Archive for August, 2012

Oops! I Did It Again…Well, Almost

I surprise even myself sometimes with the stuff that goes on in my head.

I’m considered an expert in health and fitness, respected my peers, have a few friends that think I’m awesome (T I’m talking to you!) and I’ve got an adorable, loving husband that thinks I’m beautiful…..but once again I felt too fat, too out of shape, too this, too this, too that, to answer a resounding “YES!!” when the call came in to be on TV.

Seems not that long ago, I was a new grad and a very new New Yorker who was feeling optimistic that living here in the Big Apple would one day present big opportunities such as the coveted TV spot. Had the phone rang 6 years ago I’m sure I would’ve been wetting my pants with excitement…but feeling insecure nonetheless. Years later, how was I feeling?

Still insecure. Was I ready? Was I looking the part? Would anyone want to hear what I had to say if I don’t look like Jillian Michaels?

What truly makes me sad that in many ways, despite all I’ve accomplished professionally and all the work I continue to do on myself, that when the voice on the other end of the phone asked me to be a guest on their show, all those same questions ran through my mind. My initial response was, “Crap! No, I haven’t lost all the baby weight yet! I’m not in perfect shape and my breast feeding boobs are huge…ugh! Does anything I could wear on TV even fit over these ladies? I’ll look chubby, ridiculous and no one will want to hear what the fat girl is saying.”

Geesh Brooke……how about trying that again without the drama and self loathing…

Over the course of 2 weeks I was asked to be on 4 different segments for Veria TV and to film something for Prevention Magazine. When it media rained, it media poured! Each time I was asked to film something, my fears wanted to scream, “No!” Or at least, “No thank you, I’m just swamped with the baby and my practice. Please call again, I promise to be in better shape.”

But instead I said, “Yes.” And I said, “Shut up!” to the negative banter in my head. (I had to say it a few times though.)

That was new for me: to hear that voice, acknowledge it and not fall to pieces about it. I realized I still have a lot of work to do in the body image –they are gonna think I’m not good enough – find me out for a fraud – if I only looked better – area, but I was able to not give in to it this time.

Joe, my hubby, was stunned. He told me after I taped my first segment that he had been bracing for the worst week ever and he didn’t want to jinx it by saying how great I was doing! He’s been down this road with me before – it’s not just an irrational fear for me. I’ve actually been called too fat to know about fat loss by a reviewer on Amazon. ..so the fear of being “called out” is not just in my head.

After my first taping and pre-celebratory dinner!

Granted I took that review in stride, but it wasn’t the easiest thing I’ve ever been through and it definitely wasn’t the easiest thing Joe had been through with me! What typically happens for me is this: panic about how I’m looking for this big event (getting ready for my book launch or yikes, getting ready to be on TV!), swear off all carbs and any trace of sugar, workout twice per day, drink 3 liters of water per day and not a drop less, don’t even look at a glass of wine, avoid salt at all costs, lose hours upon hours of sleep, and completely stress to the detriment of everyone around me. Not balanced….not healthy.

I had all the same “I’m too fat fears”, but the difference was that this time, I didn’t let it stop me. Instead losing my s#^*! that week, pulling double workouts, no carbs and no sleep, I tamed the voices in my head – for perhaps the first time ever.

So why was it different (thankfully) this time? What have I learned about me?

I’ve learned that this negative self talk in my head is a real thing. I can’t pretend it’s not there, I have to deal with it. I can’t just feel stupid that I still do this.

I’ve also learned that just because it’s the first thing I think, and have been saying it since I can remember, doesn’t make it true. That even on my worst days, I look better than the insecure girl in my head thinks I do. I can choose to work on myself and my body because I want to, not because the voice in my head is telling me I have to cuz I’m just too chubby.

I try to remember when I’m being nasty about my body that I’m talking to this little happy girl.
Dr Brooke, circa 1979

And one final reason……I do not want to demonstrate this body image neurosis on a daily basis to my baby daughter. I’m thankful that I’ve struggled with it so I can help my patients and readers, but I don’t want to be flipping out, feeling inadequate and letting fear of how I look stop me from living my life – and doing my job. I want to be her champion in a body image obsessed world, which means I have to not be my own worst enemy….and dare I say, love myself even if I never lose another pound.

Given all that….why did I still want to say, “No!” when the phone rang? Why did I start to spin and let all those nasty thoughts almost cause me to miss an opportunity? Why do we cling so tightly to what doesn’t work for us?

We’re comfortable. Change is never comfortable – but nothing great comes from staying comfy. Comfy is fine, but stretching past comfy is where great happens, where we can grow.

About 6 years ago I was beyond comfortable living in Seattle. I’d just graduated from Bastyr University and lived in the Pacific Northwest where naturopathic medicine abounded. I had a group of fabulous girlfriends who, like me, had all just graduated from graduate or doctoral programs and met the men of our dreams (within months we went from singles in the city to serious couples – we all married those boys by the way!). I had the perfect apartment, the coffee shop where they all knew my name, my gym I’d been sweating at for 7 years…..life was very comfortable.

On not more than a whim, my brand new boyfriend and I decided to move to New York City together. It was nuts…and it was entirely uncomfortable. We had no money, no connections (save

We later got married at that apartment we once couch-crashed at. I heart NYC! And I’m learning to heart this booty.

Aunt Sally whose couch we crashed on), people thought I was some sort of hypnotherapist or witch doctor at worst and a nutritionist at best,  but no one knew what an ND was and I don’t have a license in NY state to be a primary care provider (aka a “real doctor) as I had in Seattle. And I had no  idea where I was when I surfaced from the subway station.

But what’s happened here has been amazing – and more days were uncomfortable than not. None of the amazing things that have happened could have happened so quickly if I’d stayed in my comfort zone. This is true of facing my body image issues as well. Without living in NYC, publishing a book and getting on to a much bigger stage, I could have stayed small, stayed safe.

We are meant to stretch. It challenges us to be BETTER.

Pick one thing today that mixes it up for you. Do one thing you’re nervous to do. Be a bit different than you were yesterday. Say YES! to the thing that scares you (even if it’s as simple as trying a pull-up or giving up diet soda). You’ll be surprised at what you’re capable of.

For me, today I choose to not be stopped by those negative voices in my head. It is totally uncomfortable and not my norm to not worry about how I look, but when I look at Lola I am reminded of the little girl in me who’s always felt insecure about her body. It makes me very sad. I look back at my childhood, high school, and good heavens college, and I was perpetually feeling bad about my body for this or that.

I don’t want to look back one more day, miss one more opportunity, be preoccupied with one more flaw, or miss one moment with my perfect little family because I’m stressed about my big butt. It’s exhausting…and it’s a waste of my time. And it keeps me playing small, and hiding.

What I do want is to continue to workout daily in a way that fits my new lifestyle as doctor, business owner, author, wife and mommy. I’m working out at home with a few pieces of equipment and a flight of steep stairs – not the perfect gym workout I want, but it’s what’s working now and I do it everyday. I do want to eat as clean as I can as often as I can – it feels good and it’s simple. And I want to continue to strive for my best self and my best body without all the drama, all the berating myself and without saying “no” to TV appearances as they pop up….and without saying “no” to my life.

Remember, not hating ourselves as we are doesn’t not preclude us from wanting and having something BETTER for ourselves. Get to work on your goals, find ways to be consistent in your efforts, skip the stress, skip the crash diets, skip the berating.

As fate would have it, my first TV segment ever in my life was about body image and eating disorders.  Life is funny that way.

August 14, 2012 at 6:41 pm 10 comments

7 Reasons Why You Didn’t Lose Weight Going Gluten Free

Seems every tabloid in circulation has a “how this celeb lost weight” headline, but these days we don’t need to be on the cover of People magazine to get the word out about how we lost weight. We simply Tweet, Pin or update our Facebook status to “I’m down a dress size thanks to being gluten free!” And all of us looking for a super quick fix for our weights loss woes, are willing to eschew just about anything with the promise of losing 10 pounds.

But why all of a sudden is everyone talking about going gluten free to lose weight? It’s not a new idea, but with health information now widely available on the web, what has always been going on in natural health circles (discussing food allergens, digestion and diet) is now a common conversation – and of course, a celeb or two has lost weight recently avoiding gluten.

And it’s not just those looking to shed the fat that considering a life sans gluten, people with conditions that aren’t managed well in our conventional model (like Hashiomoto’s Hypothyroidism, PCOS or many a digestive ailment) often turn to nutrition for answers. Going gluten (and usually dairy) free is often espoused as a treatment for these and whatever else ails you. And most often when people give it a shot -voila! They feel better.

Is this avoidance of wheat a cure all? No, but it does work some wonders. Well, for many of us at least.

Gluten avoidance is something I do with most of my patients because I work with a population that has hypothyroidism, autoimmune disease, PCOS, female hormone imbalances, infertility, acne and stubborn weight loss. Going gluten free may not the answer for everything under the sun, but the proof is in the gluten free pudding: although some do not feel as dramatically different as others and some don’t lose 20 pounds overnight, most everyone at least feels BETTER and loses at least some weight. However, most do have dramatic improvements and joyously shed the brain fog, the fatigue, the puffy look and several unwanted pounds within a matter of days.

Did you go gluten free and unlike your friend, you didn’t lose 7 pounds in a week? Was your experience less miraculous than your co-worker’s who dropped 20 easy pounds in a month and looks 10 years younger? What’s up with that?

Here are the big reasons why your gluten free plan didn’t result in big time weight loss:

Gluten Free Junk Food
A gluten free cookie is still a cookie. Many gluten abstainers fall prey to the vast array of packaged, high carb – but gluten free – foods in our health food stores. Everything from muffins to cereal to cake is available without gluten – but not without weight loss consequences.

These simple carbs are not fat loss friendly foods. But the fear of feeling restricted by being on a gluten free plan scares many straight into the loving embrace of a gluten free, sugar laden, processed food frenzy. Although they can help you feel like you’re not missing out, steer clear of the gluten free packaged foods like breads, pastas, cakes, etc except when you want a treat or a bit of a splurge – but not every day. Keep your diet focused on vegetables, fruits and lean, high quality proteins.

You Could Be Reacting To The Gluten Free Grains You’re Now Eating
A sensitivity to gluten increases the chances that you’re also sensitive to many of the foods you’ll turn to on a gluten free lifestyle including sorghum, millet, tapioca, amaranth, quinoa, rice, hemp, corn, and potato. These foods do not contain gluten but may still be a problem for you, this is called “gluten cross reactivity”.  And if you’ve got a gluten issue, I’ve got some really bad news: coffee and chocolate are among the most common cross reactors. Tragic, I know.

Consider a grain free diet and utilize non-grain based starches such as sweet potato, pumpkin, squash, and legumes (note: autoimmune patents are also at high risk for reacting to the lectins in legumes, sorry! Best for you folks to leave them out as well.) Cyrex Labs offers a gluten cross reactivity panel if you’ve committed to gluten free and wondering which grains, etc might be good alternatives for you.  Visit www.cyrexlabs.com and look at Array 4.

Gluten Is Hardly The Only Factor in Fat loss
You still have to balance your blood sugar, get enough sleep, not overdo your carbs, manage your stress and exercise in order to lose weight – and consistently keep doing all these things. Even for those people that drop some instantaneous pounds, this other work still need to be done to keep losing fat. Losing the inflammation water weight is the easy part…that is if you can stay off those foods that cause it! And rest assured, if you’ve lowered your inflammation you will have an easier time losing weight as inflammation mucks up the works for every hormone in your body.

You May Have Increased Intestinal Permeability (AKA Leaky Gut)
This means larger proteins are getting through a leaky intestinal barrier causing inflammation and winding up you immune system. A “leaky gut” is due to inflammation in the gut that has caused a bit of swelling in the cells of your intestines, damaging the junctions between the cells allowing larger proteins to get through. Normally only small things pass through such as a single amino acid or a molecule of glucose. When these larger proteins end up in our blood stream where our immune system sees them and attacks, causing inflammation, bloating, puffiness and trouble shedding fat.

This creates inflammation in and of itself, which makes it hard to lose weight, but it also increase the chance that you’re have any of those cross reactivities I just mentioned.

We can get a leaky gut from years of a bad diet, eating foods that we are sensitive to, taking antibiotics or doing anything that disrupts the delicate balance of probiotics in our gut, various medications, having hypothyroidism or being under high stress.

Gluteomorphins May Be At Play
You may be reacting to gluteomorphins, a byproduct of our own digestion of gluten which act in the brain on opiod receptors causing a “high”. When we take that away, you obviously feel worse for a period of time as you go through a withdrawal period. Crazy huh? Our food is literally medicine!

When people have this reaction, they not only feel pretty lousy when they first come off gluten but their cravings for it sky rocket. If they manage to stick to their gluten free guns, they will usually end up eating a lot of other carbs to satisfy the cravings causing weight loss to stall….or worse, causing a weight gain.

Hidden Exposure
Despite your best efforts – you may still be eating gluten. Here’s a lengthy list of at least some of the more common places you’ll see it:

Gluten Containing Grains:
Wheat
Barley
Spelt
Kalmut
Rye
Trticale
Most processed cereal
Oats (unless specifically labeled gluten free and note: oats are common cross reactors as well)
Couscous
Bulgar wheat

Short List of Commonly Used Gluten Derivatives:

Alcohol made from grains: beer, whisky, vodka (unless purely potato), Scotch, most liquors and cheaper wines.
Artificial coloring additives
Chewing Gum
Battered Foods (i.e. fish sticks, fried appetizers, occasionally sweet potato or regular fries) and foods fried in same oil as battered foods (French fries).
Biscotti, pastries and any baked good made from flour, not specified as gluten free
Bran
Many juices and fruit drinks
Sauces in general, horseradish sauce and most premade salad dressings (unless gluten free)
Canned meat containing preservatives, canned vegetables (unless in water only)
Items containing hydrolyzed vegetable protein (often made with wheat)
Caramel (other than from US and Canada)
Imitation seafood (usually made with a starch, common in sushi)
Instant hot drinks (coffee, tea, hot chocolate, etc)
Ketchup and most condiments (anything made with modified food starch has corn and/or wheat)
Rice syrup (may contain barley malt)
Soups (most commercially made canned or frozen soup)
Spices including white pepper, curry powder, bouillon cubes or powder
Soy sauce (except Tamari wheat free soy sauce) and most Chinese sauces
Malt
Veined cheeses (may be made from molds that may be of bread origin)
Mustards (unless specifically gluten free, read label for modified food starch)
Margarines
Sausages
Flavor enhancers including MSG (monosodium glutamate), glutamic acid, monopotassium glutamate, ammonium glutamate

Note: gluten free grains include rice, millet, quinoa, buckwheat, amaranth and teff.

And one final thing: gluten may simply not be as inflammatory for you as it is your friend who had the skies part and the heavens sing when they cut it out. In this case, there may be another reason why your weight loss has plateaued and some gluten containing foods on occasion will probably not make or break your health.

So, if going gluten free was less dramatic than you’d hoped, consider these things and take another pass accounting for the reasons above.

*************

Well that’s my 3 part gluten manifesto. I hope this sheds some light on how complicated gluten reactivity is, what’s wrong with our current method of testing, how avoiding it isn’t always so clear cut and made the case for gluten being so very much bigger than Celiac Disease.

I’m sure these blogs incited a lot of questions as well. For more information on thorough gluten testing or to test your reactivity to those common gluten cross reactors visit www.cyrexlabs.com. For anything else email me at drbrooke@betterbydrbrooke.com or post questions here.

Be BETTER today!

August 8, 2012 at 9:18 am 15 comments

Should We All Be Gluten Free? (But It’s So Hard!!)

Yesterday I explained how Celiac is just the beginning of the gluten conversation, hardly the end. I also discussed how our conventional model of testing is barely skimming the surface of those of us with gluten issues as it’s catching only 1 in 8 people reacting to gluten. (More on better testing at www.cyrexlabs.com)

But let’s say you’ve done some gluten testing and you appear, on paper, to be in the clear. Whew!

Should you still avoid it? Maybe.

In this article I’ll explain why we all may want to at least minimize gluten, how tough is it to avoid, why you can’t really be “almost” gluten free and why you may be more reactive to gluten now than you were before.

First, our food supply is a mess. Wheat is one grain that is very “modified genetically” (although it does not meet the criteria to be considered genetically modified, aka GMO) in our country. (With most grains and all of our soy being modified, picture me now fist shaking in the air cursing, “Monsanto!”) While it’s not technically “GMO” our adulterated gluten has been genetically spliced and diced enough that it fires up our tummies and our T cells. Our immune system doesn’t like this new gluten much, so whether it’s GMO or not is sorta 6 of one, half dozen of the other….but at the end of the day, this modified gluten is largely to blame for the rash of gluten reactivity we’re seeing today.

The wheat/gluten we’re eating today is not what our parents ate and certainly not what our grandparents ate – and also not what our counterparts in Europe are eating. Our homegrown American gluten is a completely foreign molecule that our bodies, namely our immune systems, have never dealt with evolutionarily. Just like when we shake hands with our friend who has a cold and our immune system sees that virus and launches the attack, it does the same with our modern gluten.

This GMO issue makes gluten unarguably an inflammatory food in general, for us all, positive gluten testing or not.

And here’s a few more ways gluten is firing up our immune system, causing inflammation and generally being naughty:

In order to make gluten mix well with other ingredients, food manufacturers deaminate it. This chemical process makes the gluten molecules water soluble in order to make processed, packaged foods. However, this also creates a molecule that is much more reactive than plain gluten or gliadin (see my post yesterday for a graphic showing how wheat becomes gluten and gliadin, etc).

We grow and farm massive amounts of wheat and it’s stored in large bins for long periods of time, allowing mold to act on it and create little immune aggravators called enterotoxins.

Many of us have “intestinal permeability”, aka a “leaky gut”. A leaky gut is due to inflammation in the gut that has caused a bit of swelling in the cells of our intestines, damaging the junctions between the cells allowing larger proteins to get through. Normally only small things pass through such as a single amino acid, a vitamin, or a molecule of glucose. When these larger proteins end up in our blood stream, our immune system sees them, gets all wound up and here comes the inflammation baby!

We can get a leaky gut from years of a bad diet, various medications, having hypothyroidism, being under high stress, eating foods that we are sensitive to, taking antibiotics or doing anything that disrupts the delicate balance of bacteria in our gut. Many of us have poor digestion including low stomach acid production (either inherently or we take acid lowering medications such as TUMS or Zantac) or low enzyme output to digest our food (we need different enzymes to breakdown fats, proteins and carbohydrates). Any of these can disrupt the healthy gut bacteria in our intestines or cause inflammation (leading to the leaky gut issue) making us more intolerant to foods (think to back when we were young and could “eat anything” and now there are various foods that give us mild to significant digestive distress).

Ok, back to the question: if gluten is inflammatory and I could have any number of issues listed above, should I stop eating it? Is gluten inherently just bad?

Well inflammation is bad and we know this genetically modified Franken-Gluten is causing inflammation so yeah, it’s bad. Is it terribly bad for everyone? Not necessarily.

If your immune system is healthy and your gut is healthy and you don’t have a lot of other inflammation in your body, you’ll do OK vs. someone who is struggling with any of those things. For those of you lucky ones, I’d say going totally gluten free is probably not necessary but I’d still discourage anyone from eating several servings of gluten per day. Always focus on more vegetables and fruit vs. grain based carbohydrates. Think sweet potato, pumpkin, squash, fruits and legumes vs. breads, pastas, rice, etc.

However, if you have an autoimmune disorder, a thyroid condition, PCOS, digestive trouble, depression, anxiety, mood issues, acne or are struggling to get pregnant, my advice is to avoid it.

Not sold? Give it up for 45 days at least. The skies may not part and the heavens may not open up, but many of your symptoms may clear up. If they don’t add it back in and see if you feel any different.

Is It Hard To Be Gluten Free?

At first, yes. But after you’ve done it for a while, at times, still yes. It can be tough if you don’t plan ahead , you will find yourself in restaurants   awkwardly ordering some off the menu concoction, you will have friends and family give you a hard time for eating “so weird”. But it does get easier and if you feel better, look better, have more energy, are less depressed and losing weight, then it’s worth it.

And the question on everyone’s mind: is Dr Brooke gluten free? Yes. I wouldn’t ask any of my patients to do something I was unwilling to do myself or didn’t think was that important. And knowing all of the info I’ve just shared with you in the past two blogs, how could I not be? And how could I feed this food to my family?

Do I like being gluten free? Well I like feeling better – gluten makes me tired, cranky, irritable and depressed – although my gut doesn’t react at all. But no, I don’t like it all of the time. I have been very hungry in an airport when I’ve forgotten to pack snacks for myself, I’ve been sad perusing a menu seeing how limited my options are and I’ve never tasted the delicious looking chocolate croissants at my favorite Park Slope coffee shop. I can live without bread or pasta but I do miss the occasional beer, but hey, that’s life! No sense dwelling on the downsides of it and feeling restricted, that just makes it all so exhausting and depressing. I’d rather focus on all the literally thousands of foods I can eat. Feeling badly and knowing I’m damaging my body just isn’t worth the few minutes of yum I’ll have from that buttery, flaky croissant. What’s more, most of the gluten containing foods are simple carbs that wreak havoc weight loss – one more reason to avoid them.

One of my patients put it best last week when asked if she felt deprived not being able to eat gluten.  She brilliantly replied, “No! I felt deprived before when I had lower energy, worse allergies and funky digestion.” It’s all in our perspective.

Can You Make Yourself Sensitive to Gluten?

How about this conundrum: I used to eat gluten with little ill effects, avoided it and now when I eat it I feel like a truck hit me! Did I make myself allergic to it?? No, not really.

If we eat a food that we are even mildly reactive to on a daily basis our immune system just plain gets tired and depleted. When we take it out for a while and the antibodies have time to replenish, they are ready to rock when they see that food again and your reaction is quicker and seems more severe. This will not get better, the longer you avoid something you are sensitive to more often the more significant your reaction will be. (Unless the issue was due solely to a leaky gut, in this case fixing the leaky gut issue should remedy the sensitivity…but there are often multiple factors at play.)

Does this mean, to save yourself a nasty reaction you should dose yourself every day? Definitely not! This just tells you that you’ve done the right thing by cutting this food out of your daily diet. And remember, even if your symptoms seem slight such as a “little tummy ache” or just a bit of bleeding gums when you have gluten, you are reacting and it is a stress on your body and your immune system.

Can’t commit? Can you go “almost gluten free”?
If you are not someone with an autoimmune disorder or the conditions I mentioned above, don’t have significant symptoms when you eat it but still are a bit warry of this ubiquitous protein, can you just eat it on occasion? Sure. But if you do have any autoimmunity, hypothyroidism, PCOS, etc then remember this scary fact: the inflammatory reaction created from a bite as small as a crouton lasts for 3-6 months . Having a bite here and there really doesn’t let your immune system recover. That said, less is better than more so if the best you can do is minimize it, then at least do that. Like I always say: if you can’t do everything, don’t not do anything….at least do something!

So for my final trick, I’ll answer the aggravating question: Why when I ditched the gluten, I didn’t lose any weight!! What gives????  Tune in tomorrow for 7 Reasons Why You Didn’t Lose Weight Going Gluten Free. See you soon!

August 7, 2012 at 9:18 am 6 comments

The 9 Ways You Could Be Reacting To Gluten – None of Which Have Anything To Do With Celiac

With many a Hollywood starlet going gluten free as of late, including the stir caused by Miss Miley Cyrus’s gluten free fueled weight loss, this little grain based protein is grabbing everyone’s attention. Seems right now everyone from Paleo to Vegan is talking about gluten.

This “gluten free craze”, as its being called, is not new although it’s been gaining popularity the past few years. Gluten has been on the radar of natural health practitioners and nutritionists for a long time. So, why now all the fuss?

I’ve been meaning to write an article on this subject for awhile but due to my practice growing so quickly and of course my new job as mommy, my blogging has sadly gone by the wayside. But with both the mainstream media and many of my most revered nutrition and fitness peeps lately saying the gluten free lifestyle is nothing but “trendy”, I wanted to lay this out in greater detail so you can see it’s anything but a fad.

The gluten talk often turns to whether or not you have Celiac Disease (an autoimmune condition where you attack the enzyme that digests gluten in your intestines and can have antibodies to the alpha gliadin component of wheat causing destruction of the microvilli – hairlike projections on the intestines where absorption of nutrients takes place).

But let’s look closer at gluten and how it’s broken down and how Celiac disease is actually just one small facet of the gluten problem. Gluten (from the Latin word for “glue”) is the composite of two proteins called gliadin and glutenin. These exist, joined with starch, notably in wheat, rye, and barley – and most of our packaged foods, sauces, and the list goes on. Here’s how we go from wheat to gluten to gliadin and several other nasties that I’ll explain in a bit:

Not so simple as alpha gliadin huh? Here’s where the advice we hear from Dr Oz to the top fitness magazines to many a blog leads us astray. That advice being: if you do not have Celiac then you don’t need to worry about gluten. Oh my word! This is this not even the beginning of the story, let alone the end.

What’s worse, our current screening for Celiac and gluten reactivity misses 1 in 8 people with gluten issues. Surprised? Confused?

Let’s first talk about the many, many flaws with our conventional testing for gluten allergies and sensitivities (among the tests that deem you Celiac or not) and then I’ll get to how those various breakdown products of gluten cause problems for so many people – yes, even those without Celiac. Bear with me here comes some science…

To be screened for Celiac, the first testing your doc will do includes a couple of antibody tests: alpha gliadin (which is just one form of gliadin) and tissue transglutaminase (an enzyme you make in your intestines that digests gluten). Sometimes an antibody called anti-endomysium is included as well. A positive on any one of these will likely yield an “avoid gluten” recommendation from your MD, however this is not in and of itself diagnostic of Celiac. An intestinal biopsy that shows erosion and flattening of your “villi” is the gold standard for diagnosis of Celiac Disease. So literally, your tissue needs to be damage to a certain extent before we label it “Celiac”.

There are a couple major issues with this blood testing we use to say yah or nah to gluten. First, you MUST be eating gluten/wheat in order for these tests to be accurate. If the antigen, the protein (in this case alpha gliadin), is not around, the antibodies we’re looking for in your blood might not be there in high enough numbers to catch on testing. If you’ve been avoiding wheat and gluten for a while you could geat a false negative. Furthermore, you have to have a healthy immune system for these tests to be really accurate and if you have autoimmune disease (most of which have some level of gluten intolerance as a component) such as Hashimoto’s Hypothyroidism, Rheumatoid Arthritis, Lupus, etc, or are under a lot of stress, your immune system may not have the strength to show enough of these antibodies for us to pick it up. And perhaps the biggest issue is that our conventional testing screens for reactions to alpha gliadin only, but here’s the bigger picture one more time:

There are alpha, beta, gamma and omega gliadins…and you could be reactive to any of the four forms.

Or you could be reactive to deaminated gliadin. Deamination is something that’s done to make the protein water soluble so it can be mixed with other components to make packaged foods. The reaction to deaminated gliaden is much stronger than regular gliadin. There are three of types of deaminated gliadin (15, 17 and 33) and you guessed it, you could react to any of them.

Or you could be reactive to gluteomorphins (a byproduct of us digesting the gluten protein). Morphin like morphine, reacts on opioid receptors in your brain and literally gives you a high. The people reacting in this fashion are those that tear up in my office when we discuss going off gluten – they are truly addicted. This group also can feel worse when they come off gluten because their brain is missing that fix, more on this later. (FYI: there are caseomorphins found in dairy as well. Tough for you to lose the milk moustache? This mechanism may be at play.)

Or you could be reacting to glutenin (remember that gluten is made up of gliadin and glutenin) and this isn’t tested for conventionally either.

Or finally you could be reacting to wheat germ agglutinin, which is not a gluten reaction but more of a “wheat sensitivity” to the lectin portion of wheat germ.

So when we focus on “Celiac” and we look at testing for alpha gliadin and tissue transmaminase, can you see just how much we’re missing? And how a negative test from our doc can give us a false sense of security as we continue to eat gluten?

And want to know how we’re missing even more people who are reactive to gluten? Usually what gets you tested is complaining to your doc about some sort of digestive trouble (although some autoimmune patients are screened, as well as those having immediate family relatives with Celiac). However, gluten reactivity in the scientific literature is being categorized, not as a digestive issue but as a neurological one. Huh??

Consider this 2002 article from the Journal of Neurology Neurosurgery and Psychiatry: patients with enteropathy (erosion of the small intestines due to gluten) represent only 1/3 of patients with neurological manifestations of gluten sensitivity.

Yikes! That means 2/3 of us – over half – that have some sort of reactivity to gluten do not have digestive symptoms! We’re getting missed entirely. Reactions can be depression, neuropathies, brain fog, fatigue, insomnia, anxiety, infertility, female hormone imbalances, acne, etc. The gluten issue extends well beyond the gut, so notion that we are in the clear if we don’t have Celiac is simply not accurate.

This isn’t just the ramblings of gluten-phobic Dr Brooke – who by the way, is descendant of a long line of wheat farmers! (I doubt they are reading this blog though. My grandfather’s response to

The road leading to my Grandpa Steve’s farm in Montana.

a computer is “I don’t watch that thing.”) For at least 15 years, medical journals have been talking about how we’re missing the boat by focusing on Celiac, alpha gliadin and digestion symptoms only.

In 1999, the British Medical Journal stated that we are catching only about 12.5% of reactive gluten patients by diagnosing those with overt Celiac – the teeny, tiny, tip of the ice berg, so to speak. The journal Gut in 2006 said that, “For every symptomatic patient with Celiac disease there are 8 patients with no gastrointestinal symptoms”. This means we’re missing 7 of 8 people reacting somehow to gluten with our current model of testing.

If you’ve lost all confidence that you’ll get any sort of reliable gluten testing, rest assured there is now a test that will screen for reactions to all of the gluten reactivity I’ve discussed. Visit http://www.cyrexlabs.com and inquire about Array 3.

Not able to get adequate testing – or don’t want to? You have another option: you can always eliminate gluten and see if you feel better. But note that you have to eliminate it completely and usually for 4-6 weeks or until your symptoms are gone. Then you introduce it back and see how you do. If you feel better off gluten, listen to that! You’re body doesn’t lie. Most of us ignore the signals our body sends us every day, if your body does better off this inflammatory food go with it – testing or not!

But let’s face it, even with a positive test on the Cadillac of panels from Cyrex Labs, many people simply do not want to give up gluten. It’s in most of our favorite comfort foods and nearly all of our packaged, widely available, convenience foods.

I had a patient that I saw off and on for nearly a year and her weight just wouldn’t budge. She had horrible acid reflux that even with Nexxium, was so bad it affected her sleep and her workouts. When in a prone positions (face down), like for a push up, she had so much reflux she couldn’t finish a set. She had eczema, a few bouts of skin cancer, her stomach ached every time she put food in it, and no matter what we did the scale just wouldn’t budge.

Her doc had tested her for alpha gliadin and assured her that gluten wasn’t a problem for her. My suggestion to skip her beloved morning bagel was a very hard sell. Finally she agreed to a 30 day trail elimination. In that month she lost 15 pounds, eczema was gone, had zero heartburn and no reflux. She had no pain with eating and more energy than she’d had in years. At the end of the 30 days she said, “Yeah this has really worked wonders and I’ve never felt better…but it’s just too hard to avoid. I can’t do this forever.” So she’s back on bagels, back to being overweight and back to burning pain every time she eats. She’s also had another bout of skin cancer – and she was only 30 years old. Ay yi yi…..

Is gluten inherently evil? No, but our modern genetically modified gluten has proven to be a trouble maker for a whole lot of folks and there is mounting evidence that it makes a host of conditions worse – such as autoimmune disease like Hashimoto’s Hypothyroidism. And I don’t want to downplay Celiac Disease – it is a very real condition and an obvious reason to avoid gluten containing foods. But hopefully I’ve illustrated that Celiac patients are not the only ones that should consider living the gluten free life.

Who else should give up gluten? Tune in tomorrow for the answer! And up next after that: 7 reasons why, unlike Miley, you didn’t lose weight when you went gluten free.

Questions? Post them here or email me at drbrooke@betterbydrbrooke.com. Looking for tasty, you’ll-never-miss-it, gluten free recipes? Keep up with me on my Facebook page!

August 6, 2012 at 9:18 am 10 comments


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