The People's Perspective on Medicine

Show 1049: Do You Need a Gluten-Free Diet?

Celiac disease is not rare, but it is not common enough to account for the popularity of gluten-free products. Do you need a gluten-free diet?
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Do You Need a Gluten-Free Diet?

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Years ago, doctors thought that celiac disease was incredibly rare among Americans. In this auto-immune condition, exposure to gluten found in barley, rye and wheat causes the body to attack the lining of the digestive tract. The damage that is done interferes with the ability of the intestines to absorb nutrients properly and that can lead to serious consequences indeed. In fact, people with undiagnosed or untreated celiac disease are twice as likely to die prematurely as other individuals.

Celiac Disease Is Not Rare:

Research over the past decade has shown that celiac disease is nowhere near as uncommon as doctors once thought. It is possibly becoming more common. Certain drugs, such as antibiotics or PPI acid-suppressing medicines, may predispose susceptible people to developing celiac disease. It may take several years before people with celiac disease get a proper diagnosis; once they do, they need a gluten-free diet.

Who Might Need a Gluten-Free Diet?

Now, with gluten-free food available in most grocery stores, it is far easier to follow the prescribed diet. Should people be eating gluten-free even if they don’t have celiac disease?

For most people, it is important to see a doctor and be tested before starting a gluten-free diet. The diet could interfere with the accuracy of the test. And most people benefit from a dietitian’s advice, since gluten hides in many foods where you wouldn’t expect it.

Non-Celiac Gluten Sensitivity:

People who believe they react to gluten (but don’t have celiac disease) might have non-celiac gluten sensitivity. But many do not. It can be a challenge to follow a gluten-free eating plan that is balanced and provides adequate nutrition.

Do you really need a gluten-free diet? If so, how do you ensure that it provides all the necessary nutrients? Our guests discuss this dilemma.

A recent article in JAMA Internal Medicine (online Sept. 6, 2016) is extremely relevant to this show: “Time Trends in the Prevalence of Celiac Disease and Gluten-Free Diet in the US Population.”

This Week’s Guests:

Peter H.R. Green, MD, is the director of the Celiac Disease Center at Columbia University. He is the Ivan and Phyllis Seidenberg Professor of Medicine at the College of Physicians and Surgeons, Columbia University, and attending physician at the Columbia University Medical Center (New York-Presbyterian Hospital).

His recent research paper was on “Intestinal cell damage and systemic immune activation in individuals reporting sensitivity to wheat in the absence of coeliac disease.” It was published in Gut (online, July 25, 2016).

Rory Jones, MS, is a medical writer and Adjunct Professor of Narrative Medicine at Barnard College of Columbia University.

Ms. Jones and Dr. Green have co-authored two books: Celiac Disease: A Hidden Epidemic and Gluten Exposed: The Science Behind the Hype and How to Navigate to a Healthy, Symptom-Free Life.

Listen to the Podcast:

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free for four weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
Show 1049: Do You Need a Gluten-Free Diet?
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Celiac disease is not rare, but it is not common enough to account for the popularity of gluten-free products. Do you need a gluten-free diet?

Show 1049: Do You Need a Gluten-Free Diet?
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I wish to say that Alton seems to be unaware that the explosion of many auto-immune diseases of the past fifty years may be tied into the fact that the wheat we consume today has been genetically modified. This GMO wheat was introduced into our food chain about fifty years ago without testing to see if it is safe for human consumption. So while it is true that non-GMO wheat has been consumed for thousands of years, this is not our grandparents’ wheat.

My husband was diagnosed with an acute onset of RA five years ago. He was so greatly affected by it that he could hardly move. He was put on medications which helped him be mobile again, but the side effects were terrible.

Then, after a year on this drug regimen, in which he still had flares, a friend told us she read in Dr. Wm. Davis’ book that 40% of RA flares are triggered by gluten. So he went wheat free. In two weeks, his flares went away. Ultimately, he went off all prednisone (it took a year to wean off it very gradually under his doctor’s supervision) and was able to reduce his other arthritis medication (which he still takes a very small dose of to stop the crippling of his joints since he still has RA, just no longer has flares).

On top of that, he is a diabetic of over twenty years, which he controlled by diet and pills. He was a very compliant diabetic with good sugar control yet his A1C was always slightly elevated. Then when he was on prednisone, he had to use insulin to control his diabetes, which is a common occurrence when on prednisone I understand.

After going wheat free, his sugar levels became stable so he was able to get off all insulin within a couple of weeks even though it took a year to get weaned off all the prednisone. And his diabetic pill dosages have been reduced by his doctor. The most interesting thing is that his A1C is now normal. It became so one month after going wheat free and has continued to be normal for these past five years.

Also, he was on statin drugs for 25 years but still had an elevated cholesterol while taking the statin, never getting to normal levels. Guess what? His bad cholesterol number dropped immediately and has gone to within normal levels, so his doctor has decided to wean him off the statin, although we are told it takes many years to do that safely.

Anyway, that is our experience and we are thrilled at what going wheat free has done for his health. Needless to say, I have gone wheat free too. And when I cook for those who don’t want wheat free, I use organic flour which is non-GMO. I figure it cannot hurt.

The hidden-gem takeaway from this podcast was the fact that some people who are gluten-sensitive might not realize it, because we have symptoms OTHER than gastrointestinal troubles. This information is worth its weight in gold. I never guessed that I was gluten-sensitive, because I had no stomach or gut issues. But I have been plagued by mysterious skin issues and eye inflammations that dozens of doctor visits failed to diagnose or resolve.

Then, by chance, I took an allergy test called the ALCAT test, designed to test for food sensitivities. The results told me that I am “highly” sensitive to gluten. I never would have looked into Celiac or gluten sensitivities if I had not taken the ALCAT, since I lacked the stereotypical profile. I believe your guests on this episode may be overly conservative in their assessment of the overall gluten problem, but Rory Jones from Barnard is really on to something with her point about non-gut manifestations of gluten sensitivity. I hope she steps out on her own and pursues that angle of research in the future! Warm regards from Front Royal, Virginia

When my adult son was diagnosed with chronic Lyme Disease and was advised to eat gluten-free, I decided to do so as well. Not only did it give me what I call “bowel bliss”, but I dropped nearly 100 points of total cholesterol, as well as lowering blood sugar by 14 points (from 99 to 85). This took approximately 9 months or so. I continue to eat this way, avoiding as best I can the gluten in things. I had avoided taking a statin drug for years; my current doctor was amazed at the good news she was giving me at my last visit. Many years ago I was told I had a wheat allergy through allergy testing, but I had not thought it had any effect on me. Thanks for the program on this.

The doctor in the podcast talks about a gluten-containing diet being healthy and makes the asumption that gluten-free dieters are eating gluten-free products. He saying if you don’t eat gluten then you will become nutrient deficient. This is very narrow thinking and maybe only true if you are eating a crappy standard American diet. When a person is eating a gluten-free diet containing vegetables, meats, fruits, and nuts, they certainly will not have to worry about eating gluten to get their micronutrients.

Im just now learning about IMS. My two year bout with diarrhea and 15 years of fatigue and foggy brain may be about to end as I start a grain free diet.

Are there any grains that I can eat?

Celiac was rare according to retrospective blood analysis by TTA tests. After RoundUp – not so rare.

I’d like to expand a little on the sentence, “For most people, it’s important to see an MD & be tested before starting a gluten-free diet.” I am so grateful to my sister who warned me: “Now when the results of your blood tests come back, you’re going to be told to go on a g-f diet. That’s what you must NOT do!” I said, “That doesn’t make sense.” And she said, “Listen to me. When you go to have the endoscopy to find out how much damage has already been done & they learn that you’re already on a g-f diet, they’ll say they ‘won’t test you right now’.

You’ll be told to go back to eating normally, iow’s including wheat! That’s what happened to her & when she started injesting gluten again, her body reacted so powerfully she said she couldn’t take it. She knew she must have celiac disease. I don’t blame the doctor. She did say just what my sis predicted, but I think I was her first cd patient.

My husband, a type 1 diabetic,for almost 50 years struggled w constipation in spite of a diet w plenty of fiber. A relative suggested trying a gluten free diet and the problem disappeared. When we saw a new endocrinologist and we mentioned the gf diet, he said it’s not uncommon for diabetics’ systems to not process gluten well as you age. For myself, I feel more energetic , no longer bloat & don’t have the desire to overeat. I have to disagree w Dr, Green about the unhealthy aspects of a gf diet. I cook most of our meals from scratch, we eat a lot of fruits & vegetables. Olive oil & nuts are a part of our diet. We limit red meat but get plenty of protein from eggs, poultry, fish & greek yogurt. Our diet is better than most Americans and at 67, I take no medications.

Two years ago I was diagnosed with diabetes, fatty liver disease, metabolic disorder and obesity. I put myself on a strict “no sugar- no grain” diet/lifestyle and was taken off all medications two months afterward. One comment made by Dr. Peters was that there is no evidence to support inflammation or brain disease due to gluten. After reading Dr. Davis and Dr. Perlmutters books concerning grains, I believe this information to be totally untrue and should be challenged by one of the many doctors who have evidence to dispute it, similar to the opposing viewpoints on statins you had on your program, the truth is usually self-evident by the end of the discussion. My wonderful wife gave up sugar and grains at the same time I did and had her eczema clear up that she had as a child, and came off of PPI’s she was on for acid re flux. Neither my wife or I were ever diagnosed with any gluten sensitivities but eliminating it from our diets has made a huge difference in our health. I love your program because you let your guests speak without interruption, rare nowadays. Please have an opposing viewpoint to this opinion, you will be amazed by the evidence to the contrary.

Has anyone experienced relief from IBS-C (Irritable bowel with constipation) from sticking to a gluten free diet?

In the last few months, I have experienced bowel problems when eating yolks of eggs. I also expect wheat bread of causing the same problem. I think I have a sensitivity to gluten, but have never been tested. As a result, I’ve begun to lightly modify my diet to see if my suspicions may be accurate .

I was diagnosed with wheat allergy along with some other foods, but mainly wheat, eggs, and milk, by blood test. I stopped eating those foods and my bloating and gas got better. Surprisingly, my migraine auras and headaches completely went away and my eczema got better. Now, anytime I eat anything with wheat, eggs, or milk (I can eat cheese, butter, and sour cream with no problems) I will have a migraine aura sometimes with headache within 24 hours. I know for a fact that non-celiac gluten sensitivity is real!

In an effort to lose weight, I went on a low carb, paleo or atkins style diet. I cut out all grains. Amazingly, my gut problems went away. I had suffered from tons of gas for years, poop that was explosive and splattered, and recently from ongoing bouts of diverticulosis or infections in the outpouches of the intestines. I suffered from four of these in a year and intense gut pain all the time in the lower left side.

When I cut out all grains, all symptoms went away within days to two weeks. Bowels became regular and well formed and hardly any more gas even when eating lots of leafy greens. No more gut pain. No more gut infections. So the doctor said we don’t have to prove anything. I figured what the heck, I will throw grains back in just to see what happens. All negative symptoms returned quickly and the tiredness I felt was immense. I am sure historically that growing and harvesting grains were a way to prevent famine and not have to go hunt for meat as “daily bread” became a cheap, easy mass-produced form of protein. But that does not mean it is healthy. Eating corn or corn “bread” made from purely cornmeal does not set off any symptoms, but wheat, oats, and other grains do cause undesirable symptoms. I was born premature and suffered from respiratory issues my entire childhood as well as frequent respiratory infections. Cutting out grains has also significantly improved my respiratory health and resistance to sickness.

I was diagnosed with celiac sprue at age 72 after many years of vague sensations (aches and pains; I have been a life long fitness advocate but never have been outstanding in performance. I’m also ADHD and in a fog much of the time so that overall life has been a struggle) and fatigue related issues. I have been monitored for low white blood count for over 25 years without infections, re: pneumonia.

I try to be active ever day of the year gardening every day possible and walking or spin biking regularly. The only time I feel optimum is when I travel on my own and encounter new situation, people and experiences. I notice that I become a different person when out of my typical element. I guess I don’t travel enough.

Hard to believe Gluten is a problem. We have been eating it for 1000’s of years. It is a big money maker for big food. It seems to me to be a band wagon. Try to thank for your self. This day in time, it is very hard to do.

Yes wheat and its cousins are a bonanza for the crop science companies that help produce it which have strong ties to the pharmaceutical and health care industry that produces the PPI’s and the antibiotics which are the cause of what is referred to as celiac disease!

It may be good to consider that our environment has become more polluted over the years – our air, water, ground has more man-made chemicals inflicted on them than any time in history. They told us DDT was safe and slowly we are learning what else is literally killing our air, water, ground, food….us! Many of us with very sensitive bodies are the canaries in the mine field of chemicals that we have allowed to enter our daily lives. The day when the health of humans is more important than profits will only come when it directly affects those who profit from the pollution. In the mean time we canaries are dealing with auto-immune and various skin, respiratory, digestive, endocrine, reproductive, and nervous system problems.

It may not always be gluten that is messing with the health of so many. Many can not process the genetically modified product we now call wheat. A friend was chronically ill, the doctors couldn’t find the answer, so because of that told her the problem was in her head. (One arrogant doctor actually told her to just go home and die.)

When she dropped wheat from her diet, she experienced an amazing turn around. Her father subsequently dropped wheat and also experienced a dramatic increase in health and needed weight loss.

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