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.

Continue to read this Gluten-Free Blog for all sorts of gluten-free recipes, product-reviews, and related information. In addition, visit my Gluten-Free Recipes Site where many of the recipes I have featured on this blog are available.

Do you suffer "Gluten-Brain"? The neurological manifestation of Celiac Disease exposed...

If you ever needed confirmation that Gluten can lead to a lack of proper brain-functioning and/or other nervous-system disorders and symptoms thereof (without the presence of gastrointestinal manifestations as well), an article by David Perlmutter, M.D (a Board-Certified Neurologist) that I read today is sure to be enlightening.

The article discussed the case history of a 9-year old child that was previously undiagnosed (with Celiac Disease) and suffered from no particular symptoms that would make one immediately think: "Celiac!"; there was no history of the typical abdominal symptoms that doctors first associate with Celiac Disease, but rather a variable amount of cognitive impairment manifesting as difficulty thinking, memory issues, and general academic performance decline.

What caught the attention of Dr. Perlmutter was the fact that although "...she [the 9-year old patient] had no significant medical problems in her past and her overall physical, as well as neurological examinations were entirely normal...", [...] "...her problems were not constant, indicating that basically her brain was intact but something seemed to be detrimentally influencing her from time to time, causing her to have these significant issues with respect to how her brain functioned."  Dr. Perlmutter recognized the possibility that DIET was perhaps the culprit (due to the fluctuating cognitive impairment), and ran blood tests that confirmed a profound sensitivity to gluten in this girl.

Within just a couple weeks of implementing a strict gluten-free diet for this young patient, the girl experienced a remarkable change in her cognitive function (for the better), and this improvement in symptoms continued over the next several months as the gluten-free diet was maintained.  Her parents reported the following:

"Karen is completing third grade this year. Prior to removing gluten from her diet, academics, especially math, were difficult. As you can see, she is now soaring in math. Based upon this test, entering the fourth grade next year, she would be at the top of her class. The teacher indicated that if she skipped fourth grade and went to fifth grade, she would be in the middle of her class. What an accomplishment!"

WOW! Gluten was knocking this girl's brain for a loop, and once it was removed from her diet, she quickly returned to normal functioning!  This is certainly more evidence for why we need to maintain a STRICT GLUTEN-FREE DIET if we want to live life to the fullest and function normally. 

I personally can tell the difference gluten makes (with regards to my thinking process) if I am accidentally exposed to it these days, and I have other friends (with gluten sensitivity / gluten intolerance) that have repeatedly experienced "gluten brain" whereby they find it difficult to think, formulate thoughts, and even articulate themselves in a coherent fashion.  This condition is not one to be taken lightly, and we need to avoid gluten 100%.

Hopefully the medical community at large will begin to receive further education into the devastating effects of Celiac Disease -- effects that go beyond the GI tract and into our gray matter.  Like the author (Dr. Perlmuter) states:

Standard medical text books typically describe celiac disease (gluten sensitivity) as being primarily a gastrointestinal problem. I recall in medical school being taught that celiac disease was characterized by abdominal pain, abdominal distention with bloating and gas, decreased appetite, diarrhea, nausea, unexplained weight loss and growth delay in children. Newer research indicates that celiac disease can have a profound effect on the nervous system.

And, if that quote is not enough, when you start seeing the words TOXIC and BRAIN in the same sentence discussing a condition you have (Celiac), it is time to really snap to attention and take notice:

Dr. Maios Hadjivassiliou of the United Kingdom, a recognized world authority on gluten sensitivity, has reported in the journal, The Lancet, that "gluten sensitivity can be primarily and at times, exclusively a neurological disease." That is, people can manifest gluten sensitivity by having issues with brain function without any gastrointestinal problems whatsoever. Dr. Hadjivassiliou indicates that the antibodies that a person has when they are gluten sensitive can be directly and uniquely toxic to the brain.

EEK!  I do not want any brain-toxins in MY body, thank you!  This type of article may make me even more paranoid about my desire to remain free of gluten, though it seems my concern stems from substantial scientific basis.  I take quite a few precautions to keep (wheat, rye, barley) gluten out of my diet, and I will maintain vigilance with regards to this task as I go through life.   This is an allergy not to be taken lightly.

I do not want to suffer "gluten brain" ever again!  Although the article focused on the manifestation of what I call "gluten brain" (i.e., cognitive impairment) in children affected with gluten-sensitivity, the fact is this condition affects ADULTS as well.  I personally experienced severe bouts of cognitive impairment and neurological manifestations prior to discovering I had Celiac Disease.  It was a terrible period in my life, and I never want to end up like that again.  This disease nearly killed me before I knew what it was that was destroying me (i.e., gluten), and it took years for some of the symptoms to abate and/or disappear completely.  The periods of being dizzy all the time, living with parathesia (rather badly) in my feet, being unable to think clearly, and more... that is gone, along with the gluten.  Doctors I dealt with during that time of my life had, quite literally, no experience with Celiac Disease and never even considered it... luckily my brain was functioning (on "good days") enough to perform my own research discover Celiac Disease before it was too late.  It would have been nice if someone else (e.g., doctors) would have considered this prior to all those tests: MRI, CT, EKG, EEG, and a boatload of others I just assume forget.  I wonder if today those same doctors I dealt with a mere 7 or 8 years ago are now educated in spotting the neurological symptoms of Celiac Disease? They had better be... if this information is out there on the Internet for the average person to learn about, I expect medical professionals to get up to speed as well.

I hope Dr. Perlmutter's article, and additional emerging research, prevents others from ever having to go through this, or at the very least I hope it helps medical professionals (and the population at large) develop an awareness that leads to very early identification of the condition before Celiac Disease / Gluten substantially reduce the quality of life for anyone else.  

NOTE: The original article I referenced herein appears on the Huffington Post website: Gluten Impacts the Brain. 

Autism and Gluten-Free Diet

There has been a long-running debate in the Autism and Neurological Disorders community about whether adherence to a gluten-free and/or casein-free and/or whey-free diet is truly helpful to Autistic children and patients. We may soon finally see some definitive proof, or disproof, of whether the wheat-free, gluten-free, milk-free diet concept is advantageous or not, thanks to a clinical study underway at the University of Texas (UT) Health Science Center at Houston, TX.

UT Houston researchers are studying diet in Autistic Children to discover whether there is a possible link between gluten and/or dairy products. This is supposedly the first double-blind clinical study to determine whether science can back the anecdotal claims of parents that posit how removal of gluten and/or dairy products from their kids' diets brings about positive change and improvement in symptoms. The study employs some investigative experts in the fields of gastroenterology, psychiatry, and behavioral sciences.

Researchers acknowledge that a lot of children with autism present with gastrointestinal problems as well, but they currently lack any definitive scientific proof that these issues are directly related to brain development and resulting autism symptoms. So, this study will, in its first phase, enroll 38 autistic children between 3 and 9 years of age and try to elucidate the impact and influence that gluten and milk proteins effect on these children - if there is any correlation. Cosomorphin (a milk peptide) and gliadomorphin (a gluten peptide) are targets of the investigation, as they are thought to perhaps be related to behavioral changes in autistic children. Another aspect of this research will look into the intestinal permeability (leaky gut) issue to see how that concept interplays with autism and gluten / casein proteins.

I find this all quite encouraging, as it will certainly help shed some light on the impact, or lack thereof, a gluten-free diet (and/or milk-free diet) for a "treatment" for autism. I tend to favor science fact over just observation, though I give credence to both, and I especially find *proper* scientific study (like this one, which is using a double-blind placebo controlled approach) useful in understanding and assessing the prospects of any treatments for any conditions.

I have had a fair amount of our gluten-free dessert recipe books sell to parents that say they are trying a gluten-free diet for their children and to (or through) medical professionals, especially allergists (wheat and/or gluten allergy treatment), dietitians, and doctors that treat autism. Just the anecdotal evidence of a fairly strong correlation between autism and celiac disease, as shared between families that have claimed successful outcomes and improvements in autism symptoms by applying a gluten-free diet, has been enough to create demand for our recipes book among this group of people.

And, though I certainly enjoy selling our books to people with autism, so their kids can enjoy great desserts while being free of gluten, I would love for there to be some scientific proof (by way of this and other double-blind scientific diet studies) to back their decision to implement a gluten-free diet for their autistic children too. I'm sure parents of kids with autism feel the same way. Well, stay tuned and hopefully the study results will be forthcoming in the next few months!