I get questions all the time from people looking for interpretation guidance – and perhaps a bit of sanity – in light of the mounting wave of sensational medical media headlines. Things like Forbes “Gluten Intolerance May Not Exist” quickly triggered more than a dozen inquires from my own clients. Especially when someone has successfully eliminated gluten 100% from their diet (which in today’s baked-good-obsessed culture, is no small feat!) and received large-scale symptom relief in return, this type of headline can feel confusing and totally unsupportive.
Because most of our historical association with gluten “sensitivity” is celiac disease (with its typical severe diarrhea and malabsorption symptoms), many people mistakenly have the impression that if gluten is “an issue”, it will result in severe GI symptoms. Certainly gluten sensitivity can be a true root cause for symptoms such as chronic acid reflux or constipation. “Wow, as long as I don’t eat gluten, I don’t have reflux!” is a comment I have heard from over a dozen clients. But gluten “sensitivity” (similar to allergies) is an immune system reaction. Yes, it usually begins in the gut (because that is where more than 2/3 of our immune system is housed). But the inflammatory chemicals generated by an immune system reaction to a food encountered in the gut can quickly spread throughout the body and cause symptoms far from the gut (e.g. the brain, joints, muscles, heart).
What to look for:
I find in my practice that GI symptoms of gluten sensitivity are much less common than other inflammatory effects such as depression, brain fog or attention deficit, arthritis, eczema, headache, and autoimmune disorders such as lupus and scleroderma. In particular, I listen out for my clients who struggle with chronic mild depression, mental malaise, and/or brain fog (“I feel like I’m thinking under a heavy, wet blanket”) and recommend they explore a short-term gluten elimination trial (see details below). Because of its role in creating or exacerbating intestinal permeability, full, long-term gluten elimination is always a recommendation I make to every client with any autoimmune disorder. It's still amazing to me how when I eat gluten or sugar, within about a week I have not only gained weight in my middle but also have the general blah feeling and a restlessness. I have played with this a few times and the reaction I get in my body and brain is consistent.
How to find out if you are gluten sensitive:
Headlines aside, it's up to you to explore how gluten impacts your mood and should do their own elimination challenge for at least a full month (100%, cold-turkey elimination to be valid as even a tiny amount triggers the inflammation response in your brilliant body). In many cases, this elimination takes care of symptoms in an obvious way. If the benefit is unclear, however, a reintroduction challenge can test for symptoms resurgence or get food sensitivity testing done. After the full 4 (preferably 6) weeks of elimination, I recommend my clients add back a full serving of gluten-containing food (e.g. a slice of bread) twice daily for three days in a row. It’s important to make the reintroduction a strong 3-day challenge vs. a slow, bite-by-bite, gradual return to the food (which allows symptoms to slowly creep back in over time without a clear culprit).
In an attempt to garner as many clicks as possible, the medical media often touts headlines which exaggerate clinical study findings – or in some cases go completely counter to what the researchers actually stated. In this case, the study (as opposed to the headline) was limited in a couple of key ways:
(1) exploring only IBS-like gastrointestinal symptoms (and many individuals who discover gluten triggers their inflammatory symptoms such as arthritis have no GI symptoms at all)
(2) the inclusion of a capsule of purified gluten and/or casein (the dominant protein in cow dairy) vs. an actual whole food that we eat such as wheat (which includes many other potentially inflammatory components besides gluten such as lectins and wheat germ agglutinin)
There are a couple of clear, succinct write-ups available online right now which explain the assumptions and limitations of this particular study which might be helpful to you and/or your clients. As with all clinical study findings, there is always a bit of a (or a big!) devil in the detail…
- Chris Kesser: http://chriskresser.com/is-gluten-sensitivity-real
- Sayer Ji: http://www.greenmedinfo.com/blog/mainstream-media-declares-gluten-sensitivity-myth-who-cares
Both authors question whether perhaps wheat itself (vs. gluten as an isolated substance) is perhaps the larger threat in our modern diet. This is a concept which I suspect will be researched much more heavily in the next few years. I have worked with several clients who indeed found they had strong reactions to wheat but could well tolerate other gluten-containing grains (e.g. rye, barley) without issue.
Empowering your health means tuning in and listening to your own unique body. I encourage you to explore and get curious how gluten impacts you personally and see what it feels like when you take it out of your diet and then add it back in. Just don't get caught in the "gluten free" junk food sales pitch! Just because potato chips are gluten free, doesn't mean eating them every day is going to make you feel healthy and happy!
In health and happiness,
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