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Posts Tagged ‘Gluten free’

arsenic levels in GF foods copy

Recent studies have shown rice can be dangerously high in inorganic arsenic, particularly rice grown in the southern United States. This is bad news for gluten-free people who eat rice-based products — one study showed people on a gluten-free diet have twice as much arsenic in their urine compared to controls (and 70 percent more mercury).

Although guidelines exist to minimize arsenic exposure (buy rice from California, eat white rice, wash rice thoroughly before cooking, and cook rice like pasta in a ratio of about 6 to 1 water to rice), what about rice-based gluten-free foods? It’s nearly impossible to know where their rice comes from, how it’s processed, and what the arsenic levels are.

Arsenic levels in popular gluten-free foods

Until now. The Gluten-Free Watchddog has begun testing arsenic levels in popular brands of gluten-free foods  which you can view with a subscription.

Keep in mind that what is considered an acceptable amount of arsenic varies. Codex, an international collection of safety standards, proposes a maximum of 200 parts per billion in white rice. The European Union proposes 100 parts per billion.

However, arsenic expert Dr. Andrew Meharg proposes a maximum of 50 parts per billion for children, who carry a heavier toxic body burden, and a maximum of 100 parts per billion for adults.

Arsenic levels in rice-based gluten-free foods

For results of inorganic arsenic testing on various brands of gluten-free foods that you can browse by category, visit Gluten-Free Watchdog  A paid subscription is required to access the reports. However, below are examples of arsenic level ranges in some categories of popular gluten-free foods.*

Inorganic arsenic in gluten-free breads

Inorganic arsenic in popular gluten-free breads ranged from 10 parts per billion to 40 parts per billion.

Pastas

Inorganic arsenic in popular gluten-free pastas ranged from 20 parts per billion to 150 parts per billion.

Cereals

Inorganic arsenic in popular gluten-free cereals ranged from 70 parts per billion to 280 parts per billion.

Miscellaneous rice products (rice bran, rice milk, rice syrup, rice cakes)

Inorganic arsenic in miscellaneous rice products ranged from 20 parts per billion to 540 parts per billion.

Rice

Inorganic arsenic in several rice brands ranged from 80 parts per billion to 140 parts per billion. (Brown rice has more than white rice. Gluten-Free Watchdog reports a brand called Mighty Rice grown on the island of Mauritius shows very low levels of inorganic arsenic in their tests.)

Factor in frequency and amount of consumption

It’s important to understand these numbers tell us the concentration of inorganic arsenic in each product. The frequency and amount of any item eaten and whether the eater is an adult or a developing child are also very important factors in the equation. For example, at 540 parts per billion of inorganic arsenic, one rice bran product looks pretty bad. But consumed in very small quantities as brans typically are, it may not pose as much a problem, relative to the other foods listed, as it first may seem.

It would be better if rice were not high in inorganic arsenic. Thankfully groups such as Gluten Free Watchdog are around to help us reduce exposures. Also, there is a group based at Cornell University working to shift the world to a rice farming method that uses up to 50 percent less water while increasing yields, thus saving precious water while reducing the amount of arsenic in the rice produced.

*Ranges included with permission from Gluten-Free Watchdog LLC.

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gluten and thyroid copy

Hypothyroidism has received a lot of attention online since the publication of Why Do I Still Have Thyroid Symptoms? by Datis Kharrazian in 2009. While many facets should be addressed in managing hypothyroidism, one of the most important continues to be a gluten-free diet.

Research shows ninety percent of hypothyroidism cases are due to an autoimmune disease that attacks and destroys the thyroid gland. This disease is called Hashimoto’s.

Most doctors do not test for Hashimoto’s because it does not change treatment, which is thyroid medication. Also, many cases of hypothyroidism go undiagnosed because Hashimoto’s can cause the lab marker TSH to fluctuate.

Where does gluten fit in with this? Numerous studies have linked an immune reaction to gluten with Hashimoto’s hypothyroidism. Whether it’s a gluten sensitivity or celiac disease, gluten triggers an autoimmune attack on the thyroid gland in many people. Most of these people do not even know they are sensitive to gluten.

Going off gluten is the first step with Hashimoto’s

Studies, clinical observation, and patient stories make a very strong case for the benefits of going gluten-free to better manage your Hashimoto’s hypothyroidism symptoms.

A number of studies for several countries show a link between Hashimoto’s and gluten. This is because the protein structure of gluten closely resembles that of thyroid tissue. When your immune system reacts to gluten, it may start erroneously reacting to thyroid tissue as well. This will cause the immune system to attack and destroy thyroid tissue in a case of mistaken identity.

Studies also show patients improve on a strict gluten-free diet. One study showed as many as 71 percent of subjects resolved their hypothyroid symptoms after following a strict gluten-free diet for one year.

Why you may need to stop eating other foods too

Sorry to say, going gluten-free alone doesn’t always work. Many people with Hashimoto’s hypothyroidism also need to go dairy-free. Dairy, whether it’s cow, goat, or sheep, is the second biggest problem food for people with Hashimoto’s hypothyroidism.

Many people simply have an immune intolerance to dairy and aren’t aware of it until they stop consuming it. However, in an immune sensitive individual, the body may also mistake dairy for gluten and trigger an immune reaction that ultimately ends up targeting the thyroid.

For those serious about managing their Hashimoto’s hypothyroidism, a gluten-free and dairy-free diet frequently results in profound alleviation of symptoms, if not total remission.

Many find they may need to eliminate additional foods, such as certain grains, eggs, or soy. An elimination/provocation diet can help you figure out what your immune system reacts to, or a comprehensive food sensitivity test from Cyrex Labs.

What is there left to eat?

If you’re used to eating without restrictions, eliminating gluten, dairy, and possibly other foods to manage your Hashimoto’s hypothyroid symptoms may seem overwhelming and too restrictive. Many people are left wondering, what is left to eat?

Rest assured there is more than enough to eat. Most people fare well on a paleo diet that is primarily vegetables (a diverse array of plenty of vegetables helps create the healthy gut bacteria that improve immunity.)

More importantly, symptoms and general health improves so dramatically that people come to love their new diet and despise the way they feel after they cheat.

Ask my office for more information about implementing a gluten- and dairy-free diet.

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wheat reactivity copy

Turns out gluten isn’t the only culprit when it comes to an immune reaction to wheat.

New research suggests non-gluten proteins are also a source of those immune reactions to wheat.

The new suspects are a family of proteins called amylase-trypsin inhibitors, or ATIs  While they make up only four percent of the proteins in wheat, ATIs can trigger powerful immune reactions that can spread from the gut to other tissues in the body, such as the lymph nodes, kidneys, spleen, and even the brain.

ATIs are also shown to inflame pre-existing chronic conditions, including multiple sclerosis, asthma, rheumatoid arthritis, non-alcohol fatty liver disease, lupus, and inflammatory bowel disease.

And, ultimately, ATIs contribute to the development of gluten sensitivity.

At this time, it’s not entirely clear how much of a role ATI proteins play compared to gluten. We know from previous research that people with symptoms of gluten sensitivity have been shown to react to several different types of gluten, as well as lectins and agglutinin.

The evolution of understanding wheat sensitivity

It used to be celiac disease was the only recognized immune reaction to wheat. Celiac disease is an autoimmune condition that affects a small percent of the population and requires medically invasive diagnostic criteria.

Only more recently has mainstream medicine begun to accept non-celiac gluten sensitivity. Newer research, the sheer volume of gluten-sensitive patients, and the explosion of the gluten-free market has made gluten sensitivity impossible to deny.

For decades, patients who tested negative for celiac disease or even gluten sensitivity (standard testing is severely limited) have been told “It’s all in your head.” Today, the scientific legitimacy of an immune reaction to wheat is growing.

Likewise, a growing number of doctors are more willing to offer a diagnosis of gluten sensitivity and effective treatment strategies.

Gluten reactions occur in brain and elsewhere

Symptoms of gluten sensitivity can include digestive issues such as abdominal pain and symptoms similar to irritable bowel syndrome (IBS). However, common symptoms not related to the gut include headaches, joint pain, eczema, brain fog, and a number of dysfunctions related to the brain and nervous system.

Research on wheat immune sensitivity continues

Research continues and in the future, it may be your doctor recommends an “ATI-free” diet instead of a gluten-free diet.

Either way, if you react to gluten, avoiding it is the best choice for your long-term health.

If you have concerns about reactions to gluten, contact my office. Functional medicine has effective protocols to assess, diagnose, and manage gluten sensitivity.

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gluten sensitivity testing

If you tested for whether gluten might be behind your chronic health issues but a blood test came back negative, are you wondering, “Now what?”

Although it’s possible gluten may not be a problem for you, there’s a high probability that test result was inaccurate. Conventional testing for gluten sensitivity misses many important markers and can give you a false negative result. As a result, you may be told gluten is not an issue when in fact it is provoking your autoimmune disease or chronic health condition. Gluten has been linked in the literature to 55 diseases so far, most of them autoimmune.

Fortunately, newer testing has been developed by Cyrex Labs to catch the cases of gluten sensitivity that conventional testing misses.

Why standard blood tests often fail at diagnosing gluten sensitivity

Standard blood tests for gluten sensitivity have a less than 30 percent accuracy rate. Gluten has to have significantly destroyed the gut wall for blood testing to be effective. In many people, gluten damages other tissues in the body, such as neurological tissue.

Current tests only screen for one component of wheat, alpha gliadin. Yet people can react to at least 12 different portions of the wheat protein.

In some people, other foods such as dairy can trigger a gluten-like immune response because the body sees them as one in the same. This is called cross-reactivity. Conventional doctor’s offices do not screen for this.

Standard testing only looks at the response of one set of immune cells. If those cells are depressed due to immune exhaustion, results could be inaccurate. More thorough testing compensates for immune depression by testing a variety of immune cells.

Gluten damages more than the gut

Standard testing also only looks at whether gluten sensitivity is destroying gut tissue. However, in many people, gluten does not cause an immune reaction in the digestive tract to the same degree it does in the brain or in the skin. In fact, most people are affected neurologically by a gluten intolerance. Fortunately, we now have ways to screen for that.

Which part of wheat do you react to?

Gluten sensitivity isn’t as cut-and-dry as once thought. (Also, the word “gluten” is technically incorrect as “gliadin” is the portion of wheat that triggers an immune response.)

Wheat is made up of more than 100 different components that can cause a reaction, not just the alpha gliadin component most tests use.

Other parts of wheat that can cause gluten sensitivity include different forms of gliadin besides alpha gliadin, the portion of wheat found in whole wheat, the sticky portion of gluten, wheat that has been altered through industrial processing, and wheat opioids — substances produced during the digestion of wheat that have addictive properties similar to opiates. People with a wheat opioid sensitivity may go through severe withdrawals on a gluten-free diet.

In addition to comprehensive gluten sensitivity testing, Cyrex also tests for the following: foods that cross react with gluten, damage that gluten can cause to your gut and your brain, and autoimmune reactions (when your immune system attacks and destroys body tissue) that may have gone undiagnosed yet cause chronic symptoms. For more information about advanced immune testing, contact my office.

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451 FDA sued for gluten meds

A man with celiac disease is suing the FDA, demanding they take action on the undisclosed use of wheat in an estimated 150 different prescription and over-the-counter (OTC) medications.

Although about 1 percent of the population suffers from celiac disease, vastly more have gluten sensitivity and must also abstain from eating wheat to avoid a variety of health conditions that typically involve inflammation, such as joint pain, brain-based disorders, skin problems, gut problems, and more.

The man sued the FDA after they failed to respond to a petition he filed after developing gluten reactions to a generic drug he had been taking.

Manufacturers do not disclose the use of wheat in their prescription and OTC drugs, making it a crapshoot for those with celiac disease or gluten sensitivity who must take them. The man filing the lawsuit had to call the manufacturer to inquire about the use of gluten in that specific batch of drugs. (Filler ingredients are changed regularly.)

Although it’s unclear how many drugs contain gluten — a serious problem when it’s that difficult to ascertain — a university pharmacist has so far catalogued 150 drugs that don’t contain gluten  Unfortunately, however, even these drugs are questionable as there is no oversight regarding cross-contamination with gluten. In other words, if the drugs are made on equipment or in an area contaminated with gluten, then they are no longer gluten-free. Many drugs also contain corn  potato, or soy, ingredients that may cross-react with gluten, causing symptoms.

It’s good to know which drugs contain gluten, especially since some autoimmune diseases are linked in the science with gluten. If you take a medication regularly to help manage your autoimmune condition (such as insulin), it’s worth calling the manufacturer to ensure it is gluten-free. Gluten is linked to 55 diseases so far, the majority of them autoimmune and many of them neurological.

Gluten also in many household products

Medications aren’t the only thing not required to list gluten as an ingredient. Some body products and household items also contain hidden gluten.

Manufacturers often use wheat in fillers, lubricants or absorbents in various body products. While gluten is not absorbed through the skin, it is possible to transfer traces from your hands or face to your mouth, where it can be swallowed and cause symptoms.

Examples of products that may contain hidden gluten include cosmetics and lip balm; lotions and sunscreens; stickers, stamps, and envelope glue; toothpaste; soaps; play dough; pet food; and laundry detergent.

How to protect yourself from hidden gluten

Unfortunately, your doctor or pharmacist may not know whether a drug or product contains gluten. It may be up to you to hunt down which are safe. The list of gluten-free drugs compiled by the university pharmacist is helpful.

Fortunately, when it comes to body and household products, many people have already done the research and reported their results online  Finding out whether a product is safe may be just a click away so you don’t have to go through the hassle of tracking down the right person in the company.

In response to consumer demand, an increasing number of companies are making and marketing gluten-free body products so just a quick glance at the label can tell you if it’s safe.

Also, for parents of children with a gluten-sensitivity, finding safe play dough can be a hassle; the name-brand stuff is wheat-based and we know it’s difficult for kids to keep their hands out of their mouths. Fortunately, some gluten-free brands of play dough are now available online, as well as plenty of very easy recipes to make your own.

Although it takes a little bit of extra effort to use medications and other products that are gluten-free, it’s worth the peace of mind to avoid provoking inflammatory reactions and symptoms.

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403 gluten sensitivity debunked response

Recent health headlines proclaimed gluten sensitivity doesn’t exist, fueling a backlash against the gluten-free diet as a baseless fad. These stories point to a recent study questioning the relationship between non-celiac gluten sensitivity and digestive symptoms. Sadly, they mislead the public by glossing over major points of research and cherry-picking information to debunk gluten sensitivity.

The study looked at how people with gluten sensitivity reacted to varying levels of gluten. Significant to the study was the elimination of FODMAPS (Fermentable Oligo-, Di-, and Monosaccharides, and Polyols), carbohydrates in many common foods known to exacerbate irritable bowel syndrome (IBS) symptoms. Foods high in FODMAPS include garlic, onion, beans, many fruits, yogurt, and more. Researchers removed FODMAPS to rule them out as a source of digestive symptoms, clearing the slate to determine whether gluten was to blame.

Study’s view is too narrow

The study concluded gluten had no effect on patients with gluten sensitivity who were placed on a low FODMAP diet, causing journalists to declare gluten sensitivity doesn’t exist. However, the paper doesn’t actually suggest that. Instead, the authors give nod to other factors that may have affected their results, such as the possibility that FODMAPS and gluten might work together to cause gastrointestinal symptoms. They acknowledged the results were markedly different from a previous study, and point out the need for further exploration on the topic.

Gluten sensitivity does not cause digestive symptoms in most people — affects other parts of the body

More importantly, the study did not look at symptoms outside of the digestive tract. Other research shows gluten causes digestive symptoms in only about one third of those with gluten sensitivity. In fact, gluten sensitivity destroys the brain and nervous tissue more than any other tissues in the body, and symptoms can be ambiguous for years and difficult to connect with gluten. Symptoms of a gluten sensitivity can also manifest in the skin, joints, bones and teeth; gluten has been associated with more than 55 diseases so far, most of them autoimmune.

While this recent study looks at digestive symptoms in response to gluten, it does not consider other symptoms commonly associated with gluten sensitivity, such as depression (research here), muscle pains, inflammation, neurological issues  and changes in mental function.

The study also does not consider other important facets of gluten sensitivity, such as gluten cross-reactivity seen with autoimmunity (when the immune system mistakenly attacks body tissue, such as the thyroid gland or the brain, because it so closely resembles the gluten protein), leaky gut, other foods that cross-react with gluten and cause gluten sensitivity symptoms (such as dairy), and more. These other factors need to be incorporated into a more comprehensive understanding of gluten.

So does gluten sensitivity exist?

Although there is no verified biomarker for non-celiac gluten sensitivity, researchers at the Center for Celiac Research and Treatment say they are close to determining one. Also, this recent study is but one of many in the field of gluten research and other research shows very clear evidence of gluten sensitivity.

Should you abandon your gluten-free diet?

While this new study asks valuable questions, does it mean non-celiacs who experience symptoms from gluten should continue eating it? Of course not! While this study raises new questions in relation to FODMAPS, millions of people with gluten sensitivity worldwide experience relief from their symptoms and progression of chronic disease on a gluten-free diet. Functional medicine practitioners have especially seen the beneficial effect of a gluten-free diet on myriad conditions.

The body always knows best. When we learn to listen to the body, the wisdom it shares leads us to make solid choices for greater health and wellness.

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gluten in meds

So you’re officially gluten-free. You have your kitchen and shopping lists dialed in and you know how to look for hidden gluten in packaged foods. Ready to go! But wait — did you know that some body products and household items, as well as over-the-counter (OTC) and prescription medications contain hidden gluten? These items can be the source for ongoing immune activation for those with celiac disease and non-celiac gluten sensitivity. Additionally, many people with autoimmune conditions experience cross-reactions with corn, a filler used in many medications that the body can mistake for gluten.

Keeping Gluten Out Of Medications and Supplements

Most medications and many supplements contain fillers or excipients that perform several functions: they provide bulk, lubricate ingredients, or help the tablet disintegrate in the gut. Many of these ingredients are sourced from wheat, barley, or corn. Cross-contamination in the factory can also be an issue.

The FDA monitors active ingredients closely; excipients, however, are only required to be an FDA-approved substance. We assume brand name and generic drugs will be the same, but in fact, generic drug fillers may be different than the brand name version. This means you need to read the label to determine GF status. In addition, manufacturers change the inactive ingredients in products regularly, so a periodic check of ingredients is necessary on all products. Tip: keep an eye out for labeling changes that include “New and improved,” “New formulation,” “New product appearance,” or “New manufacturer.”

Apparently, some diabetes medications contain gluten; while a diabetic may not be sensitive to gluten in the same way as someone with celiac disease, gluten has been shown to cross-react with pancreatic islet cells (in the case of Type 1 diabetes). Some thyroid meds also have gluten or corn fillers, which cause immune cross-reactions for patients.

Below are some commonly used excipients and their sources:

  • Pre-gelatinized starch (corn, wheat, potato, tapioca)
  • Sodium starch glycolate (commonly potato, but has other starch sources) (Any product containing pre-gelatinized starch and sodium starch glycolate are to be avoided if not specifically labeled GF)
  • Be on the lookout for any starches; they are primarily derived from corn, potato, and tapioca, however they have been known to contain starch from wheat
  • Maltodextrin (corn, wheat, potato, rice)
  • Dextri-maltose (barley malt)
  • Dextrins (primarily corn and potato, but can come from wheat, rice, tapioca)
  • Dextrans (sugar)
  • Dextrose (corn starch)
  • Dextrate (starch — source not listed)
  • Maltodextrin (corn, wheat, potato, rice)
  • Sodium starch glycolate (commonly potato; can come from any starch source)

Useful Tips for Avoiding Hidden Gluten In Medications

1. Read those ingredient labels! Become familiar with gluten/corn-based fillers. Keep an eye out for key labeling terms that indicate the need for deeper inspection!

2. If uncertain, ask your pharmacist. Although drug experts, pharmacists may not know the source for an ingredient and may need to call the producer to ask.

3. Call the drug company yourself. Ask your pharmacist for the number or find it online.

4. Ask ahead about hospital medications; some inpatient meds for surgery, radiology and other procedures contain gluten. Explain the potential risks to your health and demand verification.

5. Remind your doctor that you will be checking into the GF status of your medications and ask for first- and second-choice medications. This can save you time and help avoid problematic gaps in medication.

6. When generic medication is available your insurance company may not approve brand name labels. If you need to go with the brand name for health reasons, call your insurance company and ask how to obtain approval for the more expensive medication.

7. If you require an unusual medication that does not offer a GF option, find a compounding pharmacy that will make a custom GF medication for you.

8. Remember to periodically re-confirm the GF status of your medications and supplements.

What About the Rest of the House?

Manufacturers often use gluten or wheat flour to aid the manufacturing process for non-food items, such as fillers, lubricants or absorbents, and gluten-based ingredients are common in certain body products. While gluten is not absorbed through the skin, it is possible to transfer traces from your hands or face to your mouth, where it can be swallowed and cause a reaction. Children are prone to putting fingers and items they touch in their mouths, so monitor them closely if they have a gluten sensitivity.

Below are some common body and household items that can have hidden gluten. Look for a GF label, and if you see an unfamiliar ingredient, don’t hesitate to call the company and ask about its source:

  • Lip stick and lip balm
  • Sunscreen
  • Children’s stickers
  • Price tag stickers
  • Stamps and envelopes
  • Cough syrup
  • Shampoo
  • Toothpaste
  • Lotions
  • Soaps
  • Mouthwash
  • Cosmetics 
  • Play dough
  • Laundry detergent
  • Pet food

As you can see, gluten can lurk in plenty of places past the dinner plate, potentially throwing a wrench in your gluten-free lifestyle. If you are gluten-free yet still experience gluten-related symptoms, it is worth checking the labels on all medications, supplements, and household and body products for ingredients that contain gluten. With good label-reading habits and an eye for hidden gluten, you can create a safe and healthy gluten-free environment for you and your family.

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