Establishing Your Healing Protocol
Now you know the diet you need (or as close to it as you’re going to get), the next thing is to suss out the best supplemental treatment to heal yourself with.
The vast majority of coeliacs, according to statistics, do not heal on a gluten free diet. That’s partly because, with both CD and NCGS, the inflammation, malabsorption and autoimmunity (if triggered) continue for a long time – despite a gluten free diet – and need to be addressed. The days of just treating with a gluten free diet are over. At least according to lots of experts, including me. We are just waiting for mainstream to catch up 😉
Getting gluten free ‘enough’ is nigh on impossible as we now know that such a tiny amount can trigger a damaging process that lasts a couple of months. So, the emphasis needs to be on healing the barriers to stop anything getting through to the bloodstream in the first place, and calming the inflammation down that is already going on.
What Happens In the Body?
This is an emerging scientific field with a truly fantastic amount of research coming out almost daily. But, this is what we think so far (see following diagram).
To trigger the GRD process, we need:
1. An environmental trigger of some kind (in this case gluten is the main one, but dairy, a fungus, bacteria, stress, trauma, chemical toxin, medicine, drug or virus could be a secondary trigger) plus
2. A genetic susceptibility (the gluten DQ genes, – all of them, not just coeliac DQ2 and DQ8) which leads to
3. An unusually permeable barrier problem. No-one is sure currently whether this always starts with the gut and spreads from there, or can start in the brain and then move onward. Barriers include skin (eg. eczema/dermatitis/psoriasis), lungs (eg. asthma), bladder (eg. interstitial cystitis), blood-brain (eg. migraine, Alzheimer’s, ataxia) and gut. This then leads to
4. Immune dysregulation which causes:
- food and/or environmental sensitivity because of the breached barriers allowing antigens through
- inflammation, either systemic (body-wide) or localised (as in the gut, joints, muscles, nerve fibres, fibromyalgia etc) and/or to
- autoimmunity and molecular mimicry – where the body starts confusing similar-looking food structures for self-antigens of body tissues, glands and cells, as in Hashimoto’s, type 1 diabetes, psoriasis, MS, coeliac disease, parietal cells causing lack of acid and enzymes, adrenal dysfunction, neurological illness etc – could literally be anywhere.
No coincidence then that most gluten sensitives have a problem with poor cognition and memory, neurological issues like anxiety and migraine, muscle and nerve issues, skin diseases like eczema and posriasis, gut symptoms and adrenal/thyroid fatigue Hence it is termed:
A Multi-Organ, Multi-System problem
The Healing Protocols
In order to heal, you need to address some key factors.
Here is a little summary I saw from Liz Lipski, a US clinical nutritionist, on the Gluten Summit 2014. She says for GRDs, we must:
“repair the leaky barriers, strengthen mucosal immunity, get rid of pathogens like candida and infections, support digestion and absorption specifically the stomach acid, digestive enzymes and bile flow, rebalance the microbiome, lower inflammation and address any other food or chemical sensitivities.”
I would also add dealing with any triggered autoimmunity too.
I was SO glad to hear that because it is really the first time I have heard someone agreeing with what I have been saying now for several years!
I have spent the last few years researching barrier repair and gluten related disorders specifically, and have reviewed zillions of different ideas and supplements. This is the approach I have come up with so far:
If you are traditional gluten free and eat dairy, follow this:
Core Traditional Gluten Free Protocol
This is the standard US protocol for gluten-related disorders and I see no reason to mess about with it. It’s just a shame they contain dairy and grains (as colostrum and rice powder mostly) so we can’t all use them.
Use NuMedica’s Gluten Sensitivity products. See Suppliers section here. YHB usually does them.
The general rule for best effect is to do the full Gluten Sensitivity Kit for 2 months, including 2 sprays per day of PRP Balance.
After 2 months, use the Gluten Sensitivity Pack only for 6-12 months. If you can, it is helpful to keep doing the PRP spray and take 1-2 sprays per day for 3 weeks on, 1 week off throughout the 6-12 months. If you weigh more than 150lb, do two packs per day.
The Restore and PRP especially contain dairy-derived ingredients. I am advised that many dairy sensitives (not IgE allergy people) tolerate them well. The PRP spray has very small peptides which makes it easier to tolerate – remember from above that it’s the larger peptides that get through and trigger immune response. If you are severely-sensitive to dairy, I would choose from the protocol below. Your choice.
If you are grain and dairy free, follow this:
If you look at the Numedica protocol above, it is a mix of the following: Anti-inflammatories, D3, fatty acids, gut healers, amino acids, antioxidants aimed at detox pathways, anti-virals, immunoglobulins and probiotics, including saccharomyces boulardii, rhamnosus and longum strains. There is a lot there.
Unfortunately, if you are grain and dairy free, supplements like that just don’t come easily! See here for more on this problem. Even if they state gluten free, they will contain other ingredients derived from grains especially corn. Did you know, for example, that 99.9% of Vitamin C is made from corn?! What we have to do is follow the same principles as the core standard protocol above, but do it using separate products a lot of the time.
Core TGF Gluten Protocol:
These are the top three core products I use in the grain and dairy free version. The rest of the protocol is a kind of ‘pick & mix’ where you choose what products you need as add-ons, depending on what’s going on in your particular case. Please make sure you read the whole Step 3 section in the Gluten Plan for much more about these products, dosages etc and others that you could substitute, plus products for specific issues as below. And always work with your health practitioner!
- Twinlabs Allergy Multi (temporarily discontinued May 16) so use ARG MultiViMin with copper and iron instead. There are two versions of this multi. This ‘with Cu and Fe’ version has none of the corny Vitamin C in the ‘without Copper and iron’ version, so is a much better bet. It does have the more absorbable folate and B12 forms which initially are fermented on corn, but we have found that the vast majority of people have been fine with it. If you are not, use combinations of other vits and mins products from the master list.
- Biotics EFA Sirt Supreme (NB. This has recently changed from Higher Nature Complete Omegas 3:6:7:9 as it now contains citric acid from corn :()
- Kirkman Pro-Bio Gold Hypoallergenic
See Suppliers for where to get these.
We talked about this in Step 2. Check your hyper-permeability levels: if you are too leaky, you will allow food sensitivities, inflammation and autoimmunity to run riot in the future, despite your diet. Do Array 2 (gut) and/or Array 20 (blood-brain barrier), the latter especially if your symptoms are neurological eg. migraine, mood, MS etc. The Arrays 2/20 will act as a starting point and progress marker later for your diet to expand. If anything is positive, treat for barrier healing using the advice in the Gluten Plan. This is not as simple as just taking glutamine, we have found, not least because glutamine feeds candida; good lesson that one!
Most gluten sensitives are malabsorbing in some way whether because of villi flattening (coeliac disease), inflammation (NCGS’s) or autommmune processes (eg parietal cells in the stomach) so you need to address your nutrient needs and boost them. Take a good gluten free multivitamin/mineral and some fatty acids as a base (as above). Do any nutrient checks needed, especially red blood cell minerals, Vitamin D, anaemia and bone markers and add anything required using the TGF safe supplements given in the Gluten Plan. Vitamin D and red blood cell magnesium have been especially important for healing we have found clinically so far. Don’t underestimate them. And don’t believe a Vitamin D test result of less than 100nmol/L or 40ug/L is OK for you, it isn’t. I aim for at least 150nmol or 65ug.
Gut Status and Inflammation
Next, check the state of your gut environment (eg bacteria, candida, parasites etc) to make sure you are not harbouring chronic infections that would scupper healing. This is the single biggest area we have found over the last few years that can hinder the healing process. Do the Doctor’s Data Stool Test, which will also give an indication of digestive ability and gut inflammation. It is also a good idea to check whole body levels of inflammation, so ask your doctor to test your ESR and CRP levels, or do this Inflammation Test. If anything is positive do an appropriate Gut Detox or Candida Plan and use a natural anti-inflammatory using the choices given in the Gluten Plan. Viruses can also be a trigger and need addressing, so don’t forget those either. So-called benign ones rarely actually are. Read more in the Gluten Plan about which viruses to check, how and which infectious nasties we already know can cross-react with gluten, for example.
Finally, but possibly most importantly for your future health, you need to look for any autoimmunity processes going on: do Array 5 to look for predictive antibodies to several organs and glands including thyroid, adrenals, intrinsic factor, parietal cells etc. If anything positive is found, treat for auto-immunity using the extended section on this in the Gluten Plan.
There are tons of other issues we could go through, including methylation difficulties, poor liver detox, adrenal and thyroid status etc, but these are some really key ones. There is much more on these and other specific issues in the Gluten Plan – check the Contents List to see what’s covered – that’s in the 38 page Preview here.