Gluten-Free Diet and Rheumatoid Arthritis

Do Food Sensitivity Tests Offer Essential Information?

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I have had rheumatoid arthritis for close to 40 years. I was diagnosed when I was a college freshman. Talk about having your apple cart turned upside down. I have seen my share of doctors -- primary doctors, rheumatologists, orthopedic surgeons, pain management doctor, and even a neurologist. I have taken my share of pills, had more injections and surgeries than I care to count, and juggled treatment regimens periodically to help manage the disease.

Through all of the ups and downs, I can honestly say I have always been a compliant patient. I knew my doctors were giving me their best shot at pain relief (no pun intended), so I felt it was essential to be compliant.

Recently, my primary care doctor ordered blood tests for food sensitivity. I have no digestive issues, so I wasn't quite sure why I was being tested, but it seemed harmless. Results showed a high sensitivity to gluten and mild sensitivity to several other things; milk, chocolate, tomato, egg white. I had read on the report from the laboratory that the test is a guideline but should not be used to diagnose a food allergy or medical condition. I asked the doctor about that. My doctor said the FDA would say these tests are experimental but the doctor emphasized my result for gluten sensitivity was very high. I was very confused. If the results were not to be used for diagnostic purposes and I was having no digestive symptoms, what was the point of knowing this?

We talked longer and besides "gluten-free", I heard words like "functional foods" and "leaky gut" -- popular buzz words that seem to have taken over for "low-carb" and "fat-free". I was informed there was another, more extensive (and expensive) test that could evaluate my blood for sensitivity to 154 foods.

The result would indicate which foods were good or bad for my body. My first inclination was to do it and find out the "good" foods. But, I did more research and found I only eat about 11 of the 154 foods as it is!

While I felt confused when I came home from the doctor, I wasn't sure what exactly had my mind spinning. I mean, I know I eat my share of junk food. I know an anti-inflammatory diet is healthy for anyone. I know about elimination diets for people who suspect they have food sensitivity or allergy. But, why, after all these years are we suddenly focused on gluten, leaky gut, and functional food? Why did it feel like the scope and direction of my care was shifting? To add to my confusion, my doctor admitted that his own blood test showed a high sensitivity to gluten but he made the decision to not go gluten-free. So, why such urgency in my case? Perhaps, if I was newly diagnosed, I would be listening more closely. But, 38 years into it, the mere suggestion that I avoid some of my favorite foods was daunting.

I said I would discuss the test result with my rheumatologist but my primary doctor discouraged that because "the rheumatologist doesn't deal with functional food."

At that point, I knew I just wanted a plate of spaghetti, dinner rolls, and a big chocolate brownie! But seriously, is there too much emphasis on being gluten-free? Or, has this been the missing link all these years? I decided to do my own research online and see what highly-respected resources say about gluten and rheumatoid arthritis.

The Latest Buzz About Gluten-Free Diet

Gluten: 5 Things You Need to Know (CNN.com 04/05/13)

Why We’re Wasting Billions on Gluten-Free Food. (Time.com 03/13/13)

Is Gluten-Free a Lifestyle or a Diet Craze? (USA Today 03/05/13)

The Boy With a Thorn in His Joints. (New York Times 02/01/13)

Gluten: What You Don't Know Might Kill You (Huffington Post 01/02/10)

Essential Information About Gluten Sensitivity and Going Gluten-Free

Gluten Sensitivity Health Risks and Links to Other Conditions. (Celiac Disease & Gluten Sensitivity, About.com, 01/22/13)

Gluten Sensitivity. (Celiac Disease & Gluten Sensitivity, About.com, 02/24/12)

Gluten Sensitivity Tests. (Celiac Disease & Gluten Sensitivity, About.com, 02/15/12)

Why Not Just Go Gluten-Free? (Quest Diagnostics)

How to Go Gluten-Free. (Celiac Disease & Gluten Sensitivity, About.com, 02/13/12)

Getting Out the Gluten. (Harvard Health Publications. June 2009)

Research Findings About Gluten and Rheumatoid Arthritis

Gluten-Free Vegan Diet Induces Decreased LDL and Oxidized LDL Levels and Raised Atheroprotective Natural Antibodies Against Phosphorylcholine in Patients With Rheumatoid Arthritis. (Arthritis Research & Therapy 03/18/08)

A Vegan Diet Free of Gluten Improves the Signs and Symptoms of Rheumatoid Arthritis: The Effects on Arthritis Correlate With a Reduction in Antibodies to Food Antigens. (Rheumatology. October 2001)

Gluten and the Small Intestine in Rheumatoid Arthritis. (The Journal of the American Medical Association. March 7, 1966)

The Bottom Line

The articles I have pointed to are a sampling of the wealth of information about gluten sensitivity that can be found online. The following quote from the Huffington Post blog resonated with me. Mark Hyman, M.D. said, "In light of the new research on the dangers of gluten sensitivity without full blown celiac disease, I consider any elevation of antibodies significant and worthy of a trial of gluten elimination. Many doctors consider elevated anti-gliadin antibodies in the absence of a positive intestinal biopsy showing damage to be "false positives." That means the test looks positive but really isn't significant. We can no longer say that. Positive is positive and, as with all illness, there is a continuum of disease, from mild gluten sensitivity to full-blown celiac disease. If your antibodies are elevated, you should go off gluten and test to see if it is leading to your health problems."

Three things are certain. First, going gluten-free takes commitment. Secondly, you should keep your expectations realistic. Thirdly, you should consult your doctor before making significant dietary changes. I have not yet made the commitment, but if I do, I will report back with the results -- especially if going gluten-free proves beneficial.

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