"One in three have some degree of gluten intolerance!" -- Dr. Kenneth Fine, laboratory director at Enterolab, (unpublished data via Dr. Osborne)
Celiac Disease and Gluten Intolerance not the same thing!
New research has recently been published in the American Journal of Gastroenterology—
Though traditionally Celiac disease and Gluten Allergy or Intolerance were once considered the same disease, there is now conclusive evidence that they are not the same thing after all. In fact, rather than gluten intolerance being a subset or symptom of Celiac disease, Celiac is now part of the subset of Gluten Intolerance. Celiac is only one disease resulting from a gluten allergy or intolerance. Of the many types of autoimmune disorders which exist, gluten intolerance can be linked to 190 of them as a possible cause.
It is important that doctors become aware that Celiac and Gluten Intolerance/Sensitivity are not the same thing. Typically doctors will test one type of gluten and look for one type of immune reaction. Unlike pregnancy, where you either are or aren't pregnant, your gluten sensitivity may fall on a spectrum rather than be positive or negative. Traditional serum blood tests for IGA antibodies or minute biopsies of random bits of a 22ft. intestinal tract are not enough to inform a doctor of your gluten sensitivity.
A recent double blind, randomized, placebo-controlled study published in the American Journal of Gastroenterology identified gluten intolerance as an existing condition separate and distinct from Celiac disease. Tissue, serum blood tests, and antibody tests come back negative for celiac but an intolerance exists.
Two new terms have been coined for this condition:
- "Non-celiac gluten sensitivity"--by Dr. Marsh, the physician who created diagnostic criteria for biopsy of celiac disease
- "Gluten Syndrome"--by Dr. Rodney Ford, a pediatric gastroenterologist and allergist
Unpublished data from Dr. Kenny Fine, who runs the Entero lab in Dallas, believes 1 in 3 people have some degree of gluten intolerance
Symptoms are on a sliding scale from gas and bloating to severe symptoms which may require hospitalization.
Classic symptoms celiac disease:
- Extreme weight loss
- diarrhea
- stomach pain
- bloating
- vomiting
"In actuality symptoms can be and usually are systemic."Dr. Peter Osborne
According to Dr. Osborne, gluten is a known inducer of autoimmune disease! He says there are a host of different symptoms associated with the onset and development of these types of conditions.
If this is true how does one discover to what degree they are sensitive? Will a blood test or biopsy reveal gluten intolerance? Serum lab tests or biopsy cannot rule out gluten sensitivity only celiac disease.
Change of perspective needed
Rather than view it as a disease, Dr. Osborne recommends gluten sensitivity be thought of as a genetically determined predisposition. Several genetic patterns and markers have been identified. If one were to be tested for specific genetic markers it would give a much better picture of whether or not someone was gluten intolerant.
Why don't blood and allergy tests work?
One of the troubles with allergy testing is that typically allergists will only test for acute allergy. This is due to the necessity to avoid anaphylactic shock reactions because they can be life threatening. If an IGA antibody is not present they typically stop there and do not look deeper into gluten intolerance. Many with chronic inflammation and illness have intolerances or sensitivities which are a very different type of immune response, ones that may take days to appear in antibody testing. One or more of several other types of immune mediated factors may or may not be present in gluten intolerance. These antibodies may not be present but symptoms, damage and disease provoked by gluten intolerance can still occur.
One of the troubles with allergy testing is that typically allergists will only test for acute allergy. This is due to the necessity to avoid anaphylactic shock reactions because they can be life threatening. If an IGA antibody is not present they typically stop there and do not look deeper into gluten intolerance. Many with chronic inflammation and illness have intolerances or sensitivities which are a very different type of immune response, ones that may take days to appear in antibody testing. One or more of several other types of immune mediated factors may or may not be present in gluten intolerance. These antibodies may not be present but symptoms, damage and disease provoked by gluten intolerance can still occur.
What type of symptoms can gluten intolerance cause?
Symptoms can vary. Just as each person can react differently to a prescription drug so can each one react differently in the presence of gluten. Symptoms can include but are not limited to:
- bloating
- diarrhea,
- stomach pain
- body aches
- migraines
- fatigue.
- hypothyroidism
- fibromyalgia and chronic fatigue syndrome
- multiple food allergies/multiple chemical sensitivities
- rheumatoid arthritis
- celiac
- epilepsy
- neurological symptoms
- anemia
- osteoporosis
- psychological disorders such as schizophrenia, bi-polar disorder, and depression
- asthma
- cancer (lymphoma)
“So in a nutshell recent studies are showing that gluten sensitivity is much more common than previously thought. In fact, may be a separate entity altogether with different mechanisms than celiac disease. While there is no doubt that the condition exists the lack of definite criteria for a diagnosis is where people are falling short. So acceptance of gluten sensitivity as a valid condition has evolved.” --Dr. Peter Green, director of the celiac disease center at Columbia University
60-70% who seek help for celiac are actually gluten sensitive not positive for celiac --Dr. Alessio Fasano from the University of Maryland Celiac Research Center
Why is the focus on celiac?
During World War II Willem Dicke found children with wasting disease (diarrhea) and failure to thrive in his hospital went into spontaneous remission from celiac disease during because grain was not available. He published his findings in 1952. He was the first doctor to realize grain caused symptoms. Grains available in his region were wheat, barley, rye, and oats. All grain has the protein gluten but those grains were prevalent in his region so the majority of research has been on those grains, with less on research on oats.
If blood tests can't be conclusive, what can reveal Gluten Sensitivity?
Dr. Osborne urges people to think of gluten sensitivity not so much as a disease but as a state of genetics. Several genetic parameters and patterns have been identified to be factors in causing a reaction to gluten. Unfortunately genetic testing can be hugely expensive! If you are interested in genetic testing and would like to know which markers to look for for gluten sensitivity, contact me and I can send you the list. There are several. Some of these are specific to Celiac. Others have been isolated in those with non celiac gluten sensitivity. It is believed these genes get switched on, activating the neurological consequences of gluten intolerance which in turn causes degeneration into disease.
Dr. Osborne urges people to think of gluten sensitivity not so much as a disease but as a state of genetics. Several genetic parameters and patterns have been identified to be factors in causing a reaction to gluten. Unfortunately genetic testing can be hugely expensive! If you are interested in genetic testing and would like to know which markers to look for for gluten sensitivity, contact me and I can send you the list. There are several. Some of these are specific to Celiac. Others have been isolated in those with non celiac gluten sensitivity. It is believed these genes get switched on, activating the neurological consequences of gluten intolerance which in turn causes degeneration into disease.
Gluten Sensitivity is not a disease but it causes disease.
There have been about 190 different diseases that have been linked to gluten sensitivity. One such condition is Silent Celiac disease. This form of celiac disease does not display the typical gastric symptoms. Instead asthma, osteoporosis, anemia and neurological disorders are present. There may also be thyroid, gall bladder, and liver changes. The intestinal mucosa can become permeated and Leaky Gut syndrome can result. This allows toxins and bacteria to access a key area in the abdomen which affects immune system response.
There have been about 190 different diseases that have been linked to gluten sensitivity. One such condition is Silent Celiac disease. This form of celiac disease does not display the typical gastric symptoms. Instead asthma, osteoporosis, anemia and neurological disorders are present. There may also be thyroid, gall bladder, and liver changes. The intestinal mucosa can become permeated and Leaky Gut syndrome can result. This allows toxins and bacteria to access a key area in the abdomen which affects immune system response.
"We have, however, shown that neurological dysfunction can not only precede coeliac disease but can also be its only manifestation...The typical clinical expression of a patient with gluten sensitivity where the sole manifestation is neurological is cerebellar ataxia, often with a peripheral neuropathy. Most of these patients will have histologically normal mucosa on biopsy and few or no gastrointestinal symptoms. Both the ataxia and the neuropathy may be reversible."
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