GLUTEN 101

Let’s start with the basics, so when people ask you, and they WILL ask you, you will be ready with an educated response. Remember, they might have undiagnosed symptoms, too, so consider those inquiries as “teachable moments” and not some sort of inquisition.

WHAT IS GLUTEN, ANYWAY?

Gluten is a specific protein found in certain grains, including wheat, barley, rye, and other relatives such as spelt, farro, triticale, einkhorn, kamut and malt. Oats also contain gluten and should also be avoided unless specifically labeled Gluten-Free.

In short, it is a protein and because of its abundance and low cost, it is often used to add protein fillers in other foods, specifically processed foods, which makes it somewhat difficult to track. Ice cream! Ketchup! Pickles! Yes to all three….

WHAT DOES GLUTEN DO TO ME IF I HAVE CELIAC’S DISEASE?

For folks with Celia’s Disease, which is 1 out every 133 Americans, it causes an auto-immune response. Gluten irritates tiny villi in the small intestine, causing them to whither away. They are important because they allow you to absorb vitamins and nutrients from the food you eat into the blood stream. Over the long run, the lack of villi results in malnutrition and can lead to a host of other illnesses including some cancers, thyroid disease, osteoporosis, and infertility. Other auto-immune diseases are often associated with gluten sensitivity or intolerance, too, including arthritis, psoriasis and general inflammation.

DO I HAVE TO EAT GLUTEN TO BE EFFECTED BY IT?

YES and NO! Gluten is often hidden in places you would never suspect. Cosmetics, sunscreens, lipstick, body lotions, shampoos, vitamin E, all can contain gluten. It comes in many names, such as Avena, Secale cereal extract, hordeum, Sodium lauroyl amino acids, to name a few, so the answer is a big NO! And while you don’t traditionally eat lipstick or sunscreen, you do lick your lips and you may perspire causing you to ingest gluten.

With regard to cosmetics, read labels carefully and know what to look for. There is usually a toll free number on packaging to call the manufacturer or look for contact information on the internet. I advise you to call and verify that what you are using is Gluten-free.

WHAT MIGHT CONTAIN GLUTEN THAT I WOULDN’T THINK OF?

Medications, both prescription and over the counter, and some vitamins and supplements all can contain gluten. Specific words to look for include dextrin, dextrate, pregelatinized starch, and sodium starch glycolate, but cross-contamination can also be a big issue. Pharmacists measure pills in the came container, so be sure and consult with your Pharmacist about possible issues with contamination and your medications. You can also verify that none of the inactive ingredients in your medications contain hidden gluten. The last thing you need is for the medications that are supposed to be making you better to actually be making you worse. Villi allow you to absorb some medications into your bloodstream, as well, so they would be a waste if they weren’t working because they weren’t being absorbed. A thorough list of prescription and over-the-counter medications that are gluten-free can be found here. (www.glutenfreedrugs.com)

PlayDoh and pet food are another two that comes to mind. If you have a child that is living with Celiac disease, you know that children often put EVERYTHING in their mouths and Playdoh contains wheat so should not be ingested or even touched because kids put their hands in their mouths, too. Pet foods are often made with wheat as a protein source, so if you come in contact with it EVER or if your toddler likes to eat it, perhaps switching brands to one verified gluten-free is a wise idea. Better safe than sick. It might be a source of what is making your pet unhealthy, too, but that is another book!

WHAT ARE THE SYPMTOMS OF BEING SENSITIVE TO GLUTEN OR HAVING CELIAC DISEASE?

This IS the reason that 95% of celiacs are undiagnosed or misdiagnosed with other conditions and why it can take between 6 to 10 years to get an accurate diagnosis; there is a laundry list of over 300 common symptoms related to gluten sensitivity and Celiac disease that are seemingly unrelated. Many people with Celiacs Disease may have one or more symptoms. People with gluten sensitivity can experience the same symptoms, they are just clinically less severe. Common symptoms:

Abdominal Pain
Abdominal Bloating
Anemia
Canker Sores
Constipation
Delay in growth
Depression
Dermatitis Herpetiformis (celiac of the skin)
Dental Enamel defects
Diarrhea
Fatigue
Infertility
Intestinal Gas
Joint Pain
Migraine Headaches
Nausea
Numbness or tingling in extremities
Osteopenia
Osteoporosis
Poor Weight Gain
Small stature
Skin Rashes

*****This is a small list of some of the more common symptoms and they vary in severity from person to person.*****

IS THERE A CURE FOR CELIAC DISEASE?

If you are one of the fortunate one’s to have gotten a confirmed diagnosis, then there is finally real hope for you! The only cure is to live a gluten-free life for the rest of your life. Period. From now on, no gluten…anywhere….anytime! Sadly, not everyone that follow a strict gluten-free diet is CURED and some require other treatments, but most have a noticeable decrease in symptoms!

CAN I TAKE MEDICATION TO TREAT MY CELIAC DISEASE?

Currently, there are no medications or prescriptive remedies for Celiacs other than a diet free of gluten. If you have been taking medications to treat some of the symptoms that were caused by EATING gluten, then you may soon be able to remove those from your life as your symptoms clear over time. You might be taking FEWER pills. Of course, always consult your prescribing physician or health care provider prior to stopping or starting any prescription medication, and this advice is not meant to replace medical advice. Always consult your doctor.

CAN I CHEAT ONCE I START FEELING BETTER?

NO! Celiac’s Disease is a ZERO TOLERANCE AUTO-IMMUNE disease. You are not trying to get into a cute dress or look good for a reunion and it is not a temporary “diet” you have to do. IT IS A WAY OF LIFE FOR YOU! At least, if you want a healthier and therefore happier life. Any amount of gluten, no matter how small or minute, is doing damage to the villi in the small intestine and causing malnutrition. Period! NO! NO! NO! You cannot cheat!

IS GLUTEN-FREE THE SAME AS WHEAT-FREE?

NO! Gluten-free will be wheat-free, but wheat free will not be gluten free. Let me explain. Gluten is found in wheat, rye, barley, oats and other grains. Other examples of things that have wheat would be bulgur, couscous, durum, and semolina. A product can contain no wheat and still not be gluten-free because it contained something else that did contain gluten. If a product is marked “Contains Wheat” then it is NOT gluten free. If a product is marked “Wheat-free” it may contain other forms of gluten and therefore it would NOT be gluten-free. Only the words GLUTEN FREE means Gluten-free: even seeing the words “Made with ingredients that do not contain gluten” doesn’t mean “Gluten-free” because of the potential for cross-contamination. A food labeled “Wheat-free” is safe for someone with a wheat allergy but likely not for someone with gluten sensitivity or Celiac disease.

This is why labeling is so important and understanding what the label actually means is extremely important. It is also why it is good to eat fewer processed foods and learn to prepare healthy, gluten-free meals from fresh ingredients for yourself.

SO A WHEAT ALLERGY IS DIFFERENT THAN A GLUTEN ALLERGY?

Yes. A wheat allergy and a “gluten allergy” are actually very different in that one is a medical condition and the other is a term to describe a bunch of symptoms. If you have an allergy to wheat, you may be allergic to any one or more of 27 components that make up wheat, including some fats, proteins, starches, with gluten being only 2 components. You are also likely to have more immediate and acute symptoms following a meal where you consume wheat, often within minutes and no longer than a few hours after. Symptoms of a wheat allergy often resemble “hay fever” and are respiratory in nature and may include wheezing, stuffy nose, watery or red eyes and sometimes difficulty breathing or even shock if someone is extremely allergic.

Wheat is one of the major food allergens and is always labeled in the US. Even products that are manufactured in a place where wheat is also manufactured must be labeled as such. Others include, SOY, EGGS,

Gluten allergy, is actually not really an allergy and is not a medically accepted term for any condition. Instead, people are sensitive to gluten or have one of the four medical conditions associated with gluten, which includes:

Celiac disease (also called celiac sprue), is a serious auto immune response and certainly not an allergic reaction. Celiac disease means you have an auto-immune response caused from consuming gluten which leads to the destruction of the villi in the small intestine. This process is called villous atrophy and leads to other health issues and may or may not have immediate or acute symptoms associated with it. The only way to prevent this if you have celiacs disease is to totally avoid gluten.

Non-celiac gluten sensitivity is a term for the condition some people have when they DON’T have celiacs disease but still suffer from symptoms after consuming gluten. It is believed by many that more people suffer from this form of gluten “allergy” than from actual celiacs disease. The only treatment for this sensitivity is to follow a gluten free diet and avoid gluten entirely.

Gluten ataxia is a rare and acute attack by your immune system on your brain and neurological system that happens in response to consuming food that contains gluten. It is quite rare but it does exist and would be considered in the “gluten allergy” category of our discussion.

Dermatitis herpetiformis, which is considered “celiacs of the skin” and results in an itchy rash after a person consumes food that contain gluten. It is often considered a “gluten allergy” because a rash or hives are often associated with an allergic reaction, although it is not a true allergy. Instead, it is another way that your immune system can have an “auto-immune” response and attack your own tissues. Being sensitive to gluten means you have symptoms after you consume gluten, although the symptoms can vary widely and in severity among individuals.