It’s Complicated: Exploring “Gluten Free” Part One

“Gluten Free” in Medical Terms

This is Part One of my four-part series on gluten.

Welcome to the Charny Healing Blog. I wanted to start the blog by discussing gluten, as it is a buzz word that is often misunderstood. I have many patients that jump on gluten-free diets without understanding what’s going on in their stomachs.

To understand the proper role of gluten-free diets, let’s first untangle the three medical problems connected to gluten: celiac disease, wheat allergy and gluten intolerance.

Celiac disease is a genetic autoimmune disease characterized by irritation in the small intestine. When someone with celiac disease eats gluten, it provokes a powerful immune overreaction from white blood cells. This friendly fire destroys the microscopic fingers called villi that line the small intestine and normally absorb nutrients. Once bombed out, the intestine can’t function correctly, causing symptoms such as belly pain, diarrhea, iron deficiency, and other severe problems.

Wheat Allergy is what you might consider a standard allergy. When someone with a wheat allergy eats gluten, a wheat-specific antibody called an IgE causes hives, sudden anaphylaxis, sneezing, and wheezing.

Gluten sensitivity is neither an allergic nor an autoimmune reaction. If a patient experiences “distress” when eating wheat and other grains and feel better when they cut out gluten, they may be sensitive to gluten. A key distinguishing characteristic is that their small intestine is usually normal. There’s an array of symptoms for “gluten sensitivity,” including eczema, headaches, fatigue, depression, anemia, joint pain etc.

Am I born with gluten intolerance?
Genetics play a major role in celiac disease and wheat allergies. But genetic-predisposition doesn’t mean that developing a disease is written in stone. Our environment & diet has a lot to say about how our genes are expressed.

Some of my patients experience symptoms as soon as they begin eating gluten as children, while others develop symptoms in adulthood. This often occurs at a time of physical or emotional stress in their lives, like lifestyle change, severe flu or chemicals in cleaning supplies that wears out their immune system. Pregnancy or menopause can also result in a hormonal shift that triggers a genetic food intolerance. Unfortunately, when the stressors diminishes, the food intolerance remains. Once genetic switches are flipped, they cannot be reversed.

So if my digestion is OK, I don't have a problem with gluten?
Gluten can cause many reactions outside of digestion. The symptoms you experience are linked to which antibodies you produce when gluten enters your body. Digestive issues are caused by Transglutaminase-2, which is expressed in the gut. Skin conditions like eczema or psoriasis are caused by Transglutaminase-3, which is expressed primarily in the skin, and to a lesser extent in the brain and placenta.) Conditions like depression, peripheral neuropathy, or ADHD can be caused by Transglutaminase-6, which is expressed in the brain and nervous system).

Want to decode how gluten works in your body? In addition to in-office autonomic response testing, Dr. Charny tests for gluten intolerance through Cyrex Labs. Cyrex is the only commercial test that screens for antibodies to many of the proteomes in wheat, instead of just testing for alpha gliadin. Make an appointment today: 310-553-4242.