What is gluten?
Gluten is a family of proteins. It is what makes dough and baked goods stretchy, or flaky. Gluten is made up of two main groups of proteins, the glutenins and the gliadins. An individual can be sensitive to either, or to any one of the twelve proteins that make up gliadins.
Gluten is found most commonly in wheat, but is also in rye, spelt, kamut, bulgar and barley, and oats often contain cross-contamination.
Celiac vs. Gluten Sensitivity
Most commonly when people hear about gluten intolerance, they think of celiac disease. Celiac is considered a rare disease, with the most common estimation of people affected at 1%, although it is estimated only 10-15% of these cases are diagnosed. Celiac is a very serious autoimmune disease, with extreme damage to the small intestine. Damage to the villi (the small fingerlike projections that line the small intestine and promote nutrient absorption) of the small intestine can result in malabsorption of vital nutrients. Autoimmune disorders, just for review, are very dangerous conditions in which your own immune system starts fighting and killing your cells. It is a rapidly growing disease category in recent years.
The most common blood tests for celiac are extremely accurate at diagnosing celiac, but are not sensitive enough to detect a lesser form of gluten sensitivity.
Gluten sensitivity occurs when the consumption of gluten affects the immune system. This immune system activation can result in ‘leaky gut,’ a breakdown of intestinal walls resulting in particles that would normally be kept out passing through the gut wal. Leaky gut, in turn, increases your susceptibility to additional food sensitivities in the future.
It is commonly thought that gluten sensitivity manifests itself with gut or bowel symptomatology. However, there is growing evidence that many people have a gluten sensitivity without such markers. The body’s immune response to gluten with a food sensitivity explains an observed link between gluten sensitivity and brain function, or dysfunction. Gluten sensitivity can cause inflammation in any organ of the body as a result of a heightened immune system response. These individuals are unaware as gluten causes inflammation in other parts of the body, including joints and the brain, often for years on end.
What this means:
Symptoms that you never considered having anything to do with gluten may in fact be the result of a gluten sensitivity. Pain in your joint is caused by inflammation in the joint. Depression and anxiety are often the result of a neurotransmitter imbalance that is caused by some type of inflammation. The key point here is that a gluten sensitivity can cause an immune response that results in joint inflammation or brain inflammation without giving a gastrointestinal indication of the food sensitivity.
As an example of gluten sensitivity affecting brain health, people with celiac were tested for blood flow throughout their brain, and researchers found that 73% of people with celiac had reduced brain flow to their brain. After one year of being completely gluten-free, this number reduced to 7%, meaning that 93% - instead of 27% - now had normal blood flow to their brain. This restoration of blood flow greatly decreased or eliminated depression and anxiety in these individuals.
Headaches are another incredibly common symptom of gluten sensitivity. Dr. David Perlmutter, a leading neuroscientist, treats headaches and nerve disorders with gluten-free diets, and sees incredible success. Often, his patients come to him after years of suffering during which doctors tried treatment after treatment without success, never considering that gluten might by the culprit.
The bottom line is: Gluten sensitivity is increasingly common, and frequently goes undiagnosed, decreasing many individuals' health and quality of life.
Why haven’t I heard about this?
This is not all new information.
In 1996, the English professor Marios Hadjivassliou reported in the Lancet, ‘Our data suggest that gluten sensitivity is common in patients with neurological disease of unknown cause and may have etiological significance.’
In 2006, the Journal of Attention Disorders published a study in which they concluded that ‘ADHD-like symptomatology is markedly overrepresented among untreated celiac disease patients and that a gluten-free diet may improve symptoms significantly within a short period of time.’
This research is beginning to make it into more mainstream media sources in recent years, and is available in research studies online if you're willing to do a little digging. As is often the case, there is a lag between what researchers are discovering and what is being taught in medical schools and therefore being shared with you at your regular appointment.
There is a wealth of knowledge available to explore, and your doctor can help you order blood tests that measure your antibody levels to detect if you have started down the path towards an autoimmune condition early, while there is still time to turn your situation around and regain and maintain true health.
In the meantime, considering gluten-free alternatives is a simple first step towards increased health.
For more information on this topic, consider:
· 'Grain Brain' by David Perlmutter
· ‘What is Wheat Sensitivity and Gluten Intolerance?’ interview with Dr. Tom O’Bryan