The Dr. Hyman Show - Is Gluten-Free A Fad Or Is Gluten A Real Threat To Our Health? with Maggie Ward

Episode Date: November 30, 2020

Is Gluten-Free A Fad Or Is Gluten A Real Threat To Our Health? | This episode is sponsored by Bioptimizers and Dr. Hyman’s Sleep Master Class We are all aware that “gluten-free” has become a major buzz term. Supermarket aisles are now lined with gluten-free foods and restaurants are now catering to gluten-free diners. So how did gluten come to receive so much attention? Are people with celiac disease the only ones who should be on a gluten-free diet? And how do you know if gluten is making you sick? In this episode, Dr. Hyman sits down with Maggie Ward to discuss why gluten sensitivity exists on a spectrum and how to determine if it is a threat to your health. They also share specific patient cases they have treated related to gluten sensitivity. Maggie Ward, MS, RD, LDN, is the Nutrition Director at The UltraWellness Center. Maggie holds a master’s degree in Nutrition from Bastyr University which focuses on using whole foods for holistic Nutrition Therapy. In addition, she completed her requirements to become a registered dietitian at Westchester Medical Center in NY. Prior to joining The UltraWellness Center team in 2008, Maggie worked at The Brooklyn Hospital Center in New York providing nutrition counseling to children and families dealing with HIV. She also taught at the Jewish Community Center in Manhattan and other sites throughout New York City, teaching nutritionally focused cooking classes for children and adults. Much of her focus is on food allergies, digestive disorders, inflammatory conditions, Pediatrics and Sports Nutrition. Maggie has been counseling individuals, families, and business groups on therapeutic diets to address various health concerns for more than 15 years. Her ongoing clinical training through the Institute for Functional Medicine uses a systems biology approach when working with those who suffer from chronic and acute conditions to help them find their path to healing. She has a passion for cooking and reconnecting people with their potential to heal using whole, organic and local foods. This episode is sponsored by Bioptimizers and Dr. Hyman’s Sleep Master Class. Right now, BiOptimizers is offering their Black Friday and Cyber Monday deal to Doctor’s Farmacy listeners during the entire month of November. Get free shipping, up to 40% off on select products and are giving away free bottles of their amazing enzyme, probiotic P30M as well as their HCL breakthrough supplement. Just go to bioptimizers.com/hyman and use code HYMAN10 at checkout. In this modern world we place too much value on staying busy and deprioritizing sleep, which is why Dr. Hyman created his first ever Master Class. It guides you through the most important steps to getting better sleep, starting today. Get free access to Dr. Hyman’s Sleep Master Class at drhyman.com/sleep.  In this episode, Dr. Hyman and Maggie discuss: What is gluten? And why is gluten sensitivity and intolerance suddenly so prevalent? Testing for gluten sensitivity and intolerance How gluten sensitivity can be triggered by a stressful event The link between gluten sensitivity or celiac disease and other chronic disease, conditions, and autoimmune issues Patient cases Dr. Hyman and Maggie Ward have treated involving gluten sensitivity  For more information visit drhyman.com/uwc Additional Resources:  Why gluten needs to go if you have Hashimoto’s https://drhyman.com/blog/2019/10/08/why-gluten-needs-to-go-if-you-have-hashimotos/ To Gluten or Not to Gluten https://drhyman.com/blog/2019/04/09/to-gluten-or-not-to-gluten/ Should we all avoid gluten? https://drhyman.com/blog/2018/09/26/podcast-ep20/ Here’s Why A Gluten-Free Diet Can Become Incredibly Unhealthy https://drhyman.com/blog/2017/01/19/heres-gluten-free-diet-can-become-incredibly-unhealthy/ Gluten and Dairy-Free Recipes Even an Italian Can Love https://www.ultrawellnesscenter.com/2019/06/12/gluten-and-dairy-free-recipes-even-an-italian-can-love/ Top 5 Diet Changes for Autoimmunity https://www.ultrawellnesscenter.com/2017/06/30/top-5-diet-changes-for-autoimmunity/ Hosted on Acast. See acast.com/privacy for more information.

Coming up on this episode of The Doctor's Pharmacy. There is a gluten sensitivity spectrum out there, and many of us fall somewhere on the spectrum. Most of the folks that come to see us, I think, fall on the end of the spectrum where, you know, it may not be celiac. We can't really determine that based off the tests that we've done, but they have to pretty much treat themselves as if. Hey everyone, it's Dr. Hyman. Supplements are one of those things that I'm always being asked about. Is it worth spending the money? Do we need them if we eat really well? Can your body even absorb them? The answer to most of those questions is it depends. Now there are definitely certain

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That's drhyman.com forward slash sleep. Welcome to the doctor's pharmacy. I'm Dr. Mark Hyman and that's pharmacy with an F-A-R-M-A-C-Y. And this today is a special episode of the doctor's pharmacy call house call with none other than my nutrition director at the ultra wellness Center, Maggie Ward. Now, this is a place for conversations that matter. And if you are confused about gluten, if you've heard that you should be gluten-free, if you don't even know what gluten is or why you should care about it, then this conversation is going to matter to you because it's going to go deep into what is gluten, why is it a problem, how does it affect us, and how do we deal with it? So welcome, Maggie.

Thank you. I'm happy to be here. Maggie is awesome. She's been my nutrition director for 12 years. She went to Bastyr University, got a master's in nutrition, and she's been the anchor of our whole nutrition team for well over a decade, and has helped so many patients get better using food as medicine. And as I've said before, this is probably the only practice in the country, other than now Cleveland Clinic, because I also started that one, where you cannot see the doctor

unless you also agree to see the nutritionist. Because if food is medicine, how can I practice medicine without a nutritionist? So you are it. You're the bomb, Maggie. Thank you for joining us. I'm happy to be here. Thanks for having me. Okay. So let's talk about gluten. First of all, what is gluten? Why should we care about it? And let's talk about why it's such a problem. Right. It's not just a fad. So gluten is the most predominant protein that's in some grains, wheat being the most

common one. So wheat, rye, barley, although wheat also encompasses things like spelt and kamut and farrow and triticale. So there are other grains within that family. Even oats is often have... And even oats. And we'll talk a little bit more about oats because they can go either way. But it's mostly wheat that we eat in the form of bread, crackers, pasta, right?

All the flour that comes in through our diet, we're getting gluten in many foods. And it's not necessarily a bad thing for everyone, but it is really the most common food sensitivity and something we see in so many people that we work with here at the Ultra Wellness Center. So I really wanted to kind of dive through it a little bit more of what is the big picture and who needs to be careful and how we do that. So Maggie, is this like, how come gluten is all of a sudden a thing? Because when I went to medical school 30 years ago, I was like, you had celiac disease. Maybe a few people had it.

It was like very small percent of the population, 1% of the population. But now you've got maybe 20% or more having gluten sensitivity and all these issues. We have a 400% increase in celiac disease in the last 50 years. It's been proven by research. It's not just a fad. What's going on? Right. Well, I think when it started, right, the prevalence was thought to be a lot lower,

and we know it to be a lot more common. I think it's still a minority of the population. It's missed and underdiagnosed quite a bit because, yes, in medical school, you learn about celiac disease. But I think the thinking is that for someone to have it, they would have diarrhea all day, every day. And we know that's not the case. I mean, I've had some people with no digestive issues and come back positive on a celiac panel. But for them, they had rheumatoid arthritis or another autoimmune condition going on. It just was presenting

differently. So I think for that reason, doctors aren't always screening for it. So there's that issue of celiac. But then I always kind of describe it as a spectrum. There is a gluten sensitivity spectrum out there. And many of us fall somewhere on the spectrum. Most of the folks that come to see us, I think, fall on the end of the spectrum where it may not be celiac. We can't really determine that based off the testing we've done. But they have to pretty much treat themselves as if.

So that's, I think, where it's- It's not an on or off phenomenon. Right. You either have it or you don't. Because traditional medicine, you go to the doctor, they go, well, if you have an abnormal biopsy of your intestine, you have celiac. Otherwise, you don't. So don't worry about it.

Right. Right. So there's a whole other area of gluten sensitivity. And for many people, it's making them really sick, even if it's not celiac. I also think there's something going on with the quality of gluten sensitivity. And for many people, it's making them really sick, even if it's not celiac. I also think there's something going on with the quality of gluten. You know, I saw it years ago, and I had so many folks telling me when they came back, like, oh, you know, I was eating pasta in Italy. I was eating bread in France, and I was fine. And I come back here, and I get so sick. So that's part of this epidemic of what we're seeing of gluten sensitivity is it, you know,

they hybridized. It went back in the 50s and added more gluten. Many of our breads, they put more gluten in it. Gluten is what makes bread spongy. So you put it in there and you get these nice big loaves of bread and, you know, more is better in this country. So I think that's a part of it. We spray it with glyphosate and various pesticides and there's a good chance people are reacting to that.

That destroys the microbiome. Exactly, so once you muck up with the gut microbiome, you're gonna have a lot of digestive and other issues. So that I definitely think is, I can't tell you how many people tell me I eat it abroad and I'm fine. Not our celiac folks, but many other folks that are really sensitive.

So the spectrum is what is being missed, I think, in conventional medicine. And we, I don't always. I just want to underscore what you just said. There are some key reasons why we're seeing this increase. So one, it's the change in the kind of wheat we're eating, right? They've hybridized it. The dwarf wheat has way more gluten proteins and the way more inflammatory gluten proteins

than heirloom wheat. Right. You spray with glyphosate, which not all wheat is full of glyphosate, but a lot of it is, and that causes damage to your gut, which causes more leaky gut and more gluten reactions. It also is sprayed with, in the preservative, when it's put in the bread, called calcium propionate, which is actually a toxin that causes problems with

behavior and attention and focus, so it can cause a lot of brain issues for people. And then on top of that, we've created a background level of dysfunction in our gut over the last decades by our poor quality diet, starved sugar, low fiber, processed food, which damage our microbiome, makes it more like we have a leaky gut. We've taken antibiotics, we take acid blocking drugs, we take steroids, we take hormones, all of which mess up our gut. We have increased rates of C-section, increased rates of bottle feeding. All these things make your gut more likely to become gluten sensitive. Right, it sets you up to become more sensitive.

So that's why we're seeing this sort of escalation of gluten sensitivity over the last 50 years and it's real. Right. And you know, not many of us are eating these like whole wheat berries. I mean, we're eating in the form of flour. So even if you get organic, you know, bread or whole grain bread, I mean, it's still refined carbohydrates and you're selectively feeding things in your gut. You probably don't want to be feeding too much and throwing off your blood sugar.

So when people go gluten free, I do think part of the reason they feel better, as long as they don't start eating a lot of gluten-free junk, is they transition over to more whole carbohydrates, whole foods. And they feel a lot better for that reason too. So for that reason, you know- Gluten-free junk food is still junk food. It's still. Cake and cookies, if it's gluten-free, it's still cake and cookies. Right, exactly. So I really wanted to bring attention to that because we see, I can't tell you how many

symptoms I've seen get better, you know, not across the board, but just I've had brain fog get better taking gluten out. I've had joint pain get better. I've had skin get better. So, you know, people joke around, like, do you take everyone off of gluten? I'm like, if you saw how many people got better off of gluten, you'd take it, you know, take another diet too. We see people who come to see us who are ill, right?

Yeah, right. And so we have a select, we call it selection bias. But I would say, you know, when people walk in the door with any kind of chronic illness, for me, checking gluten antibodies and what we call a Cyrix 3 test, which we'll get into, which looks at way more proteins around gluten, it's like checking their blood pressure. Yeah. Or their temperature. Right. around gluten is like checking their blood pressure or their temperature. It's a vital sign for me because it's so common. It's such a big deal. And I just saw this guy the other day

who had all this severe lymphedema and inflammation in his body. And he had one of the worst gluten tests I've ever seen. And he didn't know it. And he's like 50 years old. So anytime anybody comes in with a chronic issue that's not getting better, especially anything that's inflammatory or digestive in any way or neurologic, it's the first thing I look at. Yeah. And I think the question I get a lot too is like, well, why was I okay eating gluten through my younger years?

And why is it an issue now? And I'm like, well, even with celiac, right? That's a genetic condition. You're technically born with it. But when it develops can really vary so you need to have like the genetic predisposition gluten in your diet and some type of trigger yeah so an infection you know a really stressful event you know toxins again yeah something has compromised your gut lining and now you're reacting to these proteins so for some people it might not even be a life sentence I mean if they

have celiac or something similar they have to to be really careful. But other people, sometimes if you get the gut sorted out and healed, they can tolerate some of these proteins. Yeah, when I was really sick with mercury poisoning and when I was really sick and had gut issues, I couldn't eat any gluten. And now, I mean, I don't eat a lot, but now it doesn't really bother me and I don't really have antibodies, so I fix my gut. And I think we see a lot of these patients who may not have any symptoms for years and years, like you said, and when they're 50, they get an autoimmune disease or they get something and you check and they have celiac. They actually have celiac or they have

really severe gluten sensitivity. And I think, you know, you say it's genetic, about 30 plus percent of the population has the gene for celiac. Right. Only 1% get it. And I think it's all the things you're saying. It's all these insults. Right. That are from the environment, our diet, antibiotics, et cetera, that make us susceptible.

Right. Your genes are never going to say you're going to get that disease. It's usually your environment that needs to turn those genes on. So yeah, it's true. And even though you have the genetics, yeah, it doesn't mean that it's not a way to diagnose for it. But it's good to know your genetics, though. And it's a spectrum. You know, like you look at the antibody test and there's a normal level, right?

Like there's, you know, 0 to 20 or whatever on the antibody test on your blood level. But when you think about it, there is no normal level of antibodies to gluten in your blood, right? And you talk to Dr. Leslie Fasano, who's been on the podcast, who's the world's expert in gluten at Harvard and brilliant guy. And he said, you know, look, if you have any antibodies, it means three things. One, you've been eating wheat or gluten. Two, you have a leaky gut.

And three, your immune system doesn't like it. Right. So if the level's five, it's not as bad as 20, but it's not as good as zero. Right, and you don't want to go to 20, right? So, be careful. Right. So, a lot of people say, oh, my tests are fine. But I mean, it's a spectrum. It's a continuum. It's not on or off. Right.

And it's always worth doing elimination diet because the cost is low, the benefit's high. There's really no downside to getting off it for six weeks, let's say, or even two weeks and see what you'd feel like. And if your symptoms get better and then you eat it again and you feel weeks, let's say, or even two weeks and seeing what you'd feel like. And if your symptoms get better and then you eat it again and you feel worse, there's your answer. Right, right. I think it's a little tricky too, though, with gluten, because typically with elimination diet, you know, use two to three weeks off of that food, you should feel better. We've had a lot of people where it's up to three months, right? Before, I saw clinically for a while, and now that we're testing for it

more, you see these antibodies to gluten stay around for a long time after someone's been off of it, right? You're no longer getting exposure. Those antibodies should come down. The inflammation should come down. So that's something to keep in mind for listeners, because I've had a lot of people say, you know, I went gluten free for three weeks and I didn't feel all that much different. And then I'm like, I think you got to give it longer. It's around that three month mark that a lot of people like, you know, my joints finally started feeling better around that point. So, so that's something to keep in mind. Um, let's try to patient when she was off for 10 weeks before she started to feel better with psoriatic arthritis. Right. Yeah. And you know, usually it's a combination of a few other things that need to be sorted out, but you really

want to give yourself a good time period. So if you've never done up to three months, you should, and you know, it sneaks in, in a lot of places, which we'll talk about, but you know want to give yourself a good time period. So if you've never done up to three months, you should. And it sneaks in in a lot of places, which we'll talk about, but most folks who are fairly sensitive have to be 100 plus percent off of it or they will still be reacting. And it's 150%. I mean, if people have, Dr. Fasano said to me once, if you have a thumb fall, a thumbnail fall of gluten in three months, you're back to zero.

Yeah. Like you can't even cheat a little bit if you want to do it because your body then creates an immune response. And I remember a patient who had rheumatoid arthritis and she was very, you know, good, but you know, she was trying all the functional medicine stuff. She would get a little bit better. She was, wasn't, it wasn't cutting it. And I said, look, you think you're gluten free? And I went through a diet and it was, she was getting some and maybe she had some soy milk with barley malt and this and that.

So I said, why don't we put you on just a 10-day ultra clear plus shake, which is what we're using back then, which is basically a rice protein, low allergenic, just no other food, just this shake for 10 days, see what happens. Everything went away. And I was like, wow.

And I think I saw her like three months later or six months later and she had completely changed. She lost 40 pounds, her arthritis was gone. She felt great. And I think one of her like three months later or six months later and she had completely changed. She lost 40 pounds. Her arthritis was gone. She felt great. Right, right. And I think one of the things I just want to emphasize is that whatever condition you have, almost anything really in medicine, it should be on your list of things to think

about. Right, right. Because when you look, for example, the New England Journal of Medicine had an article years ago, which listed over 55 different diseases that were really caused by celiac and gluten, but were masquerading as something else. Osteoporosis, iron deficiency, schizophrenia, autism, cancers, you name it, autoimmune diseases, migraines, I mean, just disease after disease. And if you really look at that list, and that's just, I think, a short list compared to things I've seen over the last 30 years, you're going to think that pretty much anybody who has a serious

chronic illness or has chronic symptoms or is just not feeling great should check for it and also should try an elimination diet. Right, right. And this is where, too, testing can be helpful because there's some people that think they're 100% off of it. You know, I've had several folks come in already knowing they have celiac or very sensitive and they're off of gluten. We still test them. And the antibodies that we're looking for, this is through the Cyrex-3 panel that we do, there's about 32 different immune markers that they're looking at. It

varies parts of the gluten protein and wheat and other proteins within wheat. But so it's a very sensitive test. And these antibodies shouldn't be in your system if you have not been eating gluten and they come back positive. And that's like, okay, you're getting some hidden sources. When you eat out, are you doing all the precautions you need to do? Have you checked your body care products? Is your house gluten-free? There's so much contamination that happens in the house of, you know, not everyone in the house is gluten-free and they're sharing space and food. So this is where you have, the testing can be really helpful to kind of dig in. And again, traces can make a difference, even if you don't have celiac for

someone that's really sensitive. So tell us about like some of the common things we see. One of the cases you had was a thyroid issue. Yeah. So I wanted to kind of focus on autoimmunity, because that's a lot. Anytime I see someone with an autoimmune condition, if they're not gluten-free, I'm like, you got to start there just to make sure that's not triggering it. Because again, even if you don't have celiac- I want to emphasize what you said. Anybody who has an autoimmune disease, gluten should be on your list of what to check and what to eliminate. It is easy to do and you can have profound results.

Absolutely. Yeah, because even if you don't have the celiac, what we so often find is that when you take gluten out, these other antibodies to the thyroid, other conditions of autoimmune conditions, they get better. The numbers start getting better. So we've seen that clinically and now we're, you know, we test for it so much more. So even even on celiac, we do find it can trigger a lot of other autoimmune like conditions. So that's, I was kind of wanting to

focus on two cases around autoimmunity. The first one is a 38 year old woman with Hashimoto's, which is the autoimmune condition you can get with your thyroid. Very common and a lot of reasons to have it. But she was interesting. She was a really intense triathlete, so very competitive, high exercise person. She came with severe fatigue just in for nutrition because I think she, you know, wanted to focus on nutrition and weight loss, which is not typically what you see with low thyroid function. But her thyroid antibodies were extremely high, some of the highest I've ever seen. And she also had a liver enzyme that was elevated too. So I was wondering if there maybe was a toxicity component to that. And I do think she was a bit malnourished

given the high level of exercise that she does. Some of her nutrition labs, even her cholesterol was coming back low, which could indicate that she wasn't getting all the nutrition or maybe not absorbing all the nutrition she needs. Um, so I, you know, like I always do with on immune, I'm like, let's, let's take all the gluten out. Um, she kind of did her own research and went full on paleo, which, uh, takes out all the grains and all the legumes, which sometimes really can make a difference for folks that are gluten sensitive. Um, and I really focused again, getting enough good fats and protein, good quality carbohydrates in her diet. With the exercise piece, you know,

I was thinking there could be an adrenal component to that and your adrenals are very closely linked to your thyroid. So she, you know, worked on some other lifestyle things and did some yoga and restorative stuff that I think was important. But she, but you know, when you see Hashimoto's, which is very common, right? One in five women have both thyroid. A lot of that is autoimmune thyroid conditions, probably the most common autoimmune

disease in the country. It's not all related to gluten, but probably I would say a third of my patients who have Hashimoto's when I check their gluten antibodies are elevated. Right. It's a piece of the puzzle, right? And when they get off gluten, they get better. Right. Exactly. It's so often a piece of the puzzle. It's usually not the only thing, but it's definitely a big component for a lot of folks. And, you know, again, being a high level triathlete, your digestive system takes a hit to that, you know, and I think she got a little bit of leaky gut where before the gluten may not have been an issue. And she'd also had a daughter soon before. And, you know, sometimes just the process of going through a pregnancy can switch what goes on with the immune system as well. And on her blood test,

she found elevated. Yeah. So I had her, you know, she didn't do any specialty testing with us. I just had her, she had a good local doctor who did more integrative stuff. And I said, have them do a celiac panel and not just check tissue transglutaminase, which is what the kind of the gold standard, so to say, right, for blood work is for celiac, you can check for antibodies to gliadin, which is part of the gluten protein. You can check for deaminated gliadin. So I wrote out what to ask her doctor for and they ran it. And she did not have the tissue transglutaminase, which, right, mostly is what they're going to look for for celiac, but she did have anti-gliadin antibodies. And I was like, you should not have those, you know? So you may not have celiac, but she did have anti-glied in antibodies. And I was like, you should not have those, you know?

So you may not have celiac, but you could have something similar. So yeah, so that's a good point because a lot of doctors will check the basic test and they'll say you're fine. And they only check like one antibody called TTG. Right. But they don't check the anti-glied in antibodies, which are less specific, but actually more sensitive. So they'll show up often when the other one doesn't.

Right, right. And they do indicate a level of leaky gut, a level of wound sensitivity, and they are definitely contributing to all sorts of issues for people. Right, and we did some other nutritional stuff. She was low in iodine, and we did some sea vegetables and things,

which is important for thyroid. So again, there's other things that are going on. But that, you know, when I had a two-year follow-up with her, obviously we had a few follow-ups in between, important for thyroid so again there's there's other things that are going on um but that you know when i had a two-year follow-up with her obviously we had a few follow-ups in between but she said her digestion was great her energy was great um her thyroid antibodies and you know what i think we hear in conventional medicines like you got autoimmunity you have it you know why check antibodies it doesn't go away so her thyroid proidase, which is one of the ones they check, came down to less than zero or whatever the normal is.

And her thyroglobulin antibody, which is the other one, is slightly elevated, but came down significantly. So that's remarkable. So she had one of the highest levels of autoimmune antibodies you'd ever seen. And after getting her gut sorted and getting the gluten out of her diet and optimizing her nutritional status. Doing stress reduction. She actually had a complete normalization in one of them and almost normal in the other

one. Right. Which quote doesn't happen in traditional medicine. And she's on armor, she's on some thyroid support, she does feel better with it and I think there's you know often a need for it but you know she pretty much reversed her autoimmunity by going paleo. That's amazing. So that was pretty remarkable.

It's nice to see when things, you know, kind of quickly turn around for some folks. Yeah. And what about this other case you had? So this other one was a bit more complicated. She's a young woman, 27 years old, but she has mixed connective tissue disease, which, you know, is kind of a combination of similar to lupus or scleroderma. It's kind of a mix of where autoimmunity can affect many different tissues. Yeah, so it's a bad autoimmune disease.

It is a bad one. It affects like all the tissues and organs and skin and liver and kidneys and right. Right. Muscles. And then she came in with all those symptoms, you know, a ton of joint pain,

a lot of digestive stuff, which she said she kind of always had her whole life fatigue. She was depressed. She had weight gain, um, probably cause she was so inflamed. Um, she wanted to lose about 20 pounds or so. And her symptoms did start in her teens with some you know exercise stuff and then by the time

she came to see us again only just in her 20s she was getting arthritis in her in her hands so she was on autoimmune suppressant medications she was on cell set but she had been on a lot of things over the years a meprosol for her reflux because she had a lot of the digestion issues. She was on a low gluten diet. Yeah, yeah. That doesn't count. That's what I always talk to people. What is low?

It's like being a little bit pregnant. What is low gluten? I was like, you have all these conditions. You have to take gluten out. And she had done testing. I think some specialty tests that did show she was reactive to gluten and soy before. And that's why she was low. But I told her, you know, you got to be 100%.

And she said, you know, I do feel like my headaches are worse and my stomach's worse when I have gluten. So we got her strict gluten-free and I kind of low grain. I try to get it low allergen overall. I told her to come off the coffee, no alcohol, anything else that could be inflammatory to her gut. You also did this test, which was not the normal test. So you mentioned a little bit earlier. So when you go to the traditional doctor, they'll do a celiac panel, they'll do the TTG,

they'll do sometimes gliadin antibodies. But we at the Ultra Wellness Center do a different test from the lab called Cyrex, which looks at not just a few proteins in the wheat, but all sorts of different, like dozens of different- The gliadins, glutenins, there are different parts of the gluten protein. So they're breaking down to these smaller units. So you can really get a closer look at what the immune system's reacting to. And there's a section there of transglutaminase.

So it's not the same thing as tissue transglutaminase. You can't diagnose celiac with it. But what Cyrex says is that folks that have these other transglutaminase. You can't diagnose celiac with it. But what Cyrex says is that folks that have these other transglutaminase reactions are more likely to have an autoimmune condition related to gluten. So this is where it's like, okay, it may not be celiac, but you probably have something very similar. So out of 32 markers, 30 of them came back positive on a low gluten diet. I mean, she wasn't eating a standard American diet at all. She did have a celiac panel. Her tissue transglutaminase, again, that gold standard was borderline high, which should not really be showing anything.

And her deaminated gliadin was high. She did have the genetics. She had, it's called HLA-DQ2 and DQ8. The DQ2 is positive, which brings your risk up pretty high for celiac. We also did a Cyrex-4, which is known as kind of their autoimmune profile as well. So they're looking at dairy. Dairy we know is big allergen in and of itself, but a lot of people that react to gluten seem to react to dairy.

And they've, you know, with paleo, a lot of folks take out all grains, and sometimes that is helpful. According to Cyrex research, oats, and oats have been identified a long time ago, even when they're gluten-free, when they're not contaminated with gluten, there is a protein in there very close in structure to gluten. So many people do react to it.

I see that a lot. I mean, oh, I'm on the gluten-free oats, and I'm like, nope. Yeah, usually you can't. If you are still having any symptoms, then you should just get rid of all the oats, gluten-free or not. Yeah, so I tend to throw oats in the gluten category.

And then they also suspect rice, which I've always thought of as a low allergen grain, but we do have a lot of folks that seem reactive to rice, corn, and millet. So those are the ones I kind of focus on. They also check corn, soy, some of these other common allergens. Yeah. And so what happens is, you know, the way I think about it is gluten is sort of the gatekeeper, right? When you eat gluten, you become sensitive to it. It opens up the channels in the gut, creating what we call leaky gut. And then other foods get in and you get these

cross reactions. So you get other grains, you get dairy, you get soy, but it's really the gluten that's sort of started the whole thing. And if you fix the gluten and you heal the gut and you get rid of all those other foods for a short time, maybe three months, six months, maybe a year, you can heal the leaky gut and then become able to tolerate a much wider diet. Absolutely. So I think that's a fear of so many people

when they start reacting to so many things. I'm like, you know, a lot of these foods are not at fault. You know, there's something else compromising your gut. Maybe gluten. Like the innocent bystander. What's that? Like the innocent bystander. Yeah, and I'm like, once that gut gets healthy, you know, your immune system's not going to be

seeing it and reacting as much. And she, because she was on these immunosuppressants, we did a different type of leaky gut test called the mannitol lactulose test, which basically looks at what's leaking through the gut. And she did come back with increased permeability between the cells that line the digestive tract. So the gut is where you need to focus for autoimmunity because so much of the immune system lines that. So if that's not healthy and it's leaky, that's probably what's triggering autoimmunity for folks. Well, what's really important what you did with her was not just get rid of the gluten

or the food reactions. And I see this as a common mistake, even by traditional doctors with patients who have celiac. And I have a whole group of patients in my practice who have been diagnosed by their traditional doctor with celiac, but they're still sick. And what is happening with these patients is that there may be other cross-reactive foods like we talked about, like dairy, other grains, but their gut is leaky and needs to be healed. So once you take out the damaging force, it can heal a little bit. But that's where functional medicine comes in. That's where we do with the ultraviolet medicine comes in. We look at the whole gut, we look at the microbiome,

we do testing to figure it out, and then we put people on a whole repair program. Right. And this is so essential for people with celiac. The 5R. Yeah, the 5R program from Functional Medicine. And I just think it's such an important philosophy of restoring the gut by taking out all the bad stuff, clearing out the bad bugs, putting in pre and probiotics,

putting in the nutrients that help heal the gut, and giving all the things that are needed to actually totally fix the problem. Right, and that's what we did. The doctor who she was working with here did the 5R program. So you remove what is causing the damage, in her case, the gluten. But she had a lot of dysbiosis and imbalances of the gut microbiome. Based off a breath test, she had some overgrowth of bacteria. So the doctor treated her with a herbal protocol. We replaced her digestive enzymes, because you make enzymes in your gut. And when that becomes leaky, you need some support there and help you

break down your food while you're, until you're able to do it yourself. And then you re-inoculate by bringing good bacteria and the food has a big part to do that because a lot of our fibers and vegetables are going to feed the gut microbiome and you repair. And that's what we do a lot. Like again, with certain herbs that heal the mucosal layer of the gut and glutamine, which nourishes the gut, you know, that type of protein, we gave her some zinc. So all of that was really important because I think if we just took out the gluten, yeah. And some of these other foods, I mean, she was malnourished and she needed supplemental support and, and she needed support with her diet. And that was, we focused on getting more good fats and protein. said she was like always hungry and after she added these in

she's like i feel satiated and i've lost 15 pounds like i'm not hungry because my blood sugars are steady and my insulin's down you know she was getting it um and uh and she had lost weight around her belly yeah i mean it's amazing maggie what we see with autoimmunity here and gluten i mean when you have these patients who that's the issue, it's a miracle. People get misdiagnosed with all sorts of problems. Oh, you have rheumatoid arthritis. I mean, I just talked to one of my patients yesterday who was struggling and she had rheumatoid arthritis, been diagnosed with that. But now she had Lyme disease, not rheumatoid arthritis, right? Or another patient had rheumatoid arthritis, but it was gluten. So there was was joke in functional medicine, just because you know the name of the disease

doesn't mean you know what's wrong with you, right? Just because you have a label doesn't tell you why. And gluten is one of those things, and celiac is one of those things that can cause dozens and dozens and dozens of different diseases and symptoms that we think may be something else, right? When you see someone with schizophrenia, you don't go, oh, that's a gluten problem, but probably for about 20%, it might be. Gluteomorphins, which are measured in the Cyrex-3. So those are compounds that get produced when folks aren't digesting gluten properly. And they're basically like an opioid, right? Where they impact cognition. So whenever we see a mood disorder, you know, very common in kids on the spectrum and things, we take out gluten and we take out dairy because case disorder, you know, very common in kids on the spectrum and things,

we take out gluten and we take out dairy because casein, you know, the protein in dairy can do that too. And there's research on this, you know, that these xenomorphins, they cause effects in the brain. So this is why there's so many different mechanisms that we're starting to understand of how people can react and present with so many different symptoms. R. Rheumatoid arthritis joints is a huge one. One of my first patients here, the gentleman, 55 years old, I'll never forget because he was one of my first ones, on his intake packet, he said he had celiac. I think we may have seen him together.

And I was like, you have celiac? He's like, no, no, I had it. I'm like, well, you're born with it. You still have it. He had such bad rheumatoid arthritis, his joints were deformed. And he's like, this is celiac? And because he had no digestive issues, no one ever asked him what he was eating. Oh, yeah. I had it when I was a kid. Yeah. And I'm like, so I don't know what the thinking was back then. And his digestion got better, but it went and attacked, he had issues elsewhere. So that's, yeah, you got to think outside the box.

Well, this is great, Maggie. Gluten is such a big topic. It's sort of the topic of comedy shows and, you know, people are like, well, I'm gluten free. I don't know why. It seems like everybody's doing it, so it must be good. You know, it's like, but I think there is a reality to this. And as functional medicine doctors and nutritionists, we really see this every day. It's one of the most powerful things we can do is to identify these problems, to treat people, to clean up their gut, to clean up their diet, and to help resolve a whole myriad of symptoms. So if you're listening to this podcast and you're suffering from any kind of mysterious thing that no one can figure out, one, functional medicine might be your ticket to figure it out. And two, gluten might just be one of those things. And

it's really why I've created, wrote my book, The 10-Day Detox Diet, which is really a sugar elimination, but also eliminates gluten. That's why I've created the 10-Day Reset, which you can go to getpharmacy.com and learn more about it, which is essentially a 10-day elimination diet. You can do it longer, obviously, but it's really powerful to just get an immediate hit of, if you take out all the crap and put in the good stuff, what happens to your body? So I encourage anybody who's suffering from anything that is just not explained or not easily fixed, whether it's runny nose or headaches or eczema or psoriasis or joint pain or brain fog or whatever, digestive syndrome,

stuff that we think we have to live with, I call it FLC syndrome, it's when you feel like crap, that you can often trace it back to what you're eating and gluten is one of those big factors. And it's not a joke. It's real. It's not a fad. And I think you have to know what you're doing in order to properly treat this.

It's not just a matter of getting a regular test, seeing it's fine or abnormal, and then treating it. You really need to go through the whole process that we do in functional medicine. That's really what we're here for at the Ultra Wellness Center in Lenox, Massachusetts. We have a great team of physicians and nutritionists to work with our patients remotely now over Zoom or virtual telemedicine. We'd love to help you if you're suffering. So feel free to look us up, ultrawellnesscenter.com. And if you love this podcast, please share it with your friends and family on social media. Tell us your experience with the gluten, either eating it or getting off

it and what it's done for you. And subscribe wherever you get your podcasts. And we'll see you next time on The Doctor's Pharmacy. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my

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