Part I: Fad or Legitimate Health Concern?

There is so much talk today about gluten; gluten-free products and labels are emerging everywhere.  Is it a fad or is gluten sensitivity a legitimate health concern?  I have attended several professional conferences in the past several months on various health topics; in each conference gluten was singled out by the presenter to be the single most destructive whole food that we consume in our diet. (Note that I said “whole” food – there are many dangerous non-food chemicals in our food system that are equally destructive.)  This article is the first in a series entitled “Understanding Gluten Intolerance.”  Here are some basics of the why and how of gluten intolerance.

What is Gluten? A protein in the grains wheat, rye, barley, spelt.

What is Gliadin? An amino acid component of gluten which triggers the immune response.

How is Gluten/Gliadin destructive?

The gliadin molecule sticks to certain tissues in the body.  Usually it sticks to the upper small intestine, but it also easily crosses into the blood stream and can stick to many places in the body.  If a person’s body makes anti-gliadin antibodies, the body will mistake healthy tissue that has gliadin attached to it as a foreign invader, and the immune system will attack the cells that have the gliadin attached as well as neighboring cells.  This activation of the immune system in the areas where gluten is attached is called “inflammation.” It is also called “autoimmunity” because the immune system is unnecessarily attacking its own tissue.  This leads to:

1) Malabsorption – inability to absorb vitamins and minerals even if they are plentiful in the diet

2) Ulceration – causing “leaky gut”

3) Weakening of mucous defense – permitting more direct exposure to other toxins and infections.

Antibodies may also attach to gliadin in the bloodstream.  The antibodies attached to gliadin cause clumps that collect in capillaries leading to skin conditions such as Dermatitis Herpetiformis or may collect in other parts of the body such as joints causing arthritis or in the thyroid causing Autoimmune Thyroiditis.  In any autoimmune condition (Crohns Disease, Diabetes, Rheumatoid Arthritis, Hashimoto’s, Dermatitis Herpetiformis, Asthma, Eczema, Multiple Sclerosis, Fibromyalgia, Alzheimer’s, Parkinson’s Disease, etc.) it is very likely that a sensitivity to gluten is the original cause of the onset of inflammation.

Gluten Intolerance is technically a food allergy because it involves the immune system attacking components of food. But it is not the immediate kind of food allergy that you see with peanuts and shellfish that can be life threatening.  It is more insidious as it involves the antibodies IgA and IgG which cause a delayed reaction.

In my practice I take my patients off gluten if there is ANY digestive complaint whatsoever, also if there is a history of autoimmune disease or thyroid dysfunction.  As well, if one has an unexplained health complaint, or if their doctor tells them they are “normal” in terms of physical exam and labwork, but they just don’t feel like themselves, I will take them off gluten to see if they feel better, have improved energy, sleep better, etc.  As with any kind of allergy, a gluten intolerance can catch up with one later in life.  The body can manage some inflammation for so long, but once a certain threshold of inflammation is reached, which will be different for everyone, the scales become tipped and the body is thrust into a state of imbalance.

Diagnosing gluten intolerance with testing can be tricky and will be discussed further in upcoming article “Part II: Diagnosing Gluten Sensitivity.”  The best place to start exploring a gluten sensitivity is with a 3 week elimination of gluten followed by a reintroduction at the end.  This will be discussed further in “Part III Gluten Elimination and Reintroduction.”

Upcoming articles:

Understanding Gluten Intolerance Part II: Diagnosing Gluten Sensitivity

Understanding Gluten Intolerance Part III: Gluten Elimination and Reintroduction

Understanding Gluten Intolerance Part IV: Living with a Gluten Free Diet in a Gluten-Full World