Lupus and Celiac Disease

The debate about the link between lupus and celiac disease is ongoing. There are multiple studies seeking to pinpoint the correlation between these two autoimmune diseases. This may not be a surprise to celiac disease patients who’s diagnosis of CD may be accompanied by a variety of other diagnoses, such as diabetes, osteoporosis, fertility problems or even other immune conditions. One of these immune diseases is called systemic lupus erythematosus (SLE), or just lupus for short.

Lupus manifests itself with skin rashes, arthritis, renal problems as well as digestive disturbances, which makes for a challenging diagnosis for physicians: is it lupus? Is it celiac disease? Is it both? What makes it even harder is that, although there is a definite link between celiac disease and other immune conditions in general, it is incredibly difficult to calculate the risk associated with each condition specifically. For example, estimates suggest that out of 1000 celiac disease patients, roughly 20% will develop a second immune condition, but only two will actually be diagnosed with lupus.

Only two in 1000 patients? Still 3x higher than the general population

Only two patients with lupus in 1000 with celiac disease seems a pretty low rate, but it is still about three times higher than in the general population. In addition, some studies suggest these unlucky two patients to develop both lupus and celiac disease will most likely be women, but age does not seem to have any impact.

The opposite question is also relevant, as some studies find that patients with an initial diagnosis of lupus are also more likely to develop celiac disease. If we look at the same rate of 1000 patients with lupus, estimates suggest less than eight patients also share a celiac disease diagnosis.

Are there similar symptoms between lupus and CD?

That’s because celiac disease, lupus and other diseases shown to have a higher correlation with CD involve the immune system, an incredibly complex system that affects so many other systems and functions and includes so many variables, it can be difficult to “tease out” which disorder is actually present. Plus, because studies have shown it is common for more than one immune disorder to occur, diagnosis is even more problematic. Even when celiac disease is not present, lupus is often confused with rheumatoid arthritis which also has similar symptoms. Lupus is a complex and unpredictable disease making it challenging to diagnose. The most common symptoms of lupus include but are not limited to extreme fatigue that doesn’t go away with rest, Joint pain, stiffness, and swelling in two or more joints, fever over 100°F, muscle pain, hair loss, skin sores and rashes (which may occur in a butterfly-shaped pattern across the cheeks and nose), nose or mouth sores (usually painless), skin rashes after sun exposure. Some symptoms are similar to those of celiac disease. Click this link for a comprehensive and detailed list of the common symptoms of celiac disease.

At least one study suggests the problem in diagnosing lupus in celiac disease patients is because lupus may develop later on, and when an earlier series of tests does not find evidence of the disease, it is essentially crossed off the list of potential culprits. That study also recommends a longer period of follow-up and re-testing to determine if lupus develops over time.

Potential mechanisms

Not surprisingly, the mechanism explaining this link between celiac disease and lupus is incredibly complex. Researchers know that many factors can influence the development of both conditions, from genetics to nutrition. To cover this link between several immune diseases, researchers have developed the idea of “shared immunity”, suggesting all immune conditions share a certain common pathway, up to a point anyway.

Under this shared immunity umbrella, let’s have a look at some of the factors that may increase the risk of developing both celiac disease and lupus:

Genetic factors

In this era of genetics, it is not surprising to hear that immune diseases can alter the way some genes are expressed. What is interesting and new is that these alterations are identical, irrespective of what immune condition it is. This shared pathway certainly makes the link between celiac disease and lupus even stronger and explains why patients with one of the conditions are more likely to develop the other.

Nutritional factors

If you have a high risk of developing both celiac disease and lupus, you may not be able to do anything about your “genetics”, but it is not all bad news! Also not surprisingly, a second important factor is your nutrition. One example comes from a group of researchers from Oklahoma University suggesting that patients with vitamin D deficiency – so common in celiac disease sufferers – have a higher risk of developing lupus. In this case, ensuring a balanced gluten-free diet and adequate supplementation can go a long way to lowering the risk of developing lupus. Highlighting once again the importance of good nutritional support.

Conclusion

The take home message? Researchers still don’t know why patients with celiac disease are more likely to develop lupus (and vice-versa), but certainly genetic and nutritional factors have an impact. However, it is important not to focus on the doom and gloom: despite having a three times higher risk of developing lupus, the absolute risk for celiac disease patients is actually very low and can be even further reduced with a balanced diet and appropriate supplementation.

If you have celiac disease, and are experiencing the symptoms of lupus, but you have not yet been diagnosed (or vice versa), it is important to find support. Continue to check in on our blog; we continue to monitor current medical information about existing and emerging studies that show a direct link between the two conditions. Be sure to offset the effects of the celiac disease to the greatest extent possible, so stay on your gluten free diet and be sure you get the right nutrition. And of course, keep your doctor informed of your symptoms. An open dialogue with your Dr. can contribute to a correct diagnosis.

This original article was created by Gluten Free Therapeutics, Inc. the makers of CeliVites.