Thoughts on Gluten Cross Reactive Foods

After coming across many blogs talking about “19 gluten cross reactive foods” I was first concerned and worried, then overwhelmed by the sheer number of foods that may be problematic.

Then I found another busting the “myth” (Christina Graves), doing a better job of it than I ever could, and clearing up the confusion. This also prompted me to finally read at least the abstract and conclusion of the original study (Aristo Vojdani, Igal Tarash Cross-Reaction between Gliadin and Different Food and Tissue Antigens, Food and Nutrition Sciences, Vol.4 No.1, January 2013). The 19 foods were the initial suspects, so to speak, but among them only milk, corn, rice, and also millet and yeast (but these possibly due to cross contamination) were found to possibly cause issues. Also the study was done for cross reactivity with α-gliadin, relevant for celiac disease.

Had I gone to the source from the beginning, I would have known that this probably doesn’t apply to me to begin with. As far as I know I am not celiac. I am most likely reacting to ω-gliadin (based on the fact that my symptoms are exacerbated by exercise), another component of gluten. And those are not the only two parts that make up the structure of gluten! NCGS (non-celiac gluten sensitivity) might involve other parts.

Along with gluten, I too have problems with milk (confirmed allergy) and fresh yeast. Does it mean anything that it partially matches the study’s results?
Among the 19 suspects, I have problems with quinoa, buckwheat (confirmed allergy), and amaranth.
But are these cross reactions to gluten? More likely they are separate problems of their own or cross reactions to my other allergies.

As I too started my food journey by going gluten free, it was all too easy to think that I was either being “glutened” or was having gluten cross reactions when I continued to have symptoms. At least for me, the answer turned out to be additional allergies and sensitivities apart from gluten. This is also mentioned in the original study’s conclusion.

“If after adherence to a strict gluten-free diet and the elimination of cross-reactive foods symptoms still persist, further investigation for other food intolerances should follow.”

Yet again, cross reactivity is a complicated issue, at the molecular level. While it can  indicates increased possibility, it may or may not apply to you. Depends on how your immune system identifies the “offenders” and how accurate it is. So, individual answers may all be different.

Following such lists can be misleading, inconvenient, possibly dangerous without first testing yourself.

Regarding testing, along with formal skin tests, blood tests, or even endoscopies, carefully done elimination diets, food challenges, and possibly data tracking and molecular structure simulations might help find answers.

On the State of Stool

In my experience as someone with multiple allergies and sensitivities, if I don’t have ideal stool, it’s highly likely I am reacting to something and causing irritation, inflammation, and even bleeding in the bowels.

When I eat only my safe foods, the bathroom trip couldn’t be anymore pleasant. It is quick, painless, no urgency, and so clean. Seriously, now that I know this is possible for me, I pay more attention to when things start to deviate from the ideal.

What is ideal? Soft banana shaped stool that comes out clean, like no wiping necessary. Ever had pets or experience with livestock? One pretty clear sign of health is they have clean behinds.

Non ideal situations include constipation, diarrhea, or bloody stool, obviously. But also black or tarry (signs of internal bleeding), messy, sticky, oily or floating, or stool with no form along with a bleeding or irritated anus.

Allergies Running in Families

It is highly likely you share allergic, sensitive tendencies with members of your family. Everyone else in my immediate family has at least one food allergy and some have seasonal allergies as well, and at least one person has atopic dermatitis. I thought I was the lucky one without any food issues whatsoever, even though I was also the one most frequently in and out of the hospital.

Well, once we caught gluten, turns out I have many. And everyone else in the family also react to gluten to various degrees but no one knew so far! One person told me that for the first time in their life they are not aware of their insides, they always had some pain, and for the first time they had stool that actually had a shape! Also tinnitus (ringing in ears) disappeared and eye fatigue reduced. Another told me their severe insomnia and daily muscle cramps and restless legs syndrome greatly reduced. Another is shy about the details but felt enough difference that they eat mostly gluten free on their own. All of them also get noticeable bloating and gas when they do eat wheat.

Some studies show Neanderthal genes are to blame for allergies.

Rethinking the Cost Benefit Analysis

The allergist’s goal is to expand the patient’s diet as much as possible. Unnecessarily limiting one’s diet is too big of a cost, too difficult to maintain. The social cost is too big. And potential gaps in nutrition is worrisome. 

Arguments along these lines are used to caution against restricting one’s diet. And I used to agree with it all.

But now that I’ve experienced firsthand what a difference removing my problem foods made, I argue there are costs associated with not finding and following the diet right for you.

Pills for symptom control, constant inflammation, and potentially lasting brain damage for migraine sufferers, are just a few.

What really is the higher cost here?

Can we afford to not find the true cause?

Besides we in modern developed countries have access to a wider variety of foods than much of our ancestors or even many less developed areas in the present day, even if you have multiple allergies to contend with. So much so that people can afford to limit their diet based on personal values and beliefs.

Despite occasionally tiresome limits and caution needed with my diet, my quality of life has vastly improved. Much higher energy levels, not having to feel chronically sick in both mind and body, being able to enjoy exercise, etc. Isn’t being able to use and enjoy our mind and body to the best of its potential what life is all about?

People are Over-diagnosing Themselves?!

Every now and then a catchy title circulates “most adults who claim food allergies are not allergic!” or “millions of Americans not food allergic as they claim”.

This makes it sound like many are faking their illnesses.

First of all, if you actually read these studies, the percentage of people who actually do have food allergies are quite high. So you could have made the title “majority of adults who claim food allergies are actually allergic” or “millions of Americans food allergic” or “food allergy in adults are on the rise”, which would have all been closer to the truth. But maybe not quite as clickable or joke-worthy.

Dismissing them as faking it, being hypochondriacs, stupid or mental helps no one.

Then what are the possibilities? What might actually be happening?

1. False negative. They actually do have an allergy but it did not show up in testing.

2. Non-IGE mediated allergy. Some of these can be severe, like FPIES.

3. Autoimmune disorder, like celiac disease.

4. Gastrointestinal allergy. Can be both IGE or non-IGE mediated and most don’t show up on skin tests.

5. Food intolerance. Not an allergy, not immediately life threatening, but can still cause a lot of havoc.

6. Wrong culprit. They have a food issue, but to a different food.

7. Outgrew the allergy. They had the allergy but outgrew it by the time testing was done. Actually a happy ending!

The Questioning when you go Gluten Free

You feel relief from a gluten free diet. And the questions begin.

Are you celiac? That we concede. 

Do you have wheat allergy? It’s very rare.

No? Are you a suggestible fool swayed by placebo effect?

Some who have studied a bit more may also ask:

Then, are you gluten intolerant (or have NCGS: non-celiac gluten sensitivity), which may or may not exist and might be all in your head? 

Have you neglected the fact that you incidentally cut out something else that was your real culprit?

Questioning and being skeptical itself is not a bad thing. But the error here is that we forget that we don’t know everything. There is still much research needed about food reactions, especially non-IgE mediated hypersensitivity reactions.

I observed this train of thought quite a few times since gluten-free became something of a trend. People worrying that other people who don’t need to be on a gluten-free diet are hopping on the trend and possibly risking something. Their health? A balanced diet? Forgetting, again, that there are plenty of cultures that do not depend on wheat and its kin.

Observations Down the Rabbit Hole of Food Elimination Diets

Food is such a huge part of social encounters/ functions, and the culture in general.

Food is possibly the primary (at least secondary?) pleasure of travel.

People can get really religious about food choices, whether for or against.

When you really can’t eat something due to allergies or autoimmune disorders and the like you may become envious of those diets done more for moral reasons or even as a lifestyle choice. At least it won’t kill you acutely or slowly if you let it slip!

You will be met with a lot of skepticism.

Those who don’t have food issues or are not aware can get really high and mighty and all scientific on you about placebo effect and double blind studies.

There are still a lot of holes in our mainstream knowledge about allergies. Even some doctors.

Addictive Foods

It is said that there is a tendency that your problem foods are the ones you are most addicted to.

Sadly, it is entirely true for me. Almost too accurate, in fact.

I used to love bread, pasta, noodle dishes, milk in all forms, fermented soy dishes, roasted chestnuts, pecan pie, my favorite ice cream flavor (butter pecan!), cold noodles/ soba (buckwheat), seafood soups (shrimp).

Of course none of these things I would dare to eat now since I would suffer an acute reaction. It was only when I was chronically ingesting many of these things that I felt these were addictive while also feeing chronically ill most of the time.

Causes of Processed Food Troubles

I don’t usually talk about my diet issues, but in the rare cases it comes up, frequently people tell me they cannot figure out what exactly is causing their issues. They don’t think they have any issue with any one food, but they do feel a lot better when they eat out less, or eat less processed foods. Setting aside the fact that they may never have done an experiment on themselves controlled well enough to actually pin point their problem, I wondered what kind of things might be the culprit if we took this statement “feeling better with less eating out and less processed foods” at face value.

Histamine and/or other biogenic amines, mold, additives, even dust, dust mites, or other insects come to mind.

In practice it may be very difficult to narrow down the culprit much further. But then that may not make that much of a difference as there is a lot of overlap in the foods that potentially contain the substances listed above.

Alcoholic Beverages and Food Sensitivities

Alcoholic beverages are currently exempt from mandatory labeling of major allergens.

Beer

Typically contains barley, yeast, and hops. It is fermented but not really separated in any way except sedimentation.

Wine and various fining agents

Potentially allergenic fining agents include: casein (milk), egg white, chitosan (crustaceans), isinglass (fish). According to this paper (Vassilopoulou et al. Clinical and Translational Allergy 2011, 1:10), trace amounts of fining agents were not detectable in the finished wine but did cause positive skin prick test results in allergic individuals and may cause mild reactions.

Safe options?

Vegan wine, since almost all organic fining agents are derived from animals. (barnivore.com is a searchable database for vegan booze.)

Distilled spirits such as vodka, brandy (wine), tequila (agave).

 

Aside from allergies, there are many pathways that alcohol can cause problems. You might have an issue with alcohol itself, or its amines or other chemical content.

As for us, we avoid alcohol. For me it causes headaches and a low mood that I just don’t want to deal with anymore and my partner flushes (common genes in Asians) and also has bruxism and GI issues when he has a drink.