re: celiac: gluten vs. starch

[Guest guest]

In a message dated 7/21/03 3:49:09 AM Eastern Daylight Time,

heidis@... writes:

> In my case, for example, if I get a bit of gliadin in something, I get

> these

> little red itchy dots (DH). Every time. But if I eat something just

> high in starch and lousy for me -- my daughters birthday

> cake, for example -- I just get sleepy and not motivated, and

> if I eat enough cake, my gut might not like it much. But the

> two reactions are very different.

>

Right... you have an immune reaction to gluten.  No arguments.

> So for me, it isn't just a theory. The dots come from circulating

> IgA antibodies, and last time I got them it was from a piece of

> jerky (almost zero carb) that had " hydrolyzed vegetable protein "

> in it (often made from wheat). The reactions I get may or

> may not involve my gut: more often I feel them in my head.

> All I'm saying is that the allergic reaction is not the same

> as the starch reaction.

>

True, but no one is questioning the immune reaction to gluten.  The question

is what is causal in creating conditions that allow inappropriate immune

reaction.  Your gut is your second brain and apparently neurotransmitters are

made

their and not the brain, by the way, so may well be gut-involved.

> The question about whether allergies in general come about

> because of high-starch bad diets is certainly an open one.

> But there really isn't enough research to give a good answer.

> Probiotics certainly DO help some kids lick some kinds of allergies,

> so there might be some help there.

Sure, there isn't a conclusive answer as far as I'm concerned either.  There

is a lot of evidence for it.  There are strong correlations with allergy and

allergy-related problems and ill gut health.  But there's no conclusiveness

about gluten, as far as I'm concerned.  It's conclusive you react to gluten, but

once the gluten gets past your gut you're going to establish an immune

reaction to it.  The question is what made your gut permeable to it?

> The thing that DG brings up though, is that high IgA anti-gliadin

> antibodies

> are common to a lot of diseases. Those antibodies are NOT good for your

> body, and they circulate all over. " Damage to the intestines " can be vague

> --

> but the blood tests are not, they are very specific to gluten. And if gluten

> is withdrawn from the diet, the blood levels go back to normal, with or

> without starch in the diet. Isn't that proof enough that gluten was

> causing the blood test results?

Yes, but all that proves is that there's an immune reaction to the gluten. 

If you get undigested egg proteins leaking into your bloodstream you're going

to get an immune reaction to egg proteins, aren't you?  And won't you develop

IgG antibodies to them?

My friend Wayne has a newphew with LGS.  Since the doctors are morons and the

body ecology diet is too " complicated " for the parents, they are treating it

by keeping a running list of all the innumerable foods he reacts to determined

by food logs so he can avoid them.  Apparently anything that isn't digested

very easily will leak through his gut when it gets there as protein or protein

fragment, and he gets an immune reaction.  One could argue that  any given

food that he reacts to or the whole lot of them is *causing* the disease, or

that

he has some *genetic* reaction to all of them, or one could argue that the

*leakage* is the problem, and that although he needs to stay away from stuff he

reacts to until he is better, his *gut* needs to be *repaired.*

Likewise you could argue that gluten causes gut damage and since eggs have

similar protein fragments you get a lot of gluten-sensitives that can't handle

either... or you could argue that gluten is particularly hard to digest for

most people, more than other proteins, and people who can't digest it are going

to have gluten above anything else leaking through their gut once the

permeability is established, and other proteins they have problems digesting--

eggs

maybe-- could cause the same reaction.

What else causes high anti-gliadin antibodies,

> except for gliadin?

You said in the last email that anti-gliadin antibodies could also be a

reaction to any protein that leaks through the gut.

If Gottschall is right, how can the go down when

> most celiacs are eating a LOT of starch? (most people are retested after

> a year on the diet, and most people's IgA levels do go down).

>

Easily, it is NOT CONTRADICTORY AT ALL!  Because the starch causes the gut

permeability, and the gluten causes the immune reaction.  You said in the last

email that most folks who feel they've " gotten over " their gluten problems in

fact *still have the intestinal damage*.  That seems to be evidence to me that

the intestinal damage could be caused by the starch and not the gluten, if

people on no-gluten high-starch diet retain the intestinal damage.

> Gottschal deals mainly with gut issues --

> gluten intolerance is a whole-body issue. Many or most people with

> gluten intolerance don't have " celiac " and may or may not have signficant

> gut damage. I have no problem with her theory that too much of

> the wrong kind of starch can lead to gut problems (it sure does

> in cows!). I DO have a problem with her leading people to believe that

> her diet can " cure " an immune reaction that is mostly silent to begin

> with. She is making a highly extraordinary claim, and not offering

> any proof at all (since gluten reactions are normally silent, not having

> symptoms is not proof!).

>

That's a good point.  I don't think anyone should eat gluten unless they've

had an intestinal biopsy to show the damage reversed and are tested for the

anti-bodies to make sure they aren't reacting, or otherwise clearly prove

they've

" recovered " their gut.

>

> >Have you read Gottschal's book, out of curiosity?

>

> No. I read about it to see if it was worth $29, and read an interview

> with her, and basically I came away with a severe lack of respect for

> the woman (as you can tell!).

Hmm.  I paid $20 for it at a health food store.  It's short, you could read

it in a couple hours.

> But the reaction I'm talking about happens within minutes, like the skin

> prick test for IgE, way too fast for it to be a bacterial issue. It is an

> immune

> issue. And if it is an immune issue, why does she say her diet can " cure "

> celiac? No one has consistantly been able to cure ANY immune disease

> except maybe with weekly shots or steriods.

Not true.  People cure allergies and eczema all the time.  I've been cured of

allergy-related eczema and food allergies when I was a baby.  Do a search on

Mercola for infant eczema, it can be defeated with probiotics.

> Part of the confusion is the definition of " celiac " , which is a horrid

> definition.

> You are celiac if you have x-degree of villi damage. I forget the exact

> steps, but

> there are 5 or so steps, and if you are on 3 or 4 you have celiac. But a

> minor

> amount of damage is considered " normal " . Ditto with the IgA levels. If you

> have 20 units of IgA antigliadin antibodies, you are celiac, say. If you

> have 19,

> you are not. Huh? That was one of the points of DG -- antigliadin antibodies

> are dangerous things to have in your blood. Minor amounts of villi damage

> are not " normal " . It is a silly definition: it is like saying you have

> diabetes

> depending on how much eyesight you have lost.

>

Well that's one of Gottschal's points and that's why she expresses

frustration or anger and the gluten-theorists sometimes.  Because before gluten,

celiac

was treated very successfully with no-carb diets, and then later it was

discovered certain types of carbs had no effect on celiacs and the SCD evolved. 

At

that time, celiacs were diagnosed according to symptoms.  All the people with

the symptoms had bad gut health, so the diet cured all of them.  But with the

gluten theory, a small percentage of them were then considered celiacs, and

the rest were sent to ineffective treatments sometimes psychological.  I think

*everyone* seems to agree its a problematic definition now.

> The thoughts on the " sleeping " villi (and that isn't how they worded it,

> it is my poetic thoughts) were that eventually, after the villi were

> attacked

> enough, they would get visibly damaged. But they are very resilient

> and DO heal pretty quickly. Even when they are pretty well toasted, they

> can be totally healed within a month in a healthy young adult. Since

> these people did NOT have damage, then by definition they

> were not celiac, even though as you point out, the reaction they were

> undergoing is fundamentally the same reaction.

Isn't the reaction an *immune* reaction?  I believe you said that in a

previous email (not in this thread).

Now if it is, it occurred to me last night that its another chicken-egg

issue.  If the people are gluten sensitive, i.e. they've developed an immune

reaction to gluten, of *course* they are going to... well, get immune reactions

to

gluten (assuming that's what's going on in the intestine). Question is, is the

*reason* they are getting the reaction because they are genetically

programmed to, or because they already have some level of intestinal damage that

has

allowed gluten to leak into the blood stream and develop an immune response.

According to DG, you don't need flattened villi to get a leaky gut from grains.

> The definition of a lectin is " a protein that combines with a specific

> oligosaccharide " .

> Or something like that.

> Basically they are sticky proteins that glom onto saccharides.

> That is why they attach onto the villi (which gliadin does, in everyone, not

> just

> celiacs). However, if gliadin is combined with it's chosen saccharide --

> which just

> happens to be glucosamine -- then supposedly it doesn't stick to the villi.

Interesting. Is glucosamine normally present in the intestines? It would be

interesting to see if flattened villi can be induced from a glucosamine

deficiency. As they apparently can be induced by vitamin A deficiency and

something else, folic acid I think.

> Celiac is understood as basically an IgA immune reaction. The immune

> system doesn't respond to sugars much -- no one is really " allergic " to

> sugar. Sugar can cause some bad effects, and among them might be

> villi damage from bacterial overgrowth -- but bacterial overgrowth isn't

> an immune reaction.

It isn't, but so what? Gut flora is integrally tied to immune health, and

that includes allergies.

Eggs seem to cause an immune reaction in some

> people that cause the antibodies to attack the villi. Sugar might, but in

> that case the body would be attacking the microbes, not attacking

> the sugar itself.

Because there is some inherent anti-villi property of eggs, because the

person has a genetic egg-reaction, or because the person has damaged intestines

that allow egg proteins to leach into the blood which causes an immune reaction

to eggs to develop? Egg allergies come and go, like a lot of other allergies.

I used to be allergic to eggs, but lost my allergy through the same

treatments that got rid of my infant eczema.

They may go away, or it may just be that the proteins GET DIGESTED. The

> main reason these proteins are so irritating is that they are not supposed

> to be there. The stomach is supposed to digest them. I suspect this is

> why enzymes work so well for allergies too -- they digest the offending

> protein. I read once that casein caused x-reaction, but " hydrolyzed casein "

> did not. Now, hydrolyzing, as I understand it, is putting the protein in

> acid -- which should be your stomach. Good microbes can do the digesting

> too. Babies don't have a lot of microbes or stomach acid.

>

They're supposed to get digested in the stomach completely? That can't be

possible, can it? Because enzymes are needed to digest them, and the enzymes

don't work in the stomach. Digestion is done in the stomach, but specific

breakdown of amino acids happens elsewhere.

Not all allergies involve food. Pollen allergies and other environmental

allergies can be rehabilitated too.

With food, there are two things going on, the proteins are undigested, then

they are making it through a leaky gut. Bad digestion is a *result* of gut

damage too, because enzymes, some of which are on the villi, get disabled.

> >So any connection with egg protein or casein

> >reactions and celiac or gluten-sensitivity isn't any evidence that egg

> >protein or casein are causal, but that intestinal problems *cause* food

> allergies. 

> >And if there is a strong connection, then that is just more evidnece that

> >sometimes gluten-sensitivity is symptomatic rather tahn causal.

>

> If you can digest gliadin, you don't get gluten sensitivity. Unfortunately,

> few folks can digest gliadin. There are people working on enzymes to

> make it digest more. But once you are sensitized, it takes very, very little

> to set off a reaction. The best bet is not to get sensitized. Also a full

> 40%

> of the SAD is high-gluten wheat, so most Americans are sitting ducks.

>

If few folks can digest gliadin, then essentially everyone is has the gluten

gene. But not everyone gets gluten problems. If almost *everyone* has the

gluten gene, then there essentially is no gluten gene, but rather it is an

essential (almost) part of being human.

So what makes the difference in the immune reaction? The only thing I can

see is gut health. Soem people have more gut damage than others. And what

causes leaky guts and flattened villi? Maybe gliaden contributes, but it can

certainly have other causes.

One of them is undigested starches hanging out. It doesn't matter that the

immune system won't attack the starches, cause they'll feed bugs that will glob

themselves all over your precious little villi. And then say bye-bye to

villi because they're not taking a nap, they're getting knocked out cold ;-)

And undigested gliaden is the best way to insure undigested starch hanging

out in the gut, since it is unique among proteins in barricading the entire

starch from amylases and whatnot inside the protein circularly.

> The part about " few or no symptoms " that you

> quoted refers to IgG antibodies -- which are general and non-specific

> except that it means you have leaky gut. 

So we're back to a blurring distinction between gluten problems and general

intestinal damage. Most people who have a leaky gut are going to leak gluten,

since its the least digested protein. So I'd imagine gluten would be

overrepresented among IgG reactions. Nevertheless, if IgG tests are not

indicative of

gluten-specific problems, than a lot of the connections to other diseases

simply fall apart right there-- all it shows is they involved intestinal damage.

Well, no kidding Crohn's disease involves intestinal damage!

Again, severe cases of intestinal damage with the right microorganisms can be

cured even while gluten is consumed. E.g. Jordan Rubin's case of Crohn's

disease. (it's fascinating if you haven't read it. he describes it in Patient,

Heal Thyself which you can usually get for free. after a couple chapters it's

mostly promotional for his products). He was on his deathbed from Crohn's

and he cured himself with soil organisms and a " Biblical " diet that involved

sprouted breads and kefir. Afaik, sprouting doesn't do anything to gluten, but

it does break starch down into simple sugars. So with gluten in the diet

obviously the gluten wasn't causal. Yet I'm sure we can bet he had IgG reaction

to

gluten, or probably to a whole host of other foods.

So what does that say about other people who rely on IgG and intestinal

biopsies to diagnose gluten sensitivity/celiac, when BOTH tests are only

representative of INTESTINAL DAMAGE, per se, and not necessarily gluten-induced

celiac?

Food allergies tend to go with gluten problems, and ALSO go along with all

these other diseases like Crohn's, IBD, LGS, and gluten problems tend to go

along with them. But if it can be deduced that the others aren't *caused* by

gluten initially, and can heal on gluten with the proper elimination of harmful

foods and inclusion of proper healing factos, then that pretty much calls into

question *all* of the evidence that anyone has a gluten-induced disease.

To be clear: I'm not saying there is no gluten-induced disease. But most

gluten-induced disease diagnosis is taken for *granted* that it is

gluten-induced

when the IgG and the intestinal biopsy indicates it, but it *doesn't*

necessarily indicate that!

> But most of the other diseases associated with high IgA are NOT intestinal.

>

Does it talk about them in DG? It doesn't under the heading.

> I'm not sure that sprouting doesn't effect gluten. It probably does --

> whole grains

> definitely cause less damage than white too. Sprouting creates saccharides

> too,

> and maybe the saccharides that inactivate the gliadin -- gliadin is

> non-existant

> in wheat sprouts, so it must go away somewhere along the line.

> Probiotics make everything digest better, so maybe his stomach was

> actually deactivating the gliadin too, or the microbes were eating it.

Good points. The problems posed by the gliaden in terms of protein and

starch go hand in hand. As the starches are digested, the proteins *have* to be

broken down to some degree or the starch would be inaccessible. If the gliaden

is broken down *completely* then that solves that problem, and in addition the

starch is freed from the gliaden molecule so it can be digested, and is at

least partially digested in sprouting.

> And, he was diagnosed with Crohns, not celiac, and without a biopsy, no one

>

> knows what is really going on in the upper gut. Without blood tests,

> you don't know what his IgA levels were. You don't know if he would have

> gotten better faster WITHOUT the bread, or if he was having problems with

> some other food in his diet. Basically without a lot more science,

> no one can say what part of that experiment worked, except to say that

> for people with at least one type of Crohns might get better if they adopt

> a sprouted bread and kefir diet. Which is a good empirical thing to know!

> I'm all for empirical science.

Well, I think sprouted vs unsprouted is the main question. I doubt he would

have done worse without the bread! I think the soil organisms were the big

thing. If he showed flattened villi and IgG what would that prove? If he's

leaking all kinds of things into his blood, how could he possibly *not* have

IgG?

> A lot of folks with Crohn's don't have celiac. I know someone with Crohn's,

> and she gets it when she is stressed out (whether she eats wheat or not) and

> she tested negative for celiac.

Ok, but what would it prove if someone with Crohn's had the signs of celiac?

Is it not possible to get flattned villi and immune reactions to foods (hence

IgG) without being celiac? If not, then celiac is very poorly defined.

I think this is all just playing name games with diagnoses. The point is

that if flattened villi and food allergies show up for *any* reason you all the

sudden have all the signs of celiac, don't you?

> But the IgA reaction doesn't require that gluten leak into the bloodstream.

Ok, good point. And it supports the gluten-theory.

There are possible counter-points though. One is that gluten-sensitivity

often has to be induced by microbial overgrowth. If that's the case, that

*does*

mean that the person didn't *inherently* have the reaction. If the problem

is candida has protein sequences that look like gliaden, then presumably

*anyone* could develop the gluten problem from getting candida. But you also

have

to look at the fact that candida attacks organs *itself* by my understanding,

and also often goes along with all kinds of other intestinal and systemic

infections that do intestinal damage. So the protein reaction could be a

problem,

and also the candida causing bad gut health could be a problem, and they both

might be problems that work together.

So it's reasonable to speculate that, for instance, the gut might be

borerline leaky,, if you will, and that could induce allergy. While it would be

best

to not make far out speculations to support a theory, I think the above gives

us some room, since we do know that many people who have gluten problems don't

start out having them.

> You can get intestinal damage from lots of stuff, but the IgA reaction is

> a very specific one. Kind of like: you can get itchy eyes from pollen, smog,

> or dog hair. But if you are allergic to dogs, that is one specific type

> of reaction, and taking dog-shots can help it, or probiotics might help

> it, or you might be stuck with being allergic to dogs your whole life.

> And if your siblings are allergic to dogs, you are more likely to be

> allergic to dogs.

>

True, although my mom is very allergic to dogs, I used to be, and am not now.

Anyway, so if the IgA is specific to gluten I accept it as a sign of reaction

to gluten. But if most people can't digest gluten, I would expect gluten

reactions to arise with intestinal damage whether gluten caused intestinal

damage

or not

> True. But celiac babies just happen to occur only in countries that

> eat wheat a lot.

>

Are the babies fed wheat? How many baby's of *any* genetic stock can

actually digest wheat? It's well-known that babies can't digest starch well,

and

wheat starch is the hardest of all of them to digest.

> Well, something like 1/3 of the population have the gene. 1/5 of the

> population

> has high IgA. The other 2/15 of the population might not have leaky gut

> or they might be avoiding wheat or they might have IgA deficiency? Only 1 in

> 100

> develops full-blown celiac, but it's basically the same reaction. So if you

> have the

> gene you have a 1 in 30 chance of having celiac, but if you eat a low-wheat

> diet,

> and are an adult, you'll probably never develop celiac.

>

29 out of 30 people in this country definitely don't have no-wheat diets.

Sure isn't a guarantee of celiac. Are we assume the correlation with the IgA

and the gene or is this well established? That also leaves the 2/15 that don't

have it...

> That's not what they found though. If people stay off gluten, they recover

> on their biopsies. If they then go BACK on gluten, they get damaged, but

> don't feel the damage. It can take 20 years for the damage to be bad enough

> to cause symptoms. Most people -- 85% -- recover within one month to two

> years, according to biopsies. A lot of people have high IgA levels after

> supposedly

> being on the diet for a long time -- very often these people turn out to not

> be following the diet very well. And a lot of people may need a low-starch

> diet too. But the research really doesn't support Gottschal's position

> when it comes to celiac -- though her diet will and does help a lot of

> people!

>

Any abstracts or studies on line on intestinal biopsy follow-ups with

celiacs?

>

> I suspect that gluten is not good for anyone. But to prove her point you

> would

> have to get some people that truly had been rehabilitated, do biopsies, then

> have them eat gluten for a year and re-biopsy. The damage happens very

> slowly,

> like cigarette damage, for a lot of people.

True, but you'd have to use purified gluten, since the gliaden molecule has

the undigestible starch. It's very hard to separate the two issues.

> Once I gave it UP I started reacting to slight amounts of it, and maybe in

> the future

> I can eat a big plate of pasta again and feel great. But how would I know,

> given the lack

> of symptoms, that I wasn't setting myself up for the health problems I am

> just now

> recovering from?

>

>

I agree, no one should consider themselves free from gluten-- or potatoes--

because they don't have symptoms.

Chris