Celiac Disease and Neuropathy

Celiac Disease and Neuropathy2016-12-09T12:11:23+00:00

Celiac disease is an autoimmune gastrointestinal medical condition in which damage to the inner lining of the small intestine occurs. For those who have celiac disease, a substance called gliadin (a grain protein in gluten) triggers an unusual immune response that leads to flattening and altering of the millions of microscopic finger-like projections (villi) that line the inner wall of the small intestine. When the damaged villi do not work properly, the body cannot obtain enough of the essential proteins, fats, carbohydrates, vitamins, and minerals from food that are necessary for good health.

There are many different types of nerve damage, also known as neuropathy. The most common of these is peripheral neuropathy, which causes pins and needles, numbness, and burning sensations.

Researchers have long noticed a link between celiac disease and neuropathy; they first reported this association in 1966. One study found that 2.5-8% of patients with a type of neuropathy called distal symmetric polyneuropathy had celiac disease, which is much higher than the normal prevalence of about 1% of the population. In other studies, researchers found that celiac disease patients experienced more neuropathy than would be expected, but these were small studies.

Recently, researchers conducted a more thorough investigation of the link between celiac disease and neuropathy.1 They compared 28,232 celiac patients with biopsy-verified celiac disease to 139,473 control subjects, who they matched for age and sex, to find out if patients with celiac disease experienced a different amount of neuropathy than the general population.

The study showed that patients with celiac disease had a 2.5-fold increased risk of later neuropathy and of chronic inflammatory demyelinating neuropathy, autonomic neuropathy, and mononeuritis multiplex. The researchers are not exactly certain why this link exists, but recommend that individuals with neuropathy receive screening for celiac disease since this association is so strong. However, if you have celiac disease, you don’t need to worry too much, since the risk is still very small. Even though neuropathy affects a significantly larger proportion of celiac patients, only about 0.7% of celiac patients will actually develop neuropathy, compared with about 0.3% of the general population.

While focused on neuropathy, this study also had some other interesting findings. As we have reported before, individuals with celiac disease have an increased risk for type 1 diabetes mellitus. In this study, they found that type 1 diabetes mellitus affected 0.4% of controls and 3.2% of celiac disease patients.

MYTH BUSTED

Celiac Disease and Mortality

Individuals with celiac disease are more likely to be diagnosed with other ailments, which can be stressful and worrisome for those with the disease, and some individuals may wonder if the disease could increase their chance of dying prematurely. A recent study2 analyzed whether individuals with celiac disease are more likely to experience disease-related mortality than those without celiac disease. Researchers found that celiac patients were not any more likely to die early than those without the disease. There was no increased incidence of death from cancer, cardiovascular disease, respiratory disease, or digestive disease. Now that’s a relief!

 


First published in the Inside Tract® newsletter issue 194 – 2015
1. Thawani SP et al. Risk of Neuropathy Among 28232 Patients With Biopsy-Verified Celiac Disease. JAMA Neurology. 2015;72(7):806-11.
2. Abdul Sultan A et al. Causes of death in people with coeliac disease in England compared with the general population: a competing risk analysis. Gut. 2015;64(8):1220-6.