar]

74. Turco R, Boccia G, Miele E, et al.
The association of coeliac disease in childhood with functional gastrointestinal disorders: A prospective study in patients fulfilling Rome III criteria. Aliment Pharmacol Ther
2011; 34: 783–789. [PubMed] [Google Scholar]

75. Giangreco E, D’agate C, Barbera C, et al.
Prevalence of celiac disease in adult patients with refractory functional dyspepsia: Value of routine duodenal biopsy. World J Gastroenterol
2008; 14: 6948–6948. [PMC free article] [PubMed] [Google Scholar]

76. Mönnikes H.
Quality of life in patients with irritable bowel syndrome. J Clin Gastroenterol
2011; 45: S98–S101. [PubMed] [Google Scholar]

77. Filipović BF, Randjelovic T, Ille T, et al.
Anxiety, personality traits and quality of life in functional dyspepsia-suffering patients. Eur J Intern Med
2013; 24: 83–86. [PubMed] [Google Scholar]

78. Hadjivassiliou M, Grünewald R, Sharrack B, et al.
Gluten ataxia in perspective: Epidemiology, genetic susceptibility and clinical characteristics. Brain
2003; 126: 685–691. [PubMed] [Google Scholar]

79. Ludvigsson JF, Olsson T, Ekbom A, et al.
A population-based study of coeliac disease, neurodegenerative and neuroinflammatory diseases. Aliment Pharmacol Ther
2007; 25: 1317–1327. [PubMed] [Google Scholar]

80. Ludvigsson J, Zingone F, Tomson T, et al.
Increased risk of epilepsy in biopsy-verified celiac disease: A population-based cohort study. Neurology
2012; 78: 1401–1407. [PubMed] [Google Scholar]

81. Hadjivassiliou M, Grünewald R, Lawden M, et al.
Headache and CNS white matter abnormalities associated with gluten sensitivity. Neurology
2001; 56: 385–388. [PubMed] [Google Scholar]

82. Rodrigo L, Hernández-Lahoz C, Fuentes D, et al.
Prevalence of celiac disease in multiple sclerosis. BMC Neurol
2011; 11: 31–31. [PMC free article] [PubMed] [Google Scholar]

83. Ferro MA. Risk factors for health-related quality of life in children with epilepsy: A meta-analysis. Epilepsia. Epub ahead of print 19 September 2014. [PubMed]

84. Kim SY, Park SP.
The role of headache chronicity among predictors contributing to quality of life in patients with migraine: A hospital-based study. J Headache Pain
2014; 15: 68–68. [PMC free article] [PubMed] [Google Scholar]

85. Calvert M, Pall H, Hoppitt T, et al.
Health-related quality of life and supportive care in patients with rare long-term neurological conditions. Qual Life Res
2013; 22: 1231–1238. [PubMed] [Google Scholar]

86. Briani C, Zara G, Alaedini A, et al.
Neurological complications of celiac disease and autoimmune mechanisms: A prospective study. J Neuroimmunol
2008; 195: 171–175. [PubMed] [Google Scholar]

87. Currie S, Hadjivassiliou M, Clark MJ, et al.
Should we be ‘nervous’ about coeliac disease? Brain abnormalities in patients with coeliac disease referred for neurological opinion. J Neurol Neurosurg Psychiatry
2012; 83: 1216–1221. [PubMed] [Google Scholar]

88. Ballmaier M, Toga AW, Blanton RE, et al.
Anterior cingulate, gyrus rectus, and orbitofrontal abnormalities in elderly depressed patients: An MRI-based parcellation of the prefrontal cortex. Am J Psychiatry
2004; 161: 99–108. [PubMed] [Google Scholar]

89. Bremner JD, Vythilingam M, Vermetten E, et al.
Reduced volume of orbitofrontal cortex in major depression. Biol Psychiatry
2002; 51: 273–279. [PubMed] [Google Scholar]

90. Di Lazzaro V, Pilato F, Batocchi AP, et al.
Tired legs—a gut diagnosis. Lancet
2010; 376: 1798–1798. [PubMed] [Google Scholar]

91. Carnevale V, Filabozzi P, Cela P, et al.
Tiredness: A feature of coeliac disease. Age Ageing
2000; 29: 462–463. [PubMed] [Google Scholar]

92. Sanders DS, Patel D, Stephenson TJ, et al.
A primary care cross-sectional study of undiagnosed adult coeliac disease. Eur J Gastroenterol Hepatol
2003; 15: 407–413. [PubMed] [Google Scholar]

93. Skowera A, Peakman M, Cleare A, et al.
High prevalence of serum markers of coeliac disease in patients with chronic fatigue syndrome. J Clin Pathol
2001; 54: 335–336. [PMC free article] [PubMed] [Google Scholar]

94. National Collaborating Centre for Primary Care. Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): Diagnosis and management of chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy) in adults and children, London: National Institute for Health and Clinical Excellence, 2007. [Google Scholar]

95. Pulido O, Zarkadas M, Dubois S, et al.
Clinical features and symptom recovery on a gluten-free diet in Canadian adults with celiac disease. Can J Gastroenterol
2013; 27: 449–453. [PMC free article] [PubMed] [Google Scholar]

96. Ciacci C, Peluso G, Iannoni E, et al.
L-Carnitine in the treatment of fatigue in adult celiac disease patients: A pilot study. Dig Liver Dis
2007; 39: 922–928. [PubMed] [Google Scholar]

97. Li B, Lloyd ML, Gudjonsson H, et al.
The effect of enteral carnitine administration in humans. Am J Clin Nutr
1992; 55: 838–845. [PubMed] [Google Scholar]

98. Anty R, Marjoux S, Bekri S, et al.
Plasma carnitine is associated with fatigue in chronic hepatitis C but not in the irritable bowel syndrome. Aliment Pharmacol Ther
2011; 33: 961–968. [PubMed] [Google Scholar]

99. Pistone G, Marino AD, Leotta C, et al.
Levocarnitine administration in elderly subjects with rapid muscle fatigue: Effect on body composition, lipid profile and fatigue. Drugs Aging
2003; 20: 761–767. [PubMed] [Google Scholar]

All About Gluten, Coeliac Disease, Depression & Anxiety

It is quite common for people with coeliac disease or another form of gluten intolerance to report depression among their symptoms.

Back toGluten & disorders

Depression, apathy, irritability and anxiety are among the possible psychological effects of untreated coeliac disease or non-coeliac gluten sensitivity.   

Most people find that these symptoms dissipate when they switch to a gluten free diet, but this might not be the case for everybody. There is some evidence that gluten itself, as well as coeliac disease or gluten sensitivity, can be a cause of depression in some people. 

What is the link between gluten and depression?

Coeliac disease is an autoimmune disorder triggered by eating gluten, which is identified mistakenly by the coeliac patient’s immune system as a dangerous invader. The antibodies produced by the body to attack gluten cause damage to the lining of the small intestine, prompting a wide range of possible symptoms including abdominal pain, diarrhoea or constipation, chronic fatigue, joint pain, anaemia, and depression and anxiety.  

Non-coeliac gluten sensitivity (NCGS), which is caused by a different immune system reaction to gluten and does not lead to intestinal damage, includes depression as one of its more common symptoms. 

The treatment for both of these conditions is a gluten free diet, which, in most cases, will alleviate and eventually eliminate the symptoms.   

Is it coeliac disease or gluten that causes depression?

Many studies have established a link between coeliac disease and symptoms of depression. In fact, several mental illnesses, including attention deficit-hyperactivity disorder, anxiety and schizophrenia have also been linked to coeliac disease.  

Some researchers have suggested that higher-than-average incidences of depression and other mental health issues in coeliac patients may just be a result of having a chronic health problem. But there is also evidence to support the idea that depression could be trigged by coeliac disease. The damage to the intestinal mucosa impairs the absorption of nutrients.  

When a person does not absorb enough iron, they may get anaemia, which is common among coeliac patients and often the reason they are diagnosed as gluten intolerant. Similarly, deficiencies in folate and vitamin B-6 occur among people with untreated coeliac disease, two nutrients that play a role in mood and neurotransmitter health. Studies have shown that supplementing vitamin B-6 can improve mood symptoms in coeliac patients.  

In short, gluten may trigger depression in coeliac patients due to the malabsorption of certain key nutrients. 

Depression and a gluten free diet

Image

Can a gluten free diet cause depression and anxiety? There is no known direct connection between gluten free eating and depression. Most coeliac patients and people with NCGS will find their symptoms, including depression, lift as they stay gluten free. A study from 2011 by Penn State University researchers found that women who stuck to their gluten free diet more strictly had fewer depressive symptoms, although all coeliac women studied suffered from higher rates of depression than the population at large. 

It is true that embarking on a strict gluten free diet can be daunting, especially when eating outside the home. Also, many people experience bouts of depression when they make a mistake and get ‘glutened’. In such cases, it is difficult to ascertain to what extent the depression is a direct symptom of the autoimmune reaction or despair or demoralisation caused by the unwanted situation.   

The importance of a correct diagnosis

Coeliac disease is severely underdiagnosed, with more people believed to have the condition without knowing it than those who have been diagnosed. This means that there is likely to be a proportion of undiagnosed coeliac patients amongst those who are suffering from depression. Depression seems to be an even more common symptom of non-coeliac gluten sensitivity, a condition which is even harder to diagnose as there is no blood test to detect antibodies, as is the case with coeliac disease.  

Tips on managing depression in coeliac disease

The best treatment for coeliac disease and all of its associated symptoms, including depression and anxiety, is to adopt a gluten free diet. However, trying to figure out exactly what foods you can eat and maintaining a healthy, balanced diet can be stressful, especially at the beginning. It is important to seek qualified professional help from a doctor and a registered dietitian, if this is available to you.  

Go easy on yourself. The transition to a gluten free diet can be hard to master, but you will learn and eventually it will become second nature. There is a lot of healthy, wholesome food that you can still enjoy. It is a good idea to seek out a support group so you can share your concerns and feel understood by others who are working through the same set of problems.  

And, if you feel depressed, don’t soldier on alone. It is vital to talk about it, to your loved ones, and to a professional if the symptoms persist.  

Other interesting articles

Schär is worldwide

Europe

• België
• Belgique
• Danmark
• Deutschland
• España
• Ελλάδα
• France
• Italia
• Κύπρος
• Nederland
• Norge
• Österreich
• Portugal
• Schweiz
• Suomi
• Sverige
• United Kingdom/Ireland

USA, Canada and South America

• América Latina
• Argentina
• Brasil
• Canada
• México
• United States

International

• English

Choose a countryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia & HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo – BrazzavilleCongo – KinshasaCook IslandsCosta RicaCôte d’IvoireCroatiaCubaCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard & McDonald IslandsHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern CyprusNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSamoaSan MarinoSão Tomé & PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia & South Sandwich IslandsSouth KoreaSpainSri LankaSt. HelenaSt. Kitts & NevisSt. LuciaSt. Pierre & MiquelonSt. Vincent & GrenadinesSudanSurinameSvalbard & Jan MayenSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks & Caicos IslandsTuvaluU.S. Outlying IslandsU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis & FutunaWestern SaharaYemenZambiaZimbabweChoose a country

Your email address

I confirm that I have read and understood the privacy policy

How to Identify Your Gluten Intolerance

Gluten has literally become a dirty word these days. All around they are talking about its harm and that you need to stop eating foods containing it. In fact, only those who do not digest it well need to give up gluten. And here’s how to understand it.

Tags:

Health

weight loss

Nutrition

Women Health

healthy eating

Getty Images

There are different degrees of gluten intolerance, each with different symptoms.

Contents of the article

Gluten is a protein found in wheat, rye and barley. Gluten intolerance is called celiac disease, an autoimmune disease in which gluten damages the small intestine. According to statistics, 1% of people suffer from it.

A milder form is gluten sensitivity: there are symptoms, but there is no harm to the intestines. As a rule, it is diagnosed after discarding the variant with celiac disease. So if you are experiencing the symptoms described below, check if you can continue to use gluten.

Symptoms of gluten sensitivity

Some people may have a milder form of gluten intolerance that is not related to the autoimmune disease celiac disease.

Pain and cramps in the abdomen

Or bread or cakes. Abdominal pain after foods with gluten is the most common symptom of indigestion of this protein. True, it can be difficult to understand why exactly the stomach hurts. A detailed food diary will help you find out.

ADVERTISING – CONTINUED BELOW

Bloating

Most often this happens due to overeating of legumes or hormonal imbalance. And here again, a diary will help – and attention to what you ate.

Poor concentration

Gluten sensitivity can be neurological and reduce the ability to process information and focus on a problem.

Bad mood and depression

Or it often changes, signs of depression appear. This can also be affected by gluten. People with gluten intolerance appear to be more prone to anxiety and depression than people without any comorbidities. For example, in one study, up to 40% of people with gluten sensitivity stated that they regularly experience anxiety.

Memory worsens

Many patients who have found gluten intolerance complain about this.

Diarrhea and constipation

If diarrhea and constipation occur too often, it may be a sign that you have a gluten intolerance. More than 50% of people with gluten intolerance suffer from diarrhea and about 25% from constipation.

Headaches

Many people with gluten intolerance suffer from headaches and migraines. This has been confirmed by some studies.

Fatigue

Constant fatigue can be a sign of some disease. People with gluten intolerance are especially prone to fatigue.

Symptoms of celiac disease

Celiac disease is the most severe form of gluten intolerance. This autoimmune disease affects about 1% of the population. It can lead to digestive problems, skin problems, and more.

You lose weight effortlessly

It’s a dream… unless it’s because the intestines are damaged and can’t digest food properly. In the case of gluten sensitivity, you simply start eating less so that your stomach hurts less often, and so you lose weight.

Diarrhea and constipation

Celiac disease can cause inflammation in the small intestine after consuming gluten. This leads to damage to the intestinal mucosa, which contributes to poor absorption of nutrients and the occurrence of diarrhea and constipation.

Pain in muscles and joints

There is a theory that people with celiac disease have a genetically determined hypersensitive nervous system, which can cause them to feel pain in muscles and joints after eating gluten.

Iron deficiency and anemia

Symptoms of anemia and iron deficiency are:

• fatigue;
• shortness of breath;
• headaches;
• dizziness;
• pale skin;
• low hemoglobin.

In the presence of a disease such as celiac disease, there is a violation of the absorption of nutrients in the small intestine, which leads to a decrease in the amount of iron absorbed from food.

Skin diseases

Gluten intolerance directly affects digestion, which means that the skin also suffers. Blisters, rashes, and some skin conditions may appear.

• Psoriasis. This disease is characterized by redness and flaking of the skin.
• Alopecia areata is an autoimmune disease characterized by hair loss.
• Chronic urticaria is a skin disease that causes itchy, pink or red lesions on the skin.

Numbness of hands and feet

Neuropathy is characterized by numbness of the extremities and periodic tingling in them. Typically, these symptoms occur in people with diabetes or vitamin B12 deficiency, however, some studies have shown that neuropathy can also occur in patients with celiac disease.

Fatigue

Feeling tired is common among people with autoimmune diseases, including celiac disease. There may also be sleep problems, chronic pain and depression. Since celiac disease can be associated with iron deficiency, the body may experience inhibition of the production of red blood cells, which in turn causes fatigue.

Depression and anxiety

People with digestive problems have been shown to be more prone to depression than those without it. Depression and anxiety are common in people with gluten intolerance. There are several theories why this happens.

• Abnormal levels of serotonin , which is best known as the “hormone of happiness”. A decrease in its level in the body can cause depression.
• Gluten exorphins – peptides formed during the digestion of some gluten proteins. They can affect the central nervous system, which increases the risk of depression.
• Changes in the intestinal microbiota. An increase in bad bacteria and a decrease in good bacteria can negatively affect the central nervous system, which also increases the risk of depression and anxiety.

Autoimmune diseases

Having celiac disease increases the body’s susceptibility to other autoimmune diseases, such as thyroid problems, which can increase the risk of developing a depressive disorder.

Wheat allergy symptoms

Wheat allergy is a type of food allergy in which the body’s immune system reacts to certain proteins found in wheat (including gluten).

The skin has become dry and flaky

This is a rather rare symptom, it must be considered in combination with others. In particular, wheat allergy can often cause hives.

Nasal congestion

Nasal congestion and sneezing are the most common symptoms of wheat allergy and Baker’s asthma. In this condition, sensitivity to wheat and other cereals increases with frequent inhalation of bread flour.

Digestive problems

Some studies have shown that wheat allergy can cause stomach cramps, diarrhea, vomiting, nausea, bloating, indigestion. All this is the body’s immune response to the allergen.

Anaphylaxis

Anaphylaxis is an acute, life-threatening allergic reaction that can cause swelling, hives, nausea, vomiting, and difficulty breathing. Adrenaline and medications are usually used to relieve symptoms.

Conclusions

Gluten intolerance can cause many different symptoms. To accurately identify the cause and degree of your gluten intolerance, you need to contact a doctor who will prescribe tests and subsequent treatment.

Celiac Disease: 12 Signs You Should Be Gluten Free

News

Many have learned the word “celiac disease” relatively recently, but, in fact, we are talking about a disease known since the time of the Roman Empire. The first modern description of the disease dates back to 1888, but it was not until the middle of the last century that scientists managed to discover a link between the disease and gluten.

Gluten or gluten is a protein found in cereals, mainly wheat, rye and barley. Mostly gluten is found in baked goods and various types of pasta. For most people, the daily protein intake is between 10 and 40 grams.

For most, gluten is not dangerous, but in people who are intolerant to gluten, when gluten enters the body, an autoimmune reaction begins, in which the immune system mistakes healthy cells for pathological ones and attacks them, causing damage to the intestines, which, in turn, turn, leads to insufficient digestion of food. The disease causes characteristic symptoms, the most common of which we have listed below.

Bowel dysfunction

Nausea, vomiting, constipation and diarrhea are all common symptoms of celiac disease. It should be noted that due to the fact that these are relatively non-specific complaints, patients are often misdiagnosed (for example, irritable bowel syndrome).

Mouth ulcers

You may be surprised, but this is a common symptom of autoimmune diseases. In this case, we are talking about large painful wounds that significantly impair the quality of life.

Fatigue

One of the main problems in diagnosing celiac disease is the non-specificity of some of its symptoms. One such sign is fatigue, which can have many causes. In the case of gluten intolerance, it develops due to the fact that the body does not receive enough nutrients from food.

Rashes

To be extremely precise, we are talking about dermatitis herpetiformis – small cysts, most often formed on the skin of the elbow and knee joints. In most cases, the rash disappears completely after ceasing gluten.

Anemia and vitamin B deficiency

Celiac disease causes intestinal damage that impairs the ability to absorb nutrients from food. Anemia that develops due to insufficient absorption of iron can have other causes, but vitamin B deficiency most often indicates gluten intolerance.

Loss of balance and coordination – another consequence of celiac disease is a neurological disorder called ataxia. With the timely rejection of gluten, the symptoms are reversible.

Calcium leak

Osteoporosis, of course, does not develop immediately, but only if the disease remains undiagnosed for a long time. Research has shown that cutting out fiber completely can help your bones regenerate.

Depression

The exact relationship between gluten intolerance and depression has not yet been established, but it is known that the risk of its development in patients with gluten intolerance is above average.