Friday, January 14, 2011

Gluten Intolerance Can Develop with Age


I received this email earlier today (the blanks you see are to preserve her anonymity):
“We corresponded a few months back when you were kind enough to answer a question about gluten for my final paper at _______ College.  I have since finished that program and am enrolled at the Institute of _________.  Since the 1st, I have led some friends in a modified cleanse that was simply avoidance of alcohol, sugar, caffeine, dairy, gluten.  I have tried omitting gluten before for a few weeks and never noticed anything, so I went into this experience expecting the same outcome, no reaction to gluten.  Well, I have had bread twice over the course of the two weeks.  The first time I thought my reaction was a fluke, the second time, I cannot deny what happened.  I came home and went right to bed.  I slept for nearly two hours.  Generally, I am not a napper.  Also, I have been eating enough (I am a chef), getting fresh air and exercising, there should be no reason for this unexplained exhaustion.”

“Anyway, I know you probably hear these stories every day.  I am going to introduce gluten into my diet once more (on a day when I have the time to nap) to see if I experience the same result, but I wanted to share my experience with you.”

While I don’t know her exact age, she is a recent college graduate and is now enrolled in a graduate program for nutrition, so we can assume mid- twenties. There are two points I’d like to discuss regarding her experience.

First, is it a “fluke” that she seems to be reacting to gluten when she hadn’t on prior challenges? 
Second, is it odd that her symptom was severe fatigue rather than a digestive complaint?
My answer to both questions is “no” but let’s look at why.

Research from 2010 shows us that celiac disease increases with age almost 4-fold.  I am of the opinion that such an increase is seen with gluten sensitivity as well.  The presence of gluten in the diet along with a genetic predisposition to react to it is seemingly not enough to incite celiac disease or gluten sensitivity.  We require a third component, a sub optimally functioning small intestine.  This malfunction is thought to stem from a poor balance of the 60 trillion healthy bacteria (probiotics) that reside in the small intestine.  This amazing population of bacteria appears to have the ability to turn on and off gene expression.  When they are happy and healthy then can keep a gluten intolerant gene turned off, but when they are no longer functioning optimally, bad genes such as those that cause celiac disease, can be turned on and the individual “suddenly” becomes gluten intolerant.

Is there a continuum of more and more compromised health the longer one is gluten intolerant?  Yes there is.  So while our young lady who wrote the e-mail is astute enough to notice that she becomes exhausted when she challenges gluten, what would next develop symptom-wise if she ignored this response from her body?  Remember that this woman is being trained in the field of nutrition so her awareness is already quite high.  A typical person might very well have made some other excuse for needing a nap and missed the association with gluten.  In fact, that’s one of the major services we provide our nutrition patients – helping them to see the cause and effect relationship between how they feel and what they’ve eaten or done in their life. E.g. more sleep, more exercise, less caffeine, etc.

The takeaway here is that it’s a good idea to be checked for a gluten intolerance, especially if there’s anything non-optimal about your health.  If you’re feeling well now and gluten isn’t a problem, it could be several years from now, especially if your health is less ideal.  This is particularly true if you have any celiac, autoimmune diseases, or cancer in your family tree.

Let’s look at the second point.  Her symptom of exhaustion to the point of needing to sleep for two hours can definitely be attributed to a nervous system reaction to gluten.  The nervous system is often the first system to respond to gluten, even before the digestive system.  While research makes this point clearly, many people are still stuck with the idea that if you are eating something your body doesn’t care for, it will respond through the digestive tract.  It’s a concept that makes intuitive sense; it just so happens that it’s untrue.

Evaluate your symptoms.  Don’t put up with feeling poorly.  If you’ve done lab tests in the past that were negative it doesn’t preclude you from either doing them again or doing a 30 day gluten-free challenge.  I would love it if you would avoid dairy as much as possible too, but I won’t force the point!

We are learning so much about how gluten affects the body and the fact that it can create damage in a body that, when younger, seemed to tolerate it well, is undisputed at this point. I promise you that feeling healthy and energetic beats out the best gluten-containing food you ever ate!  Give it a try and let me know how it goes.

Let me know if I can be of any further assistance. HealthNOW is a destination clinic and we see patients from all over the country as well as internationally. If you want to improve your health, consider calling us for a free health analysis - call 408-733-0400. 

To your good health,

Dr Vikki Petersen
Co-author of the bestselling “The Gluten Effect”

7 comments:

Sandy said...

I was finally tested and diagnosed with gluten intolerance after my family doctor had assumed that I was in the early stages of Alzheimers and was treating me accordingly. After getting off gluten my energy level rose considerably along with getting my memory back.

Recently, I accidentally was 'gluten poisoned'. I spent a night with an upset stomach, couldn't think the next day and wanted to do nothing else except sleep! Amazing what gluten can do to someone!!

May Lien, Norway said...

I have been following your blog with interest for a few months. Having lived a low-carb life since 2000, gluten is not on my plate on any daily basis anyway. Before changing my diet, I used to wake up every morning feeling stiff and sore all over, and fall exhausted on the sofa every evening after dinner.

But there is the occasional family party with traditional dishes, work dinners etc where it can be hard to avoid it. My body seems to react by water retention (which lasts for days after) and stiff muscles, and I had started to wonder if it has anything to do with gluten and not just the insulin response to a high carb meal. This blog really as been an eye opener!

I do have one request though. You sometimes mention new research. It would be great if you could add the URL or the research paper reference in those blog posts.

qualia said...

there is now a groundbreaking new gluten sensitivity test available at cyrex labs: http://www.cyrexlabs.com/Catalog/tabid/170/Default.aspx

this is the first officially available test that tests for more than just the alpha gliadin part of gluten, which covers only about 30-50% of all gluten sensitive people. i'd recommend all people suspecting gluten sensitivity to request this kind of test (screen #3) from their doctor. there are also some additional tests which show gut permeability and potentially active cross-reactions to gluten/gliadin.

Question: In your experience, are these foods listed under "cross-reactive foods" common offenders in your practice? dairy is pretty obvious - but coffee was less obvious to me (cyrex says coffee has the strongest cross-reaction potential of ALL foods on this list). do you think this is really cross-reactivity specifically to the gliadin peptides, or do you think it's just "marketing", and they actually are just "normal" food allergies, which of course also increase when having a leaky gut from gluten. what i know is that i'm indeed reacting to coffee, chocolate and many other things, but is this *specifically* related to the gluten sensitivity? thanks!

The HealthNOW Doctors said...

Hello Qualia,
These are very good questions. Normal food allergies have what is called an IgE response by the immune system. When this occurs a person reacts dramatically to the food in questions within the hour.

Therefore I don't believe that the test in question is measuring 'normal food allergies' because they are mediated by a very different response from what the test is measuring.

I do find a tremendous degree of accuracy with this test and have been able to 'solve' some stubborn cases with the data it has provided as regards cross-reactive foods.

Of course nothing is perfect and if someone was having a sensitivity reaction to 'quinoa' let's say, even without the presence of gluten, I cannot state categorically that it wouldn't show up in this test.

We, here at HealthNOW only perform this test on those patients whom we have determined to have gluten intolerance.

I hope this helps!

To your good health,
Dr Vikki

Anonymous said...

Is it gluten in itself that's really so awful for 40% of the population as your stats say, or is it American GE wheat? A gluten-intolerant friend who visited rural France and Italy said she had decided to 'cheat' due to the amazing pastries, and found that she had zero reaction and felt great. She went on to eat breads, pasta--all the things that here would normally set her off in misery...and was fine! Then she came home...and bam, was reacting to gluten again. I'm starting to wonder about myself although I've never had suspicions until this year and allergy tested clear a few years ago. Fatigue would be hard to tell as I have had a neural disorder for years already, but my adrenals have been so taxed that I've started to wonder if there are other connections to why they crashed. Also, even with enzymes and probiotics, digestion seems off, although no extremes that I have heard from others. Nevertheless, I'm thinking of first trying to eating only organic wheat (etc) products to see what happens...and am wondering if people with only mild sensitivities generally have have good results with that.

Anonymous said...

Hi. I live in Canada and I have more neurological problems and auto immune diseases than I can count. I have been tested for celiac disease, had an intestinal biopsy for celiac disease, and had a scalp biopsy for DH, all of which came back negative. Whenever I go on a gluten free diet my joint pain goes away (poly symmetrical RA), the tingling in my hands and feet goes away, migraines go away, B12 levels go up (pernicious anemia), iron levels go up, gut bleeding stops (GAVE), I swallow more easily and my voice goes back to normal (glossopharyngeal neuralgia. My thyroid levels also become stabilized (Hashimoto's)and I poop normally for a change. I have more energy (no naps), my skin clears up, my mood becomes happy,and I become a smart person again.

I eat one cup cake and my joints swell, my brain turns to mush, my gut bleeds, my scalp blisters, my head aches, and my hands and feet tingle. My doctor's, all 10 of them, seem to think that if I don't have a positive celiac test result I don't have a gluten problem.

Well, I'm never eating wheat, rye or barely again. But I would rather be thought of as reasonable than as a superstitious woman of a certain age engaging in an extreme diet for no apparent (medically necessary) reason. Is there a way of convincing Canadian MDs that gluten sensitivity exists?

The HealthNOW Doctors said...

Hello Anonymous from Canada,

I would love to be able to get you all of the research on this topic so that you can help share the knowledge with your doctors. the easiest way for you to get these would be for you to email my assistant Eric at eric@healthnowmedical.com. He will be able to send you articles via email.

To Your Good Health.
Dr Vikki