DO I REALLY NEED TO GIVE UP GLUTEN?

The debate over whether gluten needs to be avoided or not seems to rage on without clarity. Many plant based “authorities” claim that gluten is fine, and that adding plenty of starch that includes wheat bread, wheat pasta and other gluten-containing grains should be part of a low fat plant based diet. Long term vegan-advocates Dr. Esselstyn and Dr. McDougall both encourage people not to worry about the inclusion of gluten in the diet. Some claim that books like Wheat Belly and Grain Brain are scientifically unfounded. As a 25 year vegan myself, and a science and evidence based clinical nutritionist, I agree that a large percentage of the information in books that encourage people to eat animal foods and high fat diets is not based in scientific research from the last 50 years. However, “throwing the baby out with the bathwater” is never a good idea. There are some kernels of truth and science in both of those books related specifically to the damaging effects of gluten in the body.

I will make one thing clear right from the start: I personally advocate for the removal of gluten from the human diet. That is because a) We don’t need it. It’s not like recommending we avoid vegetables or fruits, two things the body DOES need. We simply do not need gluten. I am a firm believer that food IS medicine. And if you are medicating yourself three times per day, there is no need to take medications that we know do not heal, and in fact may harm. b) It is an undisputed fact that gluten causes an upregulation of zonulin as a result of the increased intestinal inflammation that gliadin (the protein found in gluten) causes in ALL people. This sets the stage for leaky gut. We will cover this more in detail below.

Another thing that you may want to consider is my easy answer to all of the gluten “controversy”. At the end of the day, all of the science, or theory, or opinion, is nowhere near as influential as listening to my own body, and I recommend you do the same. Try going 30 days without a morsel of gluten. No bread, pasta, gluten containing grains including: couscous, kamut, semolina, spelt etcc…, soy sauce, condiments of any kind. No wraps, no pita, no muffins etc… If you can go totally grain free for a month, great. It might make it easier. If not, swap with quinoa, organic corn meal/polenta, wild rice or basmati rice, and gluten free oats.

Simple. No research to read, no opinions to ponder. This is where it gets real. Your body will SHOW you what works for you and what does not if you are honest with it. Give it 30 days of zero gluten. After the 30 days, reintroduce gluten for 3 days. Write down any changes in mood, skin, sleep, energy levels, anxiety etc… and simply decide if you want gluten in your life or not. It truly doesn’t matter what the research says if your depression lifts, your energy increases, your sleep improves and your skin isn’t quite so dry.

As to the research? Ongoing research actually points out that many cases of neurological disorders (depression, anxiety, balance, and even dementia) are a result of gluten on the brain. The active inflammatory process from gluten in the gut can trigger changes in the brain and immune system causing symptoms outside of the gut, due to the complex relationship of the gut-brain axis, causing mental and emotional dysfunction.  So let’s take a look at the process.

Anxiety, MS, Depression and Migraines

In the past, the common symptoms of celiac disease or even gluten intolerance were considered to be weight loss, diarrhea, malabsorption, anemia and abdominal bloating. While some of those are still relevant, current research shows that symptoms often appear with minimal or no gastrointestinal symptoms, but rather with brain and skin symptoms.  Neurological and psychological disorders linked with gluten sensitivity include seizure disorders, brain fog, neuropathy/nerve pain, tingling and numbness, schizophrenia, depression, migraines, anxiety, ADD/ ADHD, autism, multiple sclerosis, myasthenia gravis, myopathy or muscle weakness, and ataxia/ balance problems and cerebellar degeneration (involved with movement and body awareness.) As far back as 1998, the Lancet medical journal described loss of balance as one of the most common symptoms of gluten intolerance regardless of intestinal symptoms. Recent research shows that as many as 57 percent of those with neurological disorders from unknown causes test positive for gluten intolerance.

If you have a health care provider that is not aware of this, gluten sensitivity will easily be overlooked.

Increased Intestinal Permeability

Researchers have also discovered that gliadin, the protein found in gluten, causes increased intestinal permeability in ALL individuals, healthy or not. The research showed that all people experienced an upregulation of zonulin followed by an opening of the “tight junctions” between cells. In other words, it leads to leaky gut syndrome.  Zonulin is a protein that regulates how permeable the junctions are between the digestive tracts cell walls.

Of course, in people with celiac disease and non-celiac gluten sensitivity, the intestinal permeability was more severe. Interestingly, how your cells respond in returning back to normal after gluten exposure depends on how much of an immune compound called IL-10 you have in you system. IL-10 is an anti-inflammatory immune compound. Individuals who had high levels of this anti-inflammatory immune compound IL-10 had the best healing response to gluten exposure. Your IL-10 levels depend on your omega-3/ DHA and vitamin D status.

Compromised Methylation

Methylation has recently been more in focus in health circles, which is a good thing considering methylation affects nearly every cell it the body. It controls the stress response and production of glutathione (the master antioxidant). Glutathione is the single most important antioxidant for the brain and the immune system. But methylation also controls detoxification, inflammation, DNA repair, gene expression, brain chemistry, tissue repair, energy production, and the immune response with infections.

Studies within the past two years have identified that exposure to both gluten and casein (dairy) modulated nerve cells and gut lining cells to activate opioid receptors, leading to decreased cysteine uptake. Cysteine is an amino acid which is the precursor for glutathione. As a result, exposure to gluten caused impairment of the entire process of methylation.

Healthy methylation and optimal glutathione levels are critical to both neurological and psychological health.

Also important to note is that approximately 50% of the cells in the brain are microglial cells, which help provide immunity. When we constantly activate these cells due to an inflammatory response, the more brain fog we suffer from. It has been shown that gluten exposure and the resulting inflammation cause the brain to activate microglial cells. 

Unfortunately, problems associated with gluten are not often recognized by physicians and frequently dismissed. Symptoms may come and go, based on varying levels of inflammation. But it is tragic to think that people would have to suffer for years with migraines, anxiety, depression, and potential dementia, all from the ingestion of a common food.

Nutrition Options For Healing The Gut

If you have tried 30 days with zero gluten, re-introduced it and noticed a change in how you feel, it may be time to completely eliminate gluten from the diet and begin healing the gut. Here are some options to consider with your clinical nutritionist or functional medicine practitioner to begin the gut healing process.

Glutamine – Glutamine is an amino acid critical to the lining of the digestive tract. High levels of inflammation in the gut cause rapid turnover of the digestive lining. Glutamine can help repair digestive tract lining.

Boswellia serrata – This natural anti-inflammatory compound is derived from frankincense. Boswellia has and extensive history in helping the body handle inflammation. Excess wear-and-tear in the gut lining and oxidative stress in the brain are supported by boswellia.

DHA – The omega-3 DHA is essential for many functions throughout the body. It is critical for keeping the immune modulator IL-10, gut inflammation, and brain stress. It is also important for keeping the tight junctions in the gut lining working properly.

Coenzyme B Vitamins – Adequate daily intake of B vitamins provides critical nutrients for brain function and methylation in the body. Numerous factors like high sugar diets (refined added sugars), stress, and imbalanced gut bacteria increase the needs of B vitamins beyond the “RDA” recommended daily amounts.  Additionally, methylation gene defects – which affect about 50% of all people – dramatically increase the need for B vitaminsin their natural coenzyme forms.  

NAC – This is one of the major amino acids found to be depleted in nerve tissue after gluten ingestion. This critical amino acid is essential to the formation of glutathione. Inadequate glutathione impairs immune system function, impairs methylation, and leads to inflammation in the brain and the gut. The active form of cysteine is NAC, N-Acetyl Cysteine.

TMG - Trimethylglycine or TMG (also known as betaine) assists in the metabolism of homocysteine into methionine, which in turn can produce the important nutrient SAMe. Clearance of homocysteine and the product of SAMe is vital to protecting the nervous system and making neurotransmitters. Betaine is found in beets.