GLUTEN AND THE GUT

Does gluten only affect those who have celiac disease?

New research by Alessio Fasano, MD, shows us that when anyone, whether they have gluten sensitivity
or not, eats a gluten-containing food, the gluten proteins make their way through the stomach and
arrive at the small intestine, where the body responds by producing zonulin, a chemical that signals the
tight junctions of the intestinal walls to open, creating temporary permeability [11].
In other words, in every human body, gluten directly impacts the integrity of the intestinal lining through
zonulin production, eventually leading to leaky gut in those who are susceptible.
Gut cells renew every 48 hours; however, for someone who eats gluten and is gluten sensitive, this
permeability will not heal within that 48-hour period and their gut will remain leaky.
Is there a health impact of leaky gut?
Leaky gut plays a role in certain gastrointestinal conditions such as celiac disease, Crohn’s disease and
irritable bowel syndrome (IBS). Some studies show that leaky gut may be associated with other
autoimmune diseases (lupus, type 1 diabetes, multiple sclerosis), chronic fatigue syndrome, fibromyalgia,
arthritis, allergies, asthma, acne, obesity and even mental illness [12].
What else is gluten known to do?
Not much good.
We know it boosts oxidative stress, an imbalance of free radicals and antioxidants in the body, which can
lead to cell and tissue damage. It also induces the production of pro-inflammatory cytokines, which are
chemicals that damage cells. Gluten intake increases apoptosis (cell self-destruction) and decreases cell
viability and differentiation [13].
5. GLUTEN-RELATED
DISORDERS AND SYMPTOMS
Only a small percentage of the population has been diagnosed with a gluten-related disorder, but a
large portion of the population has symptoms that may be caused by a sensitivity to gluten [14].
Lethargy, irritable bowel symptoms, brain fog, joint pain, diarrhea, abdominal pain and distension,
weight loss and poor appetite, recurrent ulcers in the mouth, chronic headaches, itchy rashes, growth
delays (in children) and delayed menarche may seem completely unrelated, but these can all be
symptoms of gluten sensitivity [15-16].
Gluten-related disorders can manifest themselves in any tissue of the body.
The following three conditions are all impacted by consuming gluten:
CELIAC DISEASE
Celiac disease is an autoimmune disease that damages the villi of the small intestine and
interferes with the absorption of nutrients from food. It is triggered by the ingestion of gluten
[17].
An estimated 1 in 133 Americans, or about 1% of the population, has celiac disease. However,
recent screening studies point to a potentially higher prevalence than 1% in the United States
[18].
It’s estimated that up to 83% of Americans who have celiac disease are undiagnosed or
misdiagnosed with other conditions. The average time a person waits to be correctly diagnosed
is 6-10 years [19].
Celiac disease can lead to a number of other disorders, including infertility, reduced bone
density, neurological disorders, some cancers and other autoimmune diseases [20].
This is a genetic disposition where the disease is triggered in susceptible individuals carrying the
human leukocyte antigen (HLA)-DQ2 or DQ8 [21].
The only known treatment is a lifelong, strict gluten-free diet.
And those with celiac should be intentional with dairy. Research shows that the protein casein in
dairy can mimic gluten — a phenomenon known as molecular mimicry — and create an
inflammatory response because of the similarities. One recent study found that as many as 50%
of those with celiac disease reacted to dairy casein proteins [22]. This is known as cross-
reactivity, where the body reacts not only to the original trigger, but also to another trigger that
resembles the first one.9
WHEAT ALLERGY
A wheat allergy is an IgE-mediated reaction to the insoluble gliadins of wheat. Immunoglobulins
are antibodies that play an important role in fighting infections. There are 5 different types of
immunoglobulins — IgA, IgM, IgG, IgD, IgE — and the main difference between them is their
structure and function. Whereas IgE is associated with allergies, IgA is expressed in mucosal
tissues and IgG is found in all body fluids. IgG is the most abundant type of antibody; it proceeds
against bacterial and viral infections. IgM is found mainly in blood and lymph fluid, and little is
known about IgD except that it exists in small amounts in the blood [23].
There are multiple forms of wheat. Wheat manifests as wheatberries, durum, emmer, semolina,
spelt, farina, farro, graham, KAMUT® (khorasan wheat) and einkorn.
Allergic symptoms to wheat include itching, hives, trouble breathing or anaphylaxis — a life-
threatening reaction — nausea, abdominal pain, itching and swelling lips or tongue.
An estimated 0.4% of the world’s population is allergic to wheat. The majority of cases are
among children, and most will outgrow their wheat allergy by age 6 [24].
Patients are treated by allergists rather than gastrointestinal doctors. 10
NON-CELIAC GLUTEN SENSITIVITY (NCGS) AND NON-CELIAC WHEAT
SENSITIVITY (NCWS)
While