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Hi, my name is Tayler Silfverduk and I’m a registered dietitian living with both ADHD and Celiac Disease. And as a dietitian who specializes in and lives with celiac, I have personally felt like certain things are harder than everyone else makes it out to be…
And coming from someone who was diagnosed with celiac and told to “just go gluten-free”, I can attest that are very few resources out there to support people with celiac, let alone, people with celiac and ADHD.
This is one of many reasons why I am writing this blog post. So here’s what you can expect to read in this post: a discussion on what both celiac and ADHD are, the relationship between celiac and ADHD, the struggles people with celiac and ADHD face, plus some tips to help.
I hope this post informs providers of the struggles of this population, provides support and reassurance to those living with both conditions, and gives actionable steps that might be helpful in management.
Before we get into the link between ADHD and celiac, we need to understand what celiac is.
Celiac is a serious autoimmune disease that occurs in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine. When people with celiac disease eat gluten (a protein found in wheat, rye, barley, and contaminated foods like oats), their body mounts an immune response that attacks the small intestine.
These attacks lead to damage to the villi, small fingerlike projections that line the small intestine, that promote nutrient absorption. When the villi get damaged, nutrients cannot be absorbed properly into the body.
This inflammatory response to gluten and related nutrient deficiencies can cause a wide variety of symptoms in people with celiac. From bloating, headaches, constipation, joint pain, bone health complications, infertility, weight gain, weight loss, and more.
This can start at any age, and occur in any body, as long as someone is eating gluten and has the celiac genes. If left untreated, celiac disease can lead to additional serious health problems.
Another topic that often comes up in the conversation of ADHD and celiac is gluten intolerance. Gluten intolerance and celiac disease are not the same things.
The key differences between the two? Celiac disease always involves an autoimmune reaction. It always involves damage to the small intestine. Lastly, celiac disease is always lifelong. There is no cure for celiac and there is no growing out of it.
Whereas you can grow out of gluten intolerance. Meaning, gluten could be reintroduced later on in life if a root cause for gluten intolerance is identified and addressed. Additionally, damage in the small intestine is only reported in a very small group of people with wheat intolerance, not gluten intolerance.
Finally, before our deep dive into the link between ADHD and celiac, we need to understand what ADHD is too. ADHD is short for attention deficit hyperactivity disorder.
Often, ADHD is characterized by symptoms of inattention, hyperactivity, and impulsivity. Patients often experience different levels of each symptom, so it can present differently depending on the person.
The three types of ADHD can help with understanding which symptoms may dominate someone’s experience. These types are predominantly inattentive, predominantly hyperactive/impulsive, and combined type. I was diagnosed with the combined type.
Another key factor of ADHD is executive dysfunction. This is the struggle of planning, problem-solving, organizing, and managing time. This can make it difficult to manage impulsivity, remember things to help guide behavior, reframe thoughts, be motivated without consequences, and find solutions.
There’s a lot more to ADHD as a neurodevelopmental disorder. I encourage you to discuss any questions you have about it with your mental health team and do your research fi you want to know more details. Reference: Psychiatry.org.
Now that we know what ADHD and celiac are, we can talk about the relationship between them. Unfortunately, studies are mixed on if there is a link between these two conditions.
For example, a relationship was found between the two in a preliminary study on ADHD and celiac disease. In this study done in 2006, they assessed ADHD symptoms in celiac disease patients before and after going gluten-free. As a result of going gluten-free, the patient’s ADHD symptoms improved.
Another small study of 67 adults and children with ADHD done in 2011 found that 10 of the 67 people with ADHD ended up having celiac disease. Which suggested a pretty significant relationship between the two.
And then a 2020 systematic review of 8 research studies on the link between celiac and ADHD found only 3 of the studies found a positive correlation – determining that evidence was inconclusive to determine if there was an actual link.
Regardless, I think gluten exposure symptoms including brain fog could look a lot like ADHD symptoms. Additionally, celiac burnout, which is the exhaustion from managing celiac, could also result in symptoms that look like ADHD. Both of which might make it difficult to clarify the connection. And personally, when I get glutened, my ADHD symptoms are drastically elevated.
The link between ADHD and celiac is inconclusive but could it be related to iron deficiency?
You see, low iron is common in people with celiac. This can be related to the damage in the gut making it hard to absorb enough iron. And it can be related to people not getting enough iron sources on a gluten-free diet.
And low iron symptoms can sometimes look like ADHD. With the symptoms of low iron including fatigue, inattention, lack of focus, brain fog, and more. It’s also important for the creation of neurotransmitters that are important for managing ADHD.
This is just pure speculation but if celiac disease can cause low iron levels, and low iron symptoms can look like ADHD or worsen ADHD symptoms, I wonder if that’s why we might see more ADHD or ADHD-like symptoms in this population. Again, this is just pure speculation.
With the link between ADHD and celiac being inconclusive in the research, I can confidently say celiac disease does not cause ADHD. However, it can cause ADHD-like symptoms if untreated, and it could worsen ADHD in people diagnosed with it if celiac goes unmanaged.
Ultimately, the actual causes of ADHD are unknown (just like celiac). However, according to the CDC, risk factors include genetics (if other family members have ADHD) brain injury, exposure to environmental risks during pregnancy or at a young age, mom using alcohol or tobacco while pregnant, premature delivery, and low birth weight.
So we know celiac disease does not cause ADHD, but can gluten cause ADHD symptoms? This is a tricky conversation, as I’m aware several different diet modifications are touted to be a treatment for ADHD.
If you have celiac, gluten might worsen ADHD symptoms. The same goes for if you have gluten intolerance. This is proven by research. Remember that study done in 2006 where they assessed ADHD symptoms in celiac disease patients before and after going gluten-free? As a result of going gluten-free, the patient’s ADHD symptoms did improve.
Additionally, a new study from 2023 found that ADHD-like symptoms such as inattention, were associated with celiac children who weren’t staying gluten-free. In this case, the children don’t have ADHD but appear to have it due to unmanaged/untreated celiac. Anecdotally, my ADHD symptoms are absolutely worsened when I’ve been exposed to gluten.
However, in the general population, gluten has not been proven as a cause for symptoms in people with ADHD. It’s only been linked to ADHD related symptoms in those who have a medical reason to avoid gluten.
So celiac disease doesn’t cause ADHD and gluten has not been proven to cause symptoms in children with ADHD, so does being gluten-free help with ADHD?
The answer is, if you have a gluten-related disorder like celiac disease or gluten intolerance, then living gluten-free may help with ADHD. However, there’s no research to prove that if you have ADHD without a gluten-related disorder, that you have to go gluten-free to manage it.
In fact, as we’ll discuss in the upcoming section… living gluten-free with ADHD might have a significant negative quality of life impact. So if you don’t have to do it, I wouldn’t.
Now that we understand the link between ADHD and celiac disease, let’s talk about how ADHD can complicate celiac management. I surveyed over 58 individuals who self-identified as having celiac and ADHD on my Instagram and Newsletter list.
Below, I’ll be sharing their responses as well as my own experiences to highlight the added struggles people with celiac and ADHD face. After, I will then share some of my best tips for managing some of these struggles.
Kicking the morning…err list of struggles people with ADHD and celiac face has to do with Breakfast.
In the survey results I received from individuals self-identifying to have celiac and ADHD, many discussed the struggle of remembering to have breakfast or finding quick gluten-free foods to have for breakfast.
With one person saying “I rarely eat breakfast” and another person saying “[I struggle with] forgetting to eat before I leave the house”.
Forgetting to eat breakfast can impact our energy levels and make it even harder to focus during our day and lead us to feel out of control with food at night. This is another struggle people with both conditions report which we’ll discuss later.
On top of forgetting breakfast, some ADHD and celiac survey respondents expressed difficulty with skipping meals altogether.
This is understandable as both executive function (which helps with meal-planning and prepping) and interoception (which helps us read body cues) can be disrupted with ADHD. Making it hard to know when we’re hungry or full, and put meals together when realize we need food.
From people struggling to remember to eat to preparing ahead of time to make eating easy many people say this leads to overeating or binging at night, directly feeding into what many dietitians know as the binge-restrict cycle. One survey participant describes it as, “[I struggle with] remembering to eat, then binge in the evenings once I remember that food exists”.
This struggle can be worsened by common ADHD medications that suppress hunger and fullness cues.
This can also lead people to accidentally or impulsively eat gluten. One survey respondent said “[I struggle with] forgetting to prepare ahead of time with snacks or meals and then getting hangry and eating what’s available (even if there’s CC) and getting glutened.” This makes this aspect of ADHD extremely dangerous for people with celiac.
Speaking from experience, in my moments of severe hunger, I’ve made some questionable decisions that made me sick. One time, I intentionally ate Chipotle which was made without cross-contact precautions, and another time I accidentally ate a beef jerky stick that had gluten in it. I say this not to say this is okay, but that it can happen to the best of us.
Somewhat connected to skipping meals with celiac and ADHD, many survey respondents said they struggle with knowing when they’re hungry until it’s “too late”.
As I discussed earlier, the interoception of people with ADHD can be disrupted, which paired with disrupted hunger and fullness cues with celiac can make it hard to know when to eat. One person said “My ADHD brain doesn’t leave me enough time to make food until I’m so hungry that I have to find something to eat in that very minute.”
This can make it challenging to have the bandwidth to find something gluten-free AND safe to eat.
From traveling, dining out, to spending a few hours running errands, many people with celiac and ADHD expressed difficulty with planning for these trips.
One survey respondent said “It’s…tough sometimes to do all the necessary planning to do restaurant stuff or travel” and another said “remembering to have enough food with me when I’m out and don’t have easy access to gf options”.
I can say so many things about this, from masking to keeping track of everything you’re doing outside of the house, to managing a new environment if traveling or dining out… these things can be challenging with ADHD alone. Adding on the mental toll of celiac safety understandably makes this so much tougher.
Another dangerous challenge of managing ADHD and celiac together is the lack of energy to read food labels. Food label-reading fatigue is real for people living with celiac, and it weighs even heavier when you add ADHD to it.
One respondent reported “intense mental fog from ADHD [making it so] that I don’t have the energy to look at ingredients and restaurant reviews all the time” with other respondents saying they struggle with “[r]emembering to check every label everytime.”
Admittedly, I’ve done this more times than I’d like to admit. While I’ve gotten better at it, there are certain foods I have to be more mindful of because I’m more prone to skipping them.
Perhaps one of the biggest reported struggles of managing ADHD and celiac disease was related to cooking. One person said, “[I struggle with] finding recipes I like, getting the ingredients, then actually cooking, [and finally doing] the dishes after…. A Nightmare”. Ooof, I can deeply relate to that.
Another respondent explains this struggle is related to executive dysfunction, reporting “Meal planning-too much executive function. Reading labels and recipes to make sure there is no hidden gluten-too much executive function. Actually, cooking a well-balanced nutritious meal after all of those steps? Never heard of her. It all feels so daunting just in the planning stages, let alone trying to actually get to the cooking.”
I’ll share some tips I use myself to get cooking later, and for now, I’m holding so much space for anyone who can relate.
A common symptom of ADHD is known as Rejection Sensitive Dysphoria (RSD for short). This is when there is an extreme emotional sensitivity to being criticized or rejected.
In the case of celiac, you are living lifestyle that is far outside of cultural norms which might make you fearful of perceived or real rejection, loss of approval, etc.
In addition to this, you often are placed in awkward situations where you need to speak up for your needs in a social climate that views a gluten-free diet as anything but a medical necessity. This can make speaking up about celiac with ADHD very difficult.
Building on the struggle with cooking with ADHD and celiac, people also expressed difficult in meal-planning and prepping. With ADHD sometimes a little structure can be helpful and other times, it can make things far too overwhelming.
As one survey participant puts it “Meal planning/prepping feels overwhelming when it’s tough to identify what I can eat. It gets frustrating and makes me not want to try at all and instead eat go-to fast food that I know I can eat”.
Another person describes struggling with “Forgetting to take something out of the freezer for dinner or lacking the focus to prep and follow thru with a meal plan”. I know I personally struggle with both.
Food aversions can complicate managing celiac with ADHD too. Often people with ADHD struggle with flavor and texture aversions, with one survey participant saying “I have many food aversions due to sensory stuff”.
Having worked with many clients, I’ve seen this in quite a few ADHDers who also have celiac. From unexpected textures of gluten-free alternatives to the aversion to texture changes of many cooking shortcuts (like microwaving potatoes), it can make eating even harder.
Add on the fact that often ADHDers are paying a lot to try these gluten-free alternatives, it can be really disheartening. I’ve got some tips on this down below if you need help with it.
There are many things to grieve with celiac disease. And many celiac and ADHD survey respondents expressed that the number 1 struggle they faced with both is “the lack of spontaneity, I used to eat whatever I wanted whenever I wanted and I hate having to plan”.
Another person describes this struggle as “The part of me that wants to go with the flow and be spontaneous about what I’m eating, particularly outside of my home, is completely shut down at all times because there has to be planning involved with celiac disease”.
With ADHD, often you are reacting to immediate cues and urges due to increased impulsivity and impaired interoception. This makes a naturally spontaneous response to life seen in ADHD difficult because, with celiac, planning is often essential to safety.
I really deeply struggle with this because my desires and focus for the day can change on a whim. I’ll share some of my best tips for this in the management section below.
Another challenge to managing ADHD and celiac disease at the same time is the fact that many people with ADHD struggle with rumination. This is when we think too much about something.
With celiac, this can look like overthinking how you’re going to stay safe at the next party you’re invited to, or guilting yourself for turning down an event invite because you need a minute to rest. In turn, because the rumination takes up space in your mind, even though you’re trying to take a break or are safe, you can stay in a state of stress.
With time growing comfort and routine around celiac safety, rumination related to celiac often decreases. However, it’s something to note when considering additional challenges people managing celiac with ADHD face. Challenges that can contribute to burnout…
Lastly, the biggest struggle I see with celiac disease and ADHD is the combination of ADHD burnout and celiac burnout. Both of which can make it difficult to manage everyday life with both conditions.
Celiac burnout is feeling exhausted, alienated, and struggling to engage in everyday activities due to the mental toll of managing celiac disease.
Psychcentral.com describes ADHD burnout as “a feeling of exhaustion largely brought on by stress, made more complicated by ADHD symptoms”.
In the autoimmune world, this is often described as running out of spoons. The idea is you’re given a certain amount of spoons to do different things throughout the day. For most people, the spoons you get every day are enough. However, when managing health conditions, you might need to use more spoons than others… except you don’t get more spoons. So you’re drained a lot.
I’ll let the words of one of my survey respondents walk you through it “[w]hen my ADHD depletes my spoons, I don’t have as many to assess celiac risk or advocate for myself” and this can make it difficult to participate in everyday life activities like eating, as this participant says “[t]he energy spent thinking about what to eat makes me have less energy to actually make the food.”
One of the biggest things that helped me manage my burnout with celiac is making avoiding gluten and cross-contact feel routine. By making it routine, I use less mental energy on it so that I can make more space for managing my ADHD. That’s not to say I never get burnt out, but I get burnt out a lot less than I used to.
If you need help with making managing celiac routine, I give you simple strategies to do this in my Celiac Crash Course. This a self-paced course where I give you straightforward facts and actionable tips to make avoiding gluten and cross-contact routine, whether you eating at home, in a restaurant, traveling the world, etc. Check out the course here.
Now that we understand the link between ADHD and celiac, and how ADHD complicates managing celiac, let’s talk about what we can do about it.
Having ADHD and lived with celiac for over 10 years, I have quite a few strategies that I think might be helpful in supporting your celiac ADHD life.
That said, not every tip may feel applicable. ADHD shows up differently for everyone and given the large variance in celiac needs and ADHD needs, please assess the helpfulness of each tip for yourself.
P.s. If you need more help then the quick tips I share below, check out the SOS Celiac ADHD Bundle. It’s a bundle of resources made by 2 dietitians who have ADHD (and one who also has celiac) to make living gluten-free with ADHD as simple as possible.
One of the common things I hear from ADHD and celiac clients and something I saw in the survey results was that it can be hard to have the right snacks around. And by right snacks, I mean snacks that fit what someone is craving.
Often with ADHD, there are cravings for crunch, sweet, and salty snacks because they often can stimulate dopamine release (something ADHDers often crave). Celiac complicates this because often sweet, salty, and crunchy snacks contain gluten (I’m looking at you pretzels).
One survey participant said they especially struggle with knowing what they can have when they’re craving sweet, salty, and crunchy snacks. And given so many people struggle with eating enough in general, keeping gluten-free versions of these snacks on hand can be so helpful in encouraging you to eat and avoiding a binge-restrict cycle.
Some of my favorites to always have on hand include (p.s. some of these are affiliate links):
This takes me to the next tip I have…
As someone with ADHD and celiac disease, I’m like a squirrel. I have stashes of gluten-free snacks literally everywhere because I never know when I’ll need a snack and won’t have the bandwidth to read food labels.
So I’ve got snacks in my car, laptop bag, travel backpack, purse, by my desk, etc. One of the biggest struggles mentioned earlier was getting caught without food when you’re really hungry and making an unsafe choice as a result.
As someone who learned their lesson the hard way, having snacks on me at all times has been a game changer. If you want to know some of my favorite gluten-free snacks to have on hand, check out this link (affiliate link).
While I kind of touched on it in the celiac and ADHD struggle section of this blog post, a recurring challenge expressed in the survey was people felt they were forced to lean on unhealthy foods. As one person put it, they struggle with “[h]aving more unhealthy snacks cause they don’t go bad as quickly as fruit/veggies on hand.”
I’m holding so much space for anyone struggling with this kind of food guilt and shame around managing celiac and ADHD. In the autoimmune and ADHD sphere, there’s a lot of pressure to avoid processed foods and it can make the weight of trying to feed ourselves that much harder.
“Healthy” is a subjective term and looks different for different people. While yes, fruits and vegetables offer many nutritional benefits, they aren’t the only way to being healthy. We have to look at where we are and what we need to determine what healthy means for us.
And what’s “healthy” can also change by meal and day based on our changing needs. On a particularly challenging day where eating regular meals feel like a chore, just eating enough can be considered healthy.
On another day, when you have more mental space to focus on your meals, adding in fruits and vegetables can be healthy. Or when you realize you haven’t eaten anything since breakfast and have the urge to just push through until dinner, taking the time to stop and grab a handful of gluten-free crackers might be “healthy”.
There’s a lot to consider when it comes to our food choices and habits, and it’s easy to be hard on ourselves and get caught up in mainstream wellness culture, and I hope that you’re able to be more gentle with yourself as you figure out what healthy looks like for you.
One of the most life-changing lessons I learned in managing celiac and ADHD comes from my culinary courses as a student dietitian. Something I had to do in these classes was called mise en place. Mise en place is a french saying for having all of your recipe ingredients prepared before you start cooking.
On days when it’s especially difficult for me to think about cooking, I start with just getting all of my recipe ingredients in one place. If I still am on the struggle bus, I might resolve to eat a frozen gluten-free meal or pizza.
But the key is, I’ll leave the recipe ingredients grouped up on the counter (except for any refrigerated ingredients) so that the next day, the task isn’t doesn’t seem as long – because all of the ingredients are already sitting there staring at me anyways.
Now full disclosure: sometimes this means ingredients for recipes sit on my counter for way longer than I’d like to admit – so this tip isn’t foolproof. But, it helps me cook more often than I used to.
Another key part of managing celiac with ADHD is making sure you’re staying gluten-free. This includes making sure if you’re taking medications for ADHD, that they are gluten-free.
It’s uncommon but I have come across gluten in medications when checking them for clients. The last thing you want is to be exposed to gluten through your medications which could worsen not help your symptoms.
If you and your pharmacist are not sure how to check your medications for gluten, I teach you how plus I give you a handout to share with your pharmacist to teach them, in my Celiac Crash Course.
It’s a self-paced course that covers the basics of celiac-safety. Including teaching you how to make sure everything you consume (including medications) is gluten-free and free from cross-contact. To learn more check out the course here.
Something also to note is that these medications can come with side effects that could look similar to gluten exposure. Side effects like diarrhea and an upset stomach.
So if you’ve been recently diagnosed with celiac and you’re not feeling better, that might be something to factor into the equation. I’m not saying it’s definitely why, but something to pay attention to.
The last tip I’ll share with you today is to pay the gluten-free and ADHD tax. As someone who grew up as a twin daughter of a teenage mother, and in a big family that brags to each other about the $1.00 outfits we scored at the thrift store – this probably was the hardest thing for me to accept.
But first, what is the gluten-free and ADHD tax? The gluten-free tax is the extra money people with gluten-related disorders have to pay for gluten-free food. The ADHD tax is the extra money ADHD people have to pay for ADHD-friendly food.
This is a huge struggle many survey respondents noted. One person said “I’ve hit a point where I’m not eating anything that doesn’t have a third-party gluten-free certification on it and fresh produce/meat.”
Another person described their struggle with this as “paying more for things due to ADHD symptoms such as losing/misplacing items, forgetting I already have them and buying more, not having the desire to eat the things I purchased after the initial interest goes away, accidentally buying the wrong things (like non-gf versions), and food spoilage due to the mentioned reasons)”
And as hard as it was, accepting that I needed to build the gluten-free and ADHD tax into my budget was one of the most freeing things I did. Granted this does require a certain amount of financial privilege (especially with the rising food prices). And I’m holding space for the fact that some people simply aren’t in the place to do that.
At the very least, if you’re trying to find gluten-free alternatives to different gluten-filled favorites without breaking the bank, try to buy one new product a week. This can help honor your wallet while helping you find a gluten-free alternative that you actually enjo.
All of this to say, even if the link between ADHD and celiac is inconclusive in the research, the challenges people with both condition face are clear.
From skipping meals because meals often feel too difficult to put together, to accidentally or intentionally eating gluten because someone is so hungry, there are some dangers of managing both conditions at once.
The need to be prepared when leaving the house, dining out, grocery shopping, and more with celiac, can make it hard to cope with the spontaneous nature of ADHD. Additionally, following new gluten-free recipes and meal planning can feel extra hard for people struggling with executive dysfunction.
And finally, having to manage both ADHD and celiac at the same time can put you at high risk for double burnout. In other words, experience burnout from both conditions.
And while all of these challenges are valid, I hope the tips shared above help with managing at least some of them.
If you want more help with managing nutrition with celiac and ADHD, I teamed with ADHD-specialized dietitian, Becca, to bring you the SOS Celiac ADHD Bundle! A dietitian-led bundle that simplifies eating & cooking with celiac, whether you’re at home or at a restaurant.