Gluten Free Living

There is so much to discuss on this topic that I will barely scratch the surface in this post. Please feel free to contact me for further information/resources on Gluten Sensitivity/Celiac Disease.

What is Gluten? Gluten is the term given to certain types of proteins (called prolamines) which are found in wheat, barley and rye. In those with gluten intolerance, the digestive system has a difficult time breaking down these particular proteins into smaller particles, opening up the possibility to intolerance. In wheat, there are two proteins that seem to be involved in gluten intolerance. They are called Gliadin and Glutenin. In barley, these proteins (prolamins) are called hardeins. In rye, they are known as secalins.¹ These grains all derive from the grass family (all from the same sub-family and tribe). Oats are from the same sub-family but from a different tribe. However, there may be 1 in 100 that has an issue with pure oats.¹

What is Celiac Disease? Celiac Disease, also known as Celiac Sprue and Non-Topical Sprue, is an auto-immune disease whereby the body attacks itself in response to a foreign invader, in this case, Gluten. This immune reaction causes chronic inflammation and damage to the villi in the small intestine. In those that have Celiac Disease, eating gluten triggers the immune system to attack the intestinal tract. These villi are finger-like/shag-like structures on the surface of the intestinal tract. When these finger-like/shag-like structures are damaged they are flattened/blunted which means your body cannot absorb your foods nutrition. This can lead to mal-absorption and may create many other health issues. A Celiac Disease diagnosis is defined by villous atrophy. If you do not have villous atrophy but still think that gluten is an issue for you, you may have another form of gluten intolerance. Celiac Disease is a fairly common health concern and, in many cases, is undiagnosed. Research shows that at least 1 out of every 133 people have it. Celiac Disease is found in all ages, from the very young to older adults and it is also found in both genders. One can also have Celiac Disease and be asymptomatic. However, there can be other health challenges going on where one may not suspect Celiac Disease if a person is not displaying the classic symptoms. (See the information below) A person typically suffers approximately 10 or more years before getting the correct diagnosis of Celiac Disease. Celiac Disease is not the same thing as Gluten Intolerance. It is one form of gluten intolerance. Celiac Disease is a permanent intolerance to gluten! The only remedy for Celiac Disease is eating a life-long gluten free diet!

If I have Celiac Disease can I eat just a little bit of Gluten? NO! Eating just a little gluten can cause your body to produce antibodies for months after consumption/exposure. Even slight partial ingestion of substances containing gluten can cause a reaction on a physiological level whether or not you realize it is causing a problem.

Gluten Sensitivity CAN also trigger autoimmune diseases. You do not have to have villous atrophy or Celiac Disease in order to have the auto-immune process occur. The only way to eliminate your intolerance of gluten is by complete avoidance of any gluten containing products. Although we do not outgrow a gluten intolerance, it is possible that your symptoms may vary over time.

What are some possible associations with CD or Gluten Sensitivity?^2B

Abdominal Pain
Abnormal Liver Function
Autoimmune Diseases – such as Thyroiditis, Sjogrens, + Many others
Chronic Diarrhea
Constipation
Decrease in appetite
Delayed Puberty
Dementia
Dental Enamel Defects
Depression
Leg Weakness
Distended Abdomen/Bloating
Epilepsy
Fatigue
Food Allergies
Heartburn
High Parathyroid Hormone
Infertility
Iron Deficient Anemia/B12 deficiency
Irritability/Depression/Anxiety
Itchy Skin Rashes/Dermatitis Herpetiformis (blistering skin rash)
Joint Pain
Low Calcium
Low RBC Folate
Low Vitamin D Levels/Other Vitamin Deficiencies
Menstrual Disturbances
Migraines/Headaches
Mouth Ulcers
Muscle Pain
Nausea
Neurological Manifestations
Neuropathy (numbness/tingling)
Osteopenia/Osteoporosis (Especially if younger)
Recurring Mouth Ulcers
Schizophrenia
Short Stature
Vasculitis

Gluten Containing Grains: UNSAFE FOODS

Barley
Bulgur
CousCous
Durum Wheat
Einkorn
Emmer
Farinas
Graham
Kamut
Matzo
Oats (due to cross contamination… you can purchase GF Oats)
Rye
Semolina
Spelt
Triticale
Wheat
Wheat Bran
Wheat Germ

The Many Foods/Products Where Gluten May be Hidden:

Always check labels & verify

Alcohol
Barley Malt/Flavoring/Syrup
Bleu Cheese
Brewer’s Yeast
Caramel Color
Cold Cuts/Luncheon Meats
Dextrin
Dextrose
Communion Host/Wafer
Glucose Syrup
Hydrolyzed Vegetable/Plant Protein
Imitation Seafood
Licorice
Maltodextrin
Maltose
Matzah
Modified Food Starch
Seasonings
Seitan
Soup Stocks
Soy Sauce
Starch
Vitamins/Supplements, Medications, Cosmetics, Lotions, Bath & Body Products, Toothpaste, Shampoos/Conditioners, Envelopes, Stamps, Mouthwash, Hairspray, Pet food, etc.
Wheat Grass (depends on how it’s harvested)

When in doubt leave it out. If you are not clear on whether or not a food is Gluten Free… even if it appears that there are no gluten containing ingredients, check with the manufacturer as you may be unaware of cross contamination. Look for the GF symbol on any boxed/packaged foods.

Safe Foods

Foods that are safe to eat as long as they are unprocessed (kept from cross contamination) and in their natural state are: Fresh vegetables and fruits, proteins such as chicken, turkey, beef, lamb, eggs, beans and legumes, raw nuts and seeds, and avocado. Some have raised the question as to whether or not dairy products from "grain fed" animals are safe. Many will do better forgoing the dairy products altogether. However, if you are going to continue to eat dairy products…you may want to look at the option of grass fed products. Always check your labels.

Other Traditionally Accepted Safe Foods:

Almond Meal
Arrowroot
Coconut Flour
Flaxseed Meal
Guar Gum
Wild Rice
Xanthan Gum
Amaranth***
Bean Flours***
Buckwheat***
Corn***
Millet***
Potato
Quinoa***
Rice***
Sorghum***
Tapioca***
Teff***

***Some of these foods can be potential cross reactive (see Array 4 at the link) foods. If you have been on a gluten free diet for some time and are still not improving, you may want to investigate whether or not these are reactive foods for you.

***Note: Although the foods listed above are on the traditional “safe list”, keep in mind that some docs believe even these "safe" grains may pose a problem. Some docs believe it is best to forgo grains altogether.

In order to allow optimal healing to take place it is very important to work with a practitioner that is extremely knowledgeable and up to speed on the most cutting edge, recent research on the subject of Gluten Sensitivity/Celiac Disease. There are many facets to the healing process. Many naturopathic doctors/nutritionists work on intestinal repair using targeted nutritional supplementation, they will also often look into other possible food sensitivities, and nutrient deficiencies, etc.

Preventing Cross Contamination: If you are the only family member with Celiac Disease there are some precautions you need to take in your own kitchen. For example, to prevent cross contamination it is important to have a separate tub of butter (label it GF so other family members do not get confused), use separate serving utensils, and it is very important that you have a separate toaster/toaster oven from gluten containing breads/foods. You should purchase separate condiment products, as well, and be sure to have a NO double dipping rule in the house (another option is to purchase squeezable bottles)! When eating out, be very cautious…choose restaurants that offer Gluten Free Menus and are reputable. Even then, cross contamination is a very real concern.

Labeling of Gluten Free Foods: In order for a food to be labeled as GF it must contain less then 20 ppm’s of gluten or 20 mcg or less per gram of food. Some argue that this is still not low enough, especially for the highly sensitive Celiac who would like to see the gluten-free guidelines be as low as possible!

Note: If you are still eating foods that do not have the GF seal as of yet and you have confirmed in the past that the food is indeed GF …Be sure to check each time because over time you will not know if the manufacturer has changed or substituted ingredients.

Testing/Acknowledgements/References:

If you suspect that gluten is an issue for you, see your doctor for testing.

If you do the recommended testing and your results come back negative but you still think that gluten is an issue for you, consider gene testing.

See our resources page for further information and products available.

A very special thanks to Dr. Tom O’Bryan for his great work in this area. To purchase his DVD and for further information go to www.thedr.com

A great read: Healthier Without Wheat by Dr. Stephen Wangen

Testing: www.cyrexlabs.com

1 Wm K Warren – Medical Research Center for Celiac Disease @UCSD

2, 2B Dr. Tom O’Bryan – Identifying and Conquering Gluten Sensitivity