Gluten is a protein composite present in the endosperm (starchy) component of the cereal grains of the triticeae family of grains (barley, bulgur wheat, durum, einkorn, farro, graham, kamut, rye, semolina, spelt and triticale).  Gluten is composed of a prolamin and a glutelin.  The gluten among grains differs in the prolamin they contain:  wheat’s prolamin is gliadin, barley’s prolamin is hordein, rye’s prolamin is secalin. 

Prior to the invention of large-scale industrial milling of wheat, the whole-wheat seed was freshly ground into flours or other cooking forms for immediate human consumption.  The full fiber, vitamin, antioxidant and nutritional profile attributable to whole wheat were routinely available with all products. Commercially milled wheat was stripped of the bran and germ (fiber and nutrients) leaving the endosperm (starch and gluten) component to produce white flour. In the 1960’s, semi-dwarf, high-yield, disease resistant wheat hybrids were developed in response to famine and significant underproduction of food in highly populated, underdeveloped countries. The success of these wheat hybrids led to their full commercialization in developed countries like the United States of America. The reality of these wheat hybrids, however, is that they are significantly higher in gluten than traditional/ancestral species.

Celiac disease is an autoimmune disorder in which patients with this disease who eat gluten-containing grains have an immune response that severely damages cells in their small intestine. Manifestations of celiac disease are far-ranging and yet, can be subtle.  Diarrhea and weight loss are the predominant symptoms. Heartburn, constipation, osteoporosis, anemia, bloating, neurologic symptoms (including ADHD), headaches, fatigue, joint pain and skin rash are also common symptoms. Patients may also have very few symptoms and not feel “ill” at all. Celiac disease is diagnosed by blood testing for specific antibodies or biopsies of intestinal tissue. Celiac disease is not very common.  Those with celiac disease must avoid all of the gluten-containing grains. The majority of people with gluten-sensitivity do not have celiac disease.

Living gluten-free is a burgeoning food trend sparked by evidence of the detrimental health effects of modern commercial wheat. Manifestations of gluten intolerance are varied. Patients may find that they have significant heartburn, they may show signs of malabsorption, and/or they may be diagnosed with irritable bowel syndrome. Patients may have unexplained asthma and wheezing, attention deficit disorder (children and adults), unexplained fatigue, mental fogginess, chronic bloating and constipation or diarrhea. Joint aches, worsening autoimmune disease, headaches, chronic sinusitis and any other manifestation of general activation of the immune system are potentially due to food sensitivities.

Testing for food sensitivities, especially gluten, can occur through multiple mechanisms.  IgG antibodies in the blood to wheat, IgA antibodies in the gut/stool to gliadin, leukocyte sensitivity to wheat can all provide objective evidence of gluten sensitivity.  These tests can be controversial due to reported inconsistency of results and all are expensive. The gold standard for testing is the elimination diet. Eliminating all grains from the diet for 30 days and assessing for improvement in symptoms is the least expensive and most effective test. If there is marked improvement after 30 days, individual food items can be reintroduced slowly to isolate exactly which items are causing reactions. The items that are not tolerated should be eliminated from the diet for 6 months to 1 year before attempts to reintroduce them resume.

HerCare of Brevard with Dr. Donna G. Ivery uses three tests in their food sensitivity assessment: ALCAT (food sensitivity testing through a blood/leukocyte sensitivity test), Blood testing as part of Triad Bloodspot profile (Metametrix), and Stool testing as part of a GI function profile (Metametrix). The practice also offers a wide range of services in women's health, bioidentical hormones and functional medicine.  Dr. Ivery is a Diplomat of the American Board of Obstetrics and Gynecology and a Diplomat of the American Board of Integrative Holistic Medicine.  321-267-3787 HerCareofBrevard.com. Register on their patient portal for an appointment today