Lots of parents bring their children to see me because of short stature: that means they are shorter than expected.
Classically, short stature is seen in children with celiac disease. It is usually attributed to nutritional deficiency. However, this cannot be the usual reason – because most of the children I see are not nutritional deficient – they are not loosing weight, and they have no bowel damge, although they have evidnce of gluten sensitivity.
So why are these children short? Some of them come from short families – so they are genetically short.
But more likely, gluten and the immune response to gluten is adversely affecting the activity of growth hormone.
A recent paper comes to this conclusion: “short stature is one of the most common clinical manifestations of CD and should be considered in all children with short stature. Catch-up growth is observed on gluten-free diet (GFD), mostly in the first 6 months from diagnosis [if this is due to a nutritional deficiency]. The absence of catch-up growth requires the evaluation of compliance and endocrinological evaluation. Patients should be tested for GH reserve, particularly if the test for anti-pituitary antibodies (APA) is positive.”
Many research groups report a dysfunction of the endocrine growth axis in children with CD. And likewise with gluten sensitivity.
Every child with suspected growth issues needs to be checked out for celiac disease and gluten sensitivity. In these children a gluten-free diet might make a big difference.
We investigate children with short stature and poor growth at The Children’s Clinic | Allergy Centre.
Dr Rodney Ford