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Dear List,

I have been following the conversation on Tylenol, and I have also called the
company and been told that the product is gluten-free.  However, the
controversy on prescription and nonprescription drugs was started by the
following article:  "Identification of Gliadin Presence in Pharmaceutical
Products"  by I. Miletic et al., Journal of Pediatric Gastroenterology and
Nutrition, Vol. 19, No. 1, 27-33, 1994.

Briefly, the authors ground up several drugs and tested them for gliadin using
an antibody to gliadin in a dot-blot assay.  They used gliadin extracted from
wheat flour as the standard for a positive reaction.  The lowest level of
sensitivity is 0.0115 milligrams (mg) per tablet.  by this test, about 70% of
prescription and nonprescription drugs contain some gliadin (the toxic protein
in wheat gluten), including Tylenol tablets and gelcaps. They cite an article
which claims that 5-13 mg/ day of gliadin is considered to be safe by biopsy
studies:  Ciclitira et al, Panminerva Med 1991; 33:61-4.  I have not read this
article.  In this study, they say that Tylenol tablets contain 1.84 mg/ tablet.
The authors believe the source of the contamination to be pharmaceutical
starch.  this is different from "starch" used in food products and is usually
industrial grade starch.

The bottom line recommendation in this paper is that if you are going to take a
drug every day or several times a day for a few days you need to worry about
small amounts of gliadin in it.

I am a graduate student, so this is not medical advice. There are often
alternative medicines that don't contain anything related to starch, so I try
to take those whenever possible.  Otherwise, each of us has to weigh the
benefits and risks for ourselves.

Good health to all!

Ann Herman
Stanford, CA
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