Gait ataxia and gluten. Yup, what you eat can affect your running and gait.

Ok, lets exaggerate things a bit to make our point. But keep this in mind, this is some people, and they do not know it.

Think about how many people didn’t PR at the New York Marathon last week because they carb loaded on pasta and bread (and beer).  How many might have a subtle gluten sensitivity and gluten ataxia ?  Read on … .

Ataxia is a pathological lack of muscle motor coordination. Gait ataxia would be an impairment of the muscles necessary for normal gait.  Here at The Gait Guys we are well aware that there are many other causes of gait disorders other than biomechanical. We have decided to start to add a few of these other metabolic causes of gait problems, just so you are aware.  We will start off here with Gluten ataxia.  And with the plethora of gluten infused foods these days this is one you at least need to be aware of.  Both of The Gait Guys are gluten free in our diets, and because of what we know about gluten and its effects on the body, we encourage our patients to avoid it (yup, beer, pizza, bread, pasta…. anything that seems to satisfy the soul. That doesn’t mean we are soul less……. just at times sole-less…….. oh, that was bad !)

So, if you are concerned you have gluten sensitivity issues, either get tested or just cut it out of your diet.  The University of Maryland study and Annals of Medicine last year stated that since 1974 the rate of autoimmune diseases such as rheumatoid arthritis, lupus and multiple sclerosis has doubled every 15 years and gluten is suspect.

the researchers found that the number of people with blood markers for celiac disease increased steadily from one in 501 in 1974 to one in 219 in 1989. In 2003, a widely cited study conducted by the celiac research center placed the number of people with celiac disease in the U.S. at one in 133.

“You’re not necessarily born with celiac disease,” says Carlo Catassi, M.D., of the Universita Politecnica delle Marche in Italy. Dr. Catassi is the lead author of the paper and co-director of the Center for Celiac Research. “Our findings show that some people develop celiac disease quite late in life.” The trend is supported by clinical data from the center, notes Dr. Catassi, who urges physicians to consider screening their elderly patients.

“Our study shows that environmental factors cause an individual’s immune system to lose tolerance to gluten, given the fact that genetics was not a factor in our study since we followed the same individuals over time." 

The recent findings challenge the common speculation that the loss of gluten tolerance resulting in the disease usually develops in childhood and in fact shows that some people develop celiac disease quite late in life. The gluten related disorders are being seen to increase in those in their 50s and above. The finding contradicts the common wisdom that nothing can be done to prevent autoimmune disease unless the triggers that cause autoimmunity are identified and subtracted. Gluten is one of the triggers for celiac disease. But if individuals can tolerate gluten for many decades before developing celiac disease, some environmental factor or factors other than gluten must be in play, notes Dr. Fasano. What do they say ? your genes load the gun, your environment pulls the trigger ? Something like that.

Defining gluten: That mixture of proteins, including gliadins and glutelins, found in wheat grains, which are not soluble in water and which give wheat dough its elastic texture. Any of the prolamins found in cereal grains, especially the prolamins in wheat, rye, barley, and possibly oats, that cause digestive disorders such as celiac disease.

Sporadic ataxia could be from gluten ataxia. Sporadic ataxia is ataxia that does not have a genetic or other known cause. More often than not, sporadic ataxia turns out to have a link to gluten intolerance and celiac disease.

What is Gluten Ataxia?

Gluten ataxia is an autoimmune disease that is brought on by ingestion of gluten in people who are genetically predisposed. The most common symptoms of gluten ataxia, which is most closely associated with cerebellar ataxia, are:

  1. Poor coordination in physical movements and poor control of muscle movement
  2. Inability to control the speed or the power of a physical movement
  3. Headaches
  4. Inability to speak or form words correctly; speech impediments

There are also three general areas of ataxia: cerebellar, sensory and vestibular. The ataxia discussed in this article is essentially caused by damage to the cerebellum. Dr. Ivo has done videos on our youtube channel that discusses the cerebellum as the portion of the brain responsible for motor pattern coordination and balance . Of course there are other causes for ataxia other than gluten sensitivity and are generally ruled out before gluten sensitivity or celiac disease is identified as the origin. So do not go rushing over to your doctors office and start a pilgrimage for gluten testing.  Gluten ataxia is a progressive disease and can cause permanent damage to the cerebellum if not treated promptly.

Ataxia is the least easily identifiable version of gluten intolerance. Many people with gluten ataxia do not realize they have a sensitivity at all to gluten before diagnosis as they do not have any of the typical symptoms. Generally this form of ataxia is diagnosed after all other types of ataxia are ruled out and then other tests are run to determine whether gluten could be at the foundational problem.

Gluten Ataxia and Celiac Disease

Gluten ataxia is essentially a sister of celiac disease. Celiac disease is an autoimmune disorder that impacts the intestines, specifically the villi or microvilli. When an individual who is predisposed ingests gluten, the autoimmune reaction occurs and causes swelling to the lining of the intestines. Over time this swelling damages the intestines, causing villous atrophy, and makes it difficult for the small intestine to absorb any nutrients. With individuals suffering from gluten ataxia, the cause of the problem is the same: gluten. The difference is that the cerebellum is impacted instead of, or in addition to, the intestines. Both of these differ from a wheat allergy where symptoms would instead be of the histamine reaction variety: sneezing, hives, lip or face swelling.

Bottom line……..why are you taking the chance ? Even if you do not seem to have a problem with gluten, it does not mean you are safe.  The alarming increase in the incidence of the problem in the last decade ( > 1 in 133 and increasing) suggest that far more people are at risk and unknowingly sensitive to gluten than we previously thought.  It seems to be telling us that perhaps humans just do not process it well.  So, what do we say ? We say dump gluten…….. so that you do not have to put yourself at risk, and more so (joking) that you won’t have to worry about falling over with Gluten Ataxia before your race, which will let you run faster because you won’t have symptoms 1 &2,

  • Poor coordination in physical movements and poor control of muscle movement
  • Inability to control the speed or the power of a physical movement

and as an added benefit, you won’t have symptoms 3 & 4

  • Headaches
  • Inability to speak or form words correctly; speech impediments

which you might otherwise confuse with having too many beer.  And you will be aware and clear headed enough to ask for a gluten free beer the next time !

Plus, you might just PR your next race because symptoms 1&2 will be absent.

Think about how many people didn’t PR at the New York Marathon last week because they carb loaded on pasta and bread (and beer).  How many might have a subtle gluten sensitivity and gluten ataxia ? We know we may be pushing this issue to the limits of reasonable here, but with the numbers climbing each decade, and the incidence climbing in our private practices, we have to ask the question "are we really pushing the limits of reasonable here ? Or are we just ahead of the inevitable tipping point ?"  You have to decide what is best for you.  A gluten free diet is healthy, probably healthier.  We make our own bread, there is great gluten free beer out there, great gluten free pizza, pasta and bread available everywhere.  It is merely a lifestyle change.  Our patients make it work, so can you.  The first few weeks are the hardest, until you get into the swing of things.  And then, like many of our athletes, you begin to notice the subtle difference in how you feel and then the thinking begins…….. "hey, the odds are decent that the gun is already loaded, I am not going to risk pulling the trigger”.

Thanks for reading our long post today.  Forward it to your running friends, or at least those friends who seem to fall over after a pasta dinner.

Shawn and Ivo…….The Gait Guys, …….. kind of like the two physicists Dr. Sheldon Cooper & Leonard Hofstadtler from the very funny TV show “The Big Bang Theory”.  Ivo is Sheldon, he is way smarter…….. Shawn is more like Leonard, almost as smart (but at least he had a shot at winning the heart of the pretty blonde, Penny !! )………. so, who then is really smarter ?  :-)