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Episode 32
The Doctor's Farmacy: House Call

Is Gluten-Free A Fad Or Is Gluten A Real Threat To Our Health? with Maggie Ward

Open the Podcasts app and search for The Doctor’s Farmacy. If you’re viewing this site on your phone, you can just tap on the

Tap the subscribe button and new shows will be added to your library.

If you’re using a different device, our show is available on the following platforms.

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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 Course.

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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

I hope you enjoyed this conversation as much as I did. Wishing you health and happiness,
Mark Hyman, MD
Mark Hyman, MD

Guest

 
Mark Hyman, MD

Mark Hyman, MD is the Founder and Director of The UltraWellness Center, the Head of Strategy and Innovation of Cleveland Clinic's Center for Functional Medicine, and a 13-time New York Times Bestselling author.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

 
Maggie Ward, MS, RD, LDN

Maggie is the Nutrition Director at The UltraWellness Center and holds a Master’s degree in Nutrition from Bastyr University and ongoing clinical training through the Institute for Functional Medicine. She focuses on food allergies, digestive disorders, inflammatory conditions, pediatrics and sports nutrition.

Show Notes

  1. Why gluten needs to go if you have Hashimoto’s
  2. To Gluten or Not to Gluten
  3. Should we all avoid gluten?
  4. Here’s Why A Gluten-Free Diet Can Become Incredibly Unhealthy
  5. Gluten and Dairy-Free Recipes Even an Italian Can Love
  6. Top 5 Diet Changes for Autoimmunity

Transcript

Maggie Ward:
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 tests that we’ve done, but they have to pretty much treat themselves as if.

Dr. Mark Hyman:
Welcome to the Doctor’s Farmacy. I’m Dr. Mark Hyman and that’s Farmacy, F-A-R-M-A-C-Y. And this today is a special episode of the Doctor’s Farmacy called House-call with none other than my Nutrition Director at the UltraWellness 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.

Maggie Ward:
Thank you. So good to be here.

Dr. Mark Hyman:
Maggie is awesome. She’d been my nutrition director for 12 years. She went to Bastyr University and got a master’s in nutrition.

Dr. Mark Hyman:
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’re the bomb, Maggie. Thank you for joining us.

Maggie Ward:
I’m happy to be here. Thanks for having me.

Dr. Mark Hyman:
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.

Maggie Ward:
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 [crosstalk 00:01:51] yeah, so there are other grains within that domain-

Dr. Mark Hyman:
And even oats is often-

Maggie Ward:
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. 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 UltraWellness 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?

Dr. Mark Hyman:
So Maggie, how come gluten all of a sudden a thing, because when I went to medical school 30 years ago, you had celiac disease and maybe a few people had it. It was a very small percent of the population, 1% of the population, but now you’ve got like 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?

Maggie Ward:
When it started 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.

Maggie Ward:
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 tests that we’ve done, but they have to pretty much treat themselves as if. So, that’s, I think where-

Dr. Mark Hyman:
It’s not an on or off phenomenon where you have it or you don’t because traditional medicine, you go to the doctor, they go, “Well, if you have had an abnormal biopsy of your intestine, you have celiac, otherwise you don’t. So don’t worry about it.

Maggie Ward:
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. I saw it years ago and I had so many folks telling me when they came back like, “Oh 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 that they hybridized 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 loafs of bread and more is better in this country. So I think that’s a part of it. We spray it with St. Mary’s pesticides, and there’s a good chance people are reacting to that.

Dr. Mark Hyman:
Yeah, it destroys the microbiome.

Maggie Ward:
Exactly. So once you muck up with the gut microbiome, you’re going to 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 I don’t always-

Dr. Mark Hyman:
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. They’ve hybridized it. The dwarf wheat has way more gluten proteins and way more inflammatory gluten proteins than heirloom wheat. You spray with glyphosate, 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 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 with people.

Dr. Mark Hyman:
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 diets, starch sugar, low fiber, processed food, which damaged our microbiome, makes them more likely to have a leaky gut. We take antibiotics. We take acid blocking drugs, we take steroids, we take hormones. All of which mess up our gut. We are having increased rates of C-section, increased rates of bottle feeding. All these things make your gut more likely to be a little sensitive. So that’s why we’re seeing this sort of escalation of gluten sensitivity for the last 50 years and it’s real.

Maggie Ward:
Right. And not many of us are eating these like whole wheat berries. I mean, we’re eating in the form of flowers. So even if you get organic bread, 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-

Dr. Mark Hyman:
And gluten free junk food is still junk food. Cake and cookies, if it’s gluten-free is still cake and cookies.

Maggie Ward:
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. Not across the board, but I’ve had brain fog get better taking gluten out. I’ve had joint pain get better. I’ve had skin get better. So 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’ll take it out of your diet too.”

Dr. Mark Hyman:
Well, we see people who come to see us who are ill. And so we have a select, we call selection bias. But I would say when people walk in the door with any kind of chronic illness, for me checking gluten antibodies and what we call a Cyrex 3 test, which we’ll get into, which looks at way more proteins 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 was 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.

Maggie Ward:
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. So an infection, a really stressful event, toxins again. Something has compromised your gut lining and now you’re reacting to these proteins. So for some people that might not even be a life sentence. I mean, if they have celiac or something similar, they have to be really careful. But other people, sometimes if you get the gut sorted out and healed, they can tolerate some of these proteins.

Dr. Mark Hyman:
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 because I’ve fixed 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 then 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 say it’s genetic about 30 plus percent of the population has the gene for celiac. And only 1% get it and I think it’s all the things you’re saying, it’s all these insults that are from the environment or diet antibiotics, et cetera, that make us susceptible.

Maggie Ward:
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 genetic.

Dr. Mark Hyman:
It’s a spectrum like, like you look at the antibody test and there’s a normal level. Like there’s a zero to 20 or whatever on the antibody tests on your blood level. But when you think about it, there is no normal level of antibodies to gluten in your blood. And you talked to Dr. Alessio Fasano who’s been on the podcast as the world’s expert in gluten, at Harvard and… Brilliant guy. And he said 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.” So if the level is five, it’s not as bad as 20, but it’s not as good as zero.

Maggie Ward:
Right. And you don’t want to go to 20.

Dr. Mark Hyman:
Right. A lot will say my tests were fine, but they may… It’s a spectrum, it’s a continuum, it’s not on or off. And it’s always worth doing an elimination diet because the cost is low, the benefits are 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 worse, there’s your answer.

Maggie Ward:
Right. Right. I think it’s a little tricky too though with gluten, because typically with elimination diet, if you 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. I saw it 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. 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, “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 my joints finally started feeling better around that point. So that’s something to keep in mind.

Dr. Mark Hyman:
The strata patient, she was off for 10 weeks before she started feeling better with psoriatic arthritis.

Maggie Ward:
Right. Yeah. And 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 it sneaks in, in a lot of places which we’ll talk about, but most folks who are fairly sensitive have to be a hundred plus percent off of it, or they will still,

Dr. Mark Hyman:
And it’s 150%. Dr. Fasano said to me, once is if you have a thumb fall, a thumbnail fall of gluten in three months, you’re back to zero. You can’t even cheat a little bit, because your body then creates an immune response. And I remember a patient who had rheumatoid arthritis and she was very good. But she was trying all the functional medicine stuff. She would get a little bit better. It was wasn’t cutting it. And I said, “Look, you think you’re gluten free. And I went through her diet and 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 in just a 10 day ultra clear plus shake, which is what we’re using back then, which was basically a rice protein, low allergenic. Just no other food, just this shake for 10 days and see what happens. Everything went away.

Dr. Mark Hyman:
And I was like, “Wow. And I think I saw her three months later or six months later, and she’d completely changed. She lost 40 pounds. Her arthritis was gone. She felt great. 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 because when you look, for example, in 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, auto immune diseases, migraines, I mean just disease after disease. And if you really look at that list, and that’s just I think, a shortlist compared to the 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.

Maggie Ward:
Right? And this is where two testing can be helpful because there’s some people that think they’re 100% off of it. 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. And there’s about 32 different immune markers that they’re looking at. Various parts of the gluten protein and wheat and other proteins within wheat, so it’s a very sensitive test.

Maggie Ward:
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 not everyone in the house is gluten-free and they’re sharing space and food. So this is where 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.

Dr. Mark Hyman:
Hey, everybody it’s Dr. Hyman. Thanks for tuning into the Doctor’s Farmacy. 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 weekly newsletter. And in it, I share my favorite stuff from foods, to supplements, to gadgets, to tools to enhance your health. It’s all the cool stuff that I use and that my team uses to optimize and enhance our health. And I’d love you to sign up for the weekly newsletter. I’ll only send it to you once a week on Fridays. Nothing else I promise. And all you do is go to drhyman.com/picks to sign up. That’s drhyman.com/picks, P-I-C-K-S and sign up for the newsletter and I’ll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Now, back to this week’s episode. So tell us about some of the common things we see. One of the cases you had was a-

Maggie Ward:
Yeah. So I wanted to kind of focus on autoimmunity because that’s a lot. Anytime I see someone with 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-

Dr. Mark Hyman:
I want to emphasize what you just 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.

Maggie Ward:
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 now we’re we test for it so much more. So even on celiac, we do find it can trigger a lot of other autoimmune conditions. So that’s, I was kind of wanting to focus on two cases around auto-immunity 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, a high exercise person. She came with severe fatigue just in for nutrition because I think she would want 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. Were some of the highest I’ve ever seen.

Maggie Ward:
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. Her summer nutritional labs, like 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. So I like I always do with autoimmune and I’m like, “Let’s take all the gluten out.” She kind of did her own research and went full on Paleo, which takes out all the grains and all the legumes, which sometimes really can make a difference for folks that are gluten sensitive. And I really focused again, getting enough good fats and protein. Good quality carbohydrates in her diet. With the exercise piece, I was thinking there could be an adrenal component to that and your adrenals are very closely linked to your thyroid. So she worked on some other lifestyle things and did some yoga and restorative stuff that I think-

Dr. Mark Hyman:
When you see how she motos, which is very common. One in five women have no thyroid. A lot of that is thought of be Immune 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, their antibodies are elevated.

Maggie Ward:
Right. It’s a piece of the puzzle.

Dr. Mark Hyman:
When they get off gluten, they get better.

Maggie Ward:
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 again, being a high level triathlete, your digestive system takes a hit to that 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 sometimes the, just the process of going through a pregnancy can switch what goes on with the immune system as well.

Dr. Mark Hyman:
And in her blood tests you found [inaudible 00:18:55]

Maggie Ward:
Yeah. 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 transfer glutaminase, which is what the kind of the gold standard, so to say, for blood work is for celiac. You can check for antibodies to gliaden, which is part of the gluten protein. You can check for a deamidated gliadin. So I wrote out what to ask her doctor for and they ran it and she did not have the tissue trans glutaminase which mostly is what they’re going to look for celiac, but she did have anti-gliadin antibodies. And I was like, you should not have those so you may not have celiac, but you could have something similar.

Dr. Mark Hyman:
So yeah, so that’s a good point because a lot of doctors will check the basic test and they say, “You’re fine.” And they only check like one antibody called TTG but they don’t check the anti-gliadin antibodies, which are less specific, but actually more sensitive. So they’ll show up often when the other one doesn’t and they do indicate a level of leaky gut, a level of wound sensitivity and they are as definitely contributing to all sorts of issues for people.

Maggie Ward:
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. There’re other things that are going on, but when I had a two-year followup with her, obviously we had a few follow-ups in between, but she said her digestion was great. Her energy was great. Her thyroid antibodies, what I think we hear in conventional medicines, like you got autoimmunity, you have it. Why check antibodies? It doesn’t go away. So her thyroid peroxidase, 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.

Dr. Mark Hyman:
So that’s remarkable. So she had one of the highest levels of autoimmune anybody you’d ever seen. And after getting her gut sorted and getting the gluten out of her diet and optimizing nutritional status.

Maggie Ward:
And stress reduction.

Dr. Mark Hyman:
She actually had the complete normalization and one of them and almost normal, the other one, which quote doesn’t happen in traditional medicine .

Maggie Ward:
On armor she’s on some thyroid support. She does feel better with it. And I think there’s often a need for it, but she pretty much reversed her autoimmunity by going Paleo. So that was pretty remarkable. It’s nice to see when things kind of quickly turn around for some of us. 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 it’s kind of a combination of in similar lupus or scleroderma, it’s kind of a mix of where autoimmunity can affect many different tissues.

Dr. Mark Hyman:
So it’s a bad autoimmunity. It affects all the tissues and organs, skin, and liver and kidneys and muscles and something else.

Maggie Ward:
And then she came in with all those symptoms. A ton of joint pain. She had a lot of digestive stuff, which she said she kind of always had her whole life, fatigue. She was depressed. She had weight gain probably because she was so inflamed. She wanted to lose about 20 pounds or so. And her symptoms did start in her teens with some exercise stuff. And then by the time she came to see us again, only just in her twenties, she was getting arthritis in her hands. So she was on autoimmune suppressant medication. She was on CellCept, but she had been on a lot of things over the years, Metrazole for her reflux because she had a lot of the digestion issues. She was on a low gluten diet.

Dr. Mark Hyman:
And that doesn’t count.

Maggie Ward:
That’s what I was talking to me. What is low?

Dr. Mark Hyman:
Like being a little bit pregnant.

Maggie Ward:
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 got to be 100%. And she said I do feel like my headaches are worse and my stomach’s worse when I have gluten. So we got our strict gluten-free and I kind of low grain. I tried 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.

Dr. Mark Hyman:
Was it 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 glide in antibodies, but we had UltraWellness 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-

Maggie Ward:
Like the gliadens or glutinis or different parts of the gluten proteins. So they’re breaking them 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 trans glutaminase. So it’s not the same thing as tissue transplant glutaminase. You can’t diagnose celiac with it. But what Cyrex says is that folks that have these other trans glutaminase 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 trans glutaminase is again, that gold standard was borderline high, which it should not really be showing anything.

Maggie Ward:
And our deaminated gliadin was high. She did have the genetic, 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 profiles well. So they’re looking at dairy. Dairy we know is big Allergan in of itself, but a lot of people that react to gluten seem to react to dairy and 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.

Dr. Mark Hyman:
I see that a lot. I mean, Oh, I’m on gluten-free oats,” and I’m like, “No.” If you’re still having any symptoms. Then you should just get rid of all the oats, gluten free or not.

Maggie Ward:
So I tend to throw oats in, in the gluten category. And then they also suspect rice, which I’ve always thought of the 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.

Dr. Mark Hyman:
So what happens is the way I think about is gluten is sort of the gatekeeper. 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.

Maggie Ward:
Absolutely. So I think that’s a fear of so many people when they start reacting to so many things, I’m like a lot of these foods are not at fault. There’s something else compromising your gut.

Dr. Mark Hyman:
Like the innocent bystander.

Maggie Ward:
And I’m like, once that gut gets healthy 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, all the Mannitol lactulose test, which basically looks at what’s leaking through the gut. And she did come back with increased permeability between the the cells that line the digestive track. 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.

Dr. Mark Hyman:
It was 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 my 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 or their grains, but their gut is leaky and needs to be healed.

Dr. Mark Hyman:
So once you take out the damaging force, it can heal a little bit, but that’s where functional medicine comes in. That’s what we do at the UltraWellness 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. And this is so essential for people with celiac. The 5-R 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 the nutrients that help heal the gut and giving all the things that are needed to actually totally fix the problem.

Maggie Ward:
Right. And that’s what we did. The doctor who she was working with here did the 5-R 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 helped you break down your food until you’re able to do it yourself. And then you reinoculate 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. That type of protein. We gave her some zinc.

Maggie Ward:
So all of that was really important because I think if we just took out the gluten and some of these other foods, I mean, she was malnourished and she needed supplemental support and she needed support with their diet. And now as we focused on getting more good fats and protein. She 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 she was getting it and she had lost weight around her belly.

Dr. Mark Hyman:
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. You have rheumatoid arthritis. I just talked to one of my patients yesterday who was struggling and she had rheumatoid arthritis been diagnosed with that or not. She had Lyme disease, not rheumatoid arthritis or another patient had rheumatoid arthritis, but it was gluten. So there’s a joke in functional medicine. Just because you know the name of the disease doesn’t mean what’s wrong with you. Because you have a label, it 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. When you see someone with schizophrenia, you don’t go, “Oh, that’s a gluten problem.” But probably for my 20%, it might be.

Maggie Ward:
Gluteomorphins which are measured in the Cyrex 3. So those are our compounds that get produced when folks aren’t digesting gluten properly and they’re basically like an opioid where they impact cognition. So whenever we see a mood disorder, very common in kids and on the spectrum and things, we take out gluten and we take out dairy because casein, the protein in dairy can do that too. And there’s research on this that these Xeno Morphine’s 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 in with so many different symptoms.

Maggie Ward:
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 them together. And I was like, “You have celiac.” “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.

Dr. Mark Hyman:
Yeah. I had it when I was a kid.

Maggie Ward:
What the thinking was back then and his digestion got better, but he had issues elsewhere. So that’s the, I got to think outside the box.

Dr. Mark Hyman:
Well, this is great, Maggie. Gluten is such a big topic. It’s sort of the topic of comedy shows. [inaudible 00:30:56] It seems like everybody’s doing it, so it must be good. I think there is a reality to this and as functional medicine, doctors and nutritionists, we really see this every day. And 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 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.

Dr. Mark Hyman:
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 or The 10 Day Reset, which now people can do online. They can look up Doctor’s Farmacy. Sorry, do that again. 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, but 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 symptoms, stuff that we think we have to live with.

Dr. Mark Hyman:
I call it FLC syndrome is 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 testing, it’s fine or abnormal, and then draining it. You really need to go through the whole process that we do in functional medicine. And that’s really what we’re for the UltraWellness Center in Lenox, Massachusetts. We’ve 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 with your friends and family on social media. Tell us your experience with the gluten. Are they 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 Farmacy.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

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