If you are an avid reader of articles related to gluten intolerance, you may run into some confusing terminology that I’m often asked to explain. It is the difference between gluten sensitivity, celiac disease and how the different aspects of the immune system respond in each. The immune system is designed to attack ‘bad guys’, but you’re about to learn how it can differ in its approach and how that’s related to the above conditions.
While there are no ‘absolutes’ when it comes to these conditions, what follows is what research currently understands to be the case. I’m not sure when ‘absolutes’ ever occur, but certainly with the vast wealth of information emerging about celiac disease and the newly accepted gluten sensitivity, it will be several years before we are likely to enjoy stable ‘truisms’ on the subject.
Okay, let’s dive in.The human immune system is a fantastically complex and brilliant system that is truly a feat of genius. There are two different aspects to the immune system that I’d like to clarify.
Adaptive Immune System vs Innate Immune System
There are many studies that state that gluten sensitivity is associated the innate immune system while celiac disease is associated with the adaptive one. Both involve ‘taking out’ bad guys, but what is the difference and why is it significant?
The innate immune system is our first line of defense and it’s rather crude. It recognizes what’s foreign and dangerous but won’t get confused and attack “self”, such as what occurs in autoimmune disease (celiac being one such example of a hundred different autoimmune diseases). The innate immune system can orchestrate a gross level response against an invading ‘bad guy’, much like the equivalent of throwing bleach or another destructive material at it. The innate system also doesn’t require having seen the bad guy previously to decide whether it’s bad or not.
A not very pleasant analogy would be seeing a strange figure moving in your house in the middle of the night and simply throwing acid at it. It’s not elegant and it’s rather gross, but it gets the job done. Not only does it ‘take out’ the invader, but in its brilliance it doesn’t get any acid on the walls or the floor! See, I told you it was smart…
Adaptive immunity is the immune system’s secondary response and it does require the previous presence of the bad guy (called an antigen) to know that an attack is necessary. Akin to the previous analogy, the adaptive immune system would let the bad guy enter the house the first time undisturbed; it would wait until the second time to take action. It also is highly specific in the way it reacts to the ‘bad guy’. Unlike the gross example of throwing acid at the bad guy, the adaptive immune system would know exactly what jujitsu move to make to incapacitate the bad guy. It’s highly precise and specific.
This specific handling is accomplished by the production of something called antibodies that, as mentioned, are highly specific. They are effective in handling the bad guy but they unfortunately create collateral damage. In our home invader analogy that would be having the jujitsu move also break the fine china. In the human body it would involve an attack of the body’s own tissue, creating a potential autoimmune disease – witness small intestinal damage in celiac disease or joint destruction in rheumatoid arthritis – both autoimmune diseases mediated by the adaptive immune system.
While this seems very clear and concise, I recently read a study that profiled gene expression and claimed to find both adaptive and innate immunity involved in celiac disease – so to some degree the jury is still out.
Many studies state that along with the autoimmune driven destruction of the small intestine found in celiac but not gluten sensitivity, there is also a distinction between the two as regards the presence of ‘leaky gut’ found in celiac disease but not gluten sensitivity. While this once again sounds very clear cut and neat, I must express some disagreement on these points.
Is it possible that celiac disease and gluten sensitivity lie along a continuum that is less distinct than some would have us believe? I ask this question because of the following evidence:
1. Studies have stated that celiac disease IS found in patients with normal small intestine linings as well as those with inflamed, but not destroyed, linings. So the criteria of tissue destruction = celiac disease is not completely correct. It’s only true in some circumstances.
2. There are those that feel that the leaky gut tests of the past were not sensitive enough. In other words the past tests would only show leakiness when it was so severe that you could drive the proverbial ‘truck’ through the opening. More subtle and sensitive testing has revealed the presence of leaky gut in those with gluten sensitivity and no celiac disease. Is leaky gut confined to celiac disease only? I don’t believe so.
A leaky gut (correctly known as increased intestinal permeability) permits toxins, bacteria and partially digested food to flow out from the intestine into the bloodstream. Recent research feels that such transport of inappropriate substances is associated with early onset of autoimmune disease.
My clinical experience has found such occurrences in those with gluten sensitivity, not celiac disease, and I have found improvement and sometimes reversal of autoimmune disease by healing the leaky gut in these patients.
Where does this leave us?
It leaves us with unanswered questions, there’s no doubt about it. But, let’s look at what’s important. As a clinician it is my intention to improve the patient’s health, which I believe coincides with their desire as well. It is also my intention to increase their awareness of gluten intolerance, whether they suffer from celiac disease or gluten sensitivity. Increasing their awareness will not only help ensure that they remain gluten-free which is critical to their health, but they will also hopefully begin to educate others.
Remember, we only diagnose 3 to 5% of those suffering from celiac disease and maybe 1 to 2% of those suffering from gluten sensitivity. What this leaves is millions of individuals suffering needlessly from a condition that’s highly treatable.
Whether your innate immune system is involved, your adaptive immune system, or both, the point is to have them stop reacting to something they don’t need to. That means if you’re intolerant to gluten, stop eating it. If your gut is leaky and inhospitable substances are entering your bloodstream creating havoc and perhaps autoimmune disease, then we need to heal that gut.
I’m not trying to be overly simplistic here, but the bottom line is that while research is figuring out once and for all the exact mechanisms underlying these health conditions, you don’t need to continue suffering. You, your family and friends can get help.
So if your health is not where you want it to be and you haven’t been getting the help you need, please contact me for a free health analysis. Call 408-733-0400. We’re here to help!
Our destination clinic treats patients from across the country and internationally so you do not have to live locally to receive help.
I would love to hear from you. Did this help to clarify some things? Please let me know.
To your good health,
Dr Vikki Petersen, DC, CCN
Founder of HealthNOWMedical Center
Co-author of “The Gluten Effect”
Author of the eBook: “Gluten Intolerance – What you don’t know may be killing you!”