Gluten and Brain Health: Secret Symptoms of Gluten Sensitivity – Part 1

By: Michael Lam, MD, MPH; Justin Lam, ABAAHP, FMNM

How wheat, gluten and brain health relateUnless you have celiac disease, you may not be aware of the many ways gluten sensitivity affects health. Gluten sensitivity is often associated with gastrointestinal symptoms that are the usual clues for food sensitivity, but these are not the only type of symptoms it can cause. If you’ve been experiencing neurological symptoms with no clear cause, gluten could be to blame. Research is showing more and more that, for those with gluten sensitivity, there is a bigger relationship between gluten and brain health than previously thought. Gluten seems to have a wide range of activity on the body, from inflammation to neurotoxicity. And because celiac and gluten sensitivity are becoming more and more common and often go unidentified, the effects of gluten on brain health are becoming more and more of an issue.

This appears to be because conventional gluten testing is not thorough enough. Also, though gluten intolerance and sensitivity are not new, the prevalence of these problems has increased dramatically in the last fifty years or so.

Researchers don’t know how many people have these problems because they are largely unidentified or mistaken for something else. The gastrointestinal symptoms that are the hallmark signs of gluten sensitivity or celiac disease can resemble other gastrointestinal conditions, while the neurological symptoms can resemble those of other neurological conditions.

This is especially the case in parts of the world that have not yet caught up with the growing evidence that gluten is a possible culprit in many conditions that otherwise have no clear cause, such as many autoimmune and inflammatory issues.

What is Gluten and Where is it Found?

When you hear the word gluten, you probably immediately think “wheat.” And you’re right, that is the main product that contains gluten. Wheat products like pasta, bread, cakes, muffins, croissants, and other baked goods are everywhere. If you’re familiar with baking, you’ll know gluten is what makes the dough nice and fluffy and sticky.

However, gluten is also found in spelt, barley, Kamut, and semolina. Because gluten is heat stable and acts as a very good as a binder, it is also added to processed foods in order to enhance their moisture retention, flavor, and texture. Other products that can contain gluten are salad dressings, mayonnaise, supplements, and even medications and beauty products.

This means people who are advised to go on a gluten-free diet need to check labels of products.

With the average Western diet containing around 5-20 g of gluten a day, it’s no wonder there is a big hype about its effects on health. Now gluten and brain health is getting more attention than ever before, instead of the traditional focus on gastrointestinal issues.

As you read on, you might feel inclined to get tested or try an elimination diet to see if your health improves and if any neurological symptoms you have begin to clear. You are already taking the first important step to better health: getting informed.

Glutenin and Gliadin

So what exactly is gluten?

The gluten that is found in wheat is a mixture of many different kinds of proteins, with the main ones being glutenin and gliadin.

Glutenin is the protein that helps dough become strong and elastic. It is the protein that is found in highest concentration in gluten. Around 47% of gluten is composed of glutenin. Though previously thought to be the non-toxic party out of the two main proteins, recent studies are showing that it can also have some toxic effects for those suffering from celiac disease.

Gliadin seems to be the main problematic protein in gluten. Gliadin is very resistant to pancreatic, gastric, and intestinal proteolytic digestion. Proteolytic enzymes, also called proteases, specialize in breaking down proteins into amino acids. These proteolytic enzymes have an especially difficult time breaking down gliadin. This means that your digestive system’s enzymes are not well equipped to process the main protein found in gluten.

However, wheat gluten is not the only type that can cause or aggravate gluten-related disorders. There are a few others to watch out for:

Secalin in Rye

How rye bread, gluten and brain health relateRye breads are touted as healthier alternatives to white and wheat-based breads. They have a lower glycemic index and thus do not cause as much of a blood sugar spike. They also have a lower amount of gluten.

However, people with gluten sensitivity should still avoid rye because it contains the protein secalin. Secalin has a very similar amino acid sequence to wheat gluten and will result in an immune reaction.

Hordein in Barley

Hordein is a protein found in barley, as well as other cereals. It is also found in beer, which makes drinking beer difficult for those with gluten sensitivity or celiac disease, although there are some types of low-gluten and gluten-free beers available on the market now.

Because hordein can sometimes be found in processed foods and products, it is important that you check labels for it as well as for wheat gluten.

Avenins in Oats

Avenins also have a similar sequence of amino acids as wheat gluten, which means some people with gluten sensitivity or celiac disease may have an immune reaction to them. Also, oats are sometimes cross-contaminated with wheat.

If you choose to try oats, make sure they are labeled gluten free, and give them a rinse before eating them to remove any grain dust. Steel cut oats are usually less contaminated. Also, check how you feel after eating gluten-free oats to make sure you are not sensitive to avenins as well.

The bottom line here is that, whether from wheat, barley, rye or oats, gluten and brain health can affect skin, digestion, and joints. Anyone who has celiac disease should avoid all sources of gluten if they want to live a healthier, symptom-free life.

But why is it that gluten sensitivity has become such a huge problem, when a few years ago we hardly heard about it?

The Growing Epidemic

It is estimated that the rate of celiac disease has gone from one in 650 people to one in 100 people, with almost 30% of the American population experiencing gluten sensitivity. Since it is a largely unidentified condition, the numbers could be much higher.

One possible answer as to why gluten sensitivity has become almost epidemic in proportion is that the wheat we are consuming today is very different than the wheat from a few decades ago.

Sensitivity of gluten and brain healthWith such a high demand for wheat products, due to growth in population as well as growth in consumption per person, the wheat industry around the world has been crossbreeding wheat with other proteins. The goal is to help it resist environmental damage and grow faster. In some cases, the wheat is modified to get more crops out of the same stalk.

Gluten is also sometimes put through a process to make it more water-soluble, although it is usually not, so that it can easily mix with other ingredients. This is why it is now so easily added to processed and packaged products.

Another factor is that the way we are eating has changed. While our grandparents ate a diet composed mostly of seasonal whole foods, like locally sourced fresh fruits and vegetables, we, on the other hand, are eating a lot more processed foods with much higher levels of gluten.

All of these could be plausible causes for the growing numbers of celiac disease and gluten sensitivity cases.

Unfortunately, with so many of the world’s staple foods containing gluten, it can be very difficult to switch to a gluten-free diet. However, these numbers show that gluten and brain health sensitivity is important to consider and not just for gastrointestinal relief.

Eating Gluten and Brain Health

When you eat a piece of bread, cake, or any other gluten-containing product, your digestive enzymes, specifically proteases, get to work on breaking it down into its component proteins, such as the glutenin and gliadin discussed above.

The special enzyme that works on gluten is called tissue transglutaminase (tTG). This enzyme is important in the relationship between gluten and brain health, so it’s important to understand its action well.

One of the functions of tTG is to keep the gut’s microvilli close together. The microvilli are hair-like structures that line the intestinal walls. They help us absorb nutrients from food.

Once the gluten has been broken down, its component proteins go through a sort of assessment. All substances that enter the gastrointestinal tract are assessed, so the body knows how to respond to them.

This assessment is carried out by the gut’s immune system, the gut-associated lymphoid tissue (GALT), which is mainly found in the small intestine. Most of the body’s immunity starts in the gut, as the gut contains two-thirds of the body’s immune tissues.

If you have gluten sensitivity, the GALT then produces antibodies, the molecules that the immune system uses to defend the body against pathogens. These antibodies perceive gluten proteins as a threat and attack them.

If you are gluten intolerant or have celiac disease, these antibodies attack not only gluten proteins but also the enzyme that breaks them down, tTG. This creates an autoimmune reaction in the body.

When the tTG enzyme is attacked, its function of holding together the gut lining is compromised. In addition, gluten can trigger the cells of the gut lining to release zonulin, a protein that modulates the tight junctions in the gut. When zonulin is released in reaction to gluten, these tight junctions begin to break apart and create gaps or leaks.

As the gut’s lining becomes more and more permeable, substances can leak into the bloodstream that are not supposed to be there, including food particles, pathogens, and toxins. This is sometimes referred to as leaky gut. When the immune system is alerted to these substances, it mounts another attack.

The connection of gluten and brain healthIn some cases, anti-gluten antibodies can also escape into the bloodstream and travel to other parts of the body, attacking healthy tissues and organs like the brain, joints, and skin. This is one of the ways gluten and brain health intolerance creates compromises that cause autoimmunity that targets the brain.

This vicious cycle, of an immune system on overdrive with a constantly triggered inflammation response, can create a host of other issues, including other autoimmune conditions.

As research is discovering, inflammation is the root cause of many chronic illnesses. It is also at the root of many neurological and psychological issues, including depression and brain fog. This also motivates the research on the effects of gluten and brain health.

Read Part 2 | Part 3

© Copyright 2018 Michael Lam, M.D. All Rights Reserved.

Dr. Lam’s Key Question

It is only recently that medicine has accepted that the relationship between gluten and brain health can manifest without any gastrointestinal symptoms. This realization has led to research and new discoveries on how gluten affects the brain and nervous system.

Gluten and brain health