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Mark Hyman, MD: Gluten: What You Don't Know Might Kill You
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Something you\'re eating may be killing you, and you probably
don\'t even know it!
If you eat cheeseburgers or French fries all the time or drink six
sodas a day, you likely know you are shortening your life. But eating
a nice dark, crunchy slice of whole wheat bread--how could that be bad
for you?
Well, bread contains gluten, a protein found in wheat, barley, rye,
spelt, kamut, and oats. It is hidden in pizza, pasta, bread, wraps,
rolls, and most processed foods. Clearly, gluten is a staple of the
American diet.
What most people don\'t know is that gluten can cause serious health
complications for many. You may be at risk even if you don\'t have
full blown celiac disease.
In today\'s blog I want to reveal the truth about gluten, explain the
dangers, and provide you with a simple system that will help you
determine whether or not gluten is a problem for you.
The Dangers of Gluten
A recent large study in the Journal of the American Medical
Association found that people with diagnosed, undiagnosed, and
\latent\ celiac disease or gluten sensitivity had a higher risk of
death, mostly from heart disease and cancer. (i)
This study looked at almost 30,00 patients from 1969 to 2008 and
examined deaths in three groups: Those with full-blown celiac disease,
those with inflammation of their intestine but not full-blown celiac
disease, and those with latent celiac disease or gluten sensitivity
(elevated gluten antibodies but negative intestinal biopsy).
The findings were dramatic. There was a 39 percent increased risk of
death in those with celiac disease, 72 percent increased risk in those
with gut inflammation related to gluten, and 35 percent increased risk
in those with gluten sensitivity but no celiac disease.
This is ground-breaking research that proves you don\'t have to have
full-blown celiac disease with a positive intestinal biopsy (which is
what conventional thinking tells us) to have serious health problems
and complications--even death--from eating gluten.
Yet an estimated 99 percent of people who have a problem with eating
gluten don\'t even know it. They ascribe their ill health or symptoms
to something else--not gluten sensitivity, which is 100 percent
curable.
And here\'s some more shocking news ...
Another study comparing the blood of 10,000 people from 50 years ago
to 10,000 people today found that the incidences of full-blown celiac
disease increased by 400 percent (elevated TTG antibodies) during that
time period. (ii) If we saw a 400 percent increase in heart disease or
cancer, this would be headline news. But we hear almost nothing about
this. I will explain why I think that increase has occurred in a
moment. First, let\'s explore the economic cost of this hidden
epidemic.
Undiagnosed gluten problems cost the American healthcare system
oodles of money. Dr. Peter Green, Professor of Clinical Medicine for
the College of Physicians and Surgeons at Columbia University studied
all 10 million subscribers to CIGNA and found those who were correctly
diagnosed with celiac disease used fewer medical services and reduced
their healthcare costs by more than 30 perecnt. (iii) The problem is
that only one percent of those with the problem were actually
diagnosed. That means 99 percent are walking around suffering without
knowing it, costing the healthcare system millions of dollars.
And it\'s not just a few who suffer, but millions. Far more people
have gluten sensitivity than you think--especially those who are
chronically ill. The most serious form of allergy to gluten, celiac
disease, affects one in 100 people, or three million Americans, most
of who don\'t know they have it. But milder forms of gluten
sensitivity are even more common and may affect up to one-third of the
American population.
Why haven\'t you heard much about this?
Well, actually you have, but you just don\'t realize it. Celiac
disease and gluten sensitivity masquerade as dozens and dozens of
other diseases with different names.
Gluten Sensitivity: One Cause, Many Diseases
A review paper in The New England Journal of Medicine listed 55
\diseases\ that can be caused by eating gluten. (iv) These include
osteoporosis, irritable bowel disease, inflammatory bowel disease,
anemia, cancer, fatigue, canker sores, (v) and rheumatoid arthritis,
lupus, multiple sclerosis, and almost all other autoimmune diseases.
Gluten is also linked to many psychiatric (vi) and neurological
diseases, including anxiety, depression, (vii) schizophrenia, (viii)
dementia, (ix) migraines, epilepsy, and neuropathy (nerve damage).
(x) It has also been linked to autism.(ix)
We used to think that gluten problems or celiac disease were confined
to children who had diarrhea, weight loss, and failure to thrive. Now
we know you can be old, fat, and constipated and still have celiac
disease or gluten sensitivity.
Gluten sensitivity is actually an autoimmune disease that creates
inflammation throughout the body, with wide-ranging effects across all
organ systems including your brain, heart, joints, digestive tract,
and more. It can be the single cause behind many different \diseases.\
To correct these diseases, you need to treat the cause--which is often
gluten sensitivity--not just the symptoms.
Of course, that doesn\'t mean that ALL cases of depression or
autoimmune disease or any of these other problems are caused by gluten
in everyone--but it is important to look for it if you have any
chronic illness.
By failing to identify gluten sensitivity and celiac disease, we
create needless suffering and death for millions of Americans. Health
problems caused by gluten sensitivity cannot be treated with better
medication. They can only be resolved by eliminating 100 percent of
the gluten from your diet.
The question that remains is: Why are we so sensitive to this \staff
of life,\ the staple of our diet?
There are many reasons ...
They include our lack of genetic adaptation to grasses, and
particularly gluten, in our diet. Wheat was introduced into Europe
during the Middle Ages, and 30 percent of people of European descent
carry the gene for celiac disease (HLA DQ2 or HLA DQ8), (xii) which
increases susceptibility to health problems from eating gluten.
American strains of wheat have a much higher gluten content (which is
needed to make light, fluffy Wonder Bread and giant bagels) than those
traditionally found in Europe. This super-gluten was recently
introduced into our agricultural food supply and now has \infected\
nearly all wheat strains in America.
To find out if you are one of the millions of people suffering from
an unidentified gluten sensitivity, just follow this simple procedure.
The Elimination/Reintegration Diet
While testing can help identify gluten sensivity, the only way you
will know if this is really a problem for you is to eliminate all
gluten for a short period of time (2 to 4 weeks) and see how you feel.
Get rid of the following foods:
• Gluten (barley, rye, oats, spelt, kamut, wheat, triticale--see
www.celiac.com for a complete list of foods that contain gluten, as
well as often surprising and hidden sources of gluten.)
• Hidden sources (soup mixes, salad dressings, sauces, as well as
lipstick, certain vitamins, medications, stamps and envelopes you have
to lick, and even Play-Doh.)
For this test to work you MUST eliminate 100 percent of the gluten
from your diet--no exceptions, no hidden gluten, and not a single
crumb of bread.
Then eat it again and see what happens. If you feel bad at all, you
need to stay off gluten permanently. This will teach you better than
any test about the impact gluten has on your body.
But if you are still interested in testing, here are some things to
keep in mind.
Testing for Gluten Sensitivity or Celiac Disease
There are gluten allergy/celiac disease tests that are available
through Labcorp or Quest Diagnostics. All these tests help identify
various forms of allergy or sensitivity to gluten or wheat. They will
look for:
• IgA anti-gliadin antibodies
• IgG anti-gliadin antibodies
• IgA anti-endomysial antibodies
• Tissue transglutaminase antibody (IgA and IgG in questionable
cases)
• Total IgA antibodies
• HLA DQ2 and DQ8 genotyping for celiac disease (used occasionally
to detect genetic suspectibility).
• Intestinal biopsy (rarely needed if gluten antibodies are
positive--based on my interpretation of the recent study)
When you get these tests, there are a few things to keep in mind.
In light of the new research on the dangers of gluten sensitivity
without full blown celiac disease, I consider any elevation of
antibodies significant and worthy of a trial of gluten elimination.
Many doctors consider elevated anti-gliadin antibodies in the absence
of a positive intestinal biopsy showing damage to be \false
positives.\ That means the test looks positive but really isn\'t
significant.
We can no longer say that. Positive is positive and, as with all
illness, there is a continuum of disease, from mild gluten sensitivity
to full-blown celiac disease. If your antibodies are elevated, you
should go off gluten and test to see if it is leading to your health
problems.
So now you see--that piece of bread may not be so wholesome after
all! Follow the advice I\'ve shared with you today to find out if
gluten may be the hidden cause of your health problems. Simply
eliminating this insidious substnace from your diet, may help you
achieve lifelong vibrant health.
That\'s all for today. Now I\'d like to hear from you ...
Are you one of the millions that have been lead to believe gluten is
perfectly safe to eat?
How do foods that contain gluten seem to affect you?
What tips can you share with others about eliminating gluten from
your diet?
Please let me know your thoughts by posting a comment below.
To your good health,
Mark Hyman, MD
References
(i) Ludvigsson JF, Montgomery SM, Ekbom A, Brandt L, Granath F.
Small-intestinal histopathology and mortality risk in celiac disease.
JAMA. 2009 Sep 16;302(11):1171-8.
(ii) Rubio-Tapia A, Kyle RA, Kaplan EL, Johnson DR, Page W, Erdtmann
F, Brantner TL, Kim WR, Phelps TK, Lahr BD, Zinsmeister AR, Melton LJ
3rd, Murray JA. Increased prevalence and mortality in undiagnosed
celiac disease. Gastroenterology. 2009 Jul;137(1):88-93
(iii) Green PH, Neugut AI, Naiyer AJ, Edwards ZC, Gabinelle S,
Chinburapa V.
Economic benefits of increased diagnosis of celiac disease in a
national managed care population in the United States. J Insur Med.
2008;40(3-4):218-28.
(iv) Farrell RJ, Kelly CP. Celiac sprue. N Engl J Med. 2002 Jan
17;346(3):180-8. Review.
(v) Sedghizadeh PP, Shuler CF, Allen CM, Beck FM, Kalmar JR. Celiac
disease and recurrent aphthous stomatitis: a report and review of the
literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod.
2002;94(4):474-478.
(vi) Margutti P, Delunardo F, Ortona E. Autoantibodies associated
with psychiatric disorders. Curr Neurovasc Res. 2006 May;3(2):149-57.
Review.
(vii) Ludvigsson JF, Reutfors J, Osby U, Ekbom A, Montgomery SM.
Coeliac disease and risk of mood disorders--a general population-based
cohort study. J Affect Disord. 2007 Apr;99(1-3):117-26. Epub 2006 Oct
6.
(viii) Ludvigsson JF, Osby U, Ekbom A, Montgomery SM. Coeliac
disease and risk of schizophrenia and other psychosis: a general
population cohort study. Scand J Gastroenterol. 2007 Feb;42(2):179-85.
(ix) Hu WT, Murray JA, Greenaway MC, Parisi JE, Josephs KA.
Cognitive impairment and celiac disease. Arch Neurol. 2006
Oct;63(10):1440-6.
(x) Bushara KO. Neurologic presentation of celiac disease.
Gastroenterology. 2005 Apr;128(4 Suppl 1):S92-7. Review.
(xi) Millward C, Ferriter M, Calver S, Connell-Jones G. Gluten- and
casein-free diets for autistic spectrum disorder. Cochrane Database
Syst Rev. 2004;(2):CD003498. Review.
(xii) Green PH, Jabri B. Coeliac disease. Lancet. 2003 Aug
2;362(9381):383-91. Review.
Mark Hyman, M.D. practicing physician and founder of The
UltraWellness Center is a pioneer in functional medicine. Dr. Hyman
is now sharing the 7 ways to tap into your body\'s natural ability to
heal itself. You can follow him on Twitter, connect with him on
LinkedIn, watch his videos on Youtube and become a fan on Facebook.
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