A reader asked where I got the following data which I referred to in a prior post:
"Celiac is suffered by approximately 1% of our population. Research estimates that gluten sensitivity is conservatively present in approximately 40% of our population –big discrepancy there."
I was told that celiac disease = gluten intolerance/sensitivity; i.e., you either have it or you don't.
Nice question and thanks for asking it!
Let's start with the comment equating celiac disease to gluten intolerance/sensitivity. First of all you are correct - you DO either have it or you don't. Gluten sensitivity is genetic and the sooner it gets diagnosed the better your health will be.
While it is true that every celiac is gluten sensitive, the reverse doesn't hold up. In other words, not every gluten sensitive patient has celiac disease. The problem really arises from the incorrect equating that has been going on for so long in the medical community. It has been thought, for a very long time, that if a patient did not have celiac disease then they weren't gluten sensitive. And because celiac disease is relatively rare, looking for it as the root cause of a patient's symptoms was definitely no where near the top of this list for most M.D.s. It is this very misconception and the resultant patients who continue to suffer due to not being properly diagnosed, that was the driving force behind writing my book. What we kept seeing in the practice was patients who clearly couldn't tolerate gluten but who did not fit the classic narrow diagnostic criteria for celiac disease - which is villous atrophy (just think degradation of the small intestine).
Insisting that a patient is fine unless they have villous atrophy is akin to saying a person with very high cholesterol is fine unless they have a heart attack.
Add the above misconception to the fact that only 1 in 8 of those people suffering from celiac disease are diagnosed and you begin to see not only the magnitude of the problem but why it is that the average celiac patient takes 10 to 15 years to be diagnosed.
Gluten sensitivity is truly "the elephant in the room" that no one has been seeing!
In response to the first part of the question from the reader I'm going to include a little snippet from Chapter 8 of my upcoming book on gluten sensitivity.
For every one Celiac disease patient, there are eight who have asymptomatic gluten sensitivity. It is estimated that between 35-50 percent of our population have some form of gluten sensitivity. We understand more about our immune system now, and also we have many blood tests and other procedures that help us “see” how gluten affects some people. But we are just scratching the surface. It is not a surprise that a protein in our diets that has been causing bone, dental and nutritional changes for centuries still is not fully understood in its full scope of effects. Gluten has stealthily hidden itself from obvious view and continues to do so for much of the traditional medical community (a mistake we hope to correct with this book).
. The Iceberg Cometh: Establishing the Prevalence of Celiac Disease in the United States and Finland,Gastroenterology Vol.126, No.1, Jan. 2004, 359-361.
. EnteroLab. “Early Diagnosis of Gluten Sensitivity: Before the Villi are Gone,” June 2003. Kenneth Fine, M.D.
According to a New England Journal of Medicine in 2007, a gluten-free diet is a valid means for diagnosis of gluten intolerance. This is a very respected medical journal and this statement will hopefully be getting the attention it deserves.