Diet Changes May Help Beat the Pain of Gluten Neuropathy

Gluten sensitivity can lead to a disorder known as gluten neuropathy, which, in turn, can lead to crippling nerve pain. Following a strict gluten-free diet might help prevent, delay, or treat this painful condition.

Gluten sensitivity, or gluten intolerance, is a condition experienced by some people when they eat certain grain foods—mainly wheat, barley, rye and sometimes oats—that contain the protein gluten. Approximately 3 million Americans who are gluten intolerant develop celiac disease, in which the immune system reacts to gluten in the diet by damaging the small intestine. More than 18 million are estimated to have gluten sensitivity that is not related to celiac disease.

Gluten Neuropathy in a Nutshell

Although not a food allergy, per se, gluten sensitivity provokes a reaction from the immune system that causes inflammation that can lead to damage in the small intestine and symptoms of gastrointestinal distress. This inflammation can also cause other, overlapping health problems, such as celiac disease, skin disorders, and neurological disorders, including neuropathy or nerve damage and pain. The majority of people who develop the blistering skin condition known as dermatitis herpetiformis also have celiac disease, and those with celiac disease are at more than twice the risk of developing some form of neuropathy than the general population. Likewise, people with neurological conditions that are difficult to diagnose are commonly sensitive to gluten. In some cases, nerve pain may be the only symptom of gluten sensitivity.

The type of nerve pain felt by many people with gluten sensitivity is called gluten neuropathy. There are many forms of neuropathy, and the most common type experienced by those with gluten sensitivity is known as peripheral axonal neuropathy. Peripheral refers to the network of nerves that transmit signals between the brain and spinal cord and all other parts of the body. Damage within this network causes weakness, numbness or pain, most commonly in the hands and feet. Signals sent through this network help the brain recognize nerve damage as a painful condition. Axonal refers to specific fibers that project from nerve cells to help transmit information. Peripheral axonal neuropathy is a result of damage to these fibers.

Overall, more than half of all patients with gluten neuropathy reportedly experience some degree of pain. As with all types of peripheral neuropathy caused by a wide array of diseases and disorders, the nature and degree of pain associated with gluten neuropathy varies from person to person. There are many treatment options available, ranging from medications and surgery to orthopedic aids and lifestyle changes, but not all neuropathies will respond to all treatments. For most, finding relief involves a trial-and-error process.


Food Matters

While experts don’t have enough information to recommend dietary changes across the board, research presented at the 2018 annual meeting of the American Academy of Neurology suggests that, for some people with gluten neuropathy, diet can make a difference in pain levels and other symptoms. Of the 60 patients with gluten neuropathy who participated in this research, a little more than half reported having painful symptoms.

The study found that those who did not experience pain were more likely to be on a gluten-free diet, leading the researchers to believe that a gluten-free diet may, in fact, help alleviate nerve pain associated with gluten neuropathy, as well as other symptoms, such as numbness and weakness. The researchers also noted that previous studies determined that a strict gluten-free diet may improve neuropathy in general and slow down the progression of disease. However, Panagiotis Zis, MD, PhD, a consulting neurologist and honorary senior lecturer at the University of Sheffield, in the United Kingdom, and lead author of this study, emphasizes the importance of a clear diagnosis of gluten sensitivity before applying the results of the research to individual circumstances. 

“From the standpoint of treating neuropathy, gluten sensitivity must first be confirmed by a positive blood test,” Dr. Zis explains. “A positive test will reveal antibodies to gluten proteins and, along with other factors, can confirm that gluten in the diet may be involved in the development of pain.”


Following a Gluten-Free Diet

Following a gluten-free diet means eliminating all sources of gluten from your diet. That means anything made from wheat, barley or rye, and flours milled from any of these grains. Couscous, bulgur, farina, graham flour, semolina, triticale, and spelt flour are all wheat products and should be avoided. Since oats may be grown in fields close to and contaminated by other grains, it is important for those with gluten sensitivity to choose oatmeal and other oat products that are guaranteed to be gluten-free. It is also important to check the labels on all processed food products. Wheat gluten can be found in deli meats, coated French fries, processed cheeses, imitation seafood, soups and condiments such as ketchup, mayonnaise, soy sauce, teriyaki sauce, malt vinegar, and salad dressings.

When it comes to following a strict, gluten-free diet, the key word here is “strict.” If your diet isn’t completely gluten-free, you will continue to produce the same antibodies that lead to inflammation and pain. Again, Dr. Zis points out, a blood test can assess whether circulating antibodies have normalized and help determine whether or not the diet is effective.

And, you must have patience. It could be a full year before inflammation subsides to the degree that you feel a significant reduction of pain. The researchers are quick to point out that a gluten-free diet won’t necessarily work for everyone, even when neuropathy is associated with gluten sensitivity. Larger, long-term studies are necessary before the healthcare community can definitively say who may benefit from a gluten-free diet and how.

Updated on: 05/15/18
Continue Reading:
9 Ways to Reduce Inflammation and Pain Through Diet