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Dr. Jon Dunn, Licensed Naturopathic Doctor
APRIL  2009
Wheat - Not for Everyone
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What is Wheat?
Wheat contains a variety of proteins including gliadin and glutenin which vary in proportion according to the type of wheat.   Together, these two proteins create gluten, found most abundantly in wheat, rye and barley.  Gluten is what gives bread its chewy elasticity and lofty rise during the bread making process.  Gluten is also the cause of suffering for those sensitive to this protein.

Three Types of Wheat Reaction
Gluten sensitivity shows with an array of symptoms resulting from three types of immune system disorder: allergy, autoimmune (Celiac) and intolerance.

Wheat Allergy
True wheat allergies are rare, affecting about 0.5 percent of the population.  Reactions are typically immediate due to an inflammatory response triggered by exposure to the wheat protein.  Symptoms range from mild with sneezing, itching and redness, to more serious concerns such as coughing, breathing difficulties including asthma, vomiting and possibly death due to airway constriction. 

Celiac Disease
This is a genetic condition in which ingestion of wheat triggers an autoimmune attack against the cells of the small intestine.  This leads to a host of malabsorption ailments including anemia, with typical symptoms of gas and diarrhea.  

Wheat Intolerance
Maldigestion of wheat is what triggers this type of immune response known as wheat intolerance, accounting for the majority of wheat related ailments.  Reactions, while often slow and insidious in onset, can be quite serious. Chronic symptoms of wheat intolerance include:

- Cognitive impairments including headache, autism, attention disorders, depression and other mood disorders.

- Obesity, despite good diet and proper exercise, due to improper stimulation of insulin.

- Skin disorders such as eczema, psoriasis and dermatitis herpetiformis.

- Digestive complaints such as acid reflux, irritable bowel disease and colitis.

- Rheumatoid arthritis and other autoimmune diseases such as lupus, Sjogren’s and multiple sclerosis.

- Muscle pain including fibromyalgia.

- Fatigue

- Palpitations

- Infertility and miscarriage

- Wheat craving
 
Additional health risks associated with unaddressed wheat intolerance and celiac disease are numerous and include diabetes, colon cancer, anemia and osteoporosis.

How to Identify Wheat Intolerance
Blood tests are unreliable methods to identify wheat issues and skin tests will only identify immediate allergic reactions making testing irrelevant.  Saliva testing has some merit, and I have seen muscle testing or kinesiology show some reliability.  The only true and reliable test, costs nothing but a little of your time and energy; the elimination and challenge test.

Eliminate and Challenge
Do not do this test if you have or suspect you have wheat related asthma, because the challenge may lead to life threatening airway obstruction.

1.Eliminate the entire wheat family for a minimum of two weeks: wheat, oats, barley, bulgur, rye, semolina, durum, spelt (Dinkle), bran, couscous, triticum, einkorn, emmer, farina, fu, gliadin, gluten, glutenin, graham flour, grits, groats, hemp, white flour, kamut, matzah, seitan, triticale, pumpernickel.  Watch labels on packaged foods because wheat is a common additive in such things as beer, malt products like malt vinegar (unless derived from corn), soy and Teriyaki sauce (unless stated wheat free), binders, extenders, ice cream, licorice, modified starches, pudding, some herbal tea and Bouillon cubes.  Bulk items may be contaminated with gluten, so especially if you have an allergy or celiac disease, buy grain in individually packaged containers.  You may see references to corn and rice gluten; this is not accurate , because they lack the gliadin component.

2.Keep a journal.  List all of your health concerns and at the end of each day note, on a scale of 1-10, the severity of each one of your symptoms. 

3.The goal is to do this diet as long as it takes to be symptom free.  I have seen it take anywhere from seven days to eight weeks.

4.Once you are free of symptoms you can begin the challenge phase.  Cook up about 1/2 cup of wheat pasta and eat it.  Note any symptom aggravation during the next 48 hours. 

Interpreting the Challenge Results
Not Wheat Sensitive
If you find no aggravation with the challenge and found no improvement during the elimination: you are not wheat sensitive.  

Mild Wheat Sensitivity
If you find no aggravation with the challenge, yet improvement of symptoms during the elimination trial: you are mildly sensitive.  Proceed with caution, you likely can tolerate some wheat some of the time.   You may be tolerant to spelt, rye and such and have an issue primarily with wheat-flour products, especially when consumed frequently.

Wheat and Other Sensitivities
If you experience an aggravation with the challenge yet had limited improvement during the elimination you may have other sensitivities clouding the picture, such as fructose malabsorption or milk intolerance, in addition to wheat intolerance.  Milk problems can be either allergic (you react to all milk products) or due to lactose intolerance.  If you are fine with fermented milk products such as cheese or good quality yogurt, yet not fine with other milk products then you have lactose intolerance.

Wheat Intolerance
If you had an aggravation with the challenge and significant improvement of symptoms during the elimination you have wheat intolerance or Celiac disease.  You may need to stay away completely or you may be able to eat some wheat products on occasion without serious consequences.  Proceed with caution.

Summary
Health related issues due to wheat sensitivity are on the rise.  For everyone, moderation of wheat consumption is a wise choice.  For some, total avoidance, including cross contamination exposure, is required.  For others, some forms of wheat such as spelt or sprouted grains may be well tolerated, some of the time.   Local markets are now carrying a variety of wheat free/gluten free products due to increased demand.  They also carry a variety of grains which are safe for almost everyone including rice, millet, quinoa, amaranth and buckwheat.  If you are gluten sensitive, options including gluten free pizza are showing up in today’s market.  Be patient as you explore this arena of health care, and enjoy your new found health.



In Health,
Jon Dunn, ND


There are three types of food which cause illness in nearly 75 percent of the population: milk products, fruit (see my newsletter Fructose Malabsorption) and wheat.  The spectrum of ailments is due to an allergy or intolerance to these foods.  Second to corn, wheat is the most commonly grown food-grain in the world and it is the number one grain traded internationally.  The incidence of wheat sensitivity is on the rise, affecting 15 percent of the population.  Wheat flour of today is not like the wheat flour of the past, due to intense commercial manipulation and alteration of this grain, changing its original natural state into one nearly foreign to our body.
Maldigestion of wheat is what triggers the immune response known as wheat intolerance
The only true and reliable test costs nothing but a little of your time and energy - the elimination and challenge test.
For everyone, moderation of wheat consumption is a wise choice.
If, after trying the following suggestions listed under the “Natural Treatment Considerations” section, your condition does not completely resolve, I suggest a consult with a naturopathic physician. Tests may need to be run, and a more comprehensive treatment regimen using natural products may be required.

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