Why Is Your Doctor Missing Your Non-Celiac Gluten Sensitivity?
DECEMBER 22, 2016 by DR. HEATHER MODAY, MD
Have you gone to your doctor with digestive or other symptoms, only to be given a prescription for drugs and no answers?
If you’re one of the many people who think they may have a gluten sensitivity but are simply told that “your celiac testing was negative” –read on.
Non-Celiac Gluten Sensitivity (NCWS) – Symptoms & Incidence
Celiac disease is a relatively rare autoimmune disease that causes severe inflammation in the small intestine secondary to gluten which is found in all wheat, barley and other grains. This inflammation causes severe damage to the surface of the small intestine resulting in malabsorption of fats, vitamins, and minerals leading to fatigue, skin rashes, osteoporosis and other health problems. There is a strong genetic component and there are several blood tests that will diagnose bona fide Celiac disease. However, even these are sometimes negative and an intestinal biopsy is required for diagnosis.
However, many people have non-celiac wheat sensitivity (NCWS). These people do not have the characteristic antibodies you see in celiac disease and their biopsies may be negative for celiac changes. Nevertheless, ingestion of wheat can cause a range of symptoms. A study done at the University of Maryland in 2010 found the most common symptoms of NCGS “included abdominal pain (68%); eczema and/or rash (40%); headache (35%); ‘foggy mind’ (34%); fatigue (33%); diarrhea (33%); depression (22%); anemia (20%); numbness in the legs, arms or fingers 20%; and joint pain (11%).
Unfortunately, most doctors will tell you that you do not have gluten sensitivity despite severe symptoms that may occur after you eat wheat. That is because they rely on the testing available through standard commercial labs for celiac disease or wheat allergy (a IgE mediated allergic reaction). Of course you will have normal labs – you don’t have celiac disease!
There is growing data that shows many more people have varying degrees of gluten sensitivity that is unfortunately not being picked up and therefore leaving many people suffering needlessly. We have known about NCGS since the 1980‘s, but there is a resurgence in the interest surrounding the problems of wheat sensitivity. It is estimated that a far higher number of people have NCGS than have celiac disease, and often their symptoms are silent, or they are ignored as being due to other health problems.
Giladin, Leaky Gut, and Autoimmune Disease
What we know is that people with NCGS may react to a myriad of proteins found in the gluten molecule as well as to related proteins such as those found in other grains and dairy products. This occurs because gliadin (a component of gluten) causes intestinal permeability or leaky gut, by increasing the levels of a substance in the intestine called “zonulin”.
Zonulin literally dissolves the glue keeping our tightly bound intestinal cells together. Once the gut is leaky, other large molecules including partial digested proteins, bacteria and viruses can pass easily across the intestinal wall. This causes a systemic inflammation as these bacteria and foreign proteins activate our gut immune system. Many researchers now postulate that the beginnings of autoimmune disease start in the gut with intestinal permeability, often triggered by gluten.
So, how do you know if you have NCGS? In our next installment of this blog, I will discuss some state-of-the-art testing available to identify NCGS as well as how to do a proper elimination of gluten.