Numbness, loss of coordination, and migraine episodes are common neurological symptoms in people with celiac disease.

Celiac disease is an autoimmune disorder triggered by an abnormal reaction to gluten, a protein found in wheat, barley, and rye. This reaction leads to inflammation in the small intestine, which can affect nutrient absorption.

While celiac disease is primarily known for digestive symptoms, it can also affect the nervous system, with neurological complications occurring in 6% to 10% of cases. These symptoms can include:

  • loss of coordination
  • weakness
  • migraine attacks

This article examines the link between celiac disease and neurological symptoms, including what causes these symptoms and how they may be treated.

Celiac disease may cause neurological symptoms through several mechanisms:

  • Immune response to gluten: In celiac disease, the immune system reacts to gluten, producing antibodies that can attack nerve tissue. This can lead to symptoms like coordination problems (ataxia) and nerve damage (neuropathy).
  • Immune complex deposits: In severe cases, immune complexes (clusters of antibodies and antigens) can build up in the nervous system, causing inflammation and damage to the brain and nerves.
  • Direct nerve damage: Breakdown products of gluten may also directly harm nerve cells.
  • Nutrient deficiencies: Celiac disease can damage the small intestine, making it hard for the body to absorb important nutrients like vitamins B12 and D, which are needed for nerve health. This can cause problems with memory and nerve function.
  • Gut microbiota and the gut-brain axis: Changes in the gut microbiota (the bacteria in the intestines) can affect brain function through the gut-brain axis, which connects gut health to neurological symptoms.

Celiac disease is associated with several neurological disorders, including:

  • Gluten ataxia: This is one of the most common neurological manifestations. It’s a type of impaired coordination, particularly in walking, and can lead to difficulty speaking (dysarthria) and unusual eye movements.
  • Peripheral neuropathy: Peripheral neuropathy involves damage to the peripheral nerves, leading to symptoms like numbness, tingling, and weakness in the arms and legs. Up to 50% of people with celiac disease may develop peripheral neuropathy
  • Epilepsy: Seizures have been reported in some people with celiac disease, potentially triggered by malnutrition or immune system dysfunction. Epilepsy is 1.8 times more common in individuals with celiac disease compared to the general population.
  • Migraine: A 2021 study found that research participants with celiac disease were more likely to experience migraine than the control group (20.7% versus 11.9%). Migraine attacks were also more prevalent in the female research participants than in the male participants (80% in females versus 19% in males).
  • Brain fog: Difficulty concentrating, memory problems, and mental fatigue, often experienced by individuals with celiac disease due to immune responses and inflammation affecting brain function.
  • Cognitive disorders: Research suggests that people with celiac disease experience cognitive difficulties, particularly with memory and visual skills.
  • Depression and anxiety: Most gastrointestinal disorders, including celiac disease, are linked to higher rates of depression and anxiety. Neuroinflammation in the anterior cingulate cortex (ACC), a brain region involved in emotions, decision making, and attention, may contribute to mood and cognitive issues in people with GI disorders. The ACC is particularly sensitive to inflammation.
  • Myopathy: Myopathy refers to muscle weakness and may be linked to both the disease itself and nutrient deficiencies, like vitamin D or B12.
  • Brainstem encephalitis: Encephalitis is an inflammation of the brain tissue that can lead to a range of neurological symptoms.

The primary treatment for celiac disease is a strict, lifelong gluten-free diet that eliminates all sources of gluten. Following this diet helps heal the intestines, manage symptoms, and prevent further damage.

Many neurological issues, such as ataxia, peripheral neuropathy, and cognitive impairment, often improve with adherence to the gluten-free diet, as it reduces inflammation and supports the healing of the nervous system.

In addition to the gluten-free diet, other supportive treatments may include:

  • Nutrient supplementation: People with celiac disease may have deficiencies in vitamins like B12, D, and folate, which are important for nerve function. Correcting these deficiencies can help reverse or slow down neurological symptoms.
  • Symptom-specific treatments: Additional treatments may be needed for managing neurological symptoms. Peripheral neuropathy is often treated with pain relievers like gabapentin (Neurontin) or pregabalin (Lyrica). Migraine and headaches are managed with medications such as triptans or nonsteroidal anti-inflammatory drugs (NSAIDs). Seizures are managed with anticonvulsants, and depression is treated with antidepressants or therapy.
  • Physical and occupational therapy: These therapies may help with motor coordination issues, balance, and cognitive challenges caused by neurological involvement.

Celiac disease can cause a variety of neurological symptoms, including migraine attacks, gluten ataxia (impaired coordination), and peripheral neuropathy (numbness, tingling, or weakness in the arms and legs).

Early detection and strict adherence to a gluten-free diet are key to managing these issues.

If you’re experiencing neurological symptoms with celiac disease, consider talking with your healthcare professional to explore treatment options.