by Henri Roca, MD, Clinical Functional Medicine Specialist
Being gluten-free hasn’t been that hard and it has been so worth it. Yet my sensitivity to gluten came as a surprise. Why?
I had completed the celiac testing and Food Sensitivity Profile. Both were profoundly negative, yet I felt perpetually puffy and fluid filled. Being puffy could be caused by several issues: kidney dysfunction, intestinal malabsorption, leaky intestinal lining, poor protein intake, and inflammation to name a few. I had checked my blood chemistry and it looked like my kidneys and protein levels were fine. There had never been any issues with digestion. So I was left with the possibility of low-level inflammation – irritation if you will.
I say low-level inflammation because my inflammation labs – the high sensitivity C reactive protein and the erythrocyte sedimentation rate – were both extremely low to non-detectable. Still, I looked in the mirror and saw puffiness.
I tried a simple food elimination process. Food elimination can be a difficult piece of work for some people but it is the gold standard form of testing for any food sensitivity. Completing a single food elimination isn’t conceptually difficult. You simply need to remove all sources of that food substance for 6 weeks. The time frame is chosen because after 3 weeks, half of the body’s irritative/inflammatory response to the given food has been processed by the liver and removed from the body. So after 6 weeks about 75% has been removed. You can see that in some cases, the elimination needs to be longer.
For me, I chose to begin by removing gluten. Gluten occurs in many of the grass sourced grains and the foods we create with them. The easy rule is to remove all grains except rice, quinoa, amaranth, buckwheat, and teff. Those grains are gluten-free. In addition, since gluten is a food-additive used to give our food texture, you need to read labels and remove anything with gluten added to it. Some common sources of additive gluten are soy sauce, salad dressings, gravies, candies, and condiments. Of course, removing baked goods made with wheat or any other grain except the above-mentioned gluten-free grains is included.
My secret was deciding to avoid not just the gluten, but the types of products made from gluten – no breads, no pasta, no baked goods. Others chose to replace the usual bread with gluten-free bread. What a surprise! Being gluten-free wasn’t difficult at all. Instead of bread at a restaurant, I asked for crudités or olives. I used protein shakes for breakfast and increased my overall vegetable intake. My nutritional program immediately became more anti-inflammatory (even though I had already shifted toward anti-inflammatory foods prior to the gluten-free experiment).
At first I was convinced that the gluten didn’t affect me, but after 6 weeks, I saw a dramatic difference. There was less pain in my body. I dropped 10 pounds. My skin was clearer. My attention and energy improved substantially. And yes, the puffiness went away.
Now when I eat gluten in small amounts I know that I will very soon have a bout of itchiness and will produce copious amounts of clear phlegm. If I persist in having gluten, then early morning soreness occurs and I experience a tightening of my clothes.
As a physician, I try to understand why this reaction occurs especially since all the tests would not have indicated that I should have gone off gluten. My hypothesis is that the grains we now grow have changed as a result of progressive cross breeding for greater gluten content. There’s simply more gluten per unit of grain than there ever has been. Combine this with the increasing inclusion of gluten as a food additive in so many staple foods and the increasing consumption of gluten containing grain products at every meal and you have a substantially higher load of gluten antigens (compounds) that continually challenge the lining of the intestinal tract.
Now I diagnose patients with either:
Celiac Disease – a genetic inability to handle gluten that causes serious and significant consequences. These people need to avoid all gluten forever.
Gluten Sensitivity – an inflammatory reaction to the preponderance of gluten in the diet combined with a leaky gut caused both by gluten and other factors. These people also need to avoid gluten, but the presence of gluten does not necessarily cause significant reactions. This reaction can be corroborated via laboratory analysis.
Gluten Irritation – A low level inflammation discernable through personal experience, but not through existing laboratory measures. These people should at least significantly curtail and perhaps even avoid gluten.
My current recommendation:
A 6-week food elimination trial off gluten is a reasonable intervention. Consider it.