My Gluten Revelation
I first started to realise that my body reacted negatively to gluten when I was diagnosed with Multiple Sclerosis. Up until that time, I had been consuming a decent amount of gluten containing foods: toast for breakfast, biscuits for morning tea, sandwiches for lunch, more biscuits in the afternoon and pasta for dinner or meat with gluten containing sauces. Instead of giving me the energy I needed to get on with my day, I actually noticed that these foods made me feel sluggish and lethargic. After lunch, I often had to put my head down on my desk for a few minutes because I was so exhausted that I couldn't focus on what I was doing. At home, I always had to scrape myself off the couch to do the dishes, laundry or cleaning. When I didn't have work or friends to distract me, I actually felt quite depressed at times. I had no idea that an insidious process was at work.
Literally, a week after I stopped eating gluten containing foods, I felt like a blanket had been taken off my head. I felt free, energetic and able to think clearly. The brain fog that had been affecting my clarity of mind, concentration and memory lifted and I felt like a different person. The change was quite dramatic. I had also given up sugar and dairy so that also contributed to my new feeling of wellbeing. Such is the power of food that heals! I wasn't perfect in those early days of the MS diet and I often found that I couldn't resist that piece of cake or pastries at parties. I told myself that I deserved a treat because I had been so disciplined. About half an hour after I eaten these foods I felt disoriented, slow and very tired. I didn't feel like interacting with people anymore and just wanted to go home! I learnt my lesson quite quickly and started bringing my own gluten-free treats to a social gathering where I knew I would be tempted.
What is Gluten?
Gluten is actually the latin word for glue. It is a sticky protein, usually found in wheat, that makes ingredients bind together. It is best known for it's role in holding flour together in bread products. You will find it in crackers, pizza dough, biscuits, gravies, sauces and other wheat based products.
It is also found in these grains:
To go into a little more in depth, gluten is made up of two different proteins, glutenin and gliadin. A person may be sensitive to one of these proteins or to one of the twelve different smaller molecules that make up gliadin. As you can see, gluten sensitivity is not as straight forward as it seems!
Are You Gluten Sensitive?
You will, technically, have a gluten sensitivity if your immune system has developed an army of anti-gluten antibodies. Why this happens could be related to genetics or perhaps overdosing on gluten containing foods. The scary statistic is that 90% of people who react negatively to gluten don't even know it. They live with their body's aversion to gluten and a range of annoying symptoms. They chalk these symptoms down to stress or tiredness. Most people think that a gluten sensitivity involves digestive problems such as diarrhoea or bloating and if they don't have any of these, they are not gluten intolerant. This is not the case. Many gluten intolerant individuals experience only neurological symptoms that impact the effective functioning of their nervous systems.
Many people with unexplained symptoms have seen them all vastly improve after just a few days of saying goodbye to gluten. There are over 250 symptoms related to gluten sensitivity which I won't bore you with now. You can read the full list on Wikipedia. Here is a more concise list of the common physical and neurological symptoms of gluten sensitivity:
1. Physical symptoms
- abdominal pain
- intestinal distress
- lethargy and low energy levels
- constant tiredness
2. Neurological Symptoms:
- mood changes - depression is the most common
- obsessive compulsive behaviour
- brain fog and the inability to think clearly
- lack of focus and concentration
- peripheral neuropathy - tingling/pins and needles or numbness in your hands and feet
- vertigo - sensation of dizziness and spinning
The Gluten Sensitivity Spectrum
There is a broad spectrum of gluten sensitivity. A person may be slightly sensitive and experience a few but not all of the symptoms of gluten intolerance. There are people who only experience digestive symptoms and those who only experience neurological symptoms. On the other end of the continuum are the people who have been diagnosed with full blown Celiac disease. This is another auto-immune disease where the immune cells actually attack the lining of the small intestine. This results in damage and then an inability to absorb nutrients from that area of the gut.
A Note about Celiac Disease
Celiac disease is beyond the scope of this topic but it is worth noting that it has many of the same symptoms of MS and many MS'ers I have chatted to recently have been diagnosed with both MS and Celiac. If you think you may be gluten intolerant, I would highly recommend having a test done to see if you are sensitive to gluten or even if you have Celiac disease. Dr. Perlmutter, in his book 'Grain Brain' writes that Celiac disease has even been known to cause changes in the grey matter of the brain which resemble Multiple Sclerosis lesions. For this reason, he insists that people who have been diagnosed with MS, have a test for Celiac disease done because Celiac disease can sometimes be misdiagnosed as MS.
Testing for Celiac Disease & Gluten Sensitivity
To get tested for Celiac disease, you have to have a blood test done. In order for it to tell you anything about your gluten sensitivity, you have to have eaten a good portion of gluten daily for at least 2 weeks to a month so that the anti-gluten antibodies are concentrated enough to show up in your blood. Another complication is that this blood test isn't always accurate and you can get a false negative result. This means that you actually do have a sensitivity to gluten but for some reason it hasn't shown up. If you do test positive for gluten sensitivity, you can also go for a scope examination to confirm the diagnosis of Celiac disease. This involves a biopsy of your small intestine being taken and analysed for damage. Not a pleasant process but often good to get a definitive diagnosis.
I toyed with the idea of getting tested for gluten sensitivity but decided, quite quickly, that going though this process was not for me. Having rid my body of this 'modern poison' (as Dr. Perlmutter refers to gluten), I wasn't about to put myself at risk for further symptom development. Even if I was diagnosed with Celiac Disease, I wouldn't change anything I'm doing now. I would still be eating a gluten free, plant based diet which is the best treatment for Celiac Disease anyway! Having said all this, if you haven't given up gluten yet, it would be worth going for the blood test. If anything, a positive diagnosis will help motivate you to go gluten-free. A negative result, however, is not an excuse to carry on eating this inflammatory food because it will definitely make your MS symptoms worse.
How does Gluten Harm Us?
As stated above, gluten has been referred to as a toxic agent that can cause harm to the body. This is quite a statement to make seeing that most of the food Western society eats, on a daily basis, contains gluten! A gluten sensitivity is an autoimmune response. Basically, the immune system thinks that gluten is a germ or a foreign invader and is put on high alert. When the body reacts to food negatively it tries to control the damage by sending out inflammatory messgenger molecules to label the food particles as enemies.
These inflammatory chemicals create an environment of inflammation in our bodies which creates a ripe environment for disease to flourish. Killer immune cells are amongst these 'inflammation causing molecules' to ensure that the enemy food particle is wiped out. The irony is that this process, which is meant to be helpful to us, actually ends up damaging our nerve tissue and results in MS symptoms. In the stomach, the gut lining can be attacked and damaged which causes leaky gut syndrome. This leads to even more food sensitivities.
Another way gluten can harm us is if the body lacks certain enzymes needed to digest certain gluten containing foods. It is also the stickiness of gluten that interferes with the breakdown and absorption of nutrients from other foods. Poorly digested food leads to a pasty residue in the gut which again, activates the immune system, leading to an assault directed at the lining of the small intestine. This process leads to many of the above symptoms and we often respond by eating more of the offending foods. We somehow think the cause of our symptoms is hunger or low blood sugar levels. Or, we opt for carb comfort eating because we are not feeling great and good food always helps you feel better, doesn't it? It's becomes a vicious cycle that can be so easily brought to a halt.
Gluten and Brain Inflammation
I would like to, briefly, delve a bit deeper into the inflammation caused by gluten molecules and how this affects the nervous system. Cytokines are the inflammatory chemicals released by the immune system. Gluten sensitivity is actually caused by elevated levels of antibodies against the gliadin component of gluten. When the antibody combines with this protein (gliadin), creating an 'antigliadin' antibody, specific genes are turned on in a special type of immune cell in the body. Once these genes are activated, inflammatory cytokine chemicals collect and can attack the brain.
These chemicals are highly antagonistic to the brain. They damage nerve tissue and leave the brain vulnerable to disfunction and disease. They can also combine directly with specific proteins in the brain that look like the gliadin protein found in gluten containing foods. The anti-gliadin antibodies can't tell the difference. This leads to the formation of more inflammatory cytokines. Interestingly, elevated cytokine levels are seen in people with MS.
It seems that gluten sensitivity is common in patients with neurologcal diseases and definitely MS'ers. Just to reiterate, gluten sensitivity can be an exclusively neurological condition. People with gluten sensitivity can have neurological problems without having any digestive problems at all. There is actually a medical term for neurological issues caused by gluten: Gluten Neuropathy. This is a known condition when the autoimmune response to gluten is the root cause of the nerve damage. Obviously this has far reaching implications for the effects of Multiple Sclerosis and if it is not the actual cause, it surely is a contributing factor in the progression of the disease.
Gluten & MS
There is a vast amount of evidence that gluten is one of the the root causes of inflammation and disease. In autoimmune diseases such as MS, it seems to be even more rampant. The immune system is already malfunctioning to some degree and so is more prone to use gluten as the fuel for it's attacks. Some would even say that there is a strong possibility that gluten leads directly to an ms relapse in people with MS. The immune system is just waiting for an excuse to be activated and gluten does this. For this reason all MS'ers should completely avoid gluten.
Summing it up & Getting Rid of Gluten
Gluten really is best avoided, by everyone, in my opinion. Why put yourself at risk for developing a gluten sensitivity which may lead to full blown Celiac disease and a host of other neurological and digestive problems. I also don't understand why people with MS can't bring themselves to eliminate gluten from their diets when it is known to increase inflammation in the brain. It is an inflammatory substance! Inflaming an already inflamed brain more is just not worth it in my opinion.
Going gluten free could be one of the most effective and simple ways you can use to manage your MS symptoms more effectively. You are likely to experience a few or all of these benefits:
- Clearer thinking & better concentration
- Improved memory
- More energy & less tiredness
- Better quality sleep
- More stable mood (you may feel happier, I do!)
- Improved MS symptoms
In my follow up post I will be delving into the world of gluten free living. There are so many amazing alternatives to gluten. It has become a billion dollar industry over the past few years. The supermarkets are packed with gluten-free products and restaurants are waking up to the fact that they need gluten-free options on their menus. Not all gluten-free products are created equal, however, and I will help you to distinguish between the healthy ones and those crammed with sugar and unhealthy fats.
I look forward to hearing your comments and feedback, as usual!
Grain Brain. David Perlmutter & Kristin Loberg. 2013