Maintaining a gluten-free lifestyle is the prescribed treatment for celiac disease, an autoimmune disease which triggers an immune response to the protein gluten and ultimately damages the lining of small intestine, flattening the intestinal villi, and leading to malabsorption of nutrients. Medically recognized symptoms of celiac disease traditionally were limited to symptoms in the gastrointestinal tract such as diarrhea, abdominal pain, bloating, and malnutrition. However, medicine has begun to recognize a plethora of secondary symptoms that can signal celiac disease, as well as autoimmune diseases that can be connected to celiac disease.
Associated symptoms and disorders can include: osteopenia, osteoporosis, constipation, infertility, Rheumatoid Arthritis, migraines, diabetes, hair loss, seizures, depression, food allergies, multiple sclerosis, Parkinson’s disease, Epstein-Barr, Lupus, and many, many others.
Gluten is a protein made up of gliadin and glutenin. It is found in barley, rye and wheat, but also added to many processed foods in various forms. For example, it is often hidden under the heading ‘natural flavors,’ and ‘seasonings,’ in an ingredient list. Gluten can also commonly be found in salad dressing, beer, medications, vitamins, cosmetics, skin care products, flavors and fillers.
Unless a product states “gluten-free,” it is best to avoid it or contact the manufacturer to confirm if it is indeed gluten-free if not otherwise stated. In fact, learning how to read labels, memorizing and then recognizing the many ways that gluten is hidden in ingredients is one of the steepest learning curves to managing the disease.
The other problem is learning to readjust your lifestyle. We live in a gluten-saturated culture, and deviating from that is tricky at best, and a lonely and isolating path at worst. In fact, the emotional toll on having to remain 100 percent gluten-free indefinitely can be characterized by such emotions as anger, depression embarrassment and feelings of being frustrated and overwhelmed.
However, despite the emotional toll it can take, particularly in the beginning, many consider going gluten-free to be one of the best things they have done to improve their health.
Diagnosing celiac disease is done by having multiple biopsy samples removed from the small intestine, various IgA blood tests and confirmation of markers on genes HLA-DQ2 and HLA-DQ8. With 99 percent of people with celiac disease carrying these genetic markers, it’s unlikely that without them a person will be diagnosed with celiac disease. Which, if a person still responds favorably to a gluten-free diet, he or she may not have celiac disease, but may be termed ‘gluten-sensitive.’
In which case, the gluten-sensitive person will still benefit from maintaining a gluten-free lifestyle, although his or her symptoms may not be as severe as the person with celiac disease, and they may not have the impetus to adhere to it 100 percent.
Eating out may be one of the hardest areas to maintain. However, society is responding to the increase in gluten-sensitive people and those with celiac disease, since both disorders have become more prevalent. More restaurants offer gluten-free menus, major food companies have jumped on the gluten-free bandwagon offering more choices, and even the occasional bakery can be found.
In Sacramento, we are fortunate to have Pushkin’s Bakery. It is a small, relatively new bakery offering gluten-free delights in midtown Tuesdays through Saturdays from 9am-7pm. By the way, their bakery items are also dairy-free for people needing to avoid dairy, but that is for another article.