Are you Gluten Sensitive?

November 19, 2009 at 1:22 pm Leave a comment

Another Great Article from Precision Nutrition

The At-Home Test For Gluten Sensitivity
by Bryan Walsh, November 18th, 2009.

Everywhere you look, there’s a ton of discussion about gluten and gluten sensitivity. In fact, PN’s very own Ryan Andrews wrote a great article – All About Gluten – just a few weeks back.

But is gluten sensitivity really something you need to be concerned with? Or is it merely a “Hollywood fad” that’ll disappear as quickly as it came?

Well, a host of new research studies suggest that this whole gluten thing can be a pretty big deal. In fact, emerging research on gluten and its negative impacts on health, including brain function, is starting to look kinda scary.

Quick Gluten Review

Gluten is a sticky protein found in a number of grains that helps bind things together. Basically, it’s the “glue” that helps bread hold its shape, stops sauces from curdling, and gives cheese spreads, canned meats and many condiments their smooth texture.

Gluten is ubiquitous in our food supply today and is found in everything from oats, bran and cereal – to the not so obvious – ketchup, soy sauce, chewing gum and salad dressing. Truthfully, if you eat any type of processed food, you’re likely eating gluten.

For more on what gluten is and where it’s found, check out Ryan’s article here.

Interestingly, gluten-free foods are one of the fastest growing sectors in the nutritional world today – and with good reason. If you’re sensitive to gluten, yet continue to consume products that contain it, there is a strong likelihood that some aspect of your health will suffer.

Celiac Disease vs. Gluten Sensitivity

Before discussing gluten sensitivity in depth, some distinction should be made between it and its cousin, Celiac disease. Celiac disease is an autoimmune condition affecting numerous systems in the body. But its main target is the digestive tract.

Gluten sensitivity on the other hand simply implies that there is some type of immune reaction occurring to gluten in the diet. For you clinical types, this immune reaction can be detected by anti-gliadin antibodies in the serum, stool or saliva.

In the end, the primary difference between the two is whether or not there is intestinal damage.

Gluten sensitivity + Intestinal damage = Celiac Disease

Gluten sensitivity + No intestinal damage = Gluten Sensitivity

Now, you might think that gluten sensitivity only occurs in a small percentage of the population, just like with Celiac Disease. If so, you might be surprised to learn that in non-celiac disease patients, anti-gliadin antibodies can be found in as high as 35 percent of the population.

Gluten and Your Health

The seriousness of gluten sensitivity – with respect to everyday health concerns, as well as some atypical health issues issues – can’t be overstated. Really, it’s a big deal. But instead of taking my word for it, let’s take a look at some of the research.

Gluten and Women
Women with gluten sensitivity were found to have a higher incidence of stillbirths, spontaneous and repeated abortions, late onset of menarche, amenhorhea (no menses), anemia, and early menopause.

Because of the potentially negative impact of gluten on women’s hormone and reproductive system, one study recommended “celiac disease should be included in the screening of reproductive disorders.”

Gluten and Mood Disorders
Schizophrenia and depression have been linked to gluten sensitivity. In fact, gluten sensitivity seems to be a causative factor for schizophrenia in patients genetically susceptible to the condition.

In one study, “A drastic reduction, if not full remission, of schizophrenic symptoms after initiation of gluten withdrawal has been noted in a variety of studies.”

Gluten and Your Brain
Gluten has particular reactivity to our nervous system and is no longer considered to be a gut issue. Our brain and nervous system governs our perception, mood and quality of life. When our nervous system deteriorates, our life deteriorates.

Research has correlated gluten sensitivity to seizures, neuropathies, ADHD, Alzheimer’s, MS, migraines and even EEG anomalies (brain wave abnormalities).

One study concluded, “Gluten sensitivity can be primarily, and at times exclusively, a neurological disease.”

Gluten and Metabolism
Gluten sensitivity has been correlated with decreased absorption of critical minerals, such as zinc.

Zinc absorption occurs in the small intestines (duodenum and jejunum), the two areas most affected by celiac disease lesions. Researchers conclude, “These observations indicate that trace metal deficiency is another common nutrition complication of adult celiac disease.

Zinc has an important role in a variety of functions including our immune system, hormone production, brain function, taste, smell and our digestive function.

Gluten and Bone
There are numerous studies showing a link between gluten sensitivity and bone loss. Numerous mechanism have been proposed, including decreased calcium absorption. Researchers determined “Continuing long-term benefit of gluten withdrawal on bone metabolism in celiac patients.”

Gluten, Blood Sugar and Diabetes
Both Type 1 and Type 2 diabetes have been linked to gluten. “This population-based study showed the highest reported prevalence of celiac disease in Type 1 diabetes in Europe. Patients with celiac disease showed clinical improvements with a gluten-free diet (GFD). We recommend screening for celiac disease in all children with type 1 diabetes.”

Gluten and Behavior Disorders
Partial peptide digests of gluten, called “exomorphins” have been shown to have psychoactive properties that have morphine-like properties in the body and brain. Studies have shown abnormal blood flow patterns in the brain in celiac patients at rates similar to ADHD children. Also, celiac disease has been found more frequently in children with dyslexia.

There are literally hundreds more studies demonstrating the negative impacts of gluten in susceptible individuals to virtually every aspect of their physiology.

That’s right, this isn’t some fly-by-night, tree-hugging, tie-dye T-shirt wearing hippy craze. Gluten sensitivity is very real and causing major health issues for a growing number of people, even if they don’t have symptoms – yet.

At Home Gluten Testing
As highlighted above – gluten isn’t something we should all be frightened of. After all, only about 35-40% of the population may experience gluten sensitivity. So please don’t get the idea here that I’m suggesting we all start on 100% gluten-free diets immediately.

However, and here’s the crux of the issue, many of us simply don’t know whether we fall into the 60-65% of the population that can tolerate gluten or into the 35-40% of the population that can’t. So it’s important that we find out.

Fortunately, there are numerous ways of getting tested, the best of which (at least, at the present) seems to be a combination of stool and saliva testing through a company called EnteroLab (www.enterolab.com).

And here’s the cool part. You can actually do the test yourself. You simple order a test kit through the company’s website, perform the tests yourself at home, send the kit back to the lab, and receive the results a few weeks later.

Of course, it’s beyond the scope of this article to go into interpreting the test here, but should you look into this kind of testing, the tech support available at Enterolab will be able to help you with your results.

The Gluten-Free Lifestyle

So let’s say you do the test and determine that you’re sensitive. What’s next? Well, you’ll have to cut all gluten out of your diet.

But deciding to go gluten-free isn’t a simple lifestyle change. It is more akin to a meat-eater deciding to become vegetarian. Gluten is so pervasive in our society, it takes a conscious effort to avoid it. And, because many of our comfort foods are full of gluten, it requires a change in perspective as well.

When many of my patients are reluctant to go off gluten – they just don’t want to give up some of the foods they love – I simply ask them, “Your bagel or your brain?” It’s that simple.

If you have a proven gluten sensitivity, it IS destroying some part of your body every time you eat it. Your thyroid, your brain, your joints – it could be any or all of these. And you must avoid gluten permanently.

This doesn’t mean being gluten-free most of the time, or “I’m gluten-free all week except for my one Ms. Fields chocolate chip cookie.” There is evidence that gluten can stay in your system for up to 8 months making every exposure a long-term thing. Does that sound too doom and gloom? Totally, and it sucks, but it’s the reality.

In many ways, gluten sensitivity is akin to peanut allergy. Any little bit of gluten can be cause for some real problems. So again I ask – your brain or your bagel?

Additional Support
Once you’ve decided to avoid gluten, there are other things you can do to protect yourself.

Besides avoiding it everywhere you can, there have been a couple of novel enzymes found to help break down accidental exposure to gluten. However, it is not a license to eat gluten. Rather, if you know you are sensitive to gluten, you can take these enzymes on a daily basis to help avoid any gluten that may have snuck into your diet.

Research has shown that the digestion of proteins found in gluten requires an enzyme known as DPP IV (dipeptyl dipeptidase IV). This enzyme is normally found in intestinal cells and is known to be deficient in celiac patients. In non-Celiac patients, if there is any damage to the intestinal wall, DPP IV will be decreased, causing an increases susceptibility to gluten and therefore damage.

In gluten sensitive individuals following a gluten-free diet, it is recommended to take a few capsules of a supplement containing DPP IV daily to prevent damage from accidental exposure.

Summary
Gluten sensitivity is a very real condition. And if you test positive for gluten sensitivity, and you continue to eat gluten-containing foods, your health and performance are at risk.

Fortunately, we don’t have to employ any guesswork or speculate about gluten sensitivity. With the genetic testing available today, we can be sure about gluten problems.

If you’re are interested in optimizing your performance and preventing future health issues, get tested and find out.

References

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Kotze, LM. Gynecologic and obstetric findings related to nutritional status and adherence to a gluten-free diet in Brazilian patients with celiac disease. J Clin Gastroenterol.2004 Aug;38(7):567-74

Molteni N, Bardella MT, Bianchi, PA. Obstetric and Gynecological Problems in Women with Untreated Celiac Sprue. J Clin Gastroenterol.1990 Feb;12(1):37-9.

Hadjvassioulu M, et al. Headaches and CNS white matter abnormalities associated with gluten sensitivity. Neurology 56:385-388; Feb, 2001.

Neuromuscular disorder as a presenting feature of Celiac disease. J Neurol neurosurg psychiatry. 1997;63:770-775

Paul V, Henkerr J, Todt H, Eysold R. EEG Research Findings in Children with Celiac Disease According to Dietary Variations. Z.Klin.Med., 1985; 40: 707-709.

Hadjivassiliou M et al 2003. Gluten ataxia in perspective: epidemiology, genetic susceptibility and clinical characteristics. Brain 126: 685-91.

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Hadjivassiliou, et al. 2002. Gluten sensitivity as a neurological illness. J Neurol Neurosurg Psychiatry 72: 560-3

Volta U, et al. 2002. Clinical findings and anti-neuronal antibodies in coeliac disease with neurological disorders. Scand J Gastroenterol 37: 1276-81.

Tursi A et al 2001. Low prevalence of antigliadin and anti-endomysium antibodies in subclinical/silent celiac disease. Am J Gastroenterol 96: 1507-1510.

Hadjivassiliou M, et al. 2003. Dietary treatment of gluten ataxia. J Neurol Neurosurg Psychiatry 74: 1221-24.

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Cross A, and Golumbek, P. 2003. Neurologic manifestations of celiac disease. Neurology 60: 1566-1568.

Hadjivassiliou M, et al. 2002. The humoral response in the pathogenesis of gluten ataxia. Neurology 58: 1221-26.

Marsh M. Gluten, Major Histocompatbilty Complex and the small intestine. Gastroenterology 1992; 102:330-354.

Kalaydijian AE, et al. The gluten connection: the association between schizophrenia and celiac disease. Acta Psychiatr Scand. 2006 Feb;113(2):82-90.

Solomons NW, et al. Zinc nutrition in celiac sprue. Am J Clin Nutr. 1976 Apr;29(4):371-5.

Pazianas M, et al. Calcium absorption and bone mineral density in celiac after long term treatment with gluten-free die and adequate calcium intake. Osteoporos Int. 2005 Jan;16(1):56-63.

Spiekerkoetter U, et al. General screening for celiac disease is advisable in children with type 1 diabetes. Horm Metab Res. 2002 Apr;34(4):192-5.

Hansen D, et al. Clinical benefit of a gluten-free diet in type 1 diabetic children with screening-detected celiac disease: a population-based screening study with 2 years’ follow-up. Diabetes Care. 2006 Nov;29(11):2452-6.

Zioudrou, C., Streaty, R., Klee, W. (1979). Opioid Peptides Derived from Food Proteins. The Journal of Biological Chemistry 254(7), 2446-2449.

Usai P, Serra A, Marini B, Mariotti S, Satta L, Boi MF, Spanu A, Loi G, Piga M. (2004). Frontal cortical perfusion abnormalities related to gluten intake and associated autoimmune disease in adult coeliac disease: 99mTc-ECD brain SPECT study.Dig Liver Dis. Aug;36(8):513-8.

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