Celiac Disease And Gluten Sensitivity – What Do Toxins Have To Do With It?
A gluten-free diet is more than just a diet trend, it is a powerful food-as-medicine approach to address the root causes of unwanted symptoms and inflammation throughout the body.
I find that many of my patients benefit from a gluten-free diet whether they have celiac disease, the most extreme form of gluten sensitivity, non-celiac gluten sensitive, autoimmune disease, are recovering from chemical exposures or simply want to optimize their health.
Recently, I’ve come to learn about more research linking exposures to toxins to increased risk for celiac. If you’ve been following me, you already know how passionate I am about bringing you information about chemicals in the environment from a place of empowerment.
I believe once we can see the connections, we are able to change behaviors and adjust our lives in ways to limit exposures and promote our best expression of health.
In this article, you will learn more about:
- The difference between celiac disease and non-celiac gluten sensitivity
- How toxins may play a role in the development of celiac disease
- My top tips for addressing celiac and gluten sensitivity, including following a Paleo diet, getting clear about hidden gluten exposures and reducing toxins from a variety of sources.
Let’s get started!
What Is Celiac Disease?
If gluten sensitivity exists on a continuum, celiac disease is the most well-known and extreme manifestation. Celiac disease is an autoimmune disease that affects the enterocytes, the cells that line the small intestine and form microvilli.
These cells and microvilli become damaged and the body can’t effectively digest food and absorb nutrition. Think of the microvilli as fingers along the small intestine; with celiac, the fingers become flattened.
Celiac disease symptoms in adults include painful digestion, constipation, diarrhea, nutrient deficiencies, skin rashes, neuropathy and more. Or, someone may experience no classic symptoms at all, until they develop anemia, early dementia, autoimmunity, lymphoma or osteoporosis.
Like other autoimmune conditions, three factors must be present for the development of celiac disease:
- A genetic predisposition. In the case of celiac, the HLA-DQ2 and HLA-DQA genotype play a role.
- Intestinal permeability, also known as leaky gut, where the junctions between the enterocytes that line the small intestine become “leaky,” allowing larger food proteins to enter the bloodstream causing an immune response.
- An environmental trigger. With celiac, the main trigger is gluten, but as we will see toxin exposures may also play a role.
Celiac disease affects around 1 percent of the global population and many go undiagnosed. Celiac disease often occurs along with other autoimmune conditions, so should definitely be considered or ruled out for those at higher risk for autoimmunity.
The good news is that celiac disease treatment is relatively simple to implement and doesn’t cause any side effects. It includes a strict adherence to a gluten-free diet. Gluten is the protein component of wheat, barley, rye, spelt, and other gluten-containing grains. And, no, you can’t have just a little bit. Most also benefit from eliminating oats even if they say they are gluten free.
What Is Non-Celiac Gluten Sensitivity?
People with non-celiac gluten sensitivity react to gluten, but don’t have celiac disease and the associated flattened villi in the small intestine. Symptoms may be quite extreme or more mild and not only affect digestion, but may cause inflammation in any part of the body.
Symptoms of non-celiac gluten sensitivity include headaches, brain fog, joint pain, thyroid hormone imbalances and more. Any symptom that you have from a food sensitivity could be caused by gluten.
POPs And Celiac
A recent (May 2020) study in Environmental Research linked environmental chemical exposure to persistent organic pollutants, or POPs, to celiac disease. The study looked at 30 children who had been diagnosed with celiac disease by intestinal biopsy along with a control group. Blood tests were used to test for:
- Polybrominated diphenyl ether (PBDEs)
- Perfluroalkyl substances (PFAS)
- P,P-dichlorodiphenyldichloroethylene (DDE)
The study concluded that those with these chemicals in their bloodstream had twice the risk of celiac disease, and affected females at a greater rate than males. Woman, by far, are most affected by autoimmune diseases in general.
This statistic of double the risk for celiac takes into account an adjustment for genetic susceptibility. We know that certain single nucleotide polymorphisms, or SNPs (small changes in the genetic code) affect the body’s ability to detoxify, methylate and perform other functions.
People with certain SNPs are more susceptible to the effects of chemical exposure. However, this study found the effect of POPs exposure to be independent of these genetics, so is likely problematic for everyone.
The authors suggest that the POPs exposure contributes to leaky gut, allowing gluten to have more of an immune response in the body. Of course, this is a small study and we certainly need to study this further, but it is another piece of evidence connecting toxic chemicals to autoimmunity.
Tips For Addressing Celiac Disease And Non-Celiac Gluten Sensitivity
If you have a family history of celiac or gluten sensitive or have been diagnosed yourself, here are some action steps I recommend for both prevention and treatment.
1. Go Paleo. A Paleo diet is naturally gluten-free, low in toxins and nutrient-dense.
One issue that often comes up with following a gluten-free diet is avoiding cross-contaminants. Non-gluten grains, such as oats, and processed products may be contaminated with gluten through the harvesting and processing processes. For someone with celiac or gluten sensitivity, even these micro doses of gluten are enough to cause an immune response and symptoms.
On a Paleo diet, you’ll already be avoiding grains, processed products and other common sources of cross contamination.
In addition, a Paleo diet is what I recommend for autoimmune disease, often with personalization for each individual. A Paleo diet helps to heal the gut and removes compounds, including lectins, found in grains and legumes that inhibit absorption of minerals.
In addition to a Paleo diet, I often recommend testing to assess gut function, pathogens and the microbiome.
I then have patients follow a personalized 5R protocol for healing, which includes dietary strategies.
The Paleo dietary approach is often a great starting place for uncovering food sensitivities and acts like an elimination diet where you remove common offenders: gluten, grains, corn, legumes, etc. and then when added back in, observe for a reaction.
Please note that if you have celiac, you should not reintroduce gluten and it needs to be avoided for life.
In my experience, those with celiac and gluten sensitivity often have other food sensitivities. Simply removing gluten is not enough to address all concerns, although it may show some improvement at first and is a very helpful first step in many cases.
2. Be careful of hidden gluten. We discussed cross-contamination, which is important to be aware of. Reading labels is another important skill to help avoid gluten commonly added to food products, even health food products.
The whole food sources of gluten include:
Since some of these may be unfamiliar, they are the first things to look for on a label, however might be processed and refined and hidden under other names.
Here are some ingredients you might find on a food label that contain, or could contain, gluten:
- Artificial color
- Artificial flavor
- Barley malt
- Caramel coloring
- Clarifying agents
- Edible coating
- Enriched flour
- Fat replacer
- Malt, malted flavor, malted syrup
- Natural flavor
- Vegetable starch
- Wheat germ, wheat meal
To learn more about what foods contain gluten and best practices for avoiding, The Gluten Intolerance Group has many free resources. When in doubt, it is best to avoid questionable processed products or call the company to verify if something is truly gluten-free.
3. Reduce exposure to toxins. This will help to decrease your risk for developing celiac, help to maintain or improve your gut health and lower your overall body burden of toxins.
I have many resources available to you with strategies for reducing your toxin exposures in a variety of areas. Here are some tips, with links for more information.
- Reduce PFAS exposures by choosing cast iron, ceramic or glass instead of Teflon.
- Filter your water to lessen exposure to a variety of chemicals, heavy metals and POPs.
- Filter your air, for many of the same reasons, as toxins adhere to dust particles and can enter the body through the lungs.
- Reduce endocrine disruptors, including BPA and other harmful chemicals.
- Avoid pesticides by eating organic and using organic methods for your yard and garden care. The Environmental Working Group’s Dirty Dozen Guide is helpful for determining what produce is most important to buy organic.
- Reduce plastic use, especially when it comes to food. This means choose food not packaged in plastic and use alternatives, such as glass, for food storage and heating at home. Microplastics (link to article) are of concern as well.
My hope is that these resources and suggestions offer you a springboard for change. You don’t have to tackle everything today or this week, but take one step at a time. When you run out of your current cleaning product or face wash, do a little research and upgrade to a cleaner version.
When you’ve made some progress there, start with incorporating one new Paleo recipe into your weekly menu. Over time you’ll create new go-to habits, reduce your toxic exposure and ultimately improve your health.
Still feeling overwhelmed? Check out my free guide, How To Be Safe In A Toxic World for step-by-step guidance.
- Al-Toma, A., Volta, U., Auricchio, R., Castillejo, G., Sanders, D. S., Cellier, C., Mulder, C. J., & Lundin, K. (2019). European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European gastroenterology journal, 7(5), 583–613.
- Fasano A. Leaky gut and autoimmune diseases. Clin Rev Allergy Immunol. 2012;42(1):71‐78.
- Lundin, K. E., & Wijmenga, C. (2015). Coeliac disease and autoimmune disease-genetic overlap and screening. Nature reviews. Gastroenterology & hepatology, 12(9), 507–515.
- Roszkowska, A., Pawlicka, M., Mroczek, A., Bałabuszek, K., & Nieradko-Iwanicka, B. (2019). Non-Celiac Gluten Sensitivity: A Review. Medicina (Kaunas, Lithuania), 55(6), 222.
- Gaylord A., Trasande L., Kannan, K., Tomas, K., Lee, S., Liu, M. & Levine, J. Persistent organic pollutant exposure and celiac disease: A pilot study. Environmental Research. In press, available online 11 May 2020, 109439.