NON-CELIAC GLUTEN SENSITIVITY

Could wheat be the cause of your symptoms?

Researchers are finding more connections to our health and what we eat every day. A decade ago it was believed that CD (celiac disease) was the only health problem related to gluten and wheat. Since then more and more people have reported symptoms from wheat that are not the typical gluten-related celiac symptoms. Many of the symptoms are neurological including pain and brain dysfunction. As a result, increasing numbers of people are going gluten-free and reporting improvement in their overall health. Click on the references at the end of this article to see what studies are showing.

Gluten-free sales are expected to double from the year 2014 to 2020 to reach over 7.5 billion dollars. This has prompted researchers to understand why so many people have decided to say no to gluten and wheat.

A group of studies done in the USA, UK, Italy, and Australia of 27,831 people found that non-celiac gluten/wheat sensitivity (NCGS) affected approximately 8 percent of the participants. Other studies have found similar results. Since many people have symptoms that they contribute to another health problem, like fibromyalgia, for instance, these numbers are probably low. (18)

An international panel of experts in London in 2011 defined NCGS as a “non-allergic and non-autoimmune condition in which the consumption of gluten can lead to symptoms similar to those seen in CD”. Studies all over the world are now proving that NCGS related health problems are separate from CD and gluten-related issues. (23)

Other components in wheat besides gluten that can cause problems:

• Amylase trypsin inhibitors are proteins that are highly resistant to digestion.
• FODMAPS (low-fermentable poorly absorbed short-chained carbohydrates) in wheat can contribute to symptoms as well. Since FODMAPS have not been studied extensively, more research is obviously needed. (18)

Differences between Celiac disease and Non-celiac gluten sensitivity:

Non-celiac gluten sensitivity refers to symptoms that are more neurological. It affects the brain and nerves more than the gut-related destruction and autoimmune issues found with celiac disease. NCGS symptoms are unique to every individual. Unlike celiac disease which was noted more in younger children, NCGS affects an older population. In fact, 20% of those diagnosed are over the age of 60. It also affects females more with a male to female ratio of 1:3 and it is much more common than celiac disease. Celiac disease patients exposed to gliadin, the problematic component in gluten, have markers of inflammation in the intestinal mucosa that NCGS patients do not have. (19)(20)(25)

The components in wheat other than gluten have been studied and found to produce a wide range of symptoms. Symptoms vary from person to person and can begin a few hours or a few days after ingesting gluten. Healing can occur. Antibodies to gluten, IgG type, were found to disappear in those with NCGS after being on a gluten-free diet for 6 months in 93.3% of cases. (25)

Experts believe that IBS (Irritable Bowel Syndrome), an intestinal disorder affecting about 11% of the population, and NCGS are closely related. In fact, studies have shown that at least 28% of people with IBS also have NCGS. In people affected by both disorders, symptoms can be greatly improved or eliminated by removing wheat and gluten from the diet. (19)

Not your grandmother’s wheat:

The biology or genetics of wheat has been altered while the incidences of wheat-related symptoms are increasing worldwide. Given that ancient wheat had 14 chromosomes and hybridization has produced wheat that now has 42 chromosomes, it certainly has changed. Wheat has been cross-bred with different grasses to produce new strains with higher yield and less crop loss. Seed heads became so large that it had to be modified again to produce a shorter variety that would not fall over in the fields. This produced wheat with an altered protein and allergen causing content. In the meantime not a single test or study was performed to check the safety or digestibility of the wheat we eat today. (17)

Why be concerned?

Non-celiac gluten sensitivity has the potential to be one of the biggest threats to health for a large percentage of people. For most people, obvious signs are hidden as the damage is being done. Wheat has been found repeatedly to trigger inflammation in the body and inflammation is at the core of most diseases.

IBS and NCGS are like the chicken and the egg. It is difficult for experts to know which came first. Did damage by gluten or wheat give way to IBS, or did IBS cause NCGS? We do know that they have three things in common. Changes in the bowel including intestinal permeability (leaky gut), dysbiosis, (more bad bacteria in the gut than good bacteria) and the body’s own immune response to these changes are often seen in people suffering from the disorder. (18)

If you have any of the symptoms listed below and are frustrated with finding answers, you may want to read up on new research that is out there to help you understand how it may be affecting you.

What are the symptoms?

The most common symptom of NCGS noted in studies of the past few years is cerebellar ataxia, a form of brain damage caused by the destruction wheat does to sensitive brain tissue. This can be seen more in young children and the elderly. Findings on an MRI of the cerebellum are usually abnormal and often show atrophy. It is recommended that patients with Gluten ataxia be screened using AGA IgG and IgA, anti-tTG2 antibodies and if positive placed on a GFD (gluten-free diet) for one year to check for improvement. (1)(24)

Signs of cerebellar ataxia are:

• Unsteady gait or difficulty walking, this includes falls.
• Impaired coordination
• Poor fine motor skills
• Speech difficulties that can mimic having a stroke
• Abnormal gaze and eye movements, blank stares, eyes rolling back, and inability to focus.

Peripheral neuropathy is the second most common symptom and occurs in more than half of people. Numbness, tingling, and pain can be in any part of the body. This can be permanent and symptoms, when damage is long-term, do not always improve on a gluten/wheat-free diet but the destruction continues.

Cognitive impairment, including dementia, has been found in numerous studies. Even after being on a gluten/wheat-free diet, patients over the age of 65 saw less improvement of these symptoms than younger individuals.

Symptoms can mimic dementia or Alzheimer’s disease and include:

• Problems concentrating
• Changes in cognition (alternating good days and bad days)
• Episodic memory deficits
• Word-retrieval problems
• Reduced mental acuity
• Episodes of confusion or disorientation

Neuropsychiatric diseases, including schizophrenia, have been noted in various studies over the years. Many of these symptoms take longer to improve. In some studies, it took as long as 5 years for clinical improvement. It is believed that nutritional deficiencies and thyroid disease play a causative role as well as delaying improvement after starting a gluten/wheat-free diet. (1)(2)(6)(12)

Other symptoms and associated disorders observed in studies include:

• Abdominal pain, (the most common GI complaint)
• Depression, (the most common neuropsychiatric symptom)
• Fatigue
• Foggy brain
• Headache, (improved after a gluten/wheat free diet)
• Apathy
• Anxiety
• Irritability
• Eating disorders
• Joint pain
• Leg, arm, or finger numbness
• Dermatitis
• Muscle pain
• IBS (irritable bowel syndrome)
• Gas
• Weight loss
• Attention-deficit/hyperactivity disorder
• Autism, (gluten-free diet was found to improve the behavior of autistic children in studies)
• Schizophrenia
• Bipolar disorder
• Sleep complaints
• Seizures, (which occur in over 7 percent of the population due to cortical damage and calcifications)
• Genetic predisposition, HLA haplotypes, (carried by 30% of the population) (Seen in 50% of patients with NCGS) (1)(2)(6)(12)(24)(25)

Healing

Damage to the intestines from celiac disease results in nutrient deficiencies, but there is no clear evidence of deficiencies yet from NCGS since that exact type of intestinal damage does not happen with NCGS. The focus still should be on repairing the gut. This includes a variety of supplements that have been used successfully:

Dysbiosis should be corrected first to get rid of bad bacteria:

• Olive leaf extract kills many types of bacteria and viruses
• Grapefruit seed extract is good for getting rid of yeast and fungus
• Oregano kills bacteria and fungus
• Black seed oil is a wide spectrum microbe killer
• A good fiber supplement is important, methylcellulose works like little brooms sweeping the bad stuff away

To repair gut damage:

• L-glutamine repairs damage to the gut
• Vitamin and mineral supplements provide nutrients needed to repair and also corrects deficiencies
• B vitamins are most important
• Amino acids are the building blocks for creating new cells and tissues

Probiotics are needed to repopulate the normal flora of the intestines

• Make sure you use a quality probiotic with at least 20 billion CFU’s per capsule and multiple strains
• If you are a non-secretor, add strains of bifidobacterium since non-secretors lack enough of these strains
• Arabinogalactan is a great prebiotic that feeds the good bacteria and acts as a much-needed fiber supplement

If you suffer from gluten sensitivity the best thing you can do is go gluten-free. You may not have to be as strict as someone with celiac disease, but you would do better to avoid anything with obvious gluten in it. Eliminate bread, pasta, cookies and cakes. For some people, giving up these foods is the closest thing to a death sentence. People love to eat and we all crave foods that are not exactly good for us.

Start with 2 weeks on a gluten-free diet. Baby steps. For me, the reward of having less pain, more energy and a clearer head was well worth it.

I found foods and snacks to satisfy cravings I had while on gluten. My diet now consists of mostly meat and vegetables. I also eat a low oxalate diet. Feeling better is my motivation. It may take some time to notice the difference and that may depend on how much damage has been done, but you can heal with time and patience.

 

References:

(1) Neurologic and Psychiatric Manifestations of Celiac Disease and Gluten Sensitivity

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3641836/

(2) Neurophysiology of the “Celiac Brain”: Disentangling Gut-Brain Connections https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5591866/

(3) Celiac disease, non-celiac gluten sensitivity, and wheat allergy: comparison of 3 different diseases triggered by the same food

http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0370-41062017000300017&lng=en&nrm=iso&tlng=en

(4) Non-celiac gluten sensitivity: Time for sifting the grain

https://www.ncbi.nlm.nih.gov/pubmed/26217073

(5) Gluten contamination in foods labeled as "gluten-free" in the United States.

https://www.ncbi.nlm.nih.gov/pubmed/25285507/

(6) Celiac Disease and Non-celiac Gluten Sensitivity A Review

Maureen M. Leonard, MD, MMSc1,2; Anna Sapone, MD, PhD1,2,3; Carlo Catassi, MD, MPH

https://www.ncbi.nlm.nih.gov/pubmed/28810029

(7) Gluten-free diet reduces adiposity, inflammation and insulin resistance associated with the induction of PPAR-alpha and PPAR-gamma expression.\\

https://www.ncbi.nlm.nih.gov/pubmed/23253599

 (8) Parallels between Pathogens and Gluten Peptides in Celiac Sprue

http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.0040034

(9) Nutritional consequences of celiac disease and the gluten-free diet

https://search-proquest-com.cyrano.ucmo.edu/central/docview/1492569034/D7D3741C323C40F5PQ/1?accountid=6143

(10) Gut-thyroid axis and celiac disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5435852/

(11) Wheat Improvement: The Truth Unveiled

https://wheat.pw.usda.gov/ggpages/Wheat__Improvement-Myth_Versus_FactFINAL.pdf

(12) Zonulin, regulation of tight junctions, and autoimmune diseases

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384703/

 (13)   The opioid effects of gluten exorphins: asymptomatic celiac disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5025969/

(14) Rheumatoid arthritis-celiac disease relationship: joints get that gut feeling.

https://www.ncbi.nlm.nih.gov/pubmed/26190704/