I must hear this lament every single day from someone (including me!). How is it that you can have a migraine, a skin outbreak, a rush to the loo when all you did was eat a gluten free food that could have been cross-contaminated in a factory or put a trial dot of some cosmetic on your arm that contains the teensiest bit of corn citric acid?
This is the question that drives us wild. We try SO hard and still get ‘glutened’.
It all depends really on your own personal level of sensitivity. Some of us can tolerate such cross-contamination without noticeable effect whereas others (like me) are at the hyper end of the spectrum and only have to be exposed to an infinitesimal amount to react.
Even though the tests are done on gliadin and we are supposed to believe that less than 20ppm gliadin is OK for coeliacs/gluten sensitives, this is not actually the case for some. Even the FDA reckons that 1ppm is enough for some people to get intestinal inflammation.
So, I always like it when I see someone else is saying the same things about this as me – it’s lonely out here in the cold ;). Read this great summary of the ‘how much is enough’ debate by Jane Anderson on About.com:
As she says at the end, if you are not healing or getting rid of symptoms enough on the traditional gliadin free diet, then go grain free. If still not, then remove all potential sources in processed foods. That’s what being trulyglutenfree is all about – and I would go further and include toiletries in that too for some.
Of course, Jane is coming to that advice because of the cross-contamination argument – you are reacting because of the cross-contamination of gluten free foods – whereas my belief is that some of us are reacting not just to gliadins but to other forms of gluten found in all grains. End result is the same – no grains.
So, even if you only had a tiny amount, remember this:
The basis of the less than 20ppm being safe is a study by Fasano and colleagues who say:
that many or most people with celiac disease can handle up to 10 milligrams of gluten — the equivalent of 1/8th of a teaspoon of flour, or 1/350th of that slice of bread — in their diets each day without experiencing adverse effects.
However, the study was later criticised for including mostly people who were likely to be on the less sensitive end of the spectrum so that advice may not hold true for some of us more delicate flowers:
[The study] chose people to participate whose intestines were well-healed, meaning those people likely were less-sensitive to gluten cross-contamination than people who hadn’t healed on the gluten-free diet (many people’s intestines fail to heal completely, even after years on the diet). Even so, one person in that study who was consuming 10 milligrams of gluten per day — not 50 milligrams, the highest level — developed a full “clinical relapse” and dropped out of the study due to intolerable symptoms.
Note the assertion there that many people fail to heal on the traditional gluten free diet – the very premise that started me off on this truly gluten free trail in the first place.
So it seems that there is likely to be a percentage of gluten sensitives who will not heal at the so-called safe level. The FDA itself challenged the 20ppm assertion itself and:
found that for the most sensitive people, intestinal damage begins at 0.4 milligrams of gluten per day (1/200th of a teaspoon of flour or 1/8,750th of that slice of bread), while symptoms begin at 0.015 milligrams of gluten per day (less than 1/500th of a teaspoon of flour or 1/233,333th of that slice of bread).
That’s a mere speck of gliadin. Note the symptoms starting at a much lower level than the intestinal damage – our bodies warning signal, maybe? Having said that, the intestinal damage begins at a ridiculously low level too. I wonder what they would find if they actually tested glutens from the different grains..
Fascinating stuff, anyway. Thanks to Jane for a great summary.