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Should we eat gluten?
I love bread as much as anyone. My idea of heaven includes an eternal all-croissant picnic. But sadly, for those of us with autoimmunity, inflammation or neurological problems, wheat and other gluten-containing grains may be a problem. Here’s why:
Gluten increases intestinal permeability by opening little gates in the intestinal wall, called tight junctions. This means that more of whatever is in our intestines enters the bloodstream. This little change, sometimes called “leaky gut”, can have huge consequences….not just for people with Celiac disease, but for everyone.
In 2012, Dr. Alessio Fasano published several important findings showing that excessive intestinal permeability (leaky gut) can play a leading role in autoimmunity and inflammation. When a leaky gut allows more of our intestinal contents to enter the bloodstream, this includes bacteria, mold, toxins, undigested food particles, or other substances that our immune systems may perceive as threats. When the immune system attacks, we get inflammation. If more “junk” in the bloodstream keeps the immune system perpetually more activated, this can cause chronic inflammation.
In those who are susceptible, the immune system may also attack some of our own tissues, especially when we have tissues that resemble, at a molecular level, whatever was identified as the threat. When enough tissue gets damaged, we feel symptoms of an autoimmune disorder. There are over 120 different autoimmune disorders, depending on which types of tissue get damaged.
The good news about Dr. Fasano’s research is that it suggests we can prevent or sometimes even halt autoimmunity and chronic inflammation by reducing intestinal permeability. Avoiding gluten is a big help in that process.
Finally, in a related finding, Vojdani and colleagues (2014) found that eating wheat (and dairy) was associated with a significantly higher likelihood of having several neurological autoantibodies present. In other words, it appears that some people’s immune systems react to gluten (and dairy), and end up also attacking brain or nerve tissue. As someone with debilitating autoimmune neuropathy, that sure takes all the fun out of croissants for me!
So that’s why I commonly recommend that chronic illness patients do a 1-4 month trial without gluten. Many patients feel much better within days. And, for those with access to gluten-free healthy starches, then you might want to avoid gluten no matter how you feel, just to be on the safe side.
Gluten-free starch alternatives include:
For grains or baked products, look for the certified gluten-free label, because equipment that processes gluten-containing grains can cross-contaminate other foods. Also, it’s important to know that restaurants have a poor track record for accuracy in their gluten-free claims, especially for pizza and pasta dishes, where over half of the items claiming to be gluten-free had detectable gluten (Lerner et al., 2019).
Going gluten-free can be a big hassle at first, while you read labels, discover that it’s in more products than you ever imagined, and work to find alternatives. But many patients find that going gluten-free clears up many symptoms within days or weeks. If you want to learn more about this important topic, I recommend a book called “The Autoimmune Fix” by Dr. Tom O’Bryan. He has also given some fantastic live presentations at past LDN conferences. Some of the evidence he presents is absolutely mind-blowing, like how autoimmune patients in the military just happened to have had blood samples saved from decades prior to their autoimmune diagnosis, and when they tested the old blood samples, they found autoantibodies doing autoimmune damage years before any symptoms appeared. It can take a lot of slow, steady damage to finally result in an autoimmune disorder, and we may not feel it happening. My healthy husband hasn’t touched gluten since the day he heard that at Tom O’Bryan’s talk at the 2017 LDN Conference. Check it out on this website, several videos down, called “Fire in the Hole: Intestinal Permeability”:
Fasano A. Leaky Gut and Autoimmune Diseases. Clinic Rev Allerg Immunol (2012) 42: 71. doi:10.1007/s12016-011-8291-x
Fasano A. Zonulin, regulation of tight junctions, and autoimmune diseases. Ann N Y Acad Sci. 2012;1258(1):25–33. doi:10.1111/j.1749-6632.2012.
Vojdani A, Kharrazian D, & Mukhergee PS. The Prevalence of Antibodies against Wheat and Milk Proteins in Blood Donors and Their Contribution to Neuroimmune Reactivities. Nutrients 2014, 6(1), 15-36. doi: 10.3390/nu6010015
Lerner B, Vo LP, Yates S, Rundle A, Green P, & Lebwohl B. Detection of Gluten in Gluten-Free Labeled Restaurant Food: Analysis of Crowd-Sourced Data. The American Journal of Gastroenterology. 114(5):792–797, May 2019