Should You Go Gluten-Free to Improve Your Gut Health?
Gluten-free for gut health: should you try it?
If you're experiencing symptoms like bloating, abdominal pain, diarrhea, constipation, reflux, or unexplained fatigue, you’ve probably been told by a loved one, a friend, or a professional that you should eliminate gluten. If this sounds like you and you’re wondering whether or not eliminating gluten might help heal your gut, this article is for you.
Let’s dive in together.
Hi there, I’m Kari Natwick, an integrative and functional dietitian specializing in improving women's gut health. If you are a women who is confused and overwhelmed by your health issues, I'm here to help you determine the root cause of your gut, energy, and hormonal imbalances. My goal is for you to move beyond temporary and band-aid solutions by implementing customized and personalized interventions to support and guide you in your journey to healing. By doing so, you can focus on the things that matter most in your life rather than constantly worrying about finding the nearest bathroom.
What is the gluten connection?
What exactly is gluten? Gluten is a protein that can be found in grains such as wheat, barley, and rye. It is a vital component of foods such as bread, pasta, and cereal. Gluten is made up of a combination of two proteins called gliadins and glutenins.
In recent years, there has been a significant increase in the number of people experiencing gluten-related reactions, affecting up to 1 in 10 individuals. This increase may be due to a rise in gluten consumption, which can range from 5 to 20 grams daily in the US.
But why does gluten cause symptoms in some people? Although gluten is a part of many diets, some individuals may have an immune response to the proteins in gluten. For example, gliadins contain specific amino acid sequences that can trigger an immune response, leading to inflammation and gut-related symptoms. Additionally, gluten can cause intestinal permeability, allowing undigested fragments to enter the bloodstream, further increasing immune reactions.
Understanding these mechanisms has brought attention to gluten sensitivity and has led many to explore gluten-free diets in an attempt to improve their overall well-being.
Benefits of a Gluten-Free Diet for Gut Health
Reduced Bloating: If you're dealing with bloating, gluten could be the culprit. Gluten often resists full digestion by digestive enzymes. Gliadins, a protein in gluten, are tough to break down by stomach, pancreatic, and intestinal enzymes. When these proteins linger undigested, they slow down the digestive process, setting the stage for fermentation. This fermentation leads to gas buildup and, you guessed it, bloating.
Less Leaky Gut or Intestinal Permeability: Consuming gluten can lead to the formation of peptides that can disrupt the lining of your gut, promoting what's known as intestinal permeability or leaky gut.
Potential for Inflammatory Intestinal Disorders: Gluten might play a role in triggering inflammatory conditions like inflammatory bowel disease and functional gastrointestinal disorders. However, the exact extent of its involvement is still being studied.
While going gluten-free can be beneficial for some individuals, it's crucial to determine if you have gluten sensitivity or celiac disease before making significant dietary changes. Let's delve into what these conditions entail.
Gluten Sensitivity vs. Wheat Allergy vs. Celiac Disease
If you're sensitive to gluten or allergic to wheat, there are a few different ways your body might react:
Let's break it down:
-
IgE-mediated wheat allergy:
- This is a severe food allergy that triggers strong allergic reactions.
-
Celiac Disease:
- Celiac disease is an autoimmune condition in which the ingestion of gluten triggers the body's attack on an immune response that damages the lining of the small intestine.
- Diagnosis typically involves blood tests to check for specific antibodies and a small intestine biopsy to confirm damage.
- People with celiac disease must strictly avoid gluten for life to prevent damage to their intestines and related health complications.
-
Non-Celiac Gluten Sensitivity (NCGS):
- Non-celiac gluten sensitivity refers to a condition where individuals experience symptoms similar to those of celiac disease when they consume gluten. Still, they don’t have it without the autoimmune blood response.
- Diagnosis of NCGS is challenging because there are no specific tests available.
- NCGS is usually diagnosed by ruling out celiac disease and wheat allergy through testing and then having a patient remove gluten to see if their symptoms improve.
- 50% of people who have the genetic markers for celiac disease (DQ2-DQ8 HLA haplotypes) but don’t have a celiac diagnosis report having NCGS.
- Management typically involves removing gluten from the diet to alleviate symptoms, but it's not considered a medical necessity in the same way as celiac disease.
Symptoms of Gluten Intolerance
If you're grappling with gut issues, you might be curious if a gluten-free diet could help ease your symptoms. Given that these conditions often originate in the gut, it's no surprise that digestive symptoms are typically the first to appear.
Symptoms of gluten intolerance affecting the gastrointestinal (GI) tract can include:
- Bloating
- Diarrhea
- Constipation
- Abdominal Pain
- Loss of appetite
- Reflux
- Heartburn
- Vomiting
But the impact of gluten intolerance doesn't stop at the gut. There's a range of additional signs to watch out for, such as:
- Fatigue
- General malaise
- Iron deficiency anemia
- Macrocytic anemia
- Dermatitis herpetiformis (a type of skin rash)
- Osteopenia or osteoporosis
- Slowed growth or short stature
- Tooth enamel defects
- Mouth ulcers
- Joint pain or arthritis
- Skin rash or dermatitis
And that's not all! Many folks also experience symptoms related to the nervous system with gluten intolerance. These can include:
- Headaches
- Brain fog
- Balance issues
- Tingling or numbness (paresthesia)
- Inflammation
- Anxiety
- Depression
With such a wide array of symptoms, it's no wonder people are eager to find relief. Let's explore how removing gluten from your diet might just hold the key to alleviating your symptoms.
Gluten and Intestinal Permeability, aka Leaky Gut
The connection between gluten intolerance and a range of gut and overall health issues often hinges on a concept called intestinal permeability, or as it is commonly referred to, "leaky gut." It’s estimated that a significant proportion of individuals experiencing gut issues have some degree of leaky gut.
Leaky gut occurs when the lining of the intestines becomes compromised, allowing undigested food particles, toxins, and other harmful substances to leak into the bloodstream, kind of like sneaking through the TSA security check at the airport without permission.
In a healthy gut, the intestinal barrier acts as a protective shield, selectively permitting nutrients to pass through while preventing larger molecules from entering the bloodstream. However, in cases of leaky gut, this barrier becomes permeable, leading to the escape of substances that should remain confined within the digestive system. When gluten molecules, for example, breach this barrier and enter the bloodstream, the body's immune system identifies them as foreign invaders and initiates an immune response.
As our immune system gears up to tackle these perceived threats, inflammation becomes the body's primary defense mechanism. This immune-driven inflammation can lead to a variety of systemic symptoms associated with gluten intolerance, such as brain fog, fatigue, joint pain, and even autoimmune diseases.
Leaky gut further intensifies the body's immune response to gluten, worsening symptoms and contributing to the development of chronic health conditions. Addressing leaky gut through dietary and lifestyle changes, including adopting a gluten-free diet, can help restore the integrity of the intestinal barrier and alleviate symptoms linked to gluten intolerance.
Understanding the connection between gluten and intestinal permeability empowers individuals dealing with gut issues to take proactive measures to support their gut health and lessen the systemic effects of gluten intolerance. Seeking guidance from healthcare professionals and implementing personalized interventions tailored to individual needs can aid in the healing process and enhance overall well-being.
Gluten and Its Role in Inflammation
Inflammation is your body’s natural response to things that might attack the gut, like pathogens or foods that you’re sensitive to. When the trigger persists, the immune cells within your gut are constantly activated, and the inflammatory response can become chronic.
This type of inflammatory response tends to be more pronounced in people who have inflammatory bowel disease or celiac disease when they consume gluten, but it can also occur in people who consume gluten and have a sensitivity to it.
In addition to gluten itself causing an immune response leading to inflammation, eliminating gluten can also impact inflammation.
Eliminating gluten from your diet can have unintended consequences by decreasing microbial diversity in the gut (see more on that below). This makes an individual more susceptible to dysbiosis or an imbalance of beneficial and “bad” or pathogenic bacteria. Pathogenic bacteria produce toxins called lipopolysaccharides that can cause inflammation in the gut. If these toxins leak out of the gut, they can trigger inflammation throughout the body.
If you follow a gluten-free diet, it is crucial to maintain a healthy and nutritious diet that includes fiber-rich whole foods. Failing to do so may have adverse health effects. That’s why it’s essential to work with a qualified dietitian who specializes in gluten-free diets and gut health.
Glyphosate and Gluten
Glyphosate, the active ingredient in the herbicide, Roundup® has been linked to symptoms that include nausea, diarrhea, skin rashes, macrocytic anemia, and depression. It has also been associated with nutrition deficiencies, reproductive issues, obesity, dementia, an increased risk of thyroid disease, kidney failure, and cancer.
More glyphosate is used in the United States than anywhere else in the world, using over 36 million kilograms per year. It’s easily accessible and can be purchased by anyone at their local hardware or lawn and garden store. Glyphosate is the most widely used herbicide in modern agriculture, and most genetically modified crops are designed to tolerate Roundup. This means it can be sprayed on crops without destroying the crop.
There has been much discussion around the potential link between glyphosate and celiac disease and gluten intolerance. According to a study published in the journal Interdisciplinary Toxicology, glyphosate is believed to be a causal factor in the increased number of people with these conditions around the world. The study cited a case where fish exposed to glyphosate developed digestive problems akin to celiac disease. Moreover, individuals with celiac disease have a higher risk of non-Hodgkin’s lymphoma, which has been linked to exposure to glyphosate.
Additionally, research has shown that glyphosate has a negative effect on the gut microbiome, exhibiting cytotoxic and carcinogenic effects on the gut. There are “bad” bacteria and pathogens such as Staphylococcus aureus, Streptococcus pneumonia, and Escherichia coli that have developed mutations that make them mitigate the harmful effects of glyphosate, whereas beneficial bacteria are more easily destroyed by glyphosate, such as Lactobacillus spp. And Ruminococcaceae.
While further research is required to understand the connection between glyphosate and celiac disease fully, it's an area of concern that clearly deserves attention.
Impact of Going Gluten-Free on Gut Microbiota
Our diet plays a crucial role in nurturing the diverse community of microorganisms in our gut, often referred to as our gut microbiota. Just as we fuel our bodies with meals and snacks, we feed the beneficial bacteria and other microorganisms that make up our microbiome.
In general, the more varied our food choices, the greater the diversity we can observe in our microbiome—a positive outcome. These beneficial bacteria play key roles in supporting our immune system, aiding digestion, and assisting in detoxification processes.
Unfortunately, in some studies, individuals following a gluten-free diet often experience a reduction in the population of beneficial gut bacteria and an increase in unhealthy bacteria. Why does this happen? Gluten-free diets typically lack diversity and are lower in whole grains, resulting in reduced fiber intake. With less fiber available, we aren't providing as much nourishment for these beneficial bacteria.
However, in well-executed gluten-free diets that include reduced intake or processed foods, high fiber, and high intake and variability of polyphenols, the gut microbiota was abundant and diverse, and the intestinal lining was healthy and intact.
Are Gluten-Free Diets More Nutritious?
Gluten-free foods are becoming increasingly popular, with the market growing at a rate of 10% per year. You can find gluten-free options in almost any grocery store, either labeled as such or in a separate section. However, it's important to note that many of these options may not be as nutritious as whole-grain options.
As a dietitian, I want to stress the potential risks of a gluten-free diet. If not planned carefully, a gluten-free diet can lead to nutrient deficiencies, including fiber, B vitamins, iron, calcium, vitamin D, zinc, and magnesium. This is because many products that are gluten-free alternatives are low in fiber and lack whole grains. Common examples of these ingredients include white rice flour, tapioca starch, potato starch, and xanthan gum.
It's essential to remember that just because something is gluten-free, it doesn't necessarily mean it's healthy. If you decide to switch to a gluten-free diet, it's recommended that you consult a registered dietitian who specializes in gluten-free diets.
Gluten-Free challenges
Navigating a gluten-free diet extends beyond mere dietary adjustments; it encompasses a spectrum of psychological and social challenges that can significantly impact one's well-being. In social settings and dining out scenarios, the absence of gluten-free options may evoke feelings of inconvenience and discomfort. Individuals may grapple with fears of being perceived as bothersome or offending others by abstaining from shared meals, precipitating emotions of fear, shame, and isolation.
Likewise, adhering to a gluten-free regimen while traveling can amplify stress levels and diminish the enjoyment of vacations, as uncertainties surrounding food choices loom large. Moreover, the psychological toll of maintaining a gluten-free lifestyle can manifest in various forms, including depression, anxiety, and irritability, particularly among younger individuals. The constant vigilance required to safeguard against gluten exposure may foster feelings of social invisibility and exacerbate existing emotional distress.
If you find yourself grappling with these challenges, rest assured that support is available to alleviate your burden. Engaging with online support groups, participating in gluten-free cooking classes or workshops, and seeking guidance from mental health professionals specializing in dietary-related anxiety disorders are all valuable avenues for managing the psychological and social impacts of a gluten-free diet.
Remember, you are not alone in your journey, and proactive steps can be taken to cultivate a supportive environment that nurtures both your nutritional needs and overall quality of life.
Timeline for Gut Healing After Going Gluten-Free
Developing a timeline for gut healing after switching to a gluten-free diet requires taking into account several factors. Factors such as the severity of gut issues, overall health status, adherence to dietary and lifestyle interventions, and genetic predisposition all play pivotal roles in determining the trajectory of healing.
Once you've initiated the process by optimizing the microbial balance and healing the lining of your gut, it's crucial to incorporate complementary strategies. These may include integrating foods and supplements that facilitate gut lining repair, employing stress management techniques, rectifying any nutritional deficiencies, bolstering immune system function, and fostering optimal digestive processes.
While eliminating gluten constitutes a fundamental aspect of the healing journey, it's just one piece of the puzzle. Combining this dietary adjustment with other supportive measures maximizes the likelihood of favorable outcomes. However, it's essential to recognize that the duration of healing varies significantly among individuals. While some may experience substantial improvement within a few weeks, others may necessitate lifelong adherence to a gluten-free diet.
Based on my extensive experience working with numerous clients over the past decade, gut healing typically takes approximately six months. However, individual responses may vary, underscoring the importance of personalized care and ongoing monitoring to optimize gut health outcomes.
Summary
In summary, while gluten-free diets can be beneficial for some people, it's important to note that it is not a quick fix and can pose real risks if not planned properly. It's crucial to emphasize that if you have celiac disease, getting a proper diagnosis is important. If you remove gluten from your diet before undergoing blood tests, it may affect the accuracy of the results.
If you are curious about learning more about gluten and your gut, ultimately, working with an experienced and qualified functional dietitian is where it’s at. As an integrative and functional dietitian, I am uniquely qualified to support you on this journey.
If you’re interested in working with me, book a free 45-minute Discovery Call to learn more about developing a plan that is uniquely tailored for you.
Citations:
Beyond Celiac. (n.d.). Psychological impacts of celiac disease. Retrieved from https://www.beyondceliac.org/living-with-celiac-disease/psychological-impacts/. - psychological impact
Research Nester. (2023, November 3). Gluten-free Food Market. Retrieved from https://www.researchnester.com/reports/gluten-free-food-market/5362. - gluten-free food market