Headaches, fatigue, bloating, rashes – it could be non celiac gluten sensitivity. Hippocrates said: “All disease begins in the gut.” When you include the adage “You are What you Eat,” some common truths emerge. What we eat can have a significant impact on our health. Gluten free products are everywhere, and gluten is in a lot of products. People are generally confused about the difference between celiac disease and gluten sensitivity and I will shed some light on these.
Gluten sensitivity is NOT the same as celiac disease. Celiac disease is an autoimmune disorder of your gut lining, meaning your immune system gets activated in the presence of gluten and damages your gut lining leading to malabsorption, nutritional deficiencies and serious illness. Generally, people with celiac have a genetic predisposition and an environmental trigger as well as intestinal permeability otherwise known as leaky gut. An environmental trigger could be stress, trauma, infection, toxins, nutritional deficiencies, or hormonal changes and any combination of these “stressors.”
Symptoms of Non Celiac Gluten Sensitivity
Contrary to popular belief, non celiac gluten sensitivity (NCGS) is not necessarily accompanies by symptoms in your gut. The range of symptom that can occur within hours or days of eating gluten is wide and can include:
- Abdominal pain
- Altered bowel function
- Joint or bone pain
- Mood disorders such as anxiety, depression
- Skin manifestations such as rash or eczema
The best way to find out if gluten is causing this is to eliminate it for weeks to months and see if the symptoms resolve. In fact, the sensitivity can be to gliadin, a protein found in wheat or fructans found in FODMAPS. Fermentable oligo-, di-, and mono-saccharides and polyols (FODMAPs) are other components of gluten-containing grains that may play a role.
Common FODMAPs include:
- Fructose: A simple sugar found in many fruits and vegetables as well as table sugar and most added sugars.
- Lactose: A carbohydrate found in dairy products like milk.
- Fructans: Found in grains like wheat, spelt, rye and barley.
- Galactans: Found in large amounts in legumes.
- Polyols: Sugar alcohols like xylitol, sorbitol, maltitol and mannitol.
Eating gluten or gliadin as well as FODMAPS foods can change the bacteria in your gut known as the microbiome. This can lead to gut dysbiosis (bad bacteria and/or not enough good bacteria) and lead to symptoms and widespread inflammation by activating the immune system This may explain the wide variety of NCGS symptoms that are not gut related.
Autoimmune Disorders and Non Celiac Gluten Sensitivity
Many autoimmune diseases associated with NCGS such as:
- Hashimoto’s thyroiditis
- Dermatitis herpetiformis
- Rheumatologic diseases such as Rheumatoid Arthritis, Lupus
In a study of patients diagnosed with non-celiac wheat sensitivity, 29% of those patients developed an autoimmune disorder. The primary autoimmune disease developed was Hashimotos’s thyroiditis which is why susceptible people may wish to avoid gluten/gliadin. In addition, 46% of patients with non-celiac wheat sensitivity tested positive for anti-nuclear antibody (ANA), a marker for autoimmune reaction. Even though the autoimmune disorder was not celiac disease, gluten still produced an immune response to other tissues besides the gut. The treatment for NCGS and CD is eliminating the offending agents which can be gluten, gliadin, FODMAPS that include dairy as well as other foods you may be sensitive to.
A review of nutritional profiles of gluten-free foods and gluten-free diets suggested potential deficiencies in nutrients such as fiber, protein, folate, iron, potassium, and zinc, while fat, sugars, FODMAPs, and sodium amounts were higher. Also, some gluten free foods are processed and high glycemic and a high processed carbohydrate load which can lead to weight gain and insulin resistance. If you decide to go gluten free, get advice and support from a qualified health professional familiar with functional medicine.