Unfortunately, going gluten-free alone may not be enough to manage declining brain function, autoimmunity, or inflammation. This is because proteins in other foods can cross-react with gluten. Cross-reactivity means the proteins in certain foods are similar enough to those in gluten to trigger a reaction. Foods known to commonly cross-react with gluten include casein (the dairy protein), yeast, oats, sesame, and some brands of instant coffee.
The food that most commonly cross-reacts with gluten is casein. This is not to be confused with a lactose intolerance. Lactose is the sugar portion of milk whereas casein is the protein. Lactose
intolerance is a condition in which some people lack the enzymes to digest milk sugars. It is not
the same as an immune response to casein.
One study found 50 percent of patients with gluten sensitivity experienced only partial remission
of symptoms on a gluten-free diet because they had a cross-reactivity to milk. I have personally
witnessed countless cases of individuals who needed to give up both gluten and dairy for a
positive health response. Also, it’s important to test for different antibodies to milk protein or
you may miss a dairy sensitivity. These include alpha-casein, beta-casein, casomorphin, and milk
butyrophilin.
The other common cross-reactive foods—oats, yeast, sesame, and some brands of instant
coffee—can also be an issue. If your symptoms are not improving on a gluten-free diet you may
need to get tested for these cross-reactive foods or simply avoid them completely.
The other main issue with going on a gluten-free diet is many people begin eating more of other
grains, such as corn, rice, or quinoa, and develop sensitivities to those grains. This happens all
the time with gluten-sensitive people. If you are gluten sensitive and have been on a strict
gluten-free diet with minimal results, you may be sensitive to other grains.
Cyrex Labs offers a panel that checks for the foods that most commonly cross-react with gluten.
It also screens for common sensitivities to other grains and non-gluten foods and is called the
Gluten-Associated Sensitivity and Cross Reactive Foods Array 4.
Foods tested on the Cyrex Array 4 food sensitivity panel
(an [X] indicates a food that commonly cross-reacts with gluten;
a [*] indicates the food is often contaminated with wheat during the processing of the food)
[X] Rye, barley, spelt, Polish wheat
[X] Cow’s milk
[X] Alpha-casein and beta-casein (milk proteins)
[X] Casomorphin (peptide created during digestion of milk protein
that produces an opioid effect in the nervous system)
[X] Milk butyrophilin (a protein in milk fat)
[X] Whey protein
[X] Milk chocolate
[X,*] Oats
[*] Some brands of prepackaged, preground, and instant coffee are contaminated with gluten
[X] Yeast
Sesame
Buckwheat
Sorghum
[X] Millet
Hemp
Amaranth
Quinoa
Tapioca
Teff
Soy
Egg
[X] Corn
[X] Rice
Potato
I have found this panel makes it easy to quickly identify which cross-reactive and gluten-free
foods must be avoided on a gluten-free diet. If you do not have access to the testing, then follow
a diet eliminating the entire list of grains, which is beneficial anyway if you have intestinal
permeability, or leaky gut.
How to get the most out of your food sensitivity panel
To get the most out of your Cyrex food sensitivity panel, or any food sensitivity panel, it’s
important to know some immune basics.
A food sensitivity panel screens for antibodies (Cyrex measures IgA and IgG) to foods, and these
antibodies take time to develop.
Antibodies are proteins the immune system makes to tag an antigen, or harmful invader. Once
an antibody tags an antigen, the immune system knows to destroy and remove it. This immune
reaction is very useful in the case of a virus. However, if it is happening against a food you eat at
almost every meal it can cause inflammation, immune imbalances, and raise your risk of
developing or worsening autoimmune disease.
In the event of a sensitivity, it takes about one month after eating a particular food for positive
antibodies to show up on a test. If you have not consumed a food in the last three to four
months, it most likely will not produce positive antibodies, even though you may be sensitive to
- For example, someone could be sensitive to teff, but because they rarely eat it, it may not
show up as positive on the test.
What it means when all your results are below the reference range
Sometimes results show a person did not test positive for any foods and all the results are below
the lab’s reference range. When all the results are below the reference range it can mean your
immune system is suppressed and not able to produce enough antibodies for a positive test
result.
One cause for this is steroid use, which suppresses antibody production. Another cause is the
person’s immune system is simply fatigued and under-functioning. Doing a serum
immunoglobulin panel to test total IgA and IgG antibodies can verify whether this is the case.
General strategies to improve overall health—including an autoimmune diet, gut repair, and
blood sugar balancing—can help restore antibody production for more accurate results on a
retest. This mechanism explains why patients with an autoimmune disease, such as Hashimoto’s
hypothyroidism, see their antibody levels temporarily spike when they begin restoring their
health, even though symptoms may improve.
However, if many of the values are below reference range but you still test positive to one or
more foods, then immune suppression does not apply to you; the immune system is not
selective about suppression.
What to do with your test results
You got your test results back, now what? You need to immediately eliminate the foods that
showed positive on the test. Foods that are cross-reactive with gluten should be permanently
avoided, particularly if you also tested positive for transglutaminase antibodies. If you tested
negative for transglutaminase antibodies it’s possible you may be able to eat these foods again
after repairing leaky gut, but it depends on the individual.
The remaining foods are foods to which you have developed a sensitivity.
Upon restoring gut health and reducing your overall immune load, it’s possible you also may be
able to eat these foods again in the future.
Many people with gluten sensitivity and gastrointestinal inflammation develop a leaky gut. As
discussed in Chapter Nine of my brain book, you can test for leaky gut using a panel from Cyrex
Labs called the Intestinal Antigenic Permeability Panel. The dietary restrictions to repair leaky
gut, which is also discussed in the book and in my course Gut Health: Solving the Puzzle, include
the removal of gluten, dairy, and all grains. Results can be profound.
Although these dietary changes can seem severe at first, they are the foundation for lowering
overall inflammation and taming autoimmune reactions. Many people find that as their health
improves they actually begin to love their new way of eating and how good it makes them feel.
Strategies for accidental gluten exposures
Despite your best intentions, there may be times when you are accidentally exposed to gluten.
Many people with gluten sensitivity don’t realize how awful gluten makes them feel until they
have been off it for a while and then are exposed to it accidentally. It makes them realize how
significantly gluten impacts their system.
Some have more adverse reactions than others. I had a patient with an inner ear autoimmune
disorder called Meniere’s disease. If she accidentally ingests gluten she develops dizziness and
ringing in her ear. She can literally take a bite of a food with gluten and immediately develop
symptoms that last for several days. Some people will notice mild abdominal bloating and brain
fog. Others may have a subtle mental slowness or headaches. Everyone will be different.
If you have a gluten sensitivity and are exposed to gluten, several natural enzymes and
compounds can reduce the adverse reaction and help you recover faster. These natural
compounds help degrade the gluten protein to reduce the intensity and duration of the immune
response.
Please note: If you are gluten sensitive these are not to be used as an excuse to eat gluten; they
are to dampen the consequences of minor exposures. There is no predetermined dose so you
will need to experiment with doses that work best for you. These are not drugs, so you do not
need to worry about overdosing.
DPP-IV
The first supplement is a digestive enzyme called DPP-IV. It helps digest gliadin and casein and
regulate the immune response. Research shows supplementing with DPP-IV is therapeutic
for gluten-sensitive people; the naturally occurring DPP-IV enzyme is less active in people with
celiac disease and malabsorption. Also, the effects of DPP-IV activity, gluten exposure, and
inflammation have been shown to play a role in autism.
Brush border enzymes
Brush border enzymes are digestive enzymes located in the intestinal microvilli and include
amylase, cellulase, invertase, and lactase. Intestinal damage and leaky gut can destroy the
microvilli and brush border enzyme activity. I do not recommend bromelain or pancreatic
enzymes if you have positive transglutaminase antibodies and villous atrophy causing bloating
after eating, anemia, weight loss, and other symptoms of malabsorption. These enzymes can
“digest” the villi and make you feel worse. Plant-based enzymes are safer in the case of damaged
guts.
Flavonoids
For people with gluten sensitivity and celiac disease, gluten promotes severe intestinal
inflammation.63 The flavonoids (colorful plant compounds) listed below can help dampen
inflammation from gluten exposure. I prefer using a combination of all of them.
- Lycopene
- Apigenin
- Quercetin
- Luteolin
Lycopene and quercetin have been shown to prevent immune activation from gluten. Apigenin
inhibits gut microflora from triggering inflammation. Quercetin has been shown to work
against intestinal histamine secretion in response to an antigen.69 Luteolin inhibits LPS-induced
inflammation in the gut lining.
Together DPP-IV and these flavonoids can help dampen gut inflammation in the event of
accidental gluten exposure. You may find you need to take large amounts after exposure or take
smaller amounts frequently to dampen inflammation and relieve symptoms.
I use a product called GlutenFlam™ by Apex Energetics.
To learn more, download my free guide Gluten and the Brain.
