Gluten Ataxia Symptoms: What You Can Expect

Problems with Gait, Tingling in Extremities, Other Signs Common

Symptoms of gluten ataxia, a neurological condition that results from a reaction to the gluten protein, can range from progressive balance difficulties and unsteadiness on your feet to problems swallowing. You might have double vision, or even issues controlling your bladder.

Your symptoms might come on slowly or might appear suddenly, but they probably won't include digestive symptoms that could indicate celiac disease.

Gluten ataxia can be defined as an autoimmune disorder where gluten ingestion damages the cerebellum, which controls gait and muscle coordination, and comprimises fine control of voluntary movements.

Researchers have identified specific antibodies used to aid in the diagnosis of gluten ataxia, however the tests to identify them may not be widely available.

Various medical studies have outlined the symptoms of gluten ataxia, and have speculated on how many people might have gluten ataxia.

Woman on the ground outside in pain
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Gluten Ataxia Symptoms Include Gait Problems, Unsteadiness

The symptoms of gluten ataxia are identical to those of other forms of ataxia, making it more challenging to provide a proper diagnosis. Gluten ataxia patients generally are in their late 40s or early 50s when diagnosed, although the medical literature notes cases where the condition develops in young children or teens. Men and women are fairly equally represented (unlike in celiac disease, where women outnumber men).

In most cases, people notice problems with their gross motor skills first—in other words, they'll be very clumsy, they'll walk unsteadily with a tendency to stumble or make missteps, and they'll generally be extremely uncoordinated.

Gluten ataxia sufferers may also notice problems with fine motor skills—for example, someone with the condition might be unable to easily button a shirt or use a pen to write in longhand. Some patients also slur their words or have trouble speaking, and some have difficulty swallowing.

Gait Problems Come First

Medical studies report that everyone with gluten ataxia has symptoms of gait ataxia and that these problems often go hand-in-hand with gluten-related peripheral neuropathy symptoms (i.e., tingling in your extremities). Another symptom is related to the eyes, where the eyes move involuntarily back and forth.

Approximately 60% of patients show evidence of what's called "sensorimotor axonal neuropathy," which means nerve damage that causes sensations of tingling, loss of sensation and even pain in the extremities. However, these symptoms usually are mild, and don't necessarily contribute to the ataxia, researchers say.

Despite the potentially gluten-induced nature of the damage to their bodies, only around 10% of people with gluten ataxia will have gastrointestinal symptoms such as diarrhea, constipation, bloating, abdominal pain, gas, and reflux. Despite this low level of symptoms, one study found that 24% of gluten ataxia patients actually had villous atrophy from celiac disease.

Symptoms Reflect Damage To Your Brain

All these gluten ataxia symptoms stem from damage to your cerebellum, the part of your brain charged with making sure your muscles work in concert with each other.

In fact, 60% of patients diagnosed with gluten ataxia have evidence of cerebellar atrophy—literally, shrinkage of that part of their brains—when they're examined by magnetic resonance imaging (MRI). Patients who don't have visible shrinkage in their cerebellums still show abnormalities in highly sensitive medical imaging studies, according to researchers.

The condition tends to progress slowly, but it is possible for it to move rapidly, too, with cerebellar atrophy developing within a year of the first symptoms, according to Dr. Marios Hadjivassiliou, a neurologist practicing in the U.K. and the top researcher in the field of gluten ataxia.

A study performed by Dr. Hadjivassiliou looking at 68 patients with gluten ataxia noted that 78% of those people carried one or both of the primary celiac disease genes, HLA-DQ2 and HLA-DQ8. The remainder of that group carried HLA-DQ1, which Dr. Hadjivassiliou has speculated is involved with neurological symptoms stemming from gluten ingestion.

A Word from Verywell

In a paper published in the journal BMC Medicine, Dr. Hadjivassiliou and other top researchers outlined the most common symptoms of gluten ataxia and proposed a diagnostic algorithm designed to distinguish the condition from the other gluten- and wheat-related conditions: celiac disease, gluten sensitivity, dermatitis herpetiformis, and wheat allergy.

However, more research and consensus will be needed before clinicians will fully accept gluten ataxia as a diagnosis, and routinely test people for it if they show symptoms.

If you believe you may have the symptoms of gluten ataxia, you first should talk to your healthcare provider about the condition and about what you've been experiencing. Many other conditions, including other forms of ataxia, may produce similar symptoms. Also, you shouldn't begin the gluten-free diet before speaking with your healthcare provider, since removing gluten could make your test results for celiac disease inaccurate.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Mearns ES, Taylor A, Thomas craig KJ, et al. Neurological manifestations of neuropathy and ataxia in celiac disease: a systematic review. Nutrients. 2019;11(2). doi:10.3390/nu11020380

  3. Vinagre-Aaragón A, Zis P, Grunewald RA, Hadjivassiliou M. Movement disorders related to gluten sensitivity: a systematic review. Nutrients. 2018;10(8). doi:10.3390/nu10081034

  4. Khwaja GA, Bohra V, Duggal A, Ghuge VV, Chaudhary N. Gluten sensitivity - a potentially reversible cause of progressive cerebellar ataxia and myoclonus - a case report. J Clin Diagn Res. 2015;9(11):OD07-OD08. doi:10.7860/JCDR/2015/13299.6743

  5. Zis P, Hadjivassiliou M. Treatment of neurological manifestations of gluten sensitivity and coeliac disease. Curr Treat Options Neurol. 2019;21(3):10. doi:10.1007/s11940-019-0552-7

  6. Hadjivassiliou M, Sanders DD, Aeschlimann DP. Gluten-related disorders: gluten ataxia. Dig Dis. 2015;33(2):264-268. doi:10.1159/000369509

Additional Reading

By Jane Anderson
Jane Anderson is a medical journalist and an expert in celiac disease, gluten sensitivity, and the gluten-free diet.