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Recently, Rebecca Markle <[log in to unmask]> posted a very interesting
email about the possible distinction between gluten intolerance and
Celiac Disease.  She said in part:
 
>I want to summarize what I know, because I don't think
>everyone is aware that there are two distinct conditions
>that respond to a gluten-free/dairy-free diet.
 
>        CELIAC DISEASE               GlUTEN INTOLERANCE
 
>Symptoms: Diarrhea and weight        Gray Area.  Linked with migraines,
>loss prevalent, ranges to con-       dyslexia, hayfever, excema.
>stipation.                           Not sure about precise bowel
>                                     symptoms.
 
>Celiacs suffer from lactose          GI's are casein intolerant.
>intolarance, a temporary             Permanent condition.
>condition till the villi
>regenerate.
 
>Celiac disease characterized         GI seems to be inability to
>by destruction of the surface        fully digest and break down
>of the intestinal wall.              particular protein chains,
>                                     including those found in wheat
>                                     (gliadin?) and dairy (casein).
 
>How diagnosed:  biopsy               How diagnosed?  test for
>                                     "leaky gut"?
 
While this is a most interesting and thought-provoking notion, as
listowners we are concerned that our subscribers will conclude that
these points are all scientifically settled.  It is our understanding
that they are not.  Here is our understanding, based on reading list
traffic for the past year+:
 
a) The work of Shattock (England) and Reichelt (Norway) has shown that
many (but not all) individuals with developmental delays or problems
(autism, attention deficit, dyslexia, schziophrenia) have symptoms of
gluten and casein intolerance.  These researchers have found that in
these subjects, the urine shows abnormal levels of certain peptides
(peptides are protein fractions), and that by removing gluten and
casein, the behavioral problems appear to improve.
 
b) Reichelt has stated that he doubts these people have classic celiac
disease.  In one article, he noted that in a sample of about 150
autistics where endomysial antibodies where checked, and biopsies
obtained where indicated, only 3 Celiacs were found.  The proportion of
celiacs in this autism population (1 in 50) is far higher than the
ordinary population, but clearly all autistic people do not have classic
Celiac Disease.
 
c) While this is extremely exciting research which should be expanded,
it is important for our subscribers to know that it is not the
mainstream accepted wisdom that all people with developmental problems
should go on a GF diet.  Neither researcher is claiming that simply
going off gluten and casein will ensure an immediate and complete
recovery from these serious developmental problems.
 
d) Neither Shattock nor Reichelt (nor anyone else we know of) has put
forward a proof of the mechanics of how gluten and casein harm those
with developmental delays.  It is well established that many (but not
all) Celiacs with absolutely no developmental problems, after ingesting
gluten, begin to display temporary symptoms of mental or emotional
imbalance.  Thus, while it is tempting to consider all the similarities,
there is a great deal which is still not known.  It may be that
different protein fractions are responsible for Celiac Disease and
gluten intolerance in autism, or they may be the same.  No one knows.
It may be that in people with one type of genetic predisposition,
exposure to gluten causes Celiac while in others, exposure causes a
developmental problem.  In any event, it is not accurate to imply that
it is well settled that Gluten Intolerance and Celiac Disease are two
medically distinct conditions.
 
e) As to milk intolerance, some but not all Celiacs have a problem with
milk.  The problem is traditionally associated with lactose, not casein,
and some celiacs do well with lactose-reduced milk which has its full
complement of casein.  Many, but not all, of the lactose intolerant
celiacs eventually are able to digest milk products as their villi heal.
 
f) It is well established that some people have a traditional allergy to
wheat (and others to milk) even though intestinal biopsies are normal.
These allergic responses appear to be medically distinct from either
Celiac disease or autism, although the mechanics could be related.
Thus, it is not accurate to state that everyone with Gluten Intolerance
has a permanent casein intolerance.
 
Bec has touched upon what we consider to be the most medically important
and exciting research areas in the Celiac field.  We hope that
traditional celiac researchers will team up with researchers in the
developmental delay fields to further explore these critical questions.
 
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-- Jim Lyles ................... Home: [log in to unmask]
-- Holly, Michigan, USA ........ Work: [log in to unmask]
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