Is there a relationship between gluten sensitivity and postural tachycardia syndrome?
Abstract
Background: We have noticed that patients with postural tachycardia syndrome (PoTS) were placing themselves on a gluten-free diet without medical consultation. Therefore, we aimed to evaluate the prevalence of coeliac disease and self-reported gluten sensitivity in a cohort of patients with PoTS and compare this with local population data. Methods: A total of 100 patients with PoTS were recruited to complete a questionnaire that screened for gluten sensitivity, related symptoms and dietary habits. Patients were also assessed for coeliac disease. For comparison, the local coeliac prevalence was determined from a total of 1200 controls (group 1) and a further 400 controls (group 2), frequency matched for age and sex, who completed the same questionnaire. Results: Overall, 4/100 (4%) patients with PoTS had serology and biopsy-proven coeliac disease. This was significantly higher than the local population prevalence of coeliac disease (12/1200, 1%; odds ratio: 4.1, 95% confidence interval: 1.3–13.0; P =0.03). PoTS patients also had a higher prevalence of self-reported gluten sensitivity (42 vs. 19%, respectively; odds ratio: 3.1, 95% confidence interval: 2.0–5.0; P <0.0001) compared with age-matched and sex-matched controls. Conclusion: This is the first study to suggest a potential association between gluten-related disorders and PoTS. A prospective study evaluating this relationship further may enable a better understanding and management of these conditions.
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Self-reported gluten sensitivity and IBS were more prevalent in the POTS cohort than in controls.
“The prevalence of self-reported gluten sensitivity and IBS were also higher in the POTS cohort than in controls.”
From Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review (2018) · cites this paper as [51]
About 6% of POTS patients reported gluten sensitivity despite negative celiac serology and normal duodenal biopsy.
“Approximately 6% of POTS patients complained of gluten sensitivity despite having negative celiac serology and normal duodenal biopsy.”
From Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review (2018) · cites this paper as [51]
In a large POTS cohort, celiac disease prevalence was 4%, higher than the 1% in age- and gender-matched controls (OR 4.1, 95% CI 1.3-13.0; p=0.03).
“Penny et al., [51] reported that the prevalence of CD was 4% in a large POTS cohort; this prevalence was higher than the one reported in a control group (1%) matched for age and gender (OR: 4.1, 95% CI:1.3-13.0; p=0.03).”
From Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review (2018) · cites this paper as [51]
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Gluten sensitivity: from gut to brain
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Self-citationPostural tachycardia syndrome—current experience and concepts
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Quality of Life in Patients With Postural Tachycardia Syndrome
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Vernino, S., Bourne, K. M., Stiles, L. E., Grubb, B. P., Fedorowski, A., Stewart, J. M., Arnold, A. C., Pace, L. A., Axelsson, J., Boris, J. R., et al. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102828 · Cited by 304 · see citing works
Autoimmunity in postural orthostatic tachycardia syndrome: Current understanding
Vernino, S., & Stiles, L. E. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.04.005 · Cited by 107 · see citing works
Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review
Mehr, S. E., Barbul, A., & Shibao, C. A. (2018) · Clinical Autonomic Research · doi:10.1007/s10286-018-0519-x · Cited by 55 · see citing works
Brooks, R. S., Grady, J., Lowder, T. W., & Blitshteyn, S. (2021) · Rheumatology · doi:10.1093/rheumatology/keaa926 · Cited by 28 · see citing works
Aziz, Q., Harris, L. A., Goodman, B. P., Simrén, M., & Shin, A. (2025) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2025.02.015 · Cited by 27 · see citing works
- Authors
- Penny, H. A., Aziz, I., Ferrar, M., Atkinson, J., Hoggard, N., Hadjivassiliou, M., West, J. N., & Sanders, D. S.
- Affiliations
- Royal Hallamshire Hospital (GB)
- Academic Department of Gastroenterology
- Cardiology
- Upperthorpe Medical Centre, Sheffield, UK
- Radiology
- Corresponding author
- Penny, Hugo A.
- Venue
- European Journal of Gastroenterology & Hepatology
- Published
- 2016-12
- Volume
- 28
- Issue
- 12
- Pages
- 1383-1387
- ISSN
- 0954-691X (ISSN-L)
- OpenAlex
- W2516598077
- Cited by
- 30
- References
- 8
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 4 · 2023: 3 · 2022: 2 · 2021: 2 · 2020: 6 · 2019: 1 · 2018: 4 · 2017: 1
- FWCI
- 2.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Gastroenterology & Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute for Health and Care Research (ACF-2014-04-005)
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- postural orthostatic tachycardia syndrome, gluten sensitivity, celiac disease, gluten-free diet, gluten-related disorders, prevalence, self-reported symptoms, dietary habits
- MeSH terms
- Protein Glutamine gamma Glutamyltransferase 2, Adult, Autoantibodies, Biopsy, Celiac Disease, Duodenum, Female, Fibromyalgia, Humans, Joint Instability, Male, Transglutaminases, Surveys and Questionnaires, Risk Factors, Prevalence, Odds Ratio, Endoscopy, Digestive System, GTP-Binding Proteins, Postural Orthostatic Tachycardia Syndrome, Young Adult, Self Report
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