Brain Atrophy

Posted by: Cleo Libonati, RN, BSN in A LISTING OF ALL HEALTH CONDITIONS, Brain Disorders, Cerebrum (Neurologic) Disorders, Complications, System - Nervous, Vitamin B1 (Thiamin), Vitamin B12, Vitamin B3 (Niacin), Vitamin B6 (Pyridoxine) 0 6,171 Views

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Comparison of Brain Atrophy. Courtesy Source: Source: csua.berkeley.edu

Comparison of Brain Atrophy. Courtesy: csua.berkeley.edu

What Is Brain Atrophy?

Brain atrophy is a degenerative condition of the brain characterized by loss of brain tissue, causing the brain to shrink.

Q: How does loss of brain tissue affect the body?

A: Loss of brain tissue will result in dysfunction depending on the area of the brain that is affected.

For example, loss of brain tissue in the lower brain, or cerebellum, will impair muscle coordination in activities such as walking, while loss of brain tissue in the frontal lobes of the cerebrum will impair cognition such as thinking, judgment, analysis, mathematical ability, and memory.

What Is Brain Atrophy In Celiac Disease and/or Gluten Sensitivity?

  • Brain atrophy is a severe neurologic complication of celiac disease that causes progressive disability without treatment by elimination of gluten and correction of nutritional deficiencies when present.

How Prevalent is Brain Atrophy In Celiac Disease and/or Gluten Sensitivity?

  • Brain atrophy is associated with celiac disease.1
  • Diffuse cerebral atrophy is evident in 80% of patients with celiac disease and late-onset epilepsy.2
  • A study investigating the incidence of neurologic manifestations in 48 children with celiac disease found brain atrophy in 2 cases (4.1%) with cerebellar ataxia.3

What Are The Symptoms Of Brain Atrophy?

Brain atrophy is marked by neurologic dysfunction or impairment including:

  • Moderate to severe intellectual deterioration.
  • Ataxia.
  • Infrequent seizures.

How Does Brain Atrophy Develop In Celiac Disease and/or Gluten Sensitivity?

  • Brain atrophy results from obscure pathogenetic mechanisms, and immunologic mechanisms are implicated.1
  • Nutritional deficiencies contribute to brain atrophy, especially niacin, pyridoxine and thiamin or disordered biopterin synthesis. These deficiencies need to be investigated in detail.4
  • Vitamin B12 deficiency is a cause of brain atrophy.

Does Brain Atrophy Respond To Gluten-Free Diet?

Response of celiac disease-related brain atrophy to gluten free diet varies with the areas of brain affected and duration of atrophy.

6 Steps To Improve Brain Atrophy In Celiac Disease and/or Gluten Sensitivity:

Treatment. This condition responds to the complete elimination of gluten, which is the required treatment that improves both brain and gut health.

  • Gut health is the foundation to restore ALL health. Restored health will enable you to maintain a strict gluten free diet, just as other life tasks will be easier.
  • A strict gluten free diet means removing 100% of wheat, barley, rye and oats from the diet.
  • Cutting out bread and other obvious sources of gluten is not good enough for recovery. Even 1/8th teaspoon of flour or bread crumb is enough to sustain the inflammation that is damaging your small intestine, causing increased permeability (leaky gut) and allowing undigested gluten to enter your body where it can damage structures and function, and instigate immune inflammatory responses.

Correct Your Individual Nutritional Needs.

Recovery. You should begin to feel better within a week and notice more energy as inflammation subsides and the  absorbing cells that make up the surface lining of your small intestine are better able to function.

  • Intestinal lining cells are replaced every 5 days. The healing process is like sunburn where the damaged surface layer of skin sloughs off and is replaced with new normal cells.
  • Leaky gut normally resolves in two month after starting a gluten free diet and brings about a big improvement in health. Improvement in intestinal permeability precedes morphometric recovery (cell appearance and structure) of the small intestine in celiac disease.5
  • The intestinal lining may take up to a year to heal.
  • 2 Reduce Inflammation. Foods to Eat and Foods Not to Eat:

Because gluten is inflammatory, eliminate OTHER inflammatory foods from your diet to reduce an additive effect to gluten. At the same time, try to eat foods that reduce inflammation (anti-inflammatory).

Here Are Major Inflammatory Food Types That Reduce Healing:

  • Damaging Foods. In susceptible persons, includes corn, dairy (cow), and soy. Lactose, the sugar in any animal milk disrupts intestinal permeability causing leaky gut.6
  • Allergenic Foods. Includes foods that trigger the immune sytem to produce IgE antibodies. Allergy testing is the usual way to discover these offending foods.
  • Shelf Stable Processed Foods. Includes any that contain additives and preservatives. Look for them on the nutrition label of the box or package. Additives and preservatives also disrupt intestinal permeability causing leaky gut.6
  • Fats. Limit deep fried foods, trans-fats, saturated fats (animal fat/butter), and EXCESSIVE omega-6 fatty acid oils like corn oil. Rancid fats, sodium caprate (a medium chain fat), and sucrose monester fatty acid (a food grade surfactant) induce significant disruption of the intestinal barrier that causes leaky gut.6.
  • Excessive Refined White Flours (bran layer removed). Includes products made from them such as cookies, bread, cakes, pies. Bran contains the vitamins and minerals that metabolize grains and slows the otherwise rapid entry of sugar from their digestion into the bloodstream. Also disrupt intestinal permeability causing leaky gut.6
  • Refined Sugars.  Includes white sugar, corn fructose and high fructose corn syrup.
  • Certain Spices. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.6
  • Alcohol and Caffeine. Disrupt intestinal permeability causing leaky gut.6
Here Are Important Anti-Inflammatory Food Types to Promote Health:

  • Fruits. Contain ample amounts of vitamins, minerals and phytochemicals which are naturally occuring components in plants that detoxify toxins, carcinogens (reducing the risk by 50%) and mutagens.
  • Non-Starchy Vegetables. Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes lettuce, kale, onion, broccoli, garlic, and others.
  • High Quality Complex Carbohydrates. Provide vitamins, minerals, and fiber while boosting serotonin levels to help you relax and feel calm. Includes whole grains, legumes, and root vegetables such as carrots, parsnips, sweet potatoes, turnips, red beets, and others.
  • Antioxidants. Protect the body from inflammatory oxidant molecules that continually occur and help us handle stress and reduce irritability. Includes vitamin C-containing foods such as lemon, grapefruit, apricot, Brussels sprouts and strawberries, and others. Also, includes vitamin E-containing foods such as nuts, seeds, avocado, olive oil, and others. Cocoa is good, too.
  • Omega-3 Fatty Acids. Balance opposing omega-6 fatty acids and bad fats. Fish sources includes tuna, salmon, cod, and others. Plants sources include flax, chia seeds, canola oil, and others.
  • Probiotics. Supply normal microbes needed for colon health and health of the body such as these fermented foods: yogurt, kefir, and unpasteurized apple cider vinegar.
  • Prebiotics/ High Fiber Foods.  Food with fiber keeps our population of colonic microbes healthy.
  • Protective Herbs and Spices.  See below #6 below for examples.
  • 3 Information Sheet You Can Take to Your Doctor or Other Health Professional:

Click here.

 

  • 4 Manage Your Medications Safely:

Certain prescription drugs deplete these nutrients that cause brain atropy: vitamin B12, vitamin B1 (thiamin), vitamin B3 (niacin), vitamin B6 (pyridoxine). Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below. Do not stop prescribed medications without supervision.

 This is not a complete listing.

ANTACIDS / ULCER MEDICATIONS

ANTI-DEPRESSANTS

  • Adapin®, Aventyl®, Elavil®, Pamelor®, and others deplete Vitamin B12.

ANTIBIOTICS disrupt intestinal permeability.

  • Gentomycin, Neomycin, Streptomycin, Cephalosporins, Penicillins deplete B Vitamins.
  •  Tetracyclines deplete Vitamin B6.

ANTI-INFLAMMATORIES disrupt intestinal permeability.

ANTICONVULSANTS

  • Phenobarbital and Barbituates; and Dilantin®, Tegretol®, Mysoline®, Depakane/Depacon® deplete Vitamin B12, Vitamin B1.

ANTIVIRAL AGENTS

  • Zidovudine (Retrovir®, AZT and other related drugs) deplete Vitamin B12.

CARDIOVASCULAR DRUGS

CHOLESTEROL DRUGS

DIABETIC DRUGS 

DIURETICS

FEMALE HORMONES disrupt intestinal permeability.

  • 5Nutritional Supplements To Help Correct Deficiencies:

The type and quantity of nutritional supplements that may be needed depend on which nutrients are deficient.

  • Multivitamin/mineral combination once a day is useful to improve overall nutrient levels. This is a safe dose, but always check with your doctor to avoid interactions with medications.
  • Vitamin B1 as prescribed for thiamin deficiency.
  • Pryridoxine (vitamin B6) as prescribed following blood test for status.
  • Vitamin B12 as prescribed following blood test for status.
  • Niacinimide as prescribed for niacin (vitamin B3) deficiency.

Storage Note: Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet – not in the bathroom or on the kitchen table.

  • 6Manage Natural Remedies: 
Hydration:

  • Eight glasses of water are recommended per day unless there is a contraindication such as kidney or heart disease. The Institute of Medicine recommends approximately 2.7 liters (91 ounces) of total water, from all beverages and foods, each day for women and 3.7 liters (125 ounces) daily of total water for men.
  • If you are thirsty, drink water. Add fresh, squeezed lemon to water. Lemon is anti-inflammatory, alkalizing and provides vitamin C.
  • Hydration Test: Urine should be pale yellow. Fingertips should be plump, without pruning but this may not be reliable when fingers are swollen with edema. Lips should be plump, without puckering. The feeling of thirst can be unreliable.
  • What is wrong with soda, coffee, tea, and alcohol? These drinks are dehydrating, increase acid, and deplete nutrients.

Carminatives. The following  anti-inflammatory plant sources called carminitives help heal the digestive tract. They also tone the digestive muscles which improves peristalsis, thus aiding in the expulsion of gas from the stomach and intestine to relieve digestive colic and gastric discomfort.

Carminative Food Remedies:

  • Raspberry.
  • Carrot is also a cleansing digestive tonic.
  • Grape is also bile stimulating and a cleansing remedy for sluggish digestion and laxative.
  • Redbeets also stimulate and improve digestion and are easily digested.
  • Cabbage also stimulates and improves digestion and is also a liver decongestant.
  • Lettuce also stimulates and improves digestion and is also an alterative, meaning it improves the function of organs involved with the digestion and excretion of waste products to bring about a gradual change.
  • Potatoes are antispasmodic (due to atropine like properties) and a liver remedy.

Carminative Herb Remedies:

  • Sage is also a digestive, astringent, bile stimulant and energy tonic that heals the mucosa.  Drink as tea or use in cooking.
  • Chamomile, lemon balm, and fennel, (as a tea) also help relieve nervous tension.
  • Parsley also relieves indigestion.
  • Rosemary as a tea and in cooking also is a nervous system tonic for stress and fatigue, bile stimulant, and can relieve headaches and indigestion.
  • Thyme is also soothing remedy useful for stimulating digestion of rich, fatty foods.

Carminative Spice Remedies:

  • Cloves are also antispasmodic.
  • Nutmeg is also useful for indigestion.
  • Ginger.
Exercise Helps:

Exercise improves circulation and rids the body of toxins.

Note: Exercise is important, but the amount and type of exercise undertaken depends on your health. Your first priority is to heal.

What Do Medical Research Studies Tell About Brain Atrophy In Celiac Disease and/or Gluten Sensitivity?

RESEARCH STUDY SUMMARIES

“Celiac disease with neurologic manifestations in children.“ This study investigating the incidence of neurologic manifestations in 48 children with celiac disease found brain atrophy in 2 cases (4.1%) with cerebellar ataxia. All children received gluten free diet, but it had no influence on brain atrophy.

Between 2000-2010, 48 children aged 2-18 years diagnosed with celiac disease have been monitored. The diagnosis of celiac disease was made by serological tests and intestinal biopsy. The study protocol included: measurement of weight and height, biological and immunological tests, histological examination, questionnaires filled out by parents about their child motor development and some neurologic signs, psychological exam, electroencephalogram, and brain CT-scan.

16 of the 48 children presented one or more neurologic symptoms as the onset manifestation of celiac disease. The neurologic signs in order of frequency were: headache/migraine, attention-deficit/hyperactivity disorder, epileptic seizures, mental retardation, cerebellar ataxia and behavior disorders. Brain CT-scan showed cerebral calcifications in 3 patients with epilepsy, and atrophy in 2 cases with cerebellar ataxia. All children received gluten free diet, but a favorable course was noticed only in the children with migraine and epilepsy, in the other patients this diet having no influence on neurologic symptoms.

This study proved the variety of neurologic symptoms that can be included in the clinical signs of celiac disease in pediatric patients. That is why in the presence of different neurologic symptoms of unknown etiology and resistant to treatment, celiac disease must be taken into account and laboratory investigations have to include intestinal biopsy and immunological test.7

“Gluten ataxia in perspective: epidemiology, genetic susceptibility and clinical characteristics.” This study investigating celiac disease in patients with various ataxia demonstrated the following clinical characteristics for gluten ataxia: ocular signs in 84%, dysarthria in 66%, upper limb in 75%, lower limb in 90%, and gait ataxia in 100%; and atrophy of cerebellum in 79%, white matter hyperintensities in 19%; and sensorimotor axonal neuropathy in 45%. GI symptoms were present in only 13%, celiac disease in 24%, and HLA DQ2 in 72% of patients.8

“Association between celiac disease and brain atrophy.” This study investigating the occurrence celiac disease in living patients with epilepsy of unknown etiology demonstrated the prevalence of celiac disease was increased among patients with epilepsy of unknown etiology and of them 80% had supratentorial brain atrophy vs. 26% of controls. Screening of celiac disease seems warranted in patients with epilepsy of unknown etiology, particularly when there is co-existent cerebral atrophy of unknown etiology.9

CASE REPORT SUMMARIES

“Progressive myoclonic ataxia associated with coeliac disease. The myoclonus is of cortical origin, but the pathology is in the cerebellum.” This case report describes selective symmetrical atrophy (same both sides) of the cerebellar hemispheres with Purkinje cell loss and Bergmann astrocytosis and with preservation of the cerebral hemispheres and brainstem at necropsy in a patient with progressive myoclonic ataxia. Onset followed years after the development of celiac disease or dermatitis herpetiformis, and brain imaging was either normal or showed mild cerebral and cerebellar atrophy. Syndrome progressed on gluten free diet lately started.10

“Celiac disease, brain, and dementia.” This case report describes diffuse cerebral or cerebellar atrophy, with intellectual deterioration ranging from moderate to severe, found on brain CT in 5 patients subsequently diagnosed with celiac disease in whom gastrointestinal symptoms were mild. One of 5 patients responded to a gluten free diet.1

  1. Collin P, Pirttila T, Nurmikko T, Somer H, Erila T, Keyrilainen O. Celiac disease, brain, and dementia. Neurology. Mar 1991;41(3):372-5. [↩] [↩] [↩]
  2. Luostarinen, Dastidar, Collin, Peräajo, Mäki, Erilä, Pirttilä. Association between celiac disease and brain atrophy. European Neurology. 2001; 46(4):187-5. [↩]
  3. Diaconu G, Burlea M, Grigore I, Anton DT, Trandafir LM. Celiac disease with neurologic manifestations in children. Rev Med Chir Soc Med Nat Iasi. 2013 Jan-Mar;117(1):88-94. [↩]
  4. Wills AJ. The neurology and neuropathology of celiac disease. Neuropathology and Applied Neurobiology. 2000:26:493-496. [↩]
  5. Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease. Clinical Science. Apr 2001;100(4):379-86. [↩]
  6. Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease. Journal of Gastroenterology and Hepatology. 2003;18:479-91. [↩] [↩] [↩] [↩] [↩] [↩]
  7. Diaconu G, Burlea M, Grigore I, Anton DT, Trandafir LM. Celiac disease with neurologic manifestations in children. Rev Med Chir Soc Med Nat Iasi. 2013 Jan-Mar;117(1):88-94. [↩]
  8. Hadjivassiliou M, Grunewald R, Sharrack B, et al. Gluten ataxia in perspective: epidemiology, genetic susceptibility and clinical characteristics. Brain. Mar 2003;126(Pt 3):685-91. [↩]
  9. Luostarinen, Dastidar, Collin, Peräajo, Mäki, Erilä, Pirttilä. Association between celiac disease and brain atrophy. European Neurology. 2001; 46(4):187-5. [↩]
  10. Bhatia KP, Brown P, Gregory R, et al. Progressive myoclonic ataxia associated with coeliac disease. The myoclonus is of cortical origin, but the pathology is in the cerebellum. Brain. Oct 1995;118(Pt 5):1087-93. [↩]

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