GLUTEN SENSITIVITY

GLUTEN : GLUTEN : GLUTEN : GLUTEN : GLUTEN : GLUTEN : GLUTEN

Gluten is a protein found in wheat, barley, rye and triticale. Protein is made up of different combinations of standard amino acids. Wheat  protein is mainly gluten that is further made up of glutenin and gliadin. There are four different types of gliadins : alpha, beta, gamma and omega gliadins. In addition wheat also contains agglutinins (Lectins) and prodynorphins.  

Tissue transglutaminase ( tTG) enzyme breaks down wheat gluten in the gut into deamidated  gliadin and gliadorphins. The structure of gliadin is different than other proteins due to abundance of proline and glutamine amino acids. Both enzymes make a strong bond between other amino acids hence are not easily broken down and digested. Thus gluten puts a great stress on the digestive system and irritates the lining of the small intestine.

Celiac disease is characterized by an immune response to a specific single type of gliadin (alpha-gliadin) and a specific type of tissue transglutaminase (tTG-2). While the other types of gliadins (beta, gamma, omega),deamidated gliadin, gliadorphins  and transglutaminases (tTG-3 in the skin, tTG-6 in the brain) are never tested. Therefore 99 percent of gluten intolerance or celiac disease are never diagnosed. This is a great concern because conventional lab testing for celiac disease and gluten intolerance screens for antibodies to alpha gliadin and tissue transglutaminase -2 only. This means how severely you're reacting to any other fractions of gliadin( beta, gamma, omega) and tissue transglutaminase (tTG 3 &6) you'll test negative for celiac and gluten intolerance.

It is predicted that a large percentage of celiacs don't even have abdominal symptoms, making the diagnosis very complicated. According to one study done on people with celiacs, 80% of them don't even know that they have it. Humans have consumed wheat for thousands of years, so what has changed in wheat now that it would have begin to bother us only in the past few decades. The hybrid dwarf wheat varieties contain way more gluten fraction of wheat than our ancestors consumed. Our dependence on antibiotics and pain killers  for every minor disease have destroyed our intestinal flora and weakened our immune system.  Processed , deep fried and  sugar laden foods have further complicated the problem of dysbiosis. Glyphosate ( Round up) sprayed right before harvesting wheat accumulates in the grains and acts like a gasoline on fire in causing our immune system to go haywire.

A review paper published in the New England Journal of Medicine listed 55 diseases that can be caused by eating gluten. Can you imagine any other food or even a drug or narcotics comes closer to gluten in causing a multitude of diseases. The problem is that only one percent of those with the disease were actually diagnosed. Gluten is the most common environmental allergen and toxin that we are exposed to. Why would we continue to eat something that causes inflammation and increases gut permeability every time we eat it. Just a tiny amount of gluten is enough to cause a significant reaction from the immune system and the effects can last weeks or even months to pacify it. Gluten sensitivity is the next epidemic.

List of symptoms and diseases caused by gluten :

1. Digestive issues include gas, bloating, diarrhea, constipation, irritable bowel syndrome (IBS)

2. Nutrients malabsorption and keratosis pilaris ( chicken skin on back of arms) and anemia or low blood count due to iron deficiency. Iron deficiency anemia doesn't respond to iron therapy because of flattened villi.

3. Fatigue : Gluten can contribute to feelings of sluggishness and tiredness. In inflamed body, spending resources dealing with gluten proteins leads to depletion of energy.

4. Autoimmune diseases like Hashimoto's thyroiditis (Hypothyroidism), rheumatoid arthritis, ulcerative colitis, lupus, psoriasis, scleroderma and multiple sclerosis and diabetes. Since gliadin, the main problem causing gluten protein is similar in structure to other proteins found in tissues of organs such as the thyroid or the pancreas and antibodies against gliadin can end up attacking these organs and ultimately cause autoimmune diseases like hypothyroidism and type 1 diabetes. Gluten's anti-inflammatory effect in the gut causes intestinal cells to die prematurely and cause oxidation of the cells and leaky gut that allow bacterial proteins and other toxic products to get into the blood stream and lead to autoimmune attack.

5. Neurological problems such as dizziness,, feeling of being off balance. Cerebellar ataxia is the inability to coordinate balance, movements, problems talking and are directly linked to gluten intolerance and damage to the cerebellum that controls motor function. Ataxia, Schizophrenia, Epilepsy, Autism , Parkinson's, Alzheimer's disease patients show massive improvements by removing gluten from their diet.

6. Hormonal imbalances like Premenstrual Syndrome (PMS), Polycystic Ovarian Syndrome (PCOS), unexplained infertility. According to Dr Daniel Kalish a strong relationship has been established in medical literature between gluten sensitivity and the hormone progesteron , estrogen and adrenal hormonal  imbalance.

7. Migraine headaches: Gluten sensitivity is known to cause headaches and migraines. In a study 56%  people with migraines were found to have gluten sensitivity, and after removing gluten their migraines resolved. Dr Mark Hyman MD and Dr Allessio Fasano state that a 100 % gluten free diet can relieve many cases of chronic migraines.

8.  Chronic Fatigue Syndrome and Fibromyalgia: In fibromyalgia muscles and connective tissue aches and pains (Fibro=Connective tissue,Myo =muscle, Algia = pain)

9. Inflammation or pain & swelling in joints of fingers, knees,and hips.: The body while attacking gluten forms immune complexes like interleukin-6 (IL-6) that travels in the blood and settles in the joints causing inflammation. swelling and pain.

10. Mood related disorders like anxiety, depression, mood swings, chronic irritability, Attention Deficit Disorder (ADD)  and Attention deficit and hyperactivity disorder (ADHD). The immune reaction  to the gluten creates toxins and damages the villi tiny finger-like protrusions inside the small intestine. Damages to these decreases the body's ability to absorb vital nutrients like B vitamins, iron, vitamin D, omega -3 fatty acid and zinc . These nutrients are essential for brain health and mood enhancing endorphins like dopamine and serotonin. Lack of vitamin D leads to osteoporosis.

11. Brain fog : Gluten contains gluteomorphins that can act like opium & morphine causing brain fog. Gluten can also damage brain cells and cause inflammation.

12. Wheat allergy : Hay fever, Asthma, Eczema, Hives,  Skin rash, Nausea, Stomach cramps, Indigestion, Vomiting, Diarrhea, Stuffy or runny nose, Sneezing, Headache are all caused by wheat gluten. Every time you experience any of the above symptoms , suspect wheat and remove it from your diet and see the results.

13. Dermatitis Herpetiformis  and skin problems:  DH is characterized by intensely itchy, raised fluid filled areas on the skin, usually located on the elbows, knees, buttocks, lower back, face, neck, trunk, within the mouth and gluten free diet improves and heals immediately.  Other skin problems like Eczema,  Acne, Psoriasis are caused by gluten and inflammation under the skin can occur and cause eruptions, rashes, itchiness, burning, redness, and even painful blisters.The consumption of gluten can trigger an immune system response and deposits a  substance  immunoglobulin A (IgA) under the top layer of the skin.

14. Low immunity : If you're prone to frequently getting sick you should consider gluten to potentially be an issue.

15. Unexplained weight gain or loss : Gluten can trigger inflammation in  the body that mimics stubborn weight gain. Type of gut bacteria living in your gut can play a positive role in keeping your weight in healthy range.

16. Vitiligo : is an autoimmune disease because the immune sustem attacks the pigment producing cells of the body. Lack of folic acid and vitamin B12 due to leaky gut  caused by gluten could be a contributing factor. Dr Peter Green a celiac disease expert  advocates that vitiligo can be reversed on a gluten free diet if caught early enough.

The dangers of gluten doesn't stop there. Once the immune system in the small intestine starts reacting to gluten, it is exponentially more likely that the immune system will start reacting to other foods, most often dairy proteins casein, eggs, soy and other grains like rice, millet corn. So in these individuals complete elimination of problematic foods is recommended to heal the gut.

Zonulin is a fascinating  intestinal protein discovered by Dr Allessio Fasano and its main function is to regulate the passage of material from the intestine to the blood stream. Tight junctions are the spaces between cells and prevent foreign particles from entering the body.  Gluten consumption increases the production of  zonulin and results in opening of the tight junctions wide and longer and allow the undigested proteins to  enter the blood stream and causing autoimmune response.

Finally a little bit of advice to intelligent persons I encourage everyone to remove gluten from your diet for a month and see how you feel and improve most of your diseases and get the results you never expected !

References

(i) Ludvigsson JF, Montgomery SM, Ekbom A, Brandt L, Granath F. Small-intestinal histopathology and mortality risk in celiac disease. JAMA. 2009 Sep 16;302(11):1171-8.

(ii) Rubio-Tapia A, Kyle RA, Kaplan EL, Johnson DR, Page W, Erdtmann F, Brantner TL, Kim WR, Phelps TK, Lahr BD, Zinsmeister AR, Melton LJ 3rd, Murray JA. Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology. 2009 Jul;137(1):88-93

(iii) Green PH, Neugut AI, Naiyer AJ, Edwards ZC, Gabinelle S, Chinburapa V.
Economic benefits of increased diagnosis of celiac disease in a national managed care population in the United States. J Insur Med. 2008;40(3-4):218-28.

(iv) Farrell RJ, Kelly CP. Celiac sprue. N Engl J Med. 2002 Jan 17;346(3):180-8. Review.

(v) Sedghizadeh PP, Shuler CF, Allen CM, Beck FM, Kalmar JR. Celiac disease and recurrent aphthous stomatitis: a report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(4):474-478.

(vi) Margutti P, Delunardo F, Ortona E. Autoantibodies associated with psychiatric disorders. Curr Neurovasc Res. 2006 May;3(2):149-57. Review.

(vii) Ludvigsson JF, Reutfors J, Osby U, Ekbom A, Montgomery SM. Coeliac disease and risk of mood disorders--a general population-based cohort study. J Affect Disord. 2007 Apr;99(1-3):117-26. Epub 2006 Oct 6.

(viii) Ludvigsson JF, Osby U, Ekbom A, Montgomery SM. Coeliac disease and risk of schizophrenia and other psychosis: a general population cohort study. Scand J Gastroenterol. 2007 Feb;42(2):179-85.

(ix) Hu WT, Murray JA, Greenaway MC, Parisi JE, Josephs KA. Cognitive impairment and celiac disease. Arch Neurol. 2006 Oct;63(10):1440-6.

(x) Bushara KO. Neurologic presentation of celiac disease. Gastroenterology. 2005 Apr;128(4 Suppl 1):S92-7. Review.

(xi) Millward C, Ferriter M, Calver S, Connell-Jones G. Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev. 2004;(2):CD003498. Review.

(xii) Green PH, Jabri B. Coeliac disease. Lancet. 2003 Aug 2;362(9381):383-91. Review.

                                                                        DISCLAIMER

THIS INFORMATION IS INTENDED FOR INFORMATIONAL PURPOSES ONLY AND IS MEANT TO HELP AUDIENCE BETTER UNDERSTAND HEALTH CONCERNS. INFORMATION IS BASED ON REVIEW OF SCIENTIFIC RESEARCH DATA.

THIS INFORMATION SHOULD NOT BE INTERPRETED AS SPECIFIC MEDICAL ADVICE. CONSULT WITH A QUALIFIED HEALTH CARE PROVIDER FOR SPECIFIC QUESTIONS REGARDING THERAPIES, DIAGNOSIS AND/OR HEALTH CONDITIONS PRIOR TO MAKING THERAPEUTIC DECISIONS