November 4, 2022
Over the next four weeks we’ll be exploring all things gluten free, starting with a question I get asked all the time: what is gluten?
What is gluten?
Gluten is a protein that is found in certain grains, the most common is wheat. The others are barley, rye, farro, and triticale. While oats do not contain gluten, they do contain a similarly-shaped protein, called avenin. These proteins are notable because they cause an immune system reaction in some (but not all!) people. This can be due to various reasons, including Celiac Disease, Non-Celiac Gluten Sensitivity, impaired digestion, or chemical sensitivity. Not all grains contain gluten. Grains that are safe to consume for someone who is gluten sensitive are rice, corn, amaranth, and millet.
The types of reactions to gluten can vary, however sensitivity can frequently cause rashes, gas, bloating, IBS-like symptoms (constipation, diarrhea, pain), heartburn, reflux, brain fog, sinus problems, trouble concentrating, and poor memory. Since it activates the immune system, it can also cause flu-like symptoms, such as body aches, joint pain, and extreme fatigue. Gluten can cause on-going inflammation, which can damage the digestive system and create nutritional deficiencies. These deficiencies can lead to other imbalances, specifically in the thyroid, which can lead to increased anxiety.
What is Celiac Disease?
Celiac Disease is an autoimmune condition, caused by genetics, where the immune system attacks the body’s own tissues after an exposure to gluten. Exposure usually means eating gluten, even a small amount, but it can also include skin contact or inhaling particles, especially flour. For someone who is very sensitive, eating even a few breadcrumbs or licking an envelope (many glues contain wheat) can cause a reaction. In general, the tissues that the body attacks are the small intestine, though it can also affect the nervous system, larger digestive system, and the endocrine system (hormones).
Diagnosing Celiac Disease can be tricky. Since it is genetic, if others in the family are sensitive or have been diagnosed, this is a clue that it is Celiac. There is a blood test that looks for antibodies to gluten. A positive test for this indicates Celiac. This test is minimally invasive and is now easily available to consumers. It is possible to get a false negative to this test, especially if you have already cut out gluten. If someone has intolerance symptoms, I strongly encourage getting tested before making long-term dietary changes. If you want to get tested after having cut out gluten, you would have to eat three slices of bread per day for a month before taking the test. For those of us who are very sensitive, that would be torture!
The other way is through a biopsy of the small intestine, which is considered the gold standard in diagnosis. This procedure is invasive and can also produce false negatives. In some respects, a formal diagnosis doesn’t matter if you know you feel better when avoiding gluten. The upside to getting diagnosed is that it provides information on how strict you need to be and it can be helpful in setting boundaries. Someone who does not have Celiac might be able to reintroduce small amounts and still feel ok.
The most effective way to manage Celiac is to avoid gluten completely, which includes avoiding cross-contamination of cooking surfaces and oils. Since oats can be inflammatory, I usually recommend avoiding them initially, then slowly adding them back in to see if they’re ok.
Non-Celiac Gluten Sensitivity
Not all gluten intolerance is Celiac! It is entirely possible to react to gluten without having Celiac, this is called Non-Celiac Gluten Sensitivity. Gluten is a complex protein that has gotten larger due to GMO farming practices and can be difficult for some bodies to break down. This can cause inflammation, which can further disrupt digestion. NCGS can also be caused by sensitivity to chemicals. This would include synthetic perfumes, harsh cleaning agents (bleach), or exposure to pesticides. When wheat is harvested, it is sprayed down with Round Up, a pesticide that is toxic. Sometimes, reaction to wheat is actually a reaction to pesticides or other chemicals. This is more likely in someone who is regularly being exposed to chemicals or is generally sensitive to them. In addition, processed grains such as white flour are refined through chemical processes, increasing their toxic load.
When digestion isn’t working properly, the body can’t take in the nutrients it needs. Without the proper vitamins and minerals, the body has a hard time making stomach acid, which it needs to properly absorb nutrients. It’s a vicious cycle where inflammation leads to poor digestion which leads to nutrient deficiencies, which increases poor digestion. Inflammation also disrupts the microbiome, the community of bacteria, viruses, and fungi that live in our gut and help us maintain health.
Depending on sensitivity level, it may be possible to increase tolerance. This can be done by boosting digestion, choosing organic whole grains, avoiding highly processed and refined foods, increasing intake of fruits and veg, and minimizing life stress. All of these decrease inflammation and boost the absorption of nutrients. It makes sense to try these strategies before deciding to cut out gluten forever. It’s also possible to minimize gluten intake by eating more non-gluten grains and focusing on whole, nutritious fruits and veg.
Another question I get frequently, is should I cut out gluten? My answer is, if you think you might be sensitive, take it out for a short period of time and see what happens! It can cause such a wide variety of symptoms, that it’s worth playing around with taking it out for a week. During that time, focus on whole nutritious foods and plenty of filtered water. Next week I’ll get into gluten free recipes and foods you CAN eat to nourish you wherever you are in your stage of healing!