Many Vestibular Conditions are considered idiopathic, meaning they have an unknown origin such as Vestibular Migraine and Meniere’s Disease – but in some cases an Autoimmune mechanism has been hypothesised for these conditions.
Gluten (or the component known as gliadin) is an inflammatory component found in many products such as wheat products, bread and cereals for example. A multitude of studies have now linked the reduction of the consumption of gluten with the improvement in autoimmune disorders, so the question is, can the reduction in the consumption of gluten improve Vestibular symptoms and conditions?
The results to this query are mixed but for a number of Vestibular conditions such as BPPV, Vestibular Migraine, Autoimmune Inner Ear Disease (AIED) and Bilateral Vestibular Hypofunction there is some evidence of an autoimmune component and the potential benefit of excluding gluten from dietary consumption should there be signs and symptoms of inflammation such as co-existing autoimmune disorders (such as thyroid conditions) or IgA or GAD 65 antibodies for example.
This post is not medical advice but merely to suggest if you have tried all other avenues for these disorders or have co-existing autoimmune disorders, it may be worthwhile considering excluding gluten from your diet to see if there is a reduction in your symptoms.
- Benign Paroxysmal Positional Vertigo (BPPV)
Recent studies have suggested a link between anti-thyroid antibodies such as anti-thyroid peroxidase (TPOAb), anti-thyroiglobulin antibody (TgAb) and TSH receptor antibodies (TrAb) and the presence of Benign Paroxysmal Positional Vertigo (BPPV) suggesting a possible correlation however results are conflicting throughout studies. There are currently no studies on the use of gluten free diets to treat the symptoms of BPPV.
- Menieres Disease
Approximately 1/3 of Menieres Disease is considered to be Autoimmune and Menieres has recently been linked to Gluten consumption. In a recent study 75% of MD patients showed positive skin test to food and 50% showed responses specific to gliadic extract extract fraction. This included Immunoglobulin A (IgA), Immunoglobulin M (IgM) and Anti-glutamic decarboxalase (GAD65). In this particular study the anti-wheat antigen group responded particuarly well to a gluten free diet.
Another case report in a patient with Unilateral Menieres Disease had complete remission of her symptoms within 6 months of commencing a gluten free diet.
Again these studies are small but suggestive of a potential link between autoimmunity and gluten free diet as a treatment for this condition.
Celiac disease has been associated with Migraine headache in case controlled studies with the level of transglutaminase IgA antibodies higher in up to 21% of patients. One study in Italy suggested 4% of migraineurs sufferers from celiac disease. Some small case controlled studies suggested that the treatment of celiac disease via a gluten free diet resulted in the relief of Migraine however larger case controlled studies to confirm these studies are warranted.
- Autoimmune Inner Ear Disease (AIED)
A recent small study has shown a link between sudden sensorineural hearing loss (SNHL) and celiac disease with the incidence of SNHL being significantly higher in the celiac disease group (47%) when compared to controls (9%). Further studies are needed to be evaluated on the effects of gluten free diet for the treatment of SNHL and AIED.
- Bilateral Vestibular Hypofunction (BVH)
Bilateral Vestibulopathy (loss of function in both ears) is quite rare. Case reports have been disclosed surrounding the presence of celiac disease disease in patients suffering from BVH 23% of patients with BVH were known to have co-existing autoimmune disorders in their medical history. There are no known studies on the effects of gluten exclusion in BVH but given the potential autoimmune origin this could be hypothesised as a potential treatment option.
Do you still have questions? You can discuss your vestibular disorder with our vestibular physiotherapist in Melbourne. Book an appointment online today to get started.
References:
- Modugno, G. C., Pirodda, A., Ferri, G. G., Montana, T., Rasciti, L., & Ceroni, A. R. (2000). A relationship between autoimmune thyroiditis and benign paroxysmal positional vertigo?. Medical hypotheses, 54(4), 614-615.
- Di Berardino, F., & Cesarani, A. (2012). Gluten sensitivity in Meniere’s disease. The Laryngoscope, 122(3), 700-702.
- Pollak, L. (2020). Bilateral vestibulopathy disclosing the diagnosis of celiac disease. Neurological Sciences, 41(2), 463-464.
- Lucieer, F., Vonk, P., Guinand, N., Stokroos, R., Kingma, H., & van de Berg, R. (2016). Bilateral vestibular hypofunction: insights in etiologies, clinical subtypes, and diagnostics. Frontiers in neurology, 7, 26.
- van Hemert, S., Breedveld, A. C., Rovers, J. M., Vermeiden, J. P., Witteman, B. J., Smits, M. G., & de Roos, N. M. (2014). Migraine associated with gastrointestinal disorders: review of the literature and clinical implications. Frontiers in neurology, 5, 241.
