November 28, 2016

Gluten - It is time.

Part I

Have you ever wondered what the deal is with the gluten free craze? Everywhere you go now you see ads and labels for gluten free this and gluten free that. I am sure that the gluten free Twinkie will soon follow only to be fried at a southern county fair.

Is it legitimate or just another fad diet doomed to fade into oblivion like the Dodo bird?

After 6 years of personal gluten free living coupled with having read reams of literature to support the diet, I am convinced that the gluten free diet for some Americans is as right as rain!

First, my story:

In the mid 2000's, I became aware that my genetic predisposition to coronary artery disease and high cholesterol had reared its head. My father had suffered under this disease while two of his older sisters had succumbed to it. I was not going to be damned to the same fate.

At this point in my career, I was practicing hardcore old school pill for an ill medicine. I went to visit my favorite Internal Medicine colleague and followed the guidelines of cholesterol management by taking a statin medicine. The boss at home counseled me to start working on my diet and continue to exercise for the best outcome. I did just that.

My cholesterol looked beautiful at my follow up visit. "My risk" was down. The only catch was that I felt terrible. I could barely move on Mondays following weekend soccer games. The only new variable was the medicine. After 6 months of therapy, I cried uncle. I stopped taking the meds.

I was back to square one and frustrated. Around this time, I was exploring Integrative Medicine and began a concerted effort to fix myself through an anti-inflammatory diet, vigorous exercise and some herbal supplements for cholesterol management.

First, the good news. I felt great again. Running all weekend long did not equate to 90 year old Mondays. The bad news. My cholesterol was better than before but well out of the acceptable range. For the next few years, I muddled through failure after failure to improve my heart risk until something happened.

My joints started to hurt and I developed a rash on my right foot. Now, I am really annoyed. What else can go wrong! After a few long contemplative runs, I decided to try a gluten free diet to see if my joint pain and rash were related to a non celiac type gluten sensitivity.

By now you know that it must have helped since this is an article about gluten. All of my symptoms resolved. A few months later, I checked my cholesterol level. Normal! I was befuddled. The only change was the diet devoid of gluten which also meant dramatically reduced in refined flour and sugar.

How can this be???? What is the science behind my N of 1 experiment? I am convinced that my disease reduction is based on two mechanisms. 1) Non celiac gluten sensitivity and 2) reduced HMG CoA reductase activity.

To understand this, we need to understand the immune system and its relationship with food and pathogens as well as cardiac disease. To understand the reduced HMG enzyme activity read this link.

Our immune system is old and is broken down into two main parts, the innate and the adaptive. The innate side is made up of cells that are there ready and willing to fight all over the body as sentinels. They are preset to fight in their current state. On the other side, the adaptive cells are not ready to fight but are ready to change and move in response to a pathogen. They truly adapt, learn and expand their fighting force rapidly.

From birth, our system is challenged by bacteria, virus, toxin, fungus, parasite and more pathogens. The immune system's first priority is to separate what is dangerous from friendly. When this is done appropriately, we have immune tolerance. This means that we appropriately recognize the difference between a peanut and influenza and only fight the flu virus. If this does not occur according to plan, we can develop intolerance and it manifests as food allergy, autoimmune disease and diseases like celiac.

To be continued:

Be aggressive against disease,

Dr. M