Celiac Notes: Opiate Withdrawal from Gluten and Casein?

by Dr Charles Parker on August 24, 2007 · 128 comments

Opiate Withdrawal Is Real
Opiate withdrawal from discontinuing gluten and casein? Cautionary note: sounds absurd until you see it.

2649780281 86a1e9595a m14 Celiac Notes: Opiate Withdrawal from Gluten and Casein?

Image by gato-gato-gato via Flickr

You might want to warn gluten sensitive, celiac and casein sensitive patients about this odd, frequent, and painful clinical phenomenon: Withdrawal after stopping wheat or milk products can be painful, exhausting, and depressing, with weakness, anger, and brain fog as subsequent downstream effects that can drive the uniformed back to their comfort foods.

I have a very interesting and refractory client in Ohio who has struggled for years with a variety of severe reactions to psych meds, suicidal depression, mercury toxicity, and became completely regressed on previous withdrawal of Prozac before I saw him in DC. With autoimmune issues in abundance and at times psychotic like feelings of loosing control we tested him for gluten/casein sensitivity, hit pay dirt with positive findings, and asked him to go on a gluten free/casein free diet [GFCF is the acronym].

He felt remarkably better at first, better than he had in years, then the withdrawal set in. Having had previous experience with addictive opiates prescribed for pain, he recognized signs of withdrawal immediately. First a note on the opiate receptors from Great Plains Laboratory:

The peptides from gluten [gliadorphin] and casein [casomorphin] are important because the react with opiate receptors in the brain, thus mimicking the effects of opiate drugs like heroin and morphine. These compounds have been shown to react with areas of the brain such as the temporal lobes, which are involved in speech and auditory integration.

Children with autism frequently seem addicted to wheat and dairy products. Presumably, people with Autism and schizophrenia incompletely digest wheat and dairy products. These incompletely digested peptides are then absorbed into the body and bind to opiate receptors, altering behavior and other physiological reactions.

And one more reference here:

Notes From Dangerous Grains
Below is from the book Dangerous Grains by Ron Hoggan

The addictive nature of gluten is often overlooked. For some, the first
days and weeks of following a gluten-free diet are characterized by
food cravings, disorientation, irritability, sleepiness, depression,
mental fogginess, fatigue, and/or shortness of breath.

If you are a
member of this group, the very fact that you are experiencing many of
these symptoms should reinforce the need to exclude gluten from your
diet. These are common symptoms of withdrawal of detoxification from
gluten-derived opioid and brain neurochemical imbalances. The evidence
suggests that about 70 percent of celiac patients will experience these
symptoms when beginning a strict gluten-free diet.

See other withdrawal comments at Celiac Forums and the Gluten Free Forum.

Another Reference to Support What We See In The Office
From the Journal of Biological Chemistry – Opiate Peptides From Food Proteins April 10, 1979, 254, 2446-2449

- The take-home appears simple: if these symptoms occur, do go more slowly on the GFCF diet, respect the withdrawal process and support other nutritional and physiologic activities. As a side measure consider the importance of comorbid withdrawal issues from either food significantly altering neurotransmitter balance causing cognitive and emotional symptoms.

- Would welcome your experience out there with these matters so please do comment.
Thanks to my anonymous contributor from Ohio.
cp

Heroin, Oxycontin, and a whole wheat bagel (heartscanblog.org)
I Can’t Eat Your Treats – a kid’s guide to gluten-free, casein-free eating (celiacfacts.wordpress.com)
Celiac & Autism (aspergerfamily.wordpress.com)
Celiac Disease and a Gluten-Free Diet (bakeddessertcafe.wordpress.com)
Gluten Withdrawal (trulyglutenfree.co.uk)
Symptoms of Celiac Disease (everydayhealth.com)
Heroine, Oxycontin, and a whole wheat bagel (heartscanblog.blogspot.com)

Celiac Notes: Opiate Withdrawal from Gluten and Casein?

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Tagged as: autism, casein sensitive, Celiac, Coeliac disease, Depression, Gluten, Gluten sensitive, Gluten-free casein-free diet, Gluten-free casein-free diet, Gluten-free diet, milk allergies, Neurotransmitters, Opiate, opiate receptors, wheat, withdrawal

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Jen

I just noticed the delusions started to run into each other; like dreams. I mean, they started to overlap but there was an actual storyline or I would think what that was out of a book or a movie who’s editing this cause it sucks there’s no continuity. It was like having three or four different characters to play at once; I wasn’t sure who was directing me. I guess dreams are metaphorical somewhat I mean they represent things. They are manifestations of your subconscious. So on some level they are logical if you read them like a book. Umm that’s why I wondered about autism and bipolar as well because don’t bipolar people try to “read” signs or give meaning to things that one generally wouldn’t. So literally they are thinking in figures of speech possibly. If an autistic person takes everything literally if they try to imitate normal and learn to act couldn’t it result in a borderline diagnosis if you think about it the patterns are illogical but if you have to stop repeating the same pattern and you learn to act emotions that would result in the emptiness. Autistics have self injury problems too….. Could it make sense that borderline is a smart autism spectrum coping mechanism…… I have gotten borderline diagnosed twice, the last doctor I met wants to diagnose me as bipolar. If I stayed delusional for 3 weeks straight they’d diagnose me as schizophrenic or rapid cycling bipolar; especially if when I start to have problems with self care ie eating bathing dressing. Maybe ok I haven’t read in a while so I might be a bit off. Dude so borderline. Mainly I seem to be reacting to food which seems to trigger the mood and relationship instability. It just disappears, oh are all mental disorders essentially individual biochemistry. Hmm ok. I am just scared they will want to drug me out of my mind.
Jen

So it’s me again. Have been experimenting adding and subtracting various foods from my diet and apparently seem to be sensitive to soy, sulfites(possibly), and tomatoes citrus as well as the gluten and casein. Which sucks. And apples so maybe phenol or polyphenols or whatever they are. But I really have to stop experimenting because these foods cause me to become delusional. Was wondering what diagnosis one would make out of that if one was to see a psych. Are schizophrenia autism and bipolar borderline more closely tied than thought(have no question mark key sorry). Aren’t a lot of pills manufactured with gluten and are delusions basically your subconscious being overly turned on. Could autistic people be delusional. The ones that don’t speak; how would one know. Delusions are like a dream state somewhat right. But yeah i really have to stop experimenting because that means I have to go through withdrawal all over again until it is done. I took 40 painkillers of the extra strength variety that say don’t exceed 3 a day and uhh I only weigh like 105 maybe 110 and i am delusional right now and had a sort of weak workout in the gym this morning but am apparently ok and mainly coherent. How does that work seriously who measures the level of tolerance a person has. Like in grams or. I read a quarter of eating disorder patients met the criteria for an autism spectrum disorder in a study. Could body image distortion be like an actual literal mild delusion hallucination type thing caused by food or chemical sensitivity. If u watch them they do really weird things with their food like overcondiment and line them up and eat them in order and are addicted to fake sweeteners. Basically they OCD everything. Does that mean all mental disorders are basically triggered by an addiction chain. Why do we create more categories rather than merging them. Doesn’t it make disorders harder to treat. I have to see a psych tomorrow; they are going to think I’m nuts if I tell them what I just told u guys. I’ve been delusional for pretty much three weeks. Got sectioned a couple weeks ago restraints and all. Was the least helpful experience of my life although obviously I asked for it eating and drinking things that made me sick. But uh they chained me to a bed basically didn’t feed me for three days other than a muffin and a few crackers which I shouldn’t have been eating anyways. My hair got all matted. Then they took me upstairs to a weird place with glass rooms where the staff pretty much was scared of everyone(I think) because they ignored us essentially. I saw a psych twice he spoke about three sentences to me.And made a diagnosis. My last psych wrote I had alcohol problems in my chart and I barely drink.Sometimes I think they have God complexes.They gave me drugs for three days then took me off them. I was still delusional but staying there another week would have been pretty useless and depressing. Anyways hopefully what I said made sense because i am still a little high on painkillers and hopefully will come out of it soon because I have been obsessed with parasites demonic possession and hearing multiple voices. Too much science experiment for me. I feel like an animal. Have a good day everyone.

MaybeC

Hi Jen, I don’t know if you’re reading this. I still get emails from this forum whenever someone posts, so I read your newest posts. I know how you feel! It is scary and horrible. BUT you can get through it! Hang in there. Sometimes it can help to have a friend or a family member around when things get tough, especially when you have to see doctors! do you have anyone like that? I know my friends have been a saving grace for me. I have been in the hospital too, it was bad at first, but then got easier. Maybe you just need to find the right hospital for you. Anyway, please let me know how you are doing, ok?

Jen

Hmm well feel kind of shitty right now. Don’t think taking 40 painkillers was such a brilliant idea. Heart’s beating a little slower than I’d like. Really don’t think a hospital is the answer. I just have to take care of myself and stop experimenting with food because I have been sick for way too long and I need to move on. oh my god i am in pain. umm no family and friends not so helpful; feel a little alone at the moment. Home is across the country actually. I moved to Toronto at the start of last year; from Edmonton originally.

http://www.CorePsychBlog.com Dr Charles Parker

Jen,
With a complex set of symptoms such as you describe it would be inappropriate for me to suggest any details for diagnosis or treatment. I do agree with MaybeC, you do need some offline support, this ‘forum’ is a search for connections, and it sounds like you need to share the details with your regular doc. If he/she doesn’t get it, work to find one who will.

Do remember this point: who you are is not your diagnosis. Diagnosis is a set of symptoms visible from the outside that deserves direct medical attention. I would agree with any doc that says you sound bipolar and/or borderline, as some of the symptoms you describe fall in to those categories. – But I certainly wouldn’t stop with those diagnoses as end points. You very well may have serious allergies of some time, inflammation, toxic reaction, drug interaction, and people can appear very psychotic with specific allergies – documented in a previous post here from Annals of Internal Medicine.

One point is highly likely: you do sound quite ‘toxic’ from a ‘visual hallucination’ perspective. The challenging set of ‘delusional’ scripts, with your ability to stand back from them, is reassuring – and would make me want to dig even more deeply to chase down the culprit.

I do agree with MaybeC, your acuity and deterioration takes this situation away from chatting on a blog, and I do strongly encourage you to get with your current doc and go over these details with him/her ASAP.
cp

Alley

Hi Dr. Parker.
I am gluten-intolerante (tested positive for the anti-bodies but negative for Celiac in biopsy about 7 years ago). I went on a GF diet for 4 years. Then I found gluten enzymes. They seemed to work well, no bloating or other gastro problems when consuming gluten. So I started eating a full glutenous diet (taking the enzymes with every meal). After two years; I re-tested and was negative for the gluten antibodies; proving to me that the enzymes work. Yippee!

However, I stopped taking the enzymes because they are sooooo expensive. Plus, with the great gluten-free products they make now, I couldn’t see the point in spending all of that extra money.

Because I could no longer afford the enzymes, I stopped eating gluten too, cold turkey. (I have had years of experience in knowing what has gluten and what does not so this was easy for me). At first I felt okay. Now, four weeks later, I am having heart palpitations, daily headaches, sleep disruptions, feelings of exhaustion and anxiety, episodes of anger and outbursts and crying for no reason(totally NOT like me). I dispise mean people and strive never to be one… lately I have been mean!

I would have expected these side-affects after the first week or two, but after 4 weeks? Could these be withdrawals solely from the gluten or withdrawals from the enzymes… or both??

Thank you for your time and consideration.
AL

http://www.CorePsychBlog.com Dr Charles Parker

Alley,
Without more careful review of your personal history and specifics I can tell you from my own practice that I have seen gluten issues last, post discontinuation for more than 6 mos – some say longer. The length of time with the withdrawal symptoms appears most profoundly in those who don’t work hard to rebuild bowel integrity with supplements, from D3 to Vit A, to C and glutathione, omega 3 FA, Mg, and probiotics etc.

Taking the allergen away is only 1/2 of the project, healing the bowel and replacing significant deficiencies is the other half.
cp

Michael Tabet

Thank you Dr.Parker, it does explain why I feel as though i’m slowly going mad. I hope these symptoms are short lived because these symptoms are really hard to deal with on a daily basis.

http://www.corepsychblog.com Dr Charles Parker

Micheal -
Do read the several comments here for nutritional support elements to assist with the withdrawal. You don’t have to do it alone-
cp

Michael Tabet

Hi Dr.Parker,

I was just wondering if you could help me with a question please. For the past two weeks I have been on a strict Gluten Free diet. I started this diet because I have just recently found out my daughter has celiac disease and I have had Crohn’s disease for the past four years that apparently biopsies taken from my bowels, under the microscope, resemble damage due to Crohn’s as well as Celiac, my Gastroenterologist has only just told me this NOW after 4 years after I told her about my daughters diagnoses, I have tested negative for the celiac antibodies however. For the past two weeks I have been feeling incredibly antzy, depressed, anxious and fatigued and my already bad insomnia has just become worse. Is this a good indication that I have a gluten problem? bearing in mind that I did have some of these symptoms to a much lesser degree before this diet, which was the reason I started this diet to start off with in the hope these symptoms would go away not get worse.

Thank you Dr for your time
Kind regards
Michael

http://www.CorePsychBlog.com Dr Charles Parker

Michael,
Your suspicion that you are to some extent experiencing the gluten/opiate withdrawal phenomenon is quite likely. Oftentimes gluten sensitivity evades the lab testing for the antibodies, leaving the patient with the disorder for years down the line. I would accept the ‘gold standard’ findings of the biopsy and remain strong on your elimination diet, and also look at milk/casein as it closely follows comorbidly in a high percentage of gluten sensitivity patients.

To assist with the withdrawal, which, sorry to tell you, I have seen for months, I strongly suggest several interventions:
1. Nutritional evaluation and supplements are imperative to heal the bowel, and supply micronutrients that are missing for years. These could include everything from Omega 3 fatty acids to B vitamins to probiotics – you will see.
2. I would definitely look at Neurotransmitter measurements as it would be simple to specifically support those missing: see Useful References under Neurotransmitters here on the CorePsych sidebar for more info.
3. The obvious: stay with the program, often the withdrawal is shorter, 3-4 weeks and with a healthy diet will come around.

Symptoms before the diet likely reflected the pathology and the malnutrition as well as the immune dysfunction. Worse before better is often the outcome with discovery of gluten/casein issues.

Finally, don’t despair if it doesn’t work. We have see many, some documented on these pages, that actually had other significant gut allergies from garlic to corn – and only when they were specifically identified could we address them and eliminate. You may need some more measurements, so just know that you can highly likely get it all corrected with a focused effort.
cp

MaybeC

Hi, found this site while researching celiac disease. I am a 26 year old woman who has had multiple emotional/mental health diagnoses (as a teen) that I have since been told 1. I grew out of or 2. that I was mistakenly diagnosed. Except for an LD (non-verbal LD), supposedly I am not “crazy” lol. During my middle teen years I suffered several weird medical problems. From eosiniphilic gastroentoritis to a pituitary microadenoma to a normal thryroid gland (but a non-detectable TSH) to cysts on my ovaries. I have scoliosis, diagnosed w/ PCOS, asthma, triethylamenoria sp? “fishy smell disorder,” graves disease (treated with radioactive iodine 7 years ago), and now hypothyroidism (taking synthroid), no periods, then periods AFTER a biopsy to see why I wasn’t having them, but now abnormal menstration due to the hypothyroid. I also have a circadian rythym disorder that is probably one of the worst things to deal with (insomnia). Also type 2 diabetes when I was 12 or 13, but resolved with weight loss and only after stopping the prednisone for my asthma (now I’m considered “insulin resistant.” I was on several psych meds until I finally just refused to take them (when I was 15, after a surgery for sleep apnea made it too difficult for me to eat, and I didn’t want to take pills). When had just stopped taking those psych meds, I went through a horrible withdrawal. I ended up being put in residential treatment for a year. I was told I would likely end up in a group home and never accomplish anything. But, after a few years of illness (this was when my graves disease first started to present as well) and a self-destructive pattern, I was talked into taking the radioactive iodine for the graves. At this time, I did not want to do that, but I had a near-fatal reaction to the anti-thyroid med. So I did it. Then I became hypo thyroid and that slowed me down to the point where I wasn’t able to be so rebellious and self-destructive (a good thing). By that time I was 20, and had (despite difficulties) been able to maintain my own apartment for 2 years, and live fairly independently. The hypothyroidism has been so difficult, and the remaining symptoms of the graves are a daily struggle for me. I need a lot of help from family and friends to get through the week. I am very fortunate to have them, and do not require help from any social workers, etc. I have also gone to college, community college at first (where my GPA is 3.9!) and just won a large scholarship to a prestigious school to obtain my bachelors. Because of the LD and associated right-brain dysfunction, I have a little trouble driving, so I have help from my family for that. But basically I am now completely independent and haven’t taken a psych med since I was 17 and tried paxil again.
I am giving all this information as a history on which to base an answer to my questions. I think I may have celiac disease. I was diagnosed with the eosiniphilic gastroentoritis when I was 13-14, I had mast cell involvement? too. The GI doc said that it was food allergy related. This was odd, because I am only known to be allergic to mold, cephalosporins, horses and cats (after allergy testing). The medicine (crom-something, I’m not sure the name) never worked though. Then when I was around 14 I had my first colonoscopy. It showed some abnormality. Then I also had another one as an older teen, and they removed benign polyps. As an adult I have had all kinds of bowl problems– from impactions, to acute diarhea to just severe bloat and abdominal pain. I have also had very green loose stools, and pain on my upper right side (which, I’ve been told is indicative of gallbladder problems, ugh). Last but not least I have extreme pain, achiness, fatigue and brain fog that make every day a challenge for me. Oh, and I have extremely soft teeth that seem to just break, chip and decay of their own free will, (which is very painful too). Upon reading an article yesterday about celiac disease, I am wondering if my continued struggle with myopathy that I attributed to lingering grave’s disease symptoms could be attributed to celiac disease, along with the tooth problems, abdominal, plus I have sores in the corner of my mouth, iron anemia (I’ve had that since I was a teen) and more symptoms. IS it possible that all of these problems I’ve had are interrelated? Because it seems to me that they are. Like I have some auto-immune or endocrine syndrome. I don’t know. I am going to ask my endocrine doc if she can test me for celiac disease. I don’t have a GP because none in my area accept medicaid right now (at least not ones that feel comfortable going to). But now I am terrified if I would have it. Especially considering this potential withdrawal from the gluten opioids or whatever. I have only ever responded well to opiate medication (not morphine or codien, but vicodin or perocet), and always reacted poorly to psych meds (anti-psychotics actually produce psychosis, anti-depressants produce mania or I can’t absorb them at all because of that fishy-odor triehylameno-whatever). So if I go gluten-free, am I going to lose it or what? I am so afraid of ending up crazy again, that it is pretty much driving me there, lol. What can I do to prevent any emotional problems that could arise from following a gluten free diet? I have achieved so much, and I don’t want another attempt to be or get well to cause me to lose what I’ve worked so hard for.

http://www.CorePsychBlog.com Dr Charles Parker

MaybeC –
I do hope readers work their way through your history, simply because it is so completely compelling – and, I must admit, so commonly missed. I’ve missed these multiple complaints for years – as the psych office is usually the end point for ‘we don’t know what to do – you do have a psych problem.’ I have sent folks like yourself out for second medical opinions, and finally recognized I had to learn as much about these various somatic problems as possible. Take your time and find the right provider who appreciates the likelihood of an immune disorder, need for direct intervention, and someone who can mix the psych meds with your vulnerable metabolic system.

Your bowel problems reverberate and are likely causal with your endocrine problems, and your psych problems as well. I wouldn’t wait for someone to make the diagnosis at this point, – you really must become proactive – hope you don’t think I’m shouting at you!

I noticed you were trying to do what many do – find the exact name for those multiple problems. But the reality, again without examining you, just armchair with no intent to treat, is that you have classic neuro/endocrine/immune problems such as we have been discussing on these pages at CorePsych Blog for some time. You have at least these 3 systemic problems, as you can likely appreciate, and, as an obviously intelligent young woman, you would do well to do some more homework on gluten and immune dysregulation.

Do also get cracking with your doc or any local doc/nutritionist professional who will help you with more specific diagnosis and treatment. Yes gluten and/or casein could be directly causal and I have a post about 1 year ago on schizophrenia resulting from celiac, found on SPECT! [- sorry pictures not there but you can click to see them on that page - from previous posts on TypePad].

I would absolutely jump on ruling out gluten sensitivity even if full blown ‘celiac’ didn’t come up on the GI radar. An ‘elimination diet’ would be strongly recommended and you really need to get with a professional wherever you are rather than simply take my advice. Google ‘elimination diet,’ get off the wheat and milk immediately until further evidence as you are significantly malnourished based likely upon having little or no bowel villi. You likely will feel a bit weird coming off gluten, and uncomfortable as you will see from comments and posts back on those subjects. The debate: Go slowly, or get off the gluten abruptly – my take you really need to be off entirely, but don’t want to completely ‘paralyze’ yourself if you become overwhelmed. I say paralyze because you can feel sicker for awhile.

The crazy reactions to psych meds: very typical, and a reason to consider neurotransmitter testing and slow supplementation just to come back somewhat into range. Suggest go back over to NeuroScience to see if they have a provider nearby. It sound like psych med choices are almost nil.

Please do jump on this asap,
cp

Maybec

I plan on looking into the neurorelief website. It looks incredibly interesting. I just talked to my mom this morning (she is a med-tech, so she understands a lot more of the terminology than I do), and she said that when I was 12 or 13 there was a concern about some IgA antibody in my tests. So that is more indication I may have celiac, if not just a gluten sensitivity. In my case, I was going to 4 different clinics through out those years that I was being tested and diagnosed. The doctors weren’t in the same group or practice, and my med records were (as you can imagine) very large and had to be ordered from storage and wheeled on a cart to whatever office I happened to be at. So I can understand the doctors missing this stuff. The GI doc that diagnosed the eosiniphilic gastroenteroits was at a seperate hospital than the docs that did my colonoscopies, and they were both seperate from the clinic that did the testing that discovered the thryroid difficulities and the IgA antibody. So nobody had that complete picture. Before I go gluten free, I’ve decided to just get tested through that enterolab.com laboratory. It is cheaper than it would be for me to get it done through my doctor, and I can get it over with and not wait 6 months for an appt. Thank you so much for the reply. I don’t feel like a freak anymore after reading around here and neuro relief, lol.

http://www.CorePsychBlog.com Dr Charles Parker

Maybec,
You definitely have something going on with your immune system, likely gluten sensitivity, and being young may throw you and others into a denial about the issue. I look at it completely differently, you are way too sick to be so young with so many probs. Do read up, glad you are more on the path, and do keep us posted as your check out enterolab – year neurorelief would be a good thing!
cp

Jen

Was told my bowel issues were due to an eating disorder but recently gave up gluten and casein for a period of time and found that it made a huge difference. Entered eating disorder treatment numerous times where I was told my digestion would normalise as I reached a healthy weight if I waited long enough. But spans of 2 or 3 weeks without having one bowel movement were somewhat painful so I usually just gave up and started purging again. My doctor gave me diuretics and laxatives because I kept retaining more water and gaining weight on very low calories in part because of severe constipation. The laxatives helped a little for a bit then it got to the point where I had to go to the hospital and have 3 and a half bottles of Colyte because i couldn’t move anything for a month. Then I started looking on the internet and came across autism spectrum and this thing called stereotypic movement disorder which is when i decided to try the gluten free casein free thing. Because I seemed to exhibit some of the traits of a pervasive development disorder and I had a problem fidgeting with objects to the point where I would spend hours doing it; then i broke my arm and never regained a normal range of motion. And I tore my shoulder cartilage doing god knows what and my doctor is sending me to have a nerve test to see if i have carpal tunnel because i messed the arm up fidgeting with things and it goes numb and hurts to use the hand much. Falling off the wagon sucks though. I feel like I’ve spent my life in a lie and I’m trying to get out.

http://www.CorePsychBlog.com Dr Charles Parker

Jen,
Will do a post on this, as food allergies and immune dysfunction are commonly seen with a variety of levels of eating disorder [from no breakfast and ‘touchy stomach’ to full blown bulimia. We see these symptoms often several times/week in our office with eating disorders and ‘picky eaters’ – and the immune contribution is often overlooked.

Then, to make matters worse, associated as a relatively obvious consequence, malnutrition is frequently overlooked and almost never measured specifically!

Thanks for sharing this challenging problem, and do keep us posted on your progress.
cp

Alex Beckman

My boyfriend has not been diagnosed with celiac disease but I definitely think he has celiac disease and is addicted to bread. (looking at the definition of addiction as repeating a harmful behavior despite its negative consequences). I have tried to get him to stop eating gluten since it makes his stomach hurt horribly, and become bloated and hard almost like an inflated ball. If he hasn’t had gluten in a while he gets a headache and is very moody (so far, he hasn’t gone a full day without a little gluten). When he gets his gluten he has a sort of high where he is really goofy and silly and his pupils are dilated. Immediately following this high his mood swings down and this is when he is in the pain of the gluten and wishes he didn’t eat the bread or other gluten product. Also, I think this might be tied to his diagnosis of ADHD. He might need to actually get on a GFCF diet, but I haven’t had any luck of convincing him of this yet….

http://www.CorePsychBlog.com Dr Charles Parker

Gluten Intervention,
All the symptoms sound like gluten sensitivity, but a GI doc, depending on their experience in these matters, may dissuade you from the ‘celiac’ diagnosis as ‘celiac’ requires a much higher standard of pathology. Celiac is end stage gluten sensitivity.

Best to address the ‘gluten sensitivity’ first, and, yes, you need to stage a mini intervention. No, you won’t be telling him you will leave if he doesn’t get treatment, but you could give him some information, and a fun surprise [your call] if he participates in your game of ‘getting straight on the information available.’ Read the info, get the surprise….

I strongly recommend the following book to get started: Celiac Disease the Hidden Epidemic For the small price of this book he could soon have no problems, – and right next to that book are others that describe in detail how to make eating transitions.

If he wants testing: we recommend several labs: EnteroLab.com being the easiest for non-professionals to find and work with.

Hope this works, and have fun dreaming up your surprise!
cp

Glutened

I have been off gluten for a week. At the start I had a bloated stomach and pains in my abdomen. I also noticed I was feeling irritable and have been snapping at people right left and center. The symptoms feel like they are starting to wear off now but I hold my hand up to this gluten/casein withdrawal hypothesis.

Looking forward to being symptom free of this opiate drug!

http://www.CorePsychBlog.com Dr Charles Parker

Glutened-
Yes, have seen the withdrawal last for several weeks and in one case several months.
Strongly recommend nutritional counseling to rebuild your gut, as micronutrients & supplements seem to abbreviate the duration of the withdrawal challenges.
cp

Cheryl

I noticed a comment “allergic to gluten”. I am not a doctor but I don’t know of any allergy to gluten.

Gluten causes the immune system to destroy the lining of the small bowel, resulting in mal absorption of nutrition from food.

This disease is known as Celiac. It is very serious. Far more serious than an allergy. Zero gluten can be consumed. Every trace of gluten causes damamge!

If you can not eat gluten without problems you are more probably Celiac than allergic. You can not eat any gluten. This is much harder than it sounds and beyond the scope of this post. It takes most of us years to learn all the possible sources of gluten.

Good luck.

http://www.CorePsychBlog.com Dr Charles Parker

Cheryl,
Sorry to be so late getting back… strongly recommend you read one of the gluten basic books at CorePsych Books, go over there to find the ‘aisle’ Gluten with many books at many different levels. Celiac is end stage gluten sensitivity – often gluten sensitivity is overlooked with significant problems, especially regarding what you talk about in your other post, brain fog and depression. Malnutrition and actual brain compromise can occur with untreated gluten sensitivity – it is really a big problem, frequently overlooked.
cp

Cheryl

My own brain fog, depression, and mood swings cleared up on the GF diet. I am a diagnosed Celiac.

I just continued to improve on the GF diet. If this addiction thing is true, then wouldn’t every Celiac have the same problems when starting the GF diet?

I find this research hard to take. If the medical profession accepts Celiac’s as “addictive personality types” we will no longer receive proper treatment for health problems but will be labeled “drug seeking” and written off.

http://www.CorePsychBlog.com Dr Charles Parker

Cheryl,
Please don’t take these comments the wrong way… I am very much with you on the problem of finding more inadequate labels to bat around… if someone mentions ‘addictive personality types’ to me I can easily step up on the soapbox for about 4 hrs non-stop. I hate labels and their counterproductive implications.

On the other hand, using words to identify a problem so that it won’t be so confusing for those folks who are suffering with these problems, and for the reason that they can look at other possible contributions to their immune system dysregulation… now we’re over in science land. Find it, fix it, leave it alone. Evidence provides targets for the fixing process. not the dismissive process.

tnx
cp

http://profile.typekey.com/docparker/ Dr Charles Parker

Beth,
Much to address, but bottom line first: there is hope. When you discover the other allergies, some may surprise you, the next step is physiologic healing with specific nutritional supplements tailor made for your precise deficiencies.

This is routine, out with the bad, in with the good, – often the good goes overlooked. The ELISA sounds like a must, then someone to do the CMP to discover exact problems with deficiencies and toxins – sounds like you’re carrying too much ammonia – and if phase II metabolism is slowly, but inexorably encouraged, then you can actually take any meds or supplements.

If your liver isn’t working right, everything can make you sick.

Discontinuation with any SSRI is ‘always’ a problem with allergic conditions and downstream liver inadequacy.

Hang in there, get the appropriate testing and get on a program, may take 6 mo, but you can get significantly better, have seen it happen many times.

Best for the Holidays in spite of all this,
cp
Beth

This is fascinating. Almost all in my immediate family have Celiacs Disease. I was administered the IGE and it was negative, but as was for a couple of my siblings and then they got the small intestine biopsy. I am currently trying to go off of nortriptyline, almost done, and the withdrawals are unbearable…tremors, diarrhea, among the emotional stuff. And I am doing extremely small dosage reductions. I have been on antidepressants for awhile, but really going from 1 mg to .5 mg should not be so hard. The only thing I can think reading this is that nortriptyline is bound with gluten. I have been on a gluten free diet for two years, but then I realized, not really. The strangest thing is in going off the nortriptyline I am finally GAINING weight…from a low of 93 lbs. in a very quick amount of time (could also be hypothyroidism). The other odd thing is that the other meds I am prescribed are benzos and for some reason I have much stronger interdose withdrawal trying to go off the nortriptyline and once I take the benzo it kind of subsides which I know is not just tolerance because it lines up perfectly with the nortriptyline drops. Must be the opiates. Holy cow! Going gluten free was very hard for me, as is going off the nortriptyline. Next is the small amount of benzos I’m on and I figure that is going to be holy hell, as the titrations have been. Much, much worse than for most people who’ve only been on them 10 months. I am so sensitive to meds my psychiatrist nor primary know what to do with me. Not to mention the malabsorption and pieces of food in my poo now. They want to put me on more psych. meds, and I am severely depressed, but in researching I’m realizing maybe that would just prolong the suffering. One of them is time released (my stomach goes blech!). Unfortunately, there’s not a great safe way to do benzo withdrawal once already so depressed and coming off antidepressants. Big immunity of mine also: corn, eggs, fish, dairy (benzos have lactose in them). I think this is how they make their meds addictive. I would love the ELISA panel, but know it doesn’t always catch everything (aka Celiacs) but I wonder sometimes about any other allergies I may be missing.

thanks for this interesting information.

peace-
Beth
http://www.corepsychblog.com Dr Charles Parker

Jackspar -
Thanks for the heads up – I do think we have to be careful about your words *guide treatment* – implying a categorically corrective solution.

One reason I send out these blog missives is that many parents with ASD [Autism Spectrum Disorder] children have seen *improvement* correcting gluten intake. This observation, yes *anecdotal,* regularly comes up at the Defeat Autism Now [DAN] meetings as significant and contributory, not necessarily categorically causal.

Authors such as J McCandless, MD -

http://astore.amazon.com/cpbks-20/detail/1883647134/002-4746117-5332848

who write about a multiplicity of contributory factors with ASD have regularly said that a gluten and casein free diet is an important element of any ASD recovery process.

Interesting: The contrast between the research and the lives of parents who see the changes with their children.

My own take: The research has not yet found a way to connect with all of the ASD variables – thus modifying the outcomes of any single trial/intervention.

cp
http://www.opiate-addiction.com Opiate Addiction

A gluten-free casein-free diet (or GFCF diet) eliminates intake of the naturally-occurring proteins gluten (found naturally in wheat, barley, and rye) and casein (found in milk). The Autism Research Institute and other advocacy groups recommend the diet as a treatment for autism and related disorders. Studies supporting these claims have had significant flaws, so the data are inadequate to guide treatment recommendations.

________
jackspar.
http://www.corepsychblog.com Dr Charles Parker

Wheat Freak – Renamed herein Wheat Sober,
Very interesting and comprehensive questions… you have certainly been doing your homework.

Main point in quick reply: you need more information. Not likely that it is gluten withdrawal for such an extended period of time – even though you are right on that you are still quite obviously allergic to gluten.

But this is another consideration… none of this immunity business is just that simple – *only* wheat.

My armchair shot at this history is that you have nailed the gluten, but missed something else. In this recent post I told you how I got it wrong in my conjecture about wheat with a 9 yo girl [buried in the Immune Paragraph after the Web announcement at this link] – her major and very significant problem: Corn -

http://www.corepsychblog.com/2008/07/connecting-on-k.html

Yes, gluten problems are very prevalent, but not the *only* immunity. With your abundant respiratory symptoms, I am certain that you have another antigen eating up your defense system… all you have to do is chase it down. Obviously there may be other factors, other causes, but from an immunity perspective, sounds quite compelling for another bug.

Take a look at this page under Immune Dysfunction Testing for more reading – read especially the Jaffe article there:

http://www.corepsychblog.com/neuroscience/useful-references/

We do testing in this office, can consult on this matter if you wish, or your medical team can order testing from them – here:

http://www.elisaact.com/nonhc/letter.asp

The results and follow up findings in our office have proven most interesting and significantly associated with improvement, often marked and quickly, – sometimes taking longer, depending on the extent of the chronic damage and nutritional state.

These are a few leads, – please keep us posted,
cp
wheat freak

I am interested in Hoggans comment re shortness of breath. I was extremely sick with gluten in my diet and it got worse as I got older. The fatigue, gastic disturbances and depression/anxiety were terrible. Off gluten I felt better for about three months until I developed scleroderma and severe shortness of breath which has taken about 4 years to resolve with no treatment but minerals, antibiotics, antifungals and pancreatic enzymes (because I had severe pancreatic insufficiency). My pancreas recovered along with the scleroderma but I have low grade infections constantly. Recently I ate a piece of cake I couldn’t resist (as I had not eaten wheat cake for years) and it knocked me out (fell asleep) for two days and I had steatorrhoea and headache. I am of normal intelligence but barely function mentaly for that period and muscles turn to jelly. I dont have a type 1 allergy and don’t know if I have celiacs-unlikely with dq7 0301 gene. Is it possible I have been dealing with a severe and prolonged withdrawal reaction to wheat? NB I have raised IGM and Low IGA and wonder if this lead to the wheat problem.
http://www.corepsychblog.com Dr Charles Parker

geokozmo -

Well done! Thanks for the support and encouragement for those who follow in your own footsteps… the whole thing with gluten and opiates seems so counterintuitive – it takes some real testimony to see how it can help.

Many thanks for your contribution to the remarkable dialog!
cp
geokozmo

Hi Dr. CP

just want to thank for the feedback back inend of April, begining of May.

I am astonished at the differences among people going glutenfree. I am always trying to tell people how good it can be…after years of suffering now I do not feel bad at last…And some report that yeah, it works for them and some simply cannot make this move…I am baffled by this. For me it seems so perfectly simple…and it is such a relief…and I see these young and old men and women around me, with autistic or schizoid or complusive disorders and (like me six ys ago) they say, no, no it is too tough…But the suffering (for me) was way worse. Now I consider many of my past failures (in family life and in career building) as due to this extra opiates from gluten. I could be angry but instead I am grateful. It is better to find this relief late (I am 49 plus) than never.
http://www.corepsychblog.com Dr Charles Parker

Bryan -

Many reports show a strong relationship between the two, as the carbs both feed the candida overgrowth, and the gluten in the carbs feeds the celiac.

Take a look at this easy review of comorbid conditions and diagnosis of celiac/gluten sensitivity:

http://www.diagnose-me.com/cond/C341265.html

Tnx
cp
http://www.adderworld.ning.com Bryan

Dr. Parker,

I was wondering if there is a connection between Candida and Gluten sensitivity? The withdrawal process sounds a lot like what a Doctor described to me years ago, that once the Candida start dying off that I would feel drunk and dizzy etc… but I also had to stop eating yeast, sugar and wheat etc… is Candidas and Gluten interlinked and one of the same?

Just wondering… thanks!

Bryan
http://www.adderworld.ning.com Bryan

I would also like to point out, that although Dr. Parker did not assume to diagnose me from my comments here, he pinpointed on aspects I DID NOT mention and went strickly from what I mentioned here alone. That goes to show one can’t avoid the truth, because the truth is what it is and you know someone knows his biz when he can tell the truth even when an individual is trying to avoid it…
http://www.corepsychblog.com Dr Charles Parker

Bryan et al,
Thanks so much for all of your positive comments, – after having *never trod* the gluten sensitivity path for many years in my own practice, gluten, casein and celiac are now firmly on my radar… thus the inevitable question:

How many times a day do you go number 2?

Not everyone has overt bowel issues, but many do, so it is important to *put that bowel on the table,* so to speak.

I have been discussing Enterolab in many of these posts, but do have a more comprehensive option for those who may wish to review: Take a look at this page, and do download the Jaffe article there under immune dysfunction. Jaffe is the master on the multiple considerations of immune dysfunction.

http://www.corepsychblog.com/neuroscience/useful-references/

And Bryan, do go over to this page and sort through these books, any here could firm you up in your next steps.

http://astore.amazon.com/cpbks-20/104-4113148-0403906?%5Fencoding=UTF8&node=30

Best to all of you persistent readers,- and, once again, thanks for all of your interest.

And, by the way, sign up email updates on CorePsychBlog postings because I will be offering an interesting new teleseminar on Brain, Bowel and Immune Dysfunction this fall.

cp
http://www.adderworld.ning.com Bryan

I have to agree with Cecily. I have been trying to find any other answer other than this, but alas, then years ago I did this diet and took injected pro-biotics to help my flora and yes, the symptoms I suffered from went somewhat away and then I was also treated for heavy metal poisoning and from that point my symptoms vanished. Since taking PZ my symptoms have returned and I have been looking for any answer but this one, because where I live the diet is too darn tough to deal with. This place is brotchen heaven for Pete’s sake! I forgot to mention to Dr. Parker that I also have IBS… Dr. Parker has been wonderful in taking the time to respond back to me and look forward to his continued advice. Wish I lived in VA!
http://www.corepsychblog.com Dr Charles Parker

Geo-
Yours is the most frequent kind of positive response. Many feel better almost immediately. Some with outstanding symptoms for years do take longer to turn around, for a variety of reasons.

I included these withdrawal comments here because some do have very difficult times coming off wheat and/or casein and can benefit from simply knowing what is going on.

Glad to hear yours is an easier outcome-
Thanks
cp
Geo Kozmo

HI.

My experience with going gluten-free is the opposite. my previous depression and brain fog cleaned up and many of my compulsive cravings /that were quite disturbing and I needed even therapies for it/ diminished to a considerably more acceptable level.
Of course this might be the exception and others have different ways.
Geo
http://www.corepsychblog.com Dr Charles Parker

Belated thanks, JRB, on the Enterolab comment. Enterolab is linked under my Resources on this site [Bottom left of the front page] to make it an easy connection for readers, no affiliate status, just an easy link.

If you go to Enterolab, and are ambivalent, apprehensive about the gluten sensitivity diagnosis because, as many do, you just don’t want to make the necessary changes, do order for the most comprehensive test listed here. It will help you close the door on your maybe-nots.

http://www.enterolab.com/StaticPages/Frame_TestInfo.htm

With that information at 369$ you will have firm information on several layers of the pathology that can help you and family members with your HLA DQ2 – DQ8 genetic findings included.

I will send out a post on this soon with Dr Fine’s “Early Diagnosis” essay linked for everyone’s review.

Thanks for the Enterolab suggestion-
Chuck
JRB

EnteroLab (www.enterolab.com) tests for gluten, casein, soy, and yeast intolerances. They also will type your DNA, checking for gluten intolerance and celiac markers.

They are quite well known in the online celiac community; for more information, just Google!
greg

What tests do you recommend for Gluten intolerance?
http://www.corepsychblog.com Dr Charles Parker

Hey team,
Just an update on an offline question about brain function, casein and opiate withdrawal at a new post over here:
http://www.corepsychblog.com/2007/09/brain-awareness.html

See you there!
Chuck
Abigail

Here’s a bit more evidence for you. My son has a movement disorder* that has been controlled enough with PT that it takes a professional eye to spot it… at least until now. About 10 days into the GFCF diet, he started twitching all over the place, and still is. Makes sense when you figure that the way we treat movement disorders is with opiates – he’s been self-medicating with food. I can’t come up with any other reason why the change in diet would cause a clinically significant change in motor issues.

Of course, now we’re between a bit of a rock and a hard place, but we’ll come up with something.

Thanks for the welcome!

Abigail

*He’s the miracle boy – walks and talks despite total destruction of his basal ganglia (don’t think about that too hard; it’ll give you a headache, but we have the MRIs to prove it) and the movement disorder is residual.
http://www.godairyfree.org Alisa

Thanks, that would be great information to have. I will do my best to check back, but if you do find something, an email would be more than appreciated!
http://www.corepsychblog.com Dr Charles Parker

Abigail-
So true…the changes in psychiatry and brain science bring a new level of excitement/discovery to basic medical issues as they relate to emotions. So interesting, -and so useful in our clinical practices.

Be careful, you may find yourself like me waiting to ask the #2 question… and then will find yourself puzzled when they are so #2 regular but have some subtle symptom like GERD [esophageal reflux], and all the immune dysfunction anyway.

These are topics I will be covering with some upcoming cool interviews over at CorePsychPodcast so please stay tuned.

My quick, distant and non-specific arm chair thot about your son’s “hyperactivity:”

a. Yes, could be withdrawal, as the opiate receptors reconfigure.
b. Could also occur downstream of the bowel changes that occur with less inflammation…like a blush of better nutrition.
c. Could be diminished sedation from “opiate dependence” – I used to see this often when running an addiction unit – a paradoxical big energy. – Also found with benzo withdrawal and well documented in the book: “I’m Dancing as Fast as I Can.”

Thanks for your comments, really appreciate remarks from the psych-hood. So much of this seems at times so edgy, but, hey, the refs are there!

Any comments from others on this hyperactive phenomenon described by Abigail?

Thanks,
Chuck
http://www.corepsychblog.com Dr Charles Parker

Alisa,
Sorry I missed your casein posting/question on the comments with this missive, -somehow slipped by with the rush of family matters and big doings for the holiday.

Your question is very interesting, one that I don’t have an immediate link for, but I do recall some of the same symptoms for casein listed with refs on gluten withdrawal.

I will put your question on my to-do list and will post it when I have some good links.
Thanks,
Chuck
Abigail

Interesting reading. I started my 13 yo son with Asperger’s syndrome and anoxic brain damage on a GFCF diet last week just as a trial. I decided to do it with him, mostly as support but out of curiosity as well since I have some autoimmune problems. The first two days were fine. Day three we both became agitated and irritable – felt like way too much caffeine in my system. Day four, today, the irritability is lower but I have some muscle aches and pains which could be from this or something else, but my son feels great except that he’s incredibly hyperactive, completely unlike any past behavior (and if it keeps up this way, we’ll be looking at stimulants! But I’m hoping it’s just withdrawal). He also had normal bowel function without medication for the first time in nine years.

I was expecting some withdrawal issues for him, but it was quite a surprise when it started up for me. It’s been very educational; I’m an adult psychiatrist in private practice and it’s making me rethink some things I thought I knew. Fortunately, in psychiatry we get a lot of practice in learning that everything we thought we knew was wrong.
http://www.godairyfree.org Alisa

You focus a bit more on gluten in your samplings, though you have mentioned casein. I get many inquiries from people who are wondering if they are experiencing milk withdrawal symptoms when they discontinue it from their diet for health reasons. Many seem to have the symptoms you note with the gluten. Have you heard of many patients suffering casein withdrawal symptoms? Have there been any studies in this area?
http://www.corepsychblog.com Dr Charles Parker

Dru-
Many thanks for your comments, if you have any sites with opiate/gluten sensitivity bulimia hyperlinks will be happy to post them-

Have recently been in contact with my colleague Tom O’Bryan in Chicago, a national expert on these matters, and look forward to interviewing him [podcast] on the opiate aspect of this process.

We talked about him and his DVD on gluten sensitivity back here:

Thanks,
Chuck
Dru

I have done extensive research which indicates that food binging disorder and bulimia are related to the opiate sensors in the brain. This is further enforced by the fact that the introduction of an opiate blocker such as natrexone will halt or considerably stem, the disorders. Since my diagnosis of gluten intolerance, and subsequent research, I have a high degree of suspicion that bulimics and bingers should be screened for celiac disease or gluten intolerance. I personally have not experienced binging or bulimia but have observed the behavior in a relative, who has experienced relief from binging after initiation of naltrexone.
http://www.corepsychblog.com Dr Charles Parker

Cecily-
Thanks for these important observations. Yes, very much like the recovery from addictions and brings the same difficulties into family life when one person must be “sober.”

Do take a look at this last post and review the links to the forums as those two are supportive, easy to *attend* and can address problems with family cooperation.

Almost need a counselor [not trying to make business] – or a third party to set up some mediated rules. As a trained mediator I can tell you that reaching areas of agreement and compromise will bring the gray areas of “what’s for dinner” right up onto the literal and figurative table.

-Might be able to do the mediation in just 1-2 sessions. This is not a question of “conflict” – as much as respect for mutual boundaries, and a delineation of specific metaphoric territories.

Thanks
Chuck
Cecily Baldwin

Dear folks,
I am a celiac, having been diagnosed nearly 8 years ago. As there is a genetic component to this disease, several family members have since been diagnosed also.

My thought has been all along that there is a grieving process that goes along with starting a GF diet. I have seen this in many client and family members (I fascilitate group support meeting, and meet with newly diagnosed folks to aid in understanding how to live gluten free). This reaction, at time from my own observations, have led me to believe there is the psychological piece of this as well. I have seen for example, with a close family member, that they cannot stick to the diet, wanting, almost as badly as an alcoholic or drug user, glutenous products. This person, and others I have noted, seem unable to comply with the diet, stating they “just had to have” whatever it was that had gluten in it.

Hence, my thought is that going gluten free for some is a huge psychological issue. The folks I have worked with all have the same sense, “I have felt this way for so long, what difference does it make if I cheat”. This attitude and thought process is very similar to addiction.

Thank you for this interesting article and I look forward to finding out more as research become available.

Warmly,
Cecily Baldwin

http://www.CorePsychBlog.com Dr Charles Parker

Cecily,
From my own experience it does appear that psychological issues are often associated – would be interesting to know exactly what what the neurotransmitter changes are downstream from gluten sensitivity that would encourage specific emotional problems.
cp