Is Gluten Intolerance the Cause of Autoimmune Disease?

on Jul 5
by Dr. Vikki Petersen | Print the article |

Preventing Autoimmune Disease, How Healing the Gut Can Help

Autoimmune diseases taken together are the third leading cause of death in the US. The list of autoimmune diseases is long and varied:

• M.S.
• Type 1 diabetes
• Celiac disease
• Lupus
• Hashimoto’s thyroiditis
• Rheumatoid arthritis
• Sjogren’s
• Fibromyalgia

to name just a few.  But the autoimmune disease celiac, unlike all the others, has a unique feature– it’s the only autoimmune disease where the exact trigger is known.

What’s Unique About Celiac Disease?

Gluten is the trigger for celiac disease and when that trigger is removed the body stops destroying its own small intestine.

Why is this profound?  Two reasons:

1.    There is no other autoimmune disease where the exact trigger is known.

2.    Gluten and the damage it causes to the small intestine may very well be the root cause of other autoimmune diseases!

We have appreciated the interesting phenomena where people “develop” gluten intolerance at different ages.  It used to be perplexing because it was assumed that if the problem was genetically driven, as soon as the body received its first gluten “insult” damage should begin to occur.

Leaky Gut Plays a Big Role in Creating Autoimmune Disease

In the past, when patients with gluten intolerance stated that they felt perfectly fine eating gluten until a certain age, it was thought that the damage had probably begun far earlier but the patient had simply not been aware of it.  What we have come to realize is that a genetic propensity plus the presence of gluten in the diet are only two of the three necessary constituents of this puzzle – the third is damage to the small intestine that has compromised the health of this vitally important organ.

A completely healthy, intact small intestine seems to be quite able to defend itself against gluten, despite genes that ‘lean towards’ gluten intolerance. But once damage has occurred, the gut becomes “leaky”, the immune system has weakened, and not only can digestive complaints result but symptoms can arise in other systems throughout the body.

There has been proof for many years that the intestine is not the only tissue targeted by the immune reaction to gluten. The prime example of this is a disease called dermatitis herpetiformis (DH) where the gluten sensitivity manifests primarily in the skin, with only mild or no intestinal involvement.

Now, more recent research reveals that perhaps a vast number of autoimmune diseases may also involve an immune response to dietary gluten. It turns out that an enzyme in the gut called tissue transglutaminase (tTG) is a primary player in the cause of why gluten destroys the small intestine in celiac disease. Interestingly this enzyme is not solely present in the gut. It is in fact present throughout the human body.

Now imagine gluten moving through your blood stream. (Remember, it got there due to a leaky gut.) The gluten comes in contact with tTG in the thyroid and autoimmune thyroid disease results. It comes in contact with tTG in the joints and rheumatoid arthritis results. And potentially on and on it goes to include many of the 100s of autoimmune diseases afflicting millions of Americans. Can you now see why gluten has such far-reaching effects that damage other systems of the body?

When examining the cause of a leaky gut it is worth discussing the substance that dictates the permeability, or ‘leakiness’, between the cells that line the small intestine. This substance is called zonulin. Increases in zonulin cause the intestine to become leaky, thereby allowing substances to leave the intestine that shouldn’t normally. It has been seen in research that in patients with celiac disease zonulin is activated by gluten, leading to increased intestinal permeability (a leaky gut). But how does this extend to other autoimmune diseases?

Research Study Prevents Diabetes Successfully

Dr. Alessio Fasano performed a brilliant study on rats that were genetically predisposed to develop type 1 diabetes.  The premise was that if the gut was not affected negatively by zonulin and remained intact and healthy, then perhaps the antibodies made against the pancreas that create diabetes would be prevented from leaving the gut and thereby prevented from causing damage to the pancreas.  Sure enough 2/3 of these rats who were highly predisposed to develop diabetes did not simply because zonulin was prevented from creating a leaky gut!

This study was the first time that an autoimmune disease was prevented by blocking intestinal permeability.  It further puts a new face on the entire concept of how and why autoimmune disease develops.  We’ve always thought that the genetic predisposition was an overriding characteristic of autoimmune diseases that overshadowed any effort to sublimate it.

This study opens a new field of investigation into the relationship between the health of the intestine and the basis of many diseases. Imagine if the “unknown trigger” of autoimmune disease turns out to be gluten and its effect of creating a leaky gut!

It is for this reason that I am so passionate about early diagnosis of gluten intolerance.  Whether it is celiac disease or gluten sensitivity, the affect that gluten imposes on the integrity of the small intestine has far-reaching implications.  I see it clinically in my patients on a daily basis, but the above research puts a point on it that we must consider seriously.

The Longer You Eat Gluten, the Higher Your Risk

A study from Italy showed that the longer gluten sensitive people eat gluten, the more likely they are to develop autoimmune diseases. They found that in childhood celiacs, the prevalence of autoimmune disease rose from a baseline of 5% at age 2 to almost 35% by age 20. Imagine if screening of all children for gluten intolerance resulted in reductions of future autoimmune diseases!

I am currently working on a program with my patients who are gluten intolerant to restore their small intestines to the healthiest possible condition.  This is important from the obvious viewpoint that optimal digestion and absorption is critical to good health.  But it is also vital from the perspective of understanding and managing zonulin and its long-term effects on health.

The 5 Most Important Steps to Healing a Leaky Gut

I would recommend that you take the following steps to ensure that you are doing everything you can to restore your small intestine to optimal functioning.

1.    Have a comprehensive stool analysis performed to ensure that no pathogenic organisms (bacteria, amoeba, parasites, etc) are present.  Such a test should also measure the effect of your body’s enzymes to see how effectively your food is being broken down and absorbed. It should also assess the health of your intestinal bacteria or probiotics.

2.    Eliminate dairy foods from your diet. There is considerable evidence to suggest that consuming milk from other mammals is not conducive to good health, especially in our digestive tracts.  The inflammation that dairy can cause could well be contributing to a leaky gut, despite the elimination of gluten.

3.    Once you have taken the above steps, see how you’re feeling.  Some patients require certain supplements such as anti-oxidants, omega – 3 fatty acids, vitamins A, E, B and D, plus minerals including zinc and magnesium to help the intestinal lining heal fully.

4.    Additionally you should get tested for the presence of cross-reactive foods. For more information on this topic read my blog on the topic. You could also watch a You Tube video describing them and how they are significant.

5.    Finally, once the above have been done, have a lab test performed to assess how successful you have been at healing your gut. Remember that to prevent autoimmune disease, it appears to be crucial to restore health to this large 23 foot long organ. An improved lab test now exists to determine if molecules that are too large are still passing through your intestine or if this is now being prevented due to a healthy small intestine.  This is a non-invasive, non-drug test.

What You Can Do

In summary: Encourage parents you know to have their children evaluated for gluten intolerance, especially if there is any incidence of autoimmune disease in their family tree.  The more we can affect an early diagnosis, the healthier our future generations will be.

If you know someone suffering from an autoimmune disease themselves or if they have a family member afflicted, encourage them as well to get tested for gluten intolerance. Mainstream research doesn’t agree with the statement I’m about to make (yet!) but we do see some very exciting reversals in autoimmune disease symptoms once a patient has removed gluten from their diet.

Last but not least, show your doctor this data.  There is still too much ignorance in our profession about gluten and its broad reaching negative effects.

I hope you find this information helpful.  Many of the steps mentioned above are best administered with the help of an experienced clinician so let me know if I can help you to find the assistance you need.  Unfortunately there are still only a few doctors in this country who are aware of these ramifications of gluten intolerance and who utilize the needed laboratory tests to ensure accurate diagnosis and effective treatment.

It is for this reason that we became a destination clinic and treat patients from across the country as well as internationally. We are here to help. Give us a call!

To your good health,

Dr Vikki Petersen, DC, CCN
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect”

References:
Scandinavian Journal of Gastroenterology. 2006 Apr;41(4):408-19.

Annals N Y Academy Science. 2009 May;1165:195-205.

“Tight junctions, intestinal permeability, and autoimmunity: celiac disease and type 1 diabetes paradigms.”

Clinical Gastroenterology & Hepatology. 2005 Apr;3(4):335-41.
“Permeability, zonulin production, and enteropathy in dermatitis herpetiformis.”

Gut. 2003 Feb;52(2):218-23.
“Early effects of gliadin on enterocyte intracellular signalling involved in intestinal barrier function.”

Permission is granted to re-post this article in its entirety with credit to Dr Vikki Petersen & HealthNOW Medical Center and a clickable link back to this page. Dr Vikki Petersen, DC, CCN is founder of HealthNOW Medical Center and the author of “The Gluten Effect”.  She has been featured in national magazines, international medical journals and is a frequent headlined speaker.

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