Many people mistakenly believe that their symptoms can be treated and cured through food elimination. By the time you finally get to a doctor, the gluten-free diet may have intensified another condition and taken away your health.
You May Be Eating Gluten Anyway
The biggest hurdles? Contamination. If I had to sum it up, I’m very comfortable with the lifestyle, very comfortable feeding my family, the options are enormous, but I never sit down at a dinner and say, “This is perfectly right.” The kids want pizza and pasta. But when they have gluten-free pasta on the menu I still worry that they don’t know how to prepare it safely. I still struggle with it.
(ILYSSA, 39)
One pitfall in a gluten-free diet is trying to adhere to it when gluten is a hidden ingredient in or on your food. This may be due to contamination or confusion about gluten-free labeling and regulations or actual false labeling.
Cross-contamination and a lack of awareness in restaurants accounts for most of the “I got glutened” comments from people trying to follow a gluten-free diet. For preparing gluten-free meals, restaurant kitchens often use fryers or pasta water in which dishes that are breaded or contain gluten have been cooked. The cross-contamination that occurs in manufacturing also usually relates to shared equipment, confusion about barley and malt—which contain gluten but not from wheat, which is required to be listed as an allergen on labels—or gluten that finds its way from crops that share fields and storage facilities with nongluten grains.
Testing can be spotty. Several groups offer “gluten-free certification,” but they are not all using the same ELISA (enzyme-linked immunosorbent assay) tests to ascertain gluten content. It is also physically impossible to test every batch of a cereal or packaged product to ensure that it contains less than 20 parts per million, the standard set by the FDA for all foods with a “gluten-free” label.
Reading labels and talking to food servers is crucial to avoiding hidden ingredients and cross-contamination. Doing so is a source of stress and disruption for many people.
We were in a restaurant with a gluten-free menu, so I probably didn’t ask enough questions. But my daughter ate the salad and what looked like a plain chicken breast, and within 20 minutes she was vomiting all over the tablecloth. I knew she’d gotten gluten no matter what they told me.
(CISSY, 42)
Whenever we go away I go right to the head of food services in every hotel. I don’t bombard them but ask how they can help me and how I can help them. So they have the knowledge for the next person who comes with celiac disease. We get amazing dedication and great service.
(ILYSSA, 39)
Less Microbiotic Diversity
Any restrictive diet reduces the diversity of the microbiota in the gastrointestinal tract, a potentially unhealthy change. While there is no one healthy microbiome, a gluten-free diet removes foods that the intestinal microbiota dine on. Studies show that the FODMAP diet may not be a healthy one to maintain for that reason, and patients are cautioned about the consequences of remaining on it for a long period of time. (See chapter 5, “Supplements and Probiotics.”)
The Bottom Line
A gluten-free diet is lifesaving for people with celiac disease. It reduces symptoms for many with NCGS—people who have tested negative for celiac disease but who have similar symptoms—and IBS. But the long-term harm of the diet for people who do not really need it is still unknown.
What we do know is that a gluten-free diet is:
low in fiber
low in iron
low in B vitamins
high in sugar and fat
associated with elevated levels of heavy metals in the body
a risk for increased sensitivity to gluten
potentially bad for your microbiome
Be advised that when embarking on a gluten-free diet you are potentially sitting down to a banquet of consequences. If you are thinking of replacing what is lost in a gluten-free diet with supplements and probiotics, read the ºnext chapter carefully.
I had watched a TV show with [a well-known doctor] when he talked about a supplement—garcinia cambogia—for weight loss. The doctor had a very good reputation, and he seemed to think it was a good thing. A number of my friends love the show, and it’s impressive, very persuasive. I thought it seemed safe, and I took that for about a month. I didn’t feel any different, and I didn’t lose any weight but happened to see my doctor right before we were going on a trip to Mexico. The doctor called me over the weekend when he got my blood tests back and told me that I had hepatitis.
I thought, What!? It was unbelievable! Garcinia cambogia was so popular and so heavily advertised, and I thought that it didn’t seem like anything risky. My advice to someone taking something recommended on TV—don’t trust them or take anything without talking to your doctor first. Vitamins and supplements are an unregulated industry. This could have killed me and severely damaged my liver. I seem to have recovered completely but have to be checked regularly. I thought, It’s just a plant—I guess there’s nothing more lethal than nature.
(CAROL, 56)
Carol had acute drug-induced hepatitis that can be progressive and result in liver failure and even death. Luckily hers resolved because it was caught in time. She had a follow-up appointment at the Center early in the development of the disease, and a medical history showed that she had recently started taking garcinia cambogia for weight loss. She stopped taking the drug after blood tests pinpointed the problem. The literature prominently lists hepatotoxicity (liver toxicity) as a side effect of garcinia cambogia—weight loss is not.
Hepatitis does not cause symptoms early in the disease, just biochemical evidence of acute hepatitis in the form of elevated liver enzymes. Later, symptoms of liver failure develop, including nausea, vomiting, anorexia, confusion, and coma. Drug-induced liver failure may result in death if not caught early. Carol soon learned what “just a plant” meant—and that “natural” does not mean “harmless.”
Half of all Americans take some type of herbal remedy, and more than $28 billion a year is spent on various vitamins, minerals, herbal preparations, and probiotics. This number is about $104 billion globally. While visits to medical professionals have remained steady over the past decade, consultations with alternative medical practitioners and health gurus have increased dramatically—along with the use of supplements.
A tsunami of herbs, minerals, vitamins, and probiotics fill the shelves in drugstores, natural food stores, and supermarkets. They are heavily advertised not just as dietary supplements but as good for your health and claim to treat a wide spectrum of conditions from prostate problems and depression to sexual dysfunction, anxiety, insomnia, thinning hair, weight loss, and more. They are also promoted as a pharmaceutical aid for diarrhea, gas, and bacteria lost through antibiotic use, vaginal yeast infections, oncoming colds and flu, and pain. Many believe that they are safer than prescription drugs whose adverse effects are stated in accompanying