The Association between ADHD and Celiac Disease in Children

Abstract

Controversy around the association between celiac disease (CeD) and attention deficit hyperactive disorder (ADHD) was addressed by a systematic review in 2015, ultimately showing no association. Since 2015, there have been several studies showing an association between celiac disease and attention deficit hyperactive disorder. This is an updated systematic review. Background: Most experts agree on the recommendation to not screen as part of the standard of care for ADHD in persons with CeD or vice versa. Simultaneously, they propose that untreated patients with CeD and neurological symptoms such as chronic fatigue, inattention, pain, and headache could be predisposed to ADHD-like behavior, namely inattention (which may be alleviated by following a gluten-free diet). The inattentive subtype of ADHD that encompasses the symptoms of inattention is phenotypically heterogeneous, as it includes the clinical construct of sluggish cognitive tempo (SCT). SCT symptoms overlap with the neurological manifestations of CeD. Methods: A systematic search (PRISMA) of PubMed, Google Scholar, EMBASE, Web of Science, Stanford Lane, SCOPUS, and Ovid was conducted for articles up to 21 February 2022. Of these, 23 studies met the criteria. Results: Out of the 23 studies, 13 showed a positive association between ADHD and CeD. Most studies that showed a positive association had been published in the last five years. Inconsistencies in the results remain due to the heterogeneous methodology used, specifically for ADHD and the outcome questionnaires, as well as a lack of reporting on ADHD subtypes. Conclusion: There is an association between ADHD and celiac disease. The current methodological limitations will be lessened if we examine the subtypes of ADHD.

Are children with attention-deficit/ hyperactivity disorder (ADHD) more likely to develop celiac disease? A prospective study

“…A review by Sonia Gaur suggested that it is better to evaluate the association between ADHD and celiac disease on the basis of different sub-types of ADHD, specifically in the inattentive type [ 24 ]. Another pre vious study by Efe et al ., reported an improvement in inattentive behavior among ADHD patients who received a GFD [ 25 ].…”

Is Histamine and Not Acetylcholine the Missing Link between ADHD and Allergies? Speer Allergic Tension Fatigue Syndrome Re-Visited

“…Indeed, more than 85% of patients diagnosed with migraine display DAO deficiency [ 30 ]. Moreover, ADHD is closely associated with celiac disease [ 133 ] and other food allergies that might be the counterpart of what Speer coined as “gastrointestinal allergy” within SATFS. Indeed, Tryphonas and Trites (1979) reported that 47% of the 90 hyperactive children referred were allergic to at least one food [ 134 ].…”

Psychiatric and Neurological Manifestations of Celiac Disease in Adults

“…A case of CD that is left untreated increases the likelihood of having symptoms that are comparable to those of ADHD. Due to the presence of ADHD-like cognitive and behavioral features in untreated CD, doctors should be aware of the possibility of elements of ADHD [59].…”