The excessive consumption of wheat is another problem with the Mediterranean diet. While traditional Mediterranean fare focuses on whole grains, including whole wheat bread and pasta, these can be problematic for some people with anxiety.

Gluten sensitivity, also called “gluten intolerance,” is a disorder where your body reacts badly to eating gluten, a protein found in wheat, rye, and barley grains. Gluten sensitivity has some of the same symptoms as celiac disease, but doesn’t cause permanent damage to your small intestine like celiac disease can.

Celiac disease (CD), sometimes called “celiac sprue” or “gluten-sensitive enteropathy,” is an immune reaction to eating gluten. If you have celiac disease, eating gluten triggers an immune response in your small intestine. CD and gluten sensitivity have been associated with anxiety largely due to their distressing symptoms.

CD and gluten sensitivity share a lot of the same symptoms, including the following:

  • Anxiety
  • Depression
  • Brain fog
  • Headaches
  • Fatigue
  • Bloating
  • Constipation and smelly feces
  • Diarrhea
  • Gas
  • Abdominal pain
  • Iron-deficiency anemia
  • Autoimmune disorders
  • Skin problems, such as an itchy rash
  • Joint and muscle pain
  • Leg or arm numbness
  • Unexplained weight loss

A number of studies have confirmed the increased association between CD and anxiety (Hauser, 2010). A Scandinavian study of CD patients found they were significantly more likely to have anxiety when compared to controls and that after one year on a gluten-free diet, there was a significant improvement in anxiety symptoms.

Other anxiety disorders such as social anxiety disorder (SAD) and panic disorder have been linked to gluten sensitivity. An Italian CD study reported a significantly higher proportion of CD patients had SAD compared to people without CD. Additionally, a higher lifetime prevalence of panic disorder has been found in CD patients.

Researchers remain uncertain as to what causes anxiety in people with CD and gluten sensitivity. People diagnosed people with CD report feelings of both anxiety and depression. But it’s not clear whether or not gluten in the diet actually causes anxiety, or whether the anxiety is related to something else. It’s most likely be a combination of factors, including an anxious reaction to the need to follow a gluten-free diet and as well as the effect of gluten itself on the brain. Even non-celiac gluten sensitivity appears to have a significant neurological component.

It’s also possible that nutritional deficiencies and malnutrition contribute to anxiety in people with CD and gluten sensitivity because intestinal damage can prevent the absorption of nutrients. The chronic diarrhea and fat malabsorption resulting from CD and gluten sensitivity can lead to nutritional deficiencies over time. Research has found magnesium depletion in people with CD as well as those with anxiety disorders. There are also a large number of people with gluten sensitivity who don’t suffer from this same intestinal damage and yet experience higher levels of anxiety.

Neurological symptoms such as brain fog occur in about one-third of people with diagnosed gluten sensitivity, a significantly higher percentage than is reported in CD. Gluten-related anxiety also occurs at high rates. This is because gluten directly harms your nervous system leading to the increased anxiety levels.

Some people with CD, gluten sensitivity and other gastrointestinal disorders find relief with the consumption of probiotics. Probiotics are live microorganisms and beneficial bacteria that provide a number of powerful benefits for your body and brain. For some people, probiotics can improve digestive health and reduce anxiety (Yang, 2019a). Probiotics can be found in foods, such as yogurt, or they can be taken as a supplement. However, because probiotics are regulated as a dietary supplement and not a biological product, there is little, if any, requirement to validate for gluten purity or content before marketing the product. Although some supplements claim to be gluten-free, this is often not the case.

Randi Fredricks, Ph.D.

References

Hauser W, Janke KH, Klump B, Gregor M, Hinz A. (2010). Anxiety and depression in adult patients with celiac disease on a gluten-free diet. World Journal of Gastroenterology, 16, 2780–2787.

Jackson JR, Eaton WW, Cascella NG, Fasano A, Kelly DL. (2012). Neurologic and psychiatric manifestations of celiac disease and gluten sensitivity. Psychiatr Q, 83(1), 91-102.

Rubio-Tapia A, Ludvigsson JF, Brantner TL, Murray JA, Everhart JE. (2012). The prevalence of celiac disease in the United States. Am J Gastroenterol, 107(10), 1538-1544.

Carta MG, Hardoy MC, Boi MF, Mariotti S, Carpiniello B, Usai P. (2002). Association between panic disorder, major depressive disorder and celiac disease: A possible role of thyroid autoimmunity. Journal of Psychosomatic Research, 53, 789–793.

Catassi C. (2015). Gluten Sensitivity. Annals of Nutrition and Metabolism. 67 Suppl 2, 16-26.

 

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