LOS ANGELES—A strict gluten-free diet may help protect against the nerve pain that some patients with gluten sensitivity experience, according to a preliminary study presented at the American Academy of Neurology’s 70th Annual Meeting. “These findings are exciting because it might mean that a relatively simple change in diet could help alleviate painful symptoms tied to gluten neuropathy,” said lead author Panagiotis Zis, MD, PhD, Honorary Senior Lecturer at the University of Sheffield, United Kingdom. “While our study shows an association between a self-reported gluten-free diet and less pain, it does not show that one causes the other.”
Gluten neuropathy is the second most common neurologic manifestation of gluten sensitivity, after cerebellar ataxia. It is defined as an idiopathic neuropathy, in the absence of an alternative etiology despite extensive investigations, and in the presence of serologic evidence of gluten sensitivity (IgA and/or IgG antigliadin antibodies).
To establish the prevalence of pain in patients with gluten neuropathy and to describe any contributory factors, Dr. Zis and colleagues invited all consecutive patients with gluten neuropathy attending a specialist gluten/neurology clinic to participate in their study. Pain was assessed via the DN4 questionnaire and the visual analog scale. The Overall Neuropathy Limitations Scale (ONLS) was used to assess the severity of neuropathy. The Mental Health Index (MHI-5) was used to measure participants’ general mental health status.
In all, 60 patients (76.7% males, mean age 70) with gluten neuropathy were recruited. Pain was present in 33 patients (55.0%). Comparison between groups of painful and non-painful gluten neuropathy did not show significant differences regarding age, gender, neuropathy severity, or neuropathy type. Patients with painless gluten neuropathy were more likely to be on a strict gluten-free diet (55.6% vs 21.2%). Patients with painful gluten neuropathy presented with significantly worse MHI-5 score (75.9 vs 87.4). Multivariate analysis showed that, after adjusting for age, gender, and MHI-5 score, adherence to a strict gluten-free diet was associated with lowering the odds of peripheral neuropathic pain by 88.7%.
“This study is promising because it shows that a gluten-free diet may help lower the risk of pain for people with gluten neuropathy,” Dr. Zis said. “More research is needed to confirm these results and to determine whether the gluten-free diet led to the reduction in pain.”