Is gluten the cause of what ails you?

Most of the time, patients don’t come to my office at the first sign of a problem. When someone has a medical complaint, typically he goes to his primary care doctor who does tests or refers to a specialist. And if the patient doesn’t come to an answer, or the answers he gets don’t help him get relief, he will sometimes turn to alternative medicine. I see lots of patients who have been there, done that. They’ve tried everything else, had every test under the sun, are taking the medicines they’re prescribed and still don’t feel right. They figure at this point they’ll try anything to feel better. They end up in my office, where, although we can prescribe medicines, we try to use as holistic and natural an approach as possible. We take it from the top, review all the previous tests and try to put all the pieces of the puzzle together.

In my last post, I discussed the most common GI complaints and how preventive measures including diet, exercise, sleep and stress reduction can significantly help maintain normal bowel health. But one of the most important parts of working up gastrointestinal complains such as bloating, constipation, diarrhea and excess gas is ruling out celiac disease.

Many patients present to my office with non-specific complaints; generalized fatigue, brain fog, joint pains, feeling “off.” They tell me their theories, “my hormones are off” or “this all started when I had my last child.” Some of those patients are known to have rheumatoid arthritis, low thyroid or diabetes. And after all the testing and bloodwork comes back, their symptoms have been attributed to any one of their many medical problems.

Further questioning reveals an interesting constellation of symptoms that all seem to be autoimmune in nature; that is, symptoms that the body is attacking itself. Bloating, inflammation, arthritis, thinning hair, weight gain, migraines, rashes, diarrhea and constipation, nerve pain or any combination of these symptoms seem to apply. The medical workup usually includes bloodwork and imaging studies, but oftentimes, the gut is not a consideration, especially when there are other conditions that may explain the symptoms such as thyroid disorders, rheumatologic or neurologic conditions. But it was Hippocrates who once wisely said, “all disease begins in the gut.” Many of these symptoms can also be explained by celiac disease, gluten sensitivity or wheat allergy.

You’ve probably been hearing a lot about gluten these days. It seems gluten-free diets are part of a trendy lifestyle. But the health implications of eating gluten for those who have celiac disease can be severe. Celiac disease is an autoimmune condition that occurs as a result of eating gluten, which is a protein that is very difficult to digest. Chronic exposure to gluten causes damage to the lining to the intestinal wall. Finger-like projections called villi become flattened which causes malabsorption of key minerals and nutrients such as magnesium, iron, calcium, and Vitamin D. It is hypothesized that a damaged intestinal lining may the be source of, or at least is highly correlated with autoimmune disease. Foreign particles sneak through an unhealthy intestinal wall and are absorbed into the bloodstream and later trigger and immune reaction in neighboring organ systems such as the endocrine or nervous system. So it is very common to see autoimmune types of illnesses in patients who have celiac disease and vice versa.

Gluten is historically found in wheat, barley and rye. But the wheat that humans evolved on has only recently been genetically modified into a higher yield crop that has been correlated with an increase in wheat sensitivity and allergy. Today’s wheat causes more significant spikes in blood sugar than ice cream or table sugar and is therefore correlated with weight gain in celiac patients, and weight loss in those who follow a gluten-free lifestyle. It is also a very common childhood allergy that may explain eczema, asthma and behavioral problems. Diagnosis of celiac disease can be made by testing for antibodies in the blood, biopsy of the small intestine, video endoscopy, or skin allergy testing. But if testing for celiac disease turns up negative, that does not rule out gluten sensitivity.

More simple and less expensive is the gluten elimination trial diet, which is one of the first things I prescribe for patients suffering with any combination of celiac-like symptoms. Ridding your diet completely of gluten involves eating clean, whole foods that don’t have a lengthy ingredients list. Up to 80 percent of items on grocery store shelves contain wheat, wheat flour or barley flour. It’s even added to vitamins, toothpaste, chocolate and soy products. With the high visibility of gluten-free diets, many companies are making a fortune selling gluten-free products. By choosing gluten-free options, you may just be swapping out one unhealthy carbohydrate for another. Instead choose fresh produce, nuts, seeds, rice, corn, eggs, meats, fish, and legumes. Monitor your symptoms, especially brain fog, energy level, hair and nail texture, bloating, weight gain.

Compliance can be hindered in gluten-free living because meal planning and preparation can be inconvenient and eating out often poses a challenge. Also, it can take several weeks to months to notice a difference as your body begins to heal. The good news is that a gluten-free diet is often curative. In some rare instances, medication may be necessary. But this is one condition where lifestyle changes really can make all the difference, naturally and without medications.

It is very difficult to meet patients who are so frustrated at their myriad symptoms that are not seemingly related. But when multiple organ systems are affected and constitutional symptoms are predominant, my discussion about celiac, gluten and gut health brings a great sense of relief and hope to patients who are suffering.

Alexis Hugelmeyer, D.O. is the wife of Michael, mother of Isabella and Lance, and a family physician whose passion is hands-on manipulation for treatment and healing of any and every type of medical problem. She is the director of community outreach education at Peconic Bay Medical Center and also a private practitioner in Riverhead, where she has founded The Suah Center for Natural Healthcare. A graduate of Villanova University and New York College of Osteopathic Medicine, she lives in Baiting Hollow.