You may be wondering, just what is gluten and why does gluten-free matter for someone like me with PCOS? I used to wonder the same thing. But not anymore! Removing gluten from my diet and has made a remarkable improvement in my carbohydrate cravings, mood, energy levels and more. It has done the same for my clients as well.
Unfortunately, you won’t find any major study or conclusion linking gluten intolerance or celiac disease with PCOS. But, Dr. Jeffrey Aron who has been practicing gastroenterology for 35 years and is Head of Gastroenterology and Internal Medicine at California Pacific Medical Center, is quoted as saying that, “PCOS and celiac are related.”
Melissa Diane Smith who’s a nutritionist, health educator and author of Going Against the Grain says that “…85% of her PCOS clients test positive for a sensitivity to gluten. When these women remove gluten from their diets they often see a marked improvement in their PCOS symptoms.”
So there is no research studies linked to PCOS, but nevertheless, let’s explore what gluten and wheat may be doing to our PCOS bodies.
What is Gluten?
Gluten is that sticky protein in wheat that holds bread together and makes it rise. Gluten is found in wheat, barley, rye and spelt, kamut, and triticale.
Gluten May be an Underlying Cause of Some PCOS Symptoms
A review paper in The New England Journal of Medicine listed 55 "diseases" that can be caused by eating gluten. Here are some health issues that may be caused or aggravated by gluten - diarrhea, gas, bloating, nausea, constipation, inability to lose weight, chronic sinus problems, snoring, fibromyalgia, chronic fatigue, irritable bowel syndrome, reflux, cancer, depression, skin disorders, osteoporosis, diabetes or hypothyroidism, autoimmune diseases, infertility, tingling numbness in the legs, sores inside the mouth, hives, joint/muscle pains and aches.(1)
Eliminating Gluten May Help with Cravings
Your cravings for bread, cookies, cake, pasta and other foods may be caused by gluten intolerance. When you are gluten intolerant you often have food cravings for gluten containing foods and it has frequently been observed that people crave that which they are allergic to.
Gluten can cause a morphine like response in your body. When gluten proteins are not broken down completely in the body they are called peptides. This peptide is called glutomorphine. The National Institutes of Health researchers showed that these gluten-derived peptides can cross into the brain and bind to the brain’s opiate receptors. (2,3) So you can get a mild euphoria after eating a product that contains gluten. Interestingly, it has been shown that you can block that effect [in lab animals] by administering the drug naloxone. This is the same drug that you’re given if you’re a heroin addict; it’s an opiate blocker. So if gluten can cause an opiate like reaction, you can see how it can become quite addictive. Opiates can cause any or all of the following side effects: clouded mental functioning, insomnia, diarrhea, impaired social connection, blocking of pain messages, dilated pupils, inflammation on the stomach lining and depression. I also find it interesting that some doctors are using low-dose Naltrexone another opioid to help women with PCOS.
Gluten Can Cause Systemic Inflammation
Ever heard of leaky gut syndrome? Perhaps you have even been diagnosed with leaky gut. Well, gluten can damage the gut lining and cause leaky gut. A protein in your gut, called “zonulin”, is increased by exposure to gluten. The zonulin protein causes cracks or fissures in your gut which allows bacteria and food particles to leak across the intestinal barrier. Think of how a crack in your window screen causes bugs from the outside get into your house, the same goes for a crack in your gut barrier. Undigested protein and bacteria can leak across your gut barrier and are exposed to your immune system. Your immune system sees these proteins and bugs as an invader and sets you up for an inflammatory response. This leads to systemic inflammation. (4)
According to Mark Hyman, MD, “Gluten sensitivity is actually an autoimmune disease that creates inflammation throughout the body, with wide-ranging effects across all organ systems including your brain, heart, joints, digestive tract, and more. It can be the single cause behind many different "diseases." To correct these diseases, you need to treat the cause--which is often gluten sensitivity--not just the symptoms.”
Connection between Gluten Intolerance and Hypothyroid
Many women with PCOS have autoimmune hypothyroid otherwise known as Hashimotos. The results of a recent Dutch study published in the World Journal of Gastroenterology have confirmed a connection between Hashimotos Thyroiditis and Celiac (a severe form of gluten intolerance) disease. The study concludes that there is a clear association between Hashimotos Thyroiditis and Celiac Disease. Accordingly, it is recommended that patients with Hashimotos Thyroiditis be screened for celiac disease and that patients with known Celiac be screened for Hashimotos Thyroiditis. (5)
Another study of 172 patients with Hashimotos found that undiagnosed Celiac Disease may actually be part of the process that triggers an underlying autoimmune disease. In their findings researchers wrote: "We believe that undiagnosed Celiac Disease can cause other disorders by switching on some as yet unknown immunological mechanism. Untreated Celiac patients produce organ-specific (thyroid) autoantibodies."
The researchers found that the various antibodies that indicate celiac disease - organ-specific autoantibodies (i.e., thyroid antibodies) -- will disappear after 3 to 6 months of a gluten-free diet.
What About Whole Wheat?
So for all of you who have been eating whole wheat products and think whole wheat bread is a better choice (I once did as well), it is important to know that wheat has been hybridized to create a high-yielding wheat plants with much higher amounts of starch and gluten and contains proteins that never before existed in nature. Sounds a bit like Frankenfood to me. Todays wheat plants, Triticum aestivum, or modern wheat are more than two feet shorter, the result of years and years of cross-breeding and hybridization designed to make our agricultural products resistant to drought and better performing. This modern-day wheat is different from the gluten proteins found in wheat as recently as 1960. Gluten has deliberately been increased from 4% to 17%
Dr. William Davis, a preventive cardiologist and author of Wheat Belly, explains, “It contains amylopectin A, which is more efficiently converted to blood sugar than just about any other carbohydrate, including table sugar. In fact, two slices of whole wheat bread increase blood sugar to a higher level than a candy bar does. And then, after about two hours, your blood sugar plunges and you get shaky, your brain feels foggy, you're hungry. So let's say you have an English muffin for breakfast. Two hours later you're starving, so you have a handful of crackers, and then some potato chips, and your blood sugar rises again. That cycle of highs and lows just keeps going throughout the day, so you're constantly feeling hungry and constantly eating. Dieticians have responded to this by advising that we graze throughout the day, which is just nonsense. If you eliminate wheat from your diet, you're no longer hungry between meals because you've stopped that cycle. You've cut out the appetite stimulant, and consequently you lose weight very quickly. I've seen this with thousands of patients.”
So How do I Know if I am Gluten Intolerant?
Conduct your own experiment and see for yourself - your body will let you know. Remove gluten containing grains for your diet . Ideally for 3-4 weeks but even 7 days can make a difference. If after that 4-week period you discover new mental clarity, stable moods, better sleep, relief from joint pain, happier intestines, less bloating, then you’ve got our answer!
Chances are if you ask your doctor about gluten intolerance, unless you have been diagnosed with Celiac Disease they won’t acknowledge it. If you do want to be checked for Celiac Disease, according to celiac.com, "Of the two tests, the IGA gliadin and IGA endomysial tests are the most accurate. However, this test can become negative relatively quickly after going on a gluten-free diet (3-6 months), which can cause a false negative test result. The IGG is less specific, and can sometimes be positive in non-celiacs. Also, about 4% of celiacs have no IgA at all! For these reasons it is very important that both tests are done for an accurate diagnosis. The biopsy is still considered the "standard candle" to confirm a blood diagnosis, and give a 100% sure diagnosis."
Be assured that you can be tested negative for Celiac Disease and still be gluten intolerant. A recent double blind, placebo controlled Australian study published in the American Journal of Gastroenterology strongly suggested the presence of this form of nonceliac gluten sensitivity or intolerance, but was unable to determine the cause. Yet it remains largely unrecognized by conventional medicine.
Bring this research to your doctor to prove your point. You can still have gluten intolerance without a diagnosis of celiac disease and this new research proves them wrong. Celiac disease results when the body creates antibodies against the wheat (adaptive immunity), but another kind of gluten sensitivity results from a generalized activated immune system (innate immunity). (7)
Gluten Intolerance Causes Multiple Nutritional Deficiencies
When you have gluten intolerance your body does not absorb fat soluble vitamins such as vitamin A and E and K as efficiently as well as the essential fatty acids. EFA's are critical for women with PCOS because we use these to make all our reproductive hormones and adrenal hormones including estrogen, testosterone, progesterone, cortisol and DHEA. Other nutritional deficiencies include a calcium, folic acid, iron and vitamin B12 (which may already be low due to taking Metformin.
Don’t Start Eating Gluten Free Junk Food
Eating Gluten-free doesn't give you carte blanche to eat gluten free pretzels, brownies, bagels and cookies. These are still highly processed food. Processed food has a high glycemic load. Just because it is gluten-free, doesn't mean it is healthy. Stick to gluten-free whole grains like amaranth, buckwheat or kasha (not to be confused with Kashi products they are NOT gluten free) corn, millet, quinoa, rice (stick with brown or black), sorghum and teff are all gluten free grains. Oats are inherently gluten-free, but are frequently contaminated with wheat during growing or processing. Several companies like Bob’s Red Mill offer pure, uncontaminated oats. Limit servings of gluten free bread and pastas to 1 serving a day or even a few times a week.
Have you Gone Gluten-Free
Please share your experience with us in the comments below. Has eating gluten free helped with reducing your PCOS symptoms? If you are going to do the experiment, please come back and let us know your findings!
(5) World Journal of Gastroenterology 2007; 13(10).
(6) Digestive Diseases and Sciences, February 2000;45:403-406.)