Tag Archives: Tests for Gluten Allergy

Celiac Disease, Gluten Sensitivity, & Gluten Allergy

Last updated 6/2/2015.

(Source: offthegrain.com)
(Source: offthegrain.com)
Gluten is a protein found in many grains and seeds, principally wheat, rye, barley, spelt, kamut, and triticale. It is the composite of the storage proteins gliadin and a glutenin conjoined with starch in the endosperm of various grass-related grains. (Wikipedia, 5/29/2015)
Although gluten-containing foods are an important part of the modern diet,  many humans have difficulty digesting gluten. The effects of this trouble can be immediately apparent in some people while in others, deleterious reactions to gluten make themselves known only over time.
As many as 20 million Americans may be sensitive to gluten. Another 3 million  have celiac disease and 400,000 – 600,000 are allergic to wheat. (Woodward, 2011)
That’s a lot of people!

 

 

(Source: myglutenfreequest.com)
(Source: myglutenfreequest.com)

 

 

 

 

 

A BRIEF HISTORY OF GLUTEN IN THE HUMAN DIET (Guthrie, 2010)

The consumption of grains is relatively new to our diet, dating from  when we stopped being nomadic hunter-gatherers, settled down and started growing crops and domesticating animals,  15,000 years ago at the earliest. Before that time, our ancestors mostly ate the meat of animals they hunted, along with wild fruits, plants, tubers, nuts, and seeds they foraged. The planting of dietary grains as crops originated in Mesopotamia.
Some of us have adapted well to our largely grain-filled diets. Many of us have not. For example, about 30% of northern Europeans carry genes for gluten problems.
Furthermore, the wheat we eat today is also considerably changed. In today’s modern version of wheat, up to 90% of its protein content now consists of gluten – 10 times what it was even 100 years ago.

 

 

Einkorn (ancient wheat) vs Modern Wheat

(Source: www.einkorn.com)
(Source: www.einkorn.com)

 

In people with celiac disease, ingesting gluten causes the body to attack the small intestine. For the 30-40% of people who have a non-celiac gluten intolerance, the immune system mistakes gluten for a foreign body (a pathogenic bacteria or virus) and mobilizes an arsenal of antibodies to attack the ‘invader’. For me, even the small amount of gluten on French fries cooked in oil shared by a flour-containing food (eg, something breaded) is enough to set off a full blown gluten reaction.
On average, an American consumes about 150 pounds of wheat each year. We get it in the processed foods we rely on, breads, baked goods, pasta. There’s also gluten in many commercially produced seasonings and most bacon. Wheat flour is used widely as a breading and thickening agent. I recently learned the hard way that even some nutritional supplements contain gluten.
Think about what you ate today. Did you have toast, a muffin, a bagel,  pancakes, cereal, oatmeal (usually processed in factories that also process wheat) for breakfast? A sandwich, pizza, a Big Mac, soup thickened with flour, soy sauce (it’s brewed with wheat) for lunch? Cookies, pretzels or a doughnut as a snack? A beer (brewed with wheat) after work? Pasta and some cake for dinner?
That’s gluten in every meal you ate!
Here’s a list of foods containing gluten. It’s a good start but by no means complete. Gluten can also be a hidden ingredient in some very unexpected places –  your lipstick, cosmetics, hair products, toothpastes, marinades, sauces, pretty much all processed foods, textured vegetable protein, seitan, imitation crab stick, MSG, ketchup, candies, communion wafers, some pharmaceuticals and nutritional supplements, Play Doh … and many, many more.
(Source: jenniferskitchen.com)
(Source: jenniferskitchen.com)


 

 

(Source: glutenfreedietwithnutrition.com)
(Source: glutenfreedietwithnutrition.com)

 

 

 

 

 

 

CELIAC DISEASE (Fasano et al, 2003)

 

(Source: bostoniano.info)
(Source: bostoniano.info)

 

Celiac disease (CD) is an autoimmune disorder of the small intestine triggered in genetically susceptible people by the ingestion of gluten. Specifically, CD is a reaction to the gliadin, a protein which is the soluble part of gluten, found in wheat and several other cereals in the grass genus Triticum.
See this University of Chicago Celiac Disease Center site for a list of the approximately 300 symptoms and conditions potentially due to celiac disease. You’ll see why trying to diagnose celiac disease from symptoms alone can be quite confusing.
The long term health effects of undiagnosed CD can be quite serious.

 

Biopsy of the mucosal lining of a healthy small intestine: long villi providing a large area for digestion and absorption of nutrients

(Source: library.med.utah.edu)
(Source: library.med.utah.edu)

 

 

Biopsy of a small intestine with celiac disease: blunted villi, crypt hyperplasia, and lymphocyte infiltration of crypts

Coeliac_path

 

Although common in Europe, until 2003, celiac disease was thought to be rare in the United States.
Research led by world-renowned expert on celiac disease, Alessio Fasano, MD, corrected that assumption. Dr Fasano is Chief, Division of Pediatric Gastroenterology and Nutrition at Massachusetts General Hospital for Children and Professor of Pediatric Gastroenterology and the W. Allan Walker Chair of Pediatrics at Harvard Medical School.

 

Alessio Fasano, MD
Alessio Fasano, MD

 

Fasano conducted the largest rigorous study ever performed to establish the prevalence of celiac disease in at-risk and not-at-risk groups in the US.
13,145 subjects from 32 states participated in this study: 3,236 symptomatic patients (with either GI symptoms or a disorder associated with CD), 4,508 1st degree and 1,275 2nd degree relatives of patients with biopsy-proven CD,  and 4,126 not-at-risk individuals. The age distribution of the study’s subjects, infants to 65 and older, corresponded with the age distribution of the population as reported in the US Census of 2000.
Subjects defined as ‘at-risk’ were relatives of patients with CD or patients who presented with CD-associated symptoms (diarrhea, abdominal pain, and constipation) or with CD-associated disorders (type 1 diabetes mellitus, Down syndrome, anemia, arthritis, osteoporosis, infertility, and short stature).
The results suggested that celiac disease:

“… occurs frequently not only in patients with gastrointestinal symptoms, but also in first- and second-degree relatives and patients with numerous common disorders even in the absence of gastrointestinal symptoms. The prevalence of CD in symptomatic patients and not-at-risk subjects was similar to that reported in Europe. Celiac disease appears to be a more common but neglected disorder than has generally been recognized in the United States….

“The prevalence of CD was as high in first- and second-degree relatives without symptoms as in relatives with symptoms, highlighting the importance of genetic predisposition as a risk factor for CD….

” If CD is as common in the United States as our study suggests, one must question why it is not diagnosed more frequently. Foremost among the possible explanations is that if physicians believe that CD is rare, they are less likely to test for it. A failure by physicians to appreciate that many individuals with the disease initially present without gastrointestinal symptoms is another reason why CD testing may not be performed….

“The prevalence of CD in symptomatic patients and not-at-risk subjects was similar to that reported in Europe. Given the high morbidity and mortality related to untreated CD and the prolonged delay in diagnosis in the United States,  serologic testing of at-risk patients (ie, case finding) is important to alleviate unnecessary suffering, prevent complications, and improve the quality of life of a multitude of individuals with CD.”

 

Prevalence of Celiac Disease Worldwide

(Source:  World J Gastroenterol. 2012 Nov 14; 18:42, 6036–6059)
(Source:
World J Gastroenterol. 2012 Nov 14; 18:42, 6036–6059)

 

The number of people clinically diagnosed with celiac disease has been rising dramatically around the world and is now considered a major public health issue. In 2010, diagnosed celiac was four times more common than it had been 60 years ago, affecting about one in 100 people. (Mayo Clinic, 2010)
The ratio of clinically diagnosed to undiagnosed cases of CD (people who have celiac reactions to gluten, often without the usual GI symptoms) is now believed to be 1:3 to 1:5. (Catassi et al, 2014)
 

 

 

 

 

GLUTEN SENSITIVITY (AKA GLUTEN INTOLERANCE) (Woodward, 2011)

 

(Source: friedeggsandtoast.com)
(Source: friedeggsandtoast.com)

 

In 2011, Alicia Woodward, the editor of Living Without,  interviewed Dr Fasano about his research that showed gluten sensitivity is real and a medical condition distinct from celiac disease. When she asked him about the import of having demonstrated the existence of gluten sensitivity, Dr Fasano replied:

“In my humble opinion, it’s a big deal. First, we’ve moved gluten sensitivity, also called gluten intolerance, from a nebulous condition to a distinct entity—and one that’s very distinct from celiac disease. Gluten sensitivity affects 6 to 7 times more people than celiac disease so the impact is tremendous. Second, we now understand that reactions to gluten are on a spectrum. The immune system responds to gluten in different ways depending on who you are and your genetic disposition. Third, there’s a lot of confusion in terms of gluten reactions. Gluten and autism, gluten and schizophrenia—is there a link or not? These debates are on their way to being settled. And fourth and most important, for the first time we can advise those people who test negative for celiac disease but insist they’re having a bad reaction to gluten that there may be something there, that they’re not making it up, that they’re not hypochondriacs. Once it’s established that a patient has a bad reaction to gluten, it’s important to determine which part of the spectrum he or she is on before engaging in treatment, which is the gluten-free diet.”

 

(Source: www.pharmaceutical-journal.com)
(Source: www.pharmaceutical-journal.com)

 

Given that celiac disease, gluten sensitivity and gluten allergy share many clinical symptoms, Woodward wondered if people can move along the spectrum to a more serious version of difficulty with gluten:

“No, I don’t think so. The three main conditions—celiac disease, gluten sensitivity, wheat allergy—are based on very different mechanisms in the immune system. Given that fact, it’s hard to imagine the possibility that you could jump from one to the other.”

Fasano had this to say about why so many humans are having such negative reactions to gluten after generations of wheat consumption:

“Although we’ve been eating wheat for thousands of years, we are not engineered to digest gluten. We are able to completely digest every protein we put in our mouths with the exception of one—and that’s gluten. Gluten is a weird protein. We don’t have the enzymes to dismantle it completely, leaving undigested peptides that can be harmful. The immune system may perceive them as an enemy and mount an immune response.”

Fasano offered an explanation for why we’re now seeing such an explosion of gluten-related health problems:

“Two components are coming together to create this perfect storm. First, the grains we’re eating have changed dramatically. In our great-grandparents era, wheat contained very low amounts of gluten and it was harvested once a year. Now we’ve engineered our grains to substantially increase yields and contain characteristics, like more elasticity, that we like. We’re susceptible to the consequences of these extremely rich, gluten-containing grains. Second, and this applies to the prevalence of celiac disease that’s increased 4-fold in the last 40 years, is the upward trend we’re seeing in all autoimmune diseases. We’re changing our environment faster than our bodies can adapt to it.”

Woodward mentioned that she’d heard him say gluten sensitivity is where celiac disease was 30 years ago:

“It’s déjà vu. The patients, as usual, were visionary, telling us this stuff existed but healthcare professionals were skeptical. The confusion surrounding gluten sensitivity—testing, biomarkers—is exactly the same confusion we had around celiac disease 30 years ago. So we’re starting all over again now.”

Symptoms of Gluten Sensitivity:

Most patients with gluten sensitivity reported 2 or more symptoms (Fasano et al, 2011)

(Source: justinhealth.com)
(Source: justinhealth.com)
See Q & A with Alessio Fasano, MD: The latest on gluten sensitivity and celiac disease for the entire interview.

 

See Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity to read about Fasano et al’s study comparing celiac disease and gluten sensitivity. It’s a long scientific article but you can skip down to the short Conclusions section if you wish.
The researchers concluded that CD and GS are “distinct clinical entities caused by different intestinal mucosal responses to gluten.” “CD results from a complex, and as yet undetermined, interplay of increased intestinal permeability, mucosal damage, environmental factors in addition to gluten, and genetic predisposition”  while “GS is associated with prevalent activation of an innate immune response.” (Sapone et al, 2011)

 

 

 

 

GLUTEN AND WHEAT ALLERGY (Mayo Clinic, 2015) (UCLA, 2015)

(Source: www.hailmerry.com)
(Source: www.hailmerry.com)

A gluten allergy is a specific, reproducible immune response to ingesting foods containing wheat or other sources of gluten – or, in some cases, even from inhaling gluten-containing flour. Wheat (along with peanuts, tree nuts, milk, soy, egg, fish, and shellfish)  is one of the most common of the eight major recognized food allergens, responsible for 90% of all IgE (immunoglobulin E) – mediated food allergies.
In people with an IgE-mediated allergy to the gliadin found in gluten, exposure causes the release of antibodies to try to neutralize the gliadin. More rarely, the immune response to gluten may result from other specialized immune pathways (non-IgE mediated).
A wheat allergy typically presents as a food allergy but can also be a contact allergy (say from occupational exposure to wheat). Like all allergies, wheat allergy involves IgE and mast cell response.
“Typically the allergy is limited to the seed storage proteins of wheat, some reactions are restricted to wheat proteins, while others can react across many varieties of seeds and other plant tissues. Wheat allergy may be a misnomer since there are many allergenic components in wheat, for example serine protease inhibitors, glutelins and prolamins and different responses are often attributed to different proteins. Twenty-seven potential wheat allergens have been successfully identified.” (Wikipedia, 2/18/2015)

 

How the body reacts to an allergen

(Source: www.moondragon.org)
(Source: www.moondragon.org)

 

 

Symptoms of a gluten allergy  develop within a few hours, often a few minutes after exposure, and include:
  • Swelling, itching or irritation of the mouth or throat
  • Hives, itchy rash or swelling of the skin
  • Nasal congestion
  • Headache
  • Itchy, watery eyes
  • Difficulty breathing
  • Cramps, nausea or vomiting
  • Diarrhea
Some people allergic to gluten may also experience anaphylaxis, a life-threatening allergic reaction. Symptoms of anaphylaxis include:
  • Swelling or tightness of the throat
  • Chest pain or tightness
  • Severe difficulty breathing
  • Trouble swallowing
  • Pale, blue skin color
  • Dizziness or fainting
  • Fast heartbeat

 

 

Comparison of Gluten-Related Disorders

Source: (UCLA Celiac Disease Program)
Source: (UCLA Celiac Disease Program)

 

 

 

TESTING FOR GLUTEN PROBLEMS

While researching this post, I encountered conflicting information on the best ways to test for celiac disease and gluten allergy – and, in the case of gluten sensitivity, whether there even IS a test (see Update below). If you’re interested in getting tested, you may find this article by Integrative Medicine pioneer J.E. Williams, OMD, helpful: Learn the best tests for celiac disease and non-celiac gluten sensitivity.
Update:  In 2013 Dr Fasano reported he was confident that a clinical trial being conducted by his Center for Celiac Research, in collaboration with Second University of Naples, would identify a biomarker for non-celiac gluten sensitivity and that the discovery of such a biomarker would lead to the development of diagnostic tests for the condition. Patients were being enrolled for the clinical trial in January 2013. (Anderson, 2014). As far as I can tell, the results haven’t been published yet.

 

 

intestines_quote

 

 

Many thanks to Frank Lipman, MD, for pointing me to Alessio Fasano’s work on celiac disease, gluten sensitivity and gluten allergy.

 

 

 

REFERENCES

Anderson, J. (2014). Dr. Fasano: Gluten Sensitivity Biomarker Likely Coming. See: http://celiacdisease.about.com/od/glutenintolerance/fl/Dr-Fasano-Gluten-Sensitivity-Biomarker-Likely-Coming-Soon.htm

Catassi, C. et al. (2014). The New Epidemiology of Celiac Disease. Journal of Pediatric Gastroenterology & Nutrition, 59, S7-9.  See: http://journals.lww.com/jpgn/Fulltext/2014/07001/The_New_Epidemiology_of_Celiac_Disease.5.aspx

Fasano, A. et al. (2003). Prevalence of Celiac Disease in At-Risk and Not-At-Risk Groups in the United States: A Large Multicenter Study. Archives of Internal Medicine, 163:3, 286-292. See: http://archinte.jamanetwork.com/article.aspx?articleID=215079

Guthrie, C. (2010). GLUTEN: THE WHOLE STORY. See: https://experiencelife.com/article/gluten-the-whole-story/

Mayo Clinic. (2010). CELIAC DISEASE: ON THE RISE. See: http://www.mayo.edu/research/discoverys-edge/celiac-disease-rise

Mayo Clinic. (2015). Wheat allergy. See: http://www.mayoclinic.org/diseases-conditions/wheat-allergy/basics/definition/con-20031834

Misty. (2009). List of Foods Containing Gluten. See: http://www.whatcontainsgluten.com/2009/04/list-of-foods-containing-gluten.html

Sapone, A. et al. (2011). Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity. BioMed Central Medicine, 9:23. See: http://www.biomedcentral.com/1741-7015/9/23

UCLA Division of Digestive Diseases. (2015). Celiac vs Gluten-Sensitivity vs Wheat Allergies. See: http://gastro.ucla.edu/site.cfm?id=281

University of Chicago Celiac Disease Center. (undated). Symptoms and conditions potentially due to celiac disease. See: http://www.cureceliacdisease.org/wp-content/uploads/2011/09/CDCFactSheets10_SymptomList.pdf

Wikipedia. (5/29/2015). Gluten. See: http://en.wikipedia.org/wiki/Gluten

Wikipedia. (2/18/2015). Wheat Allergy. See: http://en.wikipedia.org/wiki/Wheat_allergy

Williams, J.E. (2015). LEARN THE BEST TESTS FOR CELIAC DISEASE AND NON-CELIAC GLUTEN SENSITIVITY. See: http://renegadehealth.com/blog/2015/04/24/learn-the-best-tests-for-celiac-disease-and-non-celiac-gluten-sensitivity

Woodward, Al. (2011). Q & A with Alessio Fasano, MD: The latest on gluten sensitivity and celiac disease. See: http://www.glutenfreeandmore.com/issues/4_15/qa_augsep11-2554-1.html

 

© Copyright 2015 Joan Rothchild Hardin. All Rights Reserved.

 

DISCLAIMER:  Nothing on this site or blog is intended to provide medical advice, diagnosis or treatment.

GLUTEN INTOLERANCE IS REAL

 

 

(Source: carrotstick.dk)
(Source: carrotstick.dk)

 

 

GLUTEN: WHAT IS IT AND WHERE IS IT FOUND?

Gluten is a protein composite comprised of gliadin and glutelin, conjoined with starch, in the endosperm of various grass-related grains, such as wheat, barley and rye.  Gluten is what makes bread dough elastic, helps it rise and keep it’s shape, and gives it a pleasantly chewy texture. Gluten is also used now in a large numbers foods as a thickener, binder, flavor enhancer and protein supplement.
Along with the obvious sources such as breads, cakes and pasta, you’ll encounter gluten  hidden in many processed foods – salad dressings, soups, beer, some chocolates, some licorice, flavored coffees and teas, imitation bacon bits and seafood, sausages, hot dogs, deli meats, sauces, marinades, gravies, seasonings, soy sauce. See Hidden Sources of Gluten: How to recognize gluten that’s not obvious on the label for a fairly comprehensive list.

 

 

Processed-food-and-gluten-free

Gluten is also found in a variety of pharmaceuticals (National Foundation for Celiac Awareness, 2014).

 

 

 

 

 

 

THE ARTICLE THAT WAS THE IMPETUS FOR THIS POST ON GLUTEN

 

(Source: The New Yorker)
(Source: The New Yorker)

 

 

Michael Specter’s article about gluten in The New Yorker‘s food issue (11/3/2014) so irritated me I felt compelled to address the misinformation in it. The article is called Against the Grain: Should you go gluten-free? . (Specter, 11/3/2014)
Specter has been a staff writer at The New Yorker since 1998. His writings focus on science and technology as well as global public health. He has also written for The Washington Post and The New York Times.
Looking him up after finishing the article, I was amazed to learn that he was also the author of a book published in 2009 entitled Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives. Despite my hopeful reaction to the word ‘denialism’ in the title, I learned from its review on Amazon that the denial Specter was addressing in this book is Americans’ growing mistrust of science.
So now the focus of this New Yorker article makes sense – he’s a true believer in the gods of modern science, technology and ‘progress’. From the Amazon review of Denialism:

“In the United States a growing series of studies show that dietary supplements and ‘natural’ cures have almost no value, and often cause harm…. And pharmaceutical companies that just forty years ago were perhaps the most visible symbol of our remarkable advance against disease have increasingly been seen as callous corporations propelled solely by avarice and greed…. As Michael Specter sees it, this amounts to a war against progress.”

 

 

(Source: www.flickriver.com)
(Source: www.flickriver.com)
In the New Yorker article, Specter takes a belittling tone toward the many people who are finding their physicians unable or unwilling to help them track down the root cause of their various ill health symptoms so take over that search themselves.
But does it strike YOU as the least bit odd for people to look elsewhere when they realize they’re not getting adequate advice from their doctors, not being believed when they report noticing correlations between eating X and feeling Y afterwards, or – even worse – being given drugs for what ails them, only to develop other symptoms on top of the ones they already reported?
That was certainly my experience with the allergies I suffered with for 40 years. All my doctors ever offered me were various antihistamines and decongestants – and eventually surgery when my body had become so inflamed polyps were growing inside my sinuses making it difficult to breathe. I had horrible reactions to all the drugs and none of them stopped my allergies. After the second nasal polyp surgery, I told my ENT doc that I wasn’t willing to live like that anymore and was going to find a way to fix my allergies rather than just try to treat their symptoms. He was smart and a really good human being. His response was, “I believe you. Will you let me know when you’ve figured it out?” That conversation took place about 35 years ago and my journey to figure it out led to this website.
BTW, my other experiences over the years trying to get help with my own and my family’s autoimmune and other health problems were pretty much the same as the allergies tale above until I basically stopped seeing MDs and started working with so-called ‘alternative’ health care providers who knew about identifying and correcting underlying causes rather than treating symptoms.
So it makes sense to ME that many people have decided to eliminate gluten from their diets to see if that might help. We know something is wrong and we want help getting better and then staying healthy. If we were getting adequate guidance from our doctors, we wouldn’t be so inclined to look for it elsewhere.
Please note that I am NOT saying physicians are evil or stupid. What I AM saying is that too few of them understand much about nutrition or inflammatory processes in the gut and many of them practice exactly as they were trained, in a medical model focusing on identifying diseases after they’ve developed and then treating symptoms with drugs or surgery while ignoring what’s producing those symptoms – and this is not helping us get or stay well.
This Western Medical approach also costs a bundle of money and causes a lot of unnecessary suffering.

 

(Source: cabralwellnessinstitute.com)
(Source: cabralwellnessinstitute.com)

 

 

 

 

 

 

 

TESTS FOR GLUTEN SENSITIVITY AND ALLERGY

 

 

(Source: www.amymyersmd.com)
(Source: www.amymyersmd.com)

 

Specter writes, “At present, there are no blood tests, biopsies, genetic markers, or antibodies that can confirm a diagnosis of non-celiac gluten sensitivity.” This claim is  incorrect.
An example: Cell Science Systems is a company offering a blood test for food sensitivity/intolerance and celiac disease risk factors.
From the Cell Science Systems website:

CSS has developed the only gut health profile (GHP) that evaluates the GI tract on a genetic, antibody and cellular level. Nowhere else can you test specific genetic predisposition to celiac disease as well as antibody testing and immune system activation to food sensitivities. Understand your genetic based risk of celiac disease

  • Non celiac reactions to gluten, known as Test for Food Sensivity/intolerance
  • Determines genetic based risk for celiac disease
  • One simple blood draw
  • Comprehensive genetic, antibody, and cellular analysis

Celiac disease (CD) is an autoimmune condition affecting children and adults. When people with CD eat foods that contain gluten, it creates an immune-mediated toxic reaction that causes damage to the small intestine and does not allow food to be properly absorbed. Even small amounts of gluten in foods can affect those with CD and cause health problems. Damage can occur to the small bowel even when there are no symptoms present. Celiac disease affects about 1 in 133 people, or close to 1% of the population. However, few people – some estimates are as few as 5% of the total – know they have the condition.

Test for Food Sensivity, also known as non-celiac Test for Food Sensivity or sometimes gluten intolerance, has been recently recognized as a stand-alone condition by the medical community. Many believe that Test for Food Sensitivity involves a different immune system reaction than celiac disease. A team of researchers, led by Dr. Alessio Fasano, hypothesizes that a person with Test for Food Sensitivity experiences a direct reaction to gluten – i.e., your body views the protein as an invader and fights it with inflammation both inside and outside your digestive tract.

Food sensitivity/intolerance is a non-IgE mediated reaction involving the innate immune system’s response to foods that are otherwise safe. The Alcat Test is considered the, “gold standard” laboratory method for identification of non-IgE mediated reactions to over 400 different foods, chemicals, and other categories of substances. It is a functional response test and captures the final common pathway of many of the pathogenic mechanisms, immunologic, toxic, and pharmacologic, that underlie non-IgE mediated reactions to foods and chemicals.

 

 

 

 

 

(Source: lactosesintolerances.blogspot.com)
(Source: lactosesintolerances.blogspot.com)

 

 

 

COMMON SYMPTOMS ASSOCIATED WITH GLUTEN INTOLERANCE AND SENSITIVITY (Camp, 2012) (EnteroLab, 2014)

GI: Digestive problems, abdominal pain, bloating, gas, diarrhea, constipation, irritable bowel
Physical and Neurological: Headaches, cognitive impairment, brain fog, mood swings, depression, ADHD-like behavior
Bones and Joints: Osteoporosis, fractures, bone and joint pain
Skin: Eczema, psoriasis, rashes, easy bruising
Reproductive: Hormone imbalances, menstrual irregularities, infertility
General: Chronic fatigue, weight loss or gain

This table from the Wall Street Journal differentiates between gluten sensitivity, wheat allergy and celiac disease.

 

against-the-grain

 

 

GLUTEN FREE PROCESSED FOODS

Specter expends some energy attacking the gluten free foods industry. I have to agree with him here. Of course trying to replace gluten-containing foods with a bunch of seemingly familiar gluten-free substitutes isn’t going to improve anyone’s health. As he points out, processed foods loaded with sugar, fats, non-gluten-containing refined carbohydrates and salt are quite just plain unhealthy.

 

 

(Source: simplypurelyhealthy.wordpress.com)
(Source: simplypurelyhealthy.wordpress.com)

 

What’s needed is a return to eating real, unprocessed, nutrient-filled, non-GMO  foods grown without a load of toxic pesticides.

 

 

 

 

 

WHAT COULD IT BE IN GLUTEN THAT’S CAUSING SO MANY PEOPLE TO REACT BADLY TO IT?

 

Specter poses the reasonable question, “How could gluten, present in a staple food that has sustained humanity for thousands of years, have suddenly become so threatening?” After going through some possible clues to answering his question, he ends up focusing on what he calls “gluten anxiety” and classifies it as a food fad.
He says, “Doctors rarely diagnose non-celiac gluten sensitivity, and many don’t believe that it exists.” He goes on to quote Joseph A. Murray, a professor of medicine at the Mayo Clinic and president of the North American Society for the Study of Celiac Disease: “Everyone is trying to figure out what is going on, but nobody in medicine, at least not in my field, thinks this adds up to anything like the number of people who say they feel better when they take gluten out of their diet. It’s hard to put a number on these things, but I would have to say that at least seventy percent of it is hype and desire. There is just nothing obviously related to gluten that is wrong with most of these people.”
Specter also interviewed Peter H. R. Green, MD, Director of The Celiac Disease Center at Columbia University and Professor of Clinical Medicine at Columbia University, and Attending Physician at the New York-Presbyterian Hospital. Dr Green is recognized as a prominent celiac doctor. Green told Specter, “In the absence of celiac disease, physicians don’t usually tell people they are sensitive to gluten. This is becoming one of the most difficult problems that I face in my daily practice.”
Dr Green then goes on to rail against  chiropractors and psychiatrists who suggest giving up gluten to their patients to see if their symptoms reduce.
It seems both Specter and Dr Green are unaware that many chiropractors are highly trained in diagnosing and treating a wide variety of health problems – including digestive issues, allergies and food sensitivities, autoimmune conditions, chronic inflammation, migraines, sinus and respiratory problems, insomnia and other sleep problems, thyroid conditions, elevated cholesterol, fertility problems, PMS, PCOS, and symptoms that are unresolved after repeatedly seeking help from MDs.

 

 

 

(Source: becuo.com)
(Source: becuo.com)
Specter and Dr Green also seem oblivious to the existence of research on the connections between the probiotics in our intestinal microbiota and mental health. Here are a few examples, including one specifically about gluten and mental health:

Selhub et al. (2014). Fermented foods, microbiota, and mental health: ancient practice meets nutritional psychiatry

Ji, S. (2013). 60 Years of Research Links Gluten Grains to Schizophrenia

Bested et al. (2013). Intestinal microbiota, probiotics and mental health

In fact, it’s likely that the future of psychotropic medicine will be diet and microbes like probiotics, not pharmaceuticals. We’re learning that what we eat and the micro-organisms living inside our guts strongly influence both our mental and physical health.
Pharmaceuticals given for problems like depression and anxiety work this way:

 

(Source: drsaulmarcus.com)
(Source: drsaulmarcus.com)

 

 

Symptom suppression certainly doesn’t address the underlying causes of anything. Correcting imbalances in the gut microbiome does. And also, as anyone who’s ever taken pharmaceuticals knows, they’re sort of poisonous – producing “side effects”. Working to get your gut bacteria and the other micro critters in there to work well addresses your health problems directly and doesn’t involve introducing any poisons.
Stay tuned – there’s some exciting research underway now on the gut microbiome and all that it influences.

 

(Source: tv.greenmedinfo.com)
Kelley Brogan, MD. (Source: tv.greenmedinfo.com)
Kelly Brogan, MD, is a psychiatrist who has looked extensively at the literature on gluten’s effects on the brain. She points out that gluten produces considerable inflammation in the body. It is well known that chronic inflammation leads to all sorts of autoimmune diseases and other serious problems. Her excellent and informative article This Is Your Gut (and Brain) on Wheat lays out a clear explanation of what happens in the body when it consumes gluten. Specter and Green’s annoying comments about psychiatrists who talk about gluten with their ailing patients aside, I highly recommend taking a look at this short article. (Brogan, 2013)

 

 

And-then

So back to Specter’s question from the beginning of this section:  What could have turned gluten into a widespread, serious health problem in the US in recent years.
Here’s a likely answer: the widespread use of the toxic chemical glyphosate.

 

 

(Source: gmo-awareness.com)
(Source: gmo-awareness.com)

 

 

Even though wheat is not a genetically modified crop, Monsanto’s glyphosate-containing weed killer, Roundup, is widely used on wheat fields before harvests to ‘dry down’ the wheat and even organic wheat fields are often  contaminated with glyphosate from poor farming practices.  (Shilhavy, 2014)
From Shilhavy’s article, ALERT: Certified Organic Food Grown in U.S. Found Contaminated with Glyphosate Herbicide:

In fact, beer brewers are having a problem with glyphosate. A few years ago, when one of my colleagues wanted to get more Abraxis test strips for testing materials for glyphosate residue, he was told that they had a 3 month backlog. He asked, what was causing this? He was told that every load of malt barley coming out of North Dakota has to be tested, because the glyphosate levels were so high that it kills the yeast in the brew mix.

 

 

contaminated_wheat_grain

 

 

The graph below plots celiac incidence against the use of glyphosate on wheat crops  between 1990 and 2010. You can see the two rising in tandem.  In fact, the connection between glyphosate and celiac disease correlates to a greater degree than glyphosate usage on either corn or soy, crops which are largely genetically modified to be able to tolerate heavy applications of Roundup.

 

Celiac Incidence/ Glyphosate Applied to Wheat 1990-2010

(Sources: USDA:NASS, CDC. Figure courtesy of Nancy Swanson)
(Sources: USDA:NASS, CDC. Figure courtesy of Nancy Swanson)
This graph appears in an article called Glyphosate, pathways to modern diseases II: Celiac sprue and gluten intolerance published in the journal Interdisciplinary Toxicology.  (Samsel & Seneff, 2013)
From the article’s abstract:

Celiac disease, and, more generally, gluten intolerance, is a growing problem worldwide, but especially in North America and Europe, where an estimated 5% of the population now suffers from it. Symptoms include nausea, diarrhea, skin rashes, macrocytic anemia and depression. It is a multifactorial disease associated with numerous nutritional deficiencies as well as reproductive issues and increased risk to thyroid disease, kidney failure and cancer. Here, we propose that glyphosate, the active ingredient in the herbicide, Roundup(®), is the most important causal factor in this epidemic. Fish exposed to glyphosate develop digestive problems that are reminiscent of celiac disease. Celiac disease is associated with imbalances in gut bacteria that can be fully explained by the known effects of glyphosate on gut bacteria….  Deficiencies in tryptophan, tyrosine, methionine and selenomethionine associated with celiac disease match glyphosate’s known depletion of these amino acids. Celiac disease patients have an increased risk to non-Hodgkin’s lymphoma, which has also been implicated in glyphosate exposure. Reproductive issues associated with celiac disease, such as infertility, miscarriages, and birth defects, can also be explained by glyphosate. Glyphosate residues in wheat and other crops are likely increasing recently due to the growing practice of crop desiccation just prior to the harvest…. We conclude with a plea to governments to reconsider policies regarding the safety of glyphosate residues in foods.

I also recommend taking a look at this article: Why the Use of Glyphosate in Wheat Has Radically Increased Celiac Disease (Mercola, 2014)

 

Stephanie Seneff, PhD, Senior Research Scientist at M.I.T.
Stephanie Seneff, PhD, Senior Research Scientist at M.I.T.

 

 

 

 

 

AND BTW, THERE’S EVIDENCE THAT SIMPLY AVOIDING GLUTEN DOESN’T SUFFICE FOR HEALING CELIAC DISEASE (Reasoner, 2014)

Here’s a shocker that challenges current medical advice for celiacs –
The University of Chicago’s Celiac Disease Center, one of the US’s leading treatment and research center for Celiac Disease, reports:

“While healing may take up to 2 years for many older adults, new research shows that the small intestines of up to 60% of adults never completely heal, especially when adherence to the diet is less than optimal.”

If you’re struggling with celiac disease, you might want to read Jordan Reasoner’s interesting article The Gluten-Free Lie: Why Most Celiacs are Slowly Dying.
From Reasoner’s article:

Conventional medicine usually works like this…

I have a problem, the doctor figures out what the problem is, and gives me a conventional prescription generally supported by Doctors, researchers, and the FDA.

This prescription is supposed to be relatively safe and effective in accordance with the laws in the United States and most modern countries.

But what if the conventional prescription doesn’t work?

Like people with Celiac Disease that follow a strict gluten-free diet and don’t get better….

 

Only 8% of Adult Patients Healed on a Gluten-Free Diet…

A 2009 study in The Journal of Alimentary Pharmacology and Therapeutics looked at 465 Celiac Disease patients and found only 8% of adult patients reached “histological normalization” after following a gluten-free diet for 16 months, meaning their gut tissue completely recovered to that of a healthy person. The authors stated:

“Complete normalization of duodenal lesions is exceptionally rare in adult coeliac patients despite adherence to GFD”

These people followed a strict gluten-free diet for 16 months and most didn’t heal their gut. The success rate of the conventional Celiac Disease prescription isn’t working… and the research is exploding the truth.

Another 2010 study in the American Journal of Gastroenterology looked at 381 adults with biopsy-proven Celiac Disease. The authors found small intestine mucosal recovery occurred in only 34% of participants following a gluten-free diet for 2 years. They concluded:

“Mucosal recovery was absent in a substantial portion of adults with CD after treatment with a GFD.”

 

65% of Gluten-Free Celiacs Still Have a Raging Fire in Their Gut

The same 2009 study in The Journal of Alimentary Pharmacology and Therapeutics of 465 Celiac Disease patients 16 months gluten-free found that 65% still had “persistent intraepithelial lymphocytosis,” a.k.a. inflammation in the gut.

 

This is highly significant. It is well known that gut inflammation is associated with a huge variety of health issues, including all the autoimmune diseases and cancer. So if celiacs follow their doctors’ advice and only avoid gluten but are still at high risk for  chronic  gut inflammation, they are definitely not healed and will never achieve good health.
Again from Reasoner’s article:
56% Have Poor Vitamin Status After 10 Years Gluten-Free

A 2002 study in the of Alimentary Pharmacology and Therapeutics looked at the vitamin status of 30 adults with Celiac Disease showing “biopsy-proven remission,” after following a gluten-free diet for 8-12 years. They found that 56% had poor vitamin status, suggesting that proper nutrient uptake is not occurring. The authors concluded that:

“It is generally assumed that coeliac patients adhering to a strict gluten-free diet for years will consume a diet that is nutritionally adequate. This is supported by the demonstration of a normal bone mineral density up to 10 years of dietary treatment. Our results may indicate otherwise. We found signs indicative of a poor vitamin status in 56% of treated adult coeliac patients.”

Even after following the conventional Celiac prescription for 10 years, 56% still showed signs of poor nutrient uptake – meaning their digestive system still isn’t working like it’s designed to.

That means after 10 years of being gluten-free, HALF of all Celiacs are likely starving for the critical nutrients required for health and longevity. It’s no wonder we have a 77X increased risk for lymphoma.

 

 

(Source: whole9life.com)
(Source: whole9life.com)

 

 

(Source: www.precisionnutrition.com)
(Source: www.precisionnutrition.com)
The Gluten-Free Diet Doesn’t Fix Leaky Gut
Reasoner discusses the role of gliadin (gluten is comprised of gliadin and glutenin in equal parts) in initiating leaky gut* by increasing the zonulin** protein in celiacs. Zonulin levels do fall in celiacs following a strict gluten free diet – but a gluten free diet doesn’t eliminate leaky gut. Gluten free celiacs continue to have elevated levels of zonulin compared to non-celiacs.

 

(Source: www.radiancehealthcenter.com)

* Leaky Gut Syndromes are clinical disorders associated with increased intestinal permeability. These disorders include inflammatory and infectious bowel diseases, chronic inflammatory arthrititis, cryptogenic skin conditions like acne, psoriasis and dermatitis herpetiformis, many diseases triggered by food allergy or specific food intolerance, including eczema, urticaria, and irritable bowel syndrome, AIDS, chronic fatigue syndromes, chronic hepatitis, chronic pancreatitis, cystic fibrosis and pancreatic carcinoma.  (Galland, undated)

 

 

(Source: healthbeginsathome.com)
(Source: healthbeginsathome.com)

 

** Zonulin is a protein that modulates the permeability of tight junctions between cells of the wall of the digestive tract. (Wikipedia, 8/21/14)

I highly recommend looking at Reasoner’s site for information on what, besides avoiding gluten, is necessary to fix Leaky Gut Syndrome.
Dr Galland’s piece on LEAKY GUT SYNDROMES: BREAKING THE VICIOUS CYCLE is a bit technical and was apparently posted in the early 1990s but even if you skip over those parts, you’ll learn a great deal about how to protect or restore your health.

 

 

(Source: www.drsharma.ca)
(Source: www.drsharma.ca)

 

 

 

REFERENCES

Bested, A.C. et al. (2013). Intestinal microbiota, probiotics and mental health.Gut Pathogens, 5:3 See: http://www.gutpathogens.com/content/5/1/3

Brogan, K. (2013). This Is Your Body (and Brain) on Gluten. See: http://www.greenmedinfo.com/blog/your-body-and-brain-gluten

Camp, M. (2012). The Difference Between Gluten Sensitivity and Celiac Disease. See: https://drmorgancamp.wordpress.com/tag/gluten/

Cell Science Systems. (2014). Test for Food Sensivity/intolerance and celiac disease risk factors with one convenient laboratory test. See: https://www.alcat.com/landing/gluten-sensitivity-test.php

EnteroLab. (2014). Which Test to Order. EnteroLab: Specialized Laboratory Testing for Optimal Intestinal and Overall Health. See: https://www.enterolab.com/staticpages/testtoorder.aspx

Galland, L. (undated). LEAKY GUT SYNDROMES: BREAKING THE VICIOUS CYCLE. See: http://www.mdheal.org/leakygut.htm

Hatfield, H. (2014). Hidden Sources of Gluten: How to recognize gluten that’s not obvious on the label. WebMD. See: http://www.webmd.com/diet/features/hidden-sources-of-gluten

Mercola, R. (2014). Why the Use of Glyphosate in Wheat Has Radically Increased Celiac Disease. See: http://articles.mercola.com/sites/articles/archive/2014/09/14/glyphosate-celiac-disease-connection.aspx?e_cid=20140914Z1_SNL_Art_1&utm_source=snl&utm_medium=email&utm_content=art1&utm_campaign=20140914Z1&et_cid=DM55859&et_rid=658330142

National Foundation for Celiac Awareness. (2014). Gluten in Medications: NFCA and the Pharmaceutical Industry. See: http://www.celiaccentral.org/gluteninmeds/Pharmacy/321/

Reasoner, J. (2014). The Gluten-Free Lie: Why Most Celiacs are Slowly Dying. SCD Lifestyle. See: http://scdlifestyle.com/2012/03/the-gluten-free-lie-why-most-celiacs-are-slowly-dying/

Samsel, A. & Seneff, S. (2013). Glyphosate, pathways to modern diseases II: Celiac sprue and gluten intolerance. Interdisciplinary Toxicology, 6(4):159-84. See: http://www.ncbi.nlm.nih.gov/pubmed/24678255

Selhub, E.M. et al. (2014). Fermented foods, microbiota, and mental health: ancient practice meets nutritional psychiatry.Journal of Physiological Anthropology, 33:2. See: http://www.jphysiolanthropol.com/content/33/1/2

Shilhavy, B. (2014). ALERT: Certified Organic Food Grown in U.S. Found Contaminated with Glyphosate Herbicide. HealthImpactNews.com. See: http://healthimpactnews.com/2014/alert-certified-organic-food-grown-in-u-s-found-contaminated-with-glyphosate-herbicide/

Specter, M. (2009). Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives. http://www.amazon.com/dp/1594202303/ref=cm_sw_su_dp

Specter, M. (11/3/2014). Against the Grain: Should you go gluten-free? The New Yorker. See: http://www.newyorker.com/magazine/2014/11/03/grain

Wikipedia. (8/21/2014). Zonulin. See: http://en.wikipedia.org/wiki/Zonulin

 

 

© Copyright 2014 Joan Rothchild Hardin. All Rights Reserved.

 

DISCLAIMER:  Nothing on this site or blog is intended to provide medical advice, diagnosis or treatment.