Gluten intolerance may really be immune dysfunction | Hacker News Reader

Gluten intolerance may really be immune dysfunction

nytimes.com

60 pointssharer58 comments

My wife doesn't have celiac disease. Her knee suffered some damage some years ago. If she adds gluten to her diet, it swells up like crazy and hurts. If she removes gluten from her diet, within two days it shrinks back down and looks like a normal knee again and feels (mostly) fine. I won't pretend to understand how gluten affects everyone's body, but I know something about what it does to hers.

It's odd to use the word "myth" in the title, but then leave the door open in the penultimate paragraph to immune system issues being wrapped up in all of this because I think it's entirely possible that for some people (like my wife), the immune system is counterproductively stimulated by gluten.

Having said that, I think a lot of this current GF stuff is simply a fad. But fad or not I'm grateful for it because it gives my wife, who really does have a problem with gluten, many more options when shopping than she had just ten years ago.

What you describe is a common symptom of celiac disease. Did you get tested?

And just to add to that, the blood test can be unreliable. A stomach biopsy is the best way to verify the condition.

I doubt that. Remember a paper I read about how a stomach biopsy may not necessarily always find a gluten intolerant.

I nearly died on that shit (Gluten). My life would have been very different if it hat been picked up in my teens. In the end I figured it out myself when I was basically dying (they looked at me when I waked into the hospital and said: Mate, sorry to tell you but the first thing we have to do is an HIV Test. This may give you an idea how I looked.) I know my form of intolerance is rare (1:10.000 to 1:100.000).

My life is different now. I feel better than ever.

No, she reviewed her symptoms (there are some others I didn't mention, they're just not so obviously observable as her knee inflammation) with a doctor and was told they didn't line up with celiac. Just seemed like a mild allergy to gluten, she went off it, problem solved[1].

Even if the doctor was wrong and she has celiac, it's very manageable so there doesn't seem to be much incentive to go to the trouble of a proper test.

[1] Okay, "solved" paints too neat a picture. Eating truly GF can be a pain in the neck, the stuff's absolutely everywhere. But fortunately the GF fad has, like I said, made that a bit easier.

All my life, I ate a ton of bread, wheat products, etc. I used to love baking, I'd bake my own bread a couple times a week, etc.

Several years ago, I was cautioned to cut wheat down to 10% of my food intake, at most. The person I got this advice from wasn't a nutritionist, wasn't a doctor, had no specific medical training, and didn't tell me what to expect or what was likely to happen. (The circumstances were weird, let's just put at that.)

I grumbled but said I'd give a try, with no expectation about what would happen. I bought a bunch of gluten-free varieties of foods and spent a week eating gluten-free bread, supplementing meals with rice instead of pasta, etc. My grain intake didn't change, just how much of it was wheat-based.

Within a few days, I realized that 1) I'd been experiencing bloated feelings in my belly for years, now gone. 2) I suddenly had a lot more energy. 3) Various of my minor joint pains (which I'd chalked up to "well, I'm getting old") went away.

So I stuck with it.

Within a month, I realized I'd lost about 10 pounds--again, no less grains, just less wheat.

After a year, I noticed that I wasn't getting sick any longer. I used to get pretty bad colds a couple times a year. That has now stopped.

Several years later, I feel like I did in my 20s, despite being near 40.

Would I go back to eating wheat regularly? Nope. I've tried, I get bloated for a few days after a big ol' slice of pizza, and if I slack off and eat lots of wheat for a few days straight, I'll start to get the scratchy-throat-feeling that I used to get when I'd get one of my regular colds.

Again, no one told me to have any expectations about going gluten-free. I didn't even know "gluten-free" was a diet--this was years before it became a fad diet--except for my celiac friend who couldn't eat wheat (poor thing, I used to think.) I certainly didn't have any idea what it would do for me.

So when these articles come out that say non-celiac gluten intolerance is bunk, I think, well, fine, but something went on with me, and it doesn't add up that it's all in my head.

How do you know you don't have celiac disease? Sounds similar to my experience and I do have celiac disease.

I don't know. I never had any reason to think I did. I would have described my quality of life as very good before I stopped eating wheat--just better now.

I did just look over a couple of lists of symptoms for celiac disease, and the only ones (fatigue and joint pain) that I could relate to, even in a small way, would be on the adult symptoms checklist--none of the childhood symptoms fit me in any way.

But of those two, I wouldn't have described either one with any kind of severity, certainly nothing worth seeing a doctor about. I'm pretty active, and I usually chalked being tired up to that, and the joint pains just from sport/outdoor activities (and getting older). Now I'm a lot less tired and sore.

I was always under the impression of celiac as being pretty severe, like, you'd know something was wrong, even if you didn't know what was going on.

Is that not the case? Can you have "mild" celiac?

I think this is a common misconception. People have varying symptoms, but it's important to remember that those are symptoms and may not equate the the damage done to your system.

I was like you re:symptoms, but instead of going gluten free, I got an allergy panel done and celiac disease came back. I was actually still kind of disbelieving since my symptoms seemed light, so I followed it up with a stomach biopsy to confirm and I discovered I do have it.

See, I wouldn't have even thought to seek out medical advice, I literally didn't think there was anything wrong except getting old.

The person who told me to cut wheat down wasn't a doctor nor a nutritionist, and the advice kind of came out of nowhere (not related to me complaining about my aching knee or anything).

I likely won't get tested at this point, because it sounds invasive, and I am (as before) happy with my quality of life, but you do raise an interesting point.

An allergy test can be as simple as a doctor dipping a small plastic spike in some concentrated allergen, then poking you (lightly, not enough to break the skin, just enough to leave a mark that will fade in a few hours) with both that and a "control" spike, then comparing the redness after a short wait. Pain wise, it is no worse than an ant bite in my experience, and I was tested for the 50 most common allergies at once (we were trying to ID the source of some symptoms I was having).

IANAD though, so testing for celiac disease may require more.

It was "stomach biopsy" that sounded more invasive than an allergen skin test. :)

The editorializing of the headline here is changing the argument. The article (titled "The Myth of Big, Bad Gluten") is arguing that gluten may not itself be bad, but rather the body's reaction. This new title implies gluten intolerance is a myth, which is contradicted by stuff like http://www.ncbi.nlm.nih.gov/pubmed/21224837 .

>gluten may not itself be bad, but rather the body's reaction

Being shot with a gun isn't bad. It's the destruction of tissue from the kinetic energy of the bullet that's bad.

The point is that there's (apparently) a great deal of variability among individuals, with respect to gluten.

Perhaps the submitter was trying to make the title less baity, in accordance with the HN guidelines. (Submitted title was "Myth of gluten intolerance".)

We've changed it to something that uses neutral language from the article. Suggestions for a better title are welcome.

Thanks as always for maintaining the tone of the site!

This is a much better summary of the evidence, in my opinion: http://slatestarcodex.com/2014/03/30/wheat-much-more-than-yo...

Not one single mention of RoundUp or any of the other toxic chemicals farmers spray on crops (especially wheat) right before/during harvest to kill them and dry them out faster. Like the article says, we as a species have eaten wheat for thousands of years with little problem. Why now? The correlation between gluten intolerance and the rise of late-crop RoundUp raises some big questions.

Um... The whole point here is that unscientific nonsense needs to be killed. And specifically that non-Celiac gluten sensitivity has no real evidence for it.

So your response is to trot out an equally unfounded (AFAIK) hippie-inspired pseudo-theory. Seriously?

Why is it so urgent to kill this?

It does nobody harm if some people choose to avoid gluten, and greatly benefits coeliac sufferers who have increasing good nutrition options.

It's a fair point. Personally I don't feel any urgency, the complaint was mostly aesthetic. But if you want to talk practicality of holding unscientific beliefs: I see your harmless gluten-free food industry and raise you a measles outbreak...

Because it's part of a much larger "anti-science" movement, and it's slipping underneath a lot of peoples' noses by sounding semi-plausible (or some other reason). If it is indeed a myth, and without merit, then it needs to be clumped together with all the other pseudo-science type stuff out there like homeopathy, chemtrails, acupuncture and chiropractors.

Because ass hattery like this actually drives people's behaviors. Missing in the hysteria about gluten, corn syrup and carb consumption is the witch hunts in the 90s for fat and chlorestrol.

Kids loading up on sugar filled, "whole grain" frosted flakes today were eating eggs 30 years ago.

anecdote: my wife has had exema her entire life. after a particularly bad episode, we eventually we tried an elimination diet methodically eliminating one food category at a time. it took about 2 months to rotate through all the possible suspects but in the end, eliminating wheat completely cleared the problem. then, one morning we had meatless sausage and she had a bad reoccurrence. first ingredient on the sausage? wheat gluten. (this was before allergy labelling in the US, and we just didn't think it would contain wheat).

On the other hand, we've had other family members try avoiding gluten because they perceived it was 'bad', without a causal linkage to any symptoms.

So, is non-celiac gluten intolerance rare? Probably. Do most people avoid it for the wrong reason? Probably. But to make the blanket statement that intolerance doesn't exist is misinformed and denigrates the very real problem that a small subset of the population does have.

Important note on anecdotes (especially on HN):

There are many thousands of active users on Hacker News. If there are 50 active users over an hours time looking at a given topic, and those 50 active users know an average of 50 people fairly well, that means there's potentially ~2500 anecdotes for any given topic.

Say something happens in .1% of the general population, but it's noteworthy enough to be an anecdote. For any given topic, it's quite possible to drastically over represent that anecdote, as it's quite possible that there will be ~3 such anecdotes for any given topic and the normal case, which isn't especially noteworthy, gets no mention.

Lesson: At a large enough scale, one-in-a-thousand anecdotes can occur several times for a given topic.

I wonder if there's an important distinction to be made between allergy to gluten and allergy to wheat. Does your wife react negatively to other gluten-heavy grains?

Unfortunately, that isn't quite true. Many GF products substitute rice for wheat, which is lower-fiber, lower-protein, and contains potentially dangerous levels of arsenic, e.g. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm352569.ht...

The only acceptable way to kill unscientific nonsense is to test the hypothesis it advances, no matter how ridiculously untestable it seems to be, and then publish the raw data without redactions.

This one actually seems testable. Get a bunch of volunteer non-Celiac "gluten sensitives" and put them on a controlled diet. Measure some objective physiological metrics. Blindly introduce gluten to random subjects. Determine which metrics, if any, change in response to gluten.

And then, to check out placebo/nocebo, you tell all the subjects that gluten will be introduced into their diets that day, and continue monitoring the metrics.

A similiar experiment could be performed on a random sample of ordinary people, with glyphosate.

> The correlation between gluten intolerance and the rise of late-crop RoundUp raises some big questions.

Does it? Does it really? Half the point of the article is that genuine gluten intolerance is not that common, for starters, so there probably isn't a simple causal relationship that "X = bad, X is on wheat, therefore wheat is bad for us now".

Secondly: Is wheat the only crop we spray RoundUp on? If not, why is it only causing issues with wheat?

Agreed! And the correlation between gluten intolerance and use of facebook is something that nobody is talking about. Yet when you examine the data, you find that there are more diagnoses and self-diagnoses of gluten intolerance during the time when facebook grew from a few thousand users to nearly a billion!

Which is most likely the real reason for it. Most of the self-diagnosed gluten intolerance seems to be nothing but a social media fad.

My wife started having problems eating wheat-based products a couple years ago, primarily gastrointestinal. Cutting it out of her diet eliminated those problems, but there's also been an additional surprise way in how to avoid the symptoms: food that has been heavily fried (e.g., onion rings) does not trigger the negative digestive response. I have no idea why -- maybe frying breaks down whichever component (e.g., the gluten itself or the residual glyphosate) is causing the problems enough?

Here is an alternative theory that tries to explain why people in the United States don't tolerate wheat very well: http://www.thehealthyhomeeconomist.com/real-reason-for-toxic...

Of course, this will be overlooked. Thanks for posting!

Be sure to dig up the USDA source document and observe on page 3 that glyphosate is not applied to a majority of wheat acres:

http://www.nass.usda.gov/Surveys/Guide_to_NASS_Surveys/Chemi...

glyphosate is on 45% of acres, so approximately half of the wheat you eat.

There are 3 types of wheat shown in the table, glyphosate is only applied to 45% of the acres for one of them (Durum).

Durum is only a small fraction of wheat grown in the US:

Durum wheat, accounting for 3-5 percent of total production

http://www.ers.usda.gov/topics/crops/wheat/background.aspx

So, no, it is not applied to nearly half of the wheat that is grown.

There's also not a whole lot of evidence that it is widely applied to the mature plants prior to harvest.

edit: This is poor phrasing: "only applied to 45% of the acres for one of them". The table does not claim to be comprehensive. So a better statement would say something like: the table only lists glyphosate being applied to 45% of one of the types.

"How to become Gluten intolerant" https://www.youtube.com/watch?v=Oht9AEq1798

Interesting story. I had a friend that didn't have celiac disease, but genuinely had some form of gluten intolerance. It mostly just caused her terrible cramps. For about six years, doctors couldn't figure out what was causing it, so she had changed her diet to be nearly carb-free, and went on with her life. Problem? Hint: she liked camping.

Ending up being a parasite she likely caught on a camping trip, which also brought on a combination of a fungal and viral infection. She was getting desperate, so she had went to an osteopath which ended up making the discovery. Her PCP prescribed a 4-week regimen of heavy meds to kill off the parasites and fungal infection, and now she's back to eating normally.

> osteopath which ended up making the discovery.

> PCP prescribed a 4-week regimen of heavy meds to kill off the parasites and fungal infection

nice teamwork!

My continued hunch is that is not gluten, but a general collection of foods that cause inflammation.

Commonly, these foods are made up of carbohydrates (such as wheat) but there are fats and proteins as well.

Not to sound too crude, but if you fill your gullet full of inflammation-causing food day in, day out - yes, you will not feel well.

If you are not at all an active person - and you're consuming 2-3 meals of over 1500 calories, well - maybe you should point to that is a potential problem?

Simply removing gluten isn't going to make your day too much better if you are washing down GF products with sodas and eating trans fats.

The article mentions hygiene in passing, even though it seems like the Hygiene hypothesis (https://en.wikipedia.org/wiki/Hygiene_hypothesis) deserves at least a paragraph.

I'm not claiming that the Hygiene hypothesis is true -- we clearly don't know that. But I think it definitely deserves further consideration.

Why is an opinion piece about a nutrition topic with 1 citation worthy of discussion on Hacker News?

Here is an article with citations and discussion of modern research and patient experience that comes to a different conclusion: http://chriskresser.com/3-reasons-gluten-intolerance-may-be-...

I won't bother submitting it to Hacker News since it doesn't have the official NYTimes scientific stamp of approval.

Chris Kresser, M.S., L.Ac is a globally recognized leader in the fields of ancestral health, Paleo nutrition, and functional and integrative medicine

Yeah...

Really scientific, unbiased, peer reviewed, modern research. Not a snake oil salesman at all.

Also any article in the format "X reasons [thing] is more harmful than [other thing]" can generally be laughed at.

TFA clearly doesn't support your re-written straw man headline, and by comparison:

- Kresser: 21 citations to "scientific, unbiased, peer reviewed, modern research"

- NYT OpEd guest writer: naked unsupported assertion that "most of these assertions [about gluten], however, are contradicted by significant evidence" providing no references or scientific discussion

Which one is snake oil again? More ironic, the Kresser article does talk about gluten as an auto-immune trigger, making your dismissal seem even more knee-jerk. There are people doing serious work on nutrition, but you won't have much luck finding them in the NYT, much less the OpEd section.

Which one is snake oil again?

Well... cod liver oil, actually. And that would be here: http://store.chriskresser.com/

Frankly, I wouldn't put a whole lot of faith in either.

IMHO that nytimes article seems to dream of a world in which we could enjoy breads and all other wheat products with no health concerns. A nice dream but it annot be applied to real world.

https://www.youtube.com/watch?v=uQF3vr2I0XY <- Clap along if you're gluten free because you think it's cool.

“If eating wheat was so bad for us, it’s hard to imagine that populations that ate it would have tolerated it for 10,000 years,” Sarah A. Tishkoff, a geneticist at the University of Pennsylvania who studies lactase persistence, told me.

Sarah, turn on your brain. What about Game Theory? What if wheat is addictive and mankind did not enslave Wheat but wheat (and possible other crops) "enslaved" mankind?

There is evidence that wheat may not be as healthy for you as you think. Also, the wheat from 60 years ago has very little to do with our current wheat.

http://en.wikipedia.org/wiki/Gluten_exorphin

http://www.wheatbellyblog.com/2012/04/wheat-is-an-opiate/

http://perfecthealthdiet.com/category/toxins-and- toxicity/wheat-grains/

http://perfecthealthdiet.com/2010/09/wheat-and-obesity-more-...

The reason we're eating wheat even though we're not made for it is because we could support larger populations on that versus hunting and gathering. Farming societies eventually won, even though hunters and gatherers were more healthy, because farming societies have a food surplus (which it can store), and can then afford to wage war and expand. If you look at skeletons from before and after farming, you see that hunter and gatherers were taller, had bigger brains than we have today, and were overall healthier.

There's zero scientific basis for the claim that height inherently has anything to do with health, such that taller people are healthier.

If that theory were correct, Asian people would be the least healthy on the planet. When in fact the people of eg Japan have been among the most healthy for thousands of years.

Caucasians - for example in Scandinavia - getting taller did not equate directly to being far healthier than their Japanese peers.

Height increases over time are driven by the type of diet consumed. The Japanese diet did not lead to height, however it did lead to health and longevity.

the height == health requires that you control for the genetics of the population.

I read the WheatBelly book, which you cite. That is one of the most heavily cited book I've read about health. It was a bit extreme in how aggressive that book cited. I'd strongly encourage people to get the book from your local library and give it a read. (edited to add a thought) Wheat isn't a problem, even spoken of within the book. It's unsprouted wheat, which is currently the norm. We've sprouted wheat for most of human's civilization, minus the last 40 or so years.

> Are the gluten haters correct that modern wheat varietals contain more gluten than past cultivars, making them more toxic? Unlikely, according to recent analysis by Donald D. Kasarda, a scientist with the United States Department of Agriculture. He analyzed records of protein content in wheat harvests going back nearly a century. It hasn’t changed.

As a plant breeder I can assure you the gluten content has certainly gone up! We call it a "Multi Trait Index" for baking quality, and we can show nearly every years released varieties increase in the MTI. What is the number one weighted factor of the baking quality MTI? Gluten percentage. Also, this article is bunk, saying, "if people can maintain an enzyme to digest lactoes, we should be able to evolve an enzyme to break down gluten too. "Total hoggerty poggerty applesauce!" NYT, you are cut off!

Not trying to put you on the defensive, but do you have some objective online resources I can examine to learn more about this?

Another study, this one from Canada supports this. "University of Saskatchewan researchers Ravi Chibbar and Pierre Hucl grew 37 varieties of wheat that date back to the 1860s and analyzed the nutrient composition in each sample. They found that the concentration of proteins, including gluten, is remarkably similar to that grown more than 150 years ago—dispelling the myth of “Frankenwheat,” the genetic modification of the grain’s protein structure by the agriculture industry in recent years."

http://words.usask.ca/news/2015/06/03/wheat-research-yields-...

Game theory tends to deal with vastly oversimplified models, so you should be very very wary of citing it to prove a point about how anything in reality actually works. You need to prove that your models' assumptions are true before you can conclude their results are true.

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