Gluten and Autoimmune Disease
What is gluten?
Gluten is a class of protein found in grains such as wheat, barley and rye. It’s what gives bread its soft and pliable texture, it prevents your biscuits from becoming a crumbly mess, and helps give your pasta that special “bite”.
What’s the problem with gluten?
Over the past few decades there has been a significant increase in the incidence of adverse health reactions associated witwhath gluten. At the severe end, gluten can cause allergic reactions in some people, or it may result in the development of celiac disease. Celiac disease is an autoimmune disease against gluten which leads to damage to intestinal cells.
At the less severe end (but nonetheless bothersome), is non-celiac gluten sensitivity (NCGS) in which eating gluten can result in a wide range of symptoms including stomach upset, bloating, confusion, joint pain, mood changes, and fatigue. There has also been a parallel increase in the development of non-celiac autoimmune diseases which could be linked to NCGS, including rheumatoid arthritis, lupus and others.
The reasons for this increase in reactions to gluten are up for debate, but it’s possible that the problems with gluten could be the result of people eating more wheat in general, excessive processing of wheat into packaged foods, genetic modification of wheat crops, or the pesticides and chemicals used in growing wheat.
The potential mechanisms through which gluten impacts health include:
- Stimulation of inflammatory signals in the body
- Promotion of “leaks” in the lining of the intestinal tract (which in turn triggers inflammation and immune system imbalance)
- Disruption of the gut microbiome
- Creation of damaging oxidative stress
- Modulation of the nervous system (impacts mental function & behaviour)
Should I stop eating gluten?
Gluten can be found in many foods made from wheat, rye and barley. This includes foods such as bread, pastas, noodles, crackers, cookies, gravies, dressings, beer, tortillas, pitas, soup mixes, soy sauce, and more. These gluten-containing foods are a valuable source of many nutrients, including vitamins, minerals, protein, and fiber. Therefore, the question of whether you should adopt a gluten-free diet should be addressed with a physician, nutritionist, or other qualified health professional to ensure that you continue to consume an adequate amount of nutrients.
Also, you may want to discuss with your doctor whether you should be tested for celiac disease, since it can co-occur with other autoimmune diseases. This is particularly the case if you’ve had a history of gastrointestinal discomfort, anemia, irregular menstrual periods (for women), joint pain, fatigue, or rashes. If you are positive for celiac disease, then it’s imperative that you adopt a gluten-free lifestyle.
If celiac disease has been ruled out, then a 3-week trial of eliminating all sources of gluten might be useful for determining whether you have non-celiac gluten sensitivity. When you reintroduce gluten after the 3-week elimination, your body’s response should tell you whether you might be gluten sensitive. People have told me they feel more pain or brain fog when they start eating gluten again. However, I highly recommend that you work with a nutrition professional before embarking on a gluten elimination challenge. This may not be appropriate (and possibly dangerous) for people who have food allergies, are at risk for eating disorders, or are poorly nourished. Plus, having a nutritionist in your back pocket can be very helpful as a resource and moral support for making this big change in your life!
If you have any questions about gluten or gluten-free diets, feel free to reach out to me directly for support.
Jacob et al. 2005. doi: 10.1136/jnnp.2004.055491.
Lerner et al. 2017. doi: 10.1093/nutrit/nux054.