Dr. Doni Wilson explains what gluten is, why it can cause health problems for some people, and how to recover from gluten reactivity through dietary changes.
These days, more and more people are talking about “going gluten-free.” The term “gluten-free” is appearing on more packaging, on menus, and even on television shows. But is there some sense in eliminating gluten from your diet, or is “going gluten-free” simply some super-trendy, 21st century diet fad? And if gluten has been in the human diet for thousands of years, why are so many people having trouble with it now?
Today, I want to help clear up any confusion you might have about dietary gluten, and how it might be affecting your health. The questions I will answer in this article are:
- What Is Gluten?
- Why Do Some People Have Problems with Gluten?
- What Kinds of Health Issues Are Caused by Gluten?
- Why Have Gluten-Related Health Issues Increased?
- What Are the Symptoms of Gluten Sensitivity or Celiac?
- How Can You Know for SURE That Gluten Is the Problem?
- How Do You Recover from Gluten Reactivity?
- What Happens Once You Start Avoiding Gluten?
- Making a Permanent Recovery
What Is Gluten?
Gluten is a protein. It is found in certain grains like wheat, barley, rye, and spelt. Although these grains are mostly made up of carbohydrates, the small amount of gluten protein (only 6%) is what makes them unique from other grains and plants. Gluten makes dough stretchy, making products chewy, which is why these gluten-containing grains are often used to make things like bread, pasta, pastries, bagels, and crackers. Many people also put flour in soups, gravies, and sauces as a thickener.
Why Do Some People Have Problems with Gluten?
When you eat something that contains gluten, it travels down through your digestive tract, to your intestines, where all your food is digested. While a protein itself, gluten is made up mainly of two smaller proteins called gliadin and glutenin. When digested, gliadin and glutenin are broken down into tiny chains of amino acids called peptides. The problem is, the human body does not produce the enzymes to break down some of these peptides, which means tiny bits of gluten will always remain undigested. This is not necessarily a cause for concern, unless one or more of the following conditions exist:
- GENETIC PREDISPOSITION. In some people, the presence of these peptides in the body can trigger the immune system to mount an “attack” identifying the peptides as “foreign invaders”, the immune system creates antibodies to protect the body. These antibodies, in turn, generate inflammation throughout the body, which can result in many negative health symptoms. This predisposition is determined largely by your DNA. Research has shown that 95% of people with Celiac Disease have a gene called HLA-DQ2, and the other 5% have the HLA-DQ8 gene. Not everyone who has these genes gets Celiac Disease, but those who do have one of these genes are more likely to react to gluten starting at some point in their life.1
- Leaky gut (intestinal permeability). Leaky gut – which can be caused by stress, imbalanced gut bacteria, toxins (like pesticides), and medications (like antibiotics and proton pump inhibitors) – makes you more susceptible to gluten reactivity. Conversely, gluten can cause or exacerbate leaky gut – especially in people with a genetic tendency toward gluten reactivity.
- High exposure to gluten. If your daily diet includes large quantities of gluten, this can overload your digestive system with undigested gluten peptides. This increases the likelihood of triggering an immune reaction and spreading inflammation throughout the body.
- Stress. If you are under a lot of physical, mental, or emotional stress, your body is less able to cope with undigested peptides than when you are unstressed. It has been estimated that at least 60% of digestive issues are caused by stress. Remember that “stress” (as far as your body is concerned) can include taking medications, not getting enough sleep, and/or eating foods (like gluten) that are stressful to your body.2
Having even one of these conditions can make you susceptible to developing gluten issues; having more than one will make you increasingly susceptible.
What Kinds of Health Issues Are Caused by Gluten?
Celiac disease is probably the most widely known gluten issue. Occurring in one out of approximately 133 people, Celiac is an autoimmune disease. That means when you ingest gluten, your immune system doesn’t just try to protect your body from the gluten; it also attacks your intestinal cells. Celiac is thought to be an example of mimicry, in which the immune system attacks anything that looks like gluten. This includes the enzyme transglutaminase, the function of which is to digest the gluten. The result is that, in trying to protect you, your immune system destroys the cells of your intestines, causing even greater intestinal permeability and autoimmunity problems.3
Non-celiac gluten sensitivity (NCGC) is the non-autoimmune form of gluten reactivity. NCGC is much more common than celiac – estimated at one in four people. The same genetic factors that predispose you to celiac also predispose you to non-celiac. However, in NCGC, your immune system responds to protect you from gluten, but it does not attack healthy tissue. Just as with celiac, the presence of intestinal permeability (leaky gut) will result in many negative effects. Those who suffer from celiac disease or NCGC should avoid gluten altogether.
Some people have a specific sensitivity to wheat (not necessarily to gluten). Sometimes referred to as a “wheat allergy,” this sensitivity is considered to be related to fructose malabsorption. Wheat is an entire grain, not just the tiny bit of protein, and thus is much larger than gluten. If your immune system identifies the whole wheat molecule as an issue, and/or when that wheat molecule is not digested well, it triggers an immune reaction. The solution is to avoid wheat, although you might not need to avoid all gluten-containing grains.
Another important point is that gluten can also disrupt the microbiome. That means gluten can kill certain bacteria in the intestines, and allow others to overgrow. When bacteria in the gut are disrupted, it inevitably leads to other problems. Too few of the right bacteria means less butyrate (a protective substance) for the colon and nervous system. Too much of the wrong bacteria leads to the production of toxins that spread through the body via the blood stream, causing symptoms such as weight gain, joint pain, and memory loss.4
Why Have Gluten-Related Health Issues Increased?
One reason gluten sensitivity seems to be on the rise is that we are simply better at identifying gluten issues now than in the past. Considering that the causes of celiac disease were only identified in the mid-20th century, and gluten sensitivity was officially named in 2011, gluten only recently appeared on our medical radar, so to speak.
In addition, mass production and pre-packaged foods have increased the amount of gluten in our diet. Bread manufacturers, for example, use concentrated gluten in their recipes to make bread chewier and tastier. You’ll never see “concentrated gluten” on the list of ingredients, though; rather, you’ll just see the word “wheat” (as in wheat flour).
Then there is the issue of pesticides and genetic modification. The pesticide most used on wheat and other grain farms is called Glyphosate, otherwise known as Roundup®. This substance, intended to poke holes in the bugs that decrease the yield of the farm, can also poke holes in your intestinal cells.5
So, when you eat products containing non-organic gluten, wheat, barley, rye, or spelt, you are essentially creating intestinal permeability/leaky gut. Leaky gut predisposes you to gluten issues, as it allows the undigested gluten protein to slip between the cells, into the area where your immune system is on guard for foreign proteins. Once your immune system notices the gluten protein – boom – it starts making antibodies to protect you. And those antibodies don’t just hang out at the intestinal lining. They can travel anywhere in your body, including your nervous system, spreading a message of inflammation (how gluten affects the nervous system will be the subject of my next blog post).6
What Are the Symptoms of Gluten Sensitivity or Celiac?
While sensitivity to gluten will sometimes show up as diarrhea or digestive upset, more than 50% of people who react to gluten don’t have any digestive complaints at all. Surprisingly, those who are gluten-reactive are more likely to experience these kinds of symptoms:7
- Joint pain
- Skin rashes
Even worse, research has shown that gluten sensitivity can also cause a variety of severe conditions:
- Bone loss8
- Nutrient deficiencies (such as iron deficiency), due to malabsorption9,10
- Mood disorders (such as depression and schizophrenia)11,12
- Autoimmunity (such as Hashimoto’s thyroid autoimmunity)13
- Fertility issues14
- ADHD and other symptoms in children, including Autism16,17
However, having some of the symptoms listed above does NOT necessarily mean you have a problem with gluten. Symptoms might be indicators, but they cannot tell you definitively whether gluten is the underlying problem.
How Can You Know for SURE That Gluten Is the Problem?
Gluten sensitivity is sneaky, and it doesn’t show up in standard blood work. What’s more, most mainstream health practitioners don’t check for it. In fact, there is no “official” test for it, yet. Most doctors will recommend a diet of exclusion, i.e. avoid gluten for at least three weeks, note how you feel, and then reintroduce it to see if eating gluten makes you feel worse. However, in my practice, I have found this method can fail to catch some people who are gluten-sensitive.
Because of this, I prefer to start my patients off with an IgA and IgG food sensitivity test, which can give us an immediate sense of whether their immune system is reacting to gluten. Most cases of gluten reactivity will show up on at least one of these tests. Even a low-level result indicates NCGS. A small percentage of cases will come up false negative, which will require us to dig a little deeper.
If the IgA and/or IgG test shows a positive result for a gluten reaction, it is important to consider being checked for Celiac disease before you start avoiding gluten, as the IgA and IgG is unable to differentiate between celiac and non-celiac gluten sensitivity. The approved way to identify celiac disease is with an intestinal biopsy during an endoscopy. This is not a failsafe method of identification, however, as a small percentage of cases won’t show positive on a biopsy. There is also a blood test for the auto-antibodies (transglutaminase antibodies and anti-endomysium antibodies), but that is not considered definitive.
IMPORTANT: If you intend to get an intestinal biopsy to test for celiac disease, I advise doing so BEFORE eliminating gluten from your diet. This is because your test might show up a false negative, as your intestinal lining might already have started to heal. Getting an accurate biopsy will require you to re-expose yourself to gluten, which can trigger your symptoms all over again.
How Do You Recover from Gluten Reactivity?
The ONLY way to recover from gluten sensitivities is to eliminate gluten from your diet – period. In addition to avoiding gluten, I recommend that you take steps to help your body recover from gluten – to heal leaky gut and rebalance your gut bacteria.
Unfortunately, in our “quick fix” culture, many people opt to take medications to address their symptoms. In some cases, this is because they haven’t yet made the link between their symptoms and their gluten reactivity. It might not occur to them that what they are eating could be causing them to feel so unwell – especially if they have no negative digestive symptoms. Others find the idea of changing their diet too overwhelming; they would rather pop a pill – even with possible side effects – than consider a dietary solution.
Those who are willing to change their diet, rather than use medications to mask their symptoms, can start to address their gluten issues head on, preferably with the help of a naturopathic doctor.
SIDE NOTE: If you would like to speak with Dr. Doni about your gluten issues, you can book a “new patient” appointment at https://doctordoni.com/make-appointment/
What Happens Once You Start Avoiding Gluten?
If gluten is your problem, and you eliminate it from your diet, your immune system will calm down and stop reacting to every food that leaks through. Your intestinal cells will start to heal and your leaky gut will start to resolve. Your body will absorb nutrients more efficiently. Inflammation throughout the body will decrease. The microbiome in your gut will re-optimize, and your body will relax once it no longer has to deal with the stress caused by gluten. By eliminating gluten, your body will finally have a chance to thrive instead of dive.
And as your body calms down, you will feel better. This will look different for different people. One person might notice a decrease in bloating, heartburn, PMS symptoms, headaches, joint pain, or thyroid antibodies. Another might find they are sleeping better and have more energy. I have even had patients tell me that going gluten-free has enabled them to get pregnant, reverse diabetes, and discontinue antidepressants and immune-suppressive medications.
How long does recovery take? Again, everyone is different. Depending on the severity of your reactivity, your “gluten recovery process” could take a few weeks or several months. In extreme cases, it might take years to recover from all the negative symptoms you’ve been suffering. Even if it takes a while, if you are gluten-reactive, don’t give up your gluten-free diet. I’ve had patients report back to me a full year after going gluten-free, saying what a positive difference it has made in their lives.
How to speed up the process? In addition to avoiding gluten 100%, I suggest taking active steps to heal leaky gut and to support your body to recover from exposure to stress.
Making a Permanent Recovery
Back in 2003, I realized I too have gluten sensitivity. At the time, my primary symptoms were frequent migraines and canker sores. I could tell I had leaky gut and an imbalance in gut bacteria, but none of my healing strategies made any difference in my symptoms. Then, I FINALLY did an IgA and IgG food panel, which revealed a low reaction to gluten.
That’s right: even a low reaction is still a reaction. While it was hard at first, I made the shift to eating gluten-free and started to feel better. I also made great strides to heal leaky gut and help my body recover from stress.
I was so amazed at what a difference going gluten-free made to my health that I wanted to help others receive the same benefit. I wrote everything down, and started implementing my strategies with my patients. In doing so, I also realized permanent healing from gluten reactivity goes beyond gluten. Yes, avoiding gluten is an essential part of the healing process, but we cannot overlook the role of STRESS in our gluten issues:
- The stress that switched on our genetic predisposition to react to gluten in the first place
- The stress that first triggered leaky gut
- The continued stress caused by leaky gut
- The stress that gluten caused in our immune system
- The stress that subsequently spread throughout our body through inflammation
To address all these forms of stress, we must break the vicious cycle in several places – through both dietary AND lifestyle changes.
If you would like to make a complete recovery from gluten issues – or any other stress-related condition – I recommend checking out:
- My book, The Stress Remedy, which described my healing approach in full, including case examples
- My 21-day Stress Remedy Program, which includes:
- a gluten-free diet plan
- a gluten-free pea protein shake mix
- and supplements, including dietary enzymes, support for healing leaky gut, and probiotics to help your body recover from the negative effects of gluten
- My Leaky Gut Support product, to help your intestinal lining recover from the damage caused by gluten.
Additionally, I suggest you implement my “Stress Remedy CARE activities”: Clean Eating, Adequate Sleep, Reducing Stress and Exercise.
Lastly, when you sign up to receive my free Weekly Wellness Wisdom newsletter, you’ll also receive my free 35-page eBook A Guide to Adrenal Recovery, which looks at stress – and how it affects your health – from many different angles and offers solutions.
Until next time,
25th July 2017
- Genetics of Celiac disease:
Ricaño-Ponce I, Wijmenga C, Gutierrez-Achury J. Genetics of celiac disease. Best Pract Res Clin Gastroenterol. 2015;29(3):399-412. https://www.ncbi.nlm.nih.gov/pubmed/26060105
- Stress and digestive issues:
Mayer E. The neurobiology of stress and gastrointestinal disease. Gut. 2000;47(6):861-869. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1728136/
- Celiac Disease and Non-Celiac Gluten Sensitivity:
Lebwohl B, Ludvigsson JF, Green PHR. Celiac disease and non-celiac gluten sensitivity. The BMJ. 2015;351:h4347. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4596973/
- Gluten and microbiome:
Nadal I, Donat E, Ribes-Koninckx C, et al. Imbalance in the composition of the duodenal microbiota of children with coeliac disease. J Med Microbiol. 2007;56:1669-74. https://www.ncbi.nlm.nih.gov/pubmed/18033837
- Gluten and Glyphosate:
Samsel A, Seneff S. Glyphosate, pathways to modern diseases II: Celiac sprue and gluten intolerance. Interdisciplinary Toxicology. 2013;6(4):159-184. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945755/
- Gluten and Intestinal Permeability:
Hollon J, Leonard Puppa E, Greenwald B, Goldberg E, Guerrerio A, Fasano A. Effect of Gliadin on Permeability of Intestinal Biopsy Explants from Celiac Disease Patients and Patients with Non-Celiac Gluten Sensitivity. Nutrients. 2015;7(3):1565-1576. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377866/
- Gluten sensitivity and listing of common symptoms:
Catassi C. Gluten Sensitivity. Ann Nutr Metab. 2015;67 Suppl 2:16-26. https://www.ncbi.nlm.nih.gov/pubmed/26605537
- Bone loss:
Zanchetta MB, Longobardi V, Bai JC. Bone and Celiac Disease. Curr Osteoporos Rep. 2016;14(2):43-8. https://www.ncbi.nlm.nih.gov/pubmed/26875096
- Anemia, fatigue, headaches, slow growth:
Jericho H, Sansotta N, Guandalini S. Extraintestinal Manifestations of Celiac Disease: Effectiveness of the Gluten-Free Diet. J Pediatr Gastroenterol Nutr. 2017;65(1):75-79. https://www.ncbi.nlm.nih.gov/pubmed/28644353
- Diabetes Type 1:
Singh P, Seth A, Kumar P, Sajjan S. Coexistence of celiac disease & type 1 diabetes mellitus in children. Indian J Med Res. 2017;145(1):28-32. https://www.ncbi.nlm.nih.gov/pubmed/28574011
- Neurological disorders and Celiac:
Casella G, Bordo BM, Schalling R, et al. Neurological disorders and celiac disease. Minerva Gastroenterol Dietol. 2016;62(2):197-206. https://www.ncbi.nlm.nih.gov/pubmed/26619901
Rowland LM, Demyanovich HK, Wijtenburg SA, et al. Antigliadin Antibodies (AGA IgG) Are Related to Neurochemistry in Schizophrenia. Front Psychiatry. 2017;8:104. https://www.ncbi.nlm.nih.gov/pubmed/28674504
- Gluten and Hashimotos:
Liontiris MI, Mazokopakis EE. A concise review of Hashimoto thyroiditis (HT) and the importance of iodine, selenium, vitamin D and gluten on the autoimmunity and dietary management of HT patients.Points that need more investigation. Hell J Nucl Med. 2017;20(1):51-56. https://www.ncbi.nlm.nih.gov/pubmed/28315909
- Gluten and fertility:
Peterson M, Grossman S. Managing Celiac Disease for Women: Implications for the Primary Care Provider. Gastroenterol Nurs. 2016;39(3):186-94. https://www.ncbi.nlm.nih.gov/pubmed/27258459
Bashiri H, Afshari D, Babaei N, Ghadami MR. Celiac Disease and Epilepsy: The Effect of Gluten-Free Diet on Seizure Control. Adv Clin Exp Med. 2016;25(4):751-4. https://www.ncbi.nlm.nih.gov/pubmed/27629850
- ADHD and other symptoms in children:
Diaconu G, Burlea M, Grigore I, Anton DT, Trandafir LM. Celiac disease with neurologic manifestations in children. Rev Med Chir Soc Med Nat Iasi. 2013;117(1):88-94. https://www.ncbi.nlm.nih.gov/pubmed/24505898
Lau NM, Green PHR, Taylor AK, et al. Markers of Celiac Disease and Gluten Sensitivity in Children with Autism. De Re V, ed. PLoS ONE. 2013;8(6):e66155. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3688832/