A gluten-free diet is a medical necessity for people with celiac disease or non-celiac gluten sensitivity; however, it is garnering increased attention as a potential treatment for certain psychological disorders, including ADHD. Research shows that gluten-related disorders, such as celiac disease, are far more prevalent among those with ADHD compared to the general population. While the exact link between gluten and ADHD is not known, results from recent research are narrowing the gap.
Gluten: A Common Protein
Gluten is a protein found in the grains wheat, rye and barley. It is also present in most processed foods in the form of additives such as modified food starch or malt flavoring. It is a desirable component in breads because its elastic properties provide structural stability to the dough and improve the texture. For those with celiac disease -- a true gluten allergy -- absolute avoidance of gluten is necessary, since even trace amounts can lead to intestinal damage and digestive discomfort.
ADHD and Gluten Intolerance
Gluten intolerance is of special concern for the ADHD population, because of the prevalence of celiac disease as compared to the general population. A study conducted in 2011 found that one out of seven ADHD subjects also had celiac disease, which is significantly more than the one out of 100 in the general population. After six months following gluten-free diet, the patients with celiac disease showed significant decreases in ADHD symptoms. Although this particular study only observed 67 subjects, it reinforced previous findings from a 2006 breakthrough study that observed 132 subjects with both celiac disease and ADHD. Together, these results show that in some cases, the presence of ADHD can be a result of another underlying condition, and treatment for celiac disease can significantly improve ADHD symptoms.
The Gluten-Brain Connection
Although scientists believe ADHD is caused by a combination of factors, diet should be considered when celiac disease or NCGS is also present. Persons with celiac disease have increased intestinal permeability, or a "leaky-gut." Basically, this means that when the small intestine is in a state of crisis -- as it is when continually in contact with gluten; then bacteria, toxins and undigested food proteins that would normally be filtered out and eliminated are instead passed through the small intestine, into the bloodstream, and then distributed throughout the body. Some of these unwanted particles can affect receptors in the brain.
In addition, people with undiagnosed celiac disease or NCGS are often in a continual state of inflammation. Since they are likely consuming gluten regularly, their digestive systems are in a constant state of distress. Besides leading to general discomfort, it can cause headaches, abdominal and joint pain and the production of stress hormones. Eventually, the small intestine will become damaged and have difficulty processing essential nutrients which, in turn, negatively effects the functioning of many body processes including the production of certain neurotransmitters for the brain.
Treatment of ADHD is complex, not only because its cause is multifaceted, but also because ADHD can be a either a primary diagnosis or a secondary one if it is the symptom of an underlying condition like celiac disease. Currently, a gluten-free diet is not considered standard treatment for ADHD, except for those who have celiac disease or other gluten-related disorders. Dr. Marie-Nathalie Beaudoin, a researcher in the area of psychological disorders, says that celiac disease should be ruled out before initiating other medical treatment, since research has shown significant improvement in ADHD symptoms with a gluten-free diet.
- National Foundation for Celiac Awareness: The Gluten-Free Link: ADHD, Autism, Celiac Disease and Non-Celiac Gluten Sensitivity
- The Primary Care Companion for CNS Disorders: Association of Attention-Deficit/Hyperactivity Disorder and Celiac Disease: A Brief Report
- National Institute of Mental Health: What is ADHD?
- Journal of Attention Disorders: A Preliminary Investigation of ADHD Symptoms in Persons with Celiac Disease.