Gluten and Your Muscles, Joints, and Skin
Oh, my aching muscles and joints. What is this rash? What’s wrong with my bones?
If you are asking yourself these questions, going to see your healthcare provider is the first step to determining what’s wrong. If you are experiencing unexplained joint or muscle pain, bone issues, or even a rash on your body — and some other factors are in place — these issues could be related to gluten intolerance.
Not everyone who experiences these types of issues is reacting to gluten, but if you have a family history of celiac disease or gluten sensitivity, or if these issues are accompanied by digestive-related symptoms or occur more frequently after you’ve consumed certain foods, ask your healthcare provider about gluten intolerance.
If you have gluten intolerance, gluten can affect other parts of your body in addition to your digestive system. While not always talked about, gluten can impact your brain and mental health. See our article Gluten and Mental Health. Adverse reactions to gluten can also show up as muscle and joint pain, weakened bones, or a skin rash. Let’s look at each of these conditions in more detail.
Gluten, Inflammation, and Pain
Physical pain is typically accompanied by inflammation. On the flip side, inflammation in your muscles or joints could cause pain. Inflammation could be a symptom of celiac disease, an autoimmune disease where an immune response is triggered in susceptible individuals when gluten is digested. This immune response damages cells in the lining of the small intestine. When the immune system is triggered in this way, it also causes inflammation that can affect other body tissues.
In non-celiac gluten sensitivity (NCGS), the connection between gluten and inflammation is less clear since NCGS is still poorly understood, and, in some cases, other components of gluten-containing grains may be involved in causing symptoms. People with NCGS still could have an inflammatory response to gluten.
Celiac disease can be hard to diagnose and confused with other conditions such as irritable bowel syndrome or even arthritis when the primary symptom is inflammation of the joints and joint pain. Testing positive for celiac disease doesn’t necessarily mean you don’t have another health condition, autoimmune or otherwise.
Likewise, being diagnosed with another autoimmune disorder or health condition doesn’t rule out celiac disease if you haven’t been tested specifically for it. While a gluten-free diet might be discussed in relation to gastrointestinal or joint symptoms, you should not stop eating gluten before you have been properly tested for celiac disease. See our article: 3 Steps to a Celiac Disease Diagnosis.
How much can gluten affect muscles? One study examined patients with gluten sensitivity, some of whom showed signs of inflammatory myopathy or conditions that affect muscles. Myopathy can be a reaction to gluten, although it is less common in people with gluten sensitivities than ataxia that affects coordination, balance, and speech or peripheral neuropathy where nerve damage can cause weakness, numbness, and pain in the hands, feet, and other parts of the body. However, patients in the study who had myopathy and went on a gluten-free diet showed improvement in their myopathy.
Check Your Bones!
Muscles, joints, and skin are not the only body parts that could be negatively affected by gluten. In some cases, people with celiac disease – or undiagnosed celiac disease – could be prone to osteoporosis, a condition where the bones lose density and weaken, or osteopenia, the precursor to osteoporosis, making them more susceptible to bone fractures.
When a person has celiac disease, the damage to their intestinal lining can interfere with the absorption of nutrients such as calcium and vitamin D, minerals that are critical for proper bone formation and growth. If your body isn’t absorbing the minerals it needs for bone development, your bones could weaken.
One study showed that bone mineral density (BMD), a sign of bone strength, was typically low in newly diagnosed celiac patients in childhood. It recommended that patients diagnosed with celiac disease have their BMD checked and found that strict gluten avoidance led to an improvement in BMD. While a gluten-free diet did not show a significant impact on osteoporosis, according to another study, it could result in a small but positive increase in BMD.
Recognizing Dermatitis Herpetiformis
Another type of reaction to gluten affects the skin. Dermatitis Herpetiformis, or DH, is considered a rare skin rash that affects about 10 percent of people with celiac disease. According to an article in the Journal of the American Academy of Dermatology, DH is found mainly in adults and is more common in men and people of northern European descent; DH is rarely found in African Americans and Asian Americans.
DH can appear as red, itchy blisters and hives on the skin, typically on the arms, legs, lower back and/or buttocks. The rash is usually bilateral, meaning it occurs on both sides of the body at the same time. In addition to gluten, DH can also be triggered by medications. The eruptions are caused by deposits of Immunoglobulin A or IgA, an immune system antibody. Chances are you went to a dermatologist first to diagnose the rash. Diagnosing DH is done with a skin biopsy called a “punch biopsy,” a tiny sample of skin on the affected area taken after an injection of a local anesthetic.
If the skin sample shows positive for IgA, you may also be referred to your doctor or a gastroenterologist for antibody blood tests specific for celiac disease. Because the DH rash is “gluten-sensitive,” and DH is considered a skin manifestation of celiac disease, a gluten-free diet is a necessary part of treatment. Your doctor may also prescribe medication to address the skin issue.
As you can see, gluten intolerance can affect many parts of your body in different ways. All of this can add to confusion when trying to obtain a diagnosis. However, with more information, you can ask your doctor or healthcare provider the right questions to check for celiac disease.
The information on this website is for educational purposes only. Consult your healthcare team when considering this information.
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