If someone doesn’t have Celiac Disease (CD) or a gluten sensitivity, are there other reasons to go gluten-free?
Although research suggests that CD and gluten sensitivity are underdiagnosed and underreported, there is no consensus in the medical community that gluten is harmful to the body. Yet, there are those who believe otherwise. The most frequently cited reasons for omitting gluten include:
- Because our ancestors didn’t have many grains in their diet, humans are not equipped to easily process grains. Some people claim that removing grains from their diet increases their energy, makes it easier to establish and maintain a healthy weight and improves mental function.
- Gluten has also been associated with inflammation in the body. Inflammation has been identified as an underlying cause of many degenerative diseases.
- Digestive issues like gas, bloating or irregular stools may sometimes be resolved simply by removing gluten, even without a diagnosis of gluten sensitivity or CD.
There are reports in medical literature of relationships between gluten and some autoimmune and neurological disorders.
- Authors Hadjivassiliou, Sanders, et al. states in an article in Lancet Neurology, “Gluten sensitivity is a systemic autoimmune disease with diverse manifestations. This disorder is characterized by abnormal immunological responsiveness to ingested gluten in genetically susceptible individuals. Celiac disease, or gluten-sensitive enteropathy, is only one aspect of a range of possible manifestations of gluten sensitivity”(6,3).
- Gluten has been linked to irritable bowel syndrome and acute pancreatitis, even when CD was ruled out (1, 15).
- A form of kidney disease called IgA nephropathy has been linked to gluten in over 1/3 of patients (12).
- Aphthous stomatitis, or recurrent canker sores, has been effectively treated by removing gluten when it was not responsive to other interventions (10).
- Autoimmune diseases like rheumatoid arthritis and Hashimoto’s thyroiditis are also closely linked to gluten consumption (19, 20, 21, 22, 23).
- We are now seeing that even common disorders like osteoporosis are connecting to gluten consumption (5).
The impact of gluten is not on the physical body alone. Researcher, R. Ford, writes, “The crucial point, however, is that gluten-sensitivity can also be associated with neurological symptoms in patients who do not have any mucosal gut damage (that is, without CD). Gluten can cause neurological harm through a combination of cross-reacting antibodies, immune complex disease and direct toxicity. (11) Neurological disorders like sensory ganglionopathy (a type of peripheral neuropathy), multiple sclerosis, and epilepsy can manifest from ingesting gluten, even without gastrointestinal symptoms (2, 3, 4, 7, 14, 16, 17, 18). Psychiatric issues such as schizophrenia, depression and developmental delays have also been linked to gluten consumption (8, 11, 13).
Whether a gluten-free diet is simply the latest fad or a recommended, healthy approach to eating remains to be determined. In the meantime, researchers will continue to study the effects of gluten on our health and the Gluten Freedom Project will provide tools, education and support to those who want to go gluten-free.
1) Am J Gastroenterol. 2011 Mar;106(3):508-14; quiz 515. Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial. Biesiekierski JR, Newnham ED, Irving PM, Barrett JS, Haines M, Doecke JD, Shepherd SJ, Muir JG, Gibson PR.
2) Neurology. 2010 Sep 14;75(11):1003-8. Sensory ganglionopathy due to gluten sensitivity. Hadjivassiliou M, Rao DG, Wharton SB, Sanders DS, Grünewald RA, Davies-Jones AG.
3) Lancet Neurol. 2010 Jul;9(7):653; author reply 654-5. Gluten sensitivity and the CNS: diagnosis and treatment. Versino M, Biagi F, Bianchi PI, Zardini E, Colnaghi S, Moglia A, Corazza GR, Franciotta D.
4) Acta Neurol Scand. 2011 Mar;123(3):175-80. doi: 10.1111/j.1600-0404.2010.01356.x. GAD antibody-associated neurological illness and its relationship to gluten sensitivity. Hadjivassiliou M, Aeschlimann D, Grünewald RA, Sanders DS, Sharrack B, Woodroofe N.
5) Orv Hetil. 2010 Mar 7;151(10):372-7. [Genetic and immunological processes in the pathomechanism of gluten-sensitive enteropathy and associated metabolic bone disorders]. Vereckei E, Poór G, Kiss E.
6) Lancet Neurol. 2010 Mar;9(3):318-30. Gluten sensitivity: from gut to brain.
Hadjivassiliou M, Sanders DS, Grünewald RA, Woodroofe N, Boscolo S, Aeschlimann D.
7) Ann N Y Acad Sci. 2009 Sep;1173:343-9. Gluten sensitivity in multiple sclerosis: experimental myth or clinical truth? Shor DB, Barzilai O, Ram M, Izhaky D, Porat-Katz BS, Chapman J, Blank M, Anaya JM, Shoenfeld Y.
8) Schizophr Res. 2010 May;118(1-3):248-55. Novel immune response to gluten in individuals with schizophrenia. Samaroo D, Dickerson F, Kasarda DD, Green PH, Briani C, Yolken RH, Alaedini A.
9) Clin Pract Epidemiol Ment Health. 2009 Jun 26;5:16. Gluten encephalopathy with psychiatric onset: case report. Poloni N, Vender S, Bolla E, Bortolaso P, Costantini C, Callegari C.
10) BMC Gastroenterol. 2009 Jun 17;9:44. Gluten sensitivity enteropathy in patients with recurrent aphthous stomatitis. Shakeri R, Zamani F, Sotoudehmanesh R, Amiri A, Mohamadnejad M, Davatchi F, Karakani AM, Malekzadeh R, Shahram F.
11) Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29. The gluten syndrome: a neurological disease. Ford RP.
12) Nephrol Dial Transplant. 2009 Aug;24(8):2476-81. Epub 2009 Mar 30. Gluten sensitivity in patients with IgA nephropathy. Smerud HK, Fellström B, Hällgren R, Osagie S, Venge P, Kristjánsson G.
13) Nutr Metab (Lond). 2009 Feb 26;6:10. Schizophrenia, gluten, and low-carbohydrate, ketogenic diets: a case report and review of the literature. Kraft BD, Westman EC.
14) J Neurol Neurosurg Psychiatry. 2009 Jun;80(6):626-30. Epub 2009 Feb 24. Hippocampal sclerosis in refractory temporal lobe epilepsy is associated with gluten sensitivity. Peltola M, Kaukinen K, Dastidar P, Haimila K, Partanen J, Haapala AM, Mäki M, Keränen T, Peltola J.
15) Rev Esp Enferm Dig. 2008 Dec;100(12):746-51. Relapsing acute pancreatitis associated with gluten enteropathy. Clinical, laboratory, and evolutive characteristics in thirty-four patients. Rodrigo L, Alvarez N, Riestra S, de Francisco R, González Bernardo O, García Isidro L, López Vázquez A, López Larrea C.
16) Ann Neurol. 2008 Sep;64(3):332-43. Autoantibodies in gluten ataxia recognize a novel neuronal transglutaminase. Hadjivassiliou M, Aeschlimann P, Strigun A, Sanders DS, Woodroofe N, Aeschlimann D.
17) Cerebellum. 2008;7(3):494-8. Gluten ataxia. Hadjivassiliou M, Sanders DS, Woodroofe N, Williamson C, Grünewald RA.
18) J Neurol Neurosurg Psychiatry. 2008 Sep;79(9):1084. Neuromyelitis optica in patients with gluten sensitivity associated with antibodies to aquaporin-4. Jarius S, Jacob S, Waters P, Jacob A, Littleton E, Vincent A.
19) Nutr Clin Pract. 2011 Jun;26(3):294-9. Gluten-free diet in nonceliac disease.
El-Chammas K, Danner E.
20) Eur J Intern Med. 2009 Dec;20(8):749-55. Epub 2009 Sep 19. Peptidylarginine deiminases and the pathogenesis of rheumatoid arthritis: a reflection of the involvement of transglutaminase in coeliac disease. Stenberg P, Roth B, Wollheim FA.
21) Hepatogastroenterology. 2003 Dec;50 Suppl 2:cclxxix-cclxxx. The presence of the antigliadin antibodies in autoimmune thyroid diseases. Akçay MN, Akçay G.
22) Horm Res. 1999;51(3):124-7. Prevalence of coeliac disease in patients with thyroid autoimmunity. Valentino R, Savastano S, Tommaselli AP, Dorato M, Scarpitta MT, Gigante M, Micillo M, Paparo F, Petrone E, Lombardi G, Troncone R.
23) Ital J Gastroenterol Hepatol. 1999 May;31(4):283-7. Prevalence and early diagnosis of coeliac disease in autoimmune thyroid disorders. Cuoco L, Certo M, Jorizzo RA, De Vitis I, Tursi A, Papa A, De Marinis L, Fedeli P, Fedeli G, Gasbarrini G.