Autoimmune diseases, probably owing to a non-specific and poorly understood immunological response, often overlap or occur together. That is, a patient with one diagnosed condition will commonly be found to have features of one or more other autoimmune diseases. It appears, according to numerous anecdotal reports and a few case studies of patient experiences, those with celiac disease may indeed be included in this group, despite very little official information on or acknowledgement of the connection.
Why are the symptoms of Raynaud’s present in those with celiac disease?
Raynaud’s phenomenon is a condition where poor circulation caused by vessel spasms in the extremities – and less commonly in other lightly vascularized areas such as ears, nose and nipples – leads to sometimes painful discoloration of the fingers and toes, often accompanied by numbness or tingling. It may be primary or secondary, and can be triggered by cold, stress or tobacco smoking. The primary form, which is known as Raynaud’s disease, occurs on its own, without any other obvious cause; in contrast, the secondary form, which is known as Raynaud’s syndrome, occurs as a result of another disorder, such as an autoimmune disease. While the primary form is more common, the secondary form has the potential for much more serious complications, such as ulcerations and gangrene. We are concerned here with the latter type, which is relevant to a discussion of autoimmunity and related conditions.
The short answer about the connection between the two diseases is that we don’t know. Like so much surrounding autoimmune diseases and their manifestations, science and medicine have yet to fully elucidate many of the causes and mechanisms involved. In very general terms (which don’t tell us all that much), it is assumed that whatever autoimmune process is at work attacking other parts of the body is also responsible for attacking parts of the blood vessels, causing them to spasm and induce symptoms. But even this is based on anecdotal evidence and not scientific evidence, and there is still a lot about autoimmune disease we simply don’t comprehend.
Is there an established connection between Raynaud’s and celiac disease?
There was only one article found, published in 2003 in the American Journal of Gastroenterology as a letter to the editor, which directly addresses the issue of this connection. The study was conducted in Rome, Italy and considered 335 patients. Their hypothesis was that the two diseases were associated, meaning that a person with Raynaud’s is more likely to have celiac disease than is the general population. The study results did not find a connection, and stated that a link between the two diseases would have to be attributed to their common root in inflammation and autoimmune phenomena in the people found to have both conditions.
However, a related article covering Raynaud’s and celiac disease had a response from a registered nurse linked to it, citing a physician’s corroboration regarding the connection between celiac and Raynaud’s phenomenon.
In addition, there was a single case report found of an atypical case of celiac disease in a young girl that involved Raynaud’s. Regrettably, these are among the weakest types of research reports, because they detail the course of only one patient’s disease without any formal experimental setup.
Are there any studies about improvement in Raynaud’s symptoms (or severity of symptoms) on a gluten-free diet?
There have been no formal scientific studies about Raynaud’s symptom improvement on a gluten free diet. This is not to say that the purported link between the two conditions is not real. It is clear from several anecdotal reports on message boards that some patients do experience this correlation and a change in symptoms after eliminating gluten.
If I have Raynaud’s, should I eliminate food with gluten even if I’m not diagnosed with celiac?
Given the information above, it is hard to make a case for empirical elimination of gluten products in the absence of a celiac diagnosis, even when Raynaud’s is present. You may want to consider testing for gluten sensitivity if you have tested negative for celiac antibodies.
Except in rare circumstances, there is generally nothing dangerous or unhealthy about being on a gluten-free diet, and if you think that your Raynaud’s may be related, there is no harm in giving it a try to see what happens. Regardless, this is something that should be discussed with your health care provider, since all patients are different and there may be additional considerations.
Questions for your doctor:
- Have you seen an association between Raynaud’s and celiac disease in your practice? If so, how often?
- Should I consider a gluten-free diet even if I haven’t been diagnosed with celiac (for Raynaud’s symptom improvement or any other reasons)?
- If I have both, should I do anything different in terms of treatment and alleviation of either or both conditions?
About the Author
Dr. Rothbard is a professional medical writer and consultant based in New York City, specializing in medical education articles targeted at a variety of audiences, from children through clinicians. After leaving medicine, he worked as a biology and medical science educator for several years, before deciding to pursue writing full-time. He may be reached at [email protected].