Celiac Disease & Asthma appear to be linked. If you have asthma it may be worthwhile eating gluten free to ease your breathing problems…

The link between celiac disease and asthma has been as difficult to prove as finding the reason celiac disease exists. However some tangible evidence (statistical relationships) have been found.

The majority of articles suggest there is no link between celiac disease and asthma, while anecdotal evidence from celiacs suggests that their asthma increases dramatically after the ingestion of any gluten foods.

For instance, an article by Dr Pradeep Bhandari (Ref 1) says that "Celiac disease and Asthma tend to run in families and the tendency to get these diseases is inherited genetically. However, they are not inter-linked. The tendency to get celiac disease is inherited genetically. It mostly affects people of European descent. It is also more common in families with Diabetes or rheumatoid Arthritis. Something in the environment is necessary to trigger the celiac disease in those who are susceptible. Asthma tends to run in families. A person with a parent who has Asthma is three to six times more likely to develop Asthma than someone who doesn't have a parent with Asthma. But no single gene is responsible for Asthma. Instead, you may inherit a general predisposition to Asthma" Ref 1

However a 2005 study was performed on a population of 86 persons residing in the Maltese Islands in the Mediterranean Sea does suggest some correlation:

MALTESE RESEARCH 2005 (Ref 2: Ellul P, Vassallo M, Montefort S)

"Patients previously diagnosed to have CD (based on serological tests and duodenal biopsy) and attending a medical out-patient clinic answered a questionnaire designed to determine whether they had previously been diagnosed to have asthma or allergic rhinitis." Ref 2

"All 86 patients (age range 16-69 [median 43] years; 65 female) answered the questionnaire about CD and asthma. They constituted 21% of the 409 patients with CD in the Maltese islands included in a register kept for controlling free prescription of gluten-free foods." Ref 2

Of 86 respondents, 24 (27.8%; 21 female) had asthma, including 22 with known asthma and 2 with previously undiagnosed asthma; the frequency of asthma in CD patients was higher than that reported in the general Maltese population (11.1%; p<0.00005).[7] In addition, four non-asthmatic patients (one smoker, two ex-smokers, one non-smoker) reported wheezing in the absence of respiratory tract infection in the past; they however had normal pulmonary function tests.

In 16 patients, asthma preceded CD by 3 months to 39 years (median 20 years). Among these patients, gluten-free diet had led to improvement in asthma in 6 patients, possible improvement in 2 patients, and no change in 8 patients. In the remaining 8 patients, asthma followed CD by 2 to 14 years (median 8). Thirty-one of 86 patients with CD and 11 of 24 patients with CD and asthma gave family history of asthma among first-degree relatives.

Eighty-two patients (62 female) answered the questionnaire about allergic rhinitis. Of these, 36 (44%) suffered from allergic rhinitis; this frequency was higher than that reported in the general Maltese population (32.3 %; p<0.05). They conclude that their findings suggest that asthma and allergic rhinitis are more common in CD patients than in the general population in Malta. In patients with atopic diseases, index of suspicion for CD should be high.

FINNISH study in 2001 (Ref 3: Journal of Allergy and Clinical Immunology)

This study tested the postulate of whether TH1 and TH2 cells could co-exist. A correlation between these would suggest a correlation between celiac disease and asthma.

"Background: Asthma is generally regarded as a disease with strong TH2-type cytokine expression, whereas in autoimmune disorders, such as celiac disease (CD), insulin-dependent diabetes mellitus (IDDM), and rheumatoid arthritis (RA), TH1-type expression is seen. According to the cross-regulatory properties of TH1 and TH2 cells, one would assume that these diseases exist in different patient populations." Ref 3

"Objective: We sought to test the hypothesis that asthma could exist in children with TH1-type diseases, such as CD, IDDM, and RA. Methods: Comparison was made of the cumulative incidence of asthma in children with CD, IDDM, or RA by linking Finnish Medical Birth Register data on the whole 1987 birth cohort (n = 60,254 births) with the data of several national health registers to obtain information on the incidences of these diseases during the first 7 years of life." Ref 3

"Results: The cumulative incidence of asthma in children with CD (24.6%) or RA (10.0%) was significantly higher than in children without CD (3.4%) or RA (3.4%; P < .001 and P = .016, respectively). Asthma tended to be more common in children with IDDM than in children without IDDM. Conclusion: These data indicate that the TH1 and TH2 diseases can coexist, indicating a common environmental denominator behind the disease processes."

IMPLICATIONS

While these two studies do not show a causal relationship (proof that one disease causes another), they do suggest that there is a strong correlation between the diseases. That means that if you have celiac disease there is a greater likelihood that you will have asthma. The main ‘take home' point from this is that for people who are celiac, or gluten intolerant, and have asthma, that the removal of gluten from their diet is likely to decreases the incidence and severity of their asthma.