Does the medical system really understand the connection between grains and chronic disease?
In this Scientific American article, “Gluten Sensitivity” May Be a Misnomer for Distinct Illnesses to Various Wheat Proteins, it is heartening to see writer Roxanne Khamsi pushing the prospect that there is more to wheat than gluten.
In my experience, articles such as these have been written for more than 25 years now. The slowness of medical systems, combined with the personalities directing their research focus, are not really assisting the increasing number of people worldwide, whose ill-health is directly due to eating grain-derived foods. The vast majority of people who have consulted with me because of diseases associated with compromised immune systems, have been able to eliminate all their symptoms by totally removing all grains from their diets. People with coeliac disease have an initial immune problem with only several peptides of many occurring in the protein known as gluten. In time, with further deterioration of adaptive immune efficiency, coeliacs invariably develop symptoms to other peptide constructions that are also found in the other grains that do not have gluten.
Before the diagnostic tests for coeliac disease were invented, it was common for doctors to use elimination-diet programs to diagnose this disorder—if their patient had chronic diarrhoea. They did this to be sure that they were helping their patients as well as the program being a practical method for their patients as well as they could through a practical program that their patients could thoroughly understand to make the most informed decisions about a rather difficult lifestyle that would improve their health.
It was straight forward. If a patient’s symptoms disappeared on a gluten-free diet, they probably had coeliac disease. Common sense dictated that they should avoid gluten-containing foods—whether they had coeliac disease or not didn’t really matter. These days, the vast majority of doctors now use antibody tests combined with biopsies to diagnose coeliac disease. Of course it costs the patient more money to have these tests, but they are saved the challenge of having to undertake their own somewhat difficult trials. It allows patients to get on with their lives and places the responsibility for their health on the medical system and its diagnosis.
The problem is that, when the tests indicate that the patients do not have coeliac disease, they are prescribed drugs and sometimes operations to address their chronic symptoms—what else can the doctor do? Most are reluctant to step beyond the rigid boundaries imposed on them by the directors of their profession. There is much conservative pressure placed on the public to beware of unorthodox diagnosis testing and treatments for coeliac disease and other immune-related illnesses that are used in the absence of scientific rationale.
Changes to the medical systems are slow, but they are occurring at a grassroots level. The recent World Gluten Summit is indicative of this. Researchers who are not necessarily medical doctors are starting to speak out about their findings—which broaden the relationships between all types of grains and many chronic immune-related illnesses. They are proposing a new term—noncoeliac wheat sensitivity—be used for people who react to wheat but are not diagnosed with coeliac disease.
This is what we called pseudocoeliac disease 20 years ago in an attempt to link awareness to the relationship between many of the chronic immune-related diseases and grain defence chemicals other than gluten. Diseases such as: Type-1b diabetes mellitus, autoimmune liver disease, Grave’s and Hashimoto’s diseases, Addison disease, anaemia (iron deficiency), irritable bowel syndrome (IBS), chronic fatigue, unexplained liver enzyme abnormalities, osteopenia, Crohn’s disease, ulcerative colitis, MS, and many other autoimmune diseases, as well as a link to many familial cancers.
Since the term coeliac disease was created, others have also been proposed in an attempt to link disease symptoms that anecdotally keep bouncing back to gluten and other grain chemicals:
• Atypical coeliac disease is proclaimed as the absence of ‘typical’ gastro-intestinal symptoms but the patient has chronic symptoms that are considered unusual and secondary to those of coeliac disease—such as iron deficiency or elevated liver enzyme levels.
• Silent coeliac disease is proclaimed in persons who are asymptomatic, but who have a positive serological test and villous atrophy on biopsy—the classic pathology of celiac disease. They are usually tested because they have relatives with coeliac disease.
• Latent coeliac disease is proclaimed by positive blood tests and a family history but have normal results for their duodenal biopsy (villous atrophy usually develops later in life).
• Gluten intolerance (gluten sensitivity) is really a grassroots movement term. It is usually proclaimed by the individual to mean that they do not have a diagnosis of normal, silent or latent coeliac disease, but they are healthier when they keep off the gluten containing grains—although in recent years this has been spreading more to include other grains like rice and corn.
What are the risks to people if coeliac disease is latent or atypical and remains undiagnosed? The medical system suggests conservatively: a four-fold increase in mortality; a five-fold higher risk of non-Hodgkin lymphoma; a significantly higher risk of lymphoma; four times greater risk of tuberculosis. What would it mean if grain chemicals other than gluten are also damaging immune systems to this degree?
If you suspect you may be having a problem with any type of grain, certainly go to your doctor and have the tests for coeliac disease, however I suggest you also undertake a strict, controlled Grain Free Trial to determine if your symptoms have any relationship to grain defence chemicals. With improvements you can then reintroduce one grain type at a time and determine for yourself if there is a connection. Scientific research is costly, slow and dependent on commercial and philosophical dictates. Do you wish to wait out your lifetime for permission by medical science to undertake your own testing?
Bill Giles Health Ecology specialises in Personal Food Trials and can help you work out if grains are impacting your health.