Wednesday, March 21, 2012

Gluten Awareness is on the Rise – But is it helping or hurting Americans?


Times are definitely changing when it comes to awareness of gluten intolerance. [Please note that I use the term ‘gluten intolerance’ as an umbrella term that embraces both celiac disease and gluten sensitivity – more on each of those later.]

While I have been committed to increasing awareness of gluten intolerance for the past 15 years, the increased ‘awareness’ occurring is a bit altered from what I hoped it would be. That ‘awareness’ currently means that people have heard the word ‘gluten’, but unfortunately they really don’t know much about how it can affect their health or if there is any reason for them to learn more about it. Due to a lot of publicity about gluten and weight loss, many people mistakenly put it into the category of just another weight loss strategy or fad.

This type of publicity is doing Americans a great disservice because, while gluten intolerance certainly can cause issues with both weight gain and weight loss, categorizing it within such narrow confines misses the fact that it is responsible for over 300 diseases and conditions ranging from diabetes to depression, from ADHD to eczema, and from infertility to liver disease.

The biggest ‘venue’ for gluten awareness is in the area of food consumption. Gluten-free food products have increased astronomically in the past 8 years or so, making their presence on grocery store shelves quite common. General Mills even has a prime time commercial touting that five of its Chex cereals are now gluten-free.

While that seems to be a positive change and a ‘plus’ in the increased awareness column, I find that most lay people have a distorted idea of what gluten intolerance really means.

Celiac disease was originally described in 250 AD but it wasn’t until 1888 that an astute clinician named Gee described it scientifically. Yet over a century later the vast majority of the cases are still unidentified – specifically we only diagnose 3 – 5% of all those who suffer. 

Why is our ability to diagnose this disease so poor?
Is it because something that’s considered “rare” is not often looked for? 
Is it because there’s no drug to treat it and we live in a ‘drug driven’ health system? 
Is it because celiac patients are thought to fit into a narrow symptomatic category of unrelenting diarrhea along with extreme weight loss and abdominal pain?

“Yes” is no doubt the answer to most of those questions.

The facts today are that an estimated 1- 4% of our population has celiac disease with 95 to 97% of them remaining undiagnosed. 

Unfortunately it also means that the undiagnosed group is being treated for something that gluten has created rather than for the gluten intolerance itself. In other words, if gluten intolerance is the underlying root cause for someone’s depression and that is undiscovered, the individual is likely, instead, to receive a dangerous antidepressant drug. Such drugs not only have life threatening side effects, but they do not address the reason why the individual suffers from depression.

I cannot tell you how many individuals suffer health problems that, once gluten intolerance is identified, enjoy complete resolution of their symptoms. It’s can be truly miraculous.

If only 3-5% of those suffering with celiac disease are diagnosed, I guarantee you that our ability to diagnose gluten sensitivity is even worse.

Why?

Gluten sensitivity has only very recently been recognized as a ‘real’ disorder. Research is just starting to occur but early estimates place its incidence at 9 to 15% of our population. Obviously that is much more impactful to our society than the 1-4% afflicted by celiac disease due to the increased number of people affected. Personally, based on my clinical experience, I anticipate that further research will find the incidence of gluten sensitivity to be much higher. But time will tell.

Gluten sensitivity affects individuals in much the same way that celiac does – its ability to negatively affect most organs and systems of the human body is well documented. And the treatment is the same as well:

1.    Eliminate all gluten from the diet for life
2.    Treat the secondary effects of gluten – this includes such things as infections, cross-reactive foods, probiotic imbalance, hormonal imbalance, nutritional deficiencies and more.

Yet I’ve been noticing a trend in some of the language associated with gluten sensitivity that concerns me. In articles written by reporters or bloggers or simply questions posed by laypeople, there is a false datum that gluten sensitivity is not a serious disorder.

I’ve heard people say “I only have a sensitivity, it’s not celiac disease.” Or a reporter might state say: “gluten sensitivity, not the serious form of gluten intolerance known as celiac disease…”

What’s the problem with these statements?

If your immune system reacts to gluten then eating it will cause you potentially life threatening problems. The immune system reaction in celiac disease is different as compared to that of gluten sensitivity, but it is still a reaction that creates health problems on a far reaching scale.

In close to two decades of working with both celiac and gluten sensitive patients, I can tell you that patients with gluten sensitivity can experience reactions that impact their health quite severely.

Nobody likes to be told that they can ‘never’ do something. So I completely understand that it’s not fun to be told that you can never eat gluten ever again. Plus it is human nature to look for the ‘loopholes’ and ways you might be able to ‘get away with it’.

But I promise you that cheating on a gluten-free diet is akin to playing Russian roulette – and that’s a very dangerous game to play with this one body that you have. And that is true whether you have celiac disease or gluten sensitivity.

At this writing there are no ‘officially’ sanctioned lab tests available to discover if you’re gluten sensitive, but there is one that a recent consensus of fifteen researchers stated ‘could be’ indicative of the problem once celiac disease has essentially been ruled out.

It’s a test that I’ve been using for several years and I do believe it has validity. It’s called an AGA test – that stands for anti-gliadin antibody. Basically the test ‘asks’ your immune system if it considers gluten to be a good guy or a bad guy.

Cyrex Labs also offers a comprehensive panel that embraces about ten different measurements that can be utilized to see if the immune system is having a negative reaction to gluten, inclusive of the above test AGA. This is a blood test.

Such testing must be backed up with an elimination diet lasting a minimum of 30 days. Why? No test is perfect and the elimination diet is still considered the ‘gold standard’ when evaluating food reactions. The most scientifically accurate follow-up to the elimination diet is a reintroduction of gluten to assess a return of symptoms. Optimally this would be done ‘blindly’ meaning that the patient would receive food with gluten and some without but they wouldn’t know when they were receiving the gluten.

Some patients, depending on the seriousness of their condition, are unwilling to take that chance with a reintroduction as they are convinced that gluten is a culprit. I wouldn’t insist upon it in such a case and in fact would never encourage someone to reintroduce gluten if they were convinced it was a problem for them.

Yet, try as we might to be perfect, life tends to ‘create’ a reintroduction when we least expect it in the form of a mistake or a contamination. Eating a food one thought was safe, only to have a reaction, and later discover the presence of gluten, is often how such unplanned ‘reintroductions’ take place.

In Italy they screen children for celiac disease the way we screen our children for scoliosis – every child is evaluated. Is it possible that screening for gluten sensitivity might someday occur in this country? Even if it was for a percentage of the population who, based on family history or symptoms, were at an increased risk, I believe that we could greatly reduce the incidence of many of the serious diseases of which we are plagued as a society.

I hope this was helpful. If you think gluten intolerance could be affecting your health or that of a loved one, I am happy to offer you a free health analysis. Call 408-733-0400 to get more information.

If you don’t live locally that’s not a problem. Our destination clinic treats patients from across the country and internationally.

To your good health,

Dr Vikki Petersen, DC, CCN
Co-Author of The Gluten Effect
Author of the eBook: “Gluten Intolerance – What you don’t know may be killing you!”

1 comment:

Anonymous said...

In Canada and I believe in the USA, one can write off the additional expense of GF food in their income tax. (over and above the standard price)

Why on earth don't they rename Celiac as type 1, type 2 and type 3. This way everyone could take the diagnosis seriously and we could all get our write offs.

I for one have never been formally diagnosed. After 48 years, a happy accident made it plain to a friend of mine who told me. I didn't even know what gluten was. I definately can't eat gluten for one reason or another and I can't get a diagnosis because I won't go back on the horrid stuff.