Fibromyalgia and Gluten Intolerance - Is there A Connection?
We all know that nutrition and exercise are important parts of fibromyalgia symptom management but did you know that there is increasing evidence that certain dietary changes and modifications play a role in the reduction of fibromyalgia symptoms! One of the biggest culprits we are learning about today and which definitely leads to flare-ups for many people with fibromyalgia is gluten.
Gluten is the protein part of wheat, rye, barley, and other related grains. Some people cannot tolerate gluten when it comes in contact with the small intestine and this condition is known as celiac disease (sometimes called non-tropical sprue or gluten sensitive enteropathy). Celiac disease is now clearly known to be genetically determined. In other words, if you or your close relatives have a certain gene, then it is more likely that you will get celiac disease some time in your life. Statistics say that 1 in 133 (or less) people have celiac disease and of great concern and interest is the fact that 9 out of 10 people with celiac disease do not know they have it.
Physical symptoms associated with gluten intolerance and celiac disease include the following.
- Abdominal cramping / bloating
- Abdominal distention
- Appetite increased (to the point of craving)
- Back pain
- Decreased ability to clot blood
- Electrolyte depletion
- Energy loss
- Gas / flatulence
- Mouth sores or cracks in the corners
- Muscle cramping (especially in the hands and legs)
- Night blindness
- Dry skin
- Weakness and lethargy
Emotional states associated with gluten intolerance and celiac disease are:
- Disinterested in normal activities
- Mood changes
- Brain fog and unable to concentrate
A review paper in The New England Journal of Medicine listed 55 "diseases" that can be caused by eating gluten. These include osteoporosis, irritable bowel disease, inflammatory bowel disease, anemia, cancer, fatigue, canker sores, and rheumatoid arthritis, lupus, multiple sclerosis, and almost all other autoimmune diseases. Gluten is also linked to many psychiatric and neurological diseases, including anxiety, depression, schizophrenia, dementia, migraines, epilepsy, and neuropathy (nerve damage). It has also been linked to autism. It is not such a far stretch to presume that gluten negatively affects people who have fibromyalgia.
It used to be thought that gluten problems or celiac disease were confined to children who had diarrhea, weight loss, and failure to thrive. Now we know that you can be old, overweight, and constipated and still have celiac disease or gluten sensitivity.
Gluten sensitivity / celiac disease is actually an autoimmune disease that creates inflammation throughout the body, with wide-ranging effects across all organ systems including your brain, heart, joints, digestive tract, and more. It can be the single cause behind many different "diseases". To correct these diseases, you need to treat the cause -- which is often gluten sensitivity -- not just the symptoms.
Of course, that doesn't mean that ALL cases of depression or autoimmune disease or any of these other problems are caused by gluten in everyone -- but it is important to look for it if you have any chronic illness.
Whether you have celiac disease or not, switching to a gluten free diet when you already have fibromyalgia is probably going to offer you many benefits in terms of minimizing your symptoms.
The Elimination / Reintegration Diet
While testing can help identify gluten sensitivity, the only way you will know if this is really a problem for you is to eliminate all gluten for a short period of time (2 to 4 weeks) and see how you feel. Get rid of the following foods:
- Gluten (barley, rye, spelt, kamut, wheat, triticale, oats -- see www.celiac.com for a complete list of foods that contain gluten, as well as often surprising and hidden sources of gluten).
- Hidden sources (soup mixes, salad dressings, sauces, as well as lipstick, certain vitamins, medications, stamps and envelopes you have to lick, and even Play-Doh.)
For this test to work you MUST eliminate 100 percent of the gluten from your diet -- no exceptions, no hidden gluten, and not a single crumb of bread.
Then eat it again and see what happens. If you feel bad at all, you need to stay off gluten permanently. This will teach you better than any test about the impact gluten has on your body.
But if you are still interested in testing, here are some things to keep in mind.
Testing for Gluten Sensitivity or Celiac Disease
There are gluten allergy/celiac disease tests that are available through Labcorp or Quest Diagnostics. All these tests help identify various forms of allergy or sensitivity to gluten or wheat. They will look for:
• IgA anti-gliadin antibodies
• IgG anti-gliadin antibodies
• IgA anti-endomysial antibodies
• Tissue transglutaminase antibody (IgA and IgG in questionable cases)
• Total IgA antibodies
• HLA DQ2 and DQ8 genotyping for celiac disease (used occasionally to detect genetic suspectibility).
• Intestinal biopsy (rarely needed if gluten antibodies are positive -- based on my interpretation of the recent study)
When you get these tests, there are a few things to keep in mind.
In light of the new research on the dangers of gluten sensitivity without full blown celiac disease, I consider any elevation of antibodies significant and worthy of a trial of gluten elimination. Many doctors consider elevated anti-gliadin antibodies in the absence of a positive intestinal biopsy showing damage to be "false positives." That means the test looks positive but really isn’t significant.
We can no longer say that. Positive is positive and, as with all illness, there is a continuum of disease, from mild gluten sensitivity to full-blown celiac disease. If your antibodies are elevated, you should go off gluten and test to see if it is leading to your health problems.
Simply eliminating this insidious substance from your diet, may help you reverse some of your symptoms and alleviate your pain.
That’s all for today. Now I’d like to hear from you ...
Are you one of the millions that have been lead to believe gluten is perfectly safe to eat?
How do foods that contain gluten seem to affect you?
What tips can you share with others about eliminating gluten from your diet?
Please let me know your thoughts by posting a comment on our FOODS FOR FIBROMYALGIA Facebook discussion board: http://www.facebook.com/group.php?gid=159990268515&ref=ts