Celiac disease is more prevalent today than ever before. In the United States, celiac disease rates have increased by five times over the past few decades, leaving everyone to wonder why. We know that a strong genetic component plays a role in the development of the disease, and our ability to detect it has improved dramatically, but there has to be more than these reasons to explain such a drastic upward trend in such a short time.
Supporters of one theory hold to the idea that celiac disease is caused in part by the use of antibiotics during early childhood. Antibiotics have been shown to alter gut microbiome, leading to digestive issues, which have been argued to contribute to leaky gut and other conditions related to celiac disease.
In 2013, a Swedish team of researchers reported a link between antibiotic use and the development of celiac disease. During this population-based study, experts examined health data of 2,933 people to determine if there was any association between systemic antibiotic use and subsequent celiac disease. Researchers determined that there was a positive association between the two. They did mention, though, that one possible explanation for the development of celiac was due to the fact that antibiotics were often prescribed to patients with symptoms of undiagnosed celiac disease. The most commonly prescribed antibiotic in this study was penicillin.
By contrast, a more recent study, published in the journal Jama Pediatrics, found that antibiotics taken during a child’s first four years of life were not associated with the development of celiac disease or type 1 diabetes, even if the child was genetically predisposed to the development of either condition.
Scientists at the University of Florida were led by Eric W. Triplett, PhD, of the Department of Microbiology and Cell Sciences. Triplett and his colleagues analyzed data from the birth cohort of The Environmental Determinants of Diabetes in the Young (TEDDY) study. The TEDDY study is an investigation by researchers worldwide who seek to find the cause of type 1 diabetes.
The 2017 study by Triplett and his team discovered that about 6,600 children from the US, Finland, Germany and Sweden who were enrolled in the TEDDY study were tested for tissue transglutaminase autoantibodies associated with celiac disease. The team also found that about 8,500 children who were enrolled in TEDDY were tested for islet antibodies linked with type 1 diabetes.
Parents had to report which antibiotics their children had previously taken and the frequency. According to study results, ear infections were the most common reason for taking antibiotics, and amoxicillin was found to be the most frequently prescribed antibiotic, followed by cephalosporins, penicillins and macrolides.
Neither the exposure to, nor frequency of, use of antibiotics reviewed during the study influenced risk of the development of celiac disease or type 1 diabetes.
The study team did mention that, although no association was found between antibiotic use and celiac disease autoimmunity, their findings do not exclude an association between antibiotic use and gut bacteria and viral infections.
Although the case for the development of celiac disease after childhood antibiotic use has seen conflicting results, as it stands today it appears that the risk is minimal. According to Dr. Triplett, you do not need to worry about standard antibiotics for children under four, even if there is a history of celiac disease or type 1 diabetes in your family. He does not believe that antibiotics will contribute to the risk of developing the disease.