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Thursday, May 29, 2008

What does gluten have to do with Lyme?

One of my colleagues, an ILADS member, who treats many chronic Lyme patients told me that her patients all had Celiac disease. That's interesting. None of my patients had this problem. Doctors are conventionally taught that Celiac disease can be reliably diagnosed by a blood antibody test called tTG of the IgA class. Celiac disease is caused by an allergic reaction to a protein found in wheat products called gluten. The gold standard for the diagnosis is a small bowel biopsy, generally obtained via an endoscope, passed through the mouth into the duodenum, which shows the characteristic pathological changes of a loss of villi. The disease is associated with gastrointestinal symptoms including diarrhea, maladsorption of nutrients, abdominal pain and bloating and weight loss. There are also non gastrointestinal manifestations of the disease which may be variable, but include fatigue, muscle and joint pain, peripheral neuropathy or numbness and tingling and cognitive impairments including brain fog. These symptoms are identical to the ones seen in chronic Lyme disease, is there a connection? Celiac disease is supposed to be present in 1% of the general population. I tested all my Lyme patients. None were positive. What's the rub? I did a little more research. Another paradigm bending idea is out there. Gluten sensitivity may be a disorder which exists on a continuum. Perhaps Celiac is the tip of the iceberg. There may be many patients who do not have full blown Celiac but still have gluten sensitivity. Perhaps many of these patients have an exacerbation of "Lyme" symptoms because they have another disorder which dovetails its symptoms with those of Lyme disease. Perhaps gluten sensitive individuals were not terribly symptomatic until they developed Lyme disease. And then the non gastrointestinal symptom complex becomes prominent. Many Lyme patients do in fact have gastrointestinal symptoms. Many patients with gluten sensitivity are diagnosed with such things as irritable bowel syndrome, non-specific or microscopic colitis, gastrointestinal reflux and a host of related disorders. Research has shown that this group of patients has a much higher incidence of gluten sensitivity. So how is this diagnosed. The standard blood test and small bowel biopsy will be normal. A specialty lab, called Enterolab, has pioneered a stool test which detects small amounts of antibodies directed against gluten. Primarily, this is the stool anti-gliaden antibody test. The test can only be ordered on line by patients and costs about $100.00. Again, the concept is that these patients do not have Celiac disease. None the less, they have a gluten allergy or sensitivity which causes many symptoms which overlap with those of Lyme patients. When such patients go on a gluten free diet they feel better and many of their symptoms improve. This is not a replacement for treating Lyme, but may be a helpful adjunct filling in a piece of a complex puzzle. I should caution the reader that this is a difficult diet. Symptom relief may not be seen for about two months. The diet must be continued indefinitely since there is no cure. Gluten has nothing to do with Lyme. A new paradigm suggests that many folks suffer with gluten sensitivity which is not Celiac disease, who may benefit from a gluten free diet.


LAC said...

I also have this sensitivity to gluten, as well as dairy, corn, and soy. I've known this for years, which is why neither I nor a very good naturopathic doc were unable to figure out for years that I had something going on behind the food sensitivities, and that (by all indications) is Lyme.

the proprietor said...

I also have this sensitivity to gluten, as well as dairy, corn, and soy. I've known this for years, which is why neither I nor a very good naturopathic doc were unable to figure out for years that I had something going on behind the food sensitivities, and that (by all indications) is Lyme.

Do you have any indications that Lyme can exacerbate food allergies? Mine seem to have worsened lately. For the first time ever. i am carrying a rescue kit.

lifeisbeautiful said...

My father, my brother, and I, all have had bad bouts with Lyme disease, and were unaware of celiac before the advent of the disease. I'm not certain, but I don't think my brother ever was officially diagnosed, but just went on a stict gluten-free diet. I don't think any of us had the dramatic arthritis that can be associated with Lyme disease. I suffered long with Lyme disease, as I got it back in the 80's, and my first ELISA was positive, but the western blot was equivocal, and based on that, they ruled it out. That was a couple of years after I first started complaining about fatigue, and brain fog, and the doctors found an elevated liver enzyme test, but since the liver biopsy found only granulomas, they never narrowed the diagnosis down from granulomotous hepatitis.

I have been saying for a while that I think there is a connection between chronic Lyme and celiac disease. I think it is likely that the immune response to Lyme triggers celiac symptoms. It happened 3 times in my family. We all feel better on a gluten-free diet.

Kitkatkatie said...

I absolutely saw an exacerbation of all allergies and sensitivities when my Lyme disease was at its worst. I used Claritin for the times when it was unmanageable, after incidentally reading that it was actually beneficial in treating neuro symptoms from Lyme and coinfections. A paleo diet was instrumental in my recovery, and I revert to that eating pattern whenever I feel unwell.

No one has all the answers, but I do believe that inflammation from allergy is not condusive to feeling well or recovering. So better to notice those substances or foods that are problematic and make lifestyle changes. Mine were not permanent issues and I do not have the same symptoms now. You will be able to eat bread or beef or milk again, once the digestive system is less permeable from Lyme. Food sensitivity could possibly be related to active infection.

Unknown said...

For those people who are celiac disease sufferer and maybe reading this, I find it hard that people are still ignorant when it comes to celiac disease.
My journey and diagnosis with celiac disease began with headaches, I gained over 50 pounds after my diagnosis. my symptoms included stomach pain, constipation, and generally feeling uncomfortable, muscle pain, bouts of fatigue and depression, stomach aches, nausea, and frequent trips to the bathroom. I endured several misdiagnoses and treatment regimens, Migraines started at age seven, I can recall suffering as a child, I grew up thinking it was normal to have daily stomach pain, headaches, though stomach problems ran in my family, but no one felt as miserable as I did on a daily basis. I fell asleep in my clothes without eating dinner not knowing how my body would react, I had become afraid of food.
I felt a moment of relief hoping that, I am free from this ailment, and I remind myself how lucky to come across Lance Justin's herbal medicine which is able to control my disease. I promised myself that I would stay strong and not sneak food that would cause me any harm again. The only thing I wanted was to feel better. I’m proud to say I am celiac disease free. You can also contact him through (

Aili said...

I was diagnosed with lymes disease about 7 years ago while working at a doggy daycare. Since then I've had to cut out red meat because that interacts with having lymes and makes you sick as a dog otherwise known as alphagal. After about 3 years I also had to cut out gluten as it's also been an upset to my system. More recently I've had one of the worst flair ups between muscle/ joint pain, severe fatigue, brain fog, numbness tingly in my arms and legs. Now reading this article I know I have to get back on a full gluten free diet, as I did cheat and now paying the price. Thank you for putting this article out their.