Chapter 49. Gluten Sensitivity, Is Your Food Making You Sick?

Chapter 49. Gluten Sensitivity, Is Your Food Making You Sick?

Jim suffered from frequent migraines which were severe and incapacitating. After seeing a number of neurologists and trying multiple medications with no improvement, Jim finally came to see me.  His last neurologist found he had a low vitamin D level, and started Jim on 10,000 units per day of vitamin D3. Jim reported that his psoriatic skin lesions were markedly better.  However, his migraines were unchanged.

Left Image: Harvesting in a wheat field , ca. 1900 Australia, courtesy of the Powerhouse Museum and wikimedia commons.

Migraines and Food Allergies

A connection between gluten sensitivity and psoriasis is well known. (18-20)  In addition, I mentioned to Jim that food allergies can cause migraines (7).  Gluten is a wheat protein, and sensitivity to wheat gluten can cause migraine headaches (8,9).     In fact, gluten sensitivity is associated with all sorts of neurological disorders: cerebellar ataxia, epilepsy, myoclonic ataxia, chronic neuropathies, and dementia, mainly in middle-aged adults.(10-13)  I suggested to Jim it was likely that a gluten free diet would be helpful in reducing his migraines.(8-9) 

Gluten Testing with Entero-Labs

Jim's lifestyle made it difficult for him to go Gluten free, so I suggested he try the EnteroLabs gluten test.(41)  Sure enough, the test panel came back positive.  Jim went on a gluten free diet, and 4 weeks later called me to report his migraines were much better.  This article will discuss sensitivity to wheat gluten, a condition which is epidemic, yet mainly ignored or unknown by the medical system.(20)

What is wheat gluten sensitivity?

Gluten is a protein in wheat products, such as bread, pasta, wheat cereals etc.  About 1% or more of the population reacts to wheat gluten with an immune response and an inflammatory disorder of the small intestine which may cause malabsorption of key minerals, amino acids and vitamins. (40)  This has an inherited autoimmune component and genetic testing is available.(17)  Other diagnostic testing involves looking for the antibodies called TTG (transglutaminase) in stool or blood samples.

Immune Response In the Wall of the Small Bowel-Malabsorption

The immune response involves production of various antibodies and immune cells which damages the small intestine, reducing its absorptive ability.(40)  This is called malabsorption, and results in the inability to absorb key vitamins and minerals such as Iron, Calcium, folate and B12.   These abnormalities will show up on the blood count as iron deficiency anemia, and B12/folate deficiency anemia.(22)   Gluten sensitivity and celiac disease may cause malabsorption of calcium, and the DEXA bone density scan may show osteoporosis (21).  The auto-immune response can circulate freely through the body, crossreacting with other organ systems, unpredictably. 

Immune Response in the Skin and Hair Follicles

Another common place for the immune response to attack is the skin, with a characteristic skin lesion called Dermatiformis Herpetiformis (it resembles Herpes) with intense burning, itching and blistering skin rash which is usually symmetrically distributed on the elbows, knees and the buttocks.  The rash usually starts as small blisters that erupt into small erosions.  Dermatologists will make the diagnosis of gluten sensitivity by doing a skin biopsy showing characteristic findings.   Immunofluorescence of normal skin next to the vesicle typically shows granular IgA deposits in the upper dermis. (27-29)  If the scalp is involved, this is called Alopecia Areata with patchy hair loss caused by auto-antibodies reacting with the hair follicles.(25-26) 

Vascular System

If the immune response attacks the vascular system, there may be increased venous thrombo-embolism, stroke (2)(3), and coronary artery disease, etc.   Thus, gluten sensitivity is one of the major causes of migraine headaches since it may cause inflammation of cerebral arteries, or the brain itself.  (9)

Neurological Problems

If the immune response attacks the brain or spinal cord, this may cause a neurological disorder (4, 10-16) such as ataxia (5), uncoordination, peripheral neuropathy (tingling with pins and needles)(6).

Going to the Endocrinologist

The patient with gluten sensitivity may end up at the endocrinologist's office with issues such as: Type 1 diabetes mellitus, autoimmune thyroid disease, Addison disease, osteomalacia, secondary hyperparathyroidism, vitamin D or iron deficiency, fertility problems, hypogonadism in men, and autoimmune hypopituitarism.(23)  Autoimmune thyroid disease is especially common among people with gluten sensitivity, with elevated anti-thyroid antibodies (Hashimoto’s Thyroiditis) which decrease after initiating a gluten free diet.(24) One can make a case for gluten sensitivity testing for all patients with autoimmune thyroid disease (Hashimoto’s).

The Heart

The gluten sensitive patient may have heart involvement with cardiomyopathy, a serious and potentially lethal form of heart failure.  In addition, the gluten sensitive individual may have heart rhythm abnormalities such as atrial fibrillation, reversible with a gluten free diet, if diagnosed early.  Testing for gluten sensitivity should be done for such patients.  (30-31)

Sarcoidosis

A unusual lung disease of unknown etiology called Sarcoidosis is linked to gluten sensitivity.  Sarcoidosis is thought to be an auto-immune disease because the treatment is immune suppression with prednisone.  These patients may benefit from a gluten free diet.(34)

Addison’s Disease and Adrenal Failure

Complete failure of the adrenal glands to manufacture cortisol is called Addison’s Disease and is associated with gluten sensitivity.(35)  These patients may benefit from a gluten free diet.

 Going on a Gluten Free Diet

Patients may go for decades with health problems, running through a succession of doctors, yet remain undiagnosed by the mainstream medical system.  Treatment is usually curative with a Gluten Free Diet (GFD) which means avoiding all wheat products such as breads, pasta, wheat cereals, bakery goods etc.

Articles with related interest: See Celiac Disease, Gluten Intolerance, the Unsuspected Epidemic in the book, Natural Medicine 101.

Links and References

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(41) http://www.enterolab.com/ Kenneth Fine MD, 10875 Plano Rd.Suite 123 Dallas, TX 75238 PH: 972-686-6869

Author: Jeffrey Dach MD  Dr Dach