Not Just Gluten: Autoimmune Triggers

It has become fashionable in popular culture to poke fun at the growing use of gluten free diets, but for those of us working on complex medical problems, gluten is a source of significant concern.

 Gluten Free

In a recent Op-Ed piece in the NY Times by Moises Velazquez-Manoff (Can Celiac disease Affect the Brain? Oct.12, 2014), the author touches on the role of gluten in relation to the increasingly common problem of autoimmune disease. He focuses on Celiac Disease which is the most generally accepted and well known form of gluten reaction, and describes how it can target other organs, especially the brain. We welcome the attention to the broad scope of Celiac Disease, but our experience indicates that gluten can cause many problems beyond the effects of Celiac.

 Autoimmunity is becoming more prevalent in Western countries, and there are a variety of theories to explain this, such as the effect our food supply has on intestinal health, or the presence of environmental toxins which affect our immune system. The important point raised by Velazquez-Manoff is the role of triggers such as gluten that may initiate an autoimmune reaction.

We at Bock Integrative Medicine make a considerable effort to detect and eliminate triggers in individuals with autoimmune conditions. One of the growing problems we are seeing is the role of microorganisms that serve as triggers of autoimmunity. In addition to the well known conditions of Rheumatic Fever and kidney disease triggered by strep, there are newer conditions such as PANDAS/PANS which is an autoimmune encephalitis triggered by strep as well as other organisms. This is also evidence pointing to a role of intestinal flora in other autoimmune conditions such as Inflammatory Bowel Disease (colitis) and Rheumatoid Arthritis. It’s even been demonstrated that gluten can damage the intestinal lining and allow bacteria to get through to the immune system and possibly trigger a variety of autoimmune reactions.

 It’s encouraging to see a discussion in the popular press about the broader problems posed by Celiac Disease, but from our perspective gluten is just the tip of the iceberg.