Episode 76: Is Going Gluten Free Just Trendy or Can Gluten Be a Problem if You Don’t Have Celiac Disease?
In today’s episode, Dr. Lisa and Dr. Toni discuss the spectrum of how you can react to gluten, from celiac disease to non-celiac gluten sensitivity or gluten intolerance. Gluten issues can cause more than tummy troubles if you are sensitive and needs to be considered whenever you are experiencing any kind of inflammation. Common reactions can include: brain fog, fatigue, skin rashes, joint pain, headaches, boating and more.
Gluten sensitivity is estimated to be 6 times more prevalent than celiac disease, which affects about 1% of the population, but about three quarters of people are undiagnosed or misdiagnosed with other conditions.
There are 3 major categories of gluten or wheat–related conditions:
- celiac disease
- wheat allergy
- gluten sensitivity (aka non-celiac gluten sensitivity or gluten intolerance)
Research by Dr. Fassano from Harvard shows that the frequency of common symptoms of gluten sensitivity:
abdominal pain (68%)
eczema or rash (40%)
“foggy mind” (34%)
numbness in legs, arms, or fingers (20%)
joint pain (11%).
What is gluten?
Gluten is a mixture of proteins found in common grains like wheat, rye and barley. It provides a gummy consistency.
What is celiac disease?
Celiac disease is a multi-system autoimmune disorder that is triggered by the ingestion of gluten in genetically susceptible individuals. Autoantibodies can be produced in your body and can be tested in the blood, along with genetic markers.
If your antibodies are positive, the second step is a small intestinal endoscopic biopsy to look for atrophy of the villi along your intestinal tract. You have to be regularly consuming gluten for the test results to be accurate.
This inflammatory autoimmune condition breaks down your gut lining, manifesting digestive symptoms and/or extraintestinal symptoms. Celiac disease is a serious disorder, resulting in an increased risk for nutritional deficiencies and development of other autoimmune disorders.
The classical or typical symptoms of celiac disease include:
- Chronic diarrhea
- Abdominal pain
- Malabsorption of macronutrients like protein, healthy fats and micronutrients like iron, vitamin B12 and other B vitamins, vitamin D and calcium
- Weight loss
Other symptoms of celiac disease are often considered as non-classical or atypical:
- Anemia, osteoporosis or osteopenia due to nutritional deficiencies, also dental enamel defects
- Extreme fatigue
- Oral ulcers and burning tongue
- Skin issues like eczema or dermatitis herpetiformis (raised blister with intense itching and burning)
- Hair loss and brittleness
- Liver enzyme elevation
- Constipation, heartburn
- Infertility (causes unexplained infertility in 5.9% of women), miscarriage, gestational diabetes
- Migraines, joint pain, carpal tunnel syndrome, muscle aches and pains
- Neurological problems like depression, anxiety, peripheral pain or tingling, balance issues
Children with celiac disease can have:
- Short stature
Gluten sensitivity can be indistinguishable from celiac disease or wheat allergy based on your symptoms alone. Lab testing is needed!
Research suggests that gluten sensitivity may be linked with the activation of your innate immune response, which causes an inflammatory response without the damage to your intestinal tract that happens due to the specific immune response that happens with celiac disease.
See Episode 8 to learn more about leaky gut and your microbiome and how gluten and other foods may be impacting your health.
Research also links the high intake of gluten containing grains during pregnancy with an increased risk of type 1 diabetes in kids.
What are sources of gluten?
Gluten is commonly found in wheat, spelt, kamut, rye and barley. Other grains that contain gluten are wheat berries, spelt, durum, emmer, semolina, farina, farro, graham, khorasan wheat, einkorn, and triticale (a blend of wheat and rye).
Oats are naturally gluten free, however commercially available oats often contain gluten from cross-contamination when they are grown near, or processed in the same facilities as the grains listed above.
Gluten is also sold as wheat gluten, or seitan, a popular vegan high-protein food. Less obvious sources of gluten include soy sauce, modified food starch and personal care products like shampoos
There also may be cross-reactivity with other foods like oats and corn.
How do you go gluten free?
Gluten free grains include:
- Brown, black, red, white rice
- Gluten-free oats
Gluten free doesn’t automatically equal healthy – check your labels!
It’s key not to rely on processed gluten-free foods that may be high in calories and sugar, and low in nutrients, such as gluten-free cookies, chips, and other snack foods. Consider gluten free grains as filler foods and focus more on getting your carbohydrates from vegetables. Listen to your body!
Other things you need to know about gluten:
A low gluten diet has been shown to increase the release of Peptide YY, which binds to your brain receptors to decrease your appetite and make you feel full after eating.
Gluten is different in North America vs. Europe!
- Faster processing of bread and pasta in North America
- Overnight to allow enzymes in yeast to break down peptides in Europe; 2 hours in North America
- Certain pesticides are not used in Europe
- Traditional forms of wheat are used in Europe instead of more modern and genetically modified wheat in North America
Glyphosate is the core ingredient in Monsanto’s Roundup herbicide sprayed on many crops, including gluten containing grains like wheat. Research on rats has found a disruption in beneficial gut bacteria at doses considered safe. Levels of glyphosate found in the human bloodstream have spiked by more than 1,000% in the last two decades!
Lab testing to consider:
- Celiac screen – IgA tissue transglutaminase antibody (TTG), endomysial antibody (EMA) and deamidated gliadin peptide (DGP)
- Endoscope and biopsy
- Other antibodies – IgA/IgG anti-gliadin, IgE wheat
- Genetic markers – (HLA-DQ2 and HLA-DQ8 genes)
- C Reactive Protein, Iron levels, vitamin B12 and D
- IgG food sensitivity testing
- Comprehensive Stool Testing with zonulin
What do you do if you are diagnosed with celiac disease, wheat allergy or gluten sensitivity:
- Eliminate gluten containing grains to lower antibody and inflammatory levels in your body
- Can consider re-introduction to tolerable levels if you have gluten sensitivity
- Re-test antibody levels if you have celiac disease to confirm you have not been exposed to gluten unknowingly
- Consider full hypoallergenic elimination challenge or food sensitivity testing
- Support gut healing with bone broth, glutamine, NAG, aloe, probiotics, digestive enzymes, DGL, slippery elm, marshmallow, mastic gum
- Consider immune support with vitamin D, fermented food, probiotics, prebiotics like arabinogalactans
Today’s Mama Must Have:
Dr. Lisa is a big fan of the gluten free bread by Slice of Life and Un-Bun, along with Glutenberg gluten free beer.
Dr. Toni loves her favourite gluten free pasta – black bean spaghetti by Explore Asian and Liviva, which is yummy, and higher in protein and fibre than regular pasta.
Dr. Toni’s next HypnoBirthing info session for expecting parents looking to trust their instincts and their body during labour and birth is happening on June 21. Join her at https://www.hypnobirthingcalgary.com/register
Sign up for Dr. Lisa’s free sleep webinar on Monday, June 7th at 8:00pm to discover how to use Naturopathic Medicine, essential oils, yoga, meditation, osteopathy and massage to get those zzz…s!
Dr. Lisa’s Wild Collective in Fall 2021: get on the waitlist: wildcollectivetoronto.com
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Stay safe and healthy everyone!