If you’ve read beyond the pamphlets in your rheumatologist’s office, you know that gluten is an autoimmune “no-no”. You probably also know that you do not have to have Celiac Disease in order for gluten to cause an autoimmune response not only in your gut, but your brain, skin, thyroid, kidneys, joint, etc. Where the inflammation arises depends on your genetics.
That said, Autoimmune Moms, avoiding not only gluten, but foods that the immune system often mistakes for gluten–its cross-reactive counterparts like dairy, coffee and grains– is highly advisable. At the very least, it’s worth a try if you want to get a handle on your health. Remember that healing your gut simultaneously cannot be emphasized enough and is discussed elsewhere.
Gluten, gliadin and glutenin are proteins found in wheat, barley and rye, although many grains and even legumes not labeled “gluten-free” are likely to be cross-contaminated, such as oats, lentils and any grain or legume bought in bulk, versus a package clearly labeled “gluten-free”. Gluten proteins are proteolytic-resistant, meaning that they cannot be broken down by human digestive secretions like pepsin in the stomach and proteases or protein digesting enzymes secreted by the pancreas into the small intestine. Since these proteins cannot be broken down into amino acid building blocks and remain whole proteins, the immune system can recognize them as foreign invaders and launches an attack to break them up. Unfortunately, the attack harms our own tissues.
I won’t lie. Avoiding gluten, plus cross-reactive foods and any other foods that you are sensitive to can be a major challenge, initially. As time goes on, the task does get easier as we become more and more creative and proactive with our food choices. We also have to learn (often the hard way) to prioritize how we will feel after we eat, as opposed to how we will feel while we are eating, including physically, emotionally and socially. Our best efforts and intentions will most often protect us from exposure.
However, we live in the real world, where gluten is king, and its cross-reactive counterparts are respected members of the royal court. Unless we completely isolate ourselves, which does not exactly make for the most fulfilling life, the odds are fairly high that we will be “glutened” here and there. Being “glutened” refers to when we unknowingly eat gluten, typically when we allow someone else to be in charge of our meal. This can easily happen when eating out or at social gatherings. Cross-contamination commonly occurs when gluten-based flours and grains are being prepared in the same kitchen as “gluten-free” meals. So, what are we to do, if throwing caution to the wind and forever isolation are not viable options?
For starters, we can continue exerting our best efforts to avoid gluten and interrogating or rather, kindly educating, our friends, families and servers. This is fundamental. Secondarily, we do have some plausible options to ensure that if and when we do get “glutened”, we can lessen or even eliminate the inflammatory blow and setback to our systems, whether we are gluten-sensitive or have Celiac Disease.
I want to be very clear that the options discussed below are by no means an excuse to eat gluten or other foods that you are sensitive to.
There has been some research on certain digestive enzymes which can break down gluten and its cross-reactive counterparts. One study analyzed the effect of two enzymes used in combination– aspergillopepsin (ASP) from Aspergillus niger and dipeptidyl peptidase IV (DPP-IV) from Aspergillus oryzae. Only in combination were the two significantly effective at breaking down not only gluten, but casein (a milk protein) (source).
A later study, which was conducted on rats, demonstrated the in vivo (in the body) ability of the gluten-digesting protease EP-B2. The authors concluded that, “EP-B2 was remarkably effective at digesting gluten in the rat stomach in a dose- and time-dependent fashion” (source).
Another aspect of protecting your system from gluten exposure is ensuring a healthy GI tract by sealing up and preventing increased intestinal permeability, or leaky gut. Key to this is promoting the growth of beneficial gut microbes, which simultaneously help to digest gluten proteins. Eating probiotic-rich foods like kim chi and other fermented veggies is helpful in maintaining a thriving microbiome. Taking probiotics can be helpful as well.
Perhaps most important, however, is including prebiotics in your diet. Prebiotics are indigestible (by humans) fibers that serve as food for our friendly gut microbes. These can be found in foods like Jerusalem artichokes, asparagus, onion, leeks, dandelion root, cruciferous vegetables and more. Supplements can also be helpful, such as Fructo-Oligo-Saccharides (FOS) from inulin. There is a highly specialized proprietary prebiotic formulation called PreforPro; apparently it is much more effective than inulin at promoting the growth of friendly gut microbes. It can also be taken in smaller doses and does not cause flatulence like inulin can. PreforPro is so far, being used in two leading gluten digestive enzyme formulas on the market. These include Glutenza and Glutarrest.
According to the tech sheet for PreforPro from Deerland Enzymes, “PreforPro has been shown under both physiological conditions in-vitro and in-vivo to preferentially promote the growth of beneficial Lactobacillus, Bifidobacterium and Bacillus subtilis strains when competing with undesirable bacterial strains. The effects are achieved at small doses within hours, in both the small and large intestine.” If PreforPro is everything Deerland Enzymes and the makers of Glutenza and Glutarrest claim it to be, these products may be worth a try. Both products additionally contain enzymes specifically shown to break down gluten proteins before they reach the small intestine, in addition to the well-researched beneficial bacteria Saccharomyces Boulardii, Bacillus subtilis and Lactobacillus acidophilus.
In his book, Why Isn’t My Brain Working?, Dr. Datis Kharrazian (AKA: Dr. K) suggests taking flavonoids (colorful plant compounds)in supplement form to help reduce inflammation from gluten exposure. His top picks are lycopene, apigenin, quercetin and luteolin. He notes that Lycopene and quercetin have been shown to prevent immune activation from gluten; apigenin inhibits gut microflora from triggering inflammation; quercetin has been shown to work against intestinal histamine secretion in response to an antigen; luteolin prevents LPS-induced inflammation in the gut lining. LPS is a component of the Gram-negative bacterial cell wall, which causes an increased immune response in animals. Dr. K suggests starting with the lowest dosing and working up, adding that overdosing is not an issue, as these are not drugs. He warns against using these compounds and gluten-digesting enzymes as an excuse to eat gluten.
Taking a gluten-digesting enzyme complex such as Glutenza or Glutarrest when eating outside of your own kitchen may be a good insurance policy against accidental gluten exposure, or being “glutened”. Additionally, taking flavonoids to reduce the inflammatory response of being “glutened” may be helpful. The supplements discussed here do not pose any known risks, which makes trying them the next few times you’re out and about, an even more attractive option.
About the Author
Angie King-Nosseir MS, RD is an Integrative and Functional Registered Dietitian, with a passion for walking with people along their path toward health transformation. Angie has a Master’s degree in Nutrition, is a Certified LEAP Therapist, corporate wellness health coach, freelance nutrition and wellness writer, and certified yoga instructor. She is trained in Functional Nutrition and Medicine through the Institute for Functional Medicine and in Food as Medicine through the Center for Mind-Body Medicine.
This blog post was originally published by AutoimmuneMom.com, written by Angie King-Nosseir, and first published on Aug 3, 2015.