Gluten Sensitivity

Gluten Sensitivity

DESTRUCTIVE EFFECTS OF GLUTEN

Most bread, especially refined white bread, causes a rapid and dramatic release of insulin in the body.  This, in turn, promotes fat storage.

And like sugar, eating bread can lead to chronic inflammation and free radical generation, which over time will set the stage for a number of serious diseases.

GLUTEN SENSITIVES:  ROOT CAUSE OF MANY HEALTH PROBLEMS

As bad as gaining unwanted fat weight and free radial formation recent studies show that grains and glutens can cause serious damage to the nervous system through a mechanism of the immune reactions and excitotoxicity.

In fact, immune reactions caused by grains and gluten can lead to crippling neurological conditions, including:

  • Memory Loss
  • Confusion
  • Ataxia (loss of balance)
  • Peripheral neuropathy
  • Seizure
  • Insomnia
  • Attention deficient disorder
  • Schizophrenia
  • Depression and anxiety

This type of immune reaction can also worsen the effects of Alzheimer’s and Parkinson’s disease. Evidence has linked the immune reaction to a substance in many grains called gluten.  This “gluten sensitivity” is also associated with some very common health problems, including:

  • Migraine headaches
  • Esophageal reflux
  • Diarrhea
  • Abdominal cramping
  • Muscle spasms
  • Obesity
  • Irritable bowel syndrome (IBS)  Ulcerative colitis

CELIAC DISEASE IMPAIRS NUTRIENT ABSORPTION

For people with celiac disease, eating grains that contains gluten results in damage to the lining the intestine that are responsible for absorbing nutrients from digested food. The patients get diarrhea alternating with constipation, abdominal cramping, muscle wasting, irritability, and sleep disturbances. Severe cases impair absorption of fats and proteins, and less so with carbohydrates. Victims of this disorder which is called malabsorption were also unable to absorb many minerals and vitamins that are critical for health. These vitamin deficiencies lead to health problems such as anemia, osteopenia, and unhealthy skin.

NEW EVIDENCE HAS DEMONSTRATED THAT GLUTEN SENSITIVITY ALSO CALLED GLUTEN INTOLERANCE IS MUCH MORE COMMON THAN WAS FIRST THOUGHT

In fact, as much as 40% of the population is probably affected. We also now know that gluten intolerance is a multisystem disease affecting a great number of systems in the body, along with the GI tract. For example, it affects fat metabolism, is associated with diabetes, can trigger autoimmune diseases such as rheumatoid arthritis, lupus, thyroid disease, multiple sclerosis, ALS, and others, can also affect the brain including higher functions such as memory, learning, attention, and behavior.

MOST CASES OF GLUTEN SENSITIVITY GO UNTREATED FOR YEARS

Gluten sensitivity is caused by an interaction between specific inherited genes and environmental factors in this case, exposure to gluten in the diet. It is possible to have the gene and never develop the condition, if you avoid exposure to the environmental agent.

Some 95% of people with celiac disease have the gene HLA-DQ2, 5% have the gene HLA-DQ8. Overall, about 30% of the general population has these genes, yet only I % will get celiac disease. The reason for this disparity is that full expression of these genes depends on a number of other factors.

EARLY SIGNS OF GLUTEN SENSITIVITY

The brain is the organ most commonly affected by gluten sensitivity, and in most cases it is the first to show signs of trouble.  We have also learned that in most cases gluten sensitivity and even full blown celiac disease remained clinically silent for decades.

Here are some of the SYMPTOMS THAT ARE OFTEN OVERLOOKED BY PHYSICIANS:

  • A sense of fatigue that appears after an illness or pregnancy and never seems     to leave.
  • Dental enamel defects.
  • Sudden appearance of diabetes
  • Intensely itchy skin with blistering this is called dermatitis herpetiformis.
  • Peripheral neuropathy.
  • Depression and anxiety.
  • Progressive osteoporosis.
  • Sudden appearance of lactose intolerance.

DON’T EXCEPT A DIAGNOSIS OF IRRITABLE BOWEL

In my opinion, many people suffering from acid reflux (GERD) that respond poorly to conventional treatments area often cured by avoiding gluten containing foods.  This is because the gluten molecule gets stuck between the layers and intestinal wall and cannot be digested.  It acts as a focus of constant immune stimulation and inflammation.  With each gluten containing meal, greater stimulation occurs.

This constant immune reaction in the wall of the intestines can lead to autoimmune diseases such as ulcerative colitis, multiple sclerosis, rheumatoid arthritis, lupus, and others.

Many gluten sensitive people are diagnosed with irritable bowel syndrome, because the testing that is done is not appropriate.  I now do autoimmune testing that looks at foods such as foods that have gluten, as well as foods that cross react with gluten.  I am also able to look at a total autoantibody array to almost every organ system.  I feel that this is extremely important.

This immune reaction interferes with the absorption of nutrients, a person with gluten sensitivity can suffer from a number of nutritional deficiencies.  This is why we see extreme weight loss, fatigue, and muscle spasm with celiac disease.  In addition, vitamin A deficiency can lead to night blindness, as well as reproductive and skin problems.  Vitamin E deficiency can cause immune disorders, ataxia which is a loss of balance, and nerve disorders.  A deficiency of vitamin K may lead to bruising.

Deficiency in the B vitamins, especially folate and vitamin B12, can result in severe anemia and neurologic problems, as well as raising homocysteine levels.  In many cases calcium is poorly absorbed, leading to osteopenia and osteoporosis that will not respond to calcium supplements or D3 supplements.

INFERTILITY AND GLUTEN

Studies have shown that gluten sensitivity can lead to a number of problems with reproduction with both males and females.  It can delay the onset of puberty in females and menstrual irregularities are also common.

Women with gluten sensitivity often have problems with miscarriages and have poor pregnancy outcomes.  One study found that women with such sensitivities had less sexual desire.  Babies of affected woman were smaller and there was a higher risk of the baby dying just before or soon after birth. Males with longstanding gluten sensitivity can have very low sperm counts, leading to infertility.  Avoiding gluten and foods that cross react with gluten in many cases can correct this problem.

AUTOIMMUNE DISEASES CAN BE WORSENED BY GLUTEN

A long list of autoimmune diseasesare also associated with celiac diseases and gluten sensitivity including:

  • Thyroid disease (Hashimoto’s disease)
  • Sjögren’s syndrome
  • Addison’s disease (adrenal gland insufficiency)
  • Liver autoimmune diseases
  • Cardiomyopathy (weakened heart muscle)
  • Alopecia areata (patches of baldness) Rheumatoid arthritis
  • Type 1 diabetes

In these gluten related immune disorders, there is an immune attack that selects specific tissues, each presenting as a separate disorder.  In many cases, gluten sensitivity may not be the sole factor involved. Rather, the condition worsens the disease, as we often see in cases of rheumatoid arthritis and others.

GLUTEN AND THE BRAIN

I feel that we need to avoid gluten containing food, as well as well as foods that cross reference gluten because a number of recent studies show that severe neurologic disorders either significant improved or are eliminated  once the person is completely gluten free and stops eating foods that cross react with gluten.

Compelling evidence suggests that immune activation and subsequent inflammation in the gut rapidly activates inflammation and immune responses in the brain. In fact, the inflammation in the brain seems to involve certain areas more often than others, principally the areas of the brain that govern memory, behavior, depression, anxiety, and special types of spasms such as tremors and Tourette’s syndrome.

Within the brain, gut derived inflammation involves activation of the principle immune cells of the brain called microglia.  When these cells are activated they release powerful inflammatory compounds and excitotoxins into the brain.

One of the most common neurological manifestations associated with gluten intolerance is ataxia a loss of balance.  The patient feels like he or she is going to fall over, especially when turning suddenly. In fact, gluten sensitivity is the leading cause of idiopathic ataxia that is, ataxia that seems to occur for no reason. The earlier a person switches to a gluten free diet, the better his or her recovery will be.

CHANGE IN DIET CAN CURE DEPRESSION

A great deal of medical evidence now demonstrates that major depression is linked to excess glutamate receptors activation in the brain. It has been found, for example, that a single dose of a drug ketamine blocks the glutamate-type receptors dramatically and can improve the symptoms of serious depression for months.

The most successful antidepressant drugs suppress this same class of glutamate receptors.

Numerous studies confirm that anything that causes inflammation in the brain will also cause worsen depression and anxiety. In the case of gluten intolerance, the brain remains in a constant state of low-grade inflammation and these people suffer from increased depression. Rarely do physicians consider gluten intolerance as a cause of depression and anxiety. Instead, they prescribe numerous prescriptions and antidepressants.  Unfortunately, approximately 60% of the patients do not respond to these drugs.

Because it is gluten (which contains glutamate) that is driving the brain’s accumulation of glutamate, removing it from the diet improves the depressive condition.

NERVE PAIN AND HEADACHES FROM GLUTEN

Peripheral neuropathy is nerve damage in the legs or arms that come from a number of causes.  Some 20 million people suffer from it in the United States. The list of causes include; secondary metabolic conditions such as diabetes, uremia, liver failure, inflammation, toxic metals, autoimmune diseases, drug-induced from statins, and hereditary causes.

Recently, it has been recognized that people with long-term gluten intolerance can develop advancing peripheral neuropathy. Unfortunately, this often goes undiagnosed. Glutens can cause peripheral nerve damage by several mechanisms, including vitamin and nutrient deficiency, inflammation, and by special autoantibodies generated by the gluten. In the office, I am checking this on my patients.  I feel that is very important.

In addition, gluten can also stimulate glutamate and cause migraine headaches and eliminating these foods have shown these patients to have improvement.  Other headaches also go away.

SEIZURES AND GLUTEN

Gluten sensitivity can trigger seizures in certain people. Most likely, gluten will not cause a seizure in a perfectly healthy person, but if one had a weakness for a seizure because of an old brain injury for instance, the inflammation caused by gluten could be enough to trigger a full-blown seizure.  In addition, gluten sensitivity makes drug treatments much less effective.  A diet that removes the gluten and simple carbohydrates can go a long way toward lessening or even stopping seizures.

NEURODEGENERATIVE DISEASES, CANCER, AND GLUTEN

Recent literature now shows a link between brain inflammation and neurodegenerative diseases such as Alzheimer’s, multiple sclerosis, Parkinson’s, and ALS (Lou Gehrig’s disease). Correcting food allergies including avoiding gluten and foods that cross react with gluten can be beneficial in these aliments.

It makes sense that if a person is sensitive to gluten or any other food for that matter that constant immune activation would cause an immunoexcitotoxic reaction in his or her brain.  This could make the neurodegenerative condition far worse and allow it to progress much more quickly.

Even if you remove gluten from your diet the immune reaction may take up to three to six months to clear up because the trapped glutens in your intestinal wall have to be eliminated from your body.

A number of cancers have been linked to celiac disease and gluten sensitivity. The most common of these include non-Hodgkin’s lymphoma, adenocarcinoma of the small intestine, and cancer of the esophagus.  Compared to the general population the risk lymphoma is 7 to 9 times greater for a person with celiac disease or gluten intolerance.

Gluten sensitivity is linked to acid reflux, and people with longstanding reflux have a high risk of esophageal cancer which usually occurs as a squamous cell type and may also involve cancer of the mouth, tonsils, and throat.

TESTING FOR GLUTEN SENSITIVITY

This is especially important to patients with a family history of autoimmune disease or with any of the symptoms mentioned above.  I do extremely complex autoimmune testing not available elsewhere from Quest or LabCorp.  The panels have even higher specificity and sensitivity.  It is important to know about all of the different types of food that can cause this in you.  Some foods that you think you are eating that are safe are not.  This testing in my opinion is essential.  It can also predict if you have autoantibodies to other organs in your entire body.

GLUTEN AND SCHIZOPHRENIA

Very interesting studies have shown that women who are gluten sensitive have a 50% increase risk having a child develop schizophrenia later in life.  The immune stimulation during pregnancy increases the risk of schizophrenia in the offspring as well.  Another important finding is that babies who are breastfeed are significantly less likely to develop gluten sensitivity.

A study between 1980 and 1990, in Swedish women looked at their breastfeeding.  During that time breastfeeding was reduced and the lead to a threefold increase in the incidents of celiac disease in their offspring.  Apparently, the immune transfer from the mother’s milk protects the baby from gluten.

THIS DISEASE IS OFTEN OVERLOOKED

I have a very high number of autoimmune patients in my practice, and unfortunately the medical profession rarely considers a diagnosis of gluten sensitivity unless there are obvious signs of gastrointestinal problems such as abdominal cramping or diarrhea.  The reason is that we as physicians were taught that celiac is a very rare disease.  Another issue is that testing for gluten sensitivity can be tricky.  Some people will show a negative test from one lab only to come up positive in another lab.  The laboratory that one uses is extremely important.  I am using a laboratory dedicated to the foods that have gluten and cross react so there is cross react with those foods. There is also a test to look at the immune response to different metals and different chemicals in our body.

SUMMARY

As discussed above, gluten has destructive effects over the entire body. This is definitely one of the causes of autoimmune diseases and goes undiagnosed.  I feel specialized autoantibody testing, as well as looking at foods that cross react with gluten are extremely important in these individuals.  Once you see what all of the antibodies are produced in your body you need to avoid those foods and eliminate whatever other causes there are.

Other causes of autoantibodies include estrogen, heavy metals, pesticides, and environmental toxins just to mention a few.  I use this testing along with mitochondrial function testing, hormone testing, and free radical testing to get to the underlying cause of the problem.

After testing, I then begin a personalized treatment program based on your test.  There are ways to lower glutamate, as well as lower your autoantibodies and your reactivity to gluten.

If you suffer from any of the above conditions and you wish to take an integrative approach to your health please call my office.