Celiac Disease Increases Cardiovascular Disease Risk

November 13, 2017 | Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

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Celiac Disease Increases Cardiovascular Disease Risk
Since 2000, increasing evidence points to several common cardiovascular diseases related to gluten intolerance and celiac disease. Celiac disease is an autoimmune disorder that affects millions of Americans, with many of whom are undiagnosed. There is, however, more to celiac disease than gastrointestinal symptoms.

Celiac disease is due to the immune system attacking the intestinal tract after gluten is consumed. Gluten is a protein found in wheat, rye, and barley. Classic celiac disease symptoms include diarrhea, bloating, gas, heartburn, indigestion, cramping, nausea, vomiting, fatigue, anemia, and weight loss.

Several cardiovascular disorders have been linked or found to be higher in individuals with untreated celiac disease. These disorders include cardiomyopathy, myocarditis, arrhythmias, atrial fibrillation, heart attacks, atherosclerosis, POTS, and several other cardiovascular disorders. Evidence shows that these cardiac disorders are more common in individuals with celiac disease than those without the disorder.

The August 2017 issue of World Journal of Cardiology published a review article entitled Cardiovascular involvement in celiac disease. This review article delves into current research and knowledge about untreated celiac disease and its systemic effects on the heart and circulatory system. This is a follow-up to a previous newsletter article Cheating on a Gluten-Free Diet? Increased Serious Risks May Occur. Here is a brief synopsis on this topic.

Arteries: Stiffening, Blockages, and Tearing


Arterial stiffness, including the aorta which is the largest artery in the body, was significantly worse in untreated celiac disease patients. Blockage of the arteries like the carotid artery occurs with higher frequency in untreated gluten sensitivity. Spontaneous coronary artery dissection or tearing that leads to acute heart attack has been seen. Cerebrovascular disease which interferes with blood flow to the brain may occur. Vascular complications seen with celiac disease are more severe in type 1 diabetics.

Atherosclerosis


Various stages of atherosclerosis were found in youth and adults with untreated celiac disease not due to any other cardiovascular risk factor. There was increased thickening of carotid arteries inner walls from inflammation. Elevated inflammatory lab markers of homocysteine levels, SED rate, C-reactive protein, LDL cholesterol, total cholesterol, and insulin were found in untreated celiac disease. Even children with untreated celiac disease had atherosclerosis, aortic stiffening, and elevated cholesterol. Complete avoidance of gluten reversed these findings, but it took at least one year for the tissues to heal and lab values improve. If gluten consumption resumed, tissue inflammation and pathology reappeared.

Blood Clots, Stoke, Hemorrhage, Blood Flow, and Angiogenesis


Blood clots like deep vein thrombosis (DVT) or clots found elsewhere in the body occur with higher frequency in untreated celiac disease. Children and adults are at increased risk for stroke and clots even in the absence of typical gastrointestinal symptoms. There was increased risk for hemorrhage which occurred because of vitamin K deficiency from malabsorption. Hemorrhage risks increased with corticosteroid and immunosuppression therapy which are commonly used for severe celiac disease.

Altered blood flow within the abdominal vascular networks was found. Inflammation and damage to the one cell thick inner endothelial lining of blood vessels was found which leads to increased vascular resistance causing hypertension. The effect is reversible when gluten is removed. Research shows that gluten induced inflammation causes lymphocytes, a type of white blood cell, to adhere to the lining of blood vessels and impair circulation.

Heart: Fluid, Myocarditis, Heart Failure, Ejection Fraction, and Heart Block


Pericardial effusion or fluid build-up around the heart, autoimmune myocarditis (inflammation of the heart), and progressive heart failure may be a complication of untreated celiac disease in children and adults. Other findings related to celiac disease and heart failure include increased severely dilated and dysfunctional left ventricle, very low ejection fractions, pulmonary hemosiderosis, heart block, and many different types of cardiomyopathy or heart muscle disease.

Celiac disease triggers these responses due to reduced immune competence, selenium deficiency, and high levels of autoimmune inflammation. Iron and carnitine deficiency, due to poor absorption, worsen the outcome of cardiomyopathy. Complete avoidance of gluten is mandatory in order to avoid progression of the cardiomyopathy. It was noted that celiac disease-induced end-stage heart failure will occur if gluten is not avoided. Iron and carnitine replenishment must be restored.

Heart: Cardiomyopathy, MVP, Heart Attacks and Ischemic Heart Disease


Acute heart attacks may occur in young and older patients with celiac disease and is thought due to calcium malabsorption. Atrial fibrillation occurs at significantly higher rates due to chronic systemic inflammation from gluten. Impaired diastolic and systolic function may occur affecting blood pressure regulation. Mitral valve prolapse (MVP) and other heart valve regurgitation disorders are seen more frequently in celiac disease. Research also recognizes an increased risk of ischemic heart disease/coronary artery disease and overall increased mortality rate from all causes in untreated celiac disease. First degree relatives (parent-child, sibling-sibling) of celiac disease patients also have an increased risk of heart disease.

Congenital Heart Defects, POTS


Children who have congenital heart defects or Down syndrome with heart defects are more likely to have gluten intolerance. Children with untreated celiac disease are more likely to experience imbalance of the autonomic nervous system parasympathetic-sympathetic activity of tone making them more prone to Postural Orthostatic Tachycardia Syndrome or POTS. Calcium malabsorption is presumed to be the cause.

Celiac Disease Causes Several Nutritional Deficiencies


In most cases, once individuals adopt a gluten-free diet and health is restored, many findings are reversed. More in-depth support with restoration of lost nutrients, healing the gut lining, and reduction of inflammation can be very helpful to speed recovery. Several key nutrients were identified as deficient and contributed to cardiovascular findings in this review article. These included carnitine, iron, calcium, protein, folate, riboflavin/vitamin B2, vitamin B12, vitamin K, and selenium. Other studies have identified deficiencies of vitamin B6, vitamin A, vitamin D, and zinc in celiac disease

Managing Cardiovascular and Gut Inflammation


In order to manage elevated homocysteine levels found in celiac disease, several nutrients are needed. Most important are vitamin B6, B12, and folate. Magnesium, vitamin B2, N-acetyl-cysteine (NAC), taurine, omega-3 DHA, choline, and trimethylglycine (TMG) are needed as accessory nutrients. C-Reactive Protein (CRP), and SED rate may be supported with nutrients like curcumin, bromelain, papain, and quercetin. These same nutrients and many others help support healthy heart and blood vessels.

Traditional celiac disease diagnosis is based on complete atrophy of the villus lining of the small intestine demonstrated by biopsy. This is full-blown tissue destruction and end-stage autoimmune disease. Other methods of testing can provide earlier recognition of gluten intolerance. Villus lining refers to the fingerlike projections that line the inner small intestine. Villous atrophy is akin to carpet that has been excessively worn down. Villi are essential for nutrient absorption. Keep in mind that gut symptoms may not always be present or recognized.

In order to restore the villi in celiac disease, gluten must be avoided. Full-spectrum pancreatic enzymes with DPP-IV may help break down gluten if accidently exposed. Other nutrients can be helpful for restoring the integrity of the gut. These include glutamine, cordyceps, vitamin D, vitamin A, omega-3 EPA/DHA, omega-6 GLA oils, N-acetyl d-glucosamine (NAGS), curcumin and beneficial bacteria. Additional information may be found at Leaky Gut Syndrome: More Than Just a Gut Problem

Cardiovascular disease is a top leading cause of death. Mounting evidence shows that untreated celiac disease causes numerous cardiovascular disorders in children and adults. The rise in celiac disease and gluten intolerance may be linked with candida, other gut problems, and increased exposure to herbicide Roundup or glyphosate. Clearly, not all cardiovascular disease is caused by gluten, therefore appropriate evaluation should take place. At the same time, researchers always say more information is needed to confirm and solidify understanding. My hope is that you take this gut information to heart and use it wisely!

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