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Wheat.  It’s been around for thousands of years, almost 10,000 BCE.  Wheat is a staple in the diets of so many Americans, with our love of bread, pasta and pizza.  But for some individuals, wheat spells disaster and pain, and figuring out which condition is causing the issue with wheat can be challenging.

Different types of wheat-related conditions

There are three primary types of wheat-related conditions:  a true food allergy to wheat, an autoimmune condition called Celiac Disease, and a newly recognized condition called Non-Celiac Gluten Sensitivity (NCGS) or Non-Celiac Wheat Sensitivity (NCWS).  They share only one thing:  a sensitivity to wheat. 

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Wheat Allergy:

Wheat allergy is most common in children.  The onset is from minutes to hours, and the symptoms may be severe (analphalaxis or an inability to breathe).  The individual will test positive to a skin prick (IgE) or a food challenge, which are an exposure, and needs to be conducted under the care of a qualified healthcare professional as an emergency situation could result.

Celiac Disease:

Celiac Disease (also called Coeliac Disease) is an autoimmune response to the intestines, triggered by a grain protein, most commonly, gluten.  Other proteins may also cause the response but this is less well studied.  Gluten is found in wheat, rye, barley and triticale (a wheat-rye hybrid).  

Celiac Disease causes damage to the villi that line the gut wall.  The villi are responsible for absorption of our nutrients, and long-standing damage may cause malnutrition.  Damage to the gut can be seen in a biopsy.

Symptoms may present in weeks to years.  However, 1 in 8 people with Celiac Disease do not have any symptoms but yet have damage occurring.  And 40-60% of people with Celiac Disease will not have the expected gastrointestinal symptoms but rather experience symptoms like joint pain, brain fog, skin rashes, osteoporosis and anemia.  

Diagnosis is usually made by checking for antibodies, and with an intestinal biopsy:

  • tTg IgA
  • tTg IgG (especially is IgA deficient)
  • Anti-deamidated gliadin
  • Anti-DGP IgG

If you are going to be tested for Celiac Disease, it is important to be eating gluten, as unpleasant as that sounds, for at least 2 – 3 months.  Otherwise, the antibody count can diminish and the gut damage healed, which can lead to a false sense that you do not have Celiac Disease.

There are genes which indicate a predisposition to Celiac Disease: HLA DQ2 and HLA DQ8.  About 40% of the population carries this gene, and carrying the gene does not mean you will develop Celiac Disease.  In fact, only about 1% of the population has Celiac Disease.   

Ridding the diet of gluten is only the first step: gluten can also be inhaled and cause problems.

Non-Celiac Gluten Sensitivity / Non-Celiac Wheat Sensitivity:

There is a third category which has received increased attention in the past five years.  It goes by either Non-Celiac Gluten Sensitivity or Non-Celiac Wheat Sensitivity.  NCWS is the preferred term as researchers are unsure if the culprit is gluten, or only gluten and not other proteins as well.

For several years, many people were led to believe if they tested negative for Celiac Disease then there was nothing wrong.  This is because we don’t have a test to confirm NCWS, but the absence of our ability to test for an issue does not mean there is not an issue!  The prevalence is believed to be higher than Celiac Disease, ranging from 0.5% – 6%.  

Individuals with NCWS may experience similar symptoms, both intestinal and other symptoms, as those with Celiac Disease.  However, symptoms typically occur more quickly – in hours to days.  However, there are key differences:

  • Absence of genetic predisposition
  • Absence of specific antigen tests
  • Absence of intestinal damage upon biopsy
  • Absence of elevations in IL-8, IL-10 and IL-12 after ingestion of gluten (elevations are seen in Celiac Disease)
  • Absence of intestinal permeability (also known as gut dysbiosis or leaky gut)

We do not have a test for NCWS, and the diagnosis is made after excluding other possible causes.  One area of research is whether it is gluten itself which is causing the symptoms,  other proteins or potentially FODMOPS.  FODMOPS are fermentable, oligosaccharides, di-sacchardies, monosaccharides and polyols  Research has been specifically promising on fructans, which are included in FODMOPS.  A low FODMOPs diet may be beneficial.

What can I do to change my diet?

Most healthcare professionals will recommend a modification in gluten or wheat intake following the proper diagnosis.

For wheat allergy, the reaction can be severe.  Avoid wheat entirely, although other grains even those containing gluten may be acceptable. For those with Celiac Disease or Non-Celiac Wheat Sensitivity, a gluten-free diet or better, a gluten-undetectable diet may be needed.  Gluten-undetectable means the product was prepared in a facility that has no other gluten-containing processes, so the risk of cross-contamination is lessened.

A good resource is:  www.foodallergy.org, and search for wheat.  This will also alert you to possible other sources of wheat and wheat products including soy sauce (use tamari!), vinegars, beers, meatballs and breaded meats, breaded vegetables, and mixes (even rice bowl mixes).  When in doubt, call the manufacturer.

Two other resources are:

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It runs in the family, doesn’t it?  While there are certain genes that seem to indicate a tendency toward autoimmune disease, like HLA B27 or HLA DQ, the presence of the gene doesn’t mean the gene will be expressed and you will get psoriasis or celiac disease – there’s far more to the picture.  Remember, most families have similar habits and share an environment.

What does trigger the expression of the gene?  Scientists are still looking into that puzzle but we do have some clues.  

A New Way of Looking at Autoimmune Disease

Autoimmune disease occurs when the immune system accidentally responds to what it sees as a threat when in fact it is your body’s own tissues.  Last week, I heard Dr. Nuzum (Idaho) describe autoimmune disease in a way that I had not previously heard, and it resonated with me.  I’m paraphrasing here, but you can get the idea. 

Imagine your immune system is a prize winning boxer and his opponent (the virus, bacteria, pathogen, etc.) is in the ring.  Our immune hero knocks out the opponent and round over.  But suppose the immune system fighter has on a blindfold, and suddenly we put not only the boxers but also the spectators in the ring.  Now our immune fighter cannot see his opponent although he knows the opponent is in the ring.  In swinging out, our immune fighter may hit something else besides the opponent.  How do we help the immune fighter?  We strengthen the immune system, and get the other people out of the ring.

That’s a very different description than I was used to hearing in mainstream medicine (the “over-active” immune system approach).  Maybe it was time to go back to the basics.

 

Genes, Leaky Gut and Exposure

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There is a saying now that “chronic disease all begins in the gut” and autoimmune disease may fall into this category too.

The wall of our intestine allows digested food to enter the bloodstream.  Digested food means food has been broken down into its smallest components (sugars, amino acids, free fatty acids) and can easily be transported from the gut through small openings in the wall and into the bloodstream.  That’s a bit over-simplified but you get the idea. 

Certain foods can irritate the gut wall lining, causing intestinal permeability or dysbiosis.  In some circles this is also referred to as “leaky gut”.  The increased permeability means the gut wall is not as tight, and larger particles such as toxins, antigens and bacteria can leak through and enter the bloodstream.  These particles often contain proteins and look like a foreign object to our immune system.  And the attack begins. 

You might not even have symptoms.

It may show itself as inflammatory bowel disease (IBD), celiac disease, or lupus among others.  It is felt that a genetic predisposition, increased intestinal permeability, and antigen exposure are the necessary ingredients for autoimmune disease to develop.

GENES + LEAKY GUT + ANTIGENS

What you can do:

I remember being astounded the first time I heard that autoimmune disease can be reversed.  How is this possible?  Most people I know would settle for remission, even if reversal is not a reality yet.   It may have taken years to get diagnosed, often interspersed with missed diagnosis and misdiagnosis, and now we may be able to reverse this?

It appears you stop the offending irritant or irritants, and allow the body to heal itself.  Get rid of the bad stuff, add more of the good stuff.  Sounds pretty simple, but in fact it can be hard to do.

Diet:

Critical to your success is to ensure that your diet is anti-inflammatory.  Your food is either working for you or against you.  It’s either pro-inflammatory or it’s anti-inflammatory.

Foods that increase inflammation include sugars, white flour products (bread, pasta), processed food, fast foods, etc.   In short, any added ingredients that don’t belong in your food (chemicals) are foreign and may irritate the body and any foods that are so refined and processed as to not be recognizable as the original food (think sugar – looks nothing like a beet or cane) may also irritate the body. 

Foods that quell inflammation include those fruits and most vegetables, fresh herbs and ethically raised meats, poultry and fish.  Our bodies need fiber and vitamins and other nutrients from those foods.  No nutrients = no healing.

Many healthcare professionals recommend a diet that is gluten free and dairy free, but also low in sugar and avoidance of nightshade plants.  Some healthcare professionals go further and eliminate soy, corn, wheat, and eggs.  This diet can be challenging to even think about, so I’ve created a free download for you here for some menu ideas.  The diet should be followed for 4 to 6 weeks, initially.  If symptoms improve, discuss longer term use of the diet with your healthcare professional.

Movement / Exercise:

Movement can decrease inflammation as well.  Walk.  Bike.  Just move.  It doesn’t matter if it’s slow, or if you rest.  Sit if you need to.  

Be consistent for the best results.

One caution: over-exercising can actually increase inflammation, so don’t over do it.

Sleep:

Our bodies heal during sleep.  It’s important to get quality, restorative sleep of about 8 hours duration.  

Breathing:

Deep breathing works against inflammation by cleansing your lymphatics.  It removes toxins that can build up.  Deep relaxation helps manage stress, which can begin a cascade of inflammation.  Yoga or meditation can help.  Sound therapy in the form of meditative music may be of value.

Supplements:

Your healthcare professional may have specific recommendations for you, but in general omega-3 oils, vitamin C and probiotics work as anti-inflammatory agents.  Others include various adaptogenic herbs which are known to be anti-inflammatory and assist in the modulation of the immune system.  Green tea and/or turmeric may be suggested.

If leaky gut has been occurring for months or more, you may be at risk for nutritional deficiencies due to malabsorption issues and a good quality multivitamin may be suggested by your healthcare professional.

Reconnect:

While the research isn’t definite to say enhanced connection to family, community and faith will help reverse autoimmune disease, given what we know about the role of stress, my thoughts are that an enhanced connection can’t hurt.  Be kind.  Feel supported; give support.  Declare your purpose.  Identify your thoughts that are toxic, and actively and intentionally work to counter them.

Final Thoughts

Well, there you have it.  It’s a choice – can you live with your symptoms?  Would you like to try to get better? 

Not everyone will.  Not everyone wants to go through the changes that are necessary.  To be successful, you have to go “all in”.  Going 80% of the way will not give you optimized results.  But if you make the commitment, you’re likely to see improvement.  Do your research; read the stories of people who have done this.  Ask your healthcare professional.  And then make your decision. 

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Future Posts

Related posts in the future will focus on additional information on autoimmune disease.