Celiac disease – triggered by hypersensitivity to gluten – can do major damage to the small intestine and cause many digestive woes.

But it’s also known to cause a whole slew of neurological issues, including migraine. In fact, people with celiac disease are about twice as likely to have migraine attacks.

“There are a number of neurological illnesses that present in patients with celiac disease, with migraine likely the most common. On the other hand, migraine attacks are also commonly seen with other GI illnesses, including irritable bowel syndrome and inflammatory bowel disease. We see this crossover frequently,” says Jeffrey Gelwan, MD, a gastroenterologist with Hartford HealthCare’s Digestive Health Institute and medical director of Connecticut GI’s Celiac Center.

But what’s the connection? Dr. Gelwan explains.

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The migraine-gluten connection

Sometimes migraine is an early symptom of celiac disease, but more often, it develops over time, says Dr. Gelwan.

Gluten does seem to be the root cause. Celiac patients tend to report migraine attacks after accidentally ingesting gluten. And for those more recently diagnosed, eliminating gluten often results in fewer or less severe migraine attacks.

Doctors aren’t sure why gluten triggers migraine, but according to one theory, inflammation may be the issue. Celiac disease leads to the production of a particular peptide, which is a potential cause of migraine. And more research is exploring how changes in the digestive system’s microbiome – all the microorganisms and viruses that live in your gut – can cause more inflammation in the body.

> Related: Your Migraine Could Be a Sign of One of These 7 Serious Health Conditions

Should I eliminate gluten if I suffer from migraine?

Patients with migraine sometimes try eliminating gluten from their diet, says Olivia Begasse de Dhaem, MD, a neurologist who works as a headache specialist for Hartford HealthCare’s Ayer Neuroscience Institute.

But taking that step without seeing a doctor can hurt more than help.

“Migraine is a neurological disease that is already so limiting due to all its symptoms, I don’t recommend eliminating gluten-containing foods without a celiac or non-celiac gluten sensitivity diagnosis,” she says. “All that does is add stress that you don’t need.”

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What other symptoms, along with migraine, indicate celiac disease?

Begasse de Dhaem says she will refer a patient for celiac testing if they also have other symptoms such as:

  • Bloating
  • Stomach pain
  • Diarrhea
  • Gait imbalance
  • Nerve dysfunction

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When to see a doctor

If you’re concerned that your migraine could be caused by celiac disease, speak with your primary care doctor. Gelwan says doctors in the Celiac Center work closely with primary care doctors and neurologists to keep celiac front of mind when treating migraine.