Have you wondered if you should avoid gluten? Is there any reason to do so, if you are not allergic to it? There is a lot of misinformation put there, with some people deriding gluten-free as a “fad”, and others saying nobody should eat it. I figured it’s about time I did a post on gluten, coeliac disease, wheat allergy, and the effects on non-coeliacs in particular.
What is gluten?
Gluten is a type of protein found in a wide variety of grains including wheat, barley, rye, and often oats (which are usually cross-contaminated). It is what gives bread the elastic and “gluey” texture.
What is coeliac disease?
Coeliac disease is an autoimmune condition, whereby antibodies to wheat proteins are created in response to eating gluten, which then attack the gut lining, and over time can erode it and impair nutrient absorption. Symptoms can include gut issues (diahhroea, constipation, stomach cramps), weight loss, nutrient deficiency symptoms and more. The symptoms are more gradual rather than immediate. Coeliac disease also slightly raises the risk of intestinal malignancy. Diagnosis involves detection of the specific antibodies, and sometimes a biopsy is done, which will show intestinal damage. Coeliac disease seems to have increased 5 fold in the last 25 years, (and likely these numbers are underrepresented) so there is clearly something in the environment (whether its the wheat itself, or other factors) that has made people more intolerant of wheat.
What is Wheat allergy?
This is when eating wheat induces production of something called IgE antibodies. These are produced in response to something recognized as “foreign and dangerous” by your body, but these antibodies are different to the ones in coeliac which specifically attack the body’s own tissues . Symptoms usually occur within minutes of eating gluten and include swelling or irritation of the mouth/throat, hives, cramps, nausea/vomiting and rarely anaphylactic reactions.
What is non coeliac gluten sensitivity?
Many people not up to date with the research, or who haven’t seen patients don’t believe those without coeliac need to avoid gluten. However it is becoming clear than some people DO have reactions to gluten even if they don’t have a full blown allergy. This is called non coeliac gluten sensitivity. Such people often report similar symptoms to ingestion of wheat as coeliacs (GI symptoms, brain fog etc) but the coeliac antibodies and severe intestinal pathology are not found, nor do they have igE antibodies.
Why are some people sensitive to gluten?
Gluten can cause release of Zonulin, a protein that regulates the permeability of the intestinal lining (“leaky gut” is essentially increased permeability which is bad as it allows you to absorb larger molecules of food, as well as bacteria that your immune system may mount a response to). This has been shown to happen in BOTH coeliacs and non coeliacs, though to a lesser degree in non coeliacs. Zonulin mediated gut permeability is a factor in some chronic inflammatory diseases, including metabolic disease, multiple sclerosis, inflammatory bowel disease and more. Furthermore, a leaky gut can trigger an immune reaction to other potentially problematic proteins, such as dairy proteins. In this case you might find lots of foods cause trouble because of a leaky gut, in which case healing the leaky gut can increase tolerance to these foods if you try to reintroduce them later.
Evidence is emerging that there is a systemic inflammatory response to eating wheat in people with gluten sensitivity (likely related to the leaky gut). It’s not specific (as in coeliac and wheat allergy) so your doctor won’t necessarily test for the inflammation, but it exists.
In mice, gliadin ( a component of wheat gluten) worsened the damage to the gut lining indueced by NSAIDS, so it might be sensible (whether you think you are sensitive or not) to avoid eating gluten when taking medications that may themselves damage the gut lining.
If coeliac rates are increasing, it is entirely possible that gluten sensitivity is increasing as well, so when people say “nobody was avoiding gluten in the olden days”, they are missing the important fact that our environment and farming methods have changed since then, as has consumption of highly processed foods
How to tell if you have gluten sensitivity?
If you think you might be reacting negatively to gluten, talk to your doctor who can at least check for coeliac antibodies or for full blown wheat allergy. If you have a functional medicine doctor, they can do a Cyrex panel which tests your potential for gluten protein reactivity and autoimmunity.
The other main thing to do is remove wheat from your diet for 30-60 days and see how you feel. You may feel the same without wheat, in which case you may be reacting to something else, or you have leaky gut/a disrupted microbiome, in which case you can try an elimination diet, let your gut lining heal, then reintroduce potential triggers one at a time, to see how you react.
Who might benefit from avoiding gluten?
Those with autoimmune disease, IBS (irritable bowel syndrome), IBD (Inflammatory bowel disease), and those with general symptoms without a specific diagnosis (including joint pain, GI issues, skin issues, fatigue and brain fog).
I have personally avoided gluten for about 15 years, since I discovered its potential problems, and because foods containing gluten aren’t particularly nutrient dense or healthy. If you feel you really don’t want to give up gluten containing foods like bread, at least aim for sourdough versions as the fermentation process breaks down some of the gluten and makes it more digestible. Some people have reported success taking gluten enzymes that help you digest gluten, (though it isn’t reccomended for those with severe reactions).
In conclusion, gluten can cause problems in many people, most insidiously contributing to leaky gut (which may be hard to trace back to gluten), while being present in most processed foods, and not contributing much in the way of nutrition. As such, I don’t consider going gluten free an “unnecessary fad”, as long as you don’t then replace it with processed gluten-free substitutes which often have a lot of additives/gums/preservatives/bad fats. As usual, healthy eating usually comes down to fresh, natural food in it’s most “whole” form!