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There is growing public awareness of food intolerances, and allergies in general. More and more people are discovering that they are adversely affected by foods of various kinds. Food manufacturers are starting to provide low-allergy foods, and gradually friends and families of those affected are becoming more understanding. But the scope of symptoms and disorders that can be caused by food intolerances is still largely misunderstood, so many people remain undiagnosed and suffer unnecessarily. This page is intended to give you a overview of some of the new knowledge and to enable you to have a better idea whether you or someone you know might be affected. There are a number of terms used to describe adverse reactions to foods - allergy, intolerance, addiction (as we are often addicted to foods we react badly to), sensitivity. For the purposes of this article, any of these can be taken as terms to describe anywhere on the whole spectrum of reactions. Although there are many foods (and other substances) that we can be sensitive too, gluten is possibly the most common and the most under-diagnosed. Many people feel that it is also one possible cause of other sensitivities. So for this article, we'll be focusing mostly on gluten, though most of what is discussed is applicable to other foods as well. Covered on this page:
WHAT ARE THE DIFFERENT TYPES OF SENSITIVITIES? There are at least three main types of antibodies associated with food sensitivities - IgE, IgA, IgG. Ig stands for Immunoglobulin, and these are proteins produced by the body to deal with foreign pathogens. They are specific to the pathogen. So what we're talking about here is when an antibody is produced to something that should be benign, like a food. To make it easier to see which is which at a glance, I'm going to give them "nicknames". IgE reactions. Associated with the "immediate" allergies, caused by a release of histamine. These aren't usually life-threatening, but sometimes cause anaphylaxis, which can be fatal if not promptly treated. Some examples of reactions are:
IgE allergies are well covered by traditional allergists, so we won't go into them in any depth here. Let's call these ones "Evergreen", in honour of the green grass of spring, a time when many people get hayfever. IgA reactions. IgA allergies to egg, yeast, soy, milk, or gluten have been identified, though gluten has been the most studied. IgA is associated with the gut, and IgA allergies can cause gut damage. In the case of gluten (and possibly also casein) the IgA causes intestinal permeability. (More on this below.) So we'll call these ones "Attackers". IgA allergies don't seem to "go away" and appear to be genetically linked. IgA (Attacker) reactions have a high correlation with some specific genes in the HLA range of genes. This is still being studied, but the following possible correlations have been identified so far:
If you have one of these genes, there is a high likelihood that that gene will have been "expressed", and you will have functional gluten intolerance. IgG reactions. Foreign proteins that enter the blood elicit an immune response by the IgG system. This is what is most often meant when people talk about “food allergies”. IgG allergies sometimes come and go, and are often associated with your favourite foods, as they are what's eaten most often. So these ones we'll call "Greedies". If a person has a lot of IgG (Greedies) allergies, chances are they have leaky gut. The good news is that if the leaky gut is healed, the foods can usually be reintroduced after a while. IgM reactions. IgM is a class of antibodies found in circulating body fluids. IgM antibodies are the first antibodies to appear in response to an initial exposure to an antigen. Apparently the IgM's are sometimes the only place where the gluten reactivity shows up - which may explain why some people test clear for gluten, yet have definite symptoms when they eat it.
Other reactions. The above reactions can be termed allergies, as they involve the immune system. But there are other reactions that could be termed sensitivities.
WHY DOES GLUTEN CAUSE SO MANY PROBLEMS Gluten intolerance linked to IgA (Attackers) causes damage to the intestinal lining, allowing partially digested food to pass into the body. This is often known as leaky gut syndrome. There are two different theories about why this happens. It is most commonly believed that the gluten sticks onto the villi, and the IgA (Attackers) attacks it there. The villi are damaged or destroyed, and the gut becomes permeable. In celiac disease, at least some of the villi are always destroyed. But Dr Fasano, of the University of Maryland School of Medicine, has another theory. He found that a human protein called zonulin, which regulates the permeability of the intestine, is at increased levels during the acute phase of celiac disease. It seems that gluten (and possibly also casein) trigger a higher than usual level of zonulin, which allows substances to pass through the gut wall. It also increases the permeability of the brain/blood barrier, which may explain how gluten is implicated in mental problems. In this case, reducing the zonulin levels could bring the gut quickly back to it's normal level of permeability. For more details, see http://www.umm.edu/news/releases/zonulin.html It's possible that both theories are right - the first kind of damage is related to celiac disease, and the second to other types of gluten intolerance.
Gluten isn't the only cause of damage leading to gut permeability though. It can also be caused by other IgA reactions or by overuse of antibiotics, candida overgrowth, parasites, bacterial infection, heavy metal toxicity and other causes. So it is possible to have sensitivities to other foods without also having a reaction to gluten. But if you have any other sensitivities, look closely at the possibly of gluten intolerance as well. HOW COMMON IS GLUTEN INTOLERANCE? James Braly and Ron Hoggan, the authors of Dangerous Grains, estimate the incidence of gluten sensitivity to be around 30% of the population. Dr Fine of Enterolab, based on results of IgA (Attackers) antibody tests and gene tests from his laboratory, estimates 30-40%. However, as some people have no symptoms, so are never tested, some commentators feel that it's closer to 50%. (That is, in the US. Due to different racial mixes, not all countries will have the same incidence.) Let's take a moment here to differentiate between different levels of gluten or wheat sensitivity.
Humans have only been eating grains for about 10,000 years. Most of us haven't fully evolved to digest and assimilate them. In the early days of agriculture, wheat was usually a food for the rich, and most people ate other grains such as oats, rye and millet. It's important to also note than the older forms of wheat had a lot less gluten in them. The modern forms have been bred to have a huge amount of gluten to make fluffy bread. So it's likely that even those people (probably less than 50% of the population) who don't fall into one of the above categories are not well served by a diet high in grains, especially wheat. This is contrary to what most nutritionists and government agencies are telling you. Those of you who can eat grains with no problems should always eat them well prepared. That is, soaked or fermented to reduce phytates.
WHAT SYMPTOMS INDICATE GLUTEN INTOLERANCE? There are a huge range of different symptoms that can be attributed to just gluten intolerance, without even considering other sensitivities. Many people believe the most common symptoms are gastrointestinal, but many people with gluten intolerance (and celiac disease) have extra-intestinal symptoms, or even no symptoms at all. So there is no easy correlation between symptoms and the cause. Below is a list of common symptoms of gluten intolerance, and some disorders that have associated with gluten intolerance. For a more complete list of related disorders, see Dangerous Grains.
This doesn't necessarily mean that if you have some of these symptoms, or one of these disorders, that you are gluten intolerant. But given that such a large portion of the population IS gluten intolerant, If you THINK you have it, you probably do. There are also a lot of gluten intolerant people who don't have any symptoms. If you are one of them, but members of your family are affected by gluten, it would be wise to be tested. Also be aware that you can be coeliac without having ANY symptoms. Some people are diagnosed with it after a family has been diagnosed, but have no symptoms of their own. Up to 40% of diagnosed coeliacs may fall into this category. HOW CAN I GET GLUTEN INTOLERANCE DIAGNOSED? There are a range of different tests, but none are 100% accurate. Mostly they are only looking for one type of sensitivity, and there is potential for false negatives and false positives. My recommendation is to take any type of testing as an indication of what might be causing problems. Then eliminate the foods in question and see if this helps the problem.
The test information given above is to help you decide which type of testing which would be most useful to you. It is recommended that you work with a doctor or natural health care practitioner experienced in working with allergies and who can help you analyse your results, and plan your diet and treatment. Eliminate potential problem foods Once potential allergens have been determined, the usual approach is to eliminate the foods from the diet for a period of time. In some cases, celiac disease for example, the foods concerned must be avoided forever. In other cases, they are reintroduced later to see if they can now be tolerated. If anyone in your household has a sensitivity, I'd recommend considering banning it from the house completely. There are several reasons for this:
Be aware that you may suffer withdrawal symptoms, as we are often addicted to the foods we are allergic to. These can range from fairly mild to severe - flu like feelings, headaches, etc. This should pass within 3-6 days and you should start feeling better. You may prefer to gradually wean yourself off the suspected foods, to let your body adapt. The withdrawal symptoms will be less severe, but will go on for longer. It can be hard to keep a balanced diet when your foods are restricted. You may want to work with a nutrition coach to help with meal planning. Look for one who follows whole food principles, and will not restrict your diet incorrectly by telling you to eat low fat and avoid red meat! Some general principles:
If you look around the internet, you'll find lots of sites with alternative recipes for people with allergies. Many of these are not compatible with eating a nutrient dense diet, so may not be very satisfactory for you. Check out the Yahoo group http://health.groups.yahoo.com/group/GFCFNN/ for recipes with a native nutrition slant. This is a very supportive group for anyone suffering from food allergies, but especially gluten or casein intolerance. In fact, much of the information in this article came direct from that group, with special thanks going out to Heidi Jean. There are some gluten free recipes in my cooking course, and there are some sample recipes you can download on that page. Further tips on changing to a GF diet are in the Resources section of the website. Healing phase Once you've eliminated gluten or other allergies from your diet, you will need time for your body to heal. Once you've adjusted to a new way of eating, your body will start to heal itself. If this doesn't seem to be happening, you may need to look at other problems such as:
Once again, the GFCFNN Yahoo group is a great place to ask questions about what you're going through, and what might be your next step. There are some therapists who have had a lot of success with treating food and environmental sensitivities using energy techniques such as NeuroLink, Kinergetics, EFT (Emotional Freedom Technique) or NAET. These have the potential to reduce the impact of sensitivities much more quickly, either by directly addressing the sensitivity or by improving the function of the digestive system. Some sensitivities can be neutralised quite quickly, and some are very resistant. I believe that IgA (Attackers), and possibly IgE (Evergreen), reactions are innate and cannot be neutralized easily, whereas IgG (Greedies) reactions are acquired and can be healed, as long as the underlying causes (eg. IgA (Attackers) reactions) are removed. Check any such treatments in the same way as you checked the test results - by using your body as a guide. WARNING - If your reactions are acute and life threatening, by all means have treatments to minimise any reaction to accidental exposure. But in this case, DO NOT test the results! For further information, do your own searches on gluten sensitivity or reactivity, as new information is being uncovered all the time. One helpful website is GlutenReactivity.com. If you're in Wellington, NZ, and think you may have allergies to gluten, casein or other foods, contact me for a free 15 minute consultation to go through your options.
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