50 Shades of Gluten

I know it’s been awhile since my last entree but I warned you guys, I am not a writer…I have too much to write and sometimes I don’t know where to start.

One of the areas I want to touch on is mental illness but I won’t speak on a personal level because I know my former wife’s attorney is just looking for anything to use against me in court w/ regards to my kids who both have gluten sensitivities and have no idea they could benefit by a grain free dairy free diet. However, their Irish family doesn’t believe in the food sensitivities so the kids are living w/ the poison in them 24/7. Not even our post-decree judge, who is married to an Irish women will do anything about the diet because gluten sensitivity is not something that is recognized my the medical world (yet) even though the government has made it a disability…We still have a long way to go.

In order to explain why gluten is bad more many people, I have to give you a quick lesson in the biochemistry of wheat and wheat digestion w/ the help of Chris Kresser.

Wheat contains several different classes of proteins. Gliadins and glutenins are the two main components of the gluten fraction of the wheat seed. (They’re essential for giving bread the ability to rise properly during baking.) Within the gliadin class, there are four different epitopes (i.e. types): alpha-, beta-, gamma- and omega-gliadin. Wheat also contains agglutinins (proteins that bind to sugar) and prodynorphins (proteins involved with cellular communication). Once wheat is consumed, enzymes in the digestive tract called tissue transglutaminases (tTG) help to break down the wheat compound. In this process, additional proteins are formed, including deamidated gliadin and gliadorphins (aka gluteomorphins).

Here’s the crucial thing to understand: Celiac disease is characterized by an immune response to a specific epitope of gliadin (alpha-gliadin) and a specific type of transglutaminase (tTG-2). But we now know that people can (and do) react to several other components of wheat and gluten but not just wheat, but barley and rye as well — including other epitopes of gliadin (beta, gamma, omega), glutenin, WGA and deamidated gliadin – as well as other types of transglutaminase, including type 3 (primarily found in the skin) and type 6 (primarily found in the brain). (3, 4, 5, 6, 7, 8)

This is a huge problem because conventional lab testing for CD and of gluten intolerance only screens for antibodies to alpha-gliadin and transglutaminase-2. If you’re reacting to any other fractions of the wheat, barley, or rye protein (e.g., beta-gliadin, gamma-gliadin or omega-gliadin), or any other types of transglutaminase (e.g., type 3 or type 6), you’ll test negative for CD and gluten intolerance no matter how severely you’re reacting to these grains.

Official statistics suggest that Celiac disease affects 1 percent of the U.S. population. But considering the limited scope of the testing, it’s possible that the actual incidence might be much higher. ABSOLUTELY! My guess is, 15-20% have a gluten sensitivity but people just don’t know it because those people are living w/ their symptoms they have had all their life, and like myself, they believe it’s just who they are.

In addition, CD is only the tip of the iceberg when it comes to gluten intolerance. Celiac disease is caused by a distinct autoimmune response to grain proteins and transglutaminase enzymes in the gut. But CD is just one possible expression of gluten intolerance; there are many other ways that sensitivity to gluten can manifest in the body. These are collectively referred to as “Non-Celiac Gluten Sensitivity,” or NCGS.

There’s no consensus definition of NCGS yet, but the most common understanding is that it’s a reaction to gluten that is not autoimmune (like CD) or allergic (like wheat allergy).

It’s difficult to estimate the prevalence of NCGS because there is no definitive diagnostic test for it. As I mentioned above, the currently available tests for gluten sensitivity are primitive and only screen for a small fraction of the components of the grain that people react to. Another issue is the variety of symptoms caused by CD and NCGS. While most people assume that gluten intolerance always causes digestive distress, this is not the case.

Almost 50 percent of new patients diagnosed with CD do not have gastrointestinal symptoms. Moreover, for every one case of CD that is diagnosed, there are 6.4 cases that remain undiagnosed – the majority of which are atypical or silent forms without GI symptoms.

Gluten intolerance can affect nearly every tissue in the body, including the brain, skin, endocrine system, stomach, liver, blood vessels, smooth muscles and even the nucleus of cells. CD and NCGS are associated with an astonishing variety of diseases, from schizophrenia and epilepsy, to Type 1 diabetes (which I just found out I had as as kid) and osteoporosis, to dermatitis and psoriasis, to Hashimoto’s hypothyroidism to peripheral neuropathy. Because the range of symptoms associated with gluten intolerance is so broad and nonspecific (e.g., can be attributed to any number of conditions), many patients and doctors don’t suspect gluten may be the cause.

Even with these limitations, some estimates suggest NCGS may occur in as many as 1 in 20 Americans. And while some mainstream medical professionals continue to insist that NCGS doesn’t exist, several studies have validated it as a distinct clinical condition — including gold-standard, double-blind, placebo-controlled trials.

The Gluten-Free Challenge: Still the Best Test for Gluten Intolerance

With all of this in mind, the obvious question that arises is, “What’s the best way to test for gluten intolerance?” Because of the limitations of current laboratory testing I described above, most experts on gluten sensitivity agree that the only reliable test is a “gluten challenge.” This involves removing wheat, barley, and rye from your diet completely for at least a week and then adding it back in after that. If symptoms improve during the elimination period, and return when gluten is reintroduced, a diagnosis of NCGS can be made.

However, for many people a gluten-free diet isn’t enough. Some grains that contain little gluten, such as corn, oats and rice have gluten parts per million (ppm) in he single digits, when wheat, rye, and barley are in the 50′s and 60′s. These are proteins that are similar enough in structure to elicit an immune response in people with CD or NCGS. In addition, about 50 percent of patients with CD show signs of intolerance to casein, the protein in milk. This may explain why up to 30 percent of CD patients continue to have symptoms or clinical signs after adopting a gluten-free diet. If you are still having issues mentally or physically, I recommend a completely grain and dairy-free diet during the gluten challenge period.

Finally, though the gluten challenge is still the gold standard test for gluten intolerance, there is a relatively new lab (Cyrex Laboratories) offering a comprehensive blood test which screens for all of the wheat and gluten proteins and transglutaminase enzymes I mentioned above. This can be a helpful diagnostic tool, but it should never replace a gluten/Paleo challenge.

To end, I will tell you how grain affects me:
Wheat – Severe ADD/ADHD
Barley – I am an ASSHOLE
Rye – I am invincible.

Think about where that grain is: Beer, Gin, some vodka’s (Kettle One, Grey Goose), Jager…

Put these grains in me and LOOKOUT!

Look for my next post soon!

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