Anxiety as a Symptom in Gluten Disorders

anxious man running his hands through his hands with elbow on a table
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Anxiety is a pretty common symptom both in celiac disease and in non-celiac gluten sensitivity—plenty of newly diagnosed people (and more than a few who've been diagnosed for some time) report feelings of both anxiety and depression. Celiac disease is an autoimmune condition that causes people to have an immune reaction in the small intestine when they consume gluten.

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 possible that nutritional deficiencies and malnutrition might contribute to anxiety in people with the diagnosed celiac disease (who have intestinal damage that prevents them from absorbing nutrients). But people with gluten sensitivity don't suffer from this same intestinal damage, and yet, some experience similar or potentially even higher levels of anxiety.

Researchers aren't certain what's causing this anxiety in people with celiac disease and gluten sensitivity. It could be a combination of factors including an anxious reaction to the necessity of following the gluten-free diet, and possibly even a direct effect of gluten itself on the brain.

Anxiety Common in People With Celiac at First Diagnosis

Several studies have identified high levels of anxiety in people with celiac disease when they're first diagnosed.

According to one study, both state anxiety (a type of anxiety that's temporary and involves a heightened autonomic nervous system response) and trait anxiety (a measure of how prone you are to anxiety) were elevated in people who had just learned they had celiac disease.

That study, which looked at 35 celiacs and compared them to 59 control subjects, found:

  • 71% of people with celiac disease had high levels of state anxiety.
  • 24% of the control subjects had high anxiety levels.
  • 26% of the newly diagnosed celiacs showed anxiety as a trait.
  • 15% of controls showed anxiety as a trait (that difference, however, did not reach statistical significance, meaning it could have been due to chance).

After a year of following the gluten-free diet, the celiacs' anxiety levels had dropped. However, 26% were still affected by state anxiety and 17% still showed anxiety as a trait.

The study authors note that the drop in trait anxiety did not reach statistical significance, again indicating it could have been due to chance.

"These findings suggest that anxiety in celiac disease patients is present predominantly as a reactive form rather than as a personality trait, probably related to the presence of the main symptoms such as abdominal pain, diarrhea, and weight loss, often reported by the patients as a reason for work and relationship invalidity and it may not be 'disease-specific' to sprue, but rather to features of chronic illness," the authors wrote.

Another study looked specifically at anxiety and depression levels in 441 adults who had celiac and who had been on a gluten-free diet for at least a year. It found a probable anxiety disorder in nearly 17% of study subjects, which is significantly higher than the 6% found in control subjects. Women had a higher risk of probable anxiety disorder than men.

Interestingly, living alone was associated with a reduced risk of having a probable anxiety disorder. The authors speculated that the problems of eating gluten-free in a shared kitchen and dealing with family members who aren't gluten-free might contribute to "financial and interpersonal problems," which in turn raise the risk for having an anxiety disorder.

It's also possible that living alone protects you against minor gluten exposure, which some people say heighten their anxiety.

There is some evidence that supplementing B vitamins might help improve anxiety in diagnosed celiacs. A study conducted in Sweden found improvement in well-being and in anxiety and depressive symptoms in celiac adults who took folic acid, vitamin B12, and vitamin B6 for six months.

Neurological Symptoms Common With Gluten Sensitivity

Although researchers only are beginning to define non-celiac gluten sensitivity, there already are indications that it may have a significant neurological component.

University of Maryland Center for Celiac Research director Dr. Alessio Fasano says neurological symptoms such as brain fog occur in about one-third of people with diagnosed gluten sensitivity, a much higher percentage than is reported in celiac disease. Gluten-related depression and anxiety also occur at high rates, he says.

It's not clear why this is so—research into gluten sensitivity is just beginning, and many physicians don't even agree it exists yet.

Dr. Rodney Ford, a New Zealand-based pediatrician and author of The Gluten Syndrome, postulates that gluten harms your nervous system directly, leading to the wide spectrum of symptoms experienced in both gluten sensitivity and celiac disease, including anxiety.

Further Research Is Needed

The link between gluten and anxiety is still unknown and further research is needed to explore this possible connection. There may be relationships between inflammation and mental health/illness as the gut and brain are connected, but there are many potential reasons for increased anxiety. This may also include a connection between the inflammation actually causing increased anxiety and lowered mood.

A Word From Verywell

Many people with celiac disease and non-celiac gluten sensitivity report symptoms of anxiety. However, there's good news: symptoms of anxiety seem to decline when you go gluten-free. Many people do report experiencing resurgences of anxiety symptoms when they get glutened, but these symptoms generally seem to be short-lived.

Still, the medical studies do show that many people struggle with high levels of anxiety even when they're eating gluten-free, possibly because of the stresses involved in maintaining the diet, especially when they live in a household shared with people who eat gluten.

If you're experiencing high levels of anxiety despite eating strictly gluten-free, you might want to consider talking to your physician about it—she might recommend you see a mental health professional for treatment that could include counseling and/or medication to ease your anxiety symptoms.

6 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Addolorato G, Capristo E, Ghittoni G, et al. Anxiety But Not Depression Decreases in Coeliac Patients After One-Year Gluten-Free Diet: A Longitudinal Study. Scandinavian Journal of Gastroenterology. 2001 May;36(5):502-6.

  3. Häuser W, Janke KH, Klump B, et al. Anxiety and Depression in Adult Patients With Celiac Disease on a Gluten-Free Diet. World Journal of Gastroenterology. 2010 Jun 14;16(22):2780-7.

  4. Hallert C, Svensson M, Tholstrup J, et al. Clinical trial: B Vitamins Improve Health in Patients With Coeliac Disease Living on a Gluten-Free Diet. Alimentary Pharmacology and Therapeutics. 2009 Apr 15;29(8):811-6.

  5. Jackson JR, Eaton WW, Cascella NG, Fasano A, Kelly DL. Neurologic and psychiatric manifestations of celiac disease and gluten sensitivityPsychiatr Q. 2012;83(1):91-102. doi:10.1007/s11126-011-9186-y

  6. Ford RP. The gluten syndrome: a neurological diseaseMed Hypotheses. 2009;73(3):438-440. doi:10.1016/j.mehy.2009.03.037

Additional Reading

By Jane Anderson
Jane Anderson is a medical journalist and an expert in celiac disease, gluten sensitivity, and the gluten-free diet.