Another Brain-Gut Clue?
I’m blogging my thoughts “out loud,” so bear with me.
This past Sunday a good friend of mine who is the advising psychiatrist to a program for adults with developmental and learning disabilities, told me she witnessed an unusual scene. Her youngest client, a woman in her late 20s (I’ll caller her “Ellen”), suddenly presented with an immense, gushing nosebleed, or epistaxis, as it is called medically.
The staff nurse and a counselor came in to calm her (she was very upset as soon as she realized she was bleeding), and made her sit with her head tipped forward while they pinched the bridge of her nose and applied ice to the nose, face, and even back of the neck. After a few minutes, as suddenly as it came, the nosebleed stopped.
My friend learned that Ellen, who had been diagnosed with learning and other disabilities and was “on the autism spectrum,” has been having nosebleeds since she was about twelve. This was the first time my friend was present when it occurred. For some reason, she hadn’t fully noted the epistaxis in the medical records.
But when she witnessed Ellen’s nosebleed, something struck a chord. Both her brothers (fraternal twins) had had frequent, heavy nosebleeds and they both were diagnosed with ADHD. She believes they also had some other mild learning disabilities, including dyslexia. One twin began getting nosebleeds at age eight, the other at nine. They lasted until their mid-to-late teens.
There are many theories about why people experience epistaxis and quite a few known causes. Trauma to the nose, tumor, infection, certain medications, alcohol or drug use, some liver disease which causes blood-platelet disorders, high blood pressure, and some environmental causes such as exposure to certain chemicals or the very dry air one finds at high altitude (the altitude itself doesn’t cause nosebleeds.)
But have nosebleeds ever been linked in any way to brain conditions and/or mental illness? It depends who you ask.
One rather scanty case study indicates that ADHD presented as recurring epistaxis. In this case, treatment with an ADHD medication (atomoxetine) appeared to quash the nosebleeds. The vast majority of medical doctors say that ADHD and nosebleeds have no causal relationship or any correlation at all.
However, reading the “mom” forums online, I’m finding they tell a different story. Several moms (and Dads, too) report that their child with ADHD also has frequent, and heavy, nosebleeds. Some forum members say that the nosebleeds occurred before their child was put on ADHD medication and others say that the nosebleeds began when the child was put on medication.
Also, I remember a family member many years ago who was diagnosed with ADD (knowing what I know now, I believe that ADHD would have been a more appropriate diagnosis), used to get heavy, frequent nosebleeds. They were frightening in their intensity.
An online search will yield quite a bit of chat about autism and nosebleeds, overlapping with celiac/gluten and multiple grain allergies and nosebleeds. Gluten and even multiple grain allergies have been anecdotally linked to symptoms of schizophrenia and autism.
There’s fierce debate about whether or not diet, especially dietary gluten, contributes to symptoms of autism, schizophrenia, and ADHD, with many pediatricians and other MDs, coming in on the “nay” side, and a just a few, on the “yay” side.
There doesn’t seem to even be a debate among professionals about whether food intolerance or food allergies can cause nosebleeds, but the moms I chatted with (or read about) have a different story to tell. One mom writes that her son would experience nose bleeds every time he ate hot dogs or bologna. In an email exchange a forum member asked: Could it have been the sodium nitrite?
Are nosebleeds one more sign pointing to the brain-gut link? An intolerance to a certain food can trigger a host of symptoms that do appear unrelated. I don’t know the answer, but when I asked my friend if she knew anything about Ellen’s diet, she told me that they had eaten lunch together in the program’s dining room a short while before the nosebleed occurred. What was on the menu? Cold cut sandwiches.
I want to reiterate: I am not suggesting that nosebleeds are a symptom of ADHD, schizophrenia, autism, or any other brain condition/mental illness/disability. Also, I’m not suggesting that food allergies are the lone cause of these conditions. I’m just looking at one more piece in the brain-gut puzzle.
Please, share your thoughts and experiences in the comments section.
& C.R. Zwolinski, R. (2012). Another Brain-Gut Clue?. Psych Central. Retrieved on April 28, 2015, from http://blogs.psychcentral.com/therapy-soup/2012/06/another-brain-gut-clue/