"For the first time, we have scientific evidence that indeed, gluten sensitivity not only exists, but is very different from celiac disease," says lead author Alessio Fasano, medical director of the University of Maryland's Center for Celiac Research.
"The news will be welcome to people who have suspected a broad range of ailments may be linked to their gluten intake, but have failed to find doctors who agree.
"'Patients have been told if it wasn't celiac disease, it wasn't anything. It was all in their heads,' says Cynthia Kupper, executive director of the nonprofit Gluten Intolerance Group of North America...."
"...Although much remains unknown, it is clear that gluten—a staple of human diets for 10,000 years—triggers an immune response like an enemy invader in some modern humans."
There we go. Eating wheat is functionally equivalent to eating poison ivy: wheat contains proteins that trigger autoimmune responses. One type of response causes celiac disease, the other causes gluten sensitivity. I'd wager there are more to come:
"'Imagine gluten ingestion on a spectrum', says Dr. Fasano. 'At one end, you have people with celiac disease, who cannot tolerate one crumb of gluten in their diet. At the other end, you have the lucky people who can eat pizza, beer, pasta and cookies—and have no ill effects whatsoever. In the middle, there is this murky area of gluten reactions, including gluten sensitivity. This is where we are looking for answers about how to best diagnose and treat this recently identified group of gluten-sensitive individuals,' says Dr. Fasano."
Dr. Davis' hypothesis seems to be getting some currency:
"'People aren't born with this. Something triggers it and with this dramatic rise in all ages, it must be something pervasive in the environment,' says Joseph A. Murray, a gastroenterologist at the Mayo Clinic in Rochester, Minn. One possible culprit: agricultural changes to wheat that have boosted its protein [gluten] content."
(Emphasis mine. Murray is wrong about people not being born with it. Gastroenterologists are moving up there with podiatrists in my estimation of the medical profession.)
If you're interested in hearing more, there's an interview with Fasano here, and the study is here.
One real pet peeve of mine:
"'There's a lot more that needs to be done for people with gluten sensitivity,' she says. 'But at least we now recognize that it's real and that these people aren't crazy.'"
This is what the medical profession does when people present with symptoms they don't understand: they don't investigate, they tell the people they're crazy. If your doctor tells you this, tell him to go to hell and find a doctor who takes you seriously. Yes, I know there are people who are crazy, and sometimes the doctor is right, but there just aren't that many crazy people running around. Gluten-free is turning into an industry while the medical profession has got its head in the sand.
P.S. A gluten-free diet is a pain in the butt. No one would do it just because it's "a trend". It's worth it, certainly in my case, but it's a pain in the butt.
Great post, but just one question in reference to your comment, "there just aren't that many crazy people running around." Have you ever spent any time in a psych unit? Cumulatively during my med school training, I spent 10 weeks in one. Yeah, there are a lot of crazy people running around. Actually, I've found more of them running around outside the unit. ;)
ReplyDeleteI do agree, however, that because many of the attitudes physicians develop during training, they tend to dismiss things they don't understand completely. Ultimately, I think we're all working in the same direction.
David, good points. I actually re-wrote that section prior to posting it because I realize that a lot of doctors have an experience like yours, which might lead them to be excessively, skeptical, shall we say.
ReplyDeleteAnd you're right, there are more crazy folks outside the psych wards than inside. But that's still just a teeny fraction of people.
The book "Freakonomics" explores this from an economic perspective, and finds that people are overwhelmingly, scrupulously honest. I think the medical profession will discover the same is true, that the hypochondriacs who waste a lot of your time are few in number.
It's entirely possible to be crazy /and/ have some kind of tangible health problem. My wife, for instance ;-)
ReplyDeleteShe's currently totally immobile with agonising joint pain and had to be admitted due to another bout of pericarditis. While she was in, she was seen by another rheumatologist who was extremely dismissive. She focussed on whether my wife was depressed (of course she is, she's 27 and has crippling health issues and nearly died from an MI last year) and was even questioning whether the pericarditis was "really pericarditis".
Long story short, wife sent home with instruction to wean off steroids and start taking amitryptiline. (she did, and had a nasty reaction to it)
We're working on the diet as it's one thing WE can do something about.
Head Case, I know I'm preaching to the choir here, but pericarditis and other heart problems can be caused by diet. Fasano's "Frontiers in Celiac Disease" that I linked to the other day mentions pericarditis as one of the linked conditions, as is cardiomyopathy.
ReplyDeleteAnd you might as well try the dietary fixes yourself, the doctors will likely never do so.