Gluten Sensitivity – Part 1

I want to start out with some humor. It’s a cartoon. The doctor is talking to the patient and says, “The high carb diet I put you on 20 years ago gave you diabetes, high blood pressure and heart disease. Oops.” How true is that?!

I have a graph that shows what’s happened over the last 20 years or so. It’s the year versus the number of diabetics. The number of diabetics was fairly stable in the early 80’s into the 90’s.  As the population grew, it went up a little bit. It was stable at about 6-7 million. Then in 1992 the US Government endorsed a high-carb, low fat diet. The American Diabetic Association and the American Heart Association followed suit with similar recommendations in 1994.  Then in 1994 the graph started going up. From the early 90’s at 6 million diabetics to the 2000’s and now it’s over 20 million. That’s a huge increase in a short period of time. Coincidence??? I don’t think so.

Gluten has been around for a long period of time. It’s a Latin word that means glue. It’s a large water soluble protein found mainly in grains. Wheat is the biggest culprit. It gives elasticity to dough. It helps it rise and keep its shape. There are a lot of disorders that can be related to gluten. We call them gluten related disorders. It’s an umbrella term of any disease that is triggered by gluten.  This includes Celiac Disease (the one that you hear about most), gluten sensitivity, and wheat allergy. You sometimes hear the term gluten intolerance.  The real term is gluten sensitivity. Intolerance means you don’t tolerate it well. All of these are immune related disorders. Your immune system is responding to the exposure of gluten. For some people it can be a life threatening problem.  If they get even close to gluten they have all kinds of problems.

Celiac disease affects about 1-2% of the population. The prevalence of this is going up and up.  We’ll talk about why later. There’s something different now about the wheat than there was years ago. Unfortunately it’s never been tested to see if it’s a safe thing. Some of the symptoms are chronic diarrhea, abdominal pain, and malabsorption. It’s a true anti-inflammatory response in the intestinal tract.  The diagnosis is made by endoscopes. A biopsy is taken. The treatment is a gluten free diet.  There’s no other treatment.

Non Celiac Gluten Sensitivity means you don’t have the full blown disease. These people feel there are certain problems that arise when they eat gluten. You may or may not have any intestinal complaints. Multiple symptoms are improved when gluten is removed.  This is much more common (30-40% of the population).The percentage of the population continues to go up.

A true Wheat Allergy is like an anaphylaxis. It’s like someone allergic to peanuts eats one by mistake, they go into anaphylaxis. This is a very quick onset. The others have a slow onset. A wheat allergy is much rarer.

Gluten is made up of glutenin and gliadin. There’s also water which gives the dough its elasticity. It tends to be everywhere! That’s where the problems come in. Many grains and products have gluten in them. Where is it hidden? The obvious one is wheat. Anything that has wheat in it is going to have gluten. It’s also found in barley, bulgur, cous cous, matzo, rye, spelt, and more. There are grains that don’t have any gluten in them. Some of those grains are relatively rare. Some of them are common like potato, corn, rice and millet.  I’ve made a list of things you wouldn’t guess have gluten in them: baked beans, beer, blue cheese, bouillon, most cereals, chocolate milk, energy bars, egg substitutes, hot dogs, fruit fillings, ice cream, imitation crab meat, ketchup, vinegar, mayonnaise and meat balls, Gluten is added to a lot of things you wouldn’t really expect.   Oats may or may not have gluten. French fries are made out of potato. But before they’re frozen they are actually sprinkled with wheat flour so they don’t stick to each other.  A lot of cosmetics have gluten. Medications, play dough, some shampoos, some vitamin supplements have gluten.  There are a lot of things that are code words for gluten. Sometimes they’ll put it as the genus species of the actual plant. There will be hidden gluten. Keep in mind that gluten free does not mean low carb. It could actually mean high carb.

Gluten sensitivity can cause all kinds of symptoms. From a GI standpoint, they can be somewhat similar symptoms as true celiac disease but not quite as dramatic. The GI symptoms are: abdominal pain, bloating, diarrhea, constipation, nausea, GERD, gas, stomatitis, and mouth ulcers.  There are also symptoms of gluten sensitivity that have nothing to do with the GI system such as:  migraines, brain fog, fatigue, fibromyalgia, joint/muscle pain, numbness, eczema, skin rashes, depression, anxiety, anemia, folate deficiency, asthma, rhinitis, and eating disorders.  There are neurologic symptoms. Gluten can set off schizophrenia. It could be a factor in autism, peripheral neuropathy, ataxia, ADD, and ADHD. We see this diagnosed all the time nowadays. It actually could be a gluten problem.

There are some antibody tests to diagnose for gluten sensitivity. However, they’re going to miss a lot of people.  The only good way is a diagnosis of exclusion.  You remove gluten from your diet for at least a month and then try and reintroduce it. If your symptoms come back, it’s probably due to gluten. It’s not the most scientific thing in the world to do but it actually works pretty well. It’s like an elimination diet.  The treatment is a gluten free diet.  Those with gluten sensitivity often have the false impression that “cutting back” is helpful, but really need to avoid all gluten. I want everyone to keep in mind that if you eliminate gluten, no nutritional deficiency will occur.

It’s really amazing some of the symptoms that can be related to gluten sensitivity. I already mentioned a lot of them. Some other symptoms are: autoimmune disorders (rheumatoid arthritis, diabetes, Hashimoto’s), bone pain, cancer,   heart disease, infertility, dental problems, skin problems, and more.  Gluten sensitivity can have a lot of things to do with things you never expect. The only way to know is getting rid of the gluten. Obviously we think of gastrointestinal problems associated with gluten sensitivity.

Unfortunately there are no real standards for testing gluten intolerance.  The simple way to do it is to get rid of the gluten. We can measure anti-gliadin antibody (IgA) in the blood or stool. If you measured everyone’s blood, 12% have antibodies to anti-gliadin.  There are 30% in the stool. It can cause an immune reaction. If something causes an immune reaction there can be damage. The reaction is usually an inflammatory reaction. Cytokines develop and are released. The Gold Standard is gluten free for 1 month, then re-introduce. If symptoms pop up, then you are sensitive to gluten.

Gluten-free should not mean eating all the junk/processed food that is labeled as gluten free.  It doesn’t correlate with low carb. The “Core Diet” is just 3 things: hydration (water), good protein sources, and salad stuff. That’s what you should eat. Get rid of most everything else. Do I agree with trying to keep a gluten-free diet??? Absolutely!

I have more to say about gluten and I’ll post another article next week.  We’ll delve into this more and look at all the major body organs that can be affected by gluten sensitivity. I’ll go into a little more detail with that.

If you think of questions, don’t hesitate to call (757-873-1880), text or stop by. This is something that’s really common. I think this is something that’s going to become more and more important. Part of the problem is that the wheat that’s being grown now is not the same wheat that was grown 100 years ago. It was genetically modified (GMO’s). You hear about GMO’s all the time. The problem with GMO’s is whether they’ve been tested for safety.

Remember to stop by and get your body comp checked.

Remember, it’s your life. Make it a healthy one.