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    Gluten-Free Diet May Lead to Poor Gut Health


    Kim Hopkins

    Celiac.com 06/05/2009 - Recently, the British Journal of Nutritionreported that following a gluten-free diet may be detrimental to guthealth, which may also affect immune health, according to a new studyfrom the Spanish National Research Council. The Spanish researchersanalyzed the gut microflora of ten healthy subjects with an average ageof 30 assigned to consume a gluten-free diet for one month.   Analysisof the participants’ feces showed that populations of healthy gutbacteria decreased following the gluten-free diet, while populations ofunhealthy bacteria increased.

    It has been previously documented that gluten can cause leaky gut, evenwithout celiac disease.  Chronic gluten exposure has been shown toactivate zonulin resulting in increased intestinal permeability (orleaky gut) even in the absence of celiac disease. Intestinalpermeability with malabsorption has been described in celiac patientsand their relatives who don’t have atrophy of the intestine on biopsybut only increased inflammatory cells.  An imbalance of intestinalbacteria has been cited as one of the main causes of leaky gutsyndrome.  This study could be the beginning of discovering the missingcomponents of the known link between celiac disease (and foodsensitivities), leaky gut syndrome, inflammation, and immune health.

    If you have celiac disease and/or other food sensitivities, your riskfor a bacteria imbalance is high.  What can you do to protect yourhealth?

    • Know the signs of bacteria imbalance: abdominal pain, asthma, chronic joint pain, chronic muscle pain,confusion, fuzzy or foggy thinking, gas, indigestion, mood swings,nervousness, poor immunity, recurrent vaginal infections, skin rashes,diarrhea, bed-wetting, recurrent bladder infections, poor memory,shortness of breath, constipation, bloating, aggressive behavior,anxiety, fatigue, feeling toxic.
    • Consider dietary changes: Limit foods that feed bad bacteria – all forms of sugar, vinegars, andmoldy foods like mushrooms.  Eat foods that promote intestinal healing,including high fiber foods rich in antioxidants (cabbage, cauliflower,beets, and onions) and omega-3 fatty acids found in salmon andflaxseed.  Healthy bacteria found in yogurt (read the label to ensurethat it contains live cultures) has also been recommended.
    • Think about chemical exposure: Eliminating or reducing substances that promote intestinalpermeability, such as avoiding antibiotics, nonsteroidalanti-inflammatory drugs, pesticides, herbicides, and meat contaminatedwith hormones.
    • Talk to your doctor: More research needs to be done, but it seems as though probiotics maybe protective against leaky gut and bowel inflammation.  Clinicalresearch shows that oral supplementation of probiotics enhances theimmune system's ability to fight foreign organisms.  Digestive Enzymescan also help to restore intestinal permeability.  Herbs and botanicalswith anti-inflammatory properties, and those that reduce congestionand/or eliminate waste may also be helpful.
    Sources
    • autoimmunedisease.suite101.com
    • About.com   Leaky Gut Syndrome/Intestinal Permeability, Cathy Wong, July 23, 2007
    • www.Foodnavigator-usa.com
    • Crook, William; Dean, C.; Crook, E (2003).  The Yeast Connection and Women’s Health
    Author's Note:  I apologize for the confusion a poorly-worded sentence caused - it has since been removed.  Obviously, this study is very flawed - it can barely be called a study.  What prompted me to write about it was the very small glimmer of hope it gave me, and many of the people I work with...so many celiacs feel good on the diet for a long time, then don't feel good anymore.  Many are told that it's in their heads, or they must be consuming gluten.  Come to find out, it's a yeast overgrowth due to bacteria imbalance.  The relief that I, and many that I know, have felt from the suggested steps in the article has been incredible.  I'm just glad this connection is being looked at!  I'm hopeful more in-depth, meaningful research is to come!
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    Recommended Comments

    Guest sarah-ann

    Posted

    Excellent article, but frustrating too. Just getting a handle on gluten free & now something else to worry about.

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    Guest brian

    Posted

    This report by Kim Hopkins is absolute nonesense. There is no such thing as a yeast which is also a bacteria. Candida is not a bacteria. Anything which follows from the logic that they are is not just suspect but dangerous. The content provided by Hopkins is extremely vague and not backed up with references (I would challenge Hopkins to provide ample evidence that consumption of meat derived from animals that have received hormone treatments results in humans with a leaky gut when compared to humans fed non-hormone treated animals).

    Anyone frustrated by their celiac disease who is further flummoxed by the additional load that Hopkins implies they should take on should simply ignore the article and make something good to eat.

     

    The study in Spain is damn near irrelevant to celiacs...10 healthy normal volunteers. Anybody here healthy and normal?

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    Guest Carol

    Posted

    Informative...and my personal experience adds credibility to the ideas presented. I am Celiac and have Fibromyalgia. It has become obvious to me that my body needs supplementation at a higher level than normal for me to see improvement in symptoms. Particularly helpful are the probiotics, omegas, antioxidants, vitamins and enzymes. Of course, it goes without saying that all supplements must be gluten free!

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    Guest Patty Ahrens

    Posted

    I have celiac disease and am currently being treated for a systemic yeast infection. Good article! Need more info about a healthy intestinal tract.

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    Just getting started with corrective measure re: celiac disease. Thank you for writing an article my non-medical mind can wrap around.

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    Guest Phyllis Morrow

    Posted

    This is an alarmist article that could lead celiacs to think that a gluten-free diet is not good for us. Brian's comment about candida (yeast, not bacteria) is absolutely correct. Also, we do not know what the study subjects were eating, just that they were not eating gluten. And a month-long study gives no information on how digestive systems might adapt after more than a month on a balanced gluten-free diet. The article does not explain why gluten would be necessary for 'helpful bacteria' to grow in the gut - there needs to be some good hypothesis for me to consider the validity of the research. Finally, the list of 'symptoms' is so broad and typical of the kinds of things that celiacs may experience that it is not very helpful. Nothing wrong with eating yogurt and probiotics and a lot more veggies and fruits than most folks eat, but no reason to start worrying about the gluten-free diet without some more rigorous evidence here.

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    Guest Sierra

    Posted

    The experience of healthy subjects may have no bearing on people who go on the gluten-free diet after developing symptoms. Also without knowing what the subjects DID eat it is meaningless to know that their gut flora became more imbalanced. Many people eat more refined starches on a gluten-free diet and this alone can cause gut flora to become imbalanced, but this is not an intrinsic problem with a gluten-free diet. My family follows the Specific Carbohydrate Diet, which is gluten-free but also cuts out the starches that feed the bad gut flora. Our gut flora has improved significantly on this diet and our leaky gut is healing. The GAPS diet takes into account all of the info given here about enzymes, probiotics, malabsorption, and EFAs.

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    Guest Tracee

    Posted

    I think she brings up a good point...just because it's gluten free doesn't mean it's healthy. If we're changing our diet to be gluten-free, why not also cut out the other bad stuff...sugar, junk carbs and beef up on the better choices? After years of gluten abuse our immune systems probably need every boost they can get. Also, years of gluten damage can't be good for our flora balance, and many of us have had to take lots of antibiotics and/or steroids because we got sick more than most.

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    Guest Brian

    Posted

    The listed signs of bacterial imbalance sound a lot like my pre-gluten, dairy, soy, corn starch, potato, green solanacea, and beet family free situation. (Yes, I can find food to eat but no more picnic baskets for me Boo-Boo! Lots of nuts & berries: Nuts!)

     

    After 8 months into gluten-free and shorter periods away from the rest, my blood pressure rises and I feel different if I have eaten something that is a known issue for me.

     

    Radical changes in diet are bound to cause some issues. Try eating a lot of plums, and see what happens. Many have reported issues early on when going gluten-free.

     

    Before going gluten-free, we ate more, fish, fruits, yogurt, and vegetables and prepared many more meals from scratch than our friends, though we are neither vegetarian nor vegan. (meat is something I can eat.) It is possible that was preconditioning and helpful to going gluten-free. I suspect the poor absorption of nutrients, made us crave nutrient-rich food.

     

    Avoidance of dairy, potato, and corn starch eliminates almost all gluten-free baked goods and desserts other than what little I make from scratch.

     

    If gluten is not very digestible and lines the gut, it is not unreasonable that as it clears, digestion changes and/or other intolerances make themselves known. It may be essential to avoid an excess of sugar and refined carbohydrates that might tax the system even though the sources are 'gluten-free', aside from any cross-contamination issues, until a new intestinal flora balance is developed.

     

    Before the casein and whey sensitivities were found, I consumed a lot of yogurt and Activia. the active cultures may also have helped more than the allergens they contained, hurt. I also noted that mushrooms in quantity did not make me feel well though they did not give an intolerance reaction and had been fine before going gluten-free.

     

    The study is WAY too small, of too short a duration, and with inadequate outlines of the diets used. It is a nice pilot study, though. At least someone is giving the issue some attention.

     

    Now they can repeat it with control, celiac going gluten-free, and non-celiac gluten-free groups of different periods of time for more publications! Publish or perish!

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    Guest Charlotte

    Posted

    I think she brings up a good point...just because it's gluten free doesn't mean it's healthy. If we're changing our diet to be gluten-free, why not also cut out the other bad stuff...sugar, junk carbs and beef up on the better choices? After years of gluten abuse our immune systems probably need every boost they can get. Also, years of gluten damage can't be good for our flora balance, and many of us have had to take lots of antibiotics and/or steroids because we got sick more than most.

    Um, grass fed beef is by far one of the healthiest foods you can eat, and is a pretty important part of any gluten free diet.

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    There is much truth to this article! 6 years into a gluten free diet for our celiac---and my husband and I have been sicker than ever!!! I was finally starting to accept that there was simply gluten in everything. Until a friend told me about the GAPS diet. Wow! Gut dysbiosis is very real and very damaging. Because you start to 'react' to just about every single food you eat, thinking there is gluten, where in reality you have severe leaky gut. So you are 'reacting' to everything, with your immune system on high alert and attack mode. GAPS and SCD provide much needed relief for those of us who need MORE than just Standard American Gluten Free.

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    Guest johan

    Posted

    This report by Kim Hopkins is absolute nonesense. There is no such thing as a yeast which is also a bacteria. Candida is not a bacteria. Anything which follows from the logic that they are is not just suspect but dangerous. The content provided by Hopkins is extremely vague and not backed up with references (I would challenge Hopkins to provide ample evidence that consumption of meat derived from animals that have received hormone treatments results in humans with a leaky gut when compared to humans fed non-hormone treated animals).

    Anyone frustrated by their celiac disease who is further flummoxed by the additional load that Hopkins implies they should take on should simply ignore the article and make something good to eat.

     

    The study in Spain is damn near irrelevant to celiacs...10 healthy normal volunteers. Anybody here healthy and normal?

    I think you misunderstand. Gut bacteria help to regulate yeast in the intestines. Nobody said yeast is a bacteria.

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    Jefferson Adams
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    Source:
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    Dr. Ron Hoggan, Ed.D.
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    So how, you may ask, is all this related to gluten? As a starting point, one report from the medical literature identifies a patient who developed aphasia after admission for severe diarrhea. By the time celiac disease was diagnosed, he had completely lost his faculty of speech. However, his speech and normal bowel function gradually returned after beginning a gluten free diet (8). This finding was so controversial at the time of publication (1988) that the authors chose to remain anonymous. Nonetheless, it is a valuable clue that suggests gluten as a factor in compromised speech production. At about the same time (late 1980’s) reports of connections between untreated celiac disease and seizures/epilepsy were emerging in the medical literature (9).
    With the advent of the Internet a whole new field of anecdotal information was emerging, connecting a variety of neurological symptoms to celiac disease. While many medical practitioners and researchers were casting aspersions on these assertions, a select few chose to explore such claims using scientific research designs and methods. While connections between stuttering and gluten consumption seem to have been overlooked by the medical research community, there is a rich literature on the Internet that cries out for more structured investigation of this connection. Conversely, perhaps a publication bias of the peer review process excludes work that explores this connection.
    Whatever the reason that stuttering has not been reported in the medical literature in association with gluten ingestion, a number of personal disclosures and comments suggesting a connection between gluten and stuttering can be found on the Internet. Abid Hussain, in an article about food allergy and stuttering said: “The most common food allergy prevalent in stutterers is that of gluten which has been found to aggravate the stutter” (10). Similarly, Craig Forsythe posted an article that includes five cases of self-reporting individuals who believe that their stuttering is or was connected to gluten, one of whom also experiences stuttering from foods containing yeast (11). The same site contains one report of a stutterer who has had no relief despite following a gluten free diet for 20 years (11). Another stutterer, Jay88, reports the complete disappearance of her/his stammer on a gluten free diet (12). Doubtless there are many more such anecdotes to be found on the Internet* but we have to question them, exercising more skepticism than we might when reading similar claims in a peer reviewed scientific or medical journal.
    There are many reports in such journals connecting brain and neurological ailments with gluten, so it is not much of a stretch, on that basis alone, to suspect that stuttering may be a symptom of the gluten syndrome. Rodney Ford has even characterized celiac disease as an ailment that may begin through gluten-induced neurological damage (13) and Marios Hadjivassiliou and his group of neurologists and neurological investigators have devoted considerable time and effort to research that reveals gluten as an important factor in a majority of neurological diseases of unknown origin (14) which, as I have pointed out previously, includes most neurological ailments.
    My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.
    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

    Jefferson Adams
    Celiac.com 06/14/2018 - Refractory celiac disease type II (RCDII) is a rare complication of celiac disease that has high death rates. To diagnose RCDII, doctors identify a clonal population of phenotypically aberrant intraepithelial lymphocytes (IELs). 
    However, researchers really don’t have much data regarding the frequency and significance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. Such data could provide useful comparison information for patients with RCDII, among other things.
    To that end, a research team recently set out to try to get some information about the frequency and importance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. The research team included Shafinaz Hussein, Tatyana Gindin, Stephen M Lagana, Carolina Arguelles-Grande, Suneeta Krishnareddy, Bachir Alobeid, Suzanne K Lewis, Mahesh M Mansukhani, Peter H R Green, and Govind Bhagat.
    They are variously affiliated with the Department of Pathology and Cell Biology, and the Department of Medicine at the Celiac Disease Center, New York Presbyterian Hospital/Columbia University Medical Center, New York, USA. Their team analyzed results of TCR-GR analyses performed on SB biopsies at our institution over a 3-year period, which were obtained from eight active celiac disease, 172 celiac disease on gluten-free diet, 33 RCDI, and three RCDII patients and 14 patients without celiac disease. 
    Clonal TCR-GRs are not infrequent in cases lacking features of RCDII, while PCPs are frequent in all disease phases. TCR-GR results should be assessed in conjunction with immunophenotypic, histological and clinical findings for appropriate diagnosis and classification of RCD.
    The team divided the TCR-GR patterns into clonal, polyclonal and prominent clonal peaks (PCPs), and correlated these patterns with clinical and pathological features. In all, they detected clonal TCR-GR products in biopsies from 67% of patients with RCDII, 17% of patients with RCDI and 6% of patients with gluten-free diet. They found PCPs in all disease phases, but saw no significant difference in the TCR-GR patterns between the non-RCDII disease categories (p=0.39). 
    They also noted a higher frequency of surface CD3(−) IELs in cases with clonal TCR-GR, but the PCP pattern showed no associations with any clinical or pathological feature. 
    Repeat biopsy showed that the clonal or PCP pattern persisted for up to 2 years with no evidence of RCDII. The study indicates that better understanding of clonal T cell receptor gene rearrangements may help researchers improve refractory celiac diagnosis. 
    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023