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With 200+ symptoms, testing essential to determine gluten intolerance

Licensed nutritionist Nonie De Long tackles the tricky question of gluten and whether it’s beneficial to avoid it
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Dear Nutritionist,
Thank you for your columns! I especially enjoyed the ones on diabetes and sugar substitutes. Can you please speak to the gluten issue a bit? I see gluten-free stuff all around the stores now and is it really healthier? I’m reading that gluten is really bad for us, but then if I’m not celiac is it really any better? It has just as much sugar and it doesn’t seem to be whole grain. It’s also more expensive. I try to eat healthier now so I’m just wondering what I should do.
Thank you! 
Lee 

Dear Lee, 
That’s a great question, thank you for writing in. It’s also a complex question, so I’ll get right into it. 

There are bonafide reasons to avoid gluten. One such is that a person has been diagnosed with celiac disease. Despite early suggestions that this was an easily diagnosed condition, it’s now understood that there are over 200 related symptoms, which can develop at any point in a person’s life, for reasons we still don’t understand. And current diagnostic procedures often do not positively diagnose cases where people are known to be reacting negatively to gluten. 

It would seem that biopsies (upper intestinal endoscopies) either have a high rate of false negatives, or the test is measuring a correlated, but not intrinsic markers of the disease, or that the threshold of that marker is particularly high and there are a large number of people who are symptomatic but do not, and may not ever, meet that criteria. In my practice I prefer genetic testing. For a more in depth analysis of this issue, I suggest you read here. It’s pertinent because studies now suggest 30% of us may be gluten reactive and all of us may have some degree of sensitivity to gluten. According to David Perlmutter, MD “It is likely that 100 percent of humans activate zonulin when exposed to gluten, and this increases gut permeability. This is thought to play an important role in autoimmunity.”

For this reason there has also emerged an understanding of a spectrum of gluten-related disorders outside of celiac disease, including dermatitis herpetiformis, wheat allergy, wheat sensitivity, and non-celiac gluten sensitivity. These disorders are present in many people even though celiac has been ruled out. 

Such people fail the celiac test or don’t have the digestive symptoms to warrant their doctor to recommend testing, yet develop symptoms when they consume foods that contain gluten. They may or may not be better on a gluten-free diet, as there are often other sensitivities at play. In such a case, removing the wheat/ gluten would improve their state mildly, but inconsistently, because other foods are still triggering them. They mistakenly conclude the work to remove the gluten isn’t worth it and often stop there.

This is why it’s essential to see a professional for testing. And, it’s important to note that typical allergy skin prick/scratch testing is not effective at determining food intolerances, in my clinical experience. Hair testing and strict elimination diets are effective, with one being obviously much more time and energy consuming than the other.

Some of the symptoms of being intolerant to gluten are not historically associated with celiac:

  • Headaches and migraines
  • Fatigue and sleep problems
  • Irritability and mood swings
  • Psychosis and thinking problems
  • Inflammation anywhere in the body
  • Autoimmune disorders

And much more.

Clinically about half of the people I see for suspected gluten intolerance were told by their physician or specialist that they were NOT gluten intolerant and/or they self tested with elimination and did not respond positively to a gluten-free diet, so they conclude they are not intolerant. They then come to me confused because they look at checklists and they are checking off reams of the boxes, but they have no answers. When I test them the results often come back showing a genetic intolerance to gluten, after which (or often before which) I put them on my gluten-free diet and they improve exponentially. 

What they learn is that gluten is actually a misnomer. We should actually be speaking about glutens, plural. 

Say whaaaaat? What on earth is she going off on now?

It turns out that wheat, barley, rye, and oats all contain their own forms of gluten and many food additives contain hidden gluten, as well. MSG, natural flavours, spices, and other obscure ingredients on food labels can contain gluten. In addition, there is often a lot of inflammation and other food intolerances in a person who is sensitive to gluten because a gluten intolerance damages the intestinal lining, allowing other food proteins to enter the body without being properly broken down, thereby increasing their chances of being tagged as threats by the immune system. Once there are a number of food intolerances, how can you improve by only eliminating one? A client needs to know exactly what to eliminate and what to include to repair the damage to the digestive tract and inflamed tissues. 

This is where a professional is absolutely necessary. 

So to answer your question, Lee, I believe gluten intolerance is far more prevalent than we have been led to believe and many people who have not been diagnosed as having celiac improve greatly when put on a professionally managed gluten-free diet. I think it’s an epidemic problem and most people benefit from removing glutens from their diet because glutens are innately inflammatory proteins, so even if a person isn’t intolerant per se, glutens are not an optimal food for human consumption. For more on this I would recommend reading Dr. Perlmutter’s Grain Brain and following his work online

When recommending a gluten-free protocol, however, I do not recommend ‘gluten-free’ processed foods. Stay away from this cardboard dressed as food! These are highly processed grain/ lentil/ potato/ corn based substitutes - all of which are high glycemic, often inflammatory, and not particularly nutritive. In the gluten intolerant person the body needs to be super saturated with easily absorbed nutrients to heal damaged tissues, and that can’t happen with such subpar foods. I recommend a whole food, low carbohydrate, ancestral diet, rich in probiotic foods, as I do for almost all ailments. It’s not glamorous and requires cooking your food at home, but this is again and again what I find to work. 

For breads, if you suspect you are gluten intolerant, and even if you don’t, my suggestion is limit it. If you need it once in a while I suggest sprouted ezekiel bread, as it’s more nutritive and less inflammatory. But I don’t think it’s suitable for those with celiac or wheat allergies, in which case, find grain-free substitutes like collard greens for wraps and cheese or cauliflower pizza crust. The internet has an abundance of great recipe sites dedicated to grain and gluten free eating, so it’s actually really easy to find great recipes. One of my favourite sites is Against All Grain by Danielle Walker. She has many great, free recipes listed there and her cookbooks are wonderful!

Thank you, Lee, for writing in with such a great question! As always, if readers have their own health questions, I welcome them. Just send me an email.
Namaste!
Nonie Nutritionista

Nonie De Long is a registered orthomolecular nutritionist with a clinic in Bradford West Gwillimbury, where she offers holistic, integrative health care for physical and mental health issues. Check out her website here.

Do you have a question about health and wellness? Email nonienutritionista@gmail.com




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