Then, while looking up causes of tremor (my hand shakes a little occasionally), I found that gluten affects nerves directly, the wheat proteins (gliadins, I think) binding to them and causing neuropathy! One study found that an immune response to a protein found in gluten, a substance in wheat, rye, and barley, can cause muscle weakness and neurological problems similar to parkinsonism (shaking, walking difficulties).
Then there's this study:
Firstly, this implies that gut biopsy testing is quite inadequate when diagnosing coeliac disease (we now have genetic testing as well). And secondly, when you realize that pelvic myoneuropathy (UCPPS) is intimately concerned with pelvic nerve function, this puts wheat's hostile role into perspective. For some people, it's a nerve poison.Lancet. 1998 Nov 14;352(9140):1582-5.
Clinical, radiological, neurophysiological, and neuropathological characteristics of gluten ataxia.
Hadjivassiliou M, Grunewald RA, Chattopadhyay AK, Davies-Jones GA, Gibson A, Jarratt JA, Kandler RH, Lobo A, Powell T, Smith CM.
Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK.
BACKGROUND: Ataxia [inability to coordinate voluntary muscle movements; unsteady movements and staggering gait] is the commonest neurological manifestation of coeliac disease. Some individuals with genetic susceptibility to the disease have serological evidence of gluten sensitivity without overt gastrointestinal symptoms or evidence of small-bowel inflammation. The sole manifestation of disease in such patients may be ataxia. We describe the clinical, radiological, and neurophysiological features of this disorder.
METHODS: Patients with ataxia attending the neurology outpatient clinics at the Royal Hallamshire Hospital, Sheffield, UK, were screened for gluten sensitivity as shown by the titre of antibody to gliadin. Those with other causes of ataxia were excluded. We carried out clinical, neurophysiological, neuroradiological, and, in two cases, neuropathological examinations.
FINDINGS: 28 patients with gluten ataxia were identified. All had gait ataxia and most had limb ataxia. Those with more severe gait ataxia had longer disease duration. No patient had tremor or other extrapyramidal features. 19 patients showed some form of peripheral neuropathy on neurophysiological examination. 16 patients had no gastrointestinal symptoms. Distal duodenal biopsy showed lymphocytic infiltration in two patients, and changes compatible with coeliac disease in 11. Six patients had evidence of cerebellar atrophy on magnetic-resonance imaging. Necropsy was done on two patients who died; there was lymphocytic infiltration of the cerebellum, damage to the posterior columns of the spinal cord, and sparse infiltration of the peripheral nerves.
INTERPRETATION: Gluten sensitivity is an important cause of apparently idiopathic ataxia and may be progressive. The ataxia is a result of immunological damage to the cerebellum, to the posterior columns of the spinal cord, and to peripheral nerves. We propose the term gluten ataxia to describe this disorder.
PMID: 9843103
2012 edit:
I like to advise all men with UCPPS to avoid gluten in their diets, at least for 3 months as a trial. Why?
- I found that gluten had a major effect on my symptoms
- Gluten is a nerve poison for celiacs. UCPPS is highly nerve-mediated, hence the connection.
- An amazing 1% of the world's population has celiac disease, but only 10-15% of that 1% know it. The rest are undiagnosed. You could be in that 1%!
