Gluten-Free?

In the early 2000s, I had rediscovered my profound interest in neuroendocrinology (NE). Specifically the NE of stress. This lead me to study functional medicine and incorporate this into my practice of traditional Chinese medicine. By 2006 I had ordered lab-tests for hundreds of patients to test for adrenal fatigue and thyroid disorders. I tested most of these patients for gluten and soy sensitivities. and was surprised by how many tested positive for one or the other.

After finally ordering a test for myself I found my own sensitivity score for gluten to be very high. Two weeks after eliminating gluten and soy from my diet my chronic post-nasal drip, bloating, digestive upsets, and eczema completely disappeared. The chronic inflammation in my lower back had improved at least 80%. I have a fractured spine since childhood that never fully healed. With resulting arthritis and disc herniations, 80% improvement was pretty spectacular to me.

Is Gluten bad?

In recent years there has been great debate around the issue of gluten in our diets. This discussion goes beyond people who have a wheat allergy or are affected by Celiac disease. Many people report feeling better on a gluten-free diet despite not being diagnosed with a gluten-related disorder. Some proclaim it to be the miracle cure for weight-loss and low energy levels. Others say the issue lacks empirical evidence, write it off as a fad, scientifically unfounded, and claim that any “health benefits” experienced are nothing but a simple placebo effect. But why would so many people volunteer to undergo a diet that is not only pretty inconvenient but also more expensive? The truth is that many people actually do better on a gluten-free diet and I am one of them.

The Center for Celiac Research estimates that in the US at least 3 million people suffer from Celiac disease. Around 1 million suffer from a wheat allergy, and at least 20 million from gluten sensitivity. There are tests to determine the first two gluten-related diseases. But according to the experts, there’s no test available to accurately check for gluten-sensitivity at this point. This will probably change soon but currently, the only way to find out is by completely eliminating gluten from the diet. And gluten is in many more things then you’d believe. People with gluten-sensitivity can also react to other foods or drinks. This is why it is important to consult with a specialized healthcare provider to point these foods out.

Divided Opinions

What is it with gluten that makes this issue so heavily debated? One issue is that at least an estimated 24 million people suffer from gluten-related disorders in America. But only a fraction of those has been diagnosed. Just for Celiac disease alone, there is an average delay in diagnosis of 10-12 years from the onset of symptoms. Currently, there are no accurate and approved tests available to confirm gluten-sensitivity. Because doctors and mainstream science are just starting to catch on, patients have been largely experimenting on their own.

Another reason is that the complementary medicine community identified and promoted the concept of gluten-intolerance well over a decade before some pioneering scientists actually verified it. Those scientists were in the minority back then and did not get a lot of attention from the mainstream. Many desperate patients that were not diagnosable started trying a gluten-free diet and experienced improvements as gluten’s popularity increased. Their doctors usually wrote this off as a placebo.

Scientific papers were published on this topic as early as 1980. In 2003 researchers from the Center of Celiac Research established that the rate of Celiac disease in the US was nearly a hundred times greater than the previous estimate.  In 2010 Dr. Alessio Fasano, Professor of Pediatrics at Harvard Medical School and founder of the Center for Celiac Research documented Gluten-Sensitivity (GS). In 2013 the same scientists published another paper documenting the spectrum of three major gluten-related disorders – Celiac disease, wheat allergy, and gluten sensitivity.

In my opinion, by 2013 it should have been clear to medical professionals and scientists that the gluten-free movement was not a fad but fact. But still, I welcome the long-due change in sentiment now.

A Rise in Gluten-Related Diseases

There have been many theories about why gluten-related problems have increased so much. One common theory is that the genetic modification of wheat caused a problem. But the spike in gluten-related problems started even before the introduction of genetically modified wheat.

Another theory is that the processing of wheat has changed a lot in recent decades, which makes it less digestible. Some people believe we shouldn’t even ingest wheat because until 10,000 years ago before we developed agriculture, we did not eat wheat at all. Most scientists agree here that wheat is actually very hard for the body to digest. Some think that the body can’t digest it at all and that humans, therefore, shouldn’t eat it. While there’s some truth to that, the majority of people do not seem to suffer any negative consequences from ingesting wheat though.

Then there are pesticides. In 2014 Stephanie Seneff, a senior research scientist at MIT, published a paper linking glyphosate to many adverse health effects including the development of autism and gluten-sensitivity. Glyphosate is an herbicide discovered by Monsanto and used in Roundup to facilitate wheat harvest. Dr. Seneff was harshly criticized for her paper. The way she was so heavily criticized made me suspicious that she was probably onto something.

The Microbiome

And then there is the human microbiome. Scientists at the Center for Celiac Research seem to hypothesize that there are many genes that could potentially affect the release of zonulin. Zonulin is a protein regulating small-intestinal permeability. In some individuals, gluten causes an excess in the release of zonulin making the small intestines hyper-permeable thus causing autoimmune disease and leading to systemic inflammation.

Certain HLA-genes are known to cause a massive release of zonulin when individuals ingest gluten. HLA-genes are usually found in people with Celiac disease. But there are most likely other genes we have not yet identified that can affect the release of zonulin. And there are probably more substances like zonluin we will discover in the future. This hypothesis would also account for the impact pesticides and certain medications like antibiotics could have on the development of gluten-sensitivity.

Compared to our ancestors our gut-microbiome is 30% less diverse. This is due to the overconsumption of processed foods, antibiotics, and anti-bacterial products. I believe that the change in our gut-microbiome is probably an important piece in explaining the increase of gluten-related disorders. We know that it is largely our gut-microbiome that regulates our genes and immune systems.

What are the Symptoms of Gluten-Related Diseases

There are currently three known gluten-related disorders – Celiac disease, wheat allergy, and gluten sensitivity. Celiac disease is an autoimmune disease, wheat allergy an allergic reaction mediated by IgE, and gluten-sensitivity an IgG-mediated reaction. Although Celiac disease and gluten-sensitivity share many symptoms, symptoms of gluten-sensitivity are usually less severe and come on very slow.

The body also does not attack itself with gluten-sensitivity. Chronic inflammation destroys the lining of the small intestines in Celiac disease. Reactions in wheat allergy come on very fast and can be quite severe. In general IgE-mediated reactions (allergies) come on fast, can be quite severe, but do not last as long. IgG mediated reactions (sensitivities) come on slow and are usually much less severe. But one exposure to something the body is sensitive to can cause an inflammatory reaction that can last for up to 3 months.

Common Symptoms of Celiac Disease:

• Abdominal bloating and pain
• Diarrhea
• Vomiting
• Constipation
• Pale, foul-smelling stool
• Anemia
• Fatigue
• Osteoporosis
• Infertility or miscarriage
• Mouth ulcers
• Tingling, numbness in the hands and feet
• Itchy skin rash
• Depression, irritability, poor memory, and trouble concentrating
• Slowed growth or even failure to thrive in children
• Pitted, grooved, discolored, or poorly formed teeth in children

Symptoms of Wheat Allergy:

• Swelling, itching or irritation of the mouth or throat.
• Hives, itchy rash or swelling of the skin.
• Nasal congestion.
• Headache.
• Difficulty breathing.
• Cramps, nausea or vomiting.
• Diarrhea.
• Anaphylaxis.

Gluten-Sensitivity – Prevalence of Common Symptoms (Center for Celiac Research):

• Abdominal Pain (70%)
• Eczema (40%)
• Rash (35%)
• Migraine Headaches (35%)
• Foggy Mind (34%)
• Chronic Fatigue (33%)
• Diarrhea (33%)
• Depression (22%)
• Anemia (20%)
• Tingling of Fingertips (20%)
• Joint Pain (11%)