Posted 01\/05\/2010<\/p>\n\n\n\n
For years doctors were taught in medical school that gluten sensitivity and its severest form, celiac disease<\/em><\/strong><\/a>, were rare, identified mainly in children who were unable to absorb food. In photographs, youngsters with celiac disease looked like starving children because in fact they were starving, for nutrients. Once the diagnosis had been made and they\u2019d been taken off all gluten grains\u2013wheat, barley, rye, oats, kamut, and triticale\u2013they rapidly regained weight and lived normal lives.<\/p>\n\n\n\n Some years later, gluten sensitivity diseases were voted by internal medicine specialists like me as the diagnosis most likely to be missed in a chronically ill patient (the runner-up was Lyme disease). Physicians began to appreciate there were many more problems linked to gluten sensitivity than the characteristic intestinal malabsorption of celiac disease. These problems were called \u201cextra-intestinal manifestations\u201d and included skin rashes, joint pain, neurologic and psychiatric conditions, and symptoms like fatigue, anxiety, and headaches. In fact, an article in the New England Journal of Medicine<\/em> listed 55 conditions that could be caused by a gluten-sensitive person regularly eating gluten.<\/p>\n\n\n\n At the time, gluten sensitivity and celiac disease were very difficult to diagnose. If you were smart enough to suspect celiac disease, you needed to have a gastroenterologist take a biopsy sample of the small intestine to confirm the diagnosis. Gluten damages the intestine in a very characteristic and easily recognizable pattern.<\/p>\n\n\n\n Now a newly published study in the Journal of the American Medical Association<\/em> says it\u2019s time for all of us to take gluten sensitivity and celiac disease very seriously, because people who are genetically predisposed to them run a significantly higher risk of early death from both heart disease and cancer.<\/p>\n\n\n\n What exactly happens in gluten sensitivity? When gluten grains were introduced as a food source sometime in the Middle Ages, for genetic reasons a large percentage of people could not safely digest them. By contrast, rice is a very safe grain and rice sensitivity is extremely rare.<\/p>\n\n\n\n If you\u2019re sensitive to gluten, your immune system has created an antibody against the gluten molecule, and these antibodies circulate in your bloodstream, triggering widespread inflammation. Gluten sensitivity is an autoimmune disorder\u2013one in which the body mistakenly attacks its own tissues. Damage from the inflammation is responsible for all the symptoms, physical signs (such as rashes and intestinal damage), and health risks, including heart disease.<\/p>\n\n\n\n \u2022 If you have chronic symptoms of virtually any kind<\/strong>\u2013digestive, musculoskeletal, psychiatric, neurological, anything chronic\u2013if gluten sensitivity is contributing to them, you\u2019ll never feel completely well until you eliminate gluten. Although there are blood tests now available with tongue twisting names (anti-gliadin antibodies, anti-endomysial antibodies, anti-tissue transglutaminase antibodies) that render the intestinal biopsy largely unnecessary, remember that you can be mildly gluten-sensitive and still test negative for gluten.<\/p>\n\n\n\n The best way to screen yourself for gluten sensitivity is via elimination-reintroduction testing\u2013eliminating all gluten and then reintroducing it. Not everyone needs to do this, but it\u2019s currently calculated that one person in 100 has a gluten sensitivity. If you have any chronic symptom of any kind, especially one that seems to unpredictably wax and wane, it\u2019s a good idea to self-test.<\/p>\n\n\n\n Click here<\/em><\/strong><\/a> for a mind-boggling list of gluten-containing foods. For three weeks, don\u2019t eat any of them, not a bite, nada. If you are gluten-sensitive, it\u2019s likely that after three weeks you will feel better than you have in years, with none of your nagging symptoms, mentally clearer, and energetic. At the end of three weeks, start eating gluten-containing foods again. If your old symptoms return, that\u2019s it. You\u2019ve made your own diagnosis.<\/p>\n\n\n\n At this point, your health is in your hands. Going gluten-free is definitely challenging at first, but most people realize they feel so well they simply don\u2019t want to go back to their old way of eating. There are some nice support websites, too, including Gluten-Free Girl and The Chef<\/em><\/strong><\/a> and Living Without<\/em><\/strong><\/a> , with lots of recipes to help you along the way.<\/p>\n\n\n\n Can you avoid the self-testing and go straight to a blood test? Sure. Just ask your doctor to test you for gluten sensitivity. If you\u2019ve self-tested and believe you\u2019re sensitive to gluten, should you confirm your diagnosis with blood tests? Probably. I generally lean toward the blood test confirmation because if your tests come back positive, you\u2019ll know you should definitely stay off gluten\u2013that the healthy feeling during those weeks of gluten elimination was not a fluke. You have gluten sensitivity and you are at risk for ultimately life-threatening illnesses if you don\u2019t eliminate the stuff.<\/p>\n\n\n\n If your blood test is negative but you know you felt a lot better off gluten, despite the reassuring blood-test result you really should listen to the wisdom of your body. The longstanding symptoms you\u2019d been experiencing were messages of distress from your body. By quitting gluten, you responded to the message and your body rewarded you with a new sense of well-being.<\/p>\n\n\n\n After hearing a message as loud as that, ignoring it by going back on gluten is like taking the phone off the hook when someone is calling to let you know your house is on fire.<\/p>\n\n\n\n Be well, For years doctors were taught in medical school that gluten sensitivity and its severest form, celiac disease, were rare, identified mainly in children who were unable to absorb food. In photographs, youngsters with celiac disease looked like starving children because in fact they were starving, for nutrients. Once the diagnosis had been made and they\u2019d been taken off all gluten grains–wheat, barley, rye, oats, kamut, and triticale–they rapidly regained weight and lived normal lives.<\/p>\n","protected":false},"author":2087,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[197,2,211,2331,3],"tags":[1115,1116,1117,1118],"class_list":["post-3330","post","type-post","status-publish","format-standard","hentry","category-allergies-food-sensitivities","category-blog","category-g","category-internal-medicine","category-knowledge-base","tag-celiac-disease","tag-gluten","tag-gluten-sensitivity","tag-gluten-free-diet"],"yoast_head":"\r\nHere\u2019s why it\u2019s important to determine if you have a gluten sensitivity:<\/strong><\/h3>\n\n\n\n
\u2022 Since we eat an astonishing amount of gluten grains<\/strong> (many people eat gluten-containing foods at every meal and for snacks), the total number of gluten-sensitive people, estimated to be in the millions, is rising dramatically and, here\u2019s a kicker, 99% of them are undiagnosed.
\u2022 You\u2019ll be in and out of the doctor\u2019s office frequently with vague symptoms<\/strong> and you\u2019ll hear your doctor say she can\u2019t find anything wrong with you, that your tests are normal. This is because gluten sensitivity testing is simply not done routinely, though it should be.
\u2022 You won\u2019t live as long.<\/strong><\/p>\n\n\n\nSelf-testing for gluten sensitivity<\/strong><\/h3>\n\n\n\n
David Edelberg, MD<\/p>\n","protected":false},"excerpt":{"rendered":"