Perhaps it may be important to understand some terms first. I am frequently asked what is the difference between gluten sensitivity, gluten allergy and celiac disease.
Most experts agree that for one to be diagnosed with an allergy, you need to have an immune reaction that includes the antibody named immunoglobulin E (IgE) and the subsequent release of histamine from a class of white blood cells called mast cells. This type of allergic response is immediate and often can be severe. The most severe reaction is called an anaphylactic reaction and can be life threatening. If you have this type of allergy you definitely know it and probably carry an EpiPen® around with you. Some people "grow out" of this type of allergy as they age because the level of IgE diminishes rapidly between the ages of 10 and 30 [1].
Gluten or other another food sensitivity typically means the sufferer has an immune response with a different set of antibodies. These antibodies are called immunoglobulin A (IgA) or immunoglobulin G (IgG). When you are diagnosed with a gluten sensitivity your testing would show you are reacting to various compounds in wheat, rye, barley. Realizing you have an IgA and/or IgG sensitivity can be more mysterious as there are many symptoms you can have that often are attributed to another cause. The mistaken attribution is commonly due to a delay between the time of ingestion of the food you are sensitive too, or due to the mild nature of a reaction at the time that you just chalk up to "just how you are".
Celiac disease refers to the destruction of your small intestinal cells (called enterocytes) and ofthen the villi and microvilli (which are the finger-like projections of your small intestine cells) by your own immune system. Imagine a piece of shag carpeting rolled up into a tube with the shags facing inward and you have an idea of how the small intestine looks on a microscopic level. Now imagine your immune system has a fleet of lawnmowers that mistakenly mow off all the shags down to nubs. That is celiac disease - and the end point destruction is called total villous atrophy (TVA). Due to the lack of villi you cannot absorb nutrients in sufficient quantity and as a result several other diseases or conditions can develop such as ostoporosis or iron deficiency, depression, abnormal results on liver blood tests and much, much more.
Here is a super important point to take to heart: gluten sensitivity and celiac disease BOTH are permanent intolerances to ingested gluten that results in immunologically mediated inflammatory damage to the small-intestinal cells.
So why is gluten sensitivity seemingly more prevalent these days? First of all, more advanced testing is now available, which makes the diagnosis more accurate with blood tests or with saliva tests. I posted a blog article about this recently and I highly suggest you take a look.
The gold standard for detecting celiac disease used to be a blood test for IgA reaction to alpha gliadin plus 3 biopsies (gliadin is a glycoprotein present in wheat and several other cereals within the grass genus Triticum). The problem with this "gold standard" test is that almost total villous atropy (TVA) was necessary before the test became unequivocally positive. In fact celiac disease patients tend to be 10-15 times more likely to exhibit IgA deficiency in the blood!
Since the advent of better testing (saliva IgA and IgG and testing more that just alpha gliadin) and awareness that gluten sensitivity and celiac disease is more prevalent than previously thought, has led clinicians to look for these disorders in their clinical workup.
In my practice I have found nearly 100% of those patients that come to me with chronic health challenges (such as fibromyalgia, hypothyroidism and balance disorders, etc.) have gluten sensitivity. I have access and use some of the most advanced non-invasive testing availabletoday and as a result, now my chronic condition patients, have found renewed hope for recovering from their illnesses.
Those patients with autoimmune thyroid, fibromyalgia, balance disorders, diabetes, menieres disease, etc. who obtain our battery of tests and are treated with my specialized Johnson Neuro-Metalbolic Therapy program are regaining a zestful life.
Additional reasons for why gluten sensitivity is seemingly more prevalent will be discussed in future blog posts.
1. Croner S (1992). "Prediction and detection of allergy development: influence of genetic and environmental factors". J. Pediatr. 121 (5 Pt 2): S58–63. 10.1016/S0022-3476(05)81408-8.
