Use of thegluten-free dietin autism is controversial (most medical studies don’t report any benefit). But some parents maintain that the diet (mainly a variant of it that also eliminates milk products) has helped their autistic children. Could the diet work because those children actually haveceliac disease, with celiac disease the cause of their autism traits?
The answer is no in most cases: going gluten-free won’t help your child’s autism. However, recent research indicates there could be some links—possibly between mothers with celiac disease (which causes digestive and other symptoms) and their autistic children. It’s also possible that non-celiacgluten sensitivity—a condition that’s not yet well understood—might play some role in autism.
All this research on links between celiac disease, non-celiac gluten sensitivity, and autism is preliminary. The findings don’t offer much hope to parents searching for help right now, but they may provide clues to future autism treatment (or even prevention) one day.
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What Is Autism?
In 2023, the CDC reported that approximately one in 36 children in the United States is diagnosed with an autism spectrum disorder (ASD). Boys are nearly four times more likely to be diagnosed with autism than girls.Autism traitsgenerally appear when a child is between age 2 and 3, although they may be apparent earlier.
As you might gather from the term “spectrum,” ASD encompasses a wide range of traits and limitations. An autistic person with low support needs might have trouble making eye contact and might appear to have little empathy, but they would be able to hold a job and maintain personal relationships. Meanwhile, someone with intense autism traits and high support needs (level 3 autism) might not be able to speak or to live independently as an adult.
Medical researchers don’t believe there’s one singlecause of autism.Instead, they believe a combination of genetic and environmental factors leads certain children to develop the condition. Autism does run in families, indicating genetic links, but other factors—including having older parents and being born very premature—also increase the risk.
Autism and the Gluten-Free, Casein-Free Diet
Parents have been using the gluten-free, casein-free diet as an autism treatment for at least two decades (casein is a protein found in milk that has some similarities to gluten). The controversial theory behind the treatment is that autistic children have a “leaky gut” that allows fragments of large proteins to leak from their digestive tracts. Gluten and casein are proteins.
According to this theory, the proteins gluten and casein—when leaked from the digestive tract—have an effect somewhat like opioids on the child’s developing brain.
In addition, many autistic children (more than 80% in one study) have digestive symptoms such as diarrhea, constipation, abdominal pain, or reflux, which in parents' minds bolsters the case for some sort of dietary intervention.
However, the truth is there’s little evidence to back up this treatment. A review of major studies on the GFCF diet in autism found minimal to no effect on autism traits.Still, some parents maintain that the GFCF diet has helped their children (in some cases dramatically), and some alternative practitioners continue to recommend it. This has led some to speculate on a potential connection to celiac disease.
Celiac Disease in Autistic Children
Could some autistic children also have celiac disease, and could that explain the success a few parents report with the gluten-free, casein-free diet? Studies have been mixed on this point, although there’s at least one documented case of an autistic child recovering from autism after being diagnosed with celiac disease and beginning the gluten-free diet.
The autistic child who recovered after being diagnosed with celiac and going gluten-free was a 5-year-old at the time of the diagnosis.The healthcare providers in charge of the child’s care wrote that nutritional deficiencies resulting from celiac disease’s intestinal damage may have been responsible for autistic traits.
However, there’s not much additional evidence in the medical literature for cases of celiac disease masquerading as autism. The largest study to date, conducted in Sweden using that country’s national health registry, found that autistic people were not more likely to later receive a diagnosis of celiac disease (which requires an endoscopy to show damage to the small intestine).
However, the study also found that autistic people were three times more likely to have positive celiac blood tests—indicating an immune system response to gluten—but no damage to their small intestines (meaning they didn’t have celiac disease).
The authors speculated that people with an immune system response to gluten but with negative tests for celiac disease may have non-celiac gluten sensitivity, a condition that isn’t well-understood but which the researchers noted has been linked to psychiatric disorders such as schizophrenia.
The researchers urged caution with the findings, saying that the results don’t necessarily indicate sensitivity to gluten in those children, or that gluten was causing or contributing to autism. However, they said that future research may point to treatment strategies for autistic people.
Autism and Autoimmunity
Could there be some other link between autism and the gluten-related autoimmune condition celiac disease? Maybe. Medical studies indicate that there may be a connection between autoimmune conditions in general and autism, specifically between mothers with autoimmune conditions (including celiac disease) and autistic children.
Research has shown that people with a family history of autoimmune conditions (remember, celiac disease is an autoimmune condition) are more likely to have an autism diagnosis.One study found that mothers who had celiac disease had three times the normal risk of having an autistic child.It’s not clear why this was so; the authors speculated that certain genes could be to blame, or possibly that the children were exposed to their mothers' antibodies during pregnancy.
Ultimately, if science could accurately identify a subset of people who were at risk of giving birth to an autistic child due to specific antibodies, researchers could explore ways to calm the immune system response during pregnancy and perhaps even prevent some cases of autism. However, we’re far from such an outcome right now.
Summary
Autism is a devastating condition, and it’s understandable that parents want to do everything they can to help their children, including dietary changes. The evidence pointing to a possible immune system response to gluten in some children is interesting, but it’s too preliminary to offer any real-world treatment strategies.
If your child has digestive symptoms (as many autistic children do), your healthcare provider can point to potential causes and treatments. If celiac disease runs in your family and your autistic child has celiac disease symptoms, you could consider testing for celiac disease.
At this time, unfortunately, there’s no testing available for non-celiac gluten sensitivity, but if you think the gluten-free diet might help your autistic child, discuss the pros and cons of the diet with your healthcare provider.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Data & Statistics on Autism Spectrum Disorder.Amaral DG.Examining the Causes of Autism.Cerebrum. 2017;2017Parzanese I, Qehajaj D, Patrinicola F, et al.Celiac disease: From pathophysiology to treatment.World J Gastrointest Pathophysiol. 2017;8(2):27-38. doi:10.4291/wjgp.v8.i2.27Piwowarczyk A, Horvath A, Łukasik J, Pisula E, Szajewska H.Gluten- and casein-free diet and autism spectrum disorders in children: a systematic review.Eur J Nutr. 2018;57(2):433-440. doi:10.1007/s00394-017-1483-2Genuis SJ, Bouchard TP.Celiac disease presenting as autism.J Child Neurol.2010;25(1):114-9. doi:10.1177/0883073809336127Ludvigsson JF, Reichenberg A, Hultman CM, Murray JA.A nationwide study of the association between celiac disease and the risk of autistic spectrum disorders.JAMA Psychiatry.2013;70(11):1224-30. doi: 10.1001/jamapsychiatry.2013.2048Lau NM, Green PH, Taylor AK, et al.Markers of Celiac Disease and Gluten Sensitivity in Children with Autism.PLoS ONE. 2013;8(6):e66155. doi:10.1371/journal.pone.0066155Atladóttir HO, Pedersen MG, Thorsen P, et al.Association of family history of autoimmune diseases and autism spectrum disorders.Pediatrics.2009;124(2):687-94. doi:10.1542/peds.2008-2445Brimberg L, Sadiq A, Gregersen PK, Diamond B.Brain-reactive IgG correlates with autoimmunity in mothers of a child with an autism spectrum disorder.Mol Psychiatry. 2013;18(11):1171-7. doi:10.1038/mp.2013.101Additional ReadingAtladóttir HO et al.Association of Family History of Autoimmune Diseases and Autism Spectrum Disorders. Pediatrics. 2009 Aug;124(2):687-94.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Data & Statistics on Autism Spectrum Disorder.Amaral DG.Examining the Causes of Autism.Cerebrum. 2017;2017Parzanese I, Qehajaj D, Patrinicola F, et al.Celiac disease: From pathophysiology to treatment.World J Gastrointest Pathophysiol. 2017;8(2):27-38. doi:10.4291/wjgp.v8.i2.27Piwowarczyk A, Horvath A, Łukasik J, Pisula E, Szajewska H.Gluten- and casein-free diet and autism spectrum disorders in children: a systematic review.Eur J Nutr. 2018;57(2):433-440. doi:10.1007/s00394-017-1483-2Genuis SJ, Bouchard TP.Celiac disease presenting as autism.J Child Neurol.2010;25(1):114-9. doi:10.1177/0883073809336127Ludvigsson JF, Reichenberg A, Hultman CM, Murray JA.A nationwide study of the association between celiac disease and the risk of autistic spectrum disorders.JAMA Psychiatry.2013;70(11):1224-30. doi: 10.1001/jamapsychiatry.2013.2048Lau NM, Green PH, Taylor AK, et al.Markers of Celiac Disease and Gluten Sensitivity in Children with Autism.PLoS ONE. 2013;8(6):e66155. doi:10.1371/journal.pone.0066155Atladóttir HO, Pedersen MG, Thorsen P, et al.Association of family history of autoimmune diseases and autism spectrum disorders.Pediatrics.2009;124(2):687-94. doi:10.1542/peds.2008-2445Brimberg L, Sadiq A, Gregersen PK, Diamond B.Brain-reactive IgG correlates with autoimmunity in mothers of a child with an autism spectrum disorder.Mol Psychiatry. 2013;18(11):1171-7. doi:10.1038/mp.2013.101Additional ReadingAtladóttir HO et al.Association of Family History of Autoimmune Diseases and Autism Spectrum Disorders. Pediatrics. 2009 Aug;124(2):687-94.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Data & Statistics on Autism Spectrum Disorder.Amaral DG.Examining the Causes of Autism.Cerebrum. 2017;2017Parzanese I, Qehajaj D, Patrinicola F, et al.Celiac disease: From pathophysiology to treatment.World J Gastrointest Pathophysiol. 2017;8(2):27-38. doi:10.4291/wjgp.v8.i2.27Piwowarczyk A, Horvath A, Łukasik J, Pisula E, Szajewska H.Gluten- and casein-free diet and autism spectrum disorders in children: a systematic review.Eur J Nutr. 2018;57(2):433-440. doi:10.1007/s00394-017-1483-2Genuis SJ, Bouchard TP.Celiac disease presenting as autism.J Child Neurol.2010;25(1):114-9. doi:10.1177/0883073809336127Ludvigsson JF, Reichenberg A, Hultman CM, Murray JA.A nationwide study of the association between celiac disease and the risk of autistic spectrum disorders.JAMA Psychiatry.2013;70(11):1224-30. doi: 10.1001/jamapsychiatry.2013.2048Lau NM, Green PH, Taylor AK, et al.Markers of Celiac Disease and Gluten Sensitivity in Children with Autism.PLoS ONE. 2013;8(6):e66155. doi:10.1371/journal.pone.0066155Atladóttir HO, Pedersen MG, Thorsen P, et al.Association of family history of autoimmune diseases and autism spectrum disorders.Pediatrics.2009;124(2):687-94. doi:10.1542/peds.2008-2445Brimberg L, Sadiq A, Gregersen PK, Diamond B.Brain-reactive IgG correlates with autoimmunity in mothers of a child with an autism spectrum disorder.Mol Psychiatry. 2013;18(11):1171-7. doi:10.1038/mp.2013.101
Centers for Disease Control and Prevention.Data & Statistics on Autism Spectrum Disorder.
Amaral DG.Examining the Causes of Autism.Cerebrum. 2017;2017
Parzanese I, Qehajaj D, Patrinicola F, et al.Celiac disease: From pathophysiology to treatment.World J Gastrointest Pathophysiol. 2017;8(2):27-38. doi:10.4291/wjgp.v8.i2.27
Piwowarczyk A, Horvath A, Łukasik J, Pisula E, Szajewska H.Gluten- and casein-free diet and autism spectrum disorders in children: a systematic review.Eur J Nutr. 2018;57(2):433-440. doi:10.1007/s00394-017-1483-2
Genuis SJ, Bouchard TP.Celiac disease presenting as autism.J Child Neurol.2010;25(1):114-9. doi:10.1177/0883073809336127
Ludvigsson JF, Reichenberg A, Hultman CM, Murray JA.A nationwide study of the association between celiac disease and the risk of autistic spectrum disorders.JAMA Psychiatry.2013;70(11):1224-30. doi: 10.1001/jamapsychiatry.2013.2048
Lau NM, Green PH, Taylor AK, et al.Markers of Celiac Disease and Gluten Sensitivity in Children with Autism.PLoS ONE. 2013;8(6):e66155. doi:10.1371/journal.pone.0066155
Atladóttir HO, Pedersen MG, Thorsen P, et al.Association of family history of autoimmune diseases and autism spectrum disorders.Pediatrics.2009;124(2):687-94. doi:10.1542/peds.2008-2445
Brimberg L, Sadiq A, Gregersen PK, Diamond B.Brain-reactive IgG correlates with autoimmunity in mothers of a child with an autism spectrum disorder.Mol Psychiatry. 2013;18(11):1171-7. doi:10.1038/mp.2013.101
Atladóttir HO et al.Association of Family History of Autoimmune Diseases and Autism Spectrum Disorders. Pediatrics. 2009 Aug;124(2):687-94.
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