The Case: Diana is 36 and suffers from irregular bowel movements and stomach upset. Endoscopies, colonoscopies and genetic testing for celiac disease provided no answers She tried adjusting her diet but nothing has helped and her doctor was stumped. My first suspicion was that her Celiac test was a false negative or that she had some underlying gluten-sensitivity. Gluten is found in wheat, rye, barley and oats and many people may have the sensitivity. It’s estimated that 30 – 40% of people are genetically positive for gluten-sensitivity. Many go undiagnosed. Dr. Peter Osborne is world renown in the field of gluten and grain sensitivity. He is the author   of the highly acclaimed bestseller, ‘No Grain, No Pain’ and is a Doctor of Chiropractic and board certified in clinical nutrition and pastoral medicine. He is the clinical director of Origins Healthcare in Sugarland, Texas and is also an advisor for Functional Medicine University. He joins me in the discussion of this case to share his significant expertise in this field. Confusion Around Gluten Terminology Many people mislabel conditions relating to gluten and mistakenly use gluten-sensitive, gluten-intolerant, gluten allergy, and celiac interchangeably. So, what is the difference between gluten sensitivity and gluten allergy? What’s the difference between gluten intolerance and celiac disease? Dr. Osborne explains that gluten sensitivity is a state of genetics which is not a disease. However, this sensitivity can lead to the development of celiac disease which is an autoimmune disease. Gluten intolerance is a reaction to gluten without the genetic disposition. The body cannot digest gluten properly because it is not producing the necessary enzyme. This can result in irritable bowel, gas, bloating and other intestinal discomforts. An allergy to gluten it very rare. Classically, this would show up as an acute response similar to other food allergies which often have symptoms like hives, swollen lips, and throat constriction. It’s potentially life-threatening. Traditional Testing for Celiac is Insufficient Most doctors will test two genetic markers for celiac disease but there are 5 antibodies that should be tested. Some people, like Diane, are told they don’t have Celiac disease and can eat gluten when that is not the case. Comprehensive tests that specifically include HLA DQ2 and DQ8 as well as the wheat zoomer (see below for links to these tests) are needed to completely rule out gluten issues. These tests are a simple cheek swab and a blood test. Gluten Sensitivity due to Genetics is Permanent While some people may feel better after giving up gluten for a period of time, this does not mean they can return to eating gluten. Dr. Osborne says that it can’t be reversed and his best advice is to stay away from it if they want to maintain their health. Eating gluten (for those that have the gluten genes) is unhealthy for them so if they go back to it, they’ll soon feel the repercussions of their unhealthy ways. Consider the Quality of Grains People who do not have the genetic markers for gluten sensitivity, antibodies to gluten, or the presence of autoimmune disease do not need to follow a gluten-free diet. However, it’s important to look at the quality of the food they’re eating. Grains can have mold or mycotoxins (see episode 006). They may also have trace amounts of pesticides that could include glyphosate which has been linked to cancer, neurodegeneration and fertility issues. In addition to that, many grains have been genetically modified. You Can’t Just Take a Pill There are enzymes available in supplement form that will help the body digest gluten. While this might seem like a ‘get out of jail free’ card, it’s not. If you have a gluten sensitivity or Celiac disease these are meant only to protect you against unwitting exposure (often through cross contamination in non-gluten-free restaurants or homes). It’s not a magic pill that you can take and then go devour a pizza.