Most people never suspect that the common foods they eat at every meal may be undermining their health or prevent them from losing weight. One out of every three people that have an illness may have gluten sensitivity, also known as gluten intolerance. As many as 6-10% of the population in general are gluten sensitive.
Foods that contain gluten include bread, pasta, bagels, crackers, cookies, most processed food and any food that contains wheat, rye, or barley. Oats contain gluten, but is merely cross contaminated with high levels of gluten during processing and transportation. An endless list of symptoms and diseases accompany gluten sensitivity, which may be completely relieved by eliminating gluten-containing foods. Given the fact that gluten, of any food, is the highest correlated with disease, it’s a good idea to reconsider including it in your diet.
What is Gluten?
Gluten (the Latin word for glue) is the primary protein found in wheat. Gluten is hard to digest and often passes through the stomach undigested. When there is low stomach acid (quite common), gluten enters the small intestine undigested, where it causes intestinal irritation. This inflammation can contribute to all kinds of health conditions. A recent study shows that even people without gluten intolerance or celiac disease suffer inflammation after consuming gluten.
The reason so many people are sensitive or intolerant to gluten is in part due to the fact that grains are a relatively new introduction into the human diet, only having begun cultivation 10,000 years ago. We are not well adapted to eating grains such as wheat, barley, and rye in the mass quantities (at almost every meal) that we do today because evolutionarily these grains were only available seasonally if at all. That doesn’t mean some people can’t eat them. It just means not everyone can handle grains.
Wheat grown in the US is a hybrid developed specifically to increase the gluten content so that baked goods will have more puff and fluffiness. The more fluffy your bread, the more gluten it contains. Hybridization to increase gluten content has made it the most indigestible flour in the world. Fluffy muffins and bread turn into a gluey, irritating mass in the small intestine, causing inflammation.
Gliadins are molecules found in gluten that frequently cause toxic reactions that trigger your immune response. When gliadin in gluten becomes water-soluble, it is free to binds to cells in your body. If you are sensitive, your body will make antibodies to gliadin and attack the cells gliadin has attached itself to, treating those cells as an infection. This immune response damages surrounding tissue and has the potential to set off, or exacerbate, many health problems throughout your body, which is why gluten can have such a devastating effect on your overall health.
Gluten Chemistry Lesson
Chris Kresser, L.ac, explains the complex issues of gluten better than I:
Wheat contains several different classes of proteins. Gliadins and glutenins are the two main components of the gluten fraction of the wheat seed. (They’re essential for giving bread the ability to rise properly during baking.) Within the gliadin class, there are four different epitopes (i.e. types): alpha-, beta-, gamma- and omega-gliadin. Wheat also contains agglutinins (proteins that bind to sugar) and prodynorphins (proteins involved with cellular communication). Once wheat is consumed, enzymes in the digestive tract called tissue transglutaminases (tTG) help to break down the wheat compound. In this process, additional proteins are formed, including deamidated gliadin and gliadorphins (aka gluteomorphins).
Here’s the crucial thing to understand: Celiac disease is characterized by an immune response to a specific epitope of gliadin (alpha-gliadin) and a specific type of transglutaminase (tTG-2). But we now know that people can (and do) react to several other components of wheat and gluten — including other epitopes of gliadin (beta, gamma, omega), glutenin, WGA and deamidated gliadin — as well as other types of transglutaminase, including type 3 (primarily found in the skin) and type 6 (primarily found in the brain).
This is a huge problem because conventional lab testing for CD and of gluten intolerance only screens for antibodies to alpha-gliadin and transglutaminase-2. If you’re reacting to any other fractions of the wheat protein (e.g., beta-gliadin, gamma-gliadin or omega-gliadin), or any other types of transglutaminase (e.g., type 3 or type 6), you’ll test negative for CD and gluten intolerance no matter how severely you’re reacting to wheat.
Symptoms of Gluten Sensitivity
There are many symptoms of gluten sensitivity:
- Carbohydrate cravings
- Digestive problems like bloating, gas, cramps, constipation or diarrhea
- Malnutrition – vitamin or mineral deficiencies
- Arthritis and joint pain
- Weight gain/weight loss
- Psychological problems like mood swings, depression, manic-depression, and schizophrenia
- Neurological symptoms similar to multiple sclerosis and other nerve disorders
- Rashes and eczema-like skin symptoms
- Food allergies
- Brain fog, poor memory and concentration
- Adverse pregnancy outcomes
Conditions Linked to Gluten Sensitivity
Gluten intolerance can affect nearly every tissue in the body, including the brain, skin, endocrine system, stomach, liver, blood vessels, smooth muscles and even the nucleus of cells. Celiac Disease and Non-Celiac Gluten Sensitivity are associated with an astonishing variety of diseases, from schizophrenia and epilepsy, to Type 1 diabetes and osteoporosis, to dermatitis and psoriasis, to Hashimoto’s hypothyroidism to peripheral neuropathy. Because the range of symptoms associated with gluten intolerance is so broad and nonspecific (e.g., can be attributed to any number of conditions), many patients and doctors don’t suspect gluten may be the cause.
According to researcher Dr. Kenneth Fine, MD, certain populations are at greater risk for developing gluten sensitivity. Gluten sensitivity may occur in 1 out of every 2 people with these conditions:
- Relatives of gluten-sensitive individuals
- Chronic diarrhea of unknown origin
- Irritable bowel syndrome
- Inflammatory bowel disease
- Microscopic colitis
- Gastroesophageal reflux disease
- Hepatitis C
- Autoimmune liver disease
- Chronic liver disease
- Any autoimmune syndrome
- Diabetes mellitus, type 1
- Rheumatoid arthritis
- Sjogren’s syndrome
- Autoimmune thyroid disease
- Dermatitis herpetiformis
- Chronic Fatigue
- Iron deficiency
- Short stature in children
- Down’s syndrome
- Mothers of kids with neural tube defects
- Female infertility
- Peripheral neuropathy
- Cerebellar ataxia
- Seizure disorders
- Psychiatric disorders
The Range of Gluten Sensitivity
Gluten issues can range from very mild sensitivity to an outright intolerance like celiac disease. Every person is different, so you have to find out for yourself where you lie on the spectrum. A recent study shows that even people without gluten intolerance/sensitivity or celiac disease suffer inflammation after consuming gluten.
Gluten Sensitivity. Also called Gluten Intolerance or Non Celiac Gluten Sensitivity (NCGS). NCGS may occur in as many as 6-10 out of 100 Americans. When you eat food that to which you are sensitive, it causes a series of negative biochemical reactions in your body, especially in your digestive tract and immune system. If you are sensitive to gluten, a serious amount of damage may occur in your body long before there are visible symptoms. This damage won’t necessarily be limited to your digestive system. Some of it may not be reversible. The insidious nature of gluten is that the damage often occurs silently and goes unrecognized for a very long time.
Gluten and Food Allergies. Gluten is highly allergenic and will frequently keep your immune system in overdrive by continually triggering the inflammatory response. Many people mistakenly do a skin test with their immunologist to see if they are allergic to gluten. Food sensitivities to gluten will not always show up on a typical allergy skin test, as the allergic reaction is in the gut. What will show up is a wheat allergy, but gluten sensitivity is not an allergic reaction. It is an autoimmune reaction. Autoimmune reactions differ in that your body, in its response to gluten, attacks itself. A different immune mechanism, the innate immune response, comes into play in reactions of gluten sensitivity, as opposed to the long-term adaptive immune response that arises in celiac disease.
Rye, barley, and oats contain less gluten than wheat. All four were originally grasses. If you are allergic to grass, you likely have to cut out all these grasses from your diet. These grains, whether whole or refined, all harbor the binding protein called gluten, which can inflame the gut to the point of causing leaky gut (think microscopic holes in the gut).When the gut is inflamed and leaky, food can’t be properly broken down and digested, nutrients from food don’t absorb well, and malnutrition sets in. When the gut is leaky, undigested large food particles leak through the intestinal wall, prompting a response from the immune system, which can create many food allergies that would otherwise not affect you. When you stop eating gluten and the gut lining becomes sealed again, the food allergies caused by the leaky gut will likely disappear. For complete info on healing a leaky gut, see The Body Ecology Diet or Gut and Psychology Syndrome.
On rare occasions an individual may experience significant improvement within weeks of eliminating gluten from their diet. But in other cases people may feel considerably worse upon initially starting a gluten-free diet. This is due to withdrawals of the heroin-like drugs in gluten. This can also be due to other unidentified food allergies and food sensitivities — a problem that plagues about 75 percent of the population. In fact, food cravings can often serve as a gauge of food sensitivity. Craving gluten foods or dairy, for example, can be an indication that you are sensitive to that food, especially if you crave it but then feel worse after eating it.
Celiac Disease (CD). Celiac Disease is a complete intolerance to gluten, as the body’s immune response attacks the nutrient absorbing villi in the small intestine, causing permanent damage. It’s generally accepted that one in 133 people have celiac disease, a genetic condition resulting in intestinal damage whenever they ingest gluten. Celiac disease is quite severe and can even lead to death if the person does not completely eliminate gluten from the diet.
Gluten and Fatigue
Among the first things that gluten-containing grains, particularly wheat, can eliminate are your energy and vigor. If you keep a food log, you may find that you routinely get lethargic and unfocused after a meal that contains these grains. How do you feel after a plate of pasta? a bowl of cereal? a sandwich? a burrito?…Sleepy? Feel as if you swallowed a brick? Does your stomach ache?
One of my clients went off gluten for ten days, then brought a piece of bread to work to eat at lunch. Her co-workers came looking for her a half-hour later and had to shake her awake! I was very surprised to find that I’m gluten intolerant. After I eat it, I feel bloated or have a stomachache for hours and feel very sleepy — almost to the point of passing out. I always thought this is just how you feel after you eat!
Chronic exhaustion caused by gluten intolerance is the reason behind why some people become addicted to stimulants like diet pills, cocaine, speed, and caffeine. These people may no longer feel the need for their drugs when they quit eating gluten and experience their own natural energy surging back. Gluten consumption exhausts the adrenal glands, which long-term can burn them out and cause fatigue. For more information about if your fatigue is being caused by adrenal exhaustion, see my article Epidemic Adrenal Fatigue.
Gluten and Food Addiction
Many have problems with starches, especially gluten-laden white flour, white-sugar starches like bread, pasta, cookies, and cakes. The eating of these foods is connected to blood-sugar imbalances, hormonal imbalances, nutritional imbalances and depression. Starchy foods are the number-one choice to “calm and comfort.” One name for this addiction is “starchaholic.” Additional symptoms of starchaholics include an immediate clarity that they feel when they have their sweet or starch, which moves to confusion; and changes in mental state from well-being to negativity and depression, from peaceful to aggressive, from a sensitive, tuned-in person to one who is numb, from energetic (which may happen initially for a few minutes to one half-hour or an hour) to lethargic.
Gluten can affect the brain like a drug. The gluten in many grains, when not digested properly, turn into substances, called gluteomorphins, with similar chemical structures to opiates, such as morphine and heroin. Quite a lot of research has been done in this area, where gluteomorphins have been found in the urine of patients with schizophrenia, autism, ADHD, postpartum psychosis, epilepsy, Down’s syndrome, depression, and autoimmune diseases like rheumatoid arthritis. These gluteomorphins are why you may ‘love’ and feel comforted by your beloved bread or pasta. As a result, gluten is one of the few food substances that can actually create a full-scale addiction. Allergic and sensitive people may actually feel a tired and headachy withdrawal reaction for a few days after going off gluten.
These opioids are clearly connected to the addictive eating patterns associated with grains. In America, people have starchy foods as often as three times a day, and even more as snacks. As people begin to withdraw from starches, many feel emotional pain associated with the withdrawal, creating a tremendous drive to have that piece of cake or pizza in order to feel better. The most common tip-off sign of being a starchaholic is the frequent consumption and powerful cravings for starches, or falling asleep after a binge. There is a tendency in starchaholics to put on a significant amount of weight, as the constant release of insulin (the fat storage hormone) instructs the body to store fat.
Gluten and Mental Health
Depression and manic-depression can result when the nutrients responsible for regulating our moods can’t be absorbed, namely the amino acids from animal proteins. Dozens of studies confirm that depression and other mental health disorders are a common symptom of gluten intolerance, ones that may disappear when wheat and gluten grains are withdrawn. Anxiety, depression, manic-depression, Tourette’s Syndrome, schizophrenia, ADD, ADHD, epilepsy, autism and other neurological problems have shown improvement with the elimination of gluten-containing grains.
People with gluten sensitivity have low levels of the antidepressant, anti-anxiety brain chemical serotonin. Due to the malabsorption and other gut problems (i.e. bad bacteria overgrowth) gluten-containing foods can cause in these people and the fact that 95% of serotonin is made in the gut, it is vitally important that depressed or mentally ill individuals assess if they are gluten sensitive. Ironically, low serotonin levels can cause you to turn to sugar and carbohydrates for relief, exacerbating your condition further. The reason being is that when we ingest sugar or carbohydrates, insulin is released and clears all the sugar and amino acids out of the blood stream, except for tryptophan, the precursor to serotonin. Tryptophan easily gets in the brain, with no competition from other aminos, and serotonin is boosted temporarily. Soaring serotonin levels depend upon a healthy gut. You may want to focus on having a healthy gut before turning to anti-depressants like SSRI’s, which deplete serotonin levels in the long-term.
Other Gluten Facts
Gluten-related health issues may not show up for years or can result in sub-clinical health conditions (where a doctor does not see a reason to treat it). When disease does finally manifest, the connection to gluten can be easily overlooked or denied, as most doctors don’t consider nutrition in their diagnosis of a patient. Gluten sensitivity is related to a whole range of health issues:
- There are 35 diseases that can be caused by eating gluten listed in a review in the New England Journal of Medicine. Some of these symptoms are arthritis, ADHD, depression, anxiety, IBS, lupus, headaches, fatigue, eczema, loss of muscle coordination, osteoporosis, a weak immune system, fungal overgrowth (candiasis), organ inflammation, weight loss/weight gain, and malnutrition.
- Gluten is purposefully put in some products because it increases hunger signals to make you eat more of a product by increasing ghrelin — the hormone that stimulates hunger — leaving you craving more of that product. Gluten also interferes with leptin — the hormone that signals your brain that you’re full and signals the break down of fat.
- Gluten sensitivity increases your risk for type 1 diabetes, obesity, gastrointestinal cancers, brain disorders, and autism.
- Bowel problems, including IBS and an increased incidence of colon cancer, are common symptoms of gluten sensitivity.
- Gluten sensitivity has been associated with autoimmune thyroid disease. It has been found that people with significant sensitivity to gluten also develop a significant allergy to their own thyroid, which disappears when the gluten is removed for 3-6 months.
- Gluten sensitivity causes inflammation that harms the body tissues by causing an autoimmune response where the immune system ends up attacking the body. This can result in a diagnosis of multiple sclerosis, other nerve disorders, and many diseases. The elimination of gluten can clear your symptoms!
- C-reactive proteins rise in response to inflammation than can be caused by gluten, causing cholesterol levels to shoot up and calcium deposits to harden the arteries and blood pressure to rise. This means that gluten and grains cause high cholesterol, hardening of the arteries and heart disease!
- Gluten has been found to play a critical role in the cancer process.
- Gluten is an excitotoxin, which like glutamate (think MSG), activates, irritates and damages brain cells. A 2006 study took 131 children with ADHD and removed gluten from their diets. All 131 children were reported to have significant improvements.
- With gluten, the N Methyl D Aspartate receptors cause spinal cord neurons to become hyper to touch. Leptin in the spinal cord normalizes pain perception and gluten interferes with that process (think fibromyalgia).
- Gluten sensitivity causes you to miss out on your fat soluble vitamins like vitamin D and K.
- Eating gluten has now been related to bone density problems (think osteoporosis). Your body is robbed of minerals and vitamins in order to metabolize flour and gluten-containing grains.
Testing for Gluten Sensitivity
Most conventionally trained physicians only test for celiac disease, the most serious form of gluten sensitivity. Celiac disease is typically only diagnosed after there is serious damage to the small intestine (80% loss of villi). Therefore, your primary care physician or gastroenterologist will be of little or no help to you if you merely have gluten sensitivity.
Current diagnostic practice embraces the ridiculous idea that until an intestinal biopsy shows structural damage, no diagnosis or therapeutic intervention is offered. With newly developed diagnostic tests, you can diagnose a gluten sensitivity or celiac disease before the end stage tissue damage has occurred, that is “before the villi are gone,” with the idea of preventing all the nutritional and immune consequences.
Elevated anti-gliadin antibodies are an indication of gluten sensitivity. Many people who test positive for anti-gliadin antibodies will never test positive for celiac disease, but may have gluten sensitivity and develop an array of health problems. Ten to twenty-five percent of North Americans (28 – 70 million people) have elevated anti-gliadin antibodies in a blood sample, but don’t exhibit visible damage in the small intestine. Despite elevated anti-gliadin antibodies, many people are routinely told by their doctors that they don’t have celiac disease and that they can continue eating gluten. Research now shows that a portion of these people have Latent Celiac Disease. They went on to develop active celiac disease because they followed their physician’s advice and continued to eat gluten.
Many people that are sensitive to gluten have no symptoms, so it is advised to test for antibodies if you suspect gluten sensitivity or just to rule it out. The best lab for testing for gluten sensitivity and celiac disease is called Cyrex Laboratories. They offer the most comprehensive blood tests which screens for all of the wheat and gluten proteins and transglutaminase enzymes. This can be a helpful diagnostic tool to find out if you have antibodies to gluten and it’s proteins. It is the only lab I can recommend, as most other labs only check for antibodies to one gluten protein, which clearly is not comprehensive enough.
One must remember that the absence of anti-gliadin antibodies in the blood does not indicate an absence of gluten sensitivity or celiac disease, especially in the early stages or mild forms of the disease.
Gluten Elimination Diet
If you can’t afford testing, you can try a “gluten challenge.” This involves removing gluten from the diet completely for a period of at least 30 days, and then adding it back in after that. If symptoms improve during the elimination period, and return when gluten is reintroduced, a diagnosis of NCGS can be made.
If you do not have the money for testing, you can do a two-week gluten elimination diet. Eat no foods that contain gluten for 30 days, then do a ‘challenge’ where you eat gluten-containing foods for a couple of days and see how you feel. If gluten is the cause of your bad moods, low energy, and stomachaches, you’ll usually feel better within two weeks once you stop eating it. But these symptoms will all return if you start eating these grains again.
Unfortunately, most people don’t feel better immediately after eliminating gluten from their diets as it may take 30 to 90 days for the inflammation to subside and the gluten antigens to be eliminated from your body. It may take up to 9 to 12 months for the lining of your small intestine to heal if you have leaky gut syndrome caused by gluten. After 6 to 9 months of being gluten-free, most people with gluten sensitivity will enjoy noticeable physical, mental, and emotional changes.
However, for many people a gluten-free diet isn’t enough. Some grains that don’t contain gluten, such as corn, oats and rice, contain proteins that are similar enough in structure to gluten to elicit an immune response in people with CD or NCGS. In addition, about 50 percent of patients with CD show signs of intolerance to casein, the protein in milk. This may explain why up to 30 percent of CD patients continue to have symptoms or clinical signs after adopting a gluten-free diet. For this reason, I recommend a completely grain- and dairy-free diet during the gluten elimination diet.
In addition, confounding factors like multiple food allergies or sensitivities can mask gluten sensitivity. For instance, if you eliminate gluten from your diet but don’t feel better, this does not necessarily mean you’re not gluten sensitive. This could mean that you are also allergic to soy or eggs, for instance, but are still eating these foods while doing the gluten elimination. In this case, you may need to do a full elimination diet and challenge test of common foods that cause food sensitivities. For more information, read my article Food Sensitivities Make You Sick and Fat.
The Gluten-Free Diet
Usually, when you remove allergenic foods such as gluten from your diet, your cravings for sweets will diminish, your mood will improve, your weight will drop, and your overall health will soar. The following chart is based on the 2006 American Dietetic Association recommendations for a gluten-free diet. This list is not complete, so people with celiac disease should discuss gluten-free food choices with a dietitian or physician who specializes in celiac disease.
corn and cornmeal
Indian rice grass
Gluten free oatmeal
|FOODS TO AVOID|
triticale (a cross between wheat and rye)
|OTHER WHEAT PRODUCTS TO AVOID|
|PROCESSED FOODS THAT MAY CONTAIN WHEAT, RYE, OR BARLEY|
brown rice syrup
cold cuts, hot dogs, salami, sausage
imitation fish or meat
|seasoned tortilla chips|
soy sauce (gluten free tamari is ok)
vegetables in sauce
Have you had health problems related to gluten sensitivity? Did you cure them by going gluten-free? Tell me your story by leaving a comment below. I want to hear your story!
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