Gluten foods include bread

Could my symptoms be caused by gluten intolerance?

Often, it won’t even occur to people that there could be a link between what they are eating and their symptoms. So when you ask could gluten cause my symptom, the simple answer is yes it could.

For every person with gut issues triggered by gluten, eight people will present with issues that seemingly have nothing to do with gut issues! The extra-intestinal symptoms (symptoms that are not manifested in the gut) may show up as arthritis or joint pain. Or it might be as anxiety, depression, foggy brain, numbness in the limbs, extreme fatigue.  Eating gluten when intolerant could cause weight gain, loss of energy or any number of auto-immune conditions.

Surely if I don’t have Coeliac disease then I don’t have gluten intolerance?

There is still this belief amongst many professionals that if you don’t have Coeliac disease (CD) then you can eat gluten to your heart’s content. And if you have CD then you will be skinny! Both these beliefs have been totally discredited by current research. Today, there is much more recognition of a condition now know as non-coeliac gluten sensitivity. If you’d like to find out more about why so many more people chose to be gluten-free go to my research paper An exploration into the motivation for gluten avoidance in the absence of coeliac disease.

So why not just have a gluten intolerance test?

This is more complicated than you might think. You can test for IgA tissue transglutaminase (tTGA) and IgA endomysial antibodies (EMA) on the NHS.  If positive, you may be referred to a gastrointestinal specialist for a biopsy to confirm CD.
One of the problems with the standard blood test for CD is that unless damage has been done to the gut lining resulting in villous atrophy, then the test may not show anything. In that case, you may well be told you are fine.

What can go wrong with testing for gluten intolerance?

The following can be issues:

• IgA deficiency (low IgA, which is part of your immune system, may not show a reaction)
•  If tTGA or IgA test comes back negative it may be a false negative

If one is positive and the other negative, you may be told all is fine – its’ not.

Which part of your immune system is being activated by gluten?  Is it the part that is being tested for?

Think of your immune system as a defence force consisting of the police, army, navy, air-force and the SAS. Which particular part of your defence force is being called out to deal with a specific allergen? The NHS tests for one or at best 2 areas of the immune system but we are not all consistent. Perhaps IgA is not being activated but another part of your immune system is.  If you don’t test, you don’t know.

Another major problem with these tests is that the current tests only look at an immune reaction to one peptide of gluten called gliadin MER 33.  But what about all the other gluten peptides? This is why there may be as many as 50% false negatives test results according to the research studies.

How else can I find out if my symptoms could be caused by gluten intolerance?

There are other ways of establishing if gluten is the issue. Cyrex Laboratories have the most thorough testing and will test for 32 different markers of gluten reactivity in their Array 3 test.
So why can’t I get this test on the NHS?
Simples! It all down to money. And the only lab to do this test is in the US.

 Can I simply eliminate gluten?

Simply eliminating gluten is an inexpensive first step. A healthy gluten-free diet requires more thought and is well worth a try. With a little bit of help, its’ really not that hard to do!  Often people think they have eliminated gluten containing foods by cutting out bread and pasta.  This is not enough as there as so many hidden sources of gluten.  If you are sensitive to gluten and activation an immune response even trace amounts can be triggers.

But?

There is a bit of a but! As I have mentioned in other posts, it is important to establish if your issue is gluten, wheat or high-FODMAPs foods. These are sugars in the food that break down lower down in the gut and are naturally fermented by gut bacteria. By cutting out gluten, you will be reducing the FODMAPs load, by reducing fructans, which may alleviate symptoms of bloating and discomfort, but you will not establish if it is gluten per se that is the issue or the FODMAPs.  You may therefore be avoiding foods unnecessarily and making your diet more restrictive than it needs to be. It may also be that you react to wheat rather than gluten and could therefore continue consuming barley, rye and oat without causing symptoms.

By working with me, we can improve your digestive health and explore the underlying causes. By taking this action, we may alleviate discomfort and restore your gut to health which should improve other symptoms!