Gluten Sensitivity — Signs, Symptoms and What to Eat

This podcast is brought to you by MaximusMark.com. Hey folks, welcome to the show that punches you in the face with information, but in a good way. It's Maximus Mark, and today I have for you the gluten show. But this isn't your average gluten show. No, we are kicking it Maximus Mark style, and I've tracked down one of the world's leading authorities on the topic, Dr. Thomas O'Brien. Dr. Thomas O'Brien is an internationally recognized speaker, specializing in gluten sensitivity and celiac disease. He is the Sherlock Holmes for chronic disease and metabolic disorders. He holds a teaching faculty position with the Institute of Functional Medicine and the National University of Life Sciences. Dr. O'Brien is passionate about teaching the many manifestations of gluten sensitivity and celiac disease as they all, all occur inside and outside the intestines. You can learn more about Dr. Thomas O'Brien by visiting www.thedoctor.com. So with that said, let's welcome Dr. Tom O'Brien to the show. Hi, Tom. It's Mark. How are you doing?

Hi, Mark. Very well, thanks. How are you today?

I'm very good. Very absolute pleasure to speak to you today. You know, really looking forward to this call. You know, I've read a lot of your stuff and listened to a lot of your videos and I went on your website, downloaded a lot of the other podcasts. And yeah, it's, it's great information. Really great what you're doing, you know, in the field of gluten. So yeah, really appreciating you coming on today to, you know, talk about it.

You bet. Happy to do it. Yeah.

Thanks for that. So let me ask you, how did you become a leading expert in the field of gluten?

Well, I was in a seminar in 2001 with Dr. David Perlmutter, neurologist from Naples, and he was talking about a study that had just been published in the journal Neurology. That talked about 10 people with unrelenting migraines, and their migraines were so bad that they were unable to work, and the average was 8 years that they had been out of work on workman's compensation. And if you're on workman's compensation for 8 years, you're not a malingerer. You know, these are people that are truly suffering. And somehow what came up for me was I wondered What's it like to live in that house? What's it like for the children of that family when dad's got a headache? Shh, shh, shh, quiet, quiet, dad's got a headache. How is it growing up in a house like that, and how suppressed might the children be? And let alone the stress of the family where they haven't had an income in 8 years, living off retirement funds and disability and whatever they could get. And so I ordered that paper because I was caught by the concept, and I read the paper, and turned out that 7 out of 10 of those migraine patients were sensitive to gluten. They did not have celiac disease, they were sensitive to gluten. And the doctor took gluten out of their diets, and 7 out of 10 never had a headache again. 2 out of 10 had partial relief, and the 10th one refused the diet. So I said that wrong. 10 out of 10 had a sensitivity to to gluten. 7 never had a headache again on a gluten-free diet. 2 got partial relief on the gluten-free diet, and the 10th one refused the diet.

Wow.

So that really caught me, and so I looked at the references in the back of the paper and ordered those papers and started reading them, and I've read hundreds of articles now on this.

Geez. So yeah, 10 out of 10. So I guess let's start with the most obvious, because, you know, I tell all my clients and all my listeners to obviously avoid gluten, but you know, one of the most common questions I get from, I guess, people who are introduced to gluten, what exactly is it and what foods is it found in?

Good, good, good question. Gluten is the protein in most grains. It's a family of proteins. Rice has gluten, corn has gluten, but there's a toxic family of glutens that are found in wheat, wheat, rye, and barley. So anything that is made from wheat, rye, and barley will have some of this protein in it, and if you're toxic to that, your body thinks that you're eating a poison. And when you're eating something that's dangerous to you, the immune system comes into action to go after it. And that's what happens with celiac disease or with gluten sensitivity in general, is that the immune system goes after these proteins of gluten to destroy them. And that's not a problem at all, except if you're having toast for breakfast and a sandwich for lunch and pasta for dinner, and the next day you're having toast for breakfast and a sandwich for lunch and lasagna for dinner, and the next day you're having toast for breakfast and a blueberry muffin at lunch and croutons on your salad at dinner. I think you get my point that we keep eating more and more and more gluten. That there's— I guess the easiest way to say is that there is collateral damage that occurs. And once the collateral damage occurs from all of the immune activity trying to protect you from a poison, once the collateral damage begins to occur, it has a life of its own.

So this is how—

sorry, this is how you develop other autoimmune diseases with gluten sensitivity. And we know that autoimmune diseases are one of the primary causes of morbidity and mortality, that means getting sick or dying, in the world today. And we know that autoimmune diseases are 10 times more common if you have gluten sensitivity. So the number one cause of death in most places of the world, of the industrialized world, is 10 times more common if you have a sensitivity to gluten. Gluten's the gasoline on the fire for most people. There may be others also, but gluten is a primary one.

One of the things I've heard you mention in past interviews and podcasts is that 70% of gluten— sorry, celiacs go undiagnosed because there's no symptoms in the gut.

Is that correct? Actually, it's— yeah, that's, that's close. It's 1 out of 8. For every 1 that has symptoms in their intestines, there are 8 that don't. They've got brain symptoms or joint symptoms or skin symptoms. They've got psoriasis or rheumatoid arthritis or recurrent ear infections or migraines or attention deficit or kidney disease or muscle cramps or anemia or miscarriages, and the list goes on and on and on.

So miscarriages are also linked to gluten intolerances, is that correct?

Oh yes, yes. Actually, I published a paper on this in the Journal of Practical Gastroenterology in 2009 called Reproductive Disorders and Celiac Disease. And gluten sensitivity, celiac disease is one of the most common causes of unexplained miscarriages.

Wow. Yeah. Yeah, I didn't know that one. So let me ask, gluten, you spoke before about obviously your immune system being on alarm. So one of the things that I sometimes get a little bit confused with is Does gluten cause an inflammation response or does it cause an immune response? And why is that significant?

Good. The inflammation is the mechanism of all degenerative diseases. As far as I know, every degenerative disease at the cellular level is always an inflammatory state, always. When you eat a food that you're allergic to, your immune system gets called into action and what it does is it goes after that food to attack it. You know, it attacks that food. And it does so by producing cytokines that are chemical bullets, if you will, that will cause that inflammation that kills the cell, or it destroys that protein. You also make antibodies against that food. First, it's the immune, the natural immune system called the innate immune system, and you make, you produce these interleukins that produce cytokines, try to destroy it, and when they can't do the job any longer, then they have to call in the reserves, and the reserves are the antibodies. And the antibodies come in and the antibodies attack the substance and try and destroy it also. It's always an inflammatory mechanism by which an invader— whatever the body considers as an invader— it's always an inflammatory response that destroys the invader.

Right, so gluten causes an inflammation response, and, and then is there any immune response to that?

Gluten causes the inflammation response. What happens is that gluten causes a mechanism in the intestines, it's called intestinal permeability, or the slang term for it is leaky gut. This leaky gut occurs within 36 hours of eating gluten. And the leaky gut occurs because the immune system is attacking these gluten protein molecules and trying to destroy them, and it does so by producing this inflammation, these cytokines that cause an inflammation that destroys the cell. When you have recurrent episodes, this minor amount of inflammation that is almost undetectable until you're being exposed to this thing day after day after day after day. Now it becomes an inflammatory state, and now you've got measurable amounts of inflammation and all the tissue damage that occurs from that.

Alrighty. So it's my understanding that if you do have any type of gluten sensitivity, you basically, you can't have it, period, in your diet. Why is that?

Well, the rule is you can't be a little pregnant. And you can't have a little gluten. And the reason for that is that the mechanism by which the antibodies are produced to the gluten proteins of wheat, barley, and rye is the same mechanism by which antibodies are produced to measles or any other of the vaccines that we've received in our life. So what happens with a measles vaccine, as an example, they give you an injection of the bug measles. Your brain says— sees this and says, well, this is not good for me. And there are generals in your immune system— Army, Air Force, Navy generals. And the brain says, you, General, you know, General Gluten, take care of this. General Gluten produces an assembly line that starts making soldiers. Those soldiers are called antibodies. And those soldiers are trained to go after gluten. That's all they do. Or, or go after measles. That's all they do is go after measles. Now those soldiers are in your bloodstream. They're going around shooting all the measles bugs that you had been injected with. And when all the measles bugs are destroyed, General Measles, who's watching all this, says, okay, turn off the assembly line. We don't need that. We don't need more measles antibodies here right now. You shouldn't have any measles antibodies in your bloodstream right now unless you were exposed to measles. You shouldn't have any. But General Measles is now vigilant the rest of his life. The rest of his life. It's his main job. If measles ever comes back, General Measles just— he doesn't have to build an assembly line again. He just has to flip the switch and turn it back on, and the antibodies are out very, very quickly. That's why if you go to Africa to visit, you need vaccinations months ahead of time for all of the strange diseases that you— dengue fever, yellow fever, all of the diseases that you might be at risk of contracting in Africa, you need these vaccinations months ahead of time. But if you're going back to visit 5 years later, you just need a booster shot 2 weeks before you go because you just have to wake up the general again to start making the antibodies.

Right. So I've heard in the past some other people talk about it takes 90 days. There's basically a 90-day rule that it takes to reset and for the antibodies and the response to go down. Can you talk a little bit more about this?

Well, the lifespan of the antibodies is anywhere from 4 to 6 weeks, perhaps a little longer, maybe up to 8 weeks. So if with one exposure to gluten General gluten gets turned on, he flips the switch, the antibodies are produced within 14 days, and they're around 4, 6 weeks, 4, 6, 8 weeks, somewhere on that category from one exposure. Now, if you're having gluten every day, the mechanism just stays— the assembly line is up and running, working 3 shifts, 3 8-hour shifts a day. It doesn't stop.

So is there— I guess we said before, you can't be a little bit pregnant. You know, I remember you telling a story about as much as 1 milligram, not even a full gram of gluten will cause this response. So, you know, if basically someone goes to a restaurant and someone's making, let's say pasta, and then they use the same spoon to make the steak, that can actually cause a gluten response. Is that right?

That's exactly right. In sensitive individuals, that's all it takes. The Codex limit is 20 parts per million. So imagine a million pinheads sitting on your desktop, a million pinheads, then just imagine how many 20 of those are. That's how much gluten it takes to activate general gluten.

Right, so not a lot at all. You know, a little bit of gluten will definitely cause the response. So let me ask you this, you know, people obviously talk about oatmeal and having oats in the morning and porridge and these type of things, But you know, it's my understanding, a lot of these products actually made in the same place as other wheat products. So in your opinion, is that to say we should avoid things like rice or oatmeal?

Well, they're different grains. Oats, it's been published on oats. When oats grow out of the ground, there's no toxic gluten in them. When you buy oats off the shelf, off the supermarket shelf, there's gluten in them. And it's contamination, it's cross-contamination from either the— when they harvested the oats in the field, they threw them in the truck to drive to the manufacturing facility and that truck hauled wheat last week and they don't clean the truck. Or in the same facility and it was in the air, it was on the assembly line, something like that. But in here in the US, there are a few companies that are very proud now to put on their label gluten-free oatmeal or gluten-free oats. And they go out of their way and they test their batches to make sure that they're completely gluten-free. Okay, so in general, in general, it's not safe to eat oatmeal out, out in a restaurant. In general, if you're a celiac, it's not safe because when they've looked at different brands of oatmeal, they're all contaminated, even, even those that are from an oats-only facility like McCann's, which is a famous oats here in the US that comes from Ireland. They're, they're grown and they're, they're packaged in Ireland and they're an oats-only facility, but 2 out of the 4 samples that they looked at had levels of gluten above the toxic limit. Right. So, so you, if you eat oats and we recommend our patients to use oatmeal, it's okay. And if they don't heal the way we see they should, then we take oats out. But you just need to make sure that the oats you're using are gluten-free oats.

Right, and that is normally advertised on the packet.

That's correct.

Yeah, cool. So let me ask you this. If, what if someone turns around, they get a test, you know, 'cause the next question I'm gonna ask you is about tests, but what if someone gets a gluten test and it comes back, they're not intolerant, they can actually have gluten, would you advise to keep having gluten?

Well, there's a couple of different levels to that answer. The first one is body language never lies. It never lies. And many of us speak a second language, perhaps Spanish or French or Italian. Many English-speaking people speak a second language. How many speak body? Most of us do not speak body at all. We don't understand the language, we don't listen to it. If we have something going on, we take an aspirin to get rid of the headache. But if we have 2 or 3 headaches a week, we take aspirin 2 or 3 times a week and not worry about it. That's like going into the— under the dashboard of a car and the hot light comes on, and so you go under the dashboard and you look for the wire going to the hot light, you cut the wire, and then you look at the dashboard and see that the hot light's not on anymore and you keep driving your car. We don't— we don't speak body, and we should learn to speak body. From that context, the best test in the world Stop eating gluten. Completely stop for 2 to 3 weeks. Notice what happens. If you feel better and then you go back to eating gluten and you start heading back to that same not better, then your body's telling you, I don't feel good when you do this, when you put this food in me. So that's the first answer. The second answer is that the tests are notoriously inaccurate. If you have— it's called total villus atrophy. That means the inside of your intestines is a, um, it's a tube. The intestines are a tube going through your abdomen. The inside of the intestines is lined with shag carpeting, and each shag absorbs different nutrients. This shag over here is calcium. The shag over here is magnesium. This one is oils. This one is good fats. This one is proteins. All the shags absorb different nutrients. Celiac disease, which is gluten sensitivity affecting the gut— celiac disease wears down your shag, so you don't have shag carpeting anymore, you've got Berber. And if you've got Berber carpeting, you don't absorb calcium, you get osteoporosis. It's not rocket science why it happens, right? That's why in the Annals of Internal Medicine they say every osteoporotic patient needs to be checked for celiac disease, as celiac disease could be the cause of their osteoporosis. So I say to the doctors when I show them that study, say, doctors, if the Annals of Internal Medicine say every osteoporotic patient needs to be tested for celiac disease because celiac disease could be the cause of osteoporosis, which one are you not going to check? You know, there's, there's silence in the room. So the tests are notoriously inaccurate because the— let me back up— the tests are right on the money completely accurate, right on the money, very high degree of sensitivity and specificity, 96, 98, 100%, very, very accurate if you have total villus atrophy. If your shags are worn down completely and you've got Berber, the blood tests are very accurate. But if you've only got partial wearing down or you've just got the inflammation and nothing's worn down yet, the blood tests are wrong up to 7 out of 10 times. So the blood tests are very accurate, and all the studies say how accurate they are for celiac disease. But celiac disease requires the shags to be worn down completely— total villus atrophy, right? So that's why I, I call this the conundrum of gluten sensitivity. This is why so many people get blood tests, they come back negative, but if they stop eating wheat, they feel better. But since the blood test was negative, I guess I can eat wheat. So they're not listening to body language, they're listening to that piece of paper that was wrong. New tests have just come out here in the US in the last 3 months where the reason the tests are wrong and they're not sensitive enough, one of the reasons is because we know that, see, gluten is a protein and the protein molecule is made up of hundreds of amino acids. They're the building blocks, if you will, or the bricks that make up the wall, the protein gluten. Digestion is removing the mortar from in between the bricks, so each brick comes off. So good digestion breaks down your proteins into single amino acids that go right through the shags into the bloodstream. That's normal. That's how it's supposed to occur. But when you have