I'm starting a new series on what it means to be gluten free and/or adopt a paleo lifestyle. This is a huge undertaking and will definitely be a slow process. However, more than information and science-y stuff, I plan to create and share some real hands-on resources. I want to help those who are on board with making these dietary changes to get going with it in a simple, straight-forward, budget-friendly way. Being gluten free, and to a further extent paleo, can be daunting, overwhelming, restrictive and downright expensive. It's my goal to help people understand why being gluten free or paleo can help heal their bodies and then HOW to do it- like in a for-real, normal, day-to-day way. So stay tuned for information but also lots of printable and resources that have helped my family. Feel free to comment with questions so I know what you are looking for!
So, to get started, here's some basic information on gluten...Gluten is the protein found in a few grains: wheat, barley and rye. It's the stuff in bread that makes it smooshy and stretchy... and well, good. It gives wheat its elasticity and allows you to knead it and helps it to rise well. Now, if you want to get down to the knitty-gritty more than that, check out Wikipedia.
The most important things to learn are the symptoms of a gluten intolerance and all the different ways it can affect your body (or your child's), but let's first look at the difference between Celiac Disease and a gluten sensitivity/allergy/intolerance... this gets a little technical so bare with me!
As far as symptoms- many people who suffer from celiac disease (or sensitivity/allergy) go undiagnosed... approximately 1:150 have it and many have no idea. Celiac is generally diagnosed in childhood when a child has severe intestinal problems and failure to thrive. Therefore, it’s typically only diagnosed in people who show an incredibly severe, “classic” case with the following symptoms:
- Chronic diarrhea and/or constipation (or cycling between both)
- Chronic gas and belly distention
- Severely underweight with malnourishment issues (anemia is very prevalent)
- Pale- foul smelling floating or greasy stools or extremely hard stools
- Delayed puberty
However, some of the other symptoms can be your ONLY symptoms:
- Mild intestinal discomfort… likely so persistent it goes unnoticed
- Body and joint paint (can be severe)
- Infertility, miscarriage, pre-term labor
- Tingling & numbness in the legs
- Discolored or malformed teeth
- Sensitivity to temperatures (cold and hot)
- A persistent skin rash called dermatitis herpetiformis or just random unexplained body rashes
- Low bone density
- Fatigue, depression, anxiety, bi-polar, schizophrenia
- Presence of other autoimmune diseases (fibromyalgia, lupus, RA, etc) <--- HUGE FLAG
- Lactose intolerance
- Being under or overweight for no known reason
If you are suffering from many or just a few of these symptoms, it’s important that you request the CORRECT tests from your doctor. Many general practitioners are uninformed and will generally be very little help. They are used to the “classic” diagnosis in children- and that’s it. You will need to request the specific tests I’ve outline here to get a firm diagnosis (your doctor can order a "celiac panel" and it should include these). When it comes to celiac disease, you have to be informed and proactive… especially for your children. These blood tests are very inaccurate for children under 2 and sometime inaccurate for children under 4. The antiendomysial antibody may not be present at all in children under 2.
There are a few blood tests used in diagnosing celiac. These are the ones that are important and relatively conclusive. As I will get into in later posts, the antibody called IgE is trigged by an allergic response and doesn't play a role in celiac so much (it's what they look for in food ALLERGY testing). The antibodies triggered by celiac are called anti-gliadin IgA and IgG. IgA is more sensitive but less specific to celiac disease. Therefore, if these antibodies are present, there is a 97% chance of celiac disease- however, if they’re absent, there’s still a 71% chance the test could be wrong. IgG on the other hand is 91% sensitive and 87% specific. Therefore, these being present are a strong sign of celiac disease but aren’t as conclusive. However, the presence of both anti-gliadin IgA and IgG make for a strong case of celiac disease.
The final blood test is 99.8% specific and conclusive to celiac disease… this is called antiendomysial antibodies. These antibodies are not measured quantitatively like IgA and IgG… they are measured as either present or absent (positive or negative). A positive presence of these antibodies gives you an assurance of slightly less than 100% that you have celiac disease.
The “golden standard” for diagnosis are these positive tests, plus a positive biopsy and a positive reaction to the removal of gluten from the diet for 6 months. I’m not a big proponent of the biopsy since the blood tests have proven so accurate.
Now, you can also order a saliva or stool test online... simply check out www.directlabs.com which does not require a doctor's orders.
Even though I mention Celiac a lot, please be aware that if your tests come back negative for celiac, and you still believe gluten could be an issue for you, please try an elimination diet. You simply do not eat gluten for 2-3 weeks, then try eating a roll and see how it goes. It's best to keep a food journal during this time.
MOST people with an allergy or sensitivity to gluten will have a reaction to the gluten within 24 hours. HOWEVER, you can have latent symptoms that slowly develop over time. If you have persistent health problems and suspect gluten, I highly recommend going gluten free for 3 months, then adding it back in, keeping a journal the whole time- watching for a slow recession of symptoms and then their slow return. Sometimes these can be so gradual, it's hard to realize that gluten was indeed the trigger. These symptoms can be just as severe in people without Celiac as those with it, so the diagnosis is really a moot point. The important thing is how you feel while gluten free.
Also be aware that many people with celiac or gluten allergy have multiple food sensitivities. This is actually more common than not. So it can be significantly more helpful to do a FULL elimination diet in order to search for your "trigger foods". I'll be discussing other trigger foods, full elimination diets, and how to do this in a later post.
Lastly, if you have been diagnosed with another autoimmune disease, it's IMPERATIVE that you look into a gluten free diet. There are countless, countless, countless people who can tesify that they had little relief from their Chron's or RA until they were fully gluten free. Many autoimmune diseases go hand in hand, so this should be no surprise. As a matter of fact, as research digs more and more into gluten, researchers are realizing that the singular factor that is pervasive among ALL autoimmune diseases is GLUTEN.
So, those are the "Gluten 101" basics. There's still a ton of information to come. We will be discussing the following:
- ther food allergies and sensitivities and a full elimination diet
- Autoimmunity (in general) and the role of gluten and other grains
- How "cheating" can cause a lot more pain than it's worth
- GAPs, Paleo, SCD and making sense of it all
- My favorite cookbooks, book-books, and websites for all things GF/Paleo
- How our children are being impacted by our diets (learning disabilities and so forth)
- What CAN I eat?
- What CAN'T I eat?
- How to begin the slow transition to GF
- Stepping it up a notch to grain-free (and why)
- Our microflora and how it makes all the difference
- What products to buy and where
- A manageable paleo budget (for your whole family)
- Suggestions for dinners, easy lunches and where can I eat out?
- Having lots and lots of grace for yourself through it all: Big Picture