It seems like “gluten-free” is the marketing buzz term of the moment. It’s in the news and labeled on products all over the grocery store. But, what is gluten and why is it affecting so many people? We’ll address the issue of gluten in this issue, help you determine the symptoms of gluten intolerance and suggest what you do to determine if you are sensitive to gluten.
Gluten is a protein found in some grains such as wheat, rye, and barley. Though it was once thought to be very rare (1 in 2200 people), Celiac Disease, a genetic intolerance to gluten, has become more common over the past few decades (1 in 100 people). In certain Western European populations, Celiac Disease is found 3 to 6 times more commonly (up to 1 in 17 people)! Blood tests can determine if you have genetic Celiac Disease.
The issue with gluten intolerance is that it creates irritation and inflammation in your small intestine which damages the lining. This prevents the small intestine from absorbing adequate nutrients to keep us healthy. In addition, it creates a break in the barrier between our intestines and the rest of our body. Food proteins that our body is not used to seeing get into our bloodstream and cause our body’s defense system to think that we are being invaded by a dangerous enemy. These food proteins may look very similar to our organs such as thyroid, pancreas and nerve cells. We make antibodies against those proteins because we think we need to protect ourselves. However, these antibodies can start attacking our healthy cells and create a number of problems.
Symptoms of gluten intolerance are varied and depend on what organs are being attacked by the antibodies. Many people experience diarrhea, gas, bloating and fatigue. However, severe untreated Celiac Disease can cause symptoms like failure to thrive in children, other autoimmune illnesses, osteoporosis, infertility and neurological diseases. Treatment is recognizing the disease and removing all gluten from the diet.
You don’t have to have the gene for celiac disease to have problems tolerating gluten. An estimated 10-15% of the population has a form of gluten intolerance called nonceliac gluten intolerance. This is not a true food allergy so the symptoms are more subtle. They may include: sinus congestion and stuffiness, fatigue, “brain fog” or difficulty concentrating, headaches, stomachaches, rashes, joint aches and autoimmune diseases. Also, there is an increase in nonceliac gluten intolerance in those with autoimmune thyroid disease due to cross reactivity of the anti-thyroid antibodies with those produced by antibodies to the various food proteins seen in gluten intolerance. In addition, there is an increase in Celiac disease and nonceliac gluten sensitivity in those with Type 1 diabetes AND their families (mom, dad, siblings and children). If you’re being treated for thyroid disease or Type 1 diabetes and are finding, even with the right medications, that the disease is difficult to control, you may have a superimposed gluten intolerance.
The best way to determine your sensitivity is to completely stop all gluten for 30 to 60 days and pay close attention to how you feel. Many people realize that they no longer have headaches, gas, bloating or the other symptoms previously listed. I have had a number of patients lose 5-10 ponds as well! Then, you can reintroduce a food that contains gluten and see how you feel. Keep in mind you need to consume gluten only 10 to 15 days to maintain symptoms of gluten intolerance, so if you don’t see a difference in the way you feel, make sure that you’re extremely careful about reading labels. Gluten is contained in many things, particularly prepared foods and sauces, so it’s easy to accidentally take in gluten without knowing it.
The best way to avoid gluten is to focus on whole foods such as meats, fruits, veggies, healthy fats, nuts and seeds. Additionally, look for foods labeled “gluten-free.” There really is a much wider selection nowadays, but be careful to read the labels for additives. Acceptable grains include: amaranth, brown rice, gluten-free oats, quinoa and sorghum. Grains and foods to avoid include: bagels, breads, breakfast cereals, cookies, foods containing refined white or wheat flour and sugar, pastas, pastries and processed grains.