Gluten may cause depression in subjects with non-c gluten sensitivity

natasa778

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Randomised clinical trial: gluten may cause depression in subjects with non-coeliac gluten sensitivity – an exploratory randomised clinical study

Interesting discussion as to why this could be happening:

The observed change in current feelings of depression is appreciable. According to Spielberger's norms for state depression scores,[24] the mean scores of participants in this study went from being largely ‘neutral depressive’ in the placebo condition to being ‘mild depressive’ following the consumption of gluten.[24] However, Spielberger's norms are based on clinical populations whereas patients in the current study had not been diagnosed as clinically depressed. That said, this observed change over a 3-day intervention is plausible. Personality and mood states are widely accepted as being transitory and rapidly changing, often from moment to moment.[29] If such a change is indeed a gluten-specific effect, the mechanisms involved require elucidation.

One explanation might be alterations in cortisol secretion as circulating concentrations of cortisol are greater with negative affect (i.e. aversive moods such as anxiety, hostility and depression). However, the degree to which this association is due to stable individual differences (i.e. traits) or transient differences in affect (i.e. states) remains unclear.[30] There is currently no evidence that gluten ingestion can stimulate cortisol secretion, but this link has been seldom studied.[31] In the current study, cortisol concentrations during each dietary period were measured in saliva, a technique that has been shown to provide a feasible, accurate and practical alternative to blood determinations.[32, 33] These were similar across all dietary treatments, indicating that state depression may not be as closely associated with cortisol secretion compared to trait depression, as previously described.[30]

A second potential mechanism is via alteration of brain serotonin (5-hydroxy-tryptophan, 5-HT). Decreased brain 5-HT concentration has been long suggested as a cause of depression.[34] The synthesis of 5-HT in the brain is dependent on the availability of its amino acid precursor, tryptophan. Interestingly, recent work has identified a link between protein ingestion, tryptophan production and concentrations of 5-HT in the brain.[35] In this study, rats consuming food supplemented with food-grade wheat for 2 h had modest reductions in concentration of tryptophan in the brain suggesting that 5-HT pathways are remarkably sensitive to various proteins present in food.[35] Whether carbohydrate-depleted gluten results in reductions of tryptophan concentration in the human brain requires further exploration. Nonetheless, serotonergic dysfunction due to impaired availability of tryptophan has been shown to play a role in various psychological conditions including depression.[36-39]

A third explanation involves the so-called gluten ‘exorphins’. These opioid peptides derived from partially digested food proteins including gluten can modulate intestinal function,[31] and can cross the blood–brain barrier and interfere with pain-inhibitory systems, emotionality and memory processes by modulating other hormonal or neurotransmitter systems via the opioid receptors as well as endogenous opioid peptides in the central nervous system (CNS).[40] Such a possibility could be investigated by, for example, the concomitant use of naloxone to block opioid receptors.

A fourth possibility might involve gluten-mediated changes in gut microbiota. Several studies have reported intestinal dysbiosis in patients with coeliac disease.[41] Interestingly, some of the alterations in gut microbiota are restored after adherence to a GFD.[41] This suggests that these changes are secondary consequences of the disease and perhaps directly related to the consumption of gluten. Evidence supporting an important influence of gut microbiota on emotional behaviour and underlying brain mechanisms is well established in adult rodents[42-44] and is emerging in humans. A recent study has provided first evidence that probiotics can modulate the activity of brain regions involved in processing emotion and sensation in adult women.[45] Whether 3 days is sufficient to induce changes in microbiota is uncertain, but this hypothesis requires further investigation in the NCGS population.

… importantly no difference was observed in anxiety or salivary cortisol levels across the three dietary challenges and depression was only associated with the ingestion of gluten.

In conclusion, the findings of gluten-specific acute changes in current feelings of depression, with no effects on trait indicates, provide a clue that the improvement reported by participants may be in the perception of their general well-being rather than in gastrointestinal symptoms. Such an association requires a larger and more detailed examination.
 

Wayne

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The book "Grain Brain" is comprehensive and easy read. --- Describes the high prevalence of "gluten sensitivity", and how it majorly impacts the body, especially the brain. This can occur even when there are NO indications of Celiac Disease, and can be even MORE serious than CD.

--- by Dr. David Perlmutter

Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar--Your Brain's Silent Killers

--- This online article is a good read as well:

The Dark Side of Wheat - New Perspectives On Celiac Disease and Wheat Intolerance - by Sayer Ji
 
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Hip

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18,108
This is very interesting. I suffered from gluten-induced depression all my life. Whenever I eat gluten, after around an hour, significant depression hits me, and this depression last for around 8 hours before subsiding. I don't get any other symptoms from eating gluten, just depression. This arrival of depression in me would occur like clockwork as soon as I ate gluten.

The odd thing, though, is that since getting ME/CFS, I no longer get depressed by eating gluten. So whatever the mechanism by which gluten triggers depression, somehow the changes that occur in ME/CFS have arrested that mechanism.

If it is exorphins — the opioid peptides derived gluten — that are causing the gluten-induced depression, then since ME/CFS patients have altered beta endorphin levels, this might explain why my ME/CFS abolished my gluten-induced depression.


Another possible mechanism for the cause of gluten-induced depression — one that is not mentioned in the above papers — is depression arising from the immune activation that gluten can cause in the intestines of some sensitive people (new studies show that immune activation may underpin depression).

I read some very interesting research by Dr Alessio Fasano, who has investigated the difference between gluten sensitivity in those with celiac disease, and non-celiac gluten sensitivity.

It turns out that in non-celiac gluten sensitivity, the innate immune system targets and attacks the gluten in the intestines, leading to inflammation both inside and outside the digestive system. Whereas in celiac gluten sensitivity, this immune attack involves both the innate immune system and the adaptive immune system responding to gluten.

It is the adaptive immune system that is behind autoimmune disease, and in celiac disease, gluten causes the adaptive immune system to mount an autoimmune attack on the intestines, leading to intestinal damage (specifically, destruction of the villi of the small intestine).

In non-celiac gluten sensitivity, because the adaptive immune system is not involved, there is no intestinal damage. Although Dr Fasano says non-celiac gluten sensitivity can produce near-identical symptoms to celiac, including diarrhea, bloating, abdominal pain, joint pain, depression, brain fog and migraines.
 

Wayne

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Location
Ashland, Oregon
The following is from Dr. David Perlmutter's Website:

Gluten Containing Products
If experiencing gluten intolerance symptoms, the products on this page should be avoided. Instead, concentrate on gluten free, brain healthy foods. Many are listed here. This is sure to help maintain or improve brain health and function.

The following grains and starches contain gluten:
  • Wheat
  • Wheat germ
  • Rye
  • Barley
  • Bulgur
  • Couscous
  • Farina
  • Graham flour
  • Kamut Matzo
  • Semolina
  • Spelt
  • Triticale
The following foods often contain gluten:
  • malt/malt flavoring
  • soups
  • commercial bullion and broths
  • cold cuts
  • French fries (often dusted with flour before freezing)
  • processed cheese (e.g., Velveeta)
  • mayonnaise
  • ketchup
  • malt vinegar
  • soy sauce and teriyaki sauces
  • salad dressings
  • imitation crab meat, bacon, etc
  • egg substitute
  • tabbouleh
  • sausage
  • non-dairy creamer
  • fried vegetables/tempura
  • gravy
  • marinades
  • canned baked beans
  • cereals
  • commercially prepared chocolate milk
  • breaded foods
  • fruit fillings and puddings
  • hot dogs
  • ice cream
  • root beer
  • energy bars
  • trail mix
  • syrups
  • seitan
  • wheatgrass
  • instant hot drinks
  • flavored coffees and teas blue cheeses
  • vodka
  • wine coolers
  • meatballs, meatloaf communion wafers
  • veggie burgers
  • roasted nuts
  • beer
  • oats (unless certified GF)
  • oat bran (unless certified GF)
The following are miscellaneous sources of gluten:
  • shampoos
  • cosmetics
  • lipsticks, lip balm
  • Play-Doh
  • medications
  • non self-adhesive stamps and envelopes
  • vitamins and supplements (check label)
The following ingredients are often code for gluten:
  • Avena sativa Cyclodextrin
  • Dextrin
  • Fermented grain extract
  • Hordeum distichon
  • Hordeum vulgare
  • Hydrolysate
  • Hydrolyzed malt extract
  • Hydrolyzed vegetable protein
  • Maltodextrin
  • Phytosphingosine extract
  • Samino peptide complex
  • Secale cereale
  • Triticum aestivum
  • Triticum vulgare
  • Tocopherol/vitamin E
  • Yeast extract
  • Natural flavoring
  • Brown rice syrup
  • Modified food starch
  • Hydrolyzed vegetable protein (HVP)
  • Hydrolyzed soy protein
  • Caramel color (frequently made from barley)
You can get tested for gluten sensitivity using a Cyrex array 3 test. More information about the Cyrex test can be found at the Cyrex website.
 
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