Gluten: allergy, sensitivity, intolerance explained

As a naturopath, when I mention gluten to an non-receptive ear I’m often met with a yawn; protestations; and mumblings about the next gravy train that could do with running out of steam.

So what actually is gluten?

Gluten is a protein present in most grains, including wheat, barley, rye, spelt, couscous and bulger. It has a ‘glue like’ consistency, which makes it very difficult to digest. Since the agricultural revolution more than 25,000 strains of wheat have been developed and over the last 500 years the gluten content of foods containing wheat has steadily increased.

The gluten confusion

The terms allergy, sensitivity, intolerance and coeliac, are often used interchangeably when discussing gluten which can lead to muddy waters. A more accurate description would be gluten-related-disorders for which there are at least four.

The first one under the umbrella is the classic allergy.  This involves your immune system generating something called an IgE reaction when it comes into contact with gluten. The second involves a different branch of the immune system (either IgA, IgG or IgM) referred to as a non-IgE immune response. This is where non-coeliac-gluten-sensitivity sits and, right now, is creating the biggest noise. 

The third is coeliac disease, whereby gluten stimulates a cascade of events leading to destruction of the lining of the small intestine, inflammation and poor nutrient absorption; and the fourth is something called non-immune-malabsorption syndrome more commonly known as intolerance and is characterised by an adverse reaction to gluten which doesn’t proliferate an immune response.

Key takeaways

A recent study found that EVERYONE had intestinal permeability when eating gluten whereby undigested gluten damages the lining of the intestine. Thankfully, the cells inside our intestines regenerate every three-five days (the fastest growing cells in the body) meaning for some the damage can be repaired and gluten doesn’t pose a problem.

The prevalence of none-coeliac-gluten-sensitivity is estimated to be six-ten times higher than coeliac disease and for every one person that develops a digestive complaint following gluten there are eight who are affected elsewhere in the body, including the brain, thyroid and musculoskeletal system. However, like with most things, we all have our individual tipping points and may develop sensitivity to this protein at any time. We especially become vulnerable when we’ve been under any form of stress.  

The University of Chicago Coeliac Disease Centre identified over 200 conditions that are triggered by gluten; and these will differ from person to person.  If you’re curious to find out if gluten is an issue for you, eliminating ALL gluten from your diet for 30 days should see an improvement in symptoms, for those with true sensitivity, and improve general well-being.

If you’d like to take the guesswork out there are highly sensitive tests available, which I use in my own work, that aren’t available in general medical practice. The current tests examine a single gluten protein, when in reality wheat is made up of 100 different components that might pose a problem, meaning that people are falling through the cracks.

The real controversy

In clinical practice, for me, the real controversy is approaching the G-word. People just don’t want to give it up and will cherry pick dietary advice to suit their lifestyle. I get it. Food, especially wheat based products, is highly emotive. Undigested wheat interacts with opiate receptors in the brain, which releases dopamine – so it’s no wonder people don’t want to break up this relationship.  Fresh bread, buttery pastry, baked goods. 

I grew up in Cornwall and was never far away from a cream tea and a pasty. I LOVE them both in equal measure so I get it – I really do. But thankfully the gluten-free market is improving and there are some more than palatable alternatives out there (just be sure to scan the ingredients list as many are highly processed containing fillers and sugars).

If giving up the grain completely is a toughie, try replacing your normal loaf with more traditional grains such as spelt, einkorn, emmer or sprouted grains.  If you do have true gluten sensitivity these won’t be tolerated but may protect against the tipping point in those that don’t. 

Finally, give your digestive system some time out by enjoying a few wheat free days a week.  But be prepared to get savvy with scanning ingredient lists – the stuff is everywhere!