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The headache of celiac disease

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People with celiac disease have more headaches and more people with headaches have celiac disease

By Amy Ratner, Medical and Science News Analyst

If celiac disease is giving you a headache, you are not alone.

People who have celiac disease are more likely to have headaches and people who have headaches are more likely to have celiac disease, a study by researchers at the Medical School at Sheffield University found.

Celiac disease patients

The UK scientists reviewed 40 headache-related scientific articles published from 1987 to 2017 and found that the prevalence of headaches in adults with celiac disease was 26 percent and in children with celiac disease, 18 percent. More than 42,000 patients with either celiac disease or headaches with an unknown cause were followed in the studies included in the review, which was published in the journal Nutrients.

Overall, adult celiac disease patients were 2.7 times more likely to have headaches than those who did not have celiac disease.

“The odds of having a headache were significantly higher in the celiac disease groups,” the study authors wrote.

Studies specific to children and adolescents showed that they, too, were significantly more likely to suffer from headaches than study controls. One cross-sectional population-based study included in the review found that likelihood was about 2 times greater.

Unexplained headaches

Likewise, the prevalence of celiac disease in patients who had headaches with an unknown cause, called idiopathic headaches, was higher. Several case studies included in the review found that headache, usually migraine, was the first symptom of celiac disease.

One study found that among 90 adult patients with idiopathic migraine, about 4 percent had celiac disease compared to less than one-half a percent of controls without celiac disease. In a population-based epidemiological study that included both children and adults, researchers found that 4.7 percent of nearly 30,000 celiac disease patients reported visiting a doctor because of headaches compared to 2.9 percent of about 140, 000 controls.

Read more: Fatigue and celiac disease

The review noted that headaches associated with celiac disease are predominantly migraines, but lack of specific information on the type of headache found in some articles made interpretation of the results less clear.

When researchers analyzed the combined study results, they found that the overall prevalence of celiac disease in children with idiopathic headache was 2.4 percent. They said this was “significantly higher as compared to the prevalence of celiac disease in the general population in the same age group.” Individual study results varied, from one that found children with migraines were not more likely to have celiac disease to others found that the odds of a child with headaches having celiac disease ranged from two to eight times greater than controls.

Role of the gluten-free diet

While headaches are more common in celiac disease patients, the good news is that the gluten-free diet is often an effective treatment.  Up to 75 percent of adult patients with celiac disease reported their headaches ended when they followed the diet. In children with celiac disease, headaches resolved in 71 percent. The authors note this is consistent with improvement in neuropathy pain. And they advised patients to meet with a dietitian who specializes in celiac disease to avoid inadvertent gluten exposure that could lead to ongoing headaches.

The authors said they could find no studies that examined the prevalence of gluten sensitivity among those with idiopathic headaches and called for more research on the topic.

Brain imaging

The review also included studies the looked at CT, MRI and PET images in those with headaches. While brain imaging of those who have celiac disease and headaches can be normal, abnormalities can frequently be found, researchers wrote. Consequently, the review study concludes that patients with unexplained headaches and abnormal brain scans should be tested for celiac disease.

You can read more about the headache and celiac disease study here.

Sheffield researchers also published a study in Nutrients that found patients with gluten ataxia who have low levels of the antibodies associated with celiac disease benefit from a gluten-free diet. They said their results suggest an urgent need to redefine the cut-off level for antigliadin antibodies in diagnosing gluten ataxia, a rare disease in which the body's immune system reacts to the ingestion of gluten by attacking the nervous system. 

Read more about gluten ataxia here and the study here.  

 

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