The Gist on Gluten
by Colleen Baxter
"All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident." ~Arthur Schopenhauer, German philosopher (1788 - 1860)
The New England Journal of Medicine has listed 55 diseases that can be linked to gluten, and more recent studies indicate a link to over 300 illnesses. This includes ALL autoimmune diseases, thyroid disorders, Leaky gut, Schizophrenia, Autism, Alzheimer's, ADD/ADHD, Diabetes, Cancer, Lymphoma, Lupus, Multiple Sclerosis, Fibromyalgia, skin rashes and breakouts, Depression, and the list goes on and on. It’s often the cause of many symptoms such as irritable bowel, constipation, diarrhea, hives, brain fog, nausea, vomiting, consistently sick, chest pain, dairy intolerance, sugar cravings, other food sensitivities, bone pain, growth issues, menstrual problems, mood disorders, chronic fatigue, sleep disorders, sexual dysfunction, infertility, obesity, and more (1). So why is it that after so many years of domesticating and consuming grains, that now it seems to be the latest 'trend' to forgo this category of sustenance? The story of how a class of food long revered as "the staff of life" can quickly become touted as toxic to a mass population, is complex and controversial and requires insight into modern agriculture, biochemical individuality and expression, and an open and investigative perspective. In order to fully understand and accept this ideology, we must delve into the myriad of contributing factors.
Agriculture and Evolution:
Evolutionarily speaking, we have been around for almost two million years, we adopted grains approximately 8,000 years ago, but it takes the human genome approximately 40,000-50,000 years to adapt to a new food (2). Additionally, todays grains are nothing like the grains from our past. We have hybridized our grains to produce higher yields and have a much higher gluten content. Our ancestors also soaked, sprouted, leavened, and fermented their grains to further improve their digestibility. We know today that grains contain toxic ‘anti-nutrients’ that if not neutralized by proper preparation methods, inhibit mineral absorption and protein digestion, cause inflammation, suppress thyroid function, dis-regulate hormone levels, and cause many other harmful effects upon the body (3).
Genetics and Bio-individuality:
Current research suggests that approximately 60% of the population actually has a genetic predisposition for prompting an immune response by producing antibodies in response to a gluten exposure (4). However, Epigenetics tells us that our genes account for only 5-10% of our health, and a growing body of research is demonstrating the wide array of ill-effects gluten has on the human body, despite presence of these gluten related genes. We are all bio-individually unique, meaning that no food or substance will affect us all in the same way. For some, a food allergy or toxic exposure will cause gastrointestinal problems, for another it affects the brain, or the hormones, or the joints, etc. A 2009 study in the Journal of the American Medical Association (JAMA Sept 16; 302(11):1171-8) found that those with celiac disease or gluten sensitivity (diagnosed or undiagnosed) had a significantly higher risk of death, particularly from heart disease and cancer; so comorbidity and epigenetics is key to understanding this condition.
Standard American Diet:
For the majority of humanity's existence we have thrived and evolved on a more paleo/primal lifestyle, eating that which is directly from nature. The introduction and domestication of grains led to this cheap and densely caloric food source becoming a significant portion of our dietary intake. Processed foods with extended shelf lives and enhanced flavors engineered to have the most addictive potential, enticed us to further move away from our natural source of nutrients, leading to the plethora of diseases increasingly evident in our culture today. The result of this hyper-exposure of sugar, refined carbohydrates, inflammatory foods, and environmental toxins leads to the perfect storm for the body to develop conditions such as Leaky Gut. Dr. Alessio Fasano is a pioneer in the field of gluten research and discovered, of many things, the production of Zonulin by the body in response to gluten. This enterotoxin regulates the permeability of the intestinal wall, causing it to 'leak'. Undigested food proteins, bacteria, viruses, and yeast can then escape into the blood system through the inflamed cell walls of the small intestine. The body recognizes these proteins as foreign invaders and mounts an immune response, causing further inflammation throughout the body, setting the stage for various disorders.
Gluten and the Brain
Despite common misconception, gluten sensitivity can affect any organ in the body, without having any intestinal discomfort or irritability. In fact, evidence is mounting that the nervous system is actually the prime site of gluten damage! When antibodies of the immune system are released and come into contact with an antigen or protein to which an individual is intolerant or allergic, it activates an inflammatory cascade, releasing cytokines, which happen to be particularly highly antagonistic to the brain and pivotal players in neurodegenerative conditions (5). Important to understand, our gut is considered our second brain, as it is a key producer of essential neurotransmitters or brain chemicals; so inflammation in the gut affects our brain. The same triggers that impede blood brain barrier activity, impede intestinal permeability; whether you have an immunological response to gluten or not, it triggers the release of zonulin which compromises the barrier of the gut and brain (6). And last but not least, regardless of an individual's known sensitivity, gluten has an addictive affect on the brain. Gluten contains peptides called exorphins or gluteomorphins, which affect the opiate receptors in our brain just like a drug (7). This is why we fear going gluten free like it is an impossible and unwanted task, and even sometimes experience withdrawal symptoms, as these morphine-like compounds are no longer being consumed and hitting the reward centers of our brain.
Believe you’ve already been tested for gluten sensitivity and are fine? Current standard blood tests to identify an immune reaction to wheat or gluten only screens for one peptide of wheat (gliadin). Yet people can react to a single peptide in wheat, or a combination of many proteins, peptides, and enzymes associated with wheat (see graphic). Most standard testing is not sensitive or comprehensive enough to detect a true result, in fact they produce false-negatives 75% of the time. The only effective blood test for twelve of the most antigenic (most likely to provoke a reaction) pathogens associated with wheat are available through Cyrex Labs (8). Any elevation of antibodies (IgA anti-gliadin antibodies, IgG anti-gliadin antibodies, IgA anti-endomysial antibodies, Tissue transglutaminase antibody, and Total IgA antibodies) is significant and worthy of a trial of gluten elimination. This lab also offers cross-reactive food sensitivity testing which is highly important to identify once gluten sensitivity has been identified.
Unfortunately most, if not all, available testing is expensive and often inconclusive of truly identifying your unique gluten sensitivity. Therefore, the cheapest and most effective way to test whether you have gluten sensitivity is to completely cut it out of your diet for at least a 2-4 week period. This means removing ALL traces of gluten from your diet 100%, no exceptions, no hidden sources, such that is found in many sauces, dressings, vitamins, etc. Then after this time frame, try some gluten and note how your body, mind, mood, and energy feel after the exposure. If gluten sensitivity, leaky gut, or autoimmunity is determined, it would be ideal to work closely with a physician who has received the necessary training and has the required skill to help patients with healing the gut; you can find a list of qualified doctors here.
Can I have gluten sometimes?
According to the journal Lancet (Vol 358, August 4, 2001) in gluten sensitive individuals (including undiagnosed) non adherence to the gluten free diet, defined as eating gluten once-per-month increased the relative risk of death by 600%. So the next time you try to rationalize that “one little piece of bread”, is it really worth the gamble?" The Journal of Neurology, Neurosurgery and Psychiatry (1997; 63; 770-775) states clearly: “Even minute traces of gliadin (gluten) are capable of triggering a state of heightened immunological activity in gluten sensitive people”, meaning prolonged inflammation and other symptoms; this inflammatory cascade can literally even take months or years in some to abate. Saying you’ve eliminated “most” gluten from your diet is a bit like saying you’re just “a little bit pregnant”. Either you are or you’re not; unfortunately there are no in-betweens. So make it a lifestyle change, focus on what you CAN have not on what you CAN'T, seek resources and support, and most of all, have fun with it!
There is no need to feel alone or frightened, in all honesty there is no one for whom gluten containing foods are actually necessary or even healthy, but there are millions upon millions of people worldwide who suffer veritable consequences connected to gluten. Fortunately the list of gluten free foods is actually longer than the list of gluten containing foods, and the gluten free products market has been growing at an exponential rate. There are tons of helpful resources out there to aid in this healthy lifestyle change but it can still be overwhelming and confusing, so don't hesitate to contact me for one on one guidance and recommendations!
References and Links for Further Information:
1) Farrell RJ, Kelly CP. Celiac sprue. N Engl J Med. 2002 Jan 17;346(3):180-8. Review.
2) Villoldo, Alberto. "Shamanic Biohacker with Alberto Villoldo." Interview by Dave Asprey. Audio blog post. https://www.bulletproofexec.com/transcript-79-shamanic-biohacker-with-alberto-villoldo/.
3&4) Daniel Auer, MD, Understanding Gluten and the Effects of Grain Based Diets. http://www.doctorauer.com/history-of-gluten-grain-based-diets/.
5) David Perlmutter, MD, Grain Brain (New York: Little, Brown and Company, 2013), 45-67.
6) Nora Gedgaudas. "Food For Consciousness with Nora Gedgaudas." Interview by Dave Asprey. Audio blog post. 20:30. https://www.bulletproofexec.com/food-for-consciousness-with-nora-gedgaudas-podcast-136/.
7) Natasha Campbell-McBride, MD, Gut and Psychology Syndrome: Natural treatment for Autism, Dyspraxia, ADD, Dyslexia, ADHD, Depression, Schizophrenia, (UK: Medinform Publishing, 2004), 53-54.
8) Tom O'brien, MD. The Conundrum of Gluten Sensitivity: Why the Tests are Often Wrong. http://cdn.thedr.com/wp-content/uploads/2014/08/The-Conundrum-of-GS-FINAL-8_4_14.pdf
Additional Recommended Books and Sites:
For a listing of common places gluten is found click here!
Dr. Tom O'brien's website is filled with great information, resources, and references.
The Gluten Summit amazing downloadable interviews with 29 experts on the topic of Gluten. Produced by Dr. Tom O'brien.
Green Med Info list of studies and articles relating to gluten here
The Body Ecology Diet by Donna Gates
Wheat Belly by Dr. William Davis
Dr. Alessio Fasano of Boston's Center for Celiac Research and Treatments has written extensively on gluten sensitivity and how it can even mimic other disorders. Visit his website and access his publications here.
Dr. David Perlmutter is a renowned neurologist whose expertise includes gluten issues, brain health & nutrition, and preventing neurodegenerative disorders. Visit his website here.
http://www.westonaprice.org. Search 'gluten' for articles in relation to.
Dr. Rodney Ford, New Zealand, regarding gluten research.
http://www.celiaccentral.org has tons of information, resources, printouts, etc greatly beneficial for anyone avoiding gluten.