In looking for effective ways to
treat Attention Deficit Hyperactivity Disorder (ADHD)
without medication, researchers often focus on dietary
issues (see Daily Health News , October 4, 2004). These
issues have centered primarily on food additives, in
particular artificial colorings, flavorings and preservatives.
So I was surprised when a reader queried me about a possible
connection between ADHD and celiac disease, which is an
inability to digest gluten (a protein found in wheat and
several other grains). It was hard to find an expert in
this area, but I did -- Aristo Vojdani, PhD, MT, CEO
of the Immunosciences Lab, Inc., a microbiology and
immunology research facility in Beverly Hills, California.
Dr. Vojdani said that his company did indeed have
research concerning celiac and ADHD.
Indirect Connection
Dr. Vojdani stressed immediately
that there is no direct connection between celiac and
ADHD. However, he says that there is indirect evidence
that having antibodies against gluten, as happens in
celiac, could make some neurological disorders,
including ADHD, worse. The explanation about how
this happens is somewhat complex -- in fact, you
may find it takes you back to your high school
biology classes...
If a person suffers from celiac
disease, his/her body sees gluten and its related
proteins as intruders and makes antibodies against
them. This has critical implications for the
gastrointestinal (GI) tract because the antibodies
make it virtually impossible for the GI tract to
digest anything with gluten in it. Symptoms include
diarrhea, bloating and flatulence... and the body
becomes unable to absorb nutrients.
ADHD also can be associated with
gluten sensitivity. With gluten sensitivity, your
body makes antibodies only against gluten, not its
related enzymes. Being gluten sensitive means that
you don't do well with gluten in your diet, but it
doesn't have the broader health consequences of
being unable to absorb nutrients that celiac
disease does. You may have mild problems of
indigestion, bloating, gas and nausea... or
you may have no symptoms at all.
More to the point for us, however,
is that, according to Dr. Vojdani's research, the
antibodies against gluten impact the function of
the brain. What happens in the brain -- very
roughly speaking -- is this. Both celiac sufferers
and those who are gluten sensitive can't digest
the gluten peptide (peptides are very short
proteins made up of an amino acid chain). Gluten
peptides escape from the GI tract and get into the
blood. Antibodies then form to fight these intruders.
In spite of the antibodies, some of the gluten
peptides manage to cross into the brain. Once there,
they bind to receptors known as opioid receptors,
which are primarily responsible for sensing positive
pleasure-like stimuli. Like in a child's game of
musical chairs, since the gluten peptides already
have claimed a place on the receptors, when the opioid
peptoids try to bind, there isn't any room. It is
as if the gluten peptides have elbowed them out of
line. The result is neurological impairment, which
manifests in autism, ADHD or migraines.
Dr. Vojdani's work has focused
largely on autism, but he says that there is reason
to think that the inability to digest gluten peptide
exacerbates symptoms in some people with ADHD, and
also some migraine sufferers. His lab has found that
about one-third of the autistic children have gluten
sensitivity and he surmises that this would be true
of about the same percentage of those with ADHD.
Now What?
For those with ADHD, Dr. Vojdani
suggests having a blood test to determine the presence
or absence of the antibodies to gluten. This is a simple
test, he says, and it will tell you if gluten sensitivity
is an issue. If antibodies are present, you should
eliminate gluten completely from the diet. (See Daily
Health News , October 4, 2004 for exactly what this entails...
another good source for information is www.celiac.com.) Dr.
Vojdani says that while a gluten-restricted diet will have
almost an immediate effect on ADHD symptoms for some people,
more typically it will take three or so months to determine
if the diet is helping.
This is just the beginning of findings
associating poor digestion with autoimmune diseases. Stay
tuned for more.
