When I was growing up, food allergies were rare. Some people could not have shellfish, but it was unheard of to have a life threatening reaction to peanuts. Today nut free schools are commonplace, thousands of gluten-free products are showing up in local Wal-Marts, and everyone knows someone who is avoiding sugar, dairy, soy or some other food that is common in the Standard American Diet (SAD).

Gluten is the protein found in wheat, rye, barley, triticale, spelt, and/or cross contaminated in oats. Casein is the protein found in all animal dairy products. Casein is also found in many processed foods.

Celiac disease is a digestive disorder that causes the body to attack the small intestines when wheat/rye/barley and/or spelt products are consumed. These grains contain the gluten protein. The journal Gastroenterology noted in 2005, “Celiac Disease is one of the most common lifelong disorders worldwide.” Symptoms vary widely and can include: fatigue, mood disorders, diarrhea/constipation, poor growth (in children), hair loss, neurological problems (seizures, impaired concentration and/or memory), anemia, mouth ulcers, abdominal pain, bloating, infertility, anxiety, depression, bone pain, weakness, liver disorders and/or malnutrition issues such as osteoporosis. Many who suffer from autoimmune disorders have gluten intolerance without intestinal symptoms. I gave up gluten, then reintroduced it a few weeks later. Within hours it felt like I had been hit by a truck.

At the age of 11, I became tired and very pale. I was diagnosed with mononucleosis and severe anemia (a shortage of red blood cells), which almost required a blood transfusion. Diagnosis: none. Treatment: take 6 iron tablets daily. After this episode I had chronic strep infections almost every two weeks for the next 7 years until I had my tonsils removed at age 18. I had almost constant antibiotic use during this time. In my 20′s I discovered a goiter, had symptoms of low thyroid function (hypothyroid) and was diagnosed with Hashimoto’s Disease, which is the leading cause of hypothyroidism in America. It is considered an autoimmune thyroid disease which eventually results in malfunction of the thyroid (which regulates metabolism, body temperature, and generally making the whole body run the way it should). Then I started down a road of chronic fatigue, depression and a constant state of feeling unwell. I have also had eczema every since I can remember, suffered from a terrible premenstrual syndrome and started to have very heavy, painful periods.

Finally, 4 years ago, I saw a Denver gynecologist who is an integrative doctor utilizing alternative and conventional therapies with a focus on health. For those who don’t know (men), women often use gynecologists as their primary care physician. I told her about my mood issues, female troubles, poor thyroid and constant fatigue. She did a test for anti-gliandin antibodies (antibodies which indicate gluten intolerance) and they were sky-high.

I finally had a diagnosis! Over the course of 20 years, I had seen too many doctors to count. This is common for those who are suffering from a gluten and/or dairy intolerance. Multiple trips to different doctors, lots of testing, no results, no diagnosis and no help. The median time for diagnosis is estimated at between 8-11 years with a patient seeing at least five different physicians. Finally, I had an answer and some relief from many of my symptoms, mainly the fatigue and depression.

I tell my story because it is the story of many Americans. Millions of Americans suffer from autoimmune diseases, depression, fatigue, neurological problems, mood disorders, poor digestion and/or irritable bowel syndrome (what a diagnosis! – those who have it already know their bowels are irritable). The underlying problem is a food intolerance (or multiple food intolerances) leading to malabsorption of nutrients needed for cellular repair and maintenance. At age 11, my anemia was a symptom of the food intolerance. Because gluten intolerance is insidious in the ways it shows up, it is difficult to find unless you know what to look for. Since it is not confined to the gut, testing for it can lead to false positives and false negatives.

Modern conventional medicine continues to view gluten intolerance or celiac sprue as an intestinal disease. Reviewing the studies regarding this issue, we find it is a systemic, inflammatory problem that can manifest itself in any part of the body.
Health care practitioners who treat those who have autism will mandate a gluten and casein free diet as part of an overall treatment plan. Why? Wheat and dairy are considered the staples of life – why take that away? There are many reasons why so many people cannot tolerate gluten and casein. Some can no longer break down the protein(s). Intestinal inflammation can ensue, causing a “leaky gut,” a permeable intestinal wall leaks out these undigested proteins, and for those with autism, and possibly other disorders of the brain, these peptides get lodged in the brain. Brain inflammation is found in many with mood and neurological disorders. Alzheimer’s has been characterized as a brain on fire. See a brain scan here: http://www.loni.ucla.edu/~thompson/AD_4D/dynamic.html.

Some of the reasons these staples are wrecking havoc are: over consumption of gluten/flour products, premature introduction of grains into the infant diet, hybridization of wheat, artificial processing of flour, inappropriate preparation of grains, pasteurization and homogenization of dairy products, all of which causes damage to the enzymes that breaks down gluten or casein.
There are long term consequences to gluten intolerance, as it can over stimulate the immune system, causing systemic inflammation in the body. Intestinal lymphoma , autoimmune disorders and premature death can result from a chronic state of inflammation if an affected individual continues to consume gluten despite having intolerance . This happens because so many people are undiagnosed or misdiagnosed or fail to comply with a gluten free diet.

What’s the solution? If you suspect that gluten and/or casein (these two culprits tend to work together) are the cause of your ill health, I advocate a trial abstinence from both of these proteins. The abstinence period should last at least 3-4 months, and then reintroduce each one, separately. Gluten and casein are different from other food intolerances in that they can have a lag time of up to 4 days to show any symptoms. If you find that abstaining from gluten improves your symptoms, you should continue a gluten-free diet. LivingGlutenfreeCaseinfree.com offers a 4 week menu plan to help get started with a gluten-free diet.

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Lolita Hanks graduated from the University of Colorado Health Sciences Center in 1995 with a Bachelor’s of Science in Nursing. She has been a certified family nurse practitioner since 2006 after graduating from Regis University with a Master’s in Science. Lolita received her certification from The American Academy of Nurse Practitioners in 2006. She currently works in integrative medication emphasizing prevention of disease, health maintenance, nutriceutical support, intravenous therapies, bio-identical hormone replacement and management of chronic disease. Lolita has done research, writes articles, and recently contributed to Dr. Terry Grossman’s new book, TRANSCEND. She lives and works in Colorado and is currently working on a gluten free cookbook. She offers a gluten-free menu plan at http://www.livingglutenfreecaseinfree.com.

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Footnotes:

1 Fasano, A., Clinical. Presentation of celiac disease in the pediatric population. Journal of Gastroenterology 2005; 128:4:S68-73.

2 Peters U, A. J. (2003). Causes of death in patients with celiac disease in a population-based Swedish cohort. Arch of Internal Medicine , 1566-72.

3 http://cat.inist.fr/?aModele=afficheN&cpsidt=1928270

4 Corrao G, C. G., & Group., C. d. (2001). Mortality in patients with coeliac disease and their relatives: a cohort study. Lancet , 356-361.

There are, however, a lot of clues in the medical literature and the lay public’s experience about how foods are causing and/or contributing to the current epidemic of chronic illness and autoimmune disease. There are several diets being used by many people with varying success to improve their health despite a general lack of iron clad scientific proof for their effectiveness. One of the clues to the cause and relief of food induced illness may lie in proteins known as lectins that are present in all foods.

Animal and plant sources of food both contain complex proteins known as lectins. These proteins typically have the ability to attach to sugars or carbohydrates on the surface of human cells. Some of these proteins can cause clumping of human red blood cells, a process that is called agglutination. The process of agglutination occurs when someone receives the wrong blood type during a blood transfusion. In fact, red blood cell agglutination specific to each person or groups of people is the basis for testing for blood types. There is some data that blood types may influence how people respond to certain foods though a blood type specific diet appears to have been disproven. The attachment or binding of certain food lectins can initiate a variety of cell specific effects. These reactions may mimic hormones or cause changes in cells. This is termed molecular mimicry.

Most plants contain lectins, some of which are toxic, inflammatory, or both. Many of these plant and dairy lectin are resistant to cooking and digestive enzymes. Grain lectins, for example, are quite resistant to human digestion but well suited for ruminants like cattle who have multi-chambered stomachs. Therefore, lectins are present in our food and are often resistant to our digestion and some have been scientifically shown to have significant GI toxicity in humans. Others have been shown to be beneficial and maybe even cancer protecting. Either way plant and animal proteins are foreign proteins to the body and are dealt with by digestion and our immune system in a positive or negative manner.

The human digestive system was created to handle a variety of plant and animal proteins through the process of digestion and elimination. Some plant and animal proteins or lectins are severely toxic to humans and cannot be eaten without causing death like those in Castor beans and some mushrooms. Other foods must be prepared before they are safe to be eaten. Preparations may include pealing, prolonged soaking and cooking like kidney beans. Other foods may be poorly tolerated because of a genetic predisposition or underlying pre-existing food allergy or intolerance. Others are tolerated to some degree or quantity but not in large amounts or on a frequent basis. People who are intolerant to the milk sugar lactose, because of inherited or acquired deficiency in lactase enzyme, may tolerate small amounts but may have severe bloating, gas, abdominal pain and cramps with explosive diarrhea when a large amount of lactose containing foods are eaten. Foods can become intolerable to some people after their immune system changes or gut is injured from another cause.

Of the food lectins, grain/cereal lectins; dairy lectins; and legume lectins (especially peanut lectin and soybean lectin) are the most common ones associated with reports of aggravation of inflammatory and digestive diseases in the body and improvement of those diseases and/or symptoms when avoided. Recent research by Loren Cordain PhD., has suggested that these lectins may effectively serve as a “Trojan horse” allowing intact or nearly intact foreign proteins to invade our natural gut defenses and enter behind the lines to cause damage well beyond the gut, commonly in joints, brain, and skin of affected individuals. Once damage occurs to the gut and the defense system is breached the result is what some refer to as a “leaky gut”. Moreover, many people who develop a “leaky gut” not only have gut symptoms such as bloating, gas, diarrhea, and abdominal pain but also other symptoms beyond the gut, or extra-intestinal symptoms. Commonly affected areas are the brain or peripheral nerves, skin, joints, and various body glands. With continued exposure of the gut by these toxic food lectins a persistent stimulation of the body’s defense mechanism in a dysfunctional manner, occurs, i.e. autoimmune disease.

Wrong types or levels of good and bad bacteria in the gut, or intestinal dysbiosis, may contribute to this process of abnormal stimulation of the immune system. Research supports the strong possibility that such stimulation may be accentuated by interaction of the bacteria with food lectins. It is believed by some that this may further worsen gut injury and autoimmune disease. This latter concept is gaining acceptance and recognition by doctors in one form as the hygiene theory. It is speculated that our gut bacteria have become altered by increased hygiene and over use of antibiotics and that this phenomenon may be playing a significant role in the rising incidence of autoimmune diseases such as diabetes, arthritis, and chronic intestinal diseases like Crohn’s disease and irritable bowel syndrome.

Lectins as a cause however are largely being ignored in the U.S. though the field of lectinology and lectins role in disease is more accepted internationally. Avoidance of certain food lectins may be helpful in achieving health and healing of chronic gut injury. Healing of a “leaky gut” and avoidance of ongoing abnormal stimulation of the immune system by toxic food lectins and bacteria in the gut is the basis for ongoing research and probable success of several popular diets such as the paleo diet, carbohydrate specific diet and gluten-free/casein-free diet. More research is needed in this exciting but often neglected area. The Food Doc, LLC features a website www.thefooddoc.com that will provide physician authored information on food intolerance, sensitivity and allergy such as lectin, gluten, casein, and lactose intolerance with dietary guidance that will feature in the near future an online symptom assessment and diet-diary.

Copyright 2006, The Food Doc, LLC. All rights reserved. http://www.thefooddoc.com

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