I have previously discussed why and how anyone diagnosed with celiac disease needs to go beyond the overly-simplistic advice to be “gluten-free” typically provided by gastroenterologists and dietitians. Eliminating dietary sources of gluten-free is only the first step on your way back to recovery—NOT taking additional steps can mean numerous future health problems, continuing gastrointestinal disruption, autoimmune diseases, muscle aches and pains, inflammation, even diverticular disease and colon cancer. So going beyond a gluten-free diet is crucial. Sadly, you cannot rely on the majority of gastroenterologists or dietitians to tell you this, given their deep and persistent ignorance on issues surrounding celiac disease and overall health.
Rachelle posted her celiac journey on the Wheat Belly Facebook page, describing how she had to learn this lesson the hard way:
“In 2 days it will be my 6 month anniversary of the day I decided the change my life for the better! I am a celiac that had been eating gluten-free and then Paleo for the last 10 years.
“I was diagnosed with rheumatoid arthritis and osteopenia [bone thinning] at the beginning of this year and was put on a narcotic for inflammation and pain. I am happy to say that my inflammation symptoms are practically non-existent and I am off any kind of pain medication. I am excited to see where my bone density is in a few more months. I have more energy and clear thinking than I ever have.
“So grateful for Wheat Belly and how it has changed my life.
“This is my before March 10, 2019 and my today September 8, 2019. I was wearing an XL shirt and size 20 pants and now I am in a large or medium shirt and size 14 pants.”
Rachelle had to go beyond just being gluten-free in order to lose weight and regain health. As her experience highlights, there are additional steps to take beyond conventional cut-out-the-gluten advice. Among those additional steps are:
- Eliminate all grains—Even if a grain does not contain gluten, such as corn, it can contain other forms of prolamin proteins (gluten, or actually gliadin within gluten, is a prolamin protein), since there can be overlap in their structure and effects, even if it is not labeled “gluten.” The zein protein of corn, for instance, while not gluten, can mimic many of the toxic effects of gluten. While rice does not have a prolamin protein, it has wheat germ agglutinin, so-called because it is identical in structure to that found in wheat. Wheat germ agglutinin is a potent bowel toxin, toxic to an already damaged intestinal tract in someone with celiac disease. People with celiac disease (as well as all other humans) should therefore be grain-free.
- Avoid gluten-free processed foods—Naturally gluten-free foods like avocados and eggs are, of course, perfectly fine. But it’s processed gluten-free breads, muffins, noodles, etc. made with cornstarch, tapioca starch, potato starch, or rice starch that create an entirely new set of problems, including extravagant weight gain and insulin resistance that leads to type 2 diabetes, as well as the problems associated with corn and rice mentioned above. The list of diseases caused by processed gluten-free foods is long and there is no reason to include such garbage foods in anyone’s lifestyle.
- Correct vitamin D deficiency—Vitamin D deficiency does not cause autoimmune conditions like celiac disease; vitamin D deficiency allows some other factor to initiate an autoimmune disease to develop, with vitamin D deficiency then allowing the process to proceed to full disease, what I call vitamin D deficiency’s “permissive” effect. Correct vitamin D deficiency to further push back on the disrupted immune response of celiac disease.
- Correct vitamin B12 deficiency—Because autoimmune gastritis is a common accompaniment to celiac disease, vitamin B12 deficiency can develop and persist due to the lack of both stomach acid (hypochlorhydria) and so-called intrinsic factor necessary for B12 absorption.
- Cultivate healthy bowel flora—Dysbiosis is the rule in people with celiac, including many with small intestinal bacterial overgrowth, SIBO, and small intestinal fungal overgrowth, SIFO. Being gluten-free does not fully correct disrupted bowel flora. Persistence of SIBO, for instance, on a gluten-free diet can still provoke muscles aches and pains, body-wide and intestinal inflammation, irritable bowel syndrome symptoms, food intolerances (nightshades, lectins, fructose, nuts, legumes, FODMAPs), diverticular disease, and colon cancer. Cultivation of healthy bowel flora, including efforts such as hydrogen breath detection, are crucial for anyone with celiac disease. We begin by removing the factors besides wheat and grains that disrupt bowel flora, such as synthetic emulsifying agents and synthetic sweeteners, then repopulate with high-potency, multi-species probiotics and fermented foods, adding prebiotic fibers in sufficient quantities, and specific efforts to address SIBO/SIFO such as herbal antiobiotics and selected food-sourced essential oils.
- Consider dairy elimination—Dairy intolerance is common in people with celiac disease and can cause continuation of intestinal inflammation. Another alternative: convert to A2 dairy, i.e., dairy products that contain the casein beta A2 form of casein, identical to that in human milk, as well as in goat’s milk.
Other common nutritional deficiencies, such as those of zinc, iron, and folate, typically correct on their own but should nonetheless be assessed, especially when celiac disease is diagnosed. Deficiencies developed due to consumption of the phytates of wheat and grains coupled with the substantial dysbiosis of celiac disease, but usually reverse without specific supplementation by correcting diet and taking efforts to cultivate healthy bowel flora.