Understanding Celiac Disease And Gluten Intolerance

Many people have noticed that there seems to be a lot more gluten intolerance being diagnosed, and some say that it’s always been around and that we’re only seeing it because there’s better testing. Yes, we have better testing now, but it IS actually on the rise and this is why: wheat these days has a higher concentration of the allergic compounds in it than in the past, since it’s being bred that way. Gluten is what makes bread chewy (think about the difference between corn bread and other bread — the corn bread has no gluten and therefore doesn’t stick together as well) and bakers have wanted wheat with more gluten in it. And the two most concentrated forms, that have the most allergic compounds in them? The “healthy” versions of whole wheat bread and sprouted wheat bread. Feels like you can’t win, right?

Gluten intolerance can happen if your system is overloaded with allergic compounds (that can actually happen with nearly anything in excess), which then irritate the gut lining and start to cause problems. For some people, it causes digestive distress. For other people, it doesn’t cause any digestive problems at all, but rather flares up hidden autoimmune problems (Hashimoto’s has a VERY high correlation with celiac disease), or attacks the nervous system, causing symptoms ranging from depression, anxiety, or ADD to neurological diseases like Multiple Sclerosis.  Someone doesn’t need to have digestive symptoms to have a gluten intolerance. Ongoing, chronic fatigue, weight problems despite dieting, joint and bone pain, ulcers, and irregular menses and infertility in women can all have their roots in gluten intolerance

The difference between gluten intolerance and celiac disease (also called “celiac sprue”) is the presence of damage to the intestines. Celiac is defined as having the gene for gluten intolerance AND having evidence that gluten has caused gut damage. Gluten intolerance isn’t necessarily any less severe. It is now believed by neurologists that the immune reaction ALWAYS damages the nervous system while damaging the intestines in only 30% of cases. The importance of knowing if you have the gene for celiac is for your kids — if you have celiac, then they may have the gene for it as well, and knowing earlier can prevent decades of damage.

We have personal experience with celiac disease, which is why we’re pretty good at helping people figure it out. Dr. Will is going to talk about the differences in the testing: why the blood test that said you were OK might not be valid, why the “gold standard” of the intestinal biopsy is not necessarily accurate either, and what test you can order yourself actually is.

Celiac Testing and Resources

In the past, all that was understood about gluten is that in some individuals, it caused damage to the intestines. This is called celiac sprue and it was a disease that only gastroenterologists worried about. It was thought that occasionally a celiac patient may have schizophrenia or depression caused by the malnutrition of having damaged intestines. In the current era, research into neurology has caught up and discovered that when an immune system is reacting to gluten, the nervous system is always damaged, while the intestines are damaged only 30%.

For years the gold standard test for diagnosing celiac sprue was an intestinal biopsy. Blood tests were developed to avoid doing an intestinal biopsy unnecessarily. The blood tests, which are still currently used, are not sensitive enough to predict who has intestinal damage. We now understand that you can have gut damage SEVEN YEARS BEFORE it shows up in the bloodstream. We currently recommend testing from a company called Enterolabs.

Of course many people will find that if they avoid gluten for a month they can certainly tell that their health has improved. And, if they choose to go back to eating gluten they can feel all the symptoms returning. If this is the case, it really isn’t necessary to spend the money on laboratory tests. In rare cases people can have an actual allergy to wheat, and in other uncommon cases people can develop a temporary reaction to wheat and/or gluten through the mechanism of leaky gut or gut inflammation. Since so many people have genes that encode for gluten sensitivity, most people who develop this temporary type of reaction end up turning on the gene and then it is a lifelong sensitivity. If somebody only had this temporary sensitivity, they could avoid wheat for three months and then go back to eating it without any reaction.

If you do discover that you have Celiac or gluten intolerance, there are plenty of resources available.  One of the best is celiac.com.  Also, while it will require a significant change in what you can and cannot eat, gluten free products are now found on almost every aisle of the grocery store and most national chains, as well as many local restaurants, offer a variety of gluten-free options.  And, as always, we are here to help!