What is gluten?

Gluten is a protein found in wheat, rye, and barley. If you suffer from a sensitivity or intolerance to gluten, including both celiac disease and non-celiac gluten sensitivity (NCGS), eating the gluten protein results in a potentially long list of negative reactions, including an attack by your immune system, which considers gluten a toxin. This “attack” can result in extensive damage to the body, creating symptoms that affect digestion, mood, heart, liver, thyroid, reproduction, brain function, muscles, and joints.

Is gluten causing your health problems?

If you are one of the many who suffer, you are in very good company. Gluten sensitivity (NCGS) is extremely common, affecting conservatively 15% of our population. Celiac disease, one of the most common life-long autoimmune disorders, affects 1 in 133 Americans or approximately 1%.

If you have celiac disease the likelihood is that you will not know it. Only 5 - 10% of the millions suffering receive a diagnosis and for those “lucky” few, it takes on average about 12 years to receive a diagnosis.

At this writing, approximately 90 to 95% of the individuals suffering from celiac disease, remain undiagnosed and therefore continue to suffer from the true cause of their problems remaining unknown.

Over 300 diseases and symptoms are caused by gluten

Some diseases and symptoms caused by gluten intolerance include:

Fatigue	Infertility
Obesity	Diabetes
Depression	Rheumatoid arthritis
Anxiety	Thyroid disease
Gas/Bloating	Liver Disease
Headaches/Migraines	ADD/ADHD
Acid Reflux	Autism
Brian fog/Poor memory	Stunted Growth
Hormonal imbalance	Osteoporosis

The list is actually much longer, but the above gives you a small sampling.

The difference between gluten sensitivity and celiac disease

Celiac disease is an autoimmune disease affecting about 1% of the population (although the figure rises with increased age). There is a genetic component to celiac disease and while most people with the disease have one or two specific genes, research is finding there may be other genes associated with the condition.

Celiac classically destroys the lining of your small intestine causing digestive problems in many. However, there are many more with celiac disease who have no digestive complaints, suffering symptoms instead in other parts of their body, chief amongst them the nervous system.

Gluten sensitivity (NCGS) is a condition that is estimated to affect anywhere from 10% to 30% of the population. Figures vary widely but increasing research should give us more precise numbers in the coming years. Until recently gluten sensitivity was questioned as to whether it legitimately existed. It is now clear that it is a bona fide condition affecting a great number of individuals, something we explore extensively in our book "The Gluten Effect", written by the Founders of Root Cause Medical Clinic.

Our celiac disease treatment protocol puts special emphasis on healing your immune system, something that is affected whether an individual has celiac disease or gluten sensitivity (NCGS). The biggest difference between the two conditions is the gluten sensitive individual does not suffer the frank destruction of the small intestine as the celiac patient does.

However, the damage that can occur to your body is in no way minor and gluten sensitivity can have a severe effect on your health status.

Common symptoms associated with gluten sensitivity (NCGS) are fatigue, headaches, mood swings, seizures, joint pain, and more.

Is there a perfectly accurate lab test you can take?

The first step is to get a blood test that evaluates for both celiac disease and gluten sensitivity (NCGS). Simply receiving a negative test result for celiac disease does not rule out the presence of gluten sensitivity, so it is recommended to test for both.

Lab tests exist to test for celiac disease and gluten sensitivity, but they can suffer from a lack of sensitivity meaning you are told you are fine when you really have a problem. Newer lab tests have been released and time will tell if they are better than their predecessors.

Diagnosing celiac disease is not a one-step process. Leading researchers from around the world devised a 4 out of 5 Rule as the gold standard for celiac diagnosis.

Test your doctor: The 4 out of 5 Rule for celiac diagnosis

I mentioned it above and here are the specifics of the rule.

In order to diagnose celiac disease, you need 4 out of the following 5 points to be positive.

1. A positive blood test – the classics are tTG and EMA.
2. Symptoms consistent with celiac disease
3. Symptom improvement on a gluten-free diet
4. A positive genetic test
5. A positive biopsy – thus this is not mandatory for a diagnosis if all the others are positive.

If you are seeking help to determine if you are suffering from either celiac disease or gluten sensitivity, you should find a clinician who knows this rule. Should you mention it and learn that your doctor has no familiarity with it, you should find a new clinician.

If celiac tests are negative but your symptoms suggest gluten could be a problem, you could be suffering from gluten sensitivity. Do a 30-day trial of a gluten-free diet and see how you feel. Noticing an improvement of symptoms on a gluten-free diet is a valid test in and of itself, and it should not be ignored.

Are you gluten-sensitive? Take the Self-Test to find out!

If you are wondering if you are part of the population that suffers from gluten sensitivity, then take this test!

Check off the symptoms that apply to you:

Digestive:

___ Craving for wheat
___ Bloating / Gas
___ IBS
___ Acid reflux
___ Constipation
___ Diarrhea
___ Poor appetite
___ Children who are picky eaters
___ Weight trouble
___ Iron-deficiency anemia
___ Indigestion
___ Nausea

Neurological:

___ Headaches
___ Migraines
___ Memory problems
___ Brain Fog
___ Poor concentration
___ ADD/ ADHD/ Spectrum Disorder
___ Joint pains and/or muscle aches
___ Ataxia
___ Fibromyalgia

Hormonal:

___ Fatigue
___ Sleep problems
___ Depression
___ Anxiety
___ Irritability
___ Mood swings
___ Menstrual problems
___ Infertility and/or Miscarriage
___ Thyroid problems
___ Osteoporosis or Osteopenia (you or your family)

Immune:

___ You get infections easily
___ Sinus congestion
___ Asthma
___ Skin rash
___ Eczema
___ Psoriasis
___ Elevated liver enzymes
___ Arthritis, any type (in you or your family)
___ Cancer history, you or your family
___ Autoimmune diseases such as diabetes, M.S., Lupus – you or your family
___ Celiac disease, you or your family

How did you score?

If you checked 1 to 3 lines: Gluten sensitivity (NCGS) may be playing a role in your health problems.

If you checked 4 to 7 lines: There is a definite possibility that you are suffering from gluten sensitivity.

If you checked 8 or more lines: The likelihood is strong that gluten sensitivity is having a negative effect on your health.

Does your score put you in the “suspicious” or “likely” category? If so, you are not alone.

What should you do now?

Let us discuss the two possible conditions that may be affecting your health, celiac disease, or non-celiac gluten sensitivity (NCGS).

Celiac disease is one of the most common life-long disorders in Europe and the United States. 1% of the population suffers and this percentage increases with age, making it quite common.

One would think such a common disorder was well diagnosed in an advanced medical system such as our own. As we discussed earlier, that is, unfortunately, not at all the case. Less than 10% of all those people suffering from the disease are diagnosed. To add insult to injury, those people who are diagnosed, take on average 7 to 12 years to receive their diagnosis.

Why does your celiac disease remain undiagnosed?

What follows are possible reasons to explain the profound failure in diagnosing celiac disease:

A.) We live in a drug-oriented society that recommends you swallow a pill to mask your symptoms. Celiac disease can only be treated with a dietary change, and it is not an easy one. There is no drug available to treat celiac disease and for that reason, there is not much emphasis placed on its diagnosis.

B.) Doctors in this country are not focused on diet and lifestyle and they do not like to tell their patients to make diet changes, especially ones that are difficult and required to be life-long. I have run across so many patients whose doctors, even once their celiac disease was diagnosed, focused on a different disease they had, one for which a drug “solution” existed while placing their celiac disease on the “back burner” untreated.

C.) The pharmaceutical companies in this country control over 70% of all the research done. With diet being the only “cure” for celiac disease that we know of, it is definitely not a disease that pharmaceutical companies are going to spend a lot of time and money researching.

D.) The lab tests that have been used for celiac disease suffer from a lack of precision. This means that many people are told that gluten is not their problem when it is. The tests often require that a tremendous amount of damage occurs to the small intestine before the test will be positive, thereby missing the “early stages” of the disease. Additionally, not everyone with celiac disease experiences the same damage to their intestine and therefore those suffering from more neurologically based celiac, skin-based, or that affect other systems of the body, are misdiagnosed as having the condition.

E.) Doctors are set in their ways, and it has only recently become apparent how common celiac disease is. Most of them were trained, erroneously, that celiac disease was rare and that patients would present with symptoms of abdominal pain, severe diarrhea, and weight loss. It is now known that most patients with celiac disease will not necessarily have such symptoms but changing how medical doctors think occurs slowly.

Causes aside, the facts remain the same – about 90% of those suffering from celiac disease – a common disease – remain undiagnosed and suffering – a statistic we aim to improve.

Do you have Non-Celiac Gluten Sensitivity (NCGS)?

NCGS is a very common condition that affects conservatively 8 to 15 times more people than those affected by celiac. Why then does not “everyone” know about it? It is only fairly recently that NCGS has been validated to legitimately exist.

In fact, when the Doctors Petersen, Founders of Root Cause Medical Clinics, wrote “The Gluten Effect” in 2009, they stated information about gluten sensitivity that was not accepted by the celiac community and leading researchers. In fact, at the time of its publication, the predominant thought was that those who “seemed” to be reacting to gluten but who did not have celiac disease, were likely mistaken and perhaps suffering from a “placebo effect” of some sort.

By the end of 2009, however, and continuing into 2010 and 2011, more and more research results have proven that gluten sensitivity is not only a very real condition but one that is affecting the health of millions of unsuspecting individuals of all ages.

You have a greater risk of suffering Gluten Sensitivity (NCGS)

Estimates vary as continued research is needed, but the incidence of gluten sensitivity appears to lie somewhere between 8% and 15%. Many argue it is higher.

Why the wide variation? Research on gluten sensitivity has only recently begun in greater earnest. As an example of how much time it can take to get a “handle” on a disease, research on the celiac disease has been occurring for decades yet it took until 2010 to discover that the incidence of celiac actually increased with age from 1% to 4 or 5%. This is minimally a 400% increase in a disease that was thought to be purely genetic – meaning you were either born with it or you were not and it would reveal itself in childhood.

It was a tremendous breakthrough to discover that diet, lifestyle factors, the health of the digestive tract, plus having the gene for celiac, were all needed to “turn on” the gene that makes one react negatively to gluten. Meaning, you can have the gene, but if you have a healthy immune system and digestive tract, you may never turn on and activate your celiac disease.

What should you do If you are sensitive to gluten?

If you discover that gluten is a problem for you, the first step in treatment is to completely eliminate all gluten from your diet. While that may seem a daunting task, we are committed to supporting you through the transition.

We have many sections of this website dedicated to just that, including the Self Test you can see above, many blogs on the topic of Gluten Sensitivity and Celiac Disease, Videos, and a list below entitled Gluten-free Diet Food List.

It is not easy to be completely gluten-free, but the benefits to your health are more than worth the effort.

Consider calling one of our clinics for a free phone consultation to ensure you get the most comprehensive health you require. Difficult as the diet change is, there is more that is required to fully optimize your health. We are here to help.

What if all your symptoms do not improve on a gluten-free diet?

As mentioned above, eliminating gluten is often just the first part of treatment. As doctors who specialize in gluten intolerance (NCGS) and celiac treatment, we see that some individuals improve dramatically with just a dietary change, but more often the improvement can be temporary and is not enough to restore one to the status of feeling good again.

Due to gluten’s effect on the immune system, several problems can occur. We call these the Secondary Effects of Gluten.

• One can develop infections in the intestine that, while “silent” symptom–wise, is preventing the intestine from completely healing.
• In addition, gluten creates a “leakiness” of the intestine that compromises the absorption of nutrients, inflames the immune system, and allows problems to develop in many other systems of the body. It is this “leaky gut” that is thought to be a major contributor to the long list of problems that can occur secondary to gluten.
• Due to the stress put on the immune system, your body can react to other foods as if they were gluten – these are called cross-reactive foods, and a specialized lab test can determine if such reactions are occurring.

Gluten-Free Diet Food List – Everything you need to know

What You Can and Cannot Eat

What is the key to success with gluten-free diets? Having a gluten-free food list. You must know where gluten resides as well as where it hides!

Gluten is present in many grains and starches, as shown in the following table:

Contains Gluten

Wheat	Kamut
Wheat Germ	Matzo
Wheat Grass	Seitan
Rye	Farino
Semolina	Barley
Spelt	Bulgar
Triticale	Couscous
Oats*	Graham Flour
Oat Fiber*	Farro
Oat Bran*	Spelt

*Problematic due to contamination

Gluten-free Foods

Amaranth	Flax
Rice	Garfava
Corn	Sorghum
Soy	Millet
Potato	Teff
Quinoa	Buckwheat
Tapioca	Arrowroot
Beans	Nut Flowers

Label Reading: Your key to a successful gluten-free diet

Foods with labels that list the following ingredients are questionable and should NOT be consumed unless you can verify they do not contain or are derived from prohibited grains.

Remember, you need to be gluten-free, not just wheat-free.

In the past, many products said they were gluten-free while having questionable ingredients. Today’s labeling laws have made that a distant memory for the most part, although we do hear about “mistakes” happening on assembly lines occasionally.

The biggest problem patients run into is “thinking” that a product “should not” contain gluten and thereby failing to read the label. Common examples among our patients include soy sauce and beer. It seems odd to patients that a liquid would have gluten.

There are also labels that say “may contain gluten” or “made in a facility that also makes gluten-containing products”. The former is something you should avoid, the latter is different for different patients, but ultimate security comes from a label that does not contain either warning.

Do not be fooled and compromise your health—always read the ingredient list carefully.

When in doubt, write to the company online. Most companies are very forthcoming with such information.

Below are some foods that frequently come up as a source of contamination for our patients. This is the current information we have but ultimately it is always best to read the label carefully and look for “gluten-free” specifically. If it does not say it is gluten-free best to avoid it.

Gluten-Free Diet Food List Tip: Foods to watch!

	Blue Cheese – check with the company; many are fine but not all and they often have no label.
	Bran — while bran should be okay, I would never eat wheat or oat bran unless the label specified that it was gluten-free.
	Brown Rice Syrup – frequently, but not always, made from barley and therefore not gluten-free.
	Caramel Color – infrequently made from barley, therefore usually safe.
	Dextrin – usually made from corn but may be derived from wheat – if so the label will state it clearly.
	Dry Roasted Nuts – processing agents may contain wheat. The label will state that.
	Emergen-C – raspberry and mixed berry flavors contain some gluten, the other flavors are fine.
	Flour or Cereal Products – all dependent on the source of the grain(s).
	Hydrolyzed Vegetable Proteins (HVP) — or any vegetable protein, hydrolyzed plant protein (HPP), hydrolyzed soy protein, or textured vegetable protein (TVP) as these labels will say “wheat” it if was made from it. Otherwise, it is safe.
	Malt or Malt Flavoring – usually made from barley, therefore not safe.
	Malt Vinegar – this typically contains gluten. Watch for this in certain chips. Occasionally it is made from corn, but typically it is barley or a barley/corn blend, neither of which is okay. There are some manufacturers that distill their vinegar. A distilled product would be safe, but I have never yet seen it on a label. This is a tricky one because malt potato chips will not have gluten listed on the ingredient list.
	Modified Food Starch — a label will say “wheat” if it is made from it.
	Ricola Cough Drops – our most recent check with the company stated, “some of our products may contain ingredients derived from wheat, such as our center filled Dual Action drops, these ingredients are highly purified.”
	Starch — a label will say “wheat” if it is made from it, otherwise, it is safe.
	Soy Sauce or Soy Sauce Solids – these do contain gluten, wheat-free tamari is something you can purchase but in restaurants assume the soy sauce contains wheat.

Foods that often contain gluten

Malt	Marinades	Seitan
Malt vinegar	Meatballs	Self-basting poultry
Breading	Meatloaf	Soup bases
Broth	Meat substitutes	Soy-based veggie burgers
Coating mixes	Monosodium glutamate	Soy sauce
Communion wafers	Pasta	Stuffings
Crab cakes	Processed meat	Tamari
Croutons	Roux	Textured vegetable protein
Hydrolyzed vegetable protein	Sauces	Thickeners
Imitation bacon	Sausages (some)	Vital wheat gluten found in imitation meats
Imitation fish

Alcohols

Beer is made from grains and thereby contains gluten.

Most other alcohols such as scotch, rye, and vodka, while made from grains that are glutinous, are distilled, which removes the gluten, thereby making them safe to consume.

Certain vodkas have additives that contain gluten, so again, read labels.

Further, many patients who have celiac disease, or who are gluten sensitive, have intestinal infections that cause a poor reaction to alcohol.

Soy

Soy is considered an acceptable food for those who are gluten sensitive. Traditional soy foods such as tofu, edamame, soy pods, and some types of miso and tempeh are gluten-free. As always, read the label as grains or wheat-containing soy sauce can be added to miso and tempeh.

Unfortunately, soy is frequently genetically modified and should only be consumed if organic.

Soy sauce contains wheat and many Asian dishes have added soy sauce. Wheat-free tamari is available when you cook at home. In this liquid form, soy sauce is one of the most common sources of hidden gluten but can be purchased gluten-free as tamari.

Seitan and most soy-based veggie burgers contain “vital wheat gluten”, the ingredient that gives these foods the texture and taste of meat.

Further, despite being gluten-free, soybeans can cause sensitivity or allergic reactions in some. Symptoms include digestive bloating, gas, and allergic symptoms.

This may be a true allergy or an intolerance created by the prevalent genetic engineering.

Evaluate your tolerance to soy and, if acceptable choose high-quality organic products (preferable fermented) and enjoy a plant-based source of good quality protein.

Oats

Oats can be an area of confusion when trying to avoid gluten.

Many companies are advertising oats as “gluten-free”. There are some gluten-free societies that become quite impassioned when defending their ability to eat oats. Others do not recommend oats due to the problem of unacceptable levels of contamination.

Oat fields frequently have wheat or rye growing in them and therefore most oats, when assayed, show gluten contamination. If the contamination does not happen in the fields then it occurs in transport or at the manufacturing facility.

While we all agree that oats contain a different protein from wheat, rye, and barley and are therefore not classically gluten, in practicality when a gluten intolerant person consumes “regular” oats they often react to them the same as if they were consuming gluten, due to contamination.

Please only consume oats from a dedicated facility that guarantees they are gluten-free. The good news is there are many companies that offer certified gluten-free oats.

Drugs

 

Some drugs contain gluten. If you are avoiding gluten it is critical that you examine any drugs you may take for the presence of gluten.

Dentists & Hygienists

You may wonder what your semi-annual teeth cleaning has to do with your gluten-free diet. The tooth polish that a hygienist uses on your teeth, as the final step to cleaning, often contains gluten.

I only discovered this after discussing my gluten intolerance with a very smart hygienist who knew that gluten was an ingredient in her tooth polish. She found one for my family and me that was gluten-free.

The good news is that there is a gluten-free polish. But you will need to remind your hygienist or dentist before you arrive to ensure they have it on hand.

Foods that are safe despite bad PR

Certain ingredients have gotten a “bad rap” in the past and continue to appear on various sites as gluten-containing. We try to give you the latest information here so that you can have a reliable resource. This site is updated regularly to reflect changes as they occur.

To clear up any lingering confusion, let us review a few different ingredients that have gotten poor reviews, mostly unnecessarily:

• Mono and Diglycerides –these are fats made from oil, usually soy, and act as emulsifiers. They are gluten-free.
• Maltodextrin –despite beginning with the word “malt,” it is gluten-free, usually made from corn, unless stated otherwise. e.g. “wheat maltodextrin” or “maltodextrin (wheat)”.
• Glucose Syrup and Citric Acid –even when derived from wheat, these are highly processed, and the final product is gluten-free. Both are usually made from corn.
• Modified Food Starch –in the past, this was a source of gluten but currently, like maltodextrin, if it contains wheat, the label will say so. Once again, this is usually made from corn.
• Seasonings and Spices –spices are pure and therefore gluten-free, but seasonings are made from several ingredients and wheat can be one of them. It must be on the label, however, so read carefully. There have been more than a few run-ins with taco and chile seasoning packets that have created misery for patients that were not careful label readers.
• Dextrose —is made from starch and is highly processed, so even if made from wheat, there would be no gluten remaining in the finished product.

You can be treated by the experts

Accurately diagnosing gluten as a problem and handling the secondary effects correctly is one of the specialties of the Doctors at Root Cause Medical Clinics.

Two of our doctors have authored a book on the subject, the bestselling “The Gluten Effect”, and they are nationally acclaimed public speakers on celiac disease and gluten sensitivity.

There are too many people needlessly suffering from the effects of gluten. We are committed to raising awareness and increasing the rate of diagnosis, thereby improving the health of affected individuals one by one, family by family.

We offer celiac disease treatment for those living locally in Silicon Valley, California, or Clearwater, Florida, and around the country via telemedicine.

Individuals travel to see us or use our telemedicine services from across the country due to our highly effective treatment protocols.

Regardless of where you live, consider the first step of a FREE phone consultation – call (408) 733-0400.

We help the world’s busiest people regain, retain, and reclaim their health, energy, and resilience.

The Doctors at Root Cause Medical Clinic are specialists in treating gluten sensitivity (NCGS) and celiac disease and are committed to changing this poor rate of diagnosis. If you are wondering if gluten is having a negative effect on your health, call us for a free consultation – (408) 733-0400. We would be happy to help!