Wheat and Milk Opiate Withdrawal Is Real
Opiate withdrawal from discontinuing gluten and casein? Cautionary note: sounds absurd - until you see it. Evidence matters.
You might want to warn gluten sensitive, celiac and casein sensitive patients about this odd, frequent, and painful clinical phenomenon: Withdrawal after stopping wheat [gluten] or milk [casein] products can be painful, exhausting, and depressing, with weakness, anger, and “brain fog” as subsequent downstream effects that can drive the uniformed back to their comfort foods.
Their “comfort foods” can create opiate withdrawal. And remember: Gluten sensitivity is far more prevalent than celiac disease. In fact, celiac disease is end stage gluten sensitivity, taking the whole discussion of celiac disease to a completely different level.
More Recent Data Confirms This ’07 Report
See this more recent post/report on gluten sensitivity and celiac disease which teases apart new diagnostic methods to assess gluten sensitivity.
Case Review
I have a very interesting and refractory client in Ohio who has struggled for years with a variety of severe reactions to psych meds, suicidal depression, mercury toxicity, and became completely regressed on previous withdrawal of Prozac before I saw him in DC. With autoimmune issues in abundance and at times psychotic like feelings of loosing control we tested him for gluten/casein sensitivity, hit pay dirt with positive findings, and asked him to go on a gluten free/casein free diet [GFCF is the acronym].
He felt remarkably better at first, better than he had in years, then the withdrawal set in. Having had previous experience with addictive opiates prescribed for pain, he recognized signs of withdrawal immediately. First a note on the opiate receptors from Great Plains Laboratory:
The peptides from gluten [gliadorphin] and casein [casomorphin] are important because the react with opiate receptors in the brain, thus mimicking the effects of opiate drugs like heroin and morphine. These compounds have been shown to react with areas of the brain such as the temporal lobes, which are involved in speech and auditory integration.
Children with autism frequently seem addicted to wheat [gluten] and dairy [casein] products. Presumably, people with Autism and schizophrenia incompletely digest wheat and dairy products. These incompletely digested peptides are then absorbed into the body and bind to opiate receptors, altering behavior and other physiological reactions.
And one more reference here:
Notes From The Book: Dangerous Grains
Below is from Dangerous Grains by Ron Hoggan:
The addictive nature of gluten is often overlooked. For some, the first
days and weeks of following a gluten-free diet are characterized by
food cravings, disorientation, irritability, sleepiness, depression,
mental fogginess, fatigue, and/or shortness of breath.
If you are a member of this group, the very fact that you are experiencing many of
these symptoms should reinforce the need to exclude gluten from your
diet. These are common symptoms of withdrawal of detoxification from
gluten-derived opioid and brain neurochemical imbalances. The evidence
suggests that about 70 percent of celiac patients will experience these
symptoms when beginning a strict gluten-free diet.
See other withdrawal comments at Celiac Forums and the Gluten Free Forum.
Another Reference: Opiates Withdrawal We See In The Office
From the Journal of Biological Chemistry – Opiate Peptides From Food Proteins April 10, 1979, 254, 2446-2449
- The take-home appears simple: if these symptoms occur, do go more slowly on the GFCF diet, respect the opiate withdrawal process and support other nutritional and physiologic activities. As a side measure consider the importance of comorbid medical withdrawal issues from either casein or gluten. It may significantly altering neurotransmitter balance causing otherwise unpredictable cognitive and emotional symptoms.
Casein sensitivity, celiac disorder and gluten sensitivity now encourage a different treatment overview.
- I would welcome your experience out there with these matters so please do comment below, and weigh in on this important and overlooked matter.
- Thanks to my anonymous contributor from Ohio.
cp
Related articles
- Heroin, Oxycontin, and a whole wheat bagel (heartscanblog.org)
- Celiac & Autism (aspergerfamily.wordpress.com)
- Celiac Disease and a Gluten-Free Diet (bakeddessertcafe.wordpress.com)
- Gluten Withdrawal (trulyglutenfree.co.uk)
- Symptoms of Celiac Disease (everydayhealth.com)
- Heroine, Oxycontin, and a whole wheat bagel (heartscanblog.blogspot.com)
- Gluten-free, casein-free diet may help some children with autism, research suggests (sciencedaily.com)
- #Gluten Sensitivity Gaining Acceptance (trulyglutenfree.co.uk)
- Why are so many foods gluten-free now? (boston.com)
- What I need to know about Celiac Disease (celestehealthyliving.wordpress.com)
- Signs of Celiac Disease (foxnews.com)
- Celiac Disease and IBS: Differences and Similarities (everydayhealth.com)
Dear folks,
I am a celiac, having been diagnosed nearly 8 years ago. As there is a genetic component to this disease, several family members have since been diagnosed also.
My thought has been all along that there is a grieving process that goes along with starting a GF diet. I have seen this in many client and family members (I fascilitate group support meeting, and meet with newly diagnosed folks to aid in understanding how to live gluten free). This reaction, at time from my own observations, have led me to believe there is the psychological piece of this as well. I have seen for example, with a close family member, that they cannot stick to the diet, wanting, almost as badly as an alcoholic or drug user, glutenous products. This person, and others I have noted, seem unable to comply with the diet, stating they “just had to have” whatever it was that had gluten in it.
Hence, my thought is that going gluten free for some is a huge psychological issue. The folks I have worked with all have the same sense, “I have felt this way for so long, what difference does it make if I cheat”. This attitude and thought process is very similar to addiction.
Thank you for this interesting article and I look forward to finding out more as research become available.
Warmly,
Cecily Baldwin
Cecily,
From my own experience it does appear that psychological issues are often associated – would be interesting to know exactly what what the neurotransmitter changes are downstream from gluten sensitivity that would encourage specific emotional problems.
cp
Cecily-
Thanks for these important observations. Yes, very much like the recovery from addictions and brings the same difficulties into family life when one person must be “sober.”
Do take a look at this last post and review the links to the forums as those two are supportive, easy to *attend* and can address problems with family cooperation.
Almost need a counselor [not trying to make business] – or a third party to set up some mediated rules. As a trained mediator I can tell you that reaching areas of agreement and compromise will bring the gray areas of “what’s for dinner” right up onto the literal and figurative table.
-Might be able to do the mediation in just 1-2 sessions. This is not a question of “conflict” – as much as respect for mutual boundaries, and a delineation of specific metaphoric territories.
Thanks
Chuck
I have done extensive research which indicates that food binging disorder and bulimia are related to the opiate sensors in the brain. This is further enforced by the fact that the introduction of an opiate blocker such as natrexone will halt or considerably stem, the disorders. Since my diagnosis of gluten intolerance, and subsequent research, I have a high degree of suspicion that bulimics and bingers should be screened for celiac disease or gluten intolerance. I personally have not experienced binging or bulimia but have observed the behavior in a relative, who has experienced relief from binging after initiation of naltrexone.
Dru-
Many thanks for your comments, if you have any sites with opiate/gluten sensitivity bulimia hyperlinks will be happy to post them-
Have recently been in contact with my colleague Tom O’Bryan in Chicago, a national expert on these matters, and look forward to interviewing him [podcast] on the opiate aspect of this process.
We talked about him and his DVD on gluten sensitivity back here:
Thanks,
Chuck
You focus a bit more on gluten in your samplings, though you have mentioned casein. I get many inquiries from people who are wondering if they are experiencing milk withdrawal symptoms when they discontinue it from their diet for health reasons. Many seem to have the symptoms you note with the gluten. Have you heard of many patients suffering casein withdrawal symptoms? Have there been any studies in this area?
Interesting reading. I started my 13 yo son with Asperger’s syndrome and anoxic brain damage on a GFCF diet last week just as a trial. I decided to do it with him, mostly as support but out of curiosity as well since I have some autoimmune problems. The first two days were fine. Day three we both became agitated and irritable – felt like way too much caffeine in my system. Day four, today, the irritability is lower but I have some muscle aches and pains which could be from this or something else, but my son feels great except that he’s incredibly hyperactive, completely unlike any past behavior (and if it keeps up this way, we’ll be looking at stimulants! But I’m hoping it’s just withdrawal). He also had normal bowel function without medication for the first time in nine years.
I was expecting some withdrawal issues for him, but it was quite a surprise when it started up for me. It’s been very educational; I’m an adult psychiatrist in private practice and it’s making me rethink some things I thought I knew. Fortunately, in psychiatry we get a lot of practice in learning that everything we thought we knew was wrong.
Alisa,
Sorry I missed your casein posting/question on the comments with this missive, -somehow slipped by with the rush of family matters and big doings for the holiday.
Your question is very interesting, one that I don’t have an immediate link for, but I do recall some of the same symptoms for casein listed with refs on gluten withdrawal.
I will put your question on my to-do list and will post it when I have some good links.
Thanks,
Chuck
Abigail-
So true…the changes in psychiatry and brain science bring a new level of excitement/discovery to basic medical issues as they relate to emotions. So interesting, -and so useful in our clinical practices.
Be careful, you may find yourself like me waiting to ask the #2 question… and then will find yourself puzzled when they are so #2 regular but have some subtle symptom like GERD [esophageal reflux], and all the immune dysfunction anyway.
These are topics I will be covering with some upcoming cool interviews over at CorePsychPodcast so please stay tuned.
My quick, distant and non-specific arm chair thot about your son’s “hyperactivity:”
a. Yes, could be withdrawal, as the opiate receptors reconfigure.
b. Could also occur downstream of the bowel changes that occur with less inflammation…like a blush of better nutrition.
c. Could be diminished sedation from “opiate dependence” – I used to see this often when running an addiction unit – a paradoxical big energy. – Also found with benzo withdrawal and well documented in the book: “I’m Dancing as Fast as I Can.”
Thanks for your comments, really appreciate remarks from the psych-hood. So much of this seems at times so edgy, but, hey, the refs are there!
Any comments from others on this hyperactive phenomenon described by Abigail?
Thanks,
Chuck
Thanks, that would be great information to have. I will do my best to check back, but if you do find something, an email would be more than appreciated!
Here’s a bit more evidence for you. My son has a movement disorder* that has been controlled enough with PT that it takes a professional eye to spot it… at least until now. About 10 days into the GFCF diet, he started twitching all over the place, and still is. Makes sense when you figure that the way we treat movement disorders is with opiates – he’s been self-medicating with food. I can’t come up with any other reason why the change in diet would cause a clinically significant change in motor issues.
Of course, now we’re between a bit of a rock and a hard place, but we’ll come up with something.
Thanks for the welcome!
Abigail
*He’s the miracle boy – walks and talks despite total destruction of his basal ganglia (don’t think about that too hard; it’ll give you a headache, but we have the MRIs to prove it) and the movement disorder is residual.
Hey team,
Just an update on an offline question about brain function, casein and opiate withdrawal at a new post over here:
http://www.corepsychblog.com/2007/09/brain-awareness.html
See you there!
Chuck
What tests do you recommend for Gluten intolerance?
EnteroLab (www.enterolab.com) tests for gluten, casein, soy, and yeast intolerances. They also will type your DNA, checking for gluten intolerance and celiac markers.
They are quite well known in the online celiac community; for more information, just Google!
Belated thanks, JRB, on the Enterolab comment. Enterolab is linked under my Resources on this site [Bottom left of the front page] to make it an easy connection for readers, no affiliate status, just an easy link.
If you go to Enterolab, and are ambivalent, apprehensive about the gluten sensitivity diagnosis because, as many do, you just don’t want to make the necessary changes, do order for the most comprehensive test listed here. It will help you close the door on your maybe-nots.
http://www.enterolab.com/StaticPages/Frame_TestInfo.htm
With that information at 369$ you will have firm information on several layers of the pathology that can help you and family members with your HLA DQ2 – DQ8 genetic findings included.
I will send out a post on this soon with Dr Fine’s “Early Diagnosis” essay linked for everyone’s review.
Thanks for the Enterolab suggestion-
Chuck
HI.
My experience with going gluten-free is the opposite. my previous depression and brain fog cleaned up and many of my compulsive cravings /that were quite disturbing and I needed even therapies for it/ diminished to a considerably more acceptable level.
Of course this might be the exception and others have different ways.
Geo
Geo-
Yours is the most frequent kind of positive response. Many feel better almost immediately. Some with outstanding symptoms for years do take longer to turn around, for a variety of reasons.
I included these withdrawal comments here because some do have very difficult times coming off wheat and/or casein and can benefit from simply knowing what is going on.
Glad to hear yours is an easier outcome-
Thanks
cp
I have to agree with Cecily. I have been trying to find any other answer other than this, but alas, then years ago I did this diet and took injected pro-biotics to help my flora and yes, the symptoms I suffered from went somewhat away and then I was also treated for heavy metal poisoning and from that point my symptoms vanished. Since taking PZ my symptoms have returned and I have been looking for any answer but this one, because where I live the diet is too darn tough to deal with. This place is brotchen heaven for Pete’s sake! I forgot to mention to Dr. Parker that I also have IBS… Dr. Parker has been wonderful in taking the time to respond back to me and look forward to his continued advice. Wish I lived in VA!
Bryan et al,
Thanks so much for all of your positive comments, – after having *never trod* the gluten sensitivity path for many years in my own practice, gluten, casein and celiac are now firmly on my radar… thus the inevitable question:
How many times a day do you go number 2?
Not everyone has overt bowel issues, but many do, so it is important to *put that bowel on the table,* so to speak.
I have been discussing Enterolab in many of these posts, but do have a more comprehensive option for those who may wish to review: Take a look at this page, and do download the Jaffe article there under immune dysfunction. Jaffe is the master on the multiple considerations of immune dysfunction.
http://www.corepsychblog.com/neuroscience/useful-references/
And Bryan, do go over to this page and sort through these books, any here could firm you up in your next steps.
http://astore.amazon.com/cpbks-20/104-4113148-0403906?%5Fencoding=UTF8&node=30
Best to all of you persistent readers,- and, once again, thanks for all of your interest.
And, by the way, sign up email updates on CorePsychBlog postings because I will be offering an interesting new teleseminar on Brain, Bowel and Immune Dysfunction this fall.
cp
I would also like to point out, that although Dr. Parker did not assume to diagnose me from my comments here, he pinpointed on aspects I DID NOT mention and went strickly from what I mentioned here alone. That goes to show one can’t avoid the truth, because the truth is what it is and you know someone knows his biz when he can tell the truth even when an individual is trying to avoid it…
Dr. Parker,
I was wondering if there is a connection between Candida and Gluten sensitivity? The withdrawal process sounds a lot like what a Doctor described to me years ago, that once the Candida start dying off that I would feel drunk and dizzy etc… but I also had to stop eating yeast, sugar and wheat etc… is Candidas and Gluten interlinked and one of the same?
Just wondering… thanks!
Bryan
Bryan -
Many reports show a strong relationship between the two, as the carbs both feed the candida overgrowth, and the gluten in the carbs feeds the celiac.
Take a look at this easy review of comorbid conditions and diagnosis of celiac/gluten sensitivity:
http://www.diagnose-me.com/cond/C341265.html
Tnx
cp
Hi Dr. CP
just want to thank for the feedback back inend of April, begining of May.
I am astonished at the differences among people going glutenfree. I am always trying to tell people how good it can be…after years of suffering now I do not feel bad at last…And some report that yeah, it works for them and some simply cannot make this move…I am baffled by this. For me it seems so perfectly simple…and it is such a relief…and I see these young and old men and women around me, with autistic or schizoid or complusive disorders and (like me six ys ago) they say, no, no it is too tough…But the suffering (for me) was way worse. Now I consider many of my past failures (in family life and in career building) as due to this extra opiates from gluten. I could be angry but instead I am grateful. It is better to find this relief late (I am 49 plus) than never.
geokozmo -
Well done! Thanks for the support and encouragement for those who follow in your own footsteps… the whole thing with gluten and opiates seems so counterintuitive – it takes some real testimony to see how it can help.
Many thanks for your contribution to the remarkable dialog!
cp
I am interested in Hoggans comment re shortness of breath. I was extremely sick with gluten in my diet and it got worse as I got older. The fatigue, gastic disturbances and depression/anxiety were terrible. Off gluten I felt better for about three months until I developed scleroderma and severe shortness of breath which has taken about 4 years to resolve with no treatment but minerals, antibiotics, antifungals and pancreatic enzymes (because I had severe pancreatic insufficiency). My pancreas recovered along with the scleroderma but I have low grade infections constantly. Recently I ate a piece of cake I couldn’t resist (as I had not eaten wheat cake for years) and it knocked me out (fell asleep) for two days and I had steatorrhoea and headache. I am of normal intelligence but barely function mentaly for that period and muscles turn to jelly. I dont have a type 1 allergy and don’t know if I have celiacs-unlikely with dq7 0301 gene. Is it possible I have been dealing with a severe and prolonged withdrawal reaction to wheat? NB I have raised IGM and Low IGA and wonder if this lead to the wheat problem.
Wheat Freak – Renamed herein Wheat Sober,
Very interesting and comprehensive questions… you have certainly been doing your homework.
Main point in quick reply: you need more information. Not likely that it is gluten withdrawal for such an extended period of time – even though you are right on that you are still quite obviously allergic to gluten.
But this is another consideration… none of this immunity business is just that simple – *only* wheat.
My armchair shot at this history is that you have nailed the gluten, but missed something else. In this recent post I told you how I got it wrong in my conjecture about wheat with a 9 yo girl [buried in the Immune Paragraph after the Web announcement at this link] – her major and very significant problem: Corn -
http://www.corepsychblog.com/2008/07/connecting-on-k.html
Yes, gluten problems are very prevalent, but not the *only* immunity. With your abundant respiratory symptoms, I am certain that you have another antigen eating up your defense system… all you have to do is chase it down. Obviously there may be other factors, other causes, but from an immunity perspective, sounds quite compelling for another bug.
Take a look at this page under Immune Dysfunction Testing for more reading – read especially the Jaffe article there:
http://www.corepsychblog.com/neuroscience/useful-references/
We do testing in this office, can consult on this matter if you wish, or your medical team can order testing from them – here:
http://www.elisaact.com/nonhc/letter.asp
The results and follow up findings in our office have proven most interesting and significantly associated with improvement, often marked and quickly, – sometimes taking longer, depending on the extent of the chronic damage and nutritional state.
These are a few leads, – please keep us posted,
cp