Gluten intolerance: a paradigm of an epidemic

Townsend Letter for Doctors and Patients, Dec, 2002 by Stacy Astor Shaul

"My stomach is really bothering me. What can I do about it?" "She's been so depressed and tired lately." "I've never had any problems with allergies before, why now?" Doctors would usually regard and treat these conditions separately with Tagamet for stomach problems, Prozac for depression, or allergy medication for allergies. But might these complaints, heard everyday in doctor's offices nationwide, be related?

Perhaps one overlooked association with these seemingly unrelated complaints is food related intolerances. Doctors just aren't aware of the role food antigens play in contributing to a disease state, with the exception of allergies. In fact, researchers are finding that health conditions related to the ingestion of "gluten," a protein most often found in wheat, rye, barley and oats, are becoming epidemic.

Celiac Disease (CD), an autoimmune disease that is considered the most common of the gluten disorders, is often overlooked as a diagnosis. CD patients often suffer from symptoms such as stomach complaints, depression and allergies. Many other autoimmune diseases are also associated with gluten intolerance including Type 1 Diabetes, Autoimmune Thyroid Disease, Rheumatoid Arthritis, as well as others.

Gluten intolerance is now being associated with Autistic Spectrum Disorders and Attention Deficit Disorders. The type of gluten intolerance associated with these conditions is considered to originate from the body's inability to break down the gluten and casein proteins rather than an autoimmune response, as in CD.

Researchers are also beginning to see a connection between gluten and other disorders, which seem to share characteristics such as biochemical, neurological, and immunological abnormalities. These "Overlapping Syndromes" are conditions such as Gulf War Syndrome, Chronic Fatigue Syndrome, and Fibromyalgia Syndrome, as well as others. Also, some psychological disorders such as depression and panic disorder as well as skin conditions such as psoriasis are suspected to have a gluten-related component.

Wheat

According to Dr. Loren Cordain, a renowned expert in Paleolithic nutrition, Paleolithic humans ate mostly fruits, vegetables and lean game meats. (1) The agriculture of cereal grains began in the Near East about 10,000 years ago and then spread to northern Europe about 5,000 years ago. "Because the estimated amount of genetic change which has occurred in the human genome over this time period is negligible, the genetic makeup of modern man has remained essentially unchanged from that of pre-agricultural man. Consequently, the human genome is most ideally adapted to those foods which were available to pre-agricultural man, namely lean muscle meats, limited fatty organ meats, and wild fruits and vegetables." (2)

In fact, the amount of cereal grains being consumed has increased tremendously in the last 200 years with the industrial revolution and more recently, with the technology revolution. With even more growth in the last 50 years, these changes have spurned more packaged and processed foods. We have also managed to greatly enhance the gluten content through genetic selection of wheat. "Today 50% of the protein in wheat is gluten, a characteristic that facilitates bread baking and adapts the grain well to cultivation and harvesting." (3)

Problems with the ingestion of gluten were first noted in the 2nd Century AD. Aretaeus the Cappadocian described the condition, "coeliac disease," as a chronic diarrhea condition consisting of undigested food, lasting an extended period, and a debilitation of the whole body. (4) Samuel Gee, in 1887, noted the disease affected persons of all ages and recognized that a gluten-free diet was the main treatment.

Gluten Intolerance Connection

Celiac Disease is considered a malabsorptive digestive disease, which is autoimmune in nature. Upon consumption of gluten-containing foods, the immune system responds by producing antibodies, which damage the small intestinal villi and lead to villous atrophy. Symptoms of CD arise from the damage done by the immune system, to the small intestine.

Symptoms of CD vary from person to person which makes it very difficult to diagnose. Symptoms may include recurring abdominal pain, chronic diarrhea/constipation, weight loss, anemia, fatigue, delayed growth, joint pain, seizures, tingling/numbness in the legs. Others might suffer from psychological disturbances like irritability or depression; 50-60% of untreated CD patients are asymptomatic! (5)

CD is most commonly misdiagnosed with conditions such as; anemia, irritable bowel syndrome/disease, psychological stress, diarrhea, diabetes, spastic colon, ulcers, viral gastroenteritis, Chronic Fatigue Syndrome, allergies, parasite infection, gall bladder disease, thyroid disease, colitis, and lactose intolerance. Dr. Vijay Kumar, a leading CD researcher, reports that the majority of CD patients had visited 5 or more doctors prior to diagnosis and that it had taken an average of 5 to 10 years, after initial presentation, for CD to be diagnosed.