Gluten Sensitivity, Is Your Food Making You Sick? by Jeffrey Dach MD

Migraines and Food Allergies

A connection between gluten sensitivity and psoriasis iswell known. (18-20) In addition, I mentioned to Jimthatfood allergies can cause migraines (7), andgluten sensitivity can causemigraine headaches(8,9). In fact, gluten sensitivity is associated with all sorts of neurological disorders: cerebellar ataxia, epilepsy, myoclonic ataxia, chronic neuropathies, and dementia, mainly in middle-aged adults.(10-13) I suggested to Jim it waslikely that a gluten free diet would be helpful in reducing his migraines.(8-9)

Gluten Testing with Entero-Labs

Jim's lifestyle made it difficult for him to go Gluten free, so I suggested he try the EnteroLabs gluten test. Sure enough, the test panel came back positive. Jim went on a gluten free diet, and 4 weeks later called me to report his migraines were much better. This article will discuss sensitivity to wheat gluten, a condition which is epidemic, yet mainly ignored or unknown by the medical system.(20)

What is wheat gluten sensitivity?

left image: Bread, courtesy of wikimedia commons

Gluten is a protein is wheat products, such as bread, pasta, wheat cereals etc. About 1% or more of the populationreacts to wheat gluten withan immune response andan inflammatory disorder of the small intestine which may cause malabsorption of key minerals, amino acids and vitamins. This has aninherited autoimmune componentandgenetic testingis available.(17) Other diagnostic testing involves looking for the antibodies called TTG (transglutaminase) instool or blood samples.

Immune Response In the Wall of the Small Bowel-Malabsorption

The immune response involves production of various antibodies and immune cells which damages thesmall intestine, reducing itsabsorptive ability. This iscalled malabsorption, andresults in the inability to absorb key vitamins and minerals such as Iron, Calcium, folate and B12.These abnormalities will show up on the blood count asiron deficiency anemia, and B12/folate deficiency anemia.(22) gluten sensitivity, celiac disease may cause malabsorption of calcium, and the DEXA bone density scan may showosteoporosis (21).

Any Organ Can Be Involved

The auto-immune response cancirculate freely through the body,crossreacting withother organ systems, unpredictably.

Immune Response in the Skinand Hair Follicles

Another common place for the immune response to attack is the skin, with a characteristicskin lesion called Dermatiformis Herpetiformis (it resembles Herpes)with intense burning, itching and blistering skin rash which is usually symmetrically distributedon the elbows, knees and the buttocks. The rash usually starts assmall blisters that errupt intosmall erosions. Dermatologists will make the diagnosis of gluten sensitivity by doing a skin biopsy showing characteristic findings.Immunofluorescence ofnormal skin next to the vesicle typically shows granular IgA deposits in the upper dermis. (27-29) If the scalp is involved, thisis called Alopecia Areata withpatchy hair loss caused by auto-antibodiesreacting with the hair follicles.(25-26)

Vascular System

If the immune response attacks the vascular system, there may be increased venous thrombo-embolism, stroke (2)(3), and coronary artery disease, etc. Thus, gluten sensitivity is one of the major causes of migraine headaches since it may cause inflammation ofcerebral arteries, or the brain itself. (9)

Neurological Problems

If the immune response attacks the brain or spinal cord, this may cause a neurological disorder (4, 10-16)such as ataxia (5), uncoordination, peripheral neuropathy (tingling with pins and needles)(6).

Going to theEndocrinologist

The patient with gluten sensitivity may end up at theendocrinologist's office with issues such as: Type 1 diabetes mellitus, autoimmune thyroid disease, Addison disease, osteomalacia, secondary hyperparathyroidism, vitamin D or iron deficiency, fertility problems, hypogonadism in men, and autoimmune hypopituitarism.(23) Autioimmune thyroid disease is especially common among people with gluten sensitivity, with elevated anti-thyroid antibodies (Hashimotos) which decrease after initiating a gluten free diet.(24) One can make a case for gluten sensitivity testing for all patients with autoimmune thyroid disease (Hashimotos).

The Heart

The gluten sensistive patient may have heart involvement with cardiomyopathy, a serious and potentially lethal form of heart failure. In addition, the gluten sensitive individual mayhaveheart rhythm abnormaliies such as atrial fibrillation, reversible with a gluten free diet, if diagnosed early.Testing for gluten sensitivity should bedone for such patients.(30-31)

Sarcoidosis

A unusual lung disease of unknown etiology called Sarcoidosis is linked to gluten sensitivity. Sarcoidosis is thought to be an auto-immune disease because the treatment is immune suppression with prednisone. These patients may benefit from a gluten free diet.(34)

Addisons, Adrenal Failure

Complete failure of theadrenal glands to manufacturecortisol is called Addisons Disease and is associated with gluten sensitivity.(35) These patients may benefit from a gluten free diet.

Going on a Gluten Free Diet

Patients may go for decades with health problems, running through a succession of doctors, yet remain undiagnosed by the mainstream medical system. Treatment is usually curative with a Gluten Free Diet (GFD) which means avoiding all wheat products such as breads, pasta, wheat cereals, bakery goods etc.

Jeffrey Dach MD

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