Antibiotics and Celiac Disease : Any Connection?

Do Antibiotics Make Celiac Disease More Likely?

Antibiotics Disrupt Gut Ecology, Metabolism

Today's Gluten-Free Blog entry was inspired as I was reading an interesting article that discussed the findings published in materials originally provided by the American Society for Microbiology, whereby researchers from Canada described many of the interactions between the intestinal microbiota and host [in their testing, the "hosts" were mice], and showed that antibiotics profoundly disrupt intestinal homeostasis (i.e., equilibrium as maintained by physiological processes). So, what happens when your intestinal equilibrium is potentially compromised by antibiotics?

Could there be a connection to gluten-intolerance and/or Celiac disease? Some portions of their findings sure made me wonder. Given how massive shifts were observed in the levels of things like hormones that affect our immune system, sugar metabolism, and more, I could not help thinking that there could be a connection with gluten-sensitivity and/or Celiac Disease.

I have also heard the term "leaky gut syndrome" thrown around by some people (though not a "recognized diagnosis", it is a hypothesis that your gut wall suffers increased permeability from exposure to toxins, infections, and medications like antibiotics). This term has been used alongside Celiac Disease and/or gluten-intolerance, autism, and chronic fatigue syndrome to name a few. Whether it is a really the cause of any of these conditions is unknown, but the theory (in relation to celiac / gluten-intolerance) is that while your intestine is in a state of increased permeability, gluten proteins (e.g., Gliadin glycoprotein) can cross into the blood where the proteins would be targeted by antibodies, and thus eventually induce an allergic/immune-response to gluten as a result of stimulating the release of cytokines (I will come back to the cytokine thing later in this blog).

Why Intestinal Microbes are Important

Normal, healthy humans each carry around several pounds of microbes in their gastro-intestinal tracts. As gross as this may sound, we need these beneficial microbes. As stated in the article (on Science Daily):

"Intestinal microbes help us digest our food, provide us with vitamins that we cannot make on our own, and protect us from microbes that make us sick, amongst other things,"

So, how profoundly do antibiotics interact with these necessary and beneficial microbes?

Antibiotics Caused Huge Changes, Including Hormone Shifts

Researchers examined over 2000 molecules present in mouse excrement before and after (administration of antibiotics to the mice) to see what changes were observable and induced by antibiotics. The "after" (antibiotics) exam showed some really amazing (perhaps scary) results where:

The second round of mass spectroscopy revealed a very different metabolic landscape. The levels of 87 percent of the molecules detected had been shifted up or down by factors ranging from 2-fold to 10,000-fold. 

The most profoundly altered pathways involved steroid hormones, eicosanoid hormones, sugar, fatty acid, and bile acid. "These hormones have very important functions in our health," says Antunes. "They [hormones observed here] control our immune system, reproductive functions, mineral balance, sugar metabolism, and many other important aspects of human metabolism."

OK, I don't know about you, but the thought of antibiotics profoundly altering various hormone levels in my body is a bit frightening. The quotation above really got my attention with regards to my interest from a gluten-intolerance / Celiac Disease standpoint, particularly  the words "control our immune system".  Given that Coeliac disease is an autoimmune disorder of the small intestine, and that the researchers observed huge shifts in the metabolic landscape that included hormones that control our immune system, one really has to start wondering if there IS a connection between Antibiotic use and Celiac Disease.

This is where I also made a mental jump back to the associated (hypothesized) "leaky-gut syndrome" and the proposed step where leaky-gut leads to the stimulated release of cytokines. Well, Cytokines are cell-signaling protein molecules secreted by the nervous and immune systems. And, more interesting may be the fact that (as Wikipedia notes): "Biochemists disagree as to which molecules should be termed cytokines and which hormones. As we learn more about each, anatomic and structural distinctions between the two are fading."    So, if cytokines are essentially a class of hormone, and antibiotics have been shown to substantially alter hormone balances, could this "leaky gut" view of Celiac Disease, Autism, and such have some merit? Hmmm... sure seems there could be some connection.

Antibiotics Can Lead to Bad Things (for Human Health)

If you have read this Gluten-Free Blog entry to this point, you are probably already thinking: "antibiotics may be causing issues for people". Well, I was sure thinking that as I read the study that inspired me to write this, and there is a nice summary-statement included in that scientific article that will confirm this line of thinking:

The findings have two important implications, says Antunes. "First, our work shows that the unnecessary use of antibiotics has deleterious effects on human health that were previously unappreciated. Also, the fact that our gut microbes control these important molecules raises the possibility that manipulating these microbes could be used to modulate diseases that have hormonal or metabolic origins (such as inmmunodeficiency, depression, diabetes and others).

The bottom-line (as I took it to be): avoid unnecessary exposure to antibiotics. Simply put, there are risks with taking them. Sure, there are some types of infections that may absolutely require treatment with antibiotics, but all too often they are over-prescribed because we (the end-user) go in to see our doctor and make a big fuss about "needing" antibiotics, or perhaps we encounter a doctor whose first line of "treatment" is antibiotics for everything (been there before!). Fact is, we need to be educated (medical) consumers and understand what antibiotics can do for us and what they can not.

Although this is just my opinion, I personally think there IS a connection between antibiotic use and Celiac Disease / Gluten-Intolerance. I developed this condition soon after being given a course of antibiotics for a supposed sinus infection (one which a week later another doctor decided I never had!), and it just makes me that much more curious as to whether there is a connection. Also, I know a LOT of people that also "developed" Celiac Disease and are now on a mandatory gluten-free diet for life, soon after a round or two of antibiotics (especially in people that normally did not take antibiotics). This is perhaps purely anecdotal evidence, but I have encountered enough such "evidence" to make me wonder. And, this scientific study just helped provide a foundation for at least a portion of my concerns.

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