Sub-clinical gluten intolerance and its negative effect on the digestive system
Good health requires proper digestion and absorption. Digestion is the mechanical and chemical breakdown of the food we eat. As food is digested, it needs to be absorbed.
Absorption is the process of bringing the nutrients from our gastrointestinal tract into the rest of our body’s tissue. Digestion is initiated when we chew food and begin to break it down with digestive enzymes. Food then enters the stomach where further breakdown occurs from the presence of stomach acid, called hydrochloric acid, and pepsin, which together begin the breakdown of proteins. From the stomach the products of digestion enter the small intestine. The small intestine is called “small” because it is smaller in diameter than the large intestine. However, it is in fact longer and in many ways more crucial to our health than the large intestine. The lining of the small intestine consists of villi, fingerlike projections that stick out from the wall of the intestine into the lumen or center. These villi are between 1/2 and 1 1/2 mm long, just barely visible to the human eye. On the ends of the villi are microvilli, sometimes referred to as the brush border. These two adaptations, villi and microvilli, increase the surface absorption area of the small intestine up to 1,000-fold. It’s estimated that the entire absorptive area of the small intestine is roughly the size of a basketball court.
This total area for absorption can be compromised by any condition that irritates the lining of the small intestine. In gluten intolerance, there is a destruction of the villi referred to as villus atrophy. This, leading to poor digestive function affects many vital structures on the intestinal wall. This poor intestinal function caused by improper digestion of food is referred to as maldigestion or literally “bad digestion.” Inadequate absorption of nutrients is referred to as malabsorption. In other words — the inability to get the vital nutrients your body needs delivered to your cells.
Inflammation and maldigestion negatively impacts the hormonal and immune system
One system significantly impacted by maldigestion and malabsorption in the small intestine is the hormonal/immune system.
Sub-clinical gluten intolerance creates a significant stress on the immune system and can lead to a compromised immune system. The mechanism of action occurs in several different ways. There are specialised immune cells that line the small intestine called immunocytes. These immune cells produce secretory IgA, a critical component of the thin, healthy mucous that makes up your first line of immune defence. The inflammatory response produced in individuals who are sensitive destroys a certain percentage of these cells, and this in turn can lower your immune defence thereby opening the door to intestinal infections. Therefore, parasites, bacteria, viruses, and yeast or fungal organisms can more easily infect someone who is gluten intolerant and suffering from a weakened first line immune defence.
This lowered immune defence is commonly referred to as depressed secretory IgA, which also can result in many other food reactions. This is because secretory IgA also helps the body handle food antigens. Food antigens can create significant health problems. An antigen is a marker that is recognised by our immune system as OK or not OK. Antigens mark substances as foreign to the human body. The recognition of what is an OK antigen and what is not an OK antigen allows our immune system to attack and destroy harmful substances.
For example, when you have a viral infection like the common cold, the viruses that infect us have antigen markers on their outer surfaces and our immune system recognises these antigens and then makes antibodies to destroy the virus. Food is also foreign to the body and so has antigens. Typically we don’t react to food antigens. However, in some people, food reactions do occur because of an inappropriate response of the immune system to antigens in food. Other people may be sensitive to pollen antigens or mold antigens and so have reactions to these substances.
The overall weakening or depression of our first line immune defence called SIgA makes us more susceptible to antigens of all sorts. This can make a person highly reactive to food antigens who might not otherwise have this problem. This is another link between gastrointestinal stress and the immune system. Another avenue through which sub-clinical gluten intolerance affects the immune system is through the inflammatory response. Many people have heard of corticosteroid medications such as prednisone or cortisone. They are used for a wide variety of medical purposes.
Dysregulation of immune system function: a state of quasi-permanent inflammation
Another avenue through which sub-clinical gluten intolerance affects the immune system is through the inflammatory response. Many people have heard of corticosteroid medications such as prednisone or cortisone. They are used for a wide variety of medical purposes. Corticosteroid injections are used for joint and muscle injuries to reduce pain. Corticosteroid sprays and inhalers are used by people who suffer from asthma and allergies to improve function of the airways.
Since cortisol is also one of the major modulators of immune function, this suppresses our immune response. As a matter of interest, this immune suppressing role of corticosteroids is used in medicine in certain circumstances when immune suppression is the goal. With organ transplants and in some serious autoimmune diseases, large doses of corticosteroids are used therapeutically to suppress immune function. However, in other situations this immune suppressing role of cortisol and corticosteroid medications works against our health.
Immune dysregulation leads to high cortisol, catabolism & adrenal exhaustion
When cortisol production becomes abnormal, our entire hormonal/immune system is affected. While elevated cortisol suppresses our immune response, it also causes a catabolic (or breakdown) state to exist in our body. Symptoms of adrenal exhaustion will eventually appear such as fatigue, depression, loss of libido, allergies and frequent illness.
Chronic inflammation and leaky gut
In a state of good health, the small intestine has healthy mucosal lining. Mucosal tissues also line the sinus passageways, the lungs, the urogenital tract, the mouth, throat, and vaginal tract. These lining tissues act as vital barriers to defend the body from infectious organisms.
Under chronic inflammatory stress, this healthy mucosal tissue breaks down and a condition called increased permeability (also known as leaky gut syndrome) occurs. Leaky gut syndrome refers to the loss of integrity of this mucosal or lining tissue that becomes overly permeable and molecules that were not intended to cross into your blood stream enter, or leak in. This leads to a great deal of immune stress as your body tries to handle all these uninvited guests.
Sub-clinical gluten intolerance and multiple delayed food allergies
Sub-clinical gluten intolerance often leads to the development of multiple delayed food allergies. Leaky gut syndrome and the accompanying premature leaking of food antigens into the bloodstream cause this.
In time, this overexposure to food antigens causes the immune system to react, and foods that would otherwise be tolerated can become allergenic. Although the problem with food allergies is generated by the damage from gluten, removal of gluten and milk/dairy from the diet is not always sufficient to remedy this problem. Depending on your circumstances, you might require a 4 to 5 day food rotation diet.
There are different types of food allergies: some are immediate and some are delayed. Immediate food allergies are usually easy to recognize – for example, you eat a strawberry and get a rash. These don’t usually require testing to determine.
However, delayed food allergies are hard to identify because the reaction may not appear for hours or days after eating the offending food. For example, eating an allergic food on a Monday night could generate a migraine headache or cause fatigue on Tuesday or Wednesday.
Due to this difficulty in identification of delayed food allergies one of two strategies should be followed. The first choice is to follow a four to five day rotation diet. By doing this, even though the exact foods to which you are allergic have not been identified, you will be rotating all your foods, so that any delayed allergic responses will be significantly reduced, This reduces the stress on your hormonal/immune system. T
The second option is to pursue additional testing for delayed food allergies. Multiple pathway food allergy testing is designed for this purpose. This testing is done from a blood sample and identifies exactly which foods you are reacting to. You will then know what foods to avoid and what foods are safe. It is important to employ one of these options, since eating foods that you are allergic to every day can interfere with healing of the intestinal tract.
It is important to note that many people who are gluten intolerant do not test positive on food allergy testing for wheat, rye, barley, and other gluten-containing grains. Do not be misled by the fact that you do not test positive to these gluten-containing foods. The only real test is to eliminate gluten and see if the symptoms improve.
On the other hand, many people live for thirty or forty years with sub-clinical gluten intolerance and do not experience obvious symptoms. Some people who are constitutionally strong and have good adrenal function and eat moderate amounts of gluten containing foods may never experience obvious symptoms. With or without obvious symptoms, intestinal damage is still taking place. And along with food allergies come food cravings, and it has frequently been observed that people crave that which they are allergic to. There have been many theories postulated as to why this is the case; at this point they are all speculative, as there is no definitive scientific proof of any one theory. Please take note, if you crave certain foods all the time there is a high probability that you are allergic to them.
Subclinical gluten intolerance and nutritional deficiencies
The lack of normal absorption in the small intestine leads to predicable nutritional deficiencies. Calcium absorption can be poor and this nutritional deficiency coupled with abnormal corticosteroid production can lead to accelerated osteoporosis.
Iron, B12 and folic acid deficiencies are also commonly observed. This can lead to fatigue, mild depression, memory loss, and greater risk for elevated homocysteine levels, a key factor in development of heart disease.
Subclinical gluten intolerance, amino acid deficiencies and poor brain function
Poor digestive function leading to maldigestion and malabsorption of protein will be reflected in amino acid deficiencies. Amino acids are the building blocks of our body and are vital for normal brain function. Our brain utilises many different chemical messengers called neurotransmitters to communicate. They are made from amino acids found in protein-containing foods. So improper digestion and/or absorption of protein generates amino acid deficiencies, which directly affects how we think and feel.
Serotonin, a neurotransmitter, is manufactured from the amino acid tryptophan. Therefore, a deficiency in amino acids can lead to a serotonin deficiency. And, conversely, restoring normal amino acid levels can help restore normal serotonin levels.
If you either (A) do not eat adequate protein, or (B) cannot digest protein well, or (C) cannot absorb the amino acids from protein, you will develop amino acid deficiencies that ultimately affect brain function and other body processes.
The approach taken in natural therapies is to look for causative agents, such as maldigestion and malabsorption and treat the cause of the deficiency directly, thereby improving the outcome. In this case, addressing dietary intake of protein, the ability to digest it with sufficient stomach acid and digestive enzymes and the ability to absorb is critical to optimal health. In certain people who have food sensitivities, this one factor can prevent recovery from chronic fatigue, recurrent infections and a cycle of chronic illness.
Depending on the extent of the problem, a person may need to use extensive nutritional supplementation to restore normal levels of vitamins, minerals, amino acids and essential fatty acids. These natural therapies can be used with great success, provided the appropriate foods are being eaten and normal gastrointestinal function has been restored.
Subclinical gluten intolerance is often accompanied by lactose intolerance
Lactose intolerance is defined as the inability to digest the carbohydrate portion of milk products. The carbohydrate portion of milk is referred to as lactose or milk sugar. Lactose intolerance frequently accompanies gluten intolerance.
Lactase, a specialised enzyme that aids digestion of lactose in milk products is usually lacking in people with sub-clinical gluten intolerance. Lactase breaks down lactose or milk sugar in the same way sucrase enzymes breaks down sugar or sucrose. Damage to the architecture of the intestinal wall and the subsequent decrease in enzymes for lactose and sucrose digestion leads to problems in digesting dairy products such as cheese, ice cream, and all types of milk products as well as sugar containing foods.
This enzyme deficiency is why people with subclinical gluten intolerance need to avoid cow’s milk products. As the villi on the intestinal lining heal from a gluten free diet, some individuals will be able to tolerate dairy products again in nine months to a year. In other people, there will be a more or less permanent sensitivity to dairy products.
However, in the initial 6 to 9 months of eliminating gluten, it is absolutely required to avoid all lactose-containing milk and dairy products because they will inflame the intestine lining just like gliadin does and prevent healing. This includes the complete elimination of cow’s milk products such as cheese, yogurt, cottage cheese, and milk.Goat’s milk yogurt and goat or sheep’s milk cheeses such as feta cheese and others are usually acceptable alternatives.
Gluten and alcohol
Hard alcohol and beer are made from grains that contain gliadin and are to be strictly avoided. Wines on the other hand, are made from grapes and therefore do not contain gluten/gliadin. However, if gluten/gliadin is ingested along with any alcohol, the gliadin is immediately put into solution and can amplify the inflammatory response up to 100 fold. Therefore, if you are gluten intolerant you must be 100% sure your meal is gluten free if you are to have any form of alcohol with your meal.
Sub-clinical gluten intolerance and parasites
The structural changes to the environment of the small intestine from gluten intolerance create the perfect habitat for development of pathogenic infections. Inflammation in the small intestine causes a structure called the crypts of Liberkuhn to deepen. The elongating of these crypts, referred to as crypt hyperplasia and deepening of the crypts, makes for a deep pocket where a pathogen such as a parasite can survive by evading the usual immune surveillance that occurs in the lining tissue. Inflammation also slowly destroys the immune cells that help protect this area and these two factors taken together create a situation where parasite infections can take hold and become chronic. Parasites deeply embedded in the intestinal lining can even be resistant to powerful antibiotic treatments. Because of this, people with gluten intolerance need to rule out the possibility that they are harbouring a chronic parasitic infection. Eliminating gluten from their diet can be the first step in getting these chronic infections cleared.
Sub-clinical gluten intolerance and Candida overgrowth
There is a relationship between Candida, an opportunistic organism in the gastrointestinal tract, and food intolerances. Inflammation caused by sub-clinical gluten intolerance and/or lactose intolerance weakens the immune response in the intestinal lining. This weakened mucosal immune defence can open the door for Candida to overpopulate and become invasive Candida (invasive means to invade and attach itself to the healthy mucous lining of the intestines).
Sub-clinical gluten intolerance and worsening of nutritional deficiencies
Gluten intolerance causes multiple nutritional deficiencies, including inability to absorb fats, proteins, and carbohydrates. Malabsorption of fats leads to deficiencies in the fat-soluble vitamins such as vitamin A and E and K and importantly, the essential fatty acids from which we manufacture all our reproductive hormones, and adrenal hormones including oestrogen, testosterone, progesterone, cortisol and DHEA. Lack of reproductive hormones leads to disruption of the normal menstrual cycle, causing PMS or menopausal symptoms.
Other nutritional deficiencies that appear early in the disease process include lack of calcium, folic acid, iron, and vitamin B12. The combination of calcium deficiency and female hormone imbalances leads to osteoporosis, or weakening of the bones. Even if women take estrogen and calcium supplements, they may not be adequately absorbed.
Folic acid, B12, and iron deficiencies lead to anaemia, depression, and increased risk of heart disease and neurological diseases. Lack of antioxidant vitamins E and A compromise our ability to get free radicals and can further contribute to degenerative conditions such as cancer and heart disease.