Should I Go Gluten Free?

The surprising gaps in celiac's testing and protocols

May 01, 2022

Dear Readers,

This week’s question comes from a cooking class I held in April. Two of the guests wanted to understand why all of my recipes are gluten-free. They both suspected they might be gluten intolerant but had received a negative biopsy for celiac’s disease. They both thought that definitively ruled out a problem with gluten. While many doctors still believe this, there is a growing body of evidence that shows that non-celiac gluten sensitivity (NCGS) is real and far more widespread than initially understood.

In fact everyone may have it. Some specialists feel strongly that gluten - and the other proteins in wheat - are toxic to everyone. This is the premise behind this TedX talk by Dr. Rodney Ford, MB. BS. MD. FRACP, a pioneer in the field of pediatric food allergies. He shares a hypothesis he developed while working with sick children. He observed that all of the sick children improved substantially when gluten and wheat were removed from their diets.

Wheat Belly

There are other specialists that agree with this premise. You may have heard of them. William Davis M.D. wrote Wheat Belly, in which he shares from decades of clinical studies removing gluten and wheat from the diets of thousands of patients. His observed and postulates that removing wheat causes:

Weight loss of twenty, thirty, even fifty pounds in the first few months
Alleviation of metabolic syndrome and type 2 diabetes
Recovery from intestinal woes, like ulcerative colitis and celiac disease
Marked improvement in overall cholesterol and LDL counts
Improvement in bone density and reversal of osteoporosis
Cessation of skin conditions from psoriasis to oral ulcers and hair loss
Reduction of inflammation and rheumatoid arthritis pain (source)

For a more complete understanding of Dr. Davis’ studies on wheat you can watch an excellent presentation here.

Grain Brain

You may also have heard of Grain Brain, Dr. Perlmutter’s bestseller book about the devastating effects of gluten, sugar, and carbs on the brain and body. When it was released, this idea was novel and went against a lot of dogma, but in a recent blog post, Dr. Perlmutter references this 2017 study wherein non-celiac gluten sensitivity is validated and stated to be ‘common’.

In Grain Brain, Dr. Perlmutter M.D. describes how even “healthy” carbs like whole grains can cause dementia, ADHD, anxiety, chronic headaches, depression, and much more. He explains that our brains thrive on fat and cholesterol, and how you can spur the growth of new brain cells at any age by simply changing your eating habits.

For an excellent interview with Dr. Perlmutter on this issue go here. In it he shares shocking data that Alzheimer’s drugs actually speed the decline of the disease and proposes a healthier and safer option.

But is it Gluten Sensitivity or Wheat Sensitivity?

Some specialists say it shouldn’t necessarily be labeled non-celiac gluten sensitivity but also wheat sensitivity. For an excellent discussion on why, you can go here. In this talk we learn that NCGS/NCWS is 5x more prevalent in women than men, typically diagnosed in the 30s or 40’s, and there’s a delay of hours to days between ingesting the gluten and experiencing the symptoms. (You may remember from last week’s article that means it’s a sensitivity, not a true allergy.) We also learn many of these patients already have known lactose sensitivity and/or an Irritable Bowel diagnosis. They usually suffer from intestinal symptoms like bloating or belly pain, nausea, diarrhea, constipation, reflux, vomiting, bowel habit problems, or unexplained weight loss. Sometimes they also have a general lack of well being, headaches, brain fog, depression, hyperactivity, neurological symptoms, rashes, psychiatric disorders, numbness and tingling in extremities, bone and muscle and joint pain, horrible migraines, and fibromyalgia. Many of these people have families with a history of food allergies and/or eczema and/or asthma. We also learn NCGS/NCWS can be related to SIBO (an overgrowth of bacteria in the small intestine).

Dr. Ken Landow goes on to explain that not everyone who avoids gluten improves. Many do, but others improve more when they remove wheat altogether, because of other proteins in wheat that are part of the sensitivity. Others need to remove all grains and go on a Paleo or ketogenic diet to get amelioration of symptoms. This has been the bulk of my clinical experience. What is known for certain is that celiac’s disease and NCGS/NCWS over time result in leaky gut syndrome, which exponentially increases the foods we become sensitive to while simultaneously reducing the ability of the intestines to absorb nutrients from foods. This creates systemic inflammation and auto-immune conditions when left unchecked.

What Role Do Toxic Agricultural Chemicals Play?

Other people question whether the problem is not the wheat, but how the wheat is grown today. The list of chemicals that are dumped on wheat crops are frightening indeed. To better understand this issue I suggest watching this great TedX talk by nutritionist Cyndi O’Meara. I and clients of mine have had different reactions to wheat in Europe than in North America. This could be a potential explanation why.

Clinical Picture - How Does it Look?

These disorders (celiac’s disease and non-celiac gluten and wheat sensitivity) can develop at any point in the lifespan. For a list of the over 200 symptoms known to be related you can go here.

Just to recap, if you’re uncertain if you may suffer from gluten sensitivity, some of the symptoms non-celiac gluten/wheat sensitivity include:

Digestive disorders like IBS, SIBO, and GI problems
Headaches and migraines
Fatigue and sleep problems
Irritability and mood swings
Psychosis and thinking problems, including schizophrenia and bipolar disorder
Chronic inflammation of the joints
Autoimmune disorders
Thyroid disorders

30% of Us May Be Affected

Some studies now suggest 30% of us may be gluten reactive and all of us may have some degree of sensitivity to gluten. According to David Perlmutter, MD “It is likely that 100% of humans activate zonulin when exposed to gluten, and this increases gut permeability. This is thought to play an important role in autoimmunity.”

I’ve seen many people fail the celiac test, yet develop symptoms when they consume foods that contain gluten. They may or may not be better on a gluten-free diet, as there are often other sensitivities at play. In such a case, removing the wheat/ gluten would improve their state mildly, but inconsistently, because other foods are still triggering them. This often happens when processed ‘gluten-free’ foods are used for removing gluten from the diet.

But when the proper diet is implemented, symptoms are eliminated and even chronic disease processes can be reversed. Left unchecked I believe gluten and grain intolerance can lead to severe autoimmune disorders like fibromyalgia, rheumatoid arthritis, schizophrenia, and ulcerative colitis, to name just a few. My own rheumatoid arthritis was linked to wheat intolerance and my son’s schizophrenia is certainly related to wheat and gluten intolerance. Both are improved exponentially by removing these foods and following a grain free diet.

Why I Recommend Grain-Free, Not Gluten-Free

When recommending a gluten-free protocol I never recommend ‘gluten-free’ processed foods. Stay away from this cardboard dressed as food! These are highly processed grain/ lentil/ potato/ corn based substitutes - all of which are high glycemic, often inflammatory, and not particularly nutritive. In the gluten intolerant person the body needs to be super saturated with easily absorbed nutrients to heal damaged tissues, and that can’t happen with such subpar foods. I recommend a whole food, low carbohydrate, ancestral diet, rich in probiotic foods, as I do for almost all ailments. It’s not glamorous and requires cooking your food at home, but this is again and again what I find to work.

But what if the problem is all the proteins in wheat, not just gluten? Removing gluten would not stop the symptoms. Wheat (and usually all grains) need to be removed.

What if the problem is a sensitivity to a combination of gluten, sugar, and dairy or a leaky gut that has created multiple food sensitivities? In that case removing gluten would not make the condition much better. Only removing all of the offending foods and working on healing the digestive system would bring complete amelioration.

It goes without saying that all of this is related to the health of the gut biome and this is where grains come in. Grains are made of starches which feed the bacteria that are typically overgrown in the Western gut. Removing them creates a much better balance of beneficial bacteria. I would not be surprised to hear data in coming years that confirms an imbalance or pathological gut microbiota is the driving factor in the reaction to gluten/wheat and grain sensitivity.

This is why it’s essential to see a professional nutritionist for guidance to remove all possible sources of wheat and gluten and to do a full assessment and screening for other intolerances if you suspect a gluten intolerance. A nutritionist is absolutely the best person to help you address the likely underlying gut biome issues and guide the elimination to ensure you get clear results.

So How Do I Know?

The gold standard to determining this sort of sensitivity is to remove the foods entirely while also removing the foods that are known to be common co-sensitivities like dairy and grains. For some, only a grain-free, ketogenic diet really works. It’s important to note that typical allergy skin prick/scratch testing is not effective at determining food intolerances, in my clinical experience. Hair and serum testing along with strict elimination diets are effective, with one being obviously much more time and energy consuming than the other. We can usually determine what’s going on with the testing and treat it with a more targeted elimination diet and gut healing protocol.

If you feel you could be gluten sensitive I highly recommend seeing a practitioner who can offer testing to guide the elimination diet and who can address the underlying gut biome issues to heal the propensity to overreactivity and inflammatory conditions.

Summary

It seems clear based on the clinical observations of many esteemed clinicians from a wide range of disciplines that gluten and wheat (and/or grain) intolerance are far more prevalent than we have been led to believe and many people who have not been diagnosed as having celiac improve greatly when put on a professionally managed gluten-free/wheat-free/grain-free diet. I think it’s an epidemic problem and almost all people benefit from removing grains from their diet. This could be due to changes in agricultural practices, changes in our gut chemistry, or because grains are full of innately inflammatory proteins, as many have postulated. Even if a person isn’t intolerant per se, it’s quite possible that these anti-nutrients are not an optimal food for human consumption and that they play a role in many inflammatory conditions. Based on my clinical observations, I believe it’s likely a combination of all three. I highly recommend a professionally managed, grain-free diet with testing to address chronic inflammatory conditions of all kinds.

The internet has an abundance of great recipe sites dedicated to grain and gluten free eating, so it’s actually really easy to find great recipes. One of my favourite sites is Against All Grain by Danielle Walker. She has many great, free recipes listed there and her cookbooks are wonderful!

I hope this is helpful! As always, if readers have their own health questions, I welcome them. Just send me an email at nonienutritionista@gmail.com. If you have experience with gluten or wheat sensitivity leave us a comment below!

Namaste!

Nonie Nutritionista