There has been considerable controversy around the possible link between sensitivity and autoimmunity to gluten in grains and the development and course of MS. The link has been suggested but not proven, yet many people with MS opt to use gluten free diets in their efforts to regain their health.

This study from Spain adds some evidence that there may be a link. The researchers examined 72 PwMS and their first degree relatives and compared them with 123 people without MS. Seven of the PwMS had antibodies suggestive of coeliac disease, versus three of the healthy controls. These antibodies to gluten were even more common in the first degree relatives of PwMS, with 23 of 126 relatives being positive. The authors then did gut biopsies, a more definitive test of coeliac disease, and found that eight of the PwMS had biopsies suggestive of coeliac disease. The authors recommended increased efforts at detecting coeliac disease in PwMS, and for anyone found to have coeliac disease, a gluten-free diet, as one would expect.

It should be noted that the numbers in this study were small, and while the prevalence of coeliac disease was several fold higher in PwMS than those without, because of the small numbers, the results were only just statistically significant. This adds weight to more careful screening of PwMS for coeliac disease, but the issue of whether gluten-free diets help PwMS who do not have frank coeliac disease remains not settled. There is currently insufficient evidence for PwMS to adopt gluten-free diets, but this study adds weight to the need for a randomised controlled trial of gluten free diet in PwMS.

Prevalence of celiac disease in multiple sclerosis