Celiac disease and cognitive decline
If you’ve marked more than five or six decades of birthdays, this is a two-word phrase that may give you a chill: cognitive decline.
New research from the Mayo Clinic College of Medicine reveals how celiac disease – a fairly common autoimmune disorder – may be at the root of some cases of cognitive impairment. Fortunately, celiac disease can often be controlled with a change of diet.
Connecting the dots
In celiac disease (CD), gluten (a component of grain) creates an obstruction to the absorption of nutrients in the small intestine. Untreated, CD may prompt malnutrition, and, in chronic cases, other dangerous digestive ailments, including gastrointestinal cancer. Some cases of celiac disease are also accompanied by cognitive problems – an observation that set the basis for the Mayo Clinic study.
- Researchers examined medical records to identify 13 cases of progressive cognitive decline within two years of a CD diagnosis
- In each case, no other cause of cognitive decline was identified
- The average age at which cognitive decline was identified was 64
- The most common features of cognitive decline in these subjects were confusion, amnesia, personality changes, and acalculia (inability to understand basic arithmetic)
- In addition, ten patients had ataxia (loss of voluntary muscle control), and peripheral neuropathy (numbness and impaired coordination of the extremities)
- When gluten was removed from the subjects’ diets, cognitive impairment improved or stabilized in three patients
Writing in the Archives of Neurology, the Mayo team noted that their research shows a probable link between CD and progressive cognitive impairment, but that further research is needed to explain the mechanism behind the link.
The Mayo study is significant because celiac disease is more common than once believed.
As reported in the Archives of Internal Medicine in 2003, researchers in several medical centers across the U.S. examined records of more than 13,000 adults and children. About 75 percent of the subjects were thought to be at risk of developing CD because of family history or prior symptoms. Data suggested that far more patients had CD than expected – perhaps as many as 1.5 million in the U.S. alone.
In the conclusion to that study, the authors stated that doctors should be more knowledgeable about symptoms so that CD cases can be caught in the early stages. The problem with a diagnosis, however, is that symptoms are sometimes directly related to digestion (abdominal cramping, unexplained weight loss, and chronic diarrhea), but sometimes not (osteoporosis, joint pain, and depression). But when symptoms occur in a patient with family history of CD, this should stand out as a red flag for any physician.
Boot the BROW
The primary treatment for celiac disease is adherence to a strict non-gluten diet. Here are some gluten basics from HSI Panelist Allan Spreen, M.D.:
“The high-gluten grains are within the mnemonic BROW (Barley, Rye, Oat, Wheat). When completely unrefined, these grains in and of themselves are not the problem. It’s when sensitive individuals run into them that trouble can occur.
“Constant exposure to one food can cause a person to become ‘sensitized.’ This is most common in the case of wheat, since wheat is absolutely everywhere. If a person craves grains, cereals, breads, etc., or eats them every day, I often test them by avoiding the potential offending agent for 7 days. Sometimes the results are remarkable.”
A number of studies have shown that a plant-based enzyme called Aspergillus oryzae may be effective in protecting the intestine from the effects of gluten. Enzyme formulas containing Aspergillus oryzae (such as Similase and Zest for Life Enzyme Boost Formula) are available from sources on the Internet. Discuss the use of enzyme supplements with your doctor before adding them to your daily regimen.
“Cognitive Impairment and Celiac Disease” Archives of Neurology, Vol. 63, No. 10, October 2006, archneur.ama-assn.org
“Prevalence of Celiac Disease in At-Risk and Not-At-Risk Groups in the United States” Archives of Internal Medicine, Vol. 163, No. 3, 2/10/03, archinte.ama-assn.org