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Gluten and Vitiligo: Is There a Connection?

Posted on December 20, 2021
Medically reviewed by
Kevin Berman, M.D., Ph.D.
Article written by
Kristopher Bunting, M.D.

If you’re living with vitiligo, you may be wondering whether anything you’ve consumed could contribute to your symptoms. In particular, some individuals with the condition say they notice their vitiligo improves if they avoid eating food containing gluten. “I try to eat mostly gluten-free and I feel it does help me,” wrote one MyVitiligoTeam member. Another said, “Sometimes, vitiligo may be associated with autoimmune conditions like celiac disease, in which case a gluten-free diet may be beneficial.”

Worldwide, vitiligo affects 0.5 percent to 1 percent of people. About 15 percent to 25 percent of those with vitiligo have at least one other autoimmune disease. If you’re wondering whether cutting gluten out of your diet might benefit your vitiligo symptoms, it’s important to understand a few key considerations.

What Is Gluten?

Glutens are proteins found in wheat and other grains, including barley and rye. People who have celiac disease, an autoimmune condition that causes gluten intolerance, cannot eat foods with gluten (such as bread and pasta made with wheat) because it can trigger damage to the small intestine. This leads to diarrhea, bloating, abdominal pain, and long-term consequences, including the inability to absorb certain nutrients from food (malabsorption).

Celiac disease is linked to other autoimmune diseases, including dermatitis herpetiformis, a rare skin condition causing very itchy and scaly skin. Celiac disease and other types of gluten sensitivity are treated by eliminating gluten-containing foods from the diet. Eating a gluten-free diet is essential for treating celiac disease, and research has shown some positive effects in people without celiac disease.

Consuming gluten has also been associated with leaky gut syndrome, increased permeability of the intestinal lining that can expose the body to a variety of things that the intestines are supposed to keep out of the bloodstream, such as bacteria. Leaky gut syndrome is controversial and is not fully accepted by the medical community as a cause of disease.

Aside from leaky gut syndrome, changes to the gut microbiome (the collection of normal bacteria in the intestines) are known to have effects on mental health, skin conditions, and other chronic diseases. An imbalance of healthy bacteria in the gut is linked to inflammation that can lead to major depressive disorder, psoriasis, and alopecia areata.

What Is an Autoimmune Disease?

The immune system normally helps rid the body of bacteria, viruses, damaged cells, and cancer, but in autoimmune diseases, the immune system creates antibodies that attack healthy parts of the body. The immune system mistakenly sees the healthy tissue as being foreign and harmful and attacks these cells. Autoimmune diseases can affect any part of the body, including the skin, bowels, thyroid, pancreas, and more. Autoimmune and autoinflammatory diseases cause inflammation in otherwise healthy tissue, leading to a variety of symptoms and diseases.

The cause of autoimmune diseases is not clearly understood, but potential causes include inherited genes and acquired exposures. A large number of specific inherited variations of genes are associated with multiple autoimmune diseases, including both vitiligo and celiac disease. Two of the most important gene variations seen in vitiligo are in the NLRP1 and PTPN22 genes, which encode immune regulator proteins (they keep the immune system in check). Specific variations in the NLRP1 gene are linked to vitiligo, Addison’s disease, and type 1 diabetes. Specific variations in the PTPN22 gene are linked to vitiligo, autoimmune thyroid diseases (Hashimoto’s disease and Graves’ disease), Addison’s disease, type 1 diabetes, rheumatoid arthritis, lupus (systemic lupus erythematosus), and other conditions.

Some of the most common comorbidities (conditions that occur in tandem) with vitiligo are autoimmune thyroid diseases and autoimmune Addison’s disease, a disease of the adrenal glands. Vitiligo may also be associated with diabetes, pernicious anemia, and alopecia areata.

There may or may not be a direct link between gluten and vitiligo, as there is currently very limited research into this link. Celiac disease is linked with other autoimmune disorders, including Hashimoto’s disease, Graves’ disease, Addison’s disease, and Sjögren's syndrome — some of the same autoimmune diseases that may be linked to vitiligo.

Watch as vitiligo expert Dr. Richard Huggins discusses whether food choices can affect your vitiligo symptoms.

However, research has found very few people diagnosed with both vitiligo and celiac disease, although many of the gene mutations seen in vitiligo are also seen in celiac disease. There is no clear, direct link between the two diseases, but they appear to be related to some of the same underlying causes of autoimmune disease.

Can a Gluten-Free Diet Help Manage Vitiligo?

Research into the effects of a gluten-free diet on vitiligo has been inconclusive and incomplete. One case study was published, which showed that a gluten-free diet helped a woman partially reverse her vitiligo and achieve repigmentation of vitiligo lesions when other treatments did not work. However, this single case is the only published scientific evidence supporting that claim. More research into the effects of a gluten-free diet on vitiligo is needed. Currently, there is no specific recommended diet for those with vitiligo.

Eating a gluten-free diet has been shown to improve symptoms in certain autoimmune conditions, such as gluten-sensitive irritable bowel syndrome, endometriosis, fibromyalgia, and psoriasis. A specific gluten-free diet, the Autoimmune Protocol Diet, has been shown to improve the quality of life in people with inflammatory bowel disease and Hashimoto’s disease.

Gluten is not the only food ingredient linked to changes in the gut microbiome and chronic medical conditions. Some people with autoimmune diseases can benefit from following an elimination diet. An elimination diet excludes several foods or groups of foods that are known to cause negative reactions in some people (such as gluten, eggs, and dairy). After eliminating these foods, they are slowly reintroduced to see if symptoms return or worsen.

Before trying a gluten-free diet, remember that it can have negative effects. In some people, eating a gluten-free diet can lead to not getting enough fiber and certain nutrients, as well as an increased risk of high blood sugar and cholesterol. Simply eliminating gluten without following a well-balanced diet is not healthy.

Consult your health care provider or a dietitian to make sure that you get proper nutrition when making major dietary changes. Make sure that any change in diet will not have a negative effect on other medical conditions or interfere with any medications you take. There is no one-size-fits-all diet that is guaranteed to address your medical condition and meet your nutritional needs.

Although there is no proven connection between gluten and vitiligo, eliminating certain ingredients from your diet and evaluating whether your symptoms improve can be helpful. Write down what foods you’ve eliminated and what results you noticed if you do try an elimination diet.

Talk With Others Who Understand

MyVitiligoTeam is the social network for people with vitiligo. On MyVitiligoTeam, more than 9,000 members come together to ask questions, give advice, and share their stories with others who understand life with vitiligo.

Have you tried eliminating gluten from your diet? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References
  1. Vitiligo — Medline Plus
  2. Definition & Facts for Celiac Disease — National Institute of Diabetes and Digestive and Kidney Diseases
  3. Dermatitis Herpetiformis — Celiac Disease Foundation
  4. Health Benefits and Adverse Effects of a Gluten-Free Diet in Non-Celiac Disease Patients — Gastroenterology & Hepatology
  5. The Leaky Gut: Mechanisms, Measurement and Clinical Implications in Humans — Gut
  6. Gut-Brain-Skin Axis in Psoriasis: A Review — Dermatology and Therapy
  7. Dysregulation of the Gut-Brain-Skin Axis and Key Overlapping Inflammatory and Immune Mechanisms of Psoriasis and Depression — Biomedicine & Pharmacotherapy
  8. The Gut Microbiome as a Major Regulator of the Gut-Skin Axis — Frontiers in Microbiology
  9. Autoimmune Diseases — National Institute of Arthritis and Musculoskeletal and Skin Diseases
  10. Autoimmune Disease List — Autoimmune Association
  11. NLRP1 Gene — MedlinePlus
  12. PTPN22 Gene — MedlinePlus
  13. Hashimoto's Disease — Mayo Clinic
  14. Graves’ Disease — Mayo Clinic
  15. Addison's Disease — Cleveland Clinic
  16. Autoimmune Disorders — Celiac Disease Foundation
  17. Vitiligo and Autoantibodies of Celiac Disease — International Journal of Preventive Medicine
  18. Can a Gluten-Free Diet Help With Vitiligo? — Vitiligo Research Foundation
  19. Rapid Partial Repigmentation of Vitiligo in a Young Female Adult With a Gluten-Free Diet — Case Reports in Dermatology
  20. An Autoimmune Protocol Diet Improves Patient-Reported Quality of Life in Inflammatory Bowel Disease — Crohn’s & Colitis 360
  21. Efficacy of the Autoimmune Protocol Diet as Part of a Multi-Disciplinary, Supported Lifestyle Intervention for Hashimoto’s Thyroiditis — Cureus
Kevin Berman, M.D., Ph.D. is a dermatologist at the Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Learn more about him here.
Kristopher Bunting, M.D. studied chemistry and life sciences at the U.S. Military Academy, West Point, and received his doctor of medicine degree from Tulane University. Learn more about him here.

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