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Celiac Disease, Gluten Sensitivity, and Gluten Intolerance

Many people cringe at the thought of giving up mouth-watering pastries, breads, and pasta. However, while most people are aware of the pleasure these foods provide, they are unaware of how these common foods can create havoc in the body. This is due to their gluten content.

Celiac disease is an allergy to wheat that creates damage to the small intestine when one has been exposed. It can cause an instantaneous negative response in the gastrointestinal system and chronic digestive and health issues. With this in mind, it is easy for one to understand why one with this disorder has to avoid gluten products.

Gluten sensitivity, on the other hand, is not an allergic response, but can cause just as many health complications as celiac disease. Symptoms can seem unrelated to gluten ingestion and make it difficult for a sufferer to track why they feel so lousy. This negative response is due to the fact that it up regulates a specific immune reaction (the innate response) that differs from celiac disease (which includes both the adaptive and innate response).

Gluten intolerance, another term in our gluten repertoire, differs in both celiac disease and gluten sensitivity in that it is a non-immune reaction. It can result from a variety of disorders. These include disorders of digestion, genetic and enzymatic disorders, and toxic exposures in food.

Celiac disease is estimated to effect 1.8 percent of people in Western cultures and some estimate gluten sensitivity to effect as much as 30 to 40 percent of all people. However, some clinicians and researchers feel that everyone is effected by gluten.

An expert commentary in Medscape further suggested that this problem may be more prevalent than what was once thought. Dr. Brown’s review on this subject states the importance of including this disorder in a clinician’s differential diagnoses. The article states:

“The first step is to agree that gluten sensitivity is emerging as a serious problem. Creating criteria for the condition is the next step, followed by research to determine its prevalence, and adding gluten sensitivity to the medical insurance list of coded conditions.”

Another commentary by Dr. Johnson continued on the various mechanisms behind gluten intolerance. This included the immune response as well as its relationship to possible changes in gut microbiome and the resultant indigestible carbohydrate by-products. Still, the underlying issue of the fact that it does exist is important:

But for people with non-celiac gluten sensitivity, it remains to be seen how much of an antigenic response will be necessary to truly make the patient feel better. I think it’s real. We need to pay attention, we need to be a little bit more pragmatic, and our patients will benefit from this as we learn.

Dr. Alessio Fasano, a researcher in the area of celiac disease at Massachusetts General Hospital, is one researcher that feels that gluten sensitivity is present in mostly everyone. This is due to the fact that whenever the intestine is exposed to gluten, a protein, found in wheat, barley and rye, it produces a substance called zonulin.

This release of zonulin causes our gut’s immune system to be activated and results in inflammation and tissue damage to the intestinal lining, making it more permeable. Furthermore, other toxicants present in the body, such as chlorine or certain medications, can speed up this process. This means that undigested food particles, various undigested toxicants, or microbes from our gut can be released systemically. This causes a variety of symptoms in different organ systems or glands because the immune system is reacting to the offending circulating molecules via an attack on these newly released compounds. It can result in autoimmune disease when the immune system becomes so determined to protect us, it also attacks the tissues gluten is attached to in order to fully rid us of the toxicants.

So, gluten can be a pretty scary thing. Why do people still consume it? As mentioned in the intro, it is because of those mouth-watering pastries, breads, and pasta, which can be addictive.

Addictive Properties of Gluten:

Gluten can cause the release of high levels of the excitotoxic l-aspartic and l-glutamic amino acids, similar to the molecules aspartame and monosodium glutamate. This can create excessive excitation and create inflammation in the brain, making it more permeable to undigested proteins. Furthermore, it can cause the undigested proteins, gliadomorphins, which make one addicted to the substance. This makes gluten hard for most to give up, even if they know it is harmful. As some clinicians say, “this makes the gut a lot like Reno, what happens in the gut, doesn’t stay in the gut.” Gut issues can cause changes in your brain.

Dr. Perlmutter, a top functional medicine neurologist, was recently interviewed by Dr. Mercola. He has studied the connection of grains and their negative impact on brain health, including Alzheimer’s disease. He further expanded on this gut-brain connection:

“We now understand that the so-called blood-brain barrier, or that barrier that keeps things out of the brain where they don’t belong, is also affected by gluten, according to new research. It’s a very exciting time when we recognize that our biggest exposure to the environment is actually the lining of our intestines – not our lungs, not our skin. We are in fact very much dependent on the microbiota, the bacteria living in the gut, to maintain our health.”

According to Dr. Perlmutter, much of our current disease burden stems from the fact that we are contaminating our immune systems with proteins to which the human immune system has never, in the history of humankind, been previously exposed to. While not discussed in this interview, a MAJOR factor is the development of genetically engineered (GE) grains, which are now pervasive in most processed foods sold in the US. These GE crops create proteins never before encountered in any natural grain or food, so GE grains deliver a double-whammy against your immune system. Food allergies clearly appear to be one of the most noticeable side effects of a GE-grain diet.

My Recent Non-Love Affair with Gluten

I had the unfortunate incident this past month of experiencing a wide range of seemingly “unrelated” symptoms from an accidental ingestion of gluten. I didn’t realize my “new favorite hummus” was “processed in a facility that included wheat, gluten, and soy.” Yes, even this doctor gets hooked and may forget to read the fine lines.

I recommend many of my clients to go “gluten-free” due to my personal and clinical experience of the power of avoiding this grain that seems to aggravate so many conditions. For me, it can range from weird sensations in my muscles, pain in my joints, or skin irritation. Not fun and thank goodness for supplements to calm down an accidental ingestion. However, the clean up and going through the process hasn’t been worth a moment of mouth-watering on the lips for me.

For tips on how to gently release the food addictive-stress patterns and more on “leaky gut syndrome”, read here.

Sources:

Syer Ji. Opening Pandora’s BreadBox. GreenMedInfo.com

NEJM. Celiac Disease: The Villian Unmasked? 348:2573, June 19, 2003 Clinical Implications of Basic Research

David A. Johnson, MD. Going Gluten-Free: Value Beyond Celiac Disease? Medscape Gastroenterology > Johnson on Gastroenterology.Mar 04, 2013. http://www.medscape.com/viewarticle/780029?src=wnl_edit_specol

Kaushal K. Prasad, et al. Review Article: Hepatobiliary Disorders in Celiac Disease: An Update. J of International Journal of Hepatology. Volume 2011 (2011), Article ID 438184, 7 pages. http://dx.doi.org/10.4061/2011/438184

Brown, A. Gluten Sensitivity: Problems of an Emerging Condition Separate From Celiac Disease.Expert Review of Gastroenterology and Hepatology. Medscape.com http://www.medscape.com/viewarticle/757916_8

Decreased levels of heat shock proteins in gut epithelial cells after exposure to plant lectins.Gut. 2000 May;46(5):679-87.PMID: 10764712

Mercola, J. How to Prevent Alzheimer’s Disease—A Neurologist Speaks Out. September 29, 2013. Mercola.com. http://articles.mercola.com/sites/articles/archive/2013/09/29/dr-perlmutter-gluten.aspx