Health Minute: Gluten Sensitivity + Filter Special
Is your gut reacting to grains?
Health Minute Audio Summary:
Many people are sensitive to gluten and gluten-containing grains. Conventional medicine looks at gluten only in terms of the very extreme gluten allergy called celiac disease, in which the small intestine villi are permanently damaged and incapable of proper absorption of nutrients. Yet, just as we have food sensitivities that are not what conventional medicine would call an allergy, we can have sensitivity to gluten without having the very serious condition of celiac disease.
WHAT IS GLUTEN?
Gluten is a protein found in the most commonly used grains, including wheat, rye, barley, and oats. It’s also found in less common grains including spelt, kamut, triticale (a wheat-rye cross), and farina. Gluten is what causes a grain to make good bread by producing a doughy elasticity to the flour. “Developing” the gluten in the kneading process is what makes a loaf of bread that rises to the typical height. Because of its particularly high gluten content, wheat tends to make the best rising loaves.
WHAT’S THE PROBLEM WITH GLUTEN?
What gluten actually does to someone sensitive to it and why is open to some debate. Some suggest that because modern grains are domesticated, hybridized versions of what were originally grasses, there may be some toxicity associated with them. Some people are more sensitive than others to these formerly “wild plants.” Celiac disease shows up much more often in northern and central Europe and northwestern India. Wheat cultivation in these areas is much more recent. For example, celiac disease is about eight times more common in Ireland than it is in the United States.
It is more widely accepted that the problem with gluten is an immune system response wherein it is perceived as a foreign protein. In the case of celiac disease this is immune response to gluten is believed to be genetic. In that case there is an antibody reaction to gliadin (the toxic component of gluten) or transglutaminase. To be diagnosed with celiac disease (also called celiac sprue, nontropical sprue, or idiopathic steatorrhea), damage to the small intestine villi must be visible on biopsy and there must be improvement in symptoms when a gluten-free diet is followed. Some authorities note that damage to the small intestine may not be detectible, even under the microscope. Thus, testing the function of the small intestine is more important than placing too much confidence in biopsies or blood tests.
However, someone that just has gluten sensitivity, will not show these antibodies on a blood test. Likewise, an intestinal biopsy will probably be normal. As is the case with other food sensitivities, it is primarily a digestive reaction, rather than an immune system reaction. While only 1 in 225 Americans have celiac disease, as many as 30% or more may be gluten sensitive.
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