A book titled The Gluten Effect makes a few interesting points. In one study of 123 patients with fibromyalgia, 73% were suffering from IBS. While 2% of the population has fibromyalgia, 9% of patients with celiac disease have the condition, much higher than the normal population.
This link actually argues that fibromyalgia is NOT associated with celiac disease because those with fibromyalgia have been found to have decreased serotonin, the argument being that there is a biological underlying issue to fibromyalgia (low serotonin) that cannot be attributed to celiac disease. BUT, in a study from 2006, it was found that those with celiac disease absorb less of the amino acid tryptophan. Tryptophan is the precursor to serotonin and decreased levels of this amino acid are directly related to decreased levels of serotonin (Margutti P, Delunardo F, Ortona E.). Coincidence? I don’t know.
What are the symptoms of fibromyalgia? Fatigue, insomnia, chronic pain, muscle and joint pain, numbness, tension/migraine headaches, memory/cognitive difficulties. Let’s look at some of these in Cleo Libonati’s book, Recognizing Celiac Disease:
75% of CD patients complain of fatigue at their time of diagnosis (including both Nadine and myself). This is primarily due to nutritional deficiencies: iron, magnesium, protein and vitamin C.
Insomnia is due to the reduction of the synthesis of neurotransmitters in the central nervous system. This can result from multiple malabsorptions in CD: vitamin B6, B-complex, magnesium, thiamin, calcium, EPA and especially tryptophan (remember this one? It is needed to make melatonin AND serotonin!).
Muscle pain is common in CD, resulting from multiple vitamin and mineral deficiencies: thiamin, vitamin C, E, K, niacin, pyridoxine, vitamin B12, magnesium or selenium.
Joint pain, or arthritis, is caused by inflammation damaging joints or connective tissues. It is an autoimmune condition, and is thought to have an outside cause. Celiac disease is in fact an autoimmune condition that causes inflammation throughout the body. In celiac disease, when your body is exposed to gluten, in produces antibodies against itself, known as tissue tranglutaminase (TTG for short). These can cause several autoimmune conditions to occur, one of which is arthritis and pain in the joints. Furthermore, there are several deficiencies that can lead to arthritis. Omega-3 deficiency is found to exacerbate psoriatic arthritis, though the reason is unknown. Vitamin C deficiency can cause rheumatic pains in the legs and can cause arthritis that often mimics rheumatoid arthritis.
In a study of patients with celiac disease and migraine headaches it was found that 64.5% had late on-set celiac disease, showing that even though there is a correlation, it might not be due to deficiencies. However, in the remaining 35.5% with childhood onset celiac disease, malabsorption of folic acid has been linked. Migraines are often the result of reduced blood flow to the brain. A gluten free diet has been shown to normalize this blood flow leading to improved/resolved migraines. Just a personal interlude here. While I don’t suffer from migraines, it is something that runs in my family on my maternal side: my sister, grandmother and uncles. I have two genes for celiac disease, one from my mother, increasing the chance that the relatives on that side have the gene, too. While most haven’t gone gluten free yet (I’m still working on them), my sister has. Her mind splitting migraines, that have existed since she was six, have virtually disappeared in the last 6 months that she has been on a gluten free diet.