Attention deficit disorder hyperactivity disorder, ADHD, is one of the most common disorders found in childhood, affecting an estimated 5 to 7 percent of school-aged children. The hallmark symptoms of this disorder are hyperactivity, poor attention span and poor impulse control. What causes ADHD is not clear. There is speculation about a possible relationship between nutritional disorders and ADHD. One such disorder is gluten sensitivity, also known as celiac disease.
Features
Celiac disease is characterized by an inability to tolerate gluten, a protein found in wheat, barley and rye. When people with celiac disease ingest foods or products containing gluten, their immune system is stimulated to damage the small intestine. This results in the intestine's ability to absorb nutrients and severe malnutrition. Although celiac disease is a digestive disorder, neuropsychological symptoms may be the only manifestation of the disorder and can lead to a misdiagnosis such as ADHD. The only treatment for celiac disease is a gluten-free diet, which eliminates symptoms in most people.
Theories/Speculation
ADHD and celiac disease are both commonly seen in childhood and both are increasing in prevalence. Both disorders can be manifested by behavioral symptoms. Celiac disease causes severe malnutrition and malnutrition in early childhood has been linked to behavioral problems. These observations along with anecdotal reports suggest a plausible association between ADHD and celic disease.
Potential
Treatment of ADHD usually involves the use of medications with potentially significant side effects, along with extensive psychotherapy. With increasing concerns about the safety and efficacy of current ADHD medications, there is interest in alternative approaches to treating ADHD. Dietary modification is one such approach, as it gives parents a more direct role in the health and well-being of their child.
Evidence
Zelnick and his colleagues found neurological disorders in more than 50 percent of patients with celiac disease. However, a gluten-free diet did not improve symptoms in those patients with learning disorders or ADHD. Later, a 2006 study did demonstrate improvement in persons with both celiac disease and ADHD-like symptoms after six months on a gluten-free diet. These studies were small and limited in design and and have yet to be duplicated in larger, randomized trials. Currently, evidence for an association between ADHD and celiac disease is mainly based on anecdotal reports from parents after removing gluten from the diet of ADHD children.
Warning
There is very little scientific evidence to support a link between ADHD and gluten sensitivity or celiac disease. It is important to understand that ADHD-like symptoms in celiac disease may simply reflect the underlying physical disease, not ADHD itself. Behavior and learning problems in the context of demonstrated celiac disease should be treated with a gluten-free diet. For ADHD children without documented celiac disease, parents should consult with a health care provider before embarking on such a drastic dietary modification.
References
- CDC - ADHD, Data and Statistics - NCBDDD
- "Nature Reviews Gastroenterology and Hepatology"; The Spectrum of Celiac Disease: Epidemiology, Clinical Aspects and Treatment; Greetje Tack et al; April 2010
- "Journal of Developmental Disabilities"; Celiac Disease: Its Many Faces and Relevance to Developmental Disabilities; Maire Percy and Evan Propst; Feb 2008
- "Pediatrics"; Range of Neurologic Disorders in Patients with Celiac Disease; N Zelnick; June 2004
- "Journal of Attention Disorders"; A Preliminary Investigation of ADHD Symptoms in Persons with Celiac Disease; N iederhofer and K Pittschieler; Nov 2006
