Until recently not too many have people heard about or knew someone with gluten sensitivity or even celiac disease. Why does it seem to be so prevalent now? Answering this question requires a bit of discussion and is by no means an in-depth treatise on the subject. Perhaps it may be important to understand some terms first. I am frequently asked what is the difference between gluten sensitivity, gluten allergy and celiac disease.
Most experts agree that for one to be diagnosed with an allergy, you need to have an immune reaction that includes the antibody named immunoglobulin E (IgE) and the subsequent release of histamine from a class of white blood cells called mast cells. This type of allergic response is immediate and often can be severe. The most severe reaction is called an anaphylactic reaction and can be life threatening. If you have this type of allergy you definitely know it and probably carry an EpiPen around with you. Some people "grow out" of this type of allergy as they age because the level of IgE diminishes rapidly between the ages of 10 and 30 [1].
Gluten or another food sensitivity typically means the sufferer has an immune response with a different set of antibodies. These antibodies are called immunoglobulin A (IgA) or immunoglobulin G (IgG). When you are diagnosed with a gluten sensitivity your testing would show you are reacting to some compound in wheat, rye, barley. Realizing you have an IgA and/or IgG sensitivity can be more mysterious as there are many symptoms you can have that many times are attributed to some other cause. The mistaken attribution is commonly due to a delay between the time of ingestion of the food you are sensitive too, or due to the mild nature of a reaction at the time that you just chalk up to "just how you are".
Celiac disease refers to the destruction of your small intestinal villi, which are the finger-like projections of your small intestine cells by your own immune system. Imagine a piece of shag carpeting rolled up into a tube with the shags facing inward and you have an idea of how the small intestine looks on a microscopic level. Now imagine your immune system has a fleet of lawnmowers that mistakenly mow off all the shags down to nubs. That is celiac disease - and the end point destruction is called total villous atrophy (TVA). Due to the lack of villi you cannot absorb nutrients in sufficient quantity and as a result several other diseases or conditions can develop such as osteoporosis or iron deficiency, depression, abnormal results on liver blood tests and much, much more. [2]
Here is a super important point to take to heart: gluten sensitivity and celiac disease BOTH are permanent intolerances to ingested gluten that results in immunologically mediated inflammatory damage to the small-intestinal cells. So why is gluten sensitivity seemingly more prevalent these days? First of all, more advanced testing is now available, which makes the diagnosis more accurate with blood tests or with saliva tests.
The gold standard for detecting celiac disease used to be a blood test for IgA reaction to alpha gliadin plus 3 biopsies (gliadin is a glycoprotein present in wheat and several other cereals within the grass genus Triticum). The problem with this "gold standard" test is that almost total villous atropy (TVA) was necessary before the test became unequivocally positive. In fact celiac disease patients tend to be 10-15 times more likely to exhibit IgA deficiency in the blood!
Since the advent of better testing (saliva IgA and IgG and testing more that just alpha gliadin) and awareness that gluten sensitivity and celiac disease is more prevalent than previously thought, has led clinicians to look for these disorders in their clinical workup. In my practice I have found nearly 100% of those patients that come to me with chronic health challenges (such as fibromyalgia, hypothyroidism and balance disorders, etc.) have gluten sensitivity. I have access and use some of the most advanced non-invasive testing available today and as a result, now my chronic condition patients, have found renewed hope for recovering from their illnesses. Those patients with autoimmune thyroid, fibromyalgia, balance disorders, diabetes, menieres disease, etc. who obtain our battery of tests and are treated with my specialized Johnson Neuro-Metalbolic Therapy program are regaining a zestful life.
Additional reasons why gluten sensitivity and celiac disease are more prevalent include:
- Genetically modified foods (GMO)
- Gluten deamidation
- Gluten storage in bins for long periods of time, leading to enterotoxin contamination
- Hygeine hypothesis
- Leaky Gut Syndrome (LGS)
- Chronic stress - and the resultant breakdown of immune system tolerance
- Poor nutrition
Unless you've had your head in the sand, you probably are aware that Monsanto and other conglomerate companies have been messing with our food supply. They think that changing food via the "better living through chemistry" mindset will make our foods more nutritious or for self-serving purposes make the modified seeds immune to the herbicide chemicals they manufacture. Wheat has been modified over the years to have more protein, which is the most allergenic portion of wheat.
Deamidation is the product of acid or enzymatic treatment of gluten used in the food processing industry. This is accomplished because gliadins are soluble in alcohol and cannot be mixed with other foods (like milk) without changing the food's qualities. Deamidated gliadin is soluble in water. Our immune system reacts with greater ferver to deamidated gliadin than to gliadin.
The average US storage time for harvested wheat is approximately 2 years! During this storage time the waste products of fungi and mold form which are called enterotoxins. Enterotoxins and be defined as a toxin produced by bacteria that is specific for intestinal cells and causes the vomiting and diarrhea associated with food poisoning. The enterotoxins lead to a leaky gut which triggers an immune reaction to the gluten that is contaminated.
The Hygeine hypothesis theory "proposes that inadequate exposure to infectious organisms leads to immune dysfunction. Under normal circumstances, the immune system is exposed to various viral, bacterial, fungal, or parasitic challenges and becomes properly calibrated to these real threats following successful defenses. Today's public health successes, coupled with the increased use of antibiotics and vaccines, minimize opportunities to mount successful attacks against genuine attackers. IgE is still present, however, and, in the absence of harmful agents, it begins attacking harmless environmental substances.
There is an enormous amount of scientific evidence for this. Children who have had early infections manifest far less atopy, allergy and autoimmune disease". [3]
Leaky Gut Syndrome LGS is an intestinal condition in which the walls of the intestines are damaged to the point where they no longer function to keep food molecules, bacteria and other unwanted material from entering the blood stream. As a result of the foreign material entering the blood stream, the immune system is activated and intact gluten molecules or any one of the other wheat breakdown products are targeted for destruction, as are the cells of the intestines. The following wheat derivatives are the target of some of the specialized testing other like-minded doctors and I offer to detect gluten sensitivity.
Derived from wheat lectins:
- Wheat Germ Agglutinin (WGA)
- Derived from wheat proteins:
- alpha, beta, gamma, and omega gliadin
- glutenin
- gluteomorphin
- transglutaminase
- deamidated gliadin (15, 17, 33)
Chronic stress alters how our immune system functions and can lead to autoimmune illness such as celiac disease, diabetes and other illnesses. [4] [5]
Chronic stress limits your body's ability to produce the antibodies needed to fight off pathogens. It suppresses the T-cells or lymphocytes allowing pathogens to proceed quickly. Elevated levels of cortisol also damage the part of your body that produce immune cells. These parts are the spleen, lymph nodes, and the thymus gland.
Poor nutrition leads to multiple vitamin and mineral deficiencies. In case you weren't aware vitamins and minerals are used in the myriad of chemical reactions your body's enzymes carry out on a daily and nightly basis. "The Standard American Diet (S.A.D.) has been implicated in many diseases and conditions. The Standard American Diet usually consists of a myriad of processed carbs (cereals, breads, pasta, cookies, cakes etc.), processed meat products, and a few fruits and veggies". [5] Of course all those wheat based carbs will trigger an immune response against gluten in those with the predisposition (people with celiac or gluten senstivity genes). A majority of Americans with northern European descent will test positive for celiac or gluten senstivity genes. I tested positive for one celiac gene and one gluten sensitvitiy gene and my wife tested positive for two gluten sensitiviety genes. As a result all our children will have some combination of thee genes as well.
So there you have it...more reason gluten sensitivity and celiac disease is more prevalent.
Remember that better (more advanced) testing and treatment and awareness of these other factors plus your positive action stepscan help you overcome or mitigate your chronic health challenges.
References:
1. Croner S (1992). "Prediction and detection of allergy development: influence of genetic and environmental factors". J. Pediatr. 121 (5 Pt 2): S58-63. 10.1016/S0022-3476(05)81408-8.
2. Murray, J (19990, "The Widening Spectrum of Celiac Disease", American Journal of Clinical Nutrition, Vol. 69, No. 3, 354-365, March 1999
3. The Hygiene Hypothesis or Old Friends Hypothesis, http://www.hygienehypothesis.com
4. Miller, G, et al, (2008). "A Functional Genomic Fingerprint of Chronic Stress in Humans: Blunted Glucocorticoid and Increased NF-κB Signaling", Biological Psychiatry, Volume 64, Issue 4, Pages 266-272
5. Willemijn V, et al, (2003). "The HLA-DQ2 gene dose effect in celiac disease is directly related to the magnitude and breadth of gluten-specific T cell responses", Proc Natl Acad Sci U S A. 2003 October 14; 100(21): 12390-12395.
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