Celiac.com 02/08/2012 - Having finally being diagnosed with celiac disease myself, I enjoy
writing about this autoimmune disease in my gluten-free advocacy work
with my mom, Tina Turbin. However, there is a whole other segment of the
population who, rather than having celiac disease, have a food
sensitivity to gluten. In fact, according to The Food Intolerance
Consumer, gluten-sensitive people make up 15% of Americans, whereas
celiac disease is currently estimated to exist in 1% of the population.
Clearly, in view of its prevalence in the U.S., gluten sensitivity
needs to be addressed, but as it turns out, research is showing that an
early diagnosis of gluten sensitivity is particularly crucial in
preventing celiac disease and other serious health conditions from
developing among the gluten-sensitive population.

According to
the website of the ALCAT Food and Chemical Sensitivity/Intolerance
Test, food sensitivity "induces chronic activation of the innate immune
system and gives rise to inflammatory process," and this inflammation
"has been linked to countless chronic conditions, including: digestive
disorders, migraines, obesity, chronic fatigue, ADD, aching joints, skin
disorders, arthritis and many more.' Perhaps you're wondering how a
food sensitivity is different from a food allergy. According to ALCAT,
food allergies encompass reactions to food that activate the immune
system to produce large amounts of histamine, which leads anaphylaxis, a
condition that can be deadly, causing swelling in the throat and
esophagus so that one can't access air from the lungs or other reactions
such as hives and rashes.
According to Kenneth Fine, MD, in a
transcript of a talk he gave to the Greater Louisville Celiac Sprue
Support Group, as published by Celiac.com, the immune system reaction
that gluten sensitivity causes starts in the intestine because this is
where gluten is found after being digested in foods. When this reaction
causes damage to the absorptive finger-like projections that line the
small intestine called villi, known as villous atrophy, celiac disease
is said to exist. However, says Dr. Fine, "Although the small intestine
is always the portal of the immune response to dietary gluten, it is not
always affected in a way that results in villous atrophy." In fact, he
says that most gluten-sensitive people don't have this symptom of celiac
disease and are therefore not celiac.
Despite this fact, the
testing that has been commonly administered in order to diagnose gluten
sensitivity have yielded positive results only when damage to the villi
was noted, a fact which can have devastating health consequences for
gluten-sensitive people without such damage, who are likely to continue
ingesting gluten. According to Dr. Fine, "This can result in significant
immune and nutritional consequences, many of which are irreversible
even after treatment with a gluten-free diet." The list of disorders and
health conditions that can manifest is long, including, Dr. Fine says,
"loss of hormone secretion by glands (hypothyroidism, diabetes,
pancreatic insufficiency, etc), osteoporosis, short stature, cognitive
impairment, and other inflammatory bowel, liver, and skin diseases,
among others." That's why he stresses early diagnosis for gluten
sensitivity.
Dr. Fine seeks to change current testing methods
and clear up misconceptions that prevent early diagnosis from being
made. One of the misconceptions he discusses is the reliability of
specific blood testing for not only antigliadin antibodies but also
autoimmune antiendomysial or anti-tissue transglutaminase antibody. He
says that "a negative test does not mean you do not have the problem.
This is the biggest pitfall of all because the only thing a very
specific test, like blood testing for celiac disease, can do is 'rule
in' the disease; it cannot 'rule it out.'" This means that people with
advanced or long-term celiac disease will show positive results. In
fact, when the villi were only partly damaged, only 30% of celiac
individuals being tested had positive results.
Detecting
gluten sensitivity early in individuals can have major health benefits,
preventing not only the development of celiac disease (that is, villous
atrophy, according to Dr. Fine), but a wide array of autoimmune diseases
and conditions such as osteoporosis, malnutrition, infertility, certain
mental disorders, and even some forms of cancer. I myself was diagnosed
in my early 20's after being in and out of hospitals and incorrect
diagnoses. Additionally, the treatment for gluten-sensitive individuals
diagnosed early would be simple-a gluten-free diet-which should result
in improvement in symptoms. With the medical community enlightened by
Dr. Fine's research, we can look forward to better testing and earlier
diagnosis of the gluten-sensitivity community and their resultant health
benefits.
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