WHEN GOING GLUTEN FREE ISN’T ENOUGH
The 411 on Gluten
In the spirit of full transparency, I’m convinced that gluten is bad for everyone. Regardless of one’s sensitivity level, gluten is of questionable nutritional value, it triggers mild-to-severe inflammation, compromises digestion, disrupts immune function, causes leaky gut syndrome and promotes auto-immunity.
Current research suggests that up to one-third of the population may be gluten intolerant to some degree and about one out of every 100 individuals may have celiac disease. If you are one those people, avoiding gluten on a permanent basis is essential to your health and well-being. But did you know that switching to a gluten-free diet may not be enough? If you are gluten sensitive, or have celiac disease, it’s quite possible that your immune system may be mistaking other non-gluten foods that you’re eating for gluten, negating all your efforts.
“I went gluten-free for months and I didn’t feel any better”.
I frequently hear some version of this statement from clients and understand how such an experience might convince them that there’s no validity in going gluten-free. But the reality is that, nine times out of ten, that same client has not been as gluten-free as they thought…for a variety of reasons:
1) They still unknowingly consume foods that contain gluten
2) They share a kitchen and pantry with people who eat and prepare gluten-based foods
3) They are exposed to gluten via personal care products, supplements and medications
4) They have developed a sensitivity to foods known to cross-react with gluten – Dairy, Corn, Millet, Rice, & Yeast
For suggestions on how to grapple with reasons 1-3, check out my Must Do Checklist for Establishing a Gluten Free House
How It Happens
When you eat something that does not agree with your immune system (we are talking food sensitivity here…not a food allergy), your immune system responds by creating antibodies to the offending food antigen. The more one consumes the offending food, the more antibodies are created and the more hyper-vigilant the immune system becomes. Because gluten is so prevalent in the American diet, unless one is actively trying to avoid it, most people get a steady drip of gluten exposure throughout the day. So, when one is gluten sensitive, the immune system spends all day “on patrol”, seeking to identify and combat the offending gluten antigens. The “seek and destroy” frenzy of the immune system often leads to some mistakes.
Because gluten is a large and complex protein structure that shares many characteristics with dairy, corn, millet, rice, and yeast, the immune system can mistake these other foods for gluten. When this happens, these non-gluten foods are “tagged” with the “gluten label” so that the next time they’re consumed, the immune system thinks they are gluten.
So, while you are busy reading labels to avoid gluten, that cream in your morning coffee could be driving up your gluten antibodies. The same might be true for that rice pasta you’re eating… or the corn-chips you’re dipping in your hummus.
Note: Oats do not cross-react with gluten specifically. However, oats are known to become contaminated with gluten during harvesting and processing
If you’re still eating gluten – even occasionally – and haven’t been tested for gluten sensitivity, I encourage you to do so. The symptoms of gluten sensitivity go way beyond the typical gastro-intestinal symptoms of gas, bloating, cramping, diarrhea or constipation. Often, the most common symptoms of gluten sensitivity, and even celiac disease, are anxiety, panic attacks, depression, migraines, chronic headaches, skin issues (psoriasis, dermatitis, eczema) and other extra-intestinal symptoms.
If you already know you are gluten sensitive, or have been diagnosed with celiac disease, I recommend running specific labs designed to identify whether you also have a sensitivity to cross-reactive foods. Such testing should be done under the guidance of a functional practitioner or a Certified Gluten Practitioner. When testing for food sensitivities, it’s crucial to also assess gut integrity. In my experience, most people who have a sensitivity to gluten and other cross-reactive foods, have some degree of gut hyperpermeability, or leaky gut. Such a combo will wreak havoc on the immune system, the body’s ability to detoxify and significantly increase the risk for autoimmune disease.
If you can’t afford the necessary lab tests (which usually aren’t covered by insurance), I recommend you avoid ALL the foods known to cross-react with gluten for a minimum of three months and see how you feel. After a 3-month period, you can begin rotating each of the foods back into your diet one at a time. During each rotation, it’s a good idea to keep a daily journal of how you feel and make note of any adverse symptoms.
Testing for Cross-reactivity
There are a couple of testing strategies to identify cross-reactive sensitivities.
Vibrant Wellness offers peptide-based arrays (called Zoomers) for several non-gluten foods. Because peptide-based arrays are far more sensitive than more traditional food sensitivity tests, I recommend utilizing them whenever possible. My preferred strategy for identifying cross-reactive sensitivities is to run the following tests from Vibrant Wellness: Corn Zoomer, Dairy Zoomer, Food Sensitivity Profiles 1 & 2.
Cyrex Labs offers the Gluten-Associated Cross-Reactive Foods and Foods Sensitivity panel, also known as the Array 4. This test measures antibody levels to gliadin (gluten) cross-reactive foods, other non-gluten foods commonly over-consumed on a gluten-free diet, as well as eggs and soy. This is not a peptide-based array and so does have some limitations and can result in false negative results.
Testing for Gluten Sensitivity
The Vibrant Wellness Wheat Zoomer test is a highly sensitive, peptide-based array designed to detect autoimmune reactions to gluten. The wheat zoomer detects antibodies to the gluten and non-gluten components of the wheat peptide and antibodies that indicate the presence of intestinal permeability.
Cyrex Labs also offers a peptide-based gluten sensitivity panel called the Wheat/Gluten Proteome Reactivity & Autoimmunity (or Array 3X) but, unlike the Wheat Zoomer, it does not provide total serum IgA and IgG levels (which help to validate test results) nor any insight into intestinal permeability.
Testing for Intestinal Permeability (Leaky Gut)
There are two methodologies for evaluating intestinal permeability; tests that measure lactulose/mannitol recovery in the urine or tests that measure serum antibodies to specific proteins and endotoxins like occludin, zonulin, lipopolysaccharides and actin. While lactulose/mannitol recovery tests tend to be cheaper, they are also prone to giving false negative results.
Both Vibrant Wellness and Cyrex Labs offer serum antibody tests. The Vibrant Wellness Wheat Zoomer kills two birds with one stone – it assesses gluten/wheat sensitivity as well as intestinal permeability. To obtain the same information utilizing Cyrex Labs, one must order two separate lab tests.
The Bottom Line
For many, choosing a gluten-free lifestyle is the path to recovering their health. But going gluten-free is not just about eliminating gluten from the diet. To ensure that your efforts are not in vain, seek advice from a functional practitioner who is trained in gluten-related disorders. A knowledgeable practitioner will help you navigate the world of food sensitivity testing, evaluate potential cross-reactive sensitivities, and identify hidden sources of possible exposure.