Multiple sclerosis linked to celiac disease and gluten sensitivity
Posted Mar 30 2011 12:00am
One of my main goals in writing a blog is to raise awareness about the conditions associated with celiac disease and gluten intolerance, in hopes that people find answers and get well. Multiple sclerosis, a disease of the central nervous system, is one of those conditions that has been linked to celiac disease, but not much research has been put forth. I could point to anecdotes from people I know who have successfully relieved their symptoms of multiple sclerosis with a gluten-free diet, and some people would be satisfied with that. There are others who like to see research and proof before they will believe in a treatment and make such a radical change in their lifestyle. I understand that thinking too, which is why I try to bring in the studies, if available, to back up the claims.
There is a new study on the prevalence of celiac disease in multiple sclerosis, published in the journal BioMed Central. Below is my summary of the study, but be sure to read my comments after to see that the number of MS patients with a gluten sensitivity may be even higher than suggested in the results of the study.
First, they analyzed 72 MS patients, who had the Relapsing-Remitting form of Multiple Sclerosis (RRMS), characterized by intermittent episodes of relapses and prolonged remissions (this type makes up 80% of MS cases)
They detected positive Tissue transglutaminase 2 (tTG-2), a blood marker for celiac disease, in 7 MS patients (10%)
They detected mild or moderate villous atrophy (Marsh III type) in duodenal biopsies, in 8 MS patients (11.1%). Villous atrophy, or flattening of the nutrient-absorbing villi in the small intestine, is indicative of celiac disease.
Overall prevalence of celiac disease in MS patients was between 5-10 times higher than the frequency found in the general population.
All the celiac patients were put on a gluten free diet and all of them improved considerably both with respect to gastrointestinal and neurological symptoms in the follow-up period.
Then, they tested the MS patients’ 126 first-degree relatives.
They found that 23 out of the 126 first-degree relatives (32%) had celiac disease.
MY THOUGHTS ON THIS STUDY:
At first I thought that 11.1% of MS patients having celiac disease is a statistic to pay attention to. But then I read the study more carefully, and saw this sentence buried in the text: “We also discovered several duodenal lesions in 21 (29%) of RRMS patients and mild villous atrophy in 8 (11.1%) of them.” Duodenal lesions in 29% of MS patients! The duodenum is the first section of the small intestine, and lesions are areas of abnormal tissue. So I investigated further, and found that according to the University of Chicago Celiac Disease Center , “celiac disease can cause patchy lesions in the duodenum.” Perhaps those people with duodenal lesions were borderline celiac, or even celiac, and should have been counted.
It’s not clear from the study whether it was 21 patients with duodenal lesions PLUS 8 with villous atrophy, or if the 21 included the 8. If they were separate, then it would be 29 patients out of 72, which would be 40% of MS patients with celiac or borderline celiac! Now that’s a stat that would turn heads!
And, as we know from experience and recent studies, gluten sensitivity is real , and considered a separate condition from celiac because gluten-sensitive people don’t necessarily have the villous atrophy that defines celiac disease. They do, however, often display neurological symptoms.
The conclusion of all this? It’s as was stated in the study:
All of these findings, together with the high prevalence of CD in first-degree relatives, support a frequent association with gluten intolerance in RRMS patients.