Wheat-free, Gluten-free: Is it for me?

bread-gluten-free

Over the years, I have had many patients request a wheat allergy test, almost all of which came out negative. However, because Celiac disease is now known to be more common than once thought, I have started checking blood tests for gluten-sensitivity. I have found many patients who would be better off gluten, which includes wheat, barley, rye and many types of oats. I used to think that the gluten-free diet was just the latest celebrity diet fad but a lecture I recently attended by Dr. Peter Green, a world-class expert on Celiac disease and gluten-sensitivity at Columbia University Medical Center, convinced me otherwise.

Celiac disease, the most severe type of gluten-sensitivity, is more common than most people realize. It affects 1 in 133 people in the U.S.A – a little over 1%. The ratio among men and women is nearly equal, although women tend to get diagnosed at an earlier age than men because women are more likely to attend to their medical needs promptly.

The symptoms for Celiac disease and gluten-sensitivity are different from those taught to most doctors, including myself, in medical school. Celiac disease was mainly taught in Pediatrics as a malabsorption syndrome, a disease where the intestine cannot absorb proper nutrients. Classic Celiac patients were shown as having rail-thin arms and legs and protruding bellies, but this is rarely seen anymore. Although diarrhea and abdominal pain account for 9% and 20%, respectively, of patients” symptoms, the scope of its symptoms is much broader.

My wife, Dr. Ricki Mitchell, a chronic fatigue s pecialist, has diagnosed numerous cases of Celiac disease in patients who for years were told that they were hopeless and needed psychiatric help. Fatigue and anemia (having a low blood count of Hemoglobin) are common symptoms of Celiac disease in adults. Because the intestine is not absorbing nutrients properly, these patients become iron and B12 deficient. In this case, replacement therapy isn’t the answer because it wouldn’t address the underlying problem.

Women, especially those already diagnosed with Osteoporosis, should be checked for Celiac disease because taking a medicine to strengthen the bones will only be a temporary fix if the real issue is po0r intestinal absorption of nutrients. Dr. Green also made the point that undetected Celiac disease can lead to an increase in malignancies, such as Intestinal Lymphoma, if left untreated. Low cholesterol and a low HDL can also be associated with Celiac disease – sometimes even a good thing, like a low cholesterol, is too good to be true.

There are many different ways to diagnose Celiac disease. The gold standard for diagnosis is a biopsy of the small intestine. This is done in order to detect the absence of microvilli, the finger-like projections that help increase surface area to absorb nutrients. However, before you even have to think about being “scoped”, there are blood tests available that indicate if you are a likely candidate for this procedure. The Tissue Transglutamanase IgA blood test is an excellent screening test to determine if a patient may have Celiac disease. A second blood test, called Endomyosomal antibody, will tell if a biopsy is needed. Another way to test for Celiac’s is through genetic testing. For this test, all the doctor has to do is swab the inside of your cheek and send it to the lab for analysis. If you have the genome HLA DQ2 or DQ8, you are at risk.

The good news is that a gluten-free diet will cure you – no meds needed. Ah, but the cure is worse than the disease, you say. No more pasta or pizza, what could be worse! Well, restaurants hear your pain and many of them now offer gluten-free pasta and pizza and supermarkets often have special sections for their gluten-free products.

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Quinoa is a wheat alternative that can satisfy your craving for grains while being tasty!

Oh, and I almost forgot to mention the best part of this diet, weight loss! Dr. William Davis, cardiologist, wrote a book called, “ Wheat Belly: Lose the Wheat, Lose the Weight”. He explains that wheat, even whole wheat has a high glycemic index – meaning that your blood sugar soars after eating wheat bread, which causes weight gain. The reason this happens – and has nothing to do with gluten sensitivity – is because modern wheat has high levels of amylopectin A, which converts to glucose faster than any other carbohydrate. If you like grains like I do look into the following products: millet, quinoa, and amaranth. They make good granola and rice-like dishes and actually taste good.

A number of celebrity A-listers have gone gluten-free: Steve Nash, the Phoenix Sun’s star, Novak Djokovic, the number 1 Tennis player in the world, and talk show host, Elizabeth Hassel back. I think there might be room on this list for me, if I jump on the gluten-free bandwagon before Dr. Oz!

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

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