Dr. Green - Gluten Exposed - The Science Behind the Hype and How to Navigate to a Healthy, Symptom-free Life

With a growing array of gluten-free products hitting the market almost monthly, it is important to know what is safe, what is hidden, and what are some of the nongluten ingredients in these products that are worse for the body than gluten. We will look at “food glue”—processed food doesn’t grow that way—as well as the many myths that still surround a gluten-free diet.

Gluten is a piece in many medical puzzles but is the ultimate answer to only a few. We will help you determine if it is an answer to yours.

Science, my lad, is made up of mistakes, but they are mistakes which it is useful to make, because they lead little by little to the truth.

—JULES VERNE, JOURNEY TO THE CENTER OF THE EARTH

The scientific theory I like best is that the rings of Saturn are composed entirely of lost airline luggage.

—MARK RUSSELL

Some people think that the truth can be hidden with a little cover-up and decoration. But as time goes by, what is true is revealed and what is fake fades away.

—ISMAIL HANIYEH

It started with an avalanche of bad things happening. Kind of an achiness and gluey feelings in my joints all the time, and it just started to escalate. A mysterious fatigue where I just felt drugged.

The joint stuff was so bad I couldn’t walk upstairs and couldn’t roll over in bed without hurting. The final straw was when I developed vertigo, which got me to go to the doctor. I thought, I’m too young for this to be going on.

She did all these tests and scans, a neck X-ray, and everything was normal. She found “nothing wrong” with me. And yet I clearly was not functional.

Someone recommended removing things from my diet to see if it would help, and I started with wheat, dairy, sugar, and eggs. By the end of that first week I started to feel better and the vertigo went right away. It was literally like the tide going out. I was very disciplined and reintroduced each food, eggs first, then dairy, sugar, and wheat. When I reintroduced the wheat the back pain reappeared instantly.

(JILL, 50) fn1

I know a ton of people who don’t eat gluten for a variety of things—or nothing.

(ANNABELLE, 33)

The gluten hysteria is killing the credibility of people with celiac disease. Because people think it’s a fad thing, that we’re watching our weight or we think it is healthier, that we’re choosing this way of life, and they’re discounting the fact that it’s a medical illness. You’d think we’d be going in a different direction. We’ve gone a few steps back.

(ILYSSA, 39)

Science is a way of thinking much more than it is a body of knowledge.

—CARL SAGAN

I observe the physician with the same diligence as the disease.

—JOHN DONNE

I understand that I don’t really know where I am on that gluten spectrum because I haven’t had any tests. And the other stuff is treated like hocus-pocus. So individuals draw their own wacky conclusions. I’d really like to know what a scientist thinks about it and what I should do.

(JILL, 50)

There are many sources today for health information and many reasons individuals do not go to a doctor to get it. Many people will see a doctor only in order to resolve a physical ailment that has either disrupted their life, will not resolve itself in the over-the-counter (OTC) drug aisles of the pharmacy, or because their spouse/child/friend/sister, etc. insisted that “it’s time to get to the bottom of this.” In fact, many do not see a doctor until their symptoms have seriously affected their ability to work, travel, or sleep. And even then, some arrive with a list of answers before asking the physician what they think is the matter.

When was the last time you:

Self-diagnosed from Internet information?

Self-treated with OTC drugs and/or diet?

Gave a doctor a diagnosis before you were examined?

Some people self-diagnose or seek alternative practitioners when medical tests fail to reveal a cause for ongoing symptoms and/or prescribed drugs fail to cure them. And many of them accept a food-related “diagnosis” as the solution to the problem. Given the current focus on foods as cause and cure, far too many roads lead to gluten. If you are looking to prove that gluten is the cause of your physical symptoms, you will undoubtedly find ammunition to justify this conclusion. As the scientist and mathematician John Lubbock noted: “What we see depends mainly on what we are looking for.”

But if you type “gas, bloating, and fatigue” into your browser, you will find more than 90 other medical and psychiatric conditions on WebMD that cause the same symptoms. And your health depends on isolating, testing for, and treating the correct underlying condition.

When I don’t eat gluten, I feel fine; when I do eat it, I don’t. My doctor did all these tests and scans and X-rays, and everything was normal. She didn’t say “it is in your head,” but there was this long “Hmmmm. I don’t have a diagnosis, but I think it’s all about gluten.”

(NANCY, 44)

Some physicians, aware of the popularity of the gluten-free diet and the susceptibility of people to dietary trends, dismiss nonceliac food intolerances as a legitimate cause for concern. These doctors may be dismissive of symptoms and therefore not interested in getting to the root of the problem, making diagnosis more difficult.

Doctors do not rely on Internet blogs, magazine articles, or website write-ups of scientific papers. They read and analyze the papers and base their diagnoses on peer-reviewed understanding of a condition. Medicine is a plastic science—studies change the understanding of diseases and their mechanisms regularly—so doctors treat conservatively rather than accepting what they may consider a diet that has no good “data” behind its efficacy. For this reason, some may believe that you are on a gluten-free diet for no real scientific reason.

Nevertheless, diagnosis is critical for social acceptance and accommodation—it confers legitimacy on a symptom or the patient. Thus, many people who feel marginalized by health care professionals turn to alternative practitioners to legitimatize their symptoms and solutions. This in turn undermines biomedical science and advocates self-diagnosis—an individual can avoid foods without a doctor’s diagnosis. This can backfire if your problem has no relation to the food(s) you are eating. And if that is the case, you are postponing a proper diagnosis that might alleviate your symptoms.

Many readers do not go beyond an article’s headline or its opening paragraph; it is also difficult for laymen to critically assess statements coming from apparent voices of authority.

—JEROME GROOPMAN, M.D., HOW DOCTORS THINK

Health advice is readily available on the Internet, TV shows, and from nutritionists or unlicensed “dietitians,” health gurus, masseuses, bloggers, newspapers, and magazines. While the advice from alternative sources can be helpful in some cases and generally ensures a sympathetic ear, it should not be a substitute for or confused with medical advice from your physician.

You Rely on Internet Advice

My patient arrived with a fistful of material from the Internet, a list of tests she wanted to confirm the diagnosis she’d come to of her problem, and possible drugs to treat it. I asked her why she bothered to consult with a doctor.