Many of our patients report feeling significantly better after removing gluten. Does that mean they are gluten intolerant, coeliac, have a wheat allergy - or are they just FODMAP sensitive?
The truth is there are many reasons why going gluten free could make you feel better - some are the presence of any of the food reactions listed above. In this case you will feel better from eliminating gluten containing foods.
However it is also possible that you have other food intolerances which may be increasing your sensitivity to gluten. In this instance you may feel better initially, and then after a few weeks many of your symptoms return.
Why is this?
Gluten is a general term given to a collection of proteins found in wheat, barley, rye, spelt, oats, triticale, khorasan, semolina and durum wheat. These proteins are pro-inflammatory (meaning they increase inflammation) and are typically quite challenging to digest.
Anyone with a stressed digestive system is likely to have increased sensitivity to gluten. Including those who do not have coeliac's disease, wheat allergy or IgG intolerance to gluten.
What does this mean?
Put simply, this means that your immune system may not be reacting to gluten - this may not be your primary issue, however you may have other intolerances, and due to your digestive system being so distressed, you initially feel better from eliminating gluten. However as your primary reactions are still being consumed, your symptoms will return.
Is gluten the most common food intolerance?
Surprisingly no. In fact a quantitative analysis of the test results of our founder's patients over her first 7 years of practice determined interesting results.
We've published the bullet points of this analysis below. This information is a breakdown of the percentages of foods required to be removed, taken from the results of patients that testing had confirmed IgG food intolerance. All patients were closely monitored for progress following elimination of their identified foods and underwent a rechallenge phase to ensure these reactions were true and not due to any testing error or misinterpretation.
Most common foods found to have a moderate or severe reaction to (requiring removal from the diet):
Dairy products 41.2%
Most common foods found to have any reaction (from mild to severe), requiring either removal or reduction:
Dairy products 53.2%
What does this mean?
Remembering again that this is a breakdown of the patients that were confirmed to have intolerance, not a study of total participants - these numbers do not mean that 53.2% of the Australian population has dairy intolerance.
What this does mean is of the thousands of people that had a positive test for IgG intolerance, 53.2% of them reacted to dairy, while only 11.6% of them reacted to wheat.
If we analyse those numbers further to determine the number of patients who needed to remove foods from their diet, 41.2% needed to remove dairy, where only 1.2% needed to remove gluten.
This strongly indicates that gluten is not the primary intolerance, and could be the reason that many people who swap their morning cereal for fruit and yoghurt experience only temporary relief.
The relief is likely from 2 things - firstly fruit and yoghurt is a light breakfast option containing beneficial bacteria that improve bowel health, along with nutritious, vitamin rich fruit which will improve overall health. Secondly, as we explained earlier, the gluten proteins are pro-inflammatory and difficult to digest, causing problems for those with irritated digestive systems.
What does this mean overall? Going off the numbers above it is far more likely that you have an intolerance to eggs or dairy than gluten or wheat. Therefore substituting your morning toast for an omelette, while a healthier choice, may not be the best choice for you if you are currently suffering with an intolerance.
However, as gluten proteins are difficult to digest and increase inflammation, consuming gluten containing foods can make other food reactions and symptoms worse.
Furthering this is a sensitivity to FODMAPs which, again, those with a distressed digestive system may experience difficulty with. Most gluten grains (along with many fruits and vegetables) contain fructans, which are oligosaccharides that are "digested" (fermented) by our gut bacteria, rather than by digestive enzymes like most other foods. The fermentation process causes gas, which is not problematic for those with healthy digestive function. However for those with food intolerances the digestive lining is inflamed and highly sensitive, therefore a small gas bubble can feel like excruciating, tearing pain.
While you may feel worse from your morning bowl of oats, the cause is more likely to be an underlying reaction to dairy or eggs, than the gluten itself. Food intolerance testing can confirm exactly what foods you should remove or reduce, however you may find additional relief from reducing your consumption of gluten, or for some all high FODMAP foods, in the short term while you work on your recovery.