Although it is not entirely accepted across the conventional healthcare system, in 2009 Dr. Alessio Fasano, a world-renowned pediatric gastroenterologist and research scientist, published a landmark study (for those interested Chris Kresser interviewed Dr. Fasano on the findings in 2012) showing that gluten may be a factor in many autoimmune diseases, not just celiac disease. (1) In his research he showed that gluten triggers the release of zonulin, a molecule that opens the tight junctions of intestinal lining, making the gut “leaky.” The resulting leaky gut, he suggested, contributes to the development of many different autoimmune disorders.
That work from Dr. Fasano was groundbreaking and most of us in the AIP community didn’t have to be told twice. We work to avoid gluten in our diets, regardless of a celiac diagnosis, because we know from personal experience that what Dr. Fasano uncovered has merit. Gluten is just not worth the setback for those of us with autoimmune disease!
Despite our best efforts though, gluten sometimes sneaks its way in. Food ingredient labeling laws help a lot and in just the ten years since my own celiac diagnosis, understanding and accommodation has come a long way in not just restaurants and other public venues, but also in the general public. Even so, getting glutened happens. This guide is all about getting you back to feeling your best quickly.
Why Does Gluten Make Us Sick?
As a health coach, I’m a big fan of why, because it usually helps my clients better embrace changes that benefit their health. At the same time, I try to keep that information simplified and focus on action over drowning in paralyzing information! We already touched on Dr. Fasano’s research, but let’s see if we can boil this “why” down further.
Gluten is an especially toxic lectin (a class of protein that is part of a plant’s defense system) called a prolamin. It’s not easily broken down by our digestive enzymes and the fragments then match with receptors in the membranes of the cells that make up our intestinal lining. That “match up” is what stimulates the release of zonulin inside the gut and starts the “leaking.” Once the tight junctions are open, bacteria can leak through which makes our immune system mad, so it produces antibodies, which leads to inflammation. The impact of the inflammation is what makes us feel so terrible.
As always, if you’d like to dive much deeper, we recommend you check out what our friend, Dr. Sarah Ballantyne, has written on gluten. (2)
Signs and Symptoms of Gluten Exposure
Chances are good that you know your personal gluten reaction well, but with celiac disease specifically having over 200 symptoms, it’s smart for those of us with autoimmune disease to have a good understanding of common symptoms. Doing some food journaling can help you develop an awareness of how gluten impacts you individually. Common symptoms include:
- Abdominal pain
- Mood swings
- Skin issues/rashes/mouth ulcers
- Joint pain
Don’t discount symptoms that aren’t gastrointestinal! While GI symptoms are a common sign of gluten exposure research shows among adults with celiac disease, only a third experience primarily GI symptoms. (3) In my personal experience, gluten caused mood swings, paralyzing anxiety, stuttering, trouble with my fine motor skills, and more. GI symptoms weren’t that profound for me, even after a decade without diagnosis and lots of damage to my small intestine.
Managing A “Glutening”
So, you went out to Great-Grandma Helen’s 90th at a restaurant you weren’t feeling so confident about and even though you tried your best, you woke up with your classic glutening symptoms in the middle of the night. How do you manage?
- Start by focusing on hydration. Get plenty of fluids and consider adding a pinch of sea salt to each glass of water if you are experiencing diarrhea or vomiting.
- Consider a binder. Activated charcoal binds toxins and can decrease gas and bloating. Do this with caution though, because it will interfere with medications and can lead to constipation if you aren’t drinking lots of water.
- Add an herbal tea to help with GI pain. Peppermint, chamomile, and ginger are especially effective at calming cramping, gas, and nausea.
- Add healing elements. Now is the time for bone broth, stirring a little collagen in your herbal tea, or l-glutamine. These options are focused on the amino acids that can help repair the gut lining. You could also consider herbs that coat the gastrointestinal tract and soothe it, like slippery elm and marshmallow root (like charcoal, these can impact medication absorption, so talk to your doctor).
- Keep your diet simple. For a few days keep your diet to easily digested foods (chicken soup, for example) and not too much fat (it can have a laxative effect, which you might not want if you’re experiencing diarrhea). As your system feels less raw, start focusing on omega-3 rich foods that are anti-inflammatory, like salmon, well-cooked veggies, and consider avoiding dairy and sugar, even if you are no longer in AIP elimination phase.
- Get some rest. Getting glutened can leave you feeling like you were hit by a truck. Prioritize as much rest as possible.
Pro-tip: As a celiac myself, I’ve found that healing from gluten exposure goes faster if I am getting lots of sunlight and prioritizing beef liver. I suspect that the Vitamin D production and incredible nutrient density of the liver are what helps.
What About Enzymes?
I know, I know . . . you’ve heard there are enzymes you can take that will help you digest gluten more rapidly and end this terrible glutening in no time. Your favorite functional medicine practitioner might even be selling them on their website and you’re wondering why it’s not included in our list. The truth is that research to this point has found that the digestive enzymes developed so far aren’t truly effective at degrading gluten. (4) There is further research being done though that will hopefully develop successful enzyme treatments, among others types of treatment, to help prevent the damaging effects of gluten. (5,6) For now, the best way to handle getting glutened is the simple steps above and giving yourself time.
How Long Will Healing from Gluten Exposure Take
The timeline for how long healing from gluten exposure will take is highly individual and dependent on a lot of factors. (7) It could be only a few days until you have no symptoms and only a few weeks for your intestine to have completely repaired itself. On the other hand, especially for diagnosed celiacs, symptoms can take months to subside, and it could be years before the intestine is truly healed.
That’s a little depressing to write. Here’s the good news: If you’re actively avoiding further exposure and taking steps to reduce inflammation and provide your body with the nutrients it needs to heal, you may be in better shape sooner than expected. For example, I am incredibly cautious about gluten exposure, even still I am certain I have had accidental exposures over the last few years. I didn’t have symptoms that lasted longer than day or two and I have annual checkups that show my antibody levels aren’t elevated. Zero antibodies, plus absence of the kinds of symptoms I had when my small intestine still showed severe blunting of the intestinal villi upon endoscopy, tells me that my intestine is healing quickly if there are accidental exposures.
There it is! The healing guide to gluten exposure! No sensationalized “gluten is no problem” approaches, but trustworthy info. We don’t want to stop here though because we’re really interested and we’re sure you are too. Let’s take the opportunity to conduct a little informal survey for the community. In the comments, please share with us:
- What autoimmune disease are you dealing with?
- What’s a “glutening” like for you?
- What are your tips for feeling better and how quickly do you typically recover?
We’re excited to keep learning about gluten and autoimmune disease! Thanks for sharing your experience.
- Visser J;Rozing J;Sapone A;Lammers K;Fasano A; (2009, May). Tight junctions, INTESTINAL PERMEABILITY, and autoimmunity: Celiac disease and type 1 Diabetes paradigms. Annals of the New York Academy of Sciences. Retrieved September 27, 2021, from https://pubmed.ncbi.nlm.nih.gov/19538307/.
- Ballantyne, D. S. (2020, April 26). How gluten (and OTHER Prolamins) damage the gut. The Paleo Mom. Retrieved September 27, 2021, from https://www.thepaleomom.com/how-gluten-and-other-prolamins-damage-the-gut/.
- Celiac disease SYMPTOMS: University of Chicago celiac Disease Center. University of Chicago Celiac Disease Center |. (2016, July 6). Retrieved September 27, 2021, from https://www.cureceliacdisease.org/symptoms/.
- Janssen, G., Christis, C., Kooy-Winkelaar, Y., Edens, L., Smith, D., Veelen, P. van, & Koning, F. (2015, June). Ineffective degradation of immunogenic gluten epitopes by currently available digestive enzyme supplements. PLOS ONE. Retrieved September 27, 2021, from https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0128065.
- Segura, V., Ruiz-Carnicer, Á., Sousa, C., & Moreno, M. de. (2021). New insights into non-dietary treatment in celiac disease: Emerging therapeutic options. Nutrients, 13(7), 2146. https://doi.org/10.3390/nu13072146
- Wei, G., Helmerhorst, E. J., Darwish, G., Blumenkranz, G., & Schuppan, D. (2020, July 15). Gluten degrading enzymes for treatment of celiac disease. Nutrients. Retrieved September 27, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400306/.
- Ballantyne, D. S. (2020, June 15). How long does it take the gut to repair after gluten exposure? The Paleo Mom. Retrieved September 27, 2021, from https://www.thepaleomom.com/how-long-does-it-take-the-gut-to-repair-after-gluten-exposure/.