Study Links Toddler Behavior Problems to Celiac Disease

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In the United States, over 2.4 million people have celiac disease, which amounts to about one in every 33 individuals. However, the majority of the people with celiac disease actually do not even know they have it.

Celiac disease is one of the most under-diagnosed conditions in the United States, meaning that doctors do not always diagnose it properly or that individuals do not seek help in the first place for their symptoms. Information from a study published by the American Academy of Pediatrics showed that toddlers and young children are one of the largest groups of individuals at risk for underdiagnosis of celiac disease.

What Is Celiac Disease?

Celiac disease is an autoimmune disorder in which the body cannot digest gluten, a protein found in wheat. Instead of nourishing the body, gluten can actually cause damage to the lining of the small intestine.

The Link Between Behavior and Celiac Disease in Toddlers

The study, published in Pediatrics, compared behavioral issues (at different ages) reported by mothers who knew their children had celiac disease to similar issues reported by mothers who were not aware that their children had celiac and mothers of children who did not have celiac disease at all.

The study began by testing blood samples collected from 8,676 two-year-old children for the presence of tissue transglutaminase autoantibodies (tTGA). Testing for tTGA antibodies is the most common approach for screening children with suspicious symptoms for celiac disease. Though not a perfect test, tTGA will identify 94% to 100% of patients eventually diagnosed with celiac disease. The researchers then collected mothers' reports of their child's behavior at 3.5 years old and again at 4.5 years old.

At the conclusion of the study, the researchers discovered that when the children were 3.5 years old, mothers who did not know that their children had celiac disease reported far more negative behavior.

Mothers of 66 children who had celiac disease (but didn't know it yet) reported more childhood anxiety and depression, withdrawn behavior, aggressive behavior, and sleep problems.

What Does It Mean?

The data from this study suggest that there may be a link between celiac disease and behavior in children, especially at a young age. Behavioral issues were noted to be more prevalent in children whose parents were unaware that there could be a health issue causing their child's behavior. Although researchers aren't entirely clear on the exact ways that gluten can affect the brain, there are theories that the gluten particles that the body cannot digest cause inflammation in the brain, which can lead to the negative behaviors.

The study also found that at older ages there was no difference in reported symptoms for behavior.

Researchers have theorized that behavioral symptoms may be especially pronounced in younger children who are unable to process or talk about their feelings as much.

For example, a toddler may act out more because her tummy hurts, while an older child may lay down or do a quiet activity instead.

Should You Have Your Child Tested for Celiac Disease?

So if your toddler or preschooler is acting out and having negative behavior, does that mean he has celiac disease? Obviously, toddlers are not the most rational or well-behaved group of humans around, so does this study mean that all toddlers who misbehave should get tested for celiac? Probably not.

But if your child has a family history of celiac disease, it would be a good idea to have them tested since they are more likely to have the disease if a first-degree relative (meaning a parent or sibling) has it. It's also helpful to speak to your doctor in any situation where your child is having behavioral problems.

Diet can be a factor, and there can be many brain-gut links that can contribute to negative behavior in a child. Simply paying attention to what your child eats and how they act following certain foods can be helpful. And if you notice that your child appears to have an increase in symptoms after consuming gluten, be sure to talk to your doctor about appropriate celiac testing.

4 Sources
Verywell Family 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. Smith LB, Lynch KF, Kurppa K, et al. Psychological manifestations of celiac disease autoimmunity in young children. Pediatrics. 2017;139(3). doi:10.1542/peds.2016-2848

  3. Rashid M, Lee J. Serologic testing in celiac disease: Practical guide for clinicians. Can Fam Physician. 2016;62(1):38-43.

  4. Fasano A. Celiac disease, gut-brain axis, and behavior: Cause, consequence, or merely epiphenomenon?. Pediatrics. 2017;139(3). doi:10.1542/peds.2016-4323

By Chaunie Brusie, RN
Chaunie Brusie is a registered nurse with experience in long-term, critical care, and obstetrical and pediatric nursing.