Surely ONE slice of bread can't hurt??? When gluten might not be for you...

I do love a gut test - here's a tale of one client which highlights why I love this test so much - it can flag up issues before they become hard to reverse.

A client (female, mid-40s) came for help with long term gut issues. The issues weren’t stopping her getting on with her day to day life, but she had a bit of a history. This history included constipation and bloating when she was younger, but she’d managed to turn that around. One of the things she did to turn this around was to cut back on gluten, though not completely cut it out. So, she managed to get away from the usual culprits – bread, pasta, cakes, pastries, crackers, etc etc – most of the time, but if she was out and about and there was no option she’d just have the bread. Also, at home, cooking for herself and the kids, she wasn’t too fussed e.g. about the ingredients in the sausages (most sausages contain breadcrumbs), or whether the sauce contained flour as a thickening ingredient.

She did have a few remaining gut issues, but nothing too serious. A bit of burping and pressure in her upper abdomen, mostly away from meals. A bit of gurgling going on. And very occasional “hanging on” to the stool - “I wouldn’t call it constipation as such, just a feeling that I haven’t completely emptied out”, she said.

However, her personal call to action was a worsening of her mother’s health. Her mother had been diagnosed with an autoimmune condition (Hashimoto’s – an autoimmune disease of the thyroid, when the cells of the thyroid gland become subject to attack by the body’s own immune defences). Her mother herself had had on and off gut issues her whole life. My client didn’t want to go the same way as her mother.

In a previous session, my client had run an epigenetic test (DNA that codes for how we deal with our environment, including how our bodies deal with the foods that we eat and their nutrients). One finding of that test was that she had a fairly major “snip” – single nucleotide polymorphism, or “glitch” on the human leukocyte antigen gene – the gene that helps the body’s immune system distinguish between foreign “invaders” like viruses and bacteria from the body’s own cells. These results mean that gluten is much more likely to trigger an immune response in the small intestine of the carrier; and is a risk factor for coeliac disease.

So my client already knew that gluten was a no-no for her, and she was doing pretty well in cutting it out. But those ongoing gut issues and her mother’s diagnosis pushed her to book in again, this time for a gut test.

The gut test was a bit of a call to action for her. There is a marker on the gut test that I normally use called “anti-gliadin IgA”. Gliadin is a sub-protein of gluten, one of the building blocks that gluten is broken down into in the gut. Anti-gliadin immunoglobulin A is an antibody, one of the clever cells in our human immune system. If this marker on a gut test is high, it means the immune system in the gut is attacking the gliadin, this gluten sub-protein. This is the client’s result:

At 287U/L (top of the reference range is 175) her gut was having a huge reaction to gluten…and she thought she’d cut it out! Also, her zonulin, the marker we use as shorthand for intestinal permeability, or leaky gut, looked like this:

This was all a bit of an eye-opener for the client. She didn’t want to develop an autoimmune disease herself…but gut inflammation (her calprotectin was also a little elevated), a “leaky” gut and a huge reaction to gluten means she needs to take care. She vowed to become an avid label reader, and to just say “no thank you” when someone said “how much damage can one slice of bread do?”. (I know this one, my parents in law are Spanish, they don’t eat without bread. In fact one of my mother in law’s mantras is “Ay, no puedo comer sin pan” – “Ay, I can’t eat without bread”. They think I am plain weird and possibly a bit rude when I turn it down repeatedly. I don't care).

This is not to say she will go on to develop an autoimmune disease. With good self-care, including healing the gut, this isn’t necessarily the case. One thing I will add – we talked a little bit about beliefs – it may sound a bit woo woo, but I did stress to my client if she lives in fear of the autoimmune disease catching up with her, if she allows her boundaries to be breached continually by e.g. allowing the bread to be pushed upon her, then she makes it infinitesimally more likely.

Just one other thought – the adrenals (oh, those again) play a role in autoimmune disease. When we get up and out of bed and get going for the day, our cortisol output goes up steeply, we call this the cortisol awakening response (it’s the difference between that cosy, still a bit sleepy just out of bed feeling, to that actually, now I’m awake feeling half an hour later. Don’t have that? Have you been over asking of your adrenals?). Anyway, that healthy cortisol awakening response or CAR plays a role in “training” our immune cells not to engage in friendly fire, in other words, not to attack our own cells, in a sort of “finishing school for immune cells” process that takes place in the thymus gland. I digress…

Boundaries…what on earth do they have to do with autoimmune disease? Well, in a way, your own immune system has crossed a boundary when it begins to attack its own self (I dislike this word “attack” but I can’t think of another way of saying it). Just think on it…how often do you allow things to be pushed onto you that you don’t want? How many times do you shut up and put up when you wanted to say something?

Something to think about. In the meantime, don’t ignore gut symptoms, they might be a call to action.