Autoimmune Disorders and Gluten Intolerance

Some medical conditions require a patient to eliminate gluten from their diet.

Celiac disease, which affects about 1% of the population of the United States (Mayo Clinic), is an autoimmune disorder based on an intolerance of gluten proteins. Autoimmune disorders occur when the immune system attacks particles that are normally not harmful to the body, either ingested food proteins or the body’s own cells.

Celiac disease occurs when the immune system attacks the body’s own cells after gluten is ingested. Specifically, the cells of the small intestine are targeted. Celiac disease-related attacks on the small intestine damage the cells that absorb nutrients during digestion (Celiac Disease Foundation).

Celiac disease is hereditary, meaning it runs in families. The pattern of inheritance is unknown (NIH). However, 95% of people with celiac disease have the same gene specific for celiac disease predisposition (Medscape, Genetics of Celiac Disease).

Rheumatoid arthritis is another autoimmune disorder relating to gluten intolerance. However, gluten is only one of many potential signals that can lead to an autoimmune attack. Rheumatoid arthritis causes inflammation of the joints – resulting in swelling, pain, and decreased movement ability (Arthritis Foundation).

Bailey Brislin, a UNC-Chapel Hill sophomore biology major preparing for medical school, was diagnosed with juvenile rheumatoid arthritis during her first year in high school. “My ankle had been swollen for months. We went to multiple doctors that couldn’t tell me what was wrong,” Brislin recalls of the time before her diagnosis. Finally, an ankle specialist ordered an MRI and referred Brislin to a rheumatologist after blood test results indicated Rheumatoid factor (RF) in her system. RF is an antibody characteristic of rheumatoid arthritis patients as well as people with other autoimmune disorders (Medscape, Rheumatoid Factor).

The next step to calculating Brislin’s proper treatment was a 5-week series of food sensitivity testing. Although the cause of rheumatoid arthritis is not fully known, potential factors triggering joint inflammation are food proteins, pathogens, female hormones, obesity, stress, and other environmental factors (Arthritis Foundation).

The results of Brislin’s sensitivity tests showed intolerance of gluten and dairy: typical occurrences among rheumatoid arthritis patients. After a while, Brislin realized that eliminating gluten from her diet had a much stronger impact on reducing  her joint inflammation than eliminating dairy.

“After a month off of gluten, I felt better. I was able to stop taking pain medication just by eliminating gluten alone,” Brislin says, “but I should be dairy-free too.” Many years later, Brislin still regularly takes immunosuppressant drugs to improve her condition.

After many years of maintaining a gluten-free diet to ensure her joint inflammation does not return, Brislin has also gathered an opinion on the growing trend of a gluten-free diet. Brislin compares people going gluten-free for no necessary reason to people trying a vegetarian diet just to see if they can do it. “There are people glorifying the gluten-free diet. It’s just bread,” Brislin says, in response to people going gluten-free for supposed “just to be healthy” reasons.

“So gluten-free becomes this very popular trend… and I get all of this criticism for being gluten-free. My rheumatologist always talks about how you don’t have to find the specific scientific data you want, just work with what has been proven in your own case,” Brislin says as she describes her encounters with gluten-free skeptics. Brislin experienced the growth of the gluten-free trend from a very unique perspective. She understands the necessity of eliminating gluten from the diet in certain circumstances but is also critical of the diet in other instances.

Her evaluation below perfectly sums up my goal in writing this series on the growing obsession with gluten:

“There are a lot of people who are very healthy who also eat gluten. I don’t think there’s anything inherently wrong with gluten – it’s not an evil food. Not eating a lot of bread is probably a good thing, but stopping eating bread and replacing it with gluten-free bread doesn’t make much sense… I’m not sure what dietary benefits people think that’s providing…”

Stay tuned for my third and last segment of my series on the gluten-free trend. This last post will contain further analysis on the development of the gluten-free trend, data from a poll of opinions about it, and an interview with Raleigh allergist Dr. Vaishali Mankad.

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