Dr. Tom O’Bryan presents on gluten sensitivity

Dr. Tom O’Bryan presents on gluten sensitivity

Dr. Tom O’Bryan presented to a full house on his recent visit to our support group, Gluten Intolerance Group of East Bay. As usual his presentation was captivating and full to the brim with great information. I’ve made an attempt to recap the main points of his presentation. I take full responsibility for repeating any facts incorrectly. My notes are sometimes hard to interpret. Continue on and learn more about, “The Conundrum of Gluten Sensitivity…Treatment of an Elusive Immune Reaction.”

classroom

Point One: Current standard testing for both celiac disease (CD) and non-celiac gluten sensitivity (NCGS) is not thorough enough.

According to a study by Digestive Disease and Science (Vol.49. No.4), “Negative blood tests in CD occur. Antibody positivity correlates with more severe villous atrophy, and not mode of presentation.” Bottom-line, you can have CD and still test negative. In a commentary by Digestive and Liver Disease, it was stated that, “Recent literature data showed that serology (not only EMA, but also anti-tTG) seems to be ineffective in detecting most of patients affected by subclinical/silent (celiac) disease.” Many people desperately seek the CD diagnosis hoping to understand what is happening in their body only to receive negative test results. One of the possible issues Dr. Tom brought up is the fact that gluten is comprised of over 100 protein peptides. According to Gastroenterology 2002 (122:1729-1737), “Although some patients respond to one set of peptides, other respond to different sets of peptides.” The report goes on to say, “Our present results indicate that CD patients are capable of responding to a large array of gluten peptides.” The current standard CD test panel measures a response to gliadin, only one of the many peptides in gluten. This may be one reason, a patient may test negative to the CD panel which is typically transglutaminase antibody – iTG – IgA and IgG and total serum IgA. Dr. Tom pointed out that there are labs that can measure a patient’s response to 10 other peptides of gluten increasing the chance of a more accurate test result measuring gluten sensitivity. Cyrex Labs offers this test panel. I’d like to note that a positive test result for the transglutaminase antibody or a gluten sensitivity panel does not warrant a CD diagnosis. The verification of damaged villi through an endoscopy examine is what warrants the official diagnosis.

NCGS is gaining more attention within the medical community. It is defined by the National Foundation of Celiac Awareness as, “those individuals who cannot tolerate gluten and experience symptoms similar to those with celiac but yet who lack the same antibodies and intestinal damage as seen in celiac disease.” NCGS involves a different type of immune response to gluten. The immune system attacks the gluten protein molecule as if it were an invader and responds with inflammation both inside and outside the digestive system. It is clear that a patient can test negative for CD and also not carry the genes common to those with a CD diagnosis, HLA DQ2 and HLA DQ8, but still be sensitive to gluten suffering with a wide variety of health issues caused by the sensitivity.

Dr TomPoint Two: Celiac disease is just one manifestation of gluten sensitivity.

Over 100 diseases and 300 symptoms have been associated with gluten sensitivity including arthritis, Hashimoto’s disease, certain types of diabetes, lupus, multiple sclerosis as well as neurological disorders such as autism, depression, anxiety, migraines and even schizophrenia (just to name a few). CD, according to Dr. Tom, is just the tip of the iceberg. According to the Journal of American Medical Association, “Cardiovascular disease was the most common cause of death in celiac disease, followed by malignancy.” Dr. Tom went on to point out that when we first began to research the body’s response to gluten, we went downward into the intestine and decided it was a “gastrointestinal disease.” He said that if we had turned around and went upward into the brain, we would have discovered that it is a  disease that affects the brain. The Journal of Neurol Neurosurg Psychiatry (2002;72:560-563) indicates, “That gluten sensitivity is regarded as principally a disease of the small bowel is a historical misconception.” In research reported by the American Journal of Medicine (March 1, 2004, 312-7), “Of the 15 untreated celiac patients, 11 (73%) had at least one hypoperfused brain region…while only 1 of 15 (7%) celiac patients on a gluten-free diet had hypoperfusion.” In the same report it states that, “High levels of anxiety were common in the untreated celiac patients 11/15 (73%)…Depression was more common in untreated celiac patients 10/15 (76%).” Gluten can affect our brain! I am sure of this as I was alleviated of both depression and anxiety by eliminating gluten. My son, Sammy, is recovered from autism primarily through diet intervention. Gluten can literally “dim” brain function.

Point Three: Many symptoms or conditions can be linked to CD and NCGS.

According to a study by Pediatrics publication (Pediatrics 2009; 124;1572-1578) the current North American guidelines recommend testing for celiac disease in a wide variety of ailments, including gastrointestinal symptoms, chronic fatigue, short stature, delayed puberty, dental enamel defects, elevated liver transaminase levels, dermatitis herpetiformis and nutritional anemia. Dr. Tom pointed out that even a large forehead can be an indicator of gluten sensitivity. According to an Italian study titled, Large forehead: a novel sign of undiagnosed coeliac disease,  the face divided into 3 equal areas: bottom of chin to under the nose, under the nose to the glabella (spot between the eyes), and glabella to the hairline, should all be equal size.  When individuals have a larger forehead size, their chances of gluten intolerance, and/or celiac disease increase (see photo below).

face_measure

The forehead on the left is larger indicating possible gluten sensitivity

Point Four: A tiny bit of gluten is too much.

Dr. Tom pointed out that many people with gluten sensitivity  (including those with a CD diagnosis) think that they can “cheat” every once in awhile and be okay. He explained that even a small, seemly insignificant, amount of gluten (1/50th of a communion wafer) can set off a cascade type immune response in the body that “takes on a life of its own.” The only way to heal the gut and then the body is to be “gluten zero.” The Lancet (vol 358, August 4, 2001) reported that, “Death was most significantly affected by diagnostic delay, pattern of presentation, and adherence to the GFD (gluten-free diet)…Non-adherence to the GFD, defined as eating gluten once-per month, increased the relative risk of death 6-fold.” A “little bit” of gluten has proven to be way too much.

The Internal Medicine Journal reports that a “strict gluten-free diet is mandatory for CD, but it frequently does not lead to normalization of (the damage to the intestines).” In a research study by Aliment Pharmacol Ther, “After at least two years on a GFD, Intestinal damage was completely corrected in only 43.6%.” Why? Dr. Tom indicates the following:

– Continuing tissue damage (intestinal permeability AKA leaky gut)

– Continued nutrient insufficiencies

– Poorly Developed skill sets for adapting, integrating and embracing a GF lifestyle (on-going inflammatory damage).

In my opinion, this is why the newly diagnosed need a gluten-free lifestyle coach…call me now! 🙂

Point Five: Heal the gut, heal the gut, heal the gut!

I thought for a moment we would have to break out the disco ball lights as Dr. Tom started his “heal the gut” dance (LOL). At least people will remember to HEAL THE GUT! Dr. Tom remarked that when a person first goes gluten-free, they very often are not thorough enough in removing gluten from their diet and end up being “glutened” without realizing it. In addition, many who go gluten-free fail to focus on truly rejuvenating the gut with a nutrient dense diet and vitamin/supplementation program to help optimize healing. As an added side benefit, healing the gut and stopping intestinal permeability can help alleviate other food sensitivities thereby eventually expanding your food choices (imagine that). Just one more reason to heal the gut, heal the gut…HEAL THE GUT!

kimDr. Tom will visit Draeger’s Market in San Mateo, California, this October. Keep posted on various GF events by “liking” my Facebook page, Thriving GF. Be sure to experience this amazing speaker and witness the famous “Heal the Gut” dance. Email me if you would like a copy of Dr. Tom’s presentation at kim@thrivinggf.com.

8 Comments

  1. I’d like to know when in Chicago or Arizona Dr. Tom O’Bryan will have gluten presentation ?

  2. I would love to know for sure if I am gluten sensitive or not. Every night I get gassy and girgly in my gut. But I really dont eat gluten in the evening. If I have bread it is early in the day and I dont seem affected by it right after.

    • Hi Hailey
      Is there something in the evening that you are eating that could be causing the distress?
      Kim

      • I really am unsure. For example I am feeling it right now and the last food I had was a salad with romaine, cucumber, tomato carrots, chia and pumpkin seeds and homade ranch. ( could be the ranch but I have that on other days and I dont get bothered. Then I had cooked butternut and zucchini with a little grass fed organic butter, ( again I have this often and I dont think it is the problem but what do I know.) Them some chocolate almond milk.

  3. Dairy is very often a culprit for digestive disturbance. Sometimes it can be a combination of foods together where eaten separately, they cause no problems.

    Is the chocolate almond milk from the store? Sometimes additives like carrageenan can be upsetting as well.

    • SILK dark chocolate almond, non gmo no carrageenan, but usually I only feel like this after pizza, or other heavy gluten products with dairy. I have not had that forever so I wonder if I am getting a new intolerance.

  4. yes, it’s possible. I developed a sensitivity to pea protein. I had been consuming it for years and then noticed some new symptoms pop up. Eventually it got so bad I ended up at the MD’s. They called it IBS and wanted to medicate me. Everyone kept saying it was my nerves too. Meanwhile, I kept thinking about what food I had been consuming pretty regularly since the beginning of the symptoms. That’s when I isolated the pea protein. I took it out (switched to Hemp protein) and all the symptoms are gone. Try taking dairy and the almond milk out for 2-3 weeks and see what happens.

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