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Wheat Woes: Celiac disease, wheat allergy and gluten sensitivity

Many people are beginning to recognize the personal benefits of a gluten-free diet. For some individuals the simple avoidance of gluten (a protein in wheat, barley and rye) can improve or completely resolve symptoms of diarrhea, constipation, gas and bloating.

So what is the problem with gluten? Why are so many people benefiting from avoiding this specific protein? The answer is not that simple. In fact, there are three distinct medical diagnoses that may apply to people who improve on a gluten free diet.

Celiac Disease

Bread slicedCeliac disease is an autoimmune disease impacting about 1 in 100 people. In this condition the body is stimulated to produce auto-antibodies against the lining of the small intestine. These auto-antibodies are only produced in the presence of gluten in the diet. Celiac disease incidence has increased 5-fold in the past 40 years – a trend that is seen with a number of autoimmune conditions. Having celiac disease increases the risk for the development of other autoimmune conditions in your lifetime. The only treatment for celiac disease is lifelong avoidance of gluten.

Wheat Allergy

Wheat allergy results when the body produces an allergic reaction to gluten or another component of wheat. The allergic sequence is similar to other allergies, with the release of histamine from mast cells and basophils, triggered by immunoglobulin E (IgE) cross-linking. Symptoms of wheat allergy include redness, swelling, hives and other allergy-type symptoms. Wheat allergy is the rarest of the wheat-associated diagnoses with only 1 in 500 people being impacted.

Gluten Sensitivity

By far the most common diagnosis associated with wheat is gluten sensitivity. It is estimated to impact 1 in 10 people and is 6x more prevalent than celiac disease. The symptoms of gluten sensitivity include:

  • Abdominal pain (68%)Gluten Free Logo
  • Eczema or rash (40%)
  • Headache (35%)
  • Foggy mind (34%)
  • Diarrhea (33%)
  • Depression (20%)
  • Anemia (20%)
  • Numbness in legs, arms or fingers (20%)
  • Joint pain (11%)

Diagnosis of gluten sensitivity is typically a diagnosis of exclusion. If you test negative for celiac disease (auto-immune antibodies), negative for wheat allergy (IgE immunoglobulins) but still improve on a gluten free diet then you will likely receive a diagnosis of gluten sensitivity.

Food sensitivity testing, such as the IgG food sensitivity panel, can help to confirm a diagnosis of gluten sensitivity. It can also identify other food sensitivities which may be occurring simultaneously, such as a dairy, egg or nut sensitivity.

If you suspect you may be gluten sensitive, cut it out of your diet for at least three weeks and watch your symptoms for improvement. Or contact your Naturopathic Doctor to discuss comprehensive testing for celiac disease, wheat allergy and gluten sensitivity. Take charge of your health, and let go of your wheat woes!

Select references

Sapone A, Lammers KM, Casolaro V, et al. Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity. BMC Med. 2011;9:e23

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

 

Hashimoto’s and Gluten

Gluten. It seems like everyone is talking about it. Books are lining shelves declaring the evils of this grain-based protein most of us have been eating for years. The grocery stores are full of “gluten-free” labels and gluten free bakeries are popping up in cities all across the country.

Gluten Free LogoWhy are we suddenly so aware of this protein? And what does it mean for people who have Hashimoto’s? Let me take you through some of the basics.

What is Gluten?

Gluten is a protein found in several different grains – wheat, barley, rye, spelt, kamut and triticale. It is a combination of two different proteins, gliadin and glutenin. Not all grains contain gluten and a gluten-free diet can still provide the essential nutrients found in these grains.

Autoimmunity

Hashimoto’s thyroiditis is an autoimmune condition where the immune system attacks and destroys the thyroid gland. It is, in essence, an immune condition with the thyroid being the unfortunate victim.

Autoimmune conditions are thought to develop when there are a combination of different factors. The three most commonly suggested factors are:

  • Genetic predisposition
  • A triggering event – this can be a nutrient deficiency, acute illness, chronic infection, dysbiosis, excess stress, food sensitivities or impaired detoxification
  • Increased intestinal hyperpermeability or “leaky gut”

The increased intestinal hyperpermeability, or “leaky gut” is where gluten becomes a major issue.

Leaky Gut

Keep outThe cells that line our digestive tract are joined at tight junctions – these close connections allow only the smallest particles of digested food to present to our immune system. Certain foods, like gluten, are more difficult for our enzymes to completely digest. These partially digested proteins, called peptides, can cause inflammation at the lining of the digestive tract, leading to damage of the tight junctions. When these tight junctions are compromised they become more permeable, or leaky, allowing larger molecules (peptides) to present to our immune system.

Once the immune system has been exposed to these large peptide molecules it may begin to produce antibodies against the peptides – an attempt to protect us from this foreign molecule.

The issue of autoimmunity, especially Hashimoto’s thyroiditis, occurs when the immune antibodies begin to circulate through our body, searching for the sequence of amino acids that make up the gluten peptide. The surface of the thyroid gland is made up of fats and proteins – and unfortunately the amino acid sequence of proteins on the surface of the thyroid is the same as the gliadin peptide in gluten. This results in the immune system destroying the thyroid gland, mistaking it for the component of gluten that triggered the response in the digestive tract.

Gluten and Food Sensitivities

wheat is a common food allergenIn my practice I recommend that all people diagnosed with Hashimoto’s thyroiditis eliminate gluten from their diet. However, leaky gut can be caused by, or lead to many other food sensitivities which can also have the same devastating effect on the thyroid gland, and other tissues in the body.

Every person with an autoimmune condition, including Hashimoto’s should seriously consider having an IgG based food sensitivity panel done to identify their own sensitivities. Understanding the action of your immune system in your body is imperative to decreasing the overactivity of the immune system and preventing further damage to your body.

For more information on Naturopathic Medicine and Hashimoto’s Thyroiditis, please read the other articles on this website written by Dr. Lisa Watson, ND: Understanding Hashimoto’s, Hashimoto’s and Fertility, Naturopathic Treatments for Hashimoto’s. If you are ready to start on your path to healing your Hashimoto’s you can book an appointment with Dr. Lisa by following the links here.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Select references

Carrocio A, D’Alcam A, Cavataio F, et al. Gastroenterology. High Proportions of People With Nonceliac Wheat Sensitivity Have Autoimmune Disease or Antinuclear Antibodies.2015 Sep;149(3):596-603.e1.

Fasano A, Shea-Donohue T. Mechanisms of Disease: the role of intestinal barrier function in the pathogenesis of gastrointestinal autoimmune diseases. Nature Clinical Practices. 2005 Sep:2(9):416-422.

 

Understanding Hashimoto’s Thyroiditis

Hypothyroidism is a common condition impacting women, with women between 5-8 times more likely to develop this condition than men. The most common cause of hypothyroidism in Canada and the US is Hashimoto’s thyroiditis.

What is Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis is an autoimmune condition in which the body’s own immune cells attack and destroy the thyroid gland resulting in decreased thyroid function (hypothyroidism). Hashimoto’s most often impacts young and middle aged women (20’s to 50’s) and can lead to permanent damage of the thyroid gland and lifelong hypothyroidism.

Symptoms of Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis in it’s early stages is often silent with few to no symptoms. Some people experience a sense of fatigue or not feeling their best, but often do not seek medical care for these common symptoms.Winter hat

The symptoms of Hashimoto’s are indistinguishable from other forms of hypothyroidism:

  • Weight gain
  • Fatigue
  • Swelling
  • Muscle weakness
  • Constipation
  • Cold intolerance
  • Dry skin
  • Dry or brittle hair
  • Hair loss
  • Firm or nodular thyroid gland on palpation

Diagnosing Hashimoto’s Thyroiditis

All hypothyroidism is diagnosed using a thyroid stimulating hormone (TSH) level. TSH is produced in the pituitary gland and tells the thyroid gland to make thyroid hormones. If the TSH is too high, that means the thyroid is not working effectively and a diagnosis of hypothyroidism can be made.

In Hashimoto’s thyroiditis anti-thyroid antibodies (antithyroid peroxidase, antithyroglobulin) are commonly present. However they are rarely tested, despite the majority of hypothyroid cases being autoimmune in origin.

In my Naturopathic practice I always test for anti-thyroid antibodies to confirm Hashimoto’s and to monitor treatment.

Hashimoto’s and Autoimmunity

An autoimmune condition is any condition where the body’s immune system begins to attack the body’s own tissues rather than the viruses and bacteria it is designed to fight. Hashimoto’s thyroiditis occurs when the immune system attacks the thyroid gland. It is not in essence a thyroid condition, but an immune condition where the thyroid is the unfortunate victim.

Once a person develops one form of autoimmune condition they are more likely to develop others. The incidence of Hashimoto’s is higher in people with pre-existing autoimmune conditions such as celiac disease, rheumatoid arthritis, psoriasis, vitiligo and lupus.

Conventional Treatment of Hashimoto’s

Thyroid medicationConventional treatment of Hashimoto’s thyroiditis does not differ significantly from treatment of other forms of hypothyroidism. The main treatment is L-thyroxine (T4) taken daily in the morning. This T4 is then converted in the body to the active thyroid hormone, T3.

There are controversies regarding this treatment for Hashimoto’s thyroiditis. Studies have shown that combined use of T4 and T3 results in better relief of hypothyroid symptoms than T4 alone. This is accomplished by using a dessicated thyroid extract, prescribed to you by your Medical Doctor, endocrinologist or Naturopathic Doctor.

Another controversy in the treatment of Hashimoto’s is the lack of treatment targeted at the immune system. The use of L-thyroxine does not prevent or treat the inflammation and autoimmune destruction of the thyroid nor does it lower anti-thyroid antibodies.

Naturopathic Treatment of Hashimoto’s Thyroiditis

An experienced Naturopathic Doctor can be an amazing ally in the treatment of Hashimoto’s. Your ND can personalize a protocol that will address the root cause of your Hashimoto’s – an overactive immune system.

In Ontario your ND may be able to prescribe dessicated thyroid, provided they have obtained additional education and a license to prescribe.

Nutritional supplements, such as selenomethionine, may also be used to decrease autoimmune thyroid antibodies. Dietary support such as gluten avoidance, immunoglobulin food sensitivity testing, celiac testing, detoxification support, gut healing protocols and more can also be used to support the immune system and decrease over-reactivity.
More information on the Naturopathic treatment of Hashimoto’s Thyroiditis can be found in the following articles: Hashimoto’s and Gluten, Naturopathic Treatment of Hashimoto’s Thyroiditis, Hashimoto’s and Fertility.  You can also book an appointment with Dr. Lisa Watson, ND and get started on healing your Hashimoto’s now.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.