Ménière disease and gluten sensitivity: Recovery after a gluten-free diet

The effect of a gluten-free diet on a patient complaining of severe tinnitus

“…GS has recently been reported in patients affected by Ménière's disease. Di Berardino et al found a positive gliadin skin test response in 57% of 58 Ménière's patients 9 and a GFD eliminated Ménière's symptoms in a subject with GS 10 . GS could be raised as a possible contributor to the genesis of tinnitus in our patient who had the HLA-DQ2 haplotype, negative autoantibody serology (tTG-IgA), increased intraepithelial lymphocytes and whose symptoms improved shortly after beginning the new diet.…”

“…New interest has developed concerning diets without gluten-containing cereals: besides wheat allergy and celiac disease, there are also cases of gluten reactions, defined as gluten sensitivity (GS), in which neither allergic nor autoimmune mechanisms are involved [6][7][8] . Recently, GS has been reported in patients affected by Ménière's disease and a gluten free diet (GFD) proved to be effective in eliminating symptoms in one such patient 9,10 . No paper has demonstrated the effect of a gluten free diet on tinnitus alone.…”

Gluten Sensitivity Biomarkers in Menière's Disease: Is It a Gluten Related Disorder?

“…[25,26,27] and our previous observation of a gluten immune reactivity in MD patients. [17,18] The association between NCGS and MD should be supported by dietary exclusions and challenges: symptoms improve or disappear upon gluten withdrawal, while they recur if gluten is reintroduced in the diet. [28,29,30] However, withdrawal diets and subsequent challenge tests, that are frequently declined by patients, owing to the consistent side effects.…”

“…[15,16] A possible relationship between NCGS and MD has been previously suggested. [17,18] Early studies categorized wheat proteins into four groups according to solubility: water-soluble albumins, salt-soluble globulins, ethanol-soluble gliadins, and alkaline/acid-soluble glutenins, [19] but the proteomic map of wheat identified ~ 1000 individual antigens. [20] For this specific reason, we planned to check the serological profile, in search of a possible useful biomarker to assist in diagnosing gluten immune reactivity and sensitivity.…”

Increased urinary volumes in symptomatic Ménière’s Disease

“…In 1923, inhalant and food allergies have been related to Ménières' disease (MD); [1] from then until now, this relation has been reported in the literature. [2][3][4][5][6][7] Since 2013, increased intestinal permeability has been shown to be an intrinsic trait in a subset of food allergic subjects. [8,9] The urinary excretion of two orally administered non-metabolizable sugars, lactulose and mannitol, also known as the "double sugar test" is a well-known, validated, non-invasive method to evaluate the intestinal permeability, because their urinary concentration is an indirect index of their intestinal absorption.…”