The Gluten-Free Diet for Kids with ADHD: Does It Actually Help?

Attention deficit hyperactivity disorder (ADHD) frequently co-occurs with other physical and mental health diagnoses. While it's a prevalent condition, there are some facts about ADHD that aren't widely known. There are also various myths about ADHD and how to treat it. You may have heard that a gluten-free diet can help with ADHD, but is it true? Furthermore, is there a link between ADHD and Celiac disease?

In this article, we'll go over what Celiac disease is, whether Celiac disease and ADHD are connected, and the differences between Celiac disease and gluten sensitivity. Then, we'll get into the facts on whether or not kids with ADHD should follow a gluten-free diet to help with their symptoms.

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What's Celiac Disease?

Celiac disease is an autoimmune disease that affects about 1 in 100 people. However, it's estimated that only around 30% of those who live with Celiac disease are diagnosed. When you have Celiac disease, consuming gluten damages the small intestine. If individuals with Celiac disease eat gluten, their body reacts by sending an immune response that attacks the small intestine. Celiac disease is serious, and it is not the same as non-Celiac gluten sensitivity.

If Celiac disease is left untreated, an individual may experience serious long-term health problems and symptoms. Acute symptoms include bloating, gas, diarrhea, fatty stools, and fatigue. If left untreated, a person with Celiac disease might develop more serious, long term consequences, including delayed growth, heart disease, infertility, malnutrition, another autoimmune disorder (e.g., type one diabetes or multiple sclerosis), or a range of neurological symptoms.

Are Celiac Disease and ADHD Connected?

There are some connections between Celiac disease and attention deficit hyperactivity disorder. First, various studies show that people with Celiac disease are more likely to have a diagnosis of ADHD. The same is true for numerous psychiatric disorders and Autism Spectrum Disorder (ASD), both of which are seen more frequently in those with a Celiac diagnosis. Some research also suggests that untreated Celiac disease can predispose individuals to ADHD. 

Does Gluten Cause ADHD Symptoms?

For most individuals without Celiac disease, gluten does not cause ADHD symptoms. However, if you have Celiac disease and ADHD, following a gluten-free diet can improve ADHD symptoms.

One small study of 67 patients with ADHD found that those who were positive for Celiac disease experienced a significant improvement in behavioral symptoms and functioning after introducing a gluten-free diet. 

There are times when undiagnosed Celiac disease might resemble ADHD and other disorders. This is due to the neurological symptoms that may occur when an individual with Celiac disease eats gluten, such as brain fog or difficulty focusing. 

When a professional diagnoses ADHD, they must rule out any other possible causes first. Other medical concerns can resemble ADHD in some cases, including both physical and mental health conditions.

If someone experiences adverse symptoms when they eat gluten but test negative for Celiac disease, the cause could be gluten sensitivity.

Gluten Sensitivity Vs. Celiac Disease 

Non-Celiac gluten sensitivity is also referred to as gluten intolerance, and it is not the same as Celiac disease. What's the difference between the two?

Celiac disease:

• Is an autoimmune disease.
• Can be diagnosed via biopsy or blood test.
• Requires a gluten-free diet for life.

Non-Celiac gluten sensitivity:

• Is not an autoimmune disease.
• Does not have a known cause.

Gluten sensitivity or intolerance symptoms are less severe than those associated with Celiac disease. Some individuals with gluten sensitivity may benefit from limiting gluten (though this can vary), whereas people with Celiac disease cannot have gluten at all. Unlike food allergies and Celiac disease, there is no test known to detect food sensitivities like non-Celiac gluten sensitivity.

If you are concerned that your child may have undiagnosed Celiac disease, it is important to get them tested.

What Should I Know Before My Child Gets Tested For Celiac Disease?

The test for Celiac disease is relatively simple. Although Celiac disease can be detected via biopsy, most people get their Celiac diagnosis with a blood test.

The most important thing parents should know before their child gets tested for Celiac disease is that gluten ingestion is crucial for the blood test to work. Although it may seem strange, removing gluten before the test may result in a false negative. This is because antibodies must have built up in the bloodstream in order for someone with Celiac disease to test positive.

Please consult with your child's medical provider for information on how long your child should eat gluten before their test and how much they need to consume (e.g., the equivalent of two slices of wheat bread daily for 6-8 weeks). 

There is a chance that someone with Celiac disease will get a false negative when tested for the condition. In this case, the medical provider - typically a gastroenterologist - might administer another test.

What Is Gluten?

Gluten is a natural protein found in most grains, but not all. Often, gluten-free products contain rice, quinoa, or other grains without gluten.

Gluten-containing foods include but aren't limited to: 

• Wheat products, including bread, pasta, and some breakfast cereals.
• Rye.
• Barley.

Many processed foods and prepared foods contain gluten. If your child is following a gluten-free diet, make sure that you check the label before you give them packaged or prepared foods.

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Should My Child with ADHD Stop Eating Gluten?

For kids, teens, and adults with Celiac disease, it is crucial to follow a gluten-free diet. However, most kids with ADHD who don't have Celiac disease will not need to go gluten-free. Unless eliminating gluten helps your child, there's no reason to follow a gluten-free diet. That said, if your child appears to benefit from eliminating gluten for any reason and it doesn't impede your child's ability to meet their nutritional needs, eating a gluten-free diet could be worthwhile.

While dietary changes can help for some, ADHD symptoms aren't managed by diet alone in children and adults who live with attention deficit hyperactivity disorder. There are various treatment options for people with ADHD that can help address symptoms and manage the condition.

Treating Attention Deficit Hyperactivity Disorder

Most of the time, ADHD symptoms are managed with medication and behavioral therapy. However, other interventions can be useful, too. Treatment options for ADHD include but aren't limited to:

Medication

There's a range of medication treatment options used for ADHD. Most often, stimulant medications are recommended first. 70-80% of children with ADHD have success with central nervous system stimulants. That said, non-stimulant medications like Strattera can be used to treat ADHD, too.

Parent training

Parent training is recommended as an initial intervention in young children. In kids younger than 6, it is recommended on a standalone basis as the first line of treatment. For kids aged 6+, parent training is recommended alongside medication. Parent training, also called parent training in behavior management, can be used for kids with ADHD 12 or under. In parent training for ADHD, parents work with a therapist to learn techniques that they can use to help their children at home.

Behavioral therapy

Individual behavioral therapy can help ADHD people of all ages toaddress symptoms and cope with co-occurring concerns (such as psychiatric conditions) if applicable. Similarly, group therapy and family therapy can be beneficial for children with ADHD.

Games

Apps and gaming devices are emerging as new treatment and support options for people with ADHD. In fact, the Food and Drug Administration approved the use of the first video-game-based therapeutic for kids with ADHD in 2020. ADHD apps and games like Joon can help kids with ADHD with executive function, task initiation and completion, and self-esteem. 

Alongside other forms of care, kids with ADHD may benefit from school accommodations, occupational therapy, and relevant lifestyle or dietary changes. Every child with ADHD is different. Although this isn't always the case, it is normal for many children and their parents to go through a period of trial and error when it comes to treating ADHD. Treating ADHD and other medical conditions your child lives with can lead to significant improvements in everyday life and well-being. 

Takeaway

Despite widespread speculation, no foods are known to cause ADHD. A gluten-free diet will not be enough to curb a child's ADHD symptoms if they have an accurate ADHD diagnosis. However, if your child has Celiac disease, eliminating gluten is vital for well-being and can reduce the severity of ADHD symptoms. Additionally, there are conditions other than ADHD that can cause some of the same symptoms. People with Celiac disease are more likely to live with a range of mental and behavioral disorders, as well as neurodevelopmental conditions like ADHD and Autism Spectrum Disorder.

Talk with your child's doctor if you believe that they may have Celiac disease or are considering a change to your child's diet.