One of the first things people cut out when trying to improve gut health and troubleshoot digestive problems is gluten.
There is so much confusion about gluten. And the gluten free health trend only adds to the confusion, bringing up the following questions:
Is gluten bad for you?
Who will benefit from avoiding it?
Is it only a problem for celiacs or can anyone with digestive issues benefit from abstaining?
How do you know if you have a problem with gluten and what problems does it actually cause?
I answer those questions.
I will also address how to counteract the inflammation caused by eating gluten-contaminated foods if your immune system is sensitive to it.
Non celiac gluten sensitivity
What’s the difference between someone who has a wheat allergy and someone with celiac disease and non celiac gluten sensitivity?
An allergy is the most serious immune system response and is also more rare. The allergy is to wheat, not gluten, and can be life threatening, leading to anaphylaxis or constricted breathing. An epipen is needed to remedy exposure. This is an IGE immune response and, unlike a sensitivity, it happens immediately after exposure.
For celiac and non celiac sensitivity, the immune system responds with an IGA and IGG antibody response.
Celiac disease is a sensitivity that involves an intense immune response to gluten. Most (but not all) people with celiac will experience IBS-like digestive systems and/or additionally, joint pain, head aches, fatigue or brain fog if they consume gluten.
Symptoms can vary greatly and about 5 percent of people with celiac disease will have no symptoms all. Despite not feeling anything they will still suffer the same internal damage as those with symptoms.
With celiac disease, consuming gluten in any form (soy sauce, beer, gluten protein, wheat, barley, rye or contaminated oats) will prompt the immune system to attack and damage the villi lining the small intestine. These villi are responsible for absorbing nutrients, healthy function and motility of the small intestine.
If not controlled, immune attacks can cripples the small intestine, leading to leaky gut or SIBO. Leaky gut can in turn cause other food reactions. This is how celiac disease can lead to IBS or the development other food sensitivities.
Non celiac gluten sensitivity also causes immune system reactions in the gut but not as severe. Gluten consumption will inflame the gut but not cause as much damage to the villi. This inflammation can still cause intestinal permeability. The immune system can also react to other proteins found in wheat, not just gluten.
If you have a sensitivity to gluten or other wheat proteins, the nonstop inflammation will prevent the gut from healing or intestinal lining from sealing up.
How to know if you have non celiac gluten sensitivity
Your doctor can test you for celiac disease. If you don’t have it, that doesn’t automatically rule out non celiac sensitivity.
There is two ways to test for that: an elimination diet or stool testing.
The challenge with testing through elimination diet is that some people can have a delayed reaction to gluten. It could take up to 3 or 4 days for symptoms to develop.
The most definitive way to test for gluten sensitivity is through the stool testing. The GI Map tests gliadin, a common immune marker for gluten.
If gliadin has a value of over 100 on the GI Map it suggests mild gluten sensitivity. Anything over 150 suggests a severe reaction. You’ll have consume a small amount of gluten within 3 months of the test to get an accurate assessment. One bite of bread is sufficient.
Stool testing is one of the most effective ways to detect gluten sensitivity. The anti-gliadin antibody can be found in fecal samples even when blood concentrations are undetectable.
High levels of fecal anti-gliadin antibodies will determine whether a gluten-free diet is mandatory for healing the gut. If so, there needs to be 100 percent compliance to a gluten-free diet. One exposure can restart the cycle of gut inflammation for months.
Surprisingly, some of my clients, who follow a gluten-free diet, have high gliadin antibodies. This indicates inadvertent exposure to gluten, where out or at home.
Foods that are notorious for being contaminated are oats. If they don’t say gluten-free, your oats may contain trace amounts of gluten.
Another test dedicated solely to wheat and gluten sensitivity is the wheat zoomer. This is a test I order for clients for whom gluten sensitivity is a root cause for IBS.
What to do if you are sensitive to gluten?
For sensitive individuals, avoiding gluten is mandatory for healing the gut lining, calming inflammation and restoring immune balance.
Depending on the level of sensitivity, eating out can be challenging, as many gluten-free foods can be contaminated if prepared in the same kitchen or fried in the same oil as gluten foods.
To remedy this you can preemptively take gluten digesting enzymes to block some of the inflammatory effects of ingesting trace amounts of gluten.
If you don’t eat out, gluten exposure may still be an issue for you. Spices are notorious for being gluten contaminated. Nuts can be also.
You can test the foods at home with a Nima. This gluten-testing device uses small capsule to test samples of food for gluten. Put a mix of kitchen spices into the Nima and if it comes back positive, you need to test each spice. You use the Nima at restaurants to test your food before you eat it.
It’s a good idea to double check that your supplements don’t have hidden traces of gluten. Many supplements are certified gluten free.
In some cases, if gluten sensitivity is mild and caused by lack of enzymes, biome imbalances, leaky gut or inflammation, fixing these issue could reverse the sensitivity. If so, gluten will no longer trigger inflammation for you.
What to do if you get “glutened”
What do you do if you accidentally get “gluten”? For some people, one bite or even a trace amount of gluten is enough to trigger a reaction.
There are binders, like charcoal, you can take at the start of a reaction to ease and shorten the inflammatory response.
Gluten should be avoided by those who have an immune reaction to it
To sum up, the only way to know for sure if you have an immune response to gluten is to test for it. This is when avoiding gluten is crucial for recovery.
If gluten exposure is the missing piece that’s driving inflammation and digestive symptoms, testing and strict avoidance is key.
Some people know that gluten is a problem from their reactions to eating it. In these cases, eating gluten once in a blue moon is not worth it because the inflammation cycle it can create will endure for much longer than expected.
Lastly, just because something is gluten-free does not mean it’s good for you. Some gluten-free products contain hidden sugars and are highly processed. This makes some gluten free replacements hard to digested and food for intestinal bacterial and fungal overgrowth.