Wednesday, August 5, 2009

Gluten Sensitivity and Intolerance

There is an increasing amount of interest and information on the subject of gluten (a protein found in wheat and some other grains) sensitivity and a gluten free lifestyle. With this comes a good deal of misinformation and confusion.

The most well known (but still very poorly diagnosed) and extreme gluten sensitivity is Celiac Disease, a gluten triggered autoimmune attack on the small intestine. Celiac disease is confirmed by a biopsy of the small intestine revealing tissue destruction, but it isn’t that clear cut. Gluten sensitivity can, and does, exist without obvious damage to the intestines. I have actually had patients who suspected they might have gluten sensitivities ask their primary doctor about it only to be dismissed because they didn’t have obvious gastrointestinal symptoms. Celiac and gluten sensitivity can manifest a wide array of non- GI symptoms including: osteoporosis, osteopenia, central and peripheral nervous system disorders, anemias, weight loss or gain, tooth enamel defects, dementia, autism, Aspergers, ADHD, schizophrenia, infertility and early menopause, depression, vitamin K deficiency, dermatitis, organ disorders and fatigue.

There also seems to be some disagreement over which testing method to use to confirm a gluten sensitivity. Many doctors rely on blood testing; however, I feel that stool testing is more sensitive and accurate. Antibodies produced as the result of gluten sensitivity are mainly secreted into the intestine rather than the blood, analyzing stool turns up many more positive tests than blood tests. It is only when the immune reaction has been present for long periods of time and/or the process is far advanced that antibodies are produced in quantities sufficient to leak into the blood.

One thing is for certain, the number of people and with gluten sensitivities is on the rise. Research studies suggest that this is not just due to increased awareness and better screening. Modern wheat is very different from the wheat eaten by our ancestors. As a result of hybridization, wheat today has much higher levels of gluten proteins.

In chronically ill patients, gluten sensitivities must be considered. If indicated, removing wheat from these patients diets can have profound effects on their health. One study using MRI revealed a reversing of plaquing of the brain (as seen in Alzheimer’s and Multiple Sclerosis) in wheat sensitive individuals following a year of being wheat free.

Living gluten free is not easy but there is an ever expanding availability of these foods and products. Grocery stores, restaurants, and even amusement parks and major league stadiums are offering gluten free options. There are also some excellent books on the subject that are very helpful making the transition to a gluten free lifestyle.

Join the State College Support Group for their bi-monthly meeting Wednesday August 26th 2009 7:00pm at Mt Nittany Medical Center, Room 3. Share recipes and learn about living gluten free.

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