Over 10,000 years ago Hunter-Gatherers of the Fertile Crescent in Africa noticed that grazing animals ate and thrived on certain grasses. There were so many advantages to converting these grasses into human food: seeds could be stored, ground, and cooked into foods that were nutritious and good tasting. When sugar and yeast were added the processed grain was baked, fermented, distilled, and brewed. Farmers produced such bounties of wheat that whole harvests were offered to the Gods in gratitude for the provision. Yet over the years, through hybridization, the wheat plant has changed dramatically from the simple grass grown on the plains. It is estimated that a modern kernel of grain contains 8 – 10 times the amount of gluten as its ancient predecessor.
Gluten is the common name given to a composite of different proteins found in grains, referring predominately to gliadin and glutenin proteins found in wheat, barley, and rye. Gliadin is an alcohol soluble protein that is toxic to many people. There are two types of gluten intolerance, Celiac’s Disease and Gluten Sensitivity, both related to the body’s reaction to gliadin.
In Celiac’s disease the immune system makes antibodies to the gliadin protein. These same antibodies also attack other normal tissue within the intestines. The antibodies do their job and the immune system obliterates the absorptive surface of the small intestine, making survival very difficult. With gluten sensitivity, the immune system handles the gliadin protein as though it were a virus – generating a cascade of inflammation that acts as though there is an infection. Over time this chronic infection significantly reduces the digestive function by infiltrating the gut barrier and destroying cells responsible for producing digestive enzymes.
The early stage of gluten sensitivity is marked by inflammation and may result in gas, bloating, heartburn, constipation, and diarrhea. Many times over the counter preparations and prescriptions are given to mask these symptoms. As the inflammation progresses, nutritional deficiencies that result in fatigue, headaches, brain fog, anxiety, depression and insomnia are likely, along with other infections of the gut such as parasites, yeast, and h. pylori. In the final stages of inflammation, the digestive barrier is compromised along with poor digestion of macro and micro nutrients. In these later stages, signs and symptoms don’t change but the metabolic and immunological functions are increasingly compromised. The result is high susceptibility to autoimmune disease, heavy metal toxicity, hormone imbalance, and neurological disorders. Some of these diseases are Chronic fatigue syndrome, fibromyalgia, Hashimoto’s thyroiditis, diabetes, rheumatoid arthritis, multiple sclerosis, hepatitis, lupus, Parkinson’s disease, and autistic spectrum disorder. For some people this process of digestive deterioration follows a path of little to no signs or symptoms. This condition is referred to as “Silent Celiac’s.”
Both Celiac’s and gluten sensitivity are genetically manifested. The Celiac genes (HLA-DQ2 or 8) are found in 42% of the population. Similarly, the gluten sensitive genes (HLA-DQ1, 7, or 9) are found in 57% of the population. The potential for gene expression is very high, perhaps 99% of the population. Yet not all people who have these genes express them.
Clinically, we find that some event, infection, or environmental toxin triggers the expression of the gene. There is good evidence that gut microbiota (good bacteria) play a critical role by inhibiting the expression of the genes from Celiac’s disease or gluten sensitivity. It is important to understand that the use of any antibiotics increases susceptibility to Celiac’s disease and gluten sensitivity because antibiotics destroy the microbiota.
Interestingly, the health consequences of Celiac’s disease and gluten sensitivity are roughly the same, although damage to the digestive system occurs more quickly with Celiac’s. Since the late 1950s it has been estimated that 1 – 2% of the population suffer from Celiac’s disease. However, new evidence is suggesting that gluten intolerance is more widespread and having a major impact on the health of the U. S.
The gold standard for diagnosing Celiac’s disease or gluten enteropathy from gluten sensitivity is a biopsy of the small intestine. A small patch of intestinal tissue is examined under a microscope by a trained pathologist. A diagnosis is given when 100% of the intestinal villa is flattened or missing. This flattening occurs over time; if the biopsy is done too soon when such a flattening is not total, a false negative diagnosis is likely. Blood tests are available but the sensitivity of the test generally yields false negatives. More accurate saliva and stool tests that measure outright antigliadin antibodies are more sensitive and reliable than the blood test.
When we test patients for gut function, we find a strong correlation between elevated anti-gliadin antibodies and pancreatic deficiency. This clinical finding suggests that chronic inflammation from gluten-sensitivity may cause a decrease in enzyme production. Since these enzymes are produced in the tips of the intestinal villa, it suggests that the gluten sensitive inflammation may obliterate intestinal villi without causing intestinal permeability. Nevertheless, poor enzyme production translates into amino acid and fatty acid deficiencies, which in turn result in hormonal, neurological, and immunological dysfunction -ultimately leading to an outright disease.
New research is exposing the relationship between gluten sensitivity and xenobiotic metabolism. In one study, the ability to detoxify environmental chemicals was significantly lowered in an animal model with gluten sensitivity. Therefore, gluten sensitivity potentially inhibits a person’s ability to eliminate multiple cancer-causing agents.
There are many health problems associated with gluten sensitivity ranging from nutritional deficiencies to autoimmune disease to cancer. It is critical to know one’s gluten sensitivity, because future health depends on an intact and functional digestive system. Diagnosis using stool or saliva is simple and this information empowers one to change dietary habits and avoid gluten containing foods.
Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity. BMC Med. 2011 Mar 9 ;9:23.
Celiac disease: from gluten to autoimmunity. Autoimmun Rev. 2008 Sep ;7(8):644-50. Epub 2008 Jun 25 .
A deregulated immune response to gliadin causes a decreased villus height in DQ8 transgenic mice. Eur J Immunol. 2009 Dec ;39(12):3552-61.
Expression of microbiota, Toll-like receptors, and their regulators in the small intestinal mucosa in celiac disease. J Pediatr Gastroenterol Nutr. 2012 Jun ;54(6):727-32.
Improved xenobiotic metabolism and reduced susceptibility to cancer in gluten-sensitive macaques upon introduction of a gluten-free diet. PLoS One. 2011 Apr 12 ;6(4):e18648.
Family and Environmental Medicine help patients with Natural and Holistic Treatments for Gluten Sensitivity and Celiac’s disease. Dr Gary Gruber provides private appointments for patients from around the country who seek health and healing with Complementary and Alternative Medicine. The majority of patients are from the local area including Greenwich CT, Stamford CT, Darien CT, Norwalk CT, New Canaan CT, Wilton CT, Westchester County, NY, NYC, and Northern NJ.