Gluten and Intestinal Permeability
Gluten is a protein that is found in many grains such as wheat, barley, and rye. On a molecular level, it breaks down into gliadin and glutenin. It is most commonly consumed as bread, pasta, cereals, and baked goods, but it can also be found hiding in other food items like dressings, sauces and gravies, ice cream, and so on. Of note, gluten provides no essential nutrients to the body. In the last decade, the prevalence of gluten-free products in grocery stores, gluten-free menus at restaurants, and gluten-free dieters has exploded. Some may wonder why suddenly people are avoiding this protein like it’s the plague when we have eaten it forever. Right? Wrong. It is important to understand that for most of human evolution, humans ate gluten-free diets. Only in the last 10,000 years, when the agricultural revolution began, did gluten become a commonly eaten grain and our diets really began to shift. Moreover, the wheat we eat today is very different from the wheat we ate back then due to hybridization. In addition, when it was included in our diets, it was in very minuscule amounts and not a staple of which we gained a large portion of our caloric needs. Prior to the agricultural revolution, most of our caloric intake was obtained from animal meat (protein and fat), with minimal carbohydrate consumption, and only when fruit or vegetables were in season. Although our DNA has not changed since these hunter-gatherer times, the food we eat has drastically changed due to the development of agriculture, usage of pesticides, and creation of GMOs, leaving us vulnerable to unfavorable epigenetic changes (that is, changes in gene expression based on environmental and lifestyle factors, wherein a gene for a disease may be turned ‘on’ if exposed to certain conditions). Clinically, I have seen the resolution of many idiopathic symptoms or conditions after patients are put on a strict gluten-free diet. Arthritis, GI symptoms (GERD, bloating, IBS, pain, constipation, nausea, diarrhea, etc), skin conditions (acne, rosacea, psoriasis, hives), thyroid disorders, and neurological symptoms/conditions (fatigue, brain fog, ADHD, headaches, and migraines, etc.) are just a few of the most common issues that can be immensely improved or resolved by going gluten-free. Because this is a widely known phenomenon in the functional medicine community, many practitioners require a patient to start a gluten-free diet before they even begin seeing them to rule out what issues are being driven by or influenced by gluten. Moreover, Dr. Hadjivassiliou, a pioneer in the study of all things gluten sensitivity, reports that gluten sensitivity can present solely as a neurological disease, with the absence of any GI symptoms whatsoever. To drive home the effects of how serious eating gluten can be in some people, there is research showing people have been misdiagnosed with ALS or Lou Gehrig's when in reality they just had a gluten sensitivity. Upon cessation of gluten in their diets, their neurological symptoms miraculously resolved. In addition, there is research showing that Hashimotos Thyroiditis, an autoimmune condition that affects the thyroid, can be greatly improved by going gluten-free. Women who adhered to the diet for 6 months significantly reduced their thyroid antibody levels. This begs the question; does gluten cause issues in just those with celiac disease and gluten sensitivity? Or even healthy people too? A newer area of research and hot topic in the nutrition and health space for the last few years has been that of intestinal permeability. Intestinal permeability, sometimes referred to as leaky gut, refers to when the gut lining, which is only one cell layer thick, becomes too loose and therefore permeable, allowing bacteria, toxins, and undigested food particles to pass into the bloodstream. When this happens, an immune response is activated which often, over time, results in food sensitivities, arthritis, autoimmune disease, and several other phenomena. While there are many things that can cause intestinal permeability, such as gut dysbiosis, overuse of antibiotics, poor diet, stress, and so on, gluten has been one of the factors shown to cause intestinal permeability as well. The integrity of the gut lining is so important because it controls the crosstalk between metabolic, neuroendocrine, and immunological functioning. When one is compromised, it creates downstream effects on other systems and functioning. Interestingly, gluten has been shown to result in intestinal permeability in the gut of not only those with celiac disease and gluten sensitivity, but healthy controls as well. Because most people have some genetic risk and familial history in terms of developing one condition or other, and gluten can act as a trigger for epigenetic change, considering whether to keep gluten in your diet is an important question to ask yourself. If you already are dealing with a chronic illness, it becomes even more important. Knowledge is power and I believe everyone should be empowered to make informed choices when it comes to what they are putting in their body. To learn more about nutrition, genetics, and functional medicine, subscribe to my newsletter below. For access to 15% off practitioner only professional-grade supplements, click here.
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The above content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Individuals should always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.
References:https://jnnp.bmj.com/content/72/5/560Perlmutter, D., & Loberg, K. (2013). Grain Brain: the surprising truth about wheat, carbs, and sugar--your brain's silent killers. First edition. New York, NY: Little, Brown and Co.Krysiak R, Szkróbka W, Okopień B. The Effect of Gluten-Free Diet on Thyroid Autoimmunity in Drug-Naïve Women with Hashimoto's Thyroiditis: A Pilot Study. Exp Clin Endocrinol Diabetes. 2019 Jul;127(7):417-422. doi: 10.1055/a-0653-7108. Epub 2018 Jul 30. PMID: 30060266.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440529/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353361/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377866/