Can Be too High by Dr. Michael Murray
Another study indicates that even on a gluten-free diet many people with celiac disease or gluten sensitivity are inadvertently being exposed to enough gluten to continue to produce symptoms. Fortunately, new data shows that supplementation with gluten digesting enzymes can help breakdown the ingested gluten thereby preventing symptoms and intestinal damage.
Gluten is the main protein complex primarily found in grains including wheat, barley, spelt and rye. According to a recent survey, 1 in every 3 adults in the United States is reducing or avoiding gluten consumption. If a person has celiac disease, a gluten-free diet is critical to the achievement of health. Many people have an intolerance to gluten along with casein, a protein found in milk. When ingested in intolerant individuals these proteins can produce gastrointestinal discomfort, especially gas and bloating.
Although the popular solution for gluten and casein intolerance is following a gluten-free, casein free diet, and eliminating the offending proteins will reduce discomfort, there are often hidden sources of gluten or casein in foods that can still lead to discomfort. That is especially true in people with celiac disease. As many as 3 million people in the United States have celiac disease. Gluten is a problem for these people because it causes an immune response that damages the lining of the small intestine leading to the absorption of gut derived toxins and impaired nutrient absorption. It can also increase the risk for autoimmune disease, thyroid disorders, systemic inflammation, and even some forms of cancer.
The FDA has strict criteria and labeling requirements in order for food manufacturers to label a food “gluten-free.” However, even with this assurance it seems that people on a gluten-free diet are ingesting enough gluten in their diets to cause issues. Eating as little as 10 mg of gluten is enough to cause issues in some sensitive individuals, while most patients with celiac disease can tolerate up to 100 mg per day. Studies indicate that many people on a gluten-free diet are eating well beyond these amounts. Fortunately, supplementing with gluten-digesting enzyme can help prevent the intestinal effects seen with low level gluten ingestion in people with celiac disease and gluten sensitivity.
A detailed analysis was conducted by researchers to determine two things:
- The amount of gluten consumed by people with celiac disease and those without celiac disease who were following a gluten-free diet by measuring the level of gluten in the stool and urine.
- The amount of gluten being ingested from clinical trials measuring the effect of gluten-digesting enzyme supplementation on improving the intestinal health in patients with celiac disease who were also following a gluten-free diet.
What the first analysis uncovered was the average inadvertent exposure to gluten by people with celiac disease on a gluten-free diet was estimated to be between 150–400 mg/d using the stool test and between 300–400 mg/d using the urine test. In the analysis of the subjects with moderate to severe symptoms of celiac disease who were also taking the gluten-digesting enzyme found that these patients also ingested significant amounts of gluten with most eating greater than 200 mg per day. Unfortunately, the study wasn’t designed to identify the sources of accidental gluten exposure.
These analyses are extremely revealing. Here is what the numbers indicate: it is critically important that patients with celiac disease as well as those with gluten sensitivity or intolerance should be on a gluten-digesting enzyme as well a gluten-free diet. Clinical trials with gluten-digesting enzymes show a statistically significant, dose-dependent reduction in the severity and frequency of symptoms as well as improved intestinal biopsy results.
Supplemental digestive enzyme preparations can help people tolerate low levels of gluten, but they are not a replacement for a gluten-free diet, especially for people with celiac disease or gluten sensitivity. DPP-IV is naturally occurring in the intestinal lining and is known to be found in lower amounts in individuals with gluten sensitivity and intolerance. In fact, there is an inverse relationship between the level of DPP-IV and intestinal damage in people with gluten sensitivity. In other words, the lower the DPP-IV the more significant the damage to the intestinal lining. So, hopefully you can understand why I feel it is critical for anyone with issues with gluten to use non-GMO DPP-IV.