If you haven’t yet read Peter Green’s Celiac Disease: A Hidden Epidemic go to Barnes and Noble today and purchase a copy.  It’s really a fantastic book to read at every stage of your diagnosis.  Dr. Green explains the disease clearly without talking down to his readers.  He also has good advice for people who are just starting on their glorious journey toward gluten free eating.

What I found particularly fascinating in Green’s book was the chapter on the various manifestations of celiac disease.  Diarrhea, bloating, constipation, and skin eruptions are the more well-known symptoms of the disease, but did you know that celiac disease can have neurological manifestations as well?

The neurological manifestations of celiac disease include peripheral neuropathy (numbness in hands and feet), ataxia (balance disturbance), epileptic seizures, migraines, and dementia.  Any one of these affect 8%-10% of the celiac population!  Celiacs are susceptible to these neurological issues because of vitamin deficiencies, the inflammation in their bodies, and the antiganglioside antibody which reacts against nerves.

Another perhaps more well-known manifestation of celiac disease is osteoporosis.  Many believe that osteoporosis is connected to celiac disease due to the malabsorption of calcium and vitamin D, and that is true but the story is even more complex than that.  Patients who went undiagnosed as children didn’t get enough calcium when their bones needed it most: during formation.  These people are at a much higher risk of osteopenia and osteoporosis.  Another reason celiacs are more likely to have problems with their bones is that they tend to go into menopause earlier than the general population.  During menopause, hormones that stimulate bone growth drop which may contribute to bone loss.  It is also possible that the antibody that attacks the gluten in celiacs might also contribute to bone loss.

Depression is another possible manifestation of celiac disease.  Dr. Green relates that in an auditorium filled with celiacs the following question was posed:  How many of you have been told that your symptoms were stress/depression related?  Over three quarters of the people raised their hands.  Depression might be result of the severely restrictive diet, a reaction to having an illness, or even a biological reaction to having a prolonged sickness.  A while back I wrote a blog about depression and celiac disease.  Check it out at  http://www.jensglutenfreeblog.com/gluten-free-health/celiac-disease-can-cause-lactose-intolerance-depression/ for more details about the link between the two.

The body is an intensely complex interrelated organism.  When one aspect is so severely affected by a disease it shouldn’t come as a shock that other systems react as well.  The problem is that the various fields within medicine are so specialized  that when you go to a neurologist for numbness in you hands he is not trained to think celiac disease.  It often takes years to diagnose the disease (when Dr. Green wrote this book in 2006 the average amount of time it took to diagnose celiac disease was 9 years!).  For those of you who have already been diagnosed, consider yourselves lucky.  For those of you who haven’t, keep pushing your doctor.  If there is one thing I learned from Dr. Green’s book it is the importance of patient advocacy.