Gluten Illness: Which Type Have You Got?

Saw an article here today that reminded me how confusing gluten illness is for people. Most people only consider coeliac disease, but it is much more complex than that, as my TrulyGlutenFree intro page here explains.

Types of Gluten Disease

Are you just not digesting gluten down properly?

Are you IgE allergic to gluten or wheat?

Have you got coeliac disease ie. have you got a DQ2 or DQ8 gene, an IgG antibody for gliadin 33 mer and/or transglutaminase 2 antibodies?

What about the more common non-coeliac gluten sensitivity, which is linked to things like chronic fatigue, IBS, migraine, infertility, thyroid problems and autoimmune disorders (plus tons of others, see here)? That’s any gluten gene, especially DQ1 and DQ3, an IgG antibody on any gluten peptide (not just 33 mer) and/or transglutaminase antibodies on 3 or 6, not just 2.

Treating Gluten Disease

Treatment depends on the type you have. Most do include a gluten free diet, but it is more complex than that.

For example, if you’re not digesting it down well and that’s causing your IBS symptoms, special enzyme products like this can help and you may then not need to be a gluten-avoider at all.

If you are classically allergic to it with an IgE acute response, you have to avoid it obviously. But, as this article mentions, people do grow out of it. That may be because you are producing a lot of IgG4, which blocks the IgE response. This is the reason for the ‘growing out of it’ phenomenon. The Allergy P88 test checks for IgG4 levels. (See my video on it here too).

If you are coeliac, you need to know about it. Testing is woefully unreliable, especially in men. Mainstream medicine only tests for one gluten peptide (gliadin 33mer) and one transglutaminase for damage (tTg2). When, in actual fact, I regularly find people don’t come up positive with those, but do come up on other gluten peptides and other transglutaminases. As the article states, an undiagnosed coeliac has a 400% higher risk of mortality! It’s crucial to get this right! Check the gluten testing factsheet here.

Coeliac testing may come up negative, but you can still have NCGS (non-coeliac gluten sensitivity). This is every bit as severe as coeliac disease for some people and is often much more difficult to deal with because it is insidious and difficult to test for.

Both coeliac disease and NCGS are serious. Both can affect anywhere in the body and can trigger autoimmune conditions. It’s just that we acknowledge the gluten and villi autoimmunity in coeliac disease, and the gliadin 33mer that has been linked to it. Gluten is the number one common denominator in ALL autoimmune disease so it should always be looked at.

Both can cause symptoms anywhere – certainly not just the gut. In fact, some experts believe CD would never be classified as a gut disease if it were found nowadays; more likely a neurological disorder since anxiety, depression, brain fog and migraines are common. I think it would be a systemic disorder as it can literally affect anywhere and any thing.

NCGS can cause malasorption problems, just in a different way to coeliac disease.

So, generally, I don’t distinguish that much nowadays between whether a person is coeliac or NCGS. If they show a gluten immunological response, they have a gluten illness. The name doesn’t matter that much. Both require a gluten free diet and, as the article states, that should include gluten in meds, supplements and toiletries as well as not inhaling it.

You’d think that would be enough. But the reason I set up TrulyGlutenFree in 2009 was partly because I realised that many gluten-sensitives (of all kinds) were not being diagnosed and also because the gluten free diet simply is not enough for many to heal or even well.

Many foods are proven to cross-react with gluten in the body. The immune system confuses these other foods that look protein-structurally-similar to gluten and will react in just the same way as if you had eaten the gluten. That is a real biggie to know about. Cyrex labs were the first to do the research and specialise in this. It’s most grains and dairy. 50% of gluten-sensitives are cross-reactive to dairy, so I always remove gluten and dairy anyway if I can.

You can see more about cross-reactive foods here. To test them, you can do a Cyrex 4 or the P88 Allergy test. (I think the P88 misses millet, so do the Cyrex 4 if you eat that or plan to).

You’re unlikely in the more serious gluten illnesses to be able to have it again. It’s avoidance for life, I’m afraid, plus avoidance of any cross-reactive ones you are showing immunological problems with on testing. I call that the gluten healing diet.

If you are not digesting it enough, the enzymes should solve that for you and you eat much less of it!

If you are IgE allergic to it, you must avoid, but hope you grow out of it! People do, which is not widely acknowledged.

There you go: a quick gluten illness rundown. I hope it helps. Do read the full TGF section here (several pages in the menu) and see the Gluten Plan here, where you’ll find other TGF resources, recipe books etc.

Hope that helps clear some of the confusion around gluten for you!

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