Vertigo and Celiac Disease

Frequently reported symptom remains little studied

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Is it possible that eating gluten can cause you become dizzy and fall over? That is what some research has started to suggest, adding vertigo to the growing list of possible symptoms associated with celiac disease. It is a condition that may affect as many as one in four people with celiac disease, although there is little actual literature on the subject.

Understanding Vertigo

Vertigo is more than just a dizzy spell.

It refers to dizziness that stems from a dysfunction in the balance system of the inner ear. When you have vertigo, you may feel as if either the room is spinning or you are spinning. It's a disconcerting experience that can often happen whether you are sitting or standing.

The dizziness can sometimes be caused by an external stimulus that affects the inner ear (such as a rocking movement that can cause motion sickness). Alternately, it may stem from an actual disorder of the inner ear itself.

One such disorder is Meniere's disease, a condition characterized by chronic and sometimes debilitating bouts of vertigo. Some research suggests that gluten may have either a direct or indirect association with the disease.

Gluten and Meniere's Disease

There have long been anecdotal reports about people with celiac disease who have had recurrent dizzy spells, only to see them disappear once they started a gluten-free diet.

Despite there being little clear-cut evidence, the known neurotoxic effects of gluten have led some researchers to question whether the link might actually be real.

In recent years, a handful of researchers have begun to look at the impact of gluten on Meniere's disease, a disorder believed to be caused, at least in part, by autoimmunity.

Meniere’s disease is itself a confusing disorder. It has no known treatment and can manifest with severe dizziness, ear pressure, ringing, nausea, vomiting, and even migraine. Many people are unable to stand or walk during a spell. Sudden falls without the loss of consciousness (call drop attacks) may also occur.

A 2012 study looked specifically at gluten sensitivity in persons with Meniere's disease. A total of 58 persons were tested by skin prick test. Of these, 33 tested positive with reactions lasting anywhere from 20 minutes (suggesting low-level sensitivity) to 24 hours (suggesting high-level sensitivity).

While the results could hardly be considered conclusive, a number of case studies have suggested more than just an incidental link. One 2013 case, involving a 68-year-old female with Meniere's disease, reported periods of remittance whenever the woman adhered to a strict gluten-free diet and periods of relapse when she did not.

Other Causes of Vertigo

Celiac disease, as an autoimmune disorder, can cause progressive nerve damage that can lead to sensory disturbances, pain, and muscular weakness. One form, called autonomic neuropathy, can interfere with everyday body functions such as blood pressure, heart rate, and perspiration.

An estimated 25 percent of people with celiac disease have autonomic neuropathy and will often experience symptoms of vertigo, syncope (fainting), and postural nausea (nausea caused by changes in position).

While this suggests a somewhat clearer connection between glutens and vertigo, the dizziness may be more an aftermath of disease rather than one affected by gluten intake. To date, no study has shown improvement in symptoms after starting a gluten-free diet.

What This Tell Us

The current research is more suggestive than conclusive about the relationship between gluten and vertigo. There is a chance that changing to a gluten-free diet may help, but then again it may not.

If you are diagnosed with celiac disease, clearly you should be on a gluten-restricted diet. But whether you are or not, if you are experiencing severe or chronic dizziness, you need to have it looked at. It may have nothing whatsoever to do with celiac disease and require examination from a neurologist and an ear, nose, and throat specialist to better pinpoint the cause.

Sources:

DiBerardino, F. and Cesarini, A. "Gluten sensitivity in Meniere's disease." The Laryngoscope. 2012 Mar;122(3):700-2.

DiBerardino, F.; Fillaponi, E.; Alpini, D. et al. "Ménière disease and gluten sensitivity: Recovery after a gluten-free diet." American Journal of Otolaryngology. 2013; 34(4):35-56.

Rashtak, S.; Marietta, E.; and Murray, J. "Celiac sprue: a unique autoimmune disorder." Expert Rev Clin Immunol. 2009; 5(5): 593-604.

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