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Gluten-Free Diet May Lead to Poor Gut Health 06/05/2009 - Recently, the British Journal of Nutrition reported that following a gluten-free diet may be detrimental to gut health, which may also affect immune health, according to a new study from the Spanish National Research Council. The Spanish researchers analyzed the gut microflora of ten healthy subjects with an average age of 30 assigned to consume a gluten-free diet for one month.   Analysis of the participants’ feces showed that populations of healthy gut bacteria decreased following the gluten-free diet, while populations of unhealthy bacteria increased.

It has been previously documented that gluten can cause leaky gut, even without celiac disease.  Chronic gluten exposure has been shown to activate zonulin resulting in increased intestinal permeability (or leaky gut) even in the absence of celiac disease. Intestinal permeability with malabsorption has been described in celiac patients and their relatives who don’t have atrophy of the intestine on biopsy but only increased inflammatory cells.  An imbalance of intestinal bacteria has been cited as one of the main causes of leaky gut syndrome.  This study could be the beginning of discovering the missing components of the known link between celiac disease (and food sensitivities), leaky gut syndrome, inflammation, and immune health.

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

  • 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
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    dietary changes: 
    Limit foods that feed bad bacteria – all forms of sugar, vinegars, and moldy 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 and flaxseed.  Healthy bacteria found in yogurt (read the label to ensure that it contains live cultures) has also been recommended.
  • Think about chemical exposure:  Eliminating or reducing substances that promote intestinal permeability, such as avoiding antibiotics, nonsteroidal anti-inflammatory drugs, pesticides, herbicides, and meat contaminated with hormones.
  • Talk to your doctor:  More research needs to be done, but it seems as though probiotics may be protective against leaky gut and bowel inflammation.  Clinical research shows that oral supplementation of probiotics enhances the immune system's ability to fight foreign organisms.  Digestive Enzymes can also help to restore intestinal permeability.  Herbs and botanicals with anti-inflammatory properties, and those that reduce congestion and/or eliminate waste may also be helpful.
  •   Leaky Gut Syndrome/Intestinal Permeability, Cathy Wong, July 23, 2007
  • 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 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! welcomes your comments below (registration is NOT required).

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12 Responses:

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said this on
06 Jun 2009 5:11:14 AM PDT
Excellent article, but frustrating too. Just getting a handle on gluten free & now something else to worry about.

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said this on
10 Jun 2009 4:45:22 PM PDT
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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said this on
09 May 2012 10:20:06 PM PDT
I think you misunderstand. Gut bacteria help to regulate yeast in the intestines. Nobody said yeast is a bacteria.

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said this on
11 Jun 2009 6:02:56 AM PDT
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!

Patty Ahrens
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said this on
11 Jun 2009 8:24:46 AM PDT
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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said this on
11 Jun 2009 9:54:00 AM PDT
Just getting started with corrective measure re: celiac disease. Thank you for writing an article my non-medical mind can wrap around.

Phyllis Morrow
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said this on
11 Jun 2009 2:16:48 PM PDT
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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said this on
11 Jun 2009 4:52:51 PM PDT
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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said this on
31 Jul 2009 10:39:13 AM PDT
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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said this on
03 Dec 2010 10:31:25 PM PDT
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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said this on
03 Aug 2009 8:57:24 PM PDT
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 GF.

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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said this on
03 Nov 2011 4:25:49 PM PDT
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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I am very interested in this too. My daughter tested negative for celiac, but has terrible primarily neurological symptoms. Because she tested positive for SIBO at the time and was having some GI symptoms, I was told it was just a Fodmap issue. I knew better and we have been gluten free for 2 years. Fast forward to this February. She had a SIBO recurrence that I treated at home with diet and herbal antibiotics because I couldn't get the insurance referral. She was doing great. Then stupid me brought in gluten containing chick feed for the new baby chicks we got. Feed dust everywhere. Total mess. Really, no GI symptoms (she was SIBO free by then)...but the neurological symptoms! my daughter couldn't walk for three days. Burning down one leg, nerve pain in the foot. Also heaviness of limbs, headache and fatigue. Better after three days. But unfortunately she had a TINY gluten exposure at that three day mark and had another severe reaction: loss of balance, loss of feeling in her back and arms, couldn't see for a few seconds, and three days of hand numbness, fatigue, concentration problems. Well, I actually contacted Dr. Hadjivassilou by email and he confirmed that the symptoms are consistent with gluten ataxia but any testing would require a gluten challenge. Even with these exposures, antibodies would not be high enough. His suggestion was maintain vigilance gluten free. I just saw my daughter's GI at U of C and she really only recognizes celiac disease and neurological complications of that. But my impression is that gluten ataxia is another branch in the autoimmune side of things (with celiac and DH being the other two). At this point, I know a diagnosis is important. But I don't know how to get there. We homeschool right now so I can give her time to heal when she is accidentally glutened, I can keep my home safe for her (ugh, that I didn't think of the chicken feed!) But at some point, she is going to be in college, needing to take exams, and totally incapacitated because of an exposure. And doctors state side that are worth seeing? Who is looking at gluten ataxia in the US?

Caro..............monitoring only the TSH to gauge thyroid function is what endo's do who don' t do a good job of managing thyroid disease. They should do the full panel and check the actual thyroid hormone numbers.........T3 and T4. The importance of the TSH comes second to hormone levels. In order to track how severely the thyroid is under attack, you need to track antibody levels.......not the TSH. I did not stay with endocrinologists because I found they did not do a very good job and found much greater help and results with a functional medicine MD. You should not have a goiter if your thyroid is functioning well and your TSH is "normal". Maybe they should do a full panel? Going gluten free can have a profound affect for the better on thyroid function and that is something that is becoming more and more accepted today. Ask most people with Celiac and thyroid disease and they will tell you that. My thyroid never functioned well or was under control under after I discovered I had Celiac and went gluten free. It was the only way I got my antibody numbers back down close to normal and they were around 1200 when it was diagnosed with Celiac. I was diagnosed with Hashi's long before the Celiac diagnosis. I am not sure Vitamin D has anything to do with thyroid antibodies but who knows? Maybe it does have an affect for the better. It is really hard to get Vitmain D levels up, depending on where you live. Mine are going up, slowly, even after 12 years gluten-free but I live in the Northeast in the US and we don't have sun levels like they do in the South. I take 5,000 IU daily and that is a safe level to take, believe it or not. I get no sun on my job so the large dose it is! Having Celiac Disease should not stop you from being able to travel, especially S. America. I travel, although I do agree that some countries might be very difficult to be gluten free in. You can be a foodie and travel with Celiac so no worries on that front. You may not be able to sample from someone else's plate, unless they are eating gluten-free too but I have had awesome experiences with food when traveling so you can too!

I don't know what you drank or where.... so here are a few thoughts. - sure, a dive bar might have dirty glasses and serve a cocktail in a beer glass? But a nice reminder place, with a dishwasher, should be fine. If it's a sketchy place, Stick to wine, then it's served in wine glasses that aren't used for beer or bottled ciders in the bottle. - ciders on tap might, just a slight chance, have an issue. Because of beer on tap, mixed up lines, etc. - you may have a problem with alcohol - you may have issues with The high sugar content of the drink. I know I have similar issues if I drink serveral ciders of extra sugary brands - are you positive it was a gluten-free drink? Not this " redds Apple" pretending to be a cider - it's beer with apple flavor. Or one of those " gluten removed " beers?

Hi Stephanie, I'm also from the UK, I've found this site more helpful than anything we have! As already mentioned above, in my experience it could depend on what and where you were drinking. Gluten free food and drink isn't always (not usually) 100% gluten free as you may know, maybe you have become more sensitive to even a trace of gluten that is probably in gluten free food/drink. Is it possible you have a problem with corn, particularly high fructose corn syrup that is in a lot of alcoholic drinks? This was a big problem for me and the only alcoholic drinks I can tolerate are William Chase vodka and gin. I contacted the company last year and all their drinks are 100% gluten and corn free, made the old fashioned way with no additives, so maybe try their products if you like the occasional drink and see how you get on. If you drink out, not many pubs sell their products but I know Wetherspoons do and smaller wine bars may too. l was never a spirit drinker but I must say their products are absolutely lovely! Very easy on a compromised gut too considering it's alcohol. I second the suggestion on seeing a natural health practitioner. I've recently started seeing a medical herbalist, as I've got nowhere with my now many food intolerances since going gluten free last year and I've noticed a difference in my health already.

Sorry for the very late reply and thanks for the replies, I didn't get a notification of any. In case anyone else comes across this and has been wondering the same as I was, I did try a vegetable broth and I did react to it in the same way as if I'd eaten the vegetables. As for the candida, I've been using coconut oil and am seeing a medical herbalist for this and leaky gut. It's only been a few weeks but I've noticed an improvement all round.