Is There a Supplement Worth Trying for Gluten Sensitivity?

I have theories about why more people, including myself, are reporting sensitivity to gluten. And this has led me to ask if a particular supplement might be helpful.

What is gluten sensitivity and what are its symptoms?

Abdominal pain, bloating, diarrhea, constipation, and fatigue are a few of the symptoms that may go away when people eliminate gluten from their diets. If medical tests have ruled out celiac disease and wheat allergy, then by default it’s called gluten sensitivity. I talked about the differences between celiac, allergies, and sensitivities in a previous blog.

Gluten sensitivity—or is it wheat sensitivity? 

In practice, eliminating gluten means avoiding wheat, barley, and rye. But in addition to gluten, these grains contain other irritating components including amylase trypsin inhibitors (ATIs). If you feel better when avoiding wheat, it’s not clear whether or not the gluten was solely responsible.

And scientific research on purified gluten may be missing the real-life consequences of eating wheat.

There’s no definitive test for it yet, but gluten/wheat sensitivity is real. It is being investigated at universities in England, Mexico, Italy, and The Netherlands. We’re learning more and more about gluten and how this unusual protein interacts with our gastrointestinal (GI) tract and immune system. And the latest finding to catch my eye had to do with effects on the nervous system. A study at the Sheffield Institute of Gluten Related Disorders reported issues with sensory nerves—tingling, numbness, and buzzing—that improved with a gluten-free (GF) diet. These findings were not restricted to people with celiac disease.

Given the skepticism around gluten sensitivity, I was amazed to find research linking gluten to symptoms outside of the GI tract, including headaches, brain fog, and problems with balance. And gluten has been linked to neuropathy that may result in loss of feeling, numbness, burning and pain in any area of the body. This is new territory, and it takes an average of 10 years longer to be diagnosed with gluten sensitivity if you suffer with non-GI symptoms compared to GI symptoms.

Why does gluten cause these problems?

Gluten is an unusual protein that is difficult to digest. Instead of being efficiently broken down by digestive enzymes to individual amino acids or tiny two or three amino acid peptides, its digestion yields longer gliadin peptides. Gliadin peptides may be toxic and inflammatory. Some people handle them just fine, while in others these peptides may contribute to celiac disease and possibly to gluten sensitivity. ATIs in wheat are also difficult to digest.

 Antibodies to gliadin may turn out to be useful for diagnosis of gluten sensitivity. Some people with IBS have antibodies to gliadin, evidence that their bodies consider it harmful and have mounted an immune response to it. These people report improvement of their IBS symptoms on a gluten-free diet.

Why are so many people reporting gluten sensitivity these days?

I’m proposing several reasons why I and others may have become sensitive to gluten: We did not evolve to eat wheat; today’s wheat contains high levels of gluten; repeated antibiotic use may play a role; and our digestion may slow down with age.

We are consuming more gluten (and ATIs) than our bodies evolved to handle.

It’s only been 10,000 years or so that people have cultivated grains on a large scale, and there is a lot more gluten in wheat these days compared to a generation ago. An article summarizing changes in wheat composition stated, “Breeders were instructed in the mid-1990s to increase gluten strength. Wheat flour has been bred to contain high levels of gluten.” I’m not the only scientist wondering whether or not the resulting strains of high-gluten wheat are contributing to increasing gluten sensitivity.  

And compared to older varieties of wheat, modern ones contain more of the ATIs that likely contribute to wheat sensitivities.

Repeated use of antibiotics may have affected our GI health.

The gut microflora plays a large role in digestive health, and this flora is disrupted by antibiotics. It’s possible that the use of antibiotics has affected our ability to digest gluten and ATIs. The use of antibiotics didn’t become common in the US until the 1960s, and it increased through the 1990s, until efforts were made to reduce unnecessary prescriptions. Many of us have been exposed to repeated courses of antibiotic treatment.

Our ability to digest protein in general may become lower over time.

In preliminary research, the average age that gluten sensitivity was reported was 55. Perhaps as our digestive tracts generally become weaker as we grow older, we may not digest protein as well. And gluten and ATIs are both resistant to digestion to begin with. There’s evidence that the production of protein-digesting enzymes may slow down with age from animal research.

Other than avoiding gluten, is there anything we can do?

Can we boost gluten digestion?

There’s not much clinical research on products that might help us handle gluten. It will be years before efficacious products are developed and recognized by the medical profession. But there are two that might be worth trying, probiotics and digestive enzymes. If you are inspired to try a new supplement, always check in with your health care practitioner first.

Probiotic bacteria might be helpful.

Preliminary research suggested that certain probiotic strains may be able to help break down gliadin into smaller, less toxic peptides. This has been reported with a mixture of probiotic lactobacilli and bifidobacteria, as well as with a combination of lactobacilli and Streptococcus thermophilus. It remains to be seen whether probiotic supplements promote gliadin digestion in the human body.

It would be even more desirable to break down the gluten in grains before consuming them. Yeast and bacteria in sourdough starter might be able to help do this under the right conditions, so people have tried fermenting bread dough for extended periods of time. And it has been proposed—this was even told to a family member by a medical doctor— that sourdough bread may be less irritating to the gut than other bread. Although this sounds reasonable in theory, fermentation hasn’t turned out to be an efficient way to break down gluten, and we don’t yet have evidence that sourdough bread is better tolerated.

Digestive enzyme supplements, including some targeted at gluten, are sold OTC.

Dietary supplements are available that contain gluten-digesting enzymes such as Tolerase-G (AN-PEP) and dipeptidyl-dipeptidase-IV (DPP-IV). I discussed the pros and cons of such products in an article I wrote for the goop PhD library a few years ago. These and other enzymes are being tested in clinical research on people with celiac disease. We don’t yet have evidence that they will be helpful for people with celiac disease or with gluten sensitivity.

My foray into self-experimentation

As I’ve written about previously in this blog, the consequence when I eat wheat is predictable constipation within 24 to 48 hours. I decided to experiment on myself by eating wheat together with an enzyme supplement. This was not a product specifically targeting gluten, but one that I happened to be familiar with from my former position at the company that makes it. Source Naturals’ Daily Essential Enzymes contains two enzymes that digest protein together with enzymes that digest fat, starch, and fibers.

The three times I’ve taken this supplement at the start of a meal and allowed myself a piece of chewy, moist wheat bread my digestion and elimination have been fine. I’ll update this as I experiment more, but so far, so good.

 My experience is not likely to be generalizable. Wheat sensitivity is not one simple phenomenon, and we don’t know how to recognize, yet alone treat all the variations. However, clinical research still uses a one size fits all approach. Large numbers of people must respond similarly to a treatment, and if not, the value of the treatment is dismissed. What matters in this paradigm is the average response. Because of this, self-diagnosis and experimenting with your gluten sensitivity may be not taken seriously by others.

Thankfully the need for personalized medicine is beginning to be recognized. A new way of thinking is to look at individual responses, to tease out the individuals in whom a treatment works, figuring out why it helps some people and not others. Efforts are being made to acknowledge and compile observations made by individuals to make sense of the vast spectrum of human characteristics and responses.

I’ll be interested to hear from you about your experiences.

Note: I am no longer associated in any way with Threshold Enterprises, the manufacturer of the Source Naturals brand of supplements, and do not benefit financially from sales of their products. Having become well-acquainted with their formulas, manufacturing facility, and quality control processes, I continue to use this brand.