Is Gluten-free right for me? (Part 1)

Gluten-free diets are becoming quite popular these days, causing a debate to rage on about who should be on one and why. On one end of the spectrum are those  who argue that eating grains is evolutionarily novel in human history and that for the most part our intestines have had insufficient time to adapt to eating them. Therefore, to be healthy, grains and more specifically, gluten, should be removed from the diet. On the other end of the spectrum are those who have suggested that by leading to nutrient deficiencies, they are downright dangerous unless you are a diagnosed with Celiac disease. So in the interest of cutting though conflicting opinions and getting down to answers that can be supported by scientific literature, here as some conditions when a gluten-free diet may be appropriate and why.

1. Diagnosed cases of Celiac disease and gluten sensitivity. These are a somewhat of a no-brainer. If you’ve had testing done that confirms your body makes antibodies to gluten, DO NOT eat gluten. In these cases, your body is reacting to gluten at an immunological level. You may or may not have symptoms right away and depending on what tissues these antibodies react with, your symptoms may or not be tolerable. If you get any negative side-effects from eating gluten, you are in all likelihood destroying tissue through this immunologic reaction. The only way to stop that reaction and preserve the tissue is to not eat gluten, in any amount.
2. Diagnosed cases of Hashimoto’s autoimmune thyroiditis. A little known fact, but in the U.S., nearly 90% of hypothyroidism cases are caused by Hashimoto’s. In this case, the body makes antibodies to its own thyroid gland, causing the destruction of thyroid tissue and decreased function of this important gland. Prescription thyroid hormone replaces what is lost in terms of thyroid hormone itself, which is necessary to stimulate metabolism in cells, but it doesn’t prevent or stop the immunologic attack on the thyroid tissue from the body’s own immune system. Enough evidence links gluten ingestion to these attacks that patients with Hashimoto’s should go gluten-free in addition to continuing their prescription. If you are currently taking replacement thyroid hormone, but don’t know if you have Hashimoto’s or not, talk to your doctor about a simple blood test that can determine if you do.
3. Diagnosed cases of autoimmune disease. New research coming out of the University of Maryland’s Center for Celiac Disease Research indicates that three things may be necessary for an autoimmune disease to develop- a gene for the disease, a genetic trigger and a leaky gut. The number one cause of a leaky gut is gluten. Gluten up-regulates the production of a protein called zonulin. Zonulin dissolves the tight junctions between the cells of the intestine, allowing intestinal contents to ‘leak’ through the intestine into the body. The problem with this is that many of these things, like toxins made by bacteria in the gut, don’t belong in our systems or they need to be digested first, like chunks of proteins the need broken down into amino acids first. Since they don’t belong, the immune system in our gut attacks them and tries to keep them out. Unfortunately, this chronic, low-grade inflammation leads to a lot of other problems in the body. One thing that can happen is that the immune cells get their wires crossed and start attacking the body’s own tissue instead of the foreign invader. This is the definition of an autoimmune disease. Many people with autoimmune diseases from MS to RA to Type I diabetes, find they have a lot better control over their symptoms when they adopt a gluten and grain free diet.

Proper testing is of course, key. Stay tuned for the next installment, where I’ll discuss proper testing to determine if a gluten-free diet is right for you.

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