Wednesday, August 26, 2009

Gluten Dangers: The Truth Is Here To Stay

If you’re gluten sensitive or have celiac disease you may have heard the comment that gluten is a "fad" from a curious friend or family member. Granted one would have to be quite “out of the loop” these days to not have heard of gluten, but more and more those who haven’t been diagnosed are asking: Why now? Why is it suddenly so large a problem?

These are good questions and I’d like to provide some possible answers.

Recently I had the good fortune to listen to Dr Harris, a celiac and gluten researcher out of the University of Maryland who works with Dr Fassano, a long time researcher in the field. Dr Harris felt that increased awareness and better detection of celiac disease has definitely gone a long way towards diagnosing more of those afflicted. (Considering there are over 90% of celiacs who remain undiagnosed, we obviously still have a long way to go but any improvement is appreciated.)

Dr Harris additionally noted that viruses and vaccines can perhaps cause an increased reaction to gluten in susceptible individuals. Viruses have been identified that trigger an immune response that cross reacts with gluten through molecular mimicry. Rotavirus is such an example. Rotavirus typically strikes children causing them to suffer with diarrhea for several days and is the most common cause of childhood diarrhea. The virus works by attacking the lining of the small intestine, causing often copious loss of fluids and electrolytes. Antibodies in celiac patients are known to cross react with rotavirus.

What does this all mean? We review this mechanism in our book The Gluten Effect. Remember that gluten is a protein (actually an array of proteins but we’ll discuss that later). It is known that certain fragments of the gluten proteins are quite similar to structures within our body as well as that of viruses. The rotavirus has such a structure. When the body has been exposed to rotavirus the immune system remembers it. Due to gluten’s similar structure, gluten ingestion occurring after the viral infection causes the body’s immune system to attack the gluten molecule “thinking” it’s the rotavirus again. In sum, this infection causes the immune system in the gluten susceptible individual to be primed to react.

My research revealed that rotavirus affects 3 million people in the US each year, 5 every minute.

What about the vaccine comment? The number of vaccines that our children are exposed to has increased dramatically over the past several decades. Based on the above mechanism of molecular mimicry a susceptible GI tract can begin reacting to gluten after receiving a vaccine.

How does one explain the genetically susceptible individual who seems to eat gluten with impunity? Dr Harris’ research is looking at a co-variable concept that I believe, based on my clinical experience, makes a lot of sense. It is thought that while an individual can possess the genes that make him or her susceptible to reacting to gluten, the reason not everyone does and the age of onset is so variable is dependent upon the presence of other factors. Dr Harris thinks that without some underlying inflammation already present in the gut, a healthy individual might go on consuming gluten with no negative effects.

It is an interesting theory. What we see here in the clinic is a varying time of onset of symptoms. While someone has been consuming gluten their whole life, they may have been “fine” until their 30s, 40s or 50s. And then there are the infants whose first exposure causes dramatic results. The time of expression may very well be dependent upon the underlying health and stability of the immune system. A stable, healthy, uncompromised immune system and small intestine could well sustain a gluten-containing diet with no apparent negative results. It’s not unusual for a patient to have suffered a severe infection of some sort or a stressful life period, after which they began to react to gluten.

And finally the structure of our grains was discussed as it relates to different cultivars containing different protein fragments. Some fragments of proteins are inflammatory and some are not. Witness the Americans who travel to Italy and eat older cultivars of wheat with seeming impunity. Don’t book a flight just yet…

There is a lot more to learn and that’s a tremendous understatement. But as a clinician I do find that the health of the small intestine and immune system plays a large role in how quickly a patient will see a resolution of their symptoms. And it also give credence to the protocol we follow that goes beyond simply removing gluten from the diet. Concurrent with a gluten-free diet one must heal the gut, remove pathogens, recolonize with healthy probiotic bacteria and follow a healthy diet – otherwise the result will be unsatisfactory.

There is much more to come on this topic and to answer the question: No, gluten sensitivity is not a fad!

Until next time,
I wish you good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of The Gluten Effect

1 comment:

Kim said...

What do you know specifically about the shingles vaccine? Is it gluten free and can it be safely used by people with gluten intolerance?