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.
on this page:
are the different types of sensitivities?
Why does gluten cause so many problems?
How common is gluten intolerance?
What symptoms indicate gluten intolerance?
How can I get gluten intolerance diagnosed?
What should I do next?
know I need to be gluten free - take
me straight to the page on how to do it!
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
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:
as a reaction to spring pollen or dust
as a reaction to eating tomatoes or other foods
and dermatitis, as a food or contact reaction
as a reaction to peanuts or bee stings
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
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.
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
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 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.
possible to have both an IgA (Attackers) allergy and an IgG
(Greedies) allergy to the same food. People with an IgA (Attackers)
allergy to gluten often also have an IgG (Greedies) allergy
to it, for example. But IgE (Evergreen) and IgG (Greedies)
allergies are incompatible.
you have an IgA (Attackers) allergy to gluten, then develop
an IgG (Greedies) one as well, you won't get an IgE (Evergreen)
one. This is probably why IgE (Evergreen) allergies to wheat
or gluten are comparatively rare.
that "allergy shots" for IgE (Evergreen) allergies
(so you don't react to dog hair, for example) work
by causing an IgG (Greedies) allergy. Injecting the protein
into the blood causes an IgG (Greedies) allergy,
which dampens the IgE (Evergreen) response.
The above reactions can be termed allergies, as they involve the
immune system. But there are other reactions that could be termed
- Lactose intolerance, for example, is the result of a deficiency
of the enzyme lactase and is not an allergy.
- Toxic reactions may occur in cases of food poisoning or in response
to eating a food that is harmful for most people by it's nature,
eg. refined sugar. Or you may be reacting to a non-food item,
such as mercury.
- There may be foods that you have no specific allergy to, but
don't enhance your health. Maybe foods that are not appropriate
for your metabolic type,
or that you just don't feel specially well on.
DOES GLUTEN CAUSE SO MANY PROBLEMS
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.
is commonly believed that "leaky gut" is the cause of
IgG (Greedies) food sensitivities, and also is one of the causes
of many autoimmune and other diseases. For example, due to the damage
to the intestines, nutrients are not properly absorbed, resulting
in various kinds of malnutrition, including anaemia. For a full
explanation of the damage gluten can cause, a recommended book is
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.
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.
- Coeliac, or celiac, disease - where the intestinal villi
are damaged by gluten (or specifically to gliadin, the gluten
in wheat). Coeliacs must stay on a 100% gluten free diet
- Gluten intolerance - where the symptoms haven't yet progressed
as far as coeliac, or are manifesting in a different way.
There are a variety of different manifestations of this.
This isn't yet widely recognised in the medical profession.
As some people use this term interchangeably with Coeliac,
a more appropriate term may be Gluten Reactivity.
- Wheat intolerance - the sensitivity isn't to the gluten,
but to other aspects of the wheat. Other gluten grains can
often be tolerated.
- No specific allergy, but health is best when grains of
any kind are kept to a minimum
- No specific allergy, but health is best when maintaining
a lowish level of carbohydrate generally. A certain number
of people also seem to be unable to digest and break down
starches, most likely because of the gut problems we've
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.
common food allergies, apart from wheat or gluten:
- Nuts or peanuts:
Usually an IgE allergy, and can result in anaphylaxis
Even for those who are not allergic to soy,
it's not a recommended food, unless fermented.
Mostly in the US where it's eaten a lot, and where many
things are sweetened with corn based sweeteners. Not as
common in NZ.
It is usually the egg white that people are allergic too,
so you may still be able to eat egg yolks, if you're careful
to remove all the white.
Note than casein is usually an actual allergy, where lactose
intolerance is an enzyme (lactase) deficiency. With lactose
intolerance, you can take lactase supplements, or eat dairy
products that either don't contain much lactose (butter,
cream, ghee, some cheeses) or have been fermented (yoghurt,
kefir). Avoiding casein is more difficult. Some people can
tolerate A2 casein, eg from sheep or goats milk, whereas
others can tolerate no diary products at all, with the possible
exception of properly prepared ghee. For more on dairy allergies,
and dairy in general, click here.
You may not be able to eat any fruits
If fruits seem to be the main problem, but doesn't quite
cover it, you may also need to check these out. If this
is a problem for you, you will also react badly to aspirin.
- Starches generally:
This is more of an inability to digest them. This may also
be associated with a gene in the HLA range - HLA-B27. Recommended
reading for more information on the Specific Carbohydrate
Diet is Breaking
The Vicious Cycle by Elaine Gottschall.
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
problems & gastrointestinal distress - eg. gas,
bloating, "beer gut", diarrhea, constipation,
- Respiratory problems - eg. asthma
problems - eg. delayed menarche (menstrual cycles),
amenorrhea (lack of periods), infertility, PCOS
- Pain - eg. headaches, migraines and bone, joint or muscle
- Mental problems - eg. inability to concentrate, ADD
problems - eg. moodiness, depression
problems, including DH or Dermatitis Herpetiformis (a "sister"
of celiac disease)
weight loss or gain
- Mouth sores
enamel hypoplasia & other dental problems
- Tingling numbness in the legs
- Short stature
history of celiac disease
diabetes (type 1)
/ spontaneous abortions / low birth-weight babies
(Irritable Bowel Syndrome)
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.
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 official way to diagnose Coeliac disease is by biopsy
of the intestinal tract. As damage to the villi occurs at
an advanced stage of the disorder, and not all of the intestinal
wall may be damaged, there are many false negatives to this
test. It is also fairly invasive. This may be done in conjunction
with blood tests looking for IgA
(Attackers) antibodies and other antibodies specific
- IgE (Evergreen) reactions can be diagnosed by either skin
scratch tests or RAST serum tests. They each have their
pros and cons. Both can have a quantity of false positives
for food allergies, but are reasonably accurate for respiratory
allergies, and insect venom reactions. For more information
see the Allergy
NZ allergy website. Another useful page for deciding
which test to choose is the Auckland
District Health Board site.
should be easy to arrange IgE testing through your doctor,
but if that is a problem, you can try approaching a lab
direct. In the US, Great
Plains Lab will arrange your tests. In NZ, FXMed
can tell you who your nearest practitioner is.
(Greedies) reactions are identified through blood tests.
But according to the Allergy
NZ website: "The relationship of IgG antibodies
to food allergy remains to be established. Many asymptomatic
individuals generate IgG antibodies to foods and other environmental
substances. These IgG antibodies may simply represent exposure
to foods in otherwise well individuals and may have no relevance
to food allergy." Or maybe it's because you have leaky
gut, so you're reacting to whatever you eat most often.
NZ, contact FXMed
for your nearest practitioner. In Christchurch, contact
Rodney Ford . In the US,York
Allergy USA can test up to 113 foods.
(Attackers) antibodies are usually looked for through blood
tests. But IgA antibodies are not supposed to be in the
blood, so although they sometimes do appear there, a blood
test will often show nothing ie. a false negative.
tests for IgA (Attackers) reactions are much more accurate.
However, some people produce low levels of IgA generally,
so even with a stool test, low amounts for individual foods
may appear as a false negative. False negatives may also
occur if you have been avoiding the food for a while. As
far as I can tell, stool sample testing is not available
in NZ (if this is not the case, please let me know). In
the US, Dr. Fine of Enterolab
does IgA stool tests for gluten, casein, eggs, and yeast
as well as a range of other tests.
a correspondent: "I'd like to point out to you a little
known blood testing panel for gluten reactivity by Immunosciences
Laboratories. It is very detailed and tests for gluteomorphins
as well as gliadins, tTG, tTG-AGA and also for foods that
may cross react and organs/tissues that may also cross react
with these food related antibodies. They also run IgA, IgG
and IgM tests on most of the items they check. However at
the moment the IgMs are temporarily unavailable. I'm told
a patient can ask to have the specimen stored until they
become available for an later add-on panel of IgM's if they
a more in depth look at some tests available, see www.glutensensitivity.net/testing.htm
- this page is still being compiled but already has a wealth
of testing information on it.
tests are available to check for genes that have a high
correlation with either celiac disease or gluten intolerance
(IgA - Attackers - reactions). In NZ, try seeing your doctor
with a list of genes you want to be checked for. In the
US, see Enterolab
involves eliminating potential problem foods to see if symptoms
improve. Then reintroduce them one at a time to see if symptoms
get worse again. Although this approach is potentially the
most accurate, even this has some pitfalls and drawbacks.
reintroducing a food that causes a problem, the reaction
may not happen straight away. Especially with gluten
and dairy, the reaction can take up to 4 days to appear.
Or in extreme cases, where the reaction is "silent",
problems may even take months to appear.
a food can cause silent damage, so neither the elimination
nor reintroduction may appear to cause any change. This
is most common with gluten. So there is still a possibility
of a “false negative”.
eliminating a food that is causing damage may not be
enough to heal the damage straight away, so you may
not get an immediate improvement. There may be other
body systems that need extra repair work to come back
into balance. Or permanent damage may have been done,
that can’t be repaired.
testing – This involves challenging a muscle to see
if a food weakens the body’s energy system in some
way. There is potential for both false positives and false
negatives with muscle testing, and a lot depends on the
skill of the kinesiologist. A single muscle test for each
substance picks up some sensitivities, but not all. It is
sometimes necessary to test in different ways to uncover
all sensitivities. From my research, it appears that double
blind testing does NOT give good results. The results are
more accurate when at least one party knows what is being
tested. Look for a kinesiologist who is experienced in allergy
testing. Ask whether their clients have had good results
when eliminating the foods identified from their diet.
test – A do-it-yourself test that involves taking
your pulse before and after each meal. If your pulse rises
by more than 10 beats per minute, there is a possibility
that you are reacting to one of the foods just eaten. There
are a lot of variables with this kind of test though, so
it would be most accurate to keep records over a number
of different meals to see what common denominators there
are. Don't discount the possibility that the pulse has been
raised purely by the act of eating, or by something that
happened during the meal.
SHOULD I DO NEXT?
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
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
If anyone in
your household has a sensitivity, I'd recommend considering banning
it from the house completely. There are several reasons for this:
- For some
gluten intolerant people, even miniscule amounts can cause a reaction.
So even having it in the house for others can cause contamination.
You may need to replace your toaster, for example, to completely
clear the house.
- If one member
of the household has an IgA (Attackers) reaction to a food, chances
are it will be harmful for others, even if not diagnosed.
- It's easier
to prepare the same meals for everybody, than to have one person
on a special diet.
- If the whole
family eats the same, the "allergic" person doesn't
have to feel like a freak, or deprived and left out.
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
- Eat properly
prepared, nutrient dense whole foods
as much as you can
- If you know
your metabolic type, keep to the macronutrient ratios (that is,
amounts of protein, fat and carbs) recommended for your type,
and eat from the recommended food lists where possible.
- If you don't
know your metabolic type, eat some protein, some fat, and some
carbohydrate at each meal
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
Further tips on changing to a GF diet are in the Resources
section of the website.
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
- Further food allergies. if you suspect that gluten is a problem
and just eliminated that, you may find that you also need to cut
out other foods. Casein intolerance is a common secondary allergy
for those with gluten intolerance.
- Impaired digestion - digestive aids may be required for a while
- Gut dysbiosis eg, candida overgrowth or insufficient "good"
- Nutritional deficiencies - both current and past.
- Hormonal imbalances
- Damage to other body systems
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)
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!
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.