Wednesday, May 5, 2010
The Answer for Gluten Sensitivity
J.E. Block, M.D. F.A.C.P.
Celiac Disease is vastly underdiagnosed. It takes an average 11 years between the first appearances of bowel symptoms to it's diagnosis. To add insult to injury, many times it is silent in the intestine and extra intestinal problems occur. The most common significant "allergen" known to civilized man is a protein found in wheat, gluten. As many as 10% of us are sensitive to it. Gluten is also in rye, spelt, triticale and kamut. Although not all Docs agree, it is found in beans (dark), oats, and peanuts. Non-Gluten cereals are rice, millet, tapioca, buckwheat, flaxseed, teff and quinoa (KEEN-WA). It is not in vegetables and meat. Gluten is used in 90% of all protein-fortified products. When this foreign protein is ingested, it attacks the intestine, causing inflammation and poor absorption of nutrients, but also the gluten antibodies destroy some of our other tissue. This genetic malady is termed CELIAC DISEASE, when it involves the intestine so that malabsorption occurs. But that is only part of the problem. Partially digested protein is also absorbed. These peptides play havoc on many of our already stressed systems as noted below. The age of onset is from infancy to senility. In children neurological symptoms, short stature and anemia happen. In adults skin rashes particularly dermatitis herpetiformis, osteoporosis, anemia, infertility, irritable bowel syndrome, GERD, neurological symptoms and autoimmune diseases such as low thyroid (Hashimotos Disease), arthritis and vitiligo are noted. Lymphoma and other Cancers are more common in folks who have sensitivity and still consume gluten.
Gluten Intolerance is frequently caused by some preceding damage to the lining of the intestines from toxic exposures, infections and medications. Gluten intolerance like true Celiac Disease is treated by avoiding gluten. I tell these poor people to stay away from BROWS where B stands for Barley and Beans (green), R is for Rye, O for Oats, W for Wheat and S for Spelt. The three criteria for true Celiac Disease are genetic predisposition, the consumption of gluten and a triggering event, which could be physical or emotional. With the loss of the integrity of the intestinal lining, the small intestine fails to absorb he micronutrients, which affects all tissues of the body. Rare, are the typical symptoms related to just the gastrointestinal tract with abdominal pain and distention, diarrhea and weight loss.
We have evolved as cereal-less Homo Sapiens for almost 500,000 years. The first wheat was accidently noted and occassionally gathered wa 8,000 BC and in England 5,500 years ago were the first wheat farmers. So we as a species went from great hunters to canaries in only 10,000 years. Science knows it takes much longer to change our genes to adapt to this gluten protein from being a foreigner to what our body recognizes as a "non-intruder". There was no wheat in the Garden of Eden and Adam and Eve with their myriad of decendents were not supposed to eat this "food".
At least a third of Gluten Intolerants have a lactose problem. The consumption of pizza, of which the dough is an extremely potent reactant, along with the cheese, can cause acute symptoms within 20 minutes. Discovered in Poland in 1953, but not known to the Western World until popularized by the English expert James Braly MD, Celiacs have a foreshortened 5th finger (Braly's sign). This is to say that the end of the pinky is shorter than the last joint of the ring finger. To document the diagnosis, many doctors do a few blood studies that are only positive if the patient has terrible bowel disease when the blood is drawn and still is consuming gluten. A STOOL study for less than $100 can be ordered online from www.enterolab.com or your doctor can contact the special laboratory, whose address is Intestinal Health Institute, PO Box 570744, Dallas, TX., 75357. This test is called an antigliadin antibody. It is only positive if the individual is still eating gluten. Also from the stool genetic studies can be done for another $50 even if the patient is gluten-free. Ninety eight percent who have celiac disease have HLA-DQ2 or HLA-DQ8 haplotype. So if a person has both of these negative, they are unlikely to have celiac disese. An even better test is the Celiac Plus® from Prometheus (888-53-0896) which does all the antibodies and the genetic haplotype test. It will also identify the more aggressive disease variant by identifying the dreaded DQB1*)0201 gene. Costing $500, it might be the best money spent to pin down this disease and preventing disability and even death secondary to cancer! Also many insurances pay for it. St Francis Hospital Lab is the only official laboratory in Tulsa that deals with insurance issues.
For now most doctors feel there is no cure for Gluten Intolerance and the best way is to stay away from gluten containing food. Very soon there will be a good enzyme product (Glutenase) available that will break down gluten much the same way lactase granules or powder will allow Lactose Intolerants to consume dairy products. My colleague Dr Jack Wise has a combination of homeopathic and natural products to include Kombu, L-Carnosine, Vitamin D, and Aryonya Berry which should soon be FDA approved. I have seen amazing healing of folks with Gluten Intolerance that can now eat bread again after using his proprietary product.
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