Sunday, April 15, 2018

Is Quinoa ALWAYS Gluten Free?

Is Quinoa ALWAYS Gluten Free?

Quinoa is grown in the Andes and is typically thought of as a grain. But that is a misnomer. Despite cooking up as a grain-like substance, quinoa is factually a seed from a plant similar to spinach and Swiss chard. Considering how healthy those two vegetables are, it is not then surprising that quinoa has a high protein content and contains all the necessary amino acids – making it one of those ‘near perfect’ foods that is nutritious, economical and easy to make. AND it’s gluten-free… or is it?

Hold on, before you stop reading because you think this is going to be depressing and you’re going to lose another of your ‘go to’ gluten-free staples, let me explain. The data that I’m about to present was published in the American Journal of Clinical Nutrition in August 2012. And I think that it’s important that you know.

The researchers, from Kings College in London, designed their study to analyze quinoa since little experimental data existed to support its safety as part of a gluten-free diet.

One of the reasons that quinoa has been on the gluten-free list is based on its protein content. Remember it is the protein in a food that tends to be problematic – gluten, more correctly gliadin, is a protein, as is casein, the problematic portion of dairy products. When someone ‘reacts’ or is allergic to a food, it is typically a reaction to the protein portion.

Wheat, barley, rye as well as non-glutinous corn, sorghum and oats, fall into the category of being high in something called prolamins.

What are prolamins? 

They are storage proteins that contain high amounts of the amino acids proline and glutamine – and are found standard in glutinous grains. It is known that prolamins may induce celiac disease and gluten sensitivity in susceptible individuals.

Quinoa is known to be low in prolamins, therefore it is little wonder that quinoa, with its low prolamin content, seemed a quite safe alternative on a gluten-free diet.

In this study the scientists looked at different cultivars of quinoa, 15 of them in all. A cultivar is a cultivated variety of a plant that is produced from a naturally occurring species and then maintained by cultivation. It turns out that different regions of the Andes produce different cultivars and it was the goal of this research to see if any of these cultivars had varying amounts of prolamin, enough that the immune system of a celiac-prone patient might react to it.

As mentioned, it is the protein portion of foods that can cause reactions to occur. When a substance such as gluten is causing a reaction, it’s called an antigen (think of it as a toxin to the body). The immune system tries to attack the toxin or antigen by making an antibody (it works against the toxin). The region on the antigen where the antibody attaches itself is called an epitope. Okay, done with all the new words!

In this study the researchers’ aim was to determine if any of the 15 cultivars contained prolamin epitopes (so it’s acting as a toxin and the body’s immune system has to attack it) in enough quantity to be deemed on par with a gluten-containing food.

Here are their results:

Of the 15 quinoa cultivars tested, 4 had measurable concentrations of toxic epitopes, but they were below the maximum permitted for a gluten-free food. In other words, the 20 parts per million (ppm) threshold of gluten that by definition allows a food to be deemed ‘gluten-free’, was not exceeded.
However, two cultivars, Ayacuchana and Pasankalla, did stimulate the immune system to react in a way that is comparable to a gluten-containing food.

What’s our take-away from this research?

1.      In the main, quinoa seems to be a safe food, with most of its cultivars not causing the immune system reaction consistent with a gluten-containing food.
2.      Four cultivars fell below the 20 ppm of gluten, but they still did contain enough of the protein to cause a reaction, albeit a mild one.
3.      Two cultivars were downright bad – they causes a gluten response that was above the 20 ppm threshold and unfortunately acted upon the immune system consistent with someone who was eating gluten.

Here is what I tell my patients about quinoa:

First of all, I ensure that they have been gluten-free for long enough that we have mostly healed their gut. Then we do a trial with quinoa to see how they feel. Most people do fine, but not all. If someone has a reaction, we wait until they have ‘healed’ from the assault and then attempt it one more time. If they react again, we deem them sensitive to quinoa and recommend abstinence.

Finally, if someone is very suspicious and wants to know for sure, we can run a cross-reactivity blood test that tests for a quinoa reaction along with many other such foods whose protein structure can mimic gluten. It’s an excellent test and a great tool to be able to take someone to their desired next level of health. 

While writing this piece I was curious to see if one could easily find out what cultivar a quinoa company used. An online search didn't yield any data, but I think it would be worthwhile to contact a company to see if they utilized either of the two cultivars mentioned above that caused a reaction.

It is possible that if those cultivars were avoided, a seemingly reactive individual might be able to tolerate quinoa quite well.

Do you react to quinoa, or do you enjoy it as a part of your gluten-free diet?
If anyone wants to do a little research and find out if any companies are forthcoming regarding the cultivars they use, please let me know. It’s definitely information I’d like to pass along.

Contact us for a Free Consultation - Call (408) 733-0400. 

If  you are not local to us you can still receive help; our Destination Clinic treats patients from across the country and internationally.

We help the world's busiest people regain, retain and reclaim their health, energy and resilience. 

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To reclaiming your best health,

Dr. Vikki Petersen DC, CCN
Certified Functional Medicine Practitioner
Founder of Root Cause Medical Clinic
Author of "The Gluten Effect"
Author of eBook: "Gluten: What You Don't Know May Be Killing You"

American Journal of Clinical Nutrition. 2012 Aug;96(2):337-44. Variable activation of immune response by quinoa (Chenopodium quinoa Willd.) prolamins in celiac disease.

Tuesday, November 14, 2017

New video on gluten by Dr. Vikki Petersen. 

For more information visit our website: or call 408-733-0400. 

Wednesday, July 26, 2017

Hidden infections and gluten intolerances

As a doctor who has written a book on the subject of gluten, I am writing about this very important, although often overlooked consequence of celiac and gluten intolerance - hidden infections.

The mechanism revolves around the inflammation that is created in the small intestine with the ingestion of gluten for many years. This inflammatory response weakens the immune system of the intestine thereby allowing pathogenic (disease causing) organisms to gain a foothold. Every 10 minutes our small intestines are exposed to pathogenic organisms. A healthy immune system destroys them but a compromised immune system can't defend itself adequately.

These organism can cause a myriad of health problems including gastrointestinal symptoms, arthritis and joint inflammation, obesity, hormone imbalance - just to name a few.

Anyone with celiac or gluten intolerance is at risk for these infections which can be bacterial, parasitic, amoeba or yeast. I find a stool test to be the most accurate way to detect them but there are some labs I prefer over others due to their sensitivity and accuracy.

To find out more information and to schedule a free consultation, call 408-733-0400.

Hope this helps anyone curious.

Dr Vikki Petersen

Also, if an infection is found it is critical to retest to ensure that it's been eradicated. And lastly, since the immune system of a celiac or gluten intolerant individual can take a few years to reestablish once gluten and any offending organisms have been removed, annual testing is probably a good idea for a couple of years.

Monday, July 17, 2017

Sometimes a Gluten-free Diet Isn't Enough...

A lot of patients find themselves in the position of having removed gluten from their diet, but they are still suffering health problems. These patients have made the Herculean effort to remove gluten entirely from their diet and while they improved - their health is still not where they would have hoped.

So what’s the problem?

In my clinical experience, I find that patients who are either Celiac or gluten intolerant are highly susceptible to intestinal infections. The damage which gluten causes to the lining of the small intestine also damages the integrity of the immune system within the intestines. Considering that it is estimated that every 10 minutes our intestines are exposed to a pathogenic (able to cause infection) organism, it is critical to good health that our immune systems are strong enough to destroy these organisms. Gluten intolerant individuals don’t have a strong immune system and thereby tend to contract infections.

You may think that if you had an intestinal infection you would have a fever, severe diarrhea or abdominal pain. While this can occur, more often than not, these infections are less extreme in their presentation. But they are not silent. A patient with an intestinal infection will not enjoy optimal health and, unfortunately, will not get the entire benefit of removing the offending gluten from their diet. When an infection is not present, the removal of gluten results in the healing of the intestines and the improved health and well being of the patient. In the presence of infection, the healing does not take place because the infectious organism continues to irritate the lining of the intestine and the patient does not improve markedly.

Most doctors who diagnose celiac disease or gluten intolerance only focus on the change of diet that is necessary. They don’t go the next step and rule out any hidden infection. Many times patients have been diagnosed with an infection and stated that they felt they had had an infection but were told that because they didn’t have a fever or acute diarrhea it was not possible.

If you have been avoiding gluten but haven’t seen all the benefits to your health which you had hoped, consider getting evaluated for hidden infection. We see this problem all the time in our patients and are happy to help you. Don't give up on your gluten-free diet! If you aren't seeing all the results you want, come see us to get evaluated.

Visit us at If you have questions or need any help, I’m here for you! Call 408-733-0400.

I look forward to hearing from you.

To your good health,
Dr Vikki Petersen, DC, CCN, CFMP

IFM Certified Practitioner

Founder of Root Cause Medical Clinic
Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”

Friday, June 30, 2017

IBS Success

Root Cause Medical Clinic 
Patient Testimonial 

IBS controlled my life... 

I could not go anywhere where I was not absolutely sure that there was a close bathroom. I tried to take over the counter and prescription diarrhea medicine, but it would only last a few hours. Because of my symptoms, I was also on depression medication on a daily basis to "help" me deal with the anxiety that was caused by my IBS. I also suffered from extreme claustrophobia, and could not travel in my car without stopping to go to the bathroom every 20 minutes or so. On a good day I had 6-7 bowel movements and on a bad day 8-9 - every day. I have had IBS for the last 20 years, but this bad, only for the last 2-3 years.

I could not go skiing, running or walking outdoors. Traveling was a nightmare for my family and I. I was stressed about when I would have to next go to the restroom.

I remember at our first meeting Dr. Petersen told me that she could help me, not with arrogance, but with confidence. She showed me pictures of what my insides probably looked like, but explained it in an easy to understand, matter of fact way. Dr Petersen told me I would have to give up eating like I was (eating myself to death, or a certain heart attack), but I could do it gradually.

I was given a diet that included none of the things I had been eating or drinking. It included giving up caffeine and gluten and sugar and aspartame. I had come to the clinic willing to try anything and I knew it would be hard but nothing could have prepared me for the withdrawal from caffeine and sugar. I thought that during the first week I was getting sicker, but I made it through. No real progress on my IBS, but I felt different. We went through blood tests and saliva tests and stool samples. It turned out I had 2 infections in my intestines that were affecting my ability to digest food. 

The antibiotics at first made me feel even worse, but I was in this for the long haul. I knew I was on the right track because soon I started to feel better. Maybe the IBS was not cured yet, but I had more good days than bad, and I felt better emotionally and physically than I had in a long time. About one week after I finished the antibiotics, I began to lead a normal life. I was only going to the bathroom 3-4 times a day, and the experience was much better. Two weeks later, I had a few days in a row with only 2-3 bowel movements per day. In three days, I had what would have been one of my bad days, but with no anxiety or discomfort.

The side benefit of my gluten free diet is that I am off of my "maintenance anxiety drug". This did not happen because my new doctors told me not to take it, I just forgot to about two weeks ago, and have not had the need for it. Today I got in a car w/ 4 other men and I wasn’t doing the driving. It suddenly dawned on me that I would never have done that before. The anxiety would have prevented me.

I have additionally lost 18 pounds, which was not why I came here, but it's definitely a benefit.

It is very difficult to explain the pain and suffering that I went through and that I put my family through with my panic attacks and IBS. I am lucky that they supported me and did not leave me. I feel that I can start to be the person that I am meant to be. My life gets better every day. Maybe everyone is not as sensitive to gluten as I am, but for me it is poison. It is easy to pass up gluten with the great results I am seeing. I asked Dr. Petersen if it was just the caffeine that made me so irritable. She explained that for some people gluten is neurotoxic. This was definitely the case for me and understanding that makes it easy to stay on a gluten free diet. I came to realize that all of the food that made me sick has gluten in it....bagels, bread, pizza, pasta, sandwiches......I was killing myself while trying to eat healthy. When I had a salad with bread and croutons, it defeated the purpose.

That is my story so far. I feel better everyday. I can not thank Dr. Petersen enough for helping me change my life.

- E.B.