Gluten: What You Don't Know Might Kill You

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.

 

 

 

Follow Mark Hyman, MD on Twitter: www.twitter.com/markhymanmd

Comments

[sampson1410]

05:28 PM on 03/02/2010

Thank you for this article, it confirms what I have thought for years. I had three stents installed when I was 45 years old due to a 95% blockage of my artery. I have always worked out and watched what I ate so my near death experience was a total shock. After my surgery I became very weak and was dropping weight although I was eating three squares a day. My bad cholesterol was getting worse and my good was dropping alarmingly low (29). I was diagnosed with celiacs disease three years later. I am 6'6" tall and was down to 196 pounds, I looked like a walking skeleton. After removing gluten from my diet I gained 32 pounds the first year and my energy has shot through the roof. My bad cholesterol has gone down and my good is continuing to climb (59). Amazing how your diet can affect your life. My only question is why did my reaction to gluten become so bad after my heart surgery?

[Alexandra Kaufman]

02:18 AM on 02/19/2010

I was very happy to hear another voice speak out about how poisonous gluten can be to those who do not have Celiac. What I am trying to figure out is the difference between a histamine allergic response (which seems to be for people with Celiac) and an FIR (Food Immune Reaction) which seems to be for a goodly portion of the rest of the population. People with Celiac seem to respond to decreasing symptoms within 2-4 weeks from gluten elimination whereas people with FIR seem to often take anywhere from a month to a year or more because the body has incurred the effects of long-term exposure. I have often heard people say, " I went off gluten for a month and didn't see an y difference." Then later find out they have a gluten problem. I understand that gluten became a toxin from all of the bioengineering of gluten to become better, stronger, faster, and that is has since mutated into a pathogen in the last, I don't know how many years. This seems to corroborate the major increase in gluten free products out on the market that companies are responding to. What's your take on this Dr. Hyman? Thanks in advance.

[Non Nosher]

09:59 AM on 02/02/2010

Thank you so much for this article. It has already helped so that people understand that Celiac is serious, and they need to take it seriously. It is not a fad.

Sometimes people do not get better when they go on a gluten free diet. A study at Mayo Clinic shows that 1 in 10 Celiacs who do not respond to a gluten free diet, have SIBO (small intestinal bacterial overgrowth).

People who suffer from SIBO desperately need more rigorous medical scientific research as well as SIBO awareness the way (many thanks to you and others) there is now awareness for Celiac and gluten free.

SIBO sufferers need people at the Huffington Post to help us out. People like you.

A SIBO awareness program is being started.

Information and links to SIBO can be found at "The Year of Eating Weirdly" http://www.celiacsurprise.com

And a twitter campaign is also being started:

http://twitter.com/NonNosher
http://twitter.com/GirrlockHolmes

An article like this one has done wonders for Celiac disease. Please help spread the word about SIBO too. Many thanks.

[Gluten Free Foodies]

12:39 PM on 01/11/2010

I figured out that I had Celiac Disease about 5 years ago. I was in a car accident 6 years ago and became very very ill in addition to having chronic pain from the accident. It took me a year to figure it out, without a medical degree, and to insist that the doctors test me. I knew something wasn't right and the doctors were looking at everything but Celiac. I went through a year of very expen$ive testing to try to find cancer and various other diseases, not to mention all of the crazy medicines they put me on. I reacted to all the medicines as well, which complicated everything! I write a blog now to help people learn more about living Gluten Free lifestyle. Please feel free to contact me at [e-mail]
http://www.glutenfreefoodies.blogspot.com , I also post for a local paper as a volunteer blogger and am on Facebook under Gluten Free Foodies

My question to you, Dr. Hyman - in addition to Celiac, over the years I am becoming more a more allergic to various other foods, etc. I am finding this common with the more people that I talk to via my blogs. I have my theories about this but would like to start a conversation with you about this as to why this is happening. Gluten Sensitivity is only the beginning ... What do you think?
Looking forward to hearing from you!
Lisa - Gluten Free Foodie
[e-mail]

[celiacspeaks]

03:40 AM on 01/10/2010

Great Article! It is amazing how many Americans have Celiac Disease or a gluten sensitivity...but don't even know it! I didn't find out until I was 15 and I was extremely sick growing up, didn't gain weight, couldn't remember what I did the day before...ugh it was horrible...and all from gluten! Crazy how much food can effect our lives!

- Jessika : Celiac Speaks - My Personal Notes

[FourPaws Acupuncture]

10:42 AM on 01/09/2010

Thank you so much! This information also applies to dogs. I have found that wheat and other gluten products exacerbate pain and other symptoms of arthritis and other ailments. FInding a dog food that is free of gluten, wheat, corn and soy makes a positive difference in the dog's health.
I gave up eating anything with gluten in it years ago and weight fell off and the mysterious pain in my body disappeared. If i am 'bad" and indulge in a slice of pizza or pasta i suffer from a gluten hangover the following day. I think the obesity epidemic in the USA could perhaps be managed if these folks stopped eating gluten!

[AmyJane]

07:53 PM on 01/08/2010

Thank you! I tested positive for gluten intolerance 4 weeks ago. I think I've had it 15-20 years. Main symptoms have been slow but steady stubborn weight gain, fatigue, joint and muscle pain, and a pain in my upper middle back for the last 5 years. I had x-rays and ultrasounds for that, never found anything. I knew I had a problem with wheat but didn't know enough about gluten to make the connection. I also tested IgG positive for 50 foods, all of which I think I will be able to eat again when I have healed. Gluten, NO--never again. I'm not even tempted. I noticed a huge improvement in 3 days. I ate gluten twice after that, once knowingly, the other not, and noticed an immediate return of symptoms. My joint pain is almost completely gone, the pain in the back is gone, I have lots of energy and I have lost 10 pounds without trying. It's an easy blood test, or just try the elimination diet. It is AMAZING the difference it can make if you are intolerant. Very disappointing that I'll probably have to pay for the dr. visit and blood tests. I know the insurance companies have paid thousands over the last 15 years for all the attempts to find out what was wrong.

[TakeSake]

02:54 AM on 01/09/2010

I figured it out 6 years ago. Now I realize that was sensitive to it for 15 or 20 years before that. Once I changed my diet, many of those various rashes and ailments that I got used to faded away.

[Lorie Abbott]

02:42 PM on 01/08/2010

Dr Hyman, thank you so much for posting this article. I suffered for over 10 years and Dr after Dr told me it was all in my head or that I must be doing something wrong. I want everyone to know about Celiac Disease because I don't want anyone else to suffer needlessly like I did. I now have many other issues because it took so long to figure out what was really going on. My family and friends don't really understand how life changing this can be. And in my case I have severe reactions to gluten that I accidentally ingest, that touches my skin or that I might inhale so my life has changed drastically. I think the more credible sources we have talking about this condition the easier it will be for people like me to be believed and understood by Drs and friends and family. Having support from friends and family is so critical because those of us with severe sensitivity to gluten struggle to find safe places in a world filled with gluten. Thanks for helping to get the word out!!

[Thinklongterm]

02:42 PM on 01/07/2010

More good info.

[sangela]

02:36 AM on 01/07/2010

Gluten makes my joints ache, makes me wheeze and provokes my asthma, sometimes gives me diahhrea, wind or contractions and pain in the gut the next morning. I can feel heavy and sleepy and inattentive too. I eat as much as possible food I cook, and non gluten breads. I now find that I am even sensitive to rice which puzzles me. Has rice got gluten?

[catsanon]

01:46 PM on 01/07/2010

No, rice does not contain the gluten which makes wheat, rye and barley a problem. Are you certain your rice has not been contaminated?

I would suggest consulting a doctor. You might be having other problems in addition to a gluten sensitivity.

[mssreader]

02:18 PM on 01/07/2010

sangela, if you are using white rice, try brown rice. Brown rice never bothers me and has all the nourishment that has been taken out of white rice.

[g-fgoatcity]

04:01 PM on 01/06/2010

Jan 1, 2007 marked the beginning of what I thought was going to be a month, maybe two, of eliminating gluten from my diet--three years later, I would never go back, and my reaction to gluten in the smallest cross-contamination form is pretty scary, so I am on the gluten-free diet, happily, for life. Never got tested, but a recent skin biopsy after a gluten exposure caused my rash (DH) to return revealed antibodies; that, coupled with the other reactions I had (asthma, gas pain, bloating, fatigue and dry, itchy and puffy eyes) let me know more than any test would have that I cannot, and should not, keep gluten in my life.
My full story and tips, recipes, etc here: http://goatcity.blogspot.com/

[dcglutie]

03:06 PM on 01/06/2010

I was diagnosed with Crohn’s disease in 2002. I endured a bowel resection which spurred a lasting remission and I have been, gastronomically speaking, lucky enough to eat whatever I want without much consequence. I did however, continue to have persistent widespread joint pain and five years later chose to try the "gluten free good life" at the persistence of a friend. To my surprise, the joint pain completely dissipated and I dropped a few pounds in a hurry not to mention I was sleeping better and generally happier. Feeling good, looking good, why would a gal ever go back? At the beginning of 2009, I had the celiac biopsy and it came back negative but my doctor agreed it was likely I suffered from a gluten sensitivity and it is best if I just steer clear of the stuff. If you are suffering from a number of inexplicable maladies, it's worth taking a 30 day gluten hiatus to see how you feel. If the results are good, discuss them with your doctor and consider a lifestyle change. I promise you won't regret it. Learn more about the gluten-free good life at www.dcgluties.com.

[Coyote50]

01:29 AM on 01/06/2010

It is hard to not eat gluten. And with kids, it's especially hard to keep the gluten away from them. Gluten Free and Fabulous makes an incredible pizza -- worth checking out http://www.glutenfreefabulous.com.

[Meenu]

11:18 PM on 01/05/2010

An eye opening article. It summarizes the sum total of what we have been reading and experiencing as a family. We are a family of five where four of us have Celiac Disease and one has Gluten Sensitivity. We have seen a world of difference after going Gluten Free. Please read about our gluten free journey at our blog - www.glutenfreediaries.com

[EddieNM]

03:14 PM on 01/05/2010

Gluten made a mess of the middle of my life: from age 38, to age 63. After a major crash in 1991, I went to MDs for 11 years and could never get a diagnosis. Then went to a naturopath, and got a diagnosis (silent celiac) within one year. It then took another 6 years to get well, requiring much personal research, to heal gluten enteropathy, fix all my nutritional deficiencies, and thyroid issues (hypothyroidism and Reverse T3 Dominance).

The history of my illness has been published in pieces, in the Journal of Gluten Sensitivity. Those who are having trouble getting well from this disorder, esp. if you have gluten-caused hypothyroidism or back pain/degeneration, will find the complete history of my illness online until about 15 Apr 2010, at this location:

ftp://ftp.ucar.edu/era/mi/MysteryIllness.htm