This is the $60 million question! There are several theories, but the permeability of the gut and other body barriers is the real key to solving the problem, in my opinion, after a lengthy and solid research review of the subject. This is the basis of the Barrier Plan.
The Process As I See It
In effect, damage to the gut caused by viruses in childhood, gluten in the genetically-susceptible, infections, environmental chemicals etc etc leads to a loss of oral tolerance of food and environmental peptides.
In 80% of people, especially those who are gluten sensitive, it also leads to an upregulation of a substance called zonulin which breaks down the tight junctions in the gut wall, causing a leaky gut.
Gut/Mucosal Immunity Starts
You start to get mucosal immune reactions where you produce antibodies in the gut initially which causes even more gut leakyness. This is the first stage of immune reaction and can be measured. If it weren’t for the zonulin and damage done by the gluten especially, the immune reaction would stay at a mucosal level – in the mucosal area of the gut.
Systemic Inflammation and Immune Reactions Start
The second stage is systemic (in the blood stream) where the food and non-food peptides have gone through the gut wall and a different type of immune reaction starts, with you producing different types of antibodies and immune complexes to them as they are seen as foreign bodies.
This kicks off two main problems in the gluten-sensitive: inflammation causing tissue damage and auto-immunity.
In the latter, because memory cells become involved, you start to react every time the peptide is seen in the blood, and eventually to anything that looks similar to it – a cross-reactive food or your own tissue/cells. Antibodies have been found in villi (coeliac disease), skin (dermatitis herpetiformis) adrenal, thyroid, ovary, brain, heart, kidneys etc so wherever the cross-reaction takes place is where the problem will start to show eventually.
You can see why gluten sensitivity is linked to so many conditions. It is termed by some as a ‘foundational’ disorder ie. at the heart of a lot of diseases, and as a ‘multi-organ-system disorder’ by some immunologists. And most people (and most health professionals) don’t even know about it!
Not Just A Leaky Gut: Broken Body Barriers
The other thing to watch is that zonulin. If we know it can break down the gut tissue junctions, does it not stand to reason that it can make other body barriers leaky too? Our barriers include the blood-brain, gut, lungs and skin. No coincidence then that most gluten sensitives have a problem with poor cognition & memory, neurological issues like anxiety, migraine, muscle and nerve issues, skin, gut symptoms and asthma!
Obviously it is a lot more complicated than that, but that is, in essence, what is believed to happen.
Can We Solve It?
Researcher Alessio Fasano published a paper in 2011 called ‘Leaky Gut and Autoimmune Diseases’. In it, he said:
“The autoimmune process can be arrested if the interplay between genes and environmental triggers is prevented by re-establishing the intestinal barrier function.”
That was a lightbulb moment and, in effect, he is saying that if we strengthen the gut (and other barriers in my opinion), we stop the foods and other antigens getting through to where they shouldn’t be and consequently stop the inflammation and immune processes which get triggered by them. Sounds simple.
He also said that for auto-immunity to develop, there need to be three triggers:
- A genetic predisposition (he was talking about the coeliac genes)
- An exposure to the environmental trigger (eg gluten in our case)
- Increased intestinal permeability (ie the leaky gut)
- A genetic predisposition (all coeliac and non-coeliac gluten sensitivity genes, not just DQ2 and 8 but all DQ genes bar DQ4 have been implicated in gluten illness)
- An exposure to the environmental trigger (eg gluten in our case, agreed)
- Increased permeability (of the gut first, I have no doubt, but other body barriers are structurally similar and will fall prey to the same problems eventually)
Here’s a nice visual picture of the process from SCD Lifestyle as it is thought to happen in coeliac disease. From ‘Leaky Gut’ bit onwards, it could go anywhere; this just shows the coeliac auto-immunity process:
I developed the Barrier protocol in the Plan to take into account all of the stages taking place, then sourced and checked all the supplements to ensure they are totally trulyglutenfree, not just gliadin-free. This is one thing that makes the Barrier Plan totally unique and took months and months of research, trial and error to find them. 99% of supplements contain the very substances that cause the problem in the first place, no matter that they say ‘gluten free’ on the label. They are not trulyglutenfree!
The protocol has to take into account the inflammation, immune reactions and leaky gut/barriers, as well as the likely consequences of having long-term unchecked NCGS – malabsorption, nutrient deficiences and system/organ dysfunction eg hypothyroid, hypoadrenia, hypochlorydia – oh yes, one of the antibody links I found was to the stomach parietal cells which begins to explain why so may gluten sensitives are short of stomach acid and hence malabsorbing!
Obviously gluten ingestion in the genetically-sensitive is enough to kick off this problem but there are many other factors we need to consider that affect barrier breakdown specifically.