Wheat Gluten Grain Intolerance and Celiac Disease
by Michael Cheikin, MD
Classic Gluten Grains
Wheat, Barley, Rye, Spelt
Non-Classic Gluten Grains
Oat, Rice, Corn, Sorghum, Millet, Teff, Bamboo Shoots, Sugar Cane
Pseudo-Grains
Quinoa, Amaranth, Buckwheat, , Tapioca (Other starches and seeds)3
We are in the midst of a new fad called "gluten free". Similar to prior dietary fads, such as "fat free", medical fads such as "menopause requires estrogen" or scientific fads such as "the earth is flat", it is hard to determine the truth.
As with many fads, there is polar-ization. The Vegan camp relies on grains as a source of protein, vitamins and minerals, while the "Paleo" or "Caveman" tribe believes all grains are "bad". Good arguments come from both sides.
This issue is very important since the substances that we do and do not ingest, ranging from ancient foods to modern chemicals, have profound effects on our immediate health, our long-term health, and the health of our children and grandchildren through epigenetics4.
"Gluten" is a family of proteins (prolamines including glutenin and gliadin) that are shared by the members of the grass family (see below). The quantity and fingerprint of gluten varies between different grains. Even "wheat" varies, based on the plant’s genetics (i.e. semolina vs. durham) and growing conditions. Wheats and grains have been cultivated for 10,000 years; but today’s grains are not those of the bible. Over-exposure and manipulation is a partial explanation for these reactions to these plants.
A "grain" is technically the seed of a member of the botanical grass family, "Gramineae". This family includes all the classic and non-classic gluten grains listed in the text box. Like members of a family, two can look exactly alike or look nothing like each other. Each of our immune systems sees these various grains differently, as alike or different. Pseudo-grains should be included in this discussion, since they are grown and processed with grains, and share anti-nutrients and other features.
These plants cannot be eaten raw since they contain "anti-nutrients" that will block absorption or create illness3. These unhealthy compounds can be de-activated by soaking, spouting, fermenting and heating, ancient methods that evolved when we learned to cultivate these foods. In addition, the storage and milling of these foods encourages the growth of molds—some of which make toxins that are heat-resistant and can cause intolerance by themselves or in combinations. When a human is exposed to these substances or their byproducts in utero, through breast milk, in the diet, or even on the skin, interactions with the immune system, (50% of which resides in the gut) can result in an unfavorable outcome.
"Intolerance" works by two mechanisms—toxic and/or immunologic. While detailed separately3, "toxicity" means that a substance is poisoning a process, usually in proportion to quantity like the dial of a dimmer ("the dose makes the poison"). "Immunologic" means that even a single molecule can trigger a process, sometimes with irreversible consequence (i.e. the small button that ignites a nuclear bomb).
Classic Celiac Disease ("CD"), or "Celiac Sprue" is a specific auto-immune reaction to gluten. The genetic tendency can now be tested, but does not mean the person has CD—the genes have to be turned on. Active CD can be detected in the blood or by biopsy of the intestines, but is not always definitive. One can be sick without having CD, or have Celiac genes without disease. CD can manifest to any degree at any time of life. Approximately 20-30% of the population carries a Celiac gene, while 1-2% develop the disease; and 5% of Celiacs do not have the gene. Clearly, wheat, grains and pseudo-grains, due to their ubiquitous use and above issues affect a large population.
The manifestations of intolerance, CD or not, include inflammation, allergy, autoimmune disease, nutrient mal-absorption, and the alteration of critical processes. These can look like ADHD, Autism, Anxiety, Depression, Dementia, Pain, Thyroid Dysfunction, Diabetes, Heart Arrhythmias, Infections, Autoimmune Disease, Allergies, Premature Aging, Infertility, etc. In other words, food intolerance can look like virtually any of the chronic diseases that are dominating our global health and economy.
Some people who can’t eat wheat, whether Celiac or not, can eat oat. Some can’t eat corn. Some do better with white rice rather than brown rice. Some get better when eating "gluten free" products, but then have recurrence of illness.
These factors are highly individual and multi-factorial; no laboratory test can fully predict an individual outcome. Therefore, the best method of testing for intolerance is to eliminate all grains and pseudo-grains for a minimum of a month (for some, the negative effects can last months). After this period, a "challenge" with a large quantity of one food at a time (i.e. rice, corn, oat, quinoa) can give important information.
The response to the elimination and/or challenge can be as subtle as inattention or constipation three days later, or as dramatic as anaphylaxis. It’s often necessary to plan this strategy in advance and implement and monitor the results with the guidance of an experienced practitioner. Substantial improvements in health can be achieved by most families by going through this process.
IMPORTANT NOTES:
1. This educational material may not be used to influence medical care without supervision by a licensed practitioner.
2. These contents are ©2013 by Michael Cheikin MD and may not be reproduced in any form without express written permission.
3. Dr. Cheikin’s website has related articles and references on Anti-Nutrients, Nutrition, Healing and Prevention and others.
4. Epigenes are the software of the genes and modulate gene expression based on lifestyle and experience of the grandparents and parents.
Michael Cheikin MD is a holistic physician, Board Certified in Physical Medicine and Rehabilitation ("Physiatry"), Pain Management, Spinal Cord Medicine and Electrodiagnostic Medicine and licensed in Medical Acupuncture. Dr. Cheikin has extensively studied yoga, diet and metabolism, Ayurvedic, Chinese and energy medicine and other alternative modalities for over 30 years. He specializes in obscure, chronic and severe problems that have not responded satisfactorily to other methods of healing. 610-239-9901 or www.cheikin.com
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