What’s the deal with GLUTEN?

Wheat seems to be the most “irritating” of the gluten-containing grains, and some folks are only wheat sensitive, without having the full-blown problem of gluten intolerance.  Total gluten sensitivity (celiac disease, or celiac “sprue”) has many faces, and the most well-known are various forms of gastro-intestinal distress:  usually diarrhea, but occasionally constipation, oral or gastric ulcers, a shiny raw-feeling tongue (glossitis), nausea after eating, and even vomiting.  General symptoms can includes “malaise” which mean feeling unwell, also weakness, unexplained weight loss, failure to grow (in children) and blunting of the fingertips (clubbing).  The skin can become itchy, or develop lots of tiny capillary breaks, and herpes-like blisters may occur, often in the mouth.

Vitamin deficiencies are common with celiac disease: especially the B vitamins (lack of which cause an easy stress response, and tingling, then numbing of the extremities), and also the fat-soluble vitamins A, D, E and K can be in short supply.  Bone density can be reduced because celiac disease causes calcium malabsorption.  What is going on in true celiac disease is that part of the gluten molecule (gliadin) destroys the absorptive surface of the small intestine, normally covered in a lush “brush border.”  These myriad tiny finger-like projections, like millions of tiny sea-anemones, become abraded and flattened, thus greatly reducing the surface area for nutrient absorption.

This is reversible — the body is, in general, naturally self-healing — once the offending substances are removed.  However, untreated, celiac can lead to osteoporosis, profound anemia and seizures.  Celiac disease is particularly prominent among those with Irish heritage.  It is estimated that 3-6% of the Irish population is afflicted with celiac.  Celiac is also more common in families with thyroid disorders and mental illness, particularly schizophrenia.  Although 40% of the US population are thought to carry the celiac HLA DQ2 or DQ8 genes, only 1% ever has a triggering event that leads to activation of these genes and the development of celiac.

There is a new finger-prick test to screen for celiac which is available in most medical offices.  However, the gold standard to confirm the diagnosis remains small intestine biopsy if the blood test is positive for the tTg and antigliaden IgA markers.  Since the treatment is complete avoidance of gluten, it seems reasonable to me that trying a gluten-free diet for 3-6 months is just as good a confirmatory as a biopsy.

It can be tricky, however, to completely avoid gluten.  Wheat, spelt, kamut, triticale, barley, millet, amaranth and rye contain gluten. Other words meaning “wheat” are cous-cous, semolina and durum.  Oats don’t contain gluten, but are often contaminated with gluten in the fields or silos.  There are sources of gluten-free oats.  Trace contamination can cause symptoms to come roaring back in sensitive patients.  In families where some folks can eat gluten and others must avoid it completely, it may be impossible to share kitchen utensils.  For example, two separate colanders are essential — one for gluten-containing pasta and another for rice pasta.  Also, the silverware drawer can become contaminated with tiny specks of gluten, which can trigger a reaction in the celiac patients.

Luckily, most folks do not have celiac disease.  However, wheat sensitivity is extremely common.  Anyone who is fully or half (from one parent only) bloodtype O, or is a non-celiac member of a family with a celiac patient, is advised to consider 12 weeks strictly off wheat, if their health has room for improvement.  Please remember that mental health is equal in importance to physical health.  Wheat sensitivity will often manifest as grumpiness, or desire for binge eating, or mania, or moody PMS.  While avoiding wheat, and certainly all gluten-containing grains, can seem impossible at first glance, there are many foods, and many world-wide cultures, who are not dependent on cheap processed flour.

In fact, once you delve into the world of non-processed food, and begin to regularly enjoy luscious, organic fruits and vegetables as the staples of your diet, all those cookies and crackers and cheese spreads become quickly unappealing.  Check it out!  You might as well live this life as radiantly healthy as possible!

Best book for celiac/gluten intolerance:
“Living Gluten Free for Dummies” by Danna Korn — helpful, user friendly, very funny

Gluten-free food and cooking supply sources:
Pamelas (415) 952-4546
Miss Roben’s (800) 891-0083
Gluten-Free Pantry (800) 291-8386
Ener-G-Foods Inc (800) 331-5222
Sylvan Border Farm (800) 297-5399
Celiac Disease Foundation (818) 990-2354
Van’s International Foods (waffles) (310) 320-8611
Authentic Foods (800) 797-5090
The Great Valley Mills (800) 688-6455

foods unexpectedly containing wheat:
Grape Nuts
Bouillon cubes
lunch meats
cooked sausages (weiners, bologna, hot dogs)
most gravies
candy bars
ice cream (thickenings)
many thickening agents (use kudzu or guar gum)
any alcoholic drink made with grain: beer, gin, non-potato vodka, whiskey
malted milk
many chocolate drinks
synthetic pepper
some yeasts

More resources:
One brand of yeast that DOES NOT contain any gluten is Red Star Active Dry Yeast               (800) 423-5422.
To make a delicious gluten-free sourdough bread, you need to make a good “starter.”  Rice flour has the ability to ferment easily, creating a wonderful base for delicious breads with a slightly sour flavor.  Once made, the sourdough starter can be used over and over again.  Replenish it each time it is used to nourish the yeast and keep the starter alive.  As the starter gets older, the flavor will become tangier.  Therefore, baked products made with “aged” starters will have more sourdough flavor.  The starter serves as the leavening, so no additional yeast is needed.  To make a starter: in a 4-cup glass or stainless steel container, combine 1 cup water (110-115 degrees F) with 1 package (2 1/4 teaspoons) of Red Star Active Dry Yeast and 1 1/2 cups of white rice flour.  The mixture will be thick.  Cover loosely with plastic wrap or foil.  Let stand in a warm place for 1 to 3 days, stirring 2 or 3 times each day.  The starter will “rise and fall” during the fermentation period; it becomes thinner as it stands.  When the starter is developed, it is bubbly and may have a liquid layer on top.  Stir this liquid into the whole starter before using.  The starter can then be used for baking, or placed in the refrigerator to use later.