Having a gluten-free diet has become a well-established dietary trend. But not everyone suffers from the genetic autoimmune disease called celiac disease. It’s estimated that around 1 percent of Americans suffer from celiac disease, which is commonly known for its gastrointestinal symptoms, such as abdominal pain, diarrhea, and constipation.

Recent studies have also shown that beyond stomach issues, there is a connection between mental health issues and celiac disease and gluten intolerance. 

Prior to diagnosis, those with celiac disease often report numerous mental health concerns. Similarly, those with gluten intolerance – also referred to as non-celiac gluten sensitivity – can suffer similar symptoms.

Gluten and Celiac Disease 

Gluten is a naturally occurring protein that’s found in several foods, particularly wheat, barley, and rye. Though it is often assumed that gluten is unhealthy and should be avoided, that’s not entirely the case for most individuals and depends highly on the person in question.

Debra Silberg, a gastroenterologist and chief science officer at Beyond Celiac, explains that around one-quarter of patients with celiac disease may suffer from mental health issues prior to diagnosis.

“We’re talking about anxiety, depression, and even eating disorders,” she says. It is also linked to changes in mood and conditions such as schizophrenia and hyperactivity disorder.

Read More: The Grim Origins of ‘Gluten-Free’

Celiac Disease and Mental Health 

Exactly why celiac disease affects mental health isn’t entirely clear, though there are leading hypotheses, Silberg continues. One is that by triggering an autoimmune response, celiac disease may cause a cascading effect in the body that ultimately affects the brain. By damaging the intestinal tract, it can also lead to nutritional deficiencies by inhibiting the absorption of key vitamins and minerals, which themselves are connected to mental health issues.

A commonly reported symptom amongst those with celiac disease and gluten intolerance is “brain fog” – also called gluten-induced neurocognitive impairment – which is associated with fatigue, issues with short-term memory, lack of concentration, and more. 

A study conducted by Beyond Celiac found high numbers of those with celiac disease and gluten intolerance reported experiencing symptoms commonly associated with brain fog.

“Brain fog and fatigue are two of the things that people complain about most after getting exposed to gluten,” says Silberg. Exactly why this occurs is currently not known.

Read More: Magnesium Deficiency Can Come From Celiac Disease and Other Medical Issues

The Mental Health Impact of a Gluten-Free Diet

Conversely, however, avoiding gluten and following a restrictive diet can also be a trigger for its own mental health concerns due to the burden of living with a chronic health condition or adjusting to a new way of life after diagnosis.

“Being on a gluten-free diet can also lead to some of these psychiatric or mental health issues,” Silberg says. “Because you have to be somewhat hyper-vigilant, and there’s also a fear of going out and becoming exposed to gluten.”

A review paper published in 2023, for instance, reports anxiety caused by dietary problems, perceptions of illness, and a lack of control over the disease amongst those with celiac disease.

Positively, however, switching to a gluten-free diet once diagnosed can help with some mental health issues. Studies show that once free from gluten, those with celiac disease often see improvements in anxiety, hyperactivity, irritability, and, to an extent, depression. Brain fog, for example, can be expected to improve once gluten is eliminated from the diet.

“Brain and psychiatric or mental health issues probably take longer to go away than some of the gastrointestinal symptoms,” Silberg says. “These do tend to improve on a gluten-free diet. However, it seems that anxiety improves more than depression for some people.”

Read More: Therapy on a Plate: How Your Diet Can Benefit Your Mental Health

Should You Go Gluten-Free?

For those who do not have celiac disease or are not intolerant to gluten, refraining from eating gluten it is not expected to help with mental health issues.

“We don’t advise someone to go on a gluten-free diet to cure other things,” Silberg says. “You should really get checked to see if gluten is the issue and go to a physician who is knowledgeable about gluten and celiac disease or gluten intolerance.”

That’s because it’s an incredibly hard diet to follow, can be more expensive, can heighten feelings of social isolation, and may contribute further to stress, she adds. A gluten-free diet can also lead to health issues, such as nutritional deficiencies, if it is not required for medical reasons. 

“You don’t want to add to your depressive feelings by going on a gluten-free diet if you don’t really need to,” Silberg explains.  

Research is still needed to find a clinical solution for celiac disease. But Silberg also stresses that seeking alternative support, in addition to a gluten-free diet, in the form of therapy or treatment for mental health issues is advised.

“I think it’s really important for people to talk to a therapist, to talk to a nutritionist or a dietitian to help with their quality of life, and to be able to talk about some of these issues, and not suffer in silence,” she says.

Read More: How to Improve Your Mental Health

Article Sources

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Sean Mowbray is a freelance writer based in Scotland. He covers the environment, archaeology, and general science topics. His work has also appeared in outlets such as Mongabay, New Scientist, Hakai Magazine, Ancient History Magazine, and others.