Gluten Intolerance and The Elimination Diet
Is gluten “bad” for people with fibromyalgia? You certainly can find a lot of people online who say it is. So far, however, research hasn’t specifically examined whether gluten poses a problem for a significant number us. With the media attention gluten-free diets have received, a lot of people with these illnesses have gone gluten free. Anecdotal results are mixed, with some people saying it’s changed their lives and others saying it did nothing other than take away their favorite foods for a while. Very little research has been done on the overlap between celiac disease, an autoimmune disorder involving gluten, and fibromyalgia.
What Is Gluten?
When researching gluten, you’ll find the term has two commonly used definitions, one that describes the storage proteins common to most grains, and one that’s relevant to those of us following a gluten-free diet. Gluten, in its generic form, simply refers to the proteins grass plants build into their seeds (which we know as grains) to support the growth of the next generation of plants. Almost all grains have gluten. However, those grains, and the gluten in them, are perfectly safe for people with celiac disease and gluten sensitivity. It’s the gluten that occurs in a specific sub-group of grains that causes specific reactions in those of us who have celiac disease or are gluten-sensitive. This sub-group of grains includes wheat, barley, rye and oats.
Gluten Gives Dough Elasticity, Structure
The gluten in wheat, barley and rye actually consists of two proteins: gliadin and glutenin. When the two combine during the baking process, they form a thick, stretchy, glue-like substance that provides bread and other baked goods with elasticity and appealing texture. Gluten also helps bread dough rise by trapping bubbles from fermenting yeast within the dough itself, allowing the dough to rise into a light and airy loaf.
Gluten Sensitivity Symptoms
Gluten-related symptoms can be extremely similar to those of fibromyalgia, including some neurological symptoms. Instead of looking for the existence of a symptom, you may need to keep a food/symptom log to see if certain symptoms get worse when you eat gluten-containing foods, or improve when you avoid them. Also, irritable bowel syndrome is extremely common in fibromyalgia. Because IBS and gluten intolerance may involve similar digestive problems, it can complicate the diagnostic process.
Getting a Diagnosis
So far, there’s no well-proven test for gluten sensitivity. If your doctor suspects a gluten problem, the first step could be to rule out the celiac disease. However, some research is starting to suggest that a gluten-intolerance test may be possible down the road.
What’s the Purpose of the Elimination Diet?
A lot of people with fibromyalgia find that certain foods, like gluten, make them feel worse. Experts believe that because of the central sensitization involved in these conditions, you can develop sensitivities to foods that then aggravate your symptoms. The best way to figure out what, if any, foods are a problem for you is an elimination diet. It’s not an easy one, but it is mercifully short compared to most diet plans. You start out by eliminating broad categories of foods that are the most likely one to cause problems. Then, you re-introduce one at a time and see how you feel.
Foods You May Eat
Initially, you’ll want to limit your foods to the following:
- Vegetables (except for corn, peas or beans)
- Fruit (except citrus or any that you currently eat 2+ times a week)
- Meat (except for bacon, sausage, hot dogs or lunch meat)
- Rice and grain alternatives such as amaranth, quinoa and buckwheat
- Bottled or distilled water
- Herbal teas
Foods to Avoid
- Dairy products (rice milk is an acceptable alternative)
- Caffeine in any form
- Sugar and aspartame (NutraSweet)
- Wheat, oats, barley and anything containing gluten
- Bacon, sausage, hot dogs and lunch meats
- Peas, beans and corn
- Citrus fruit
- All processed foods
- Anything containing monosodium glutamate (MSG)
- Food colors and dyes
- Any food you currently eat more than twice a week
Re-introducing Foods on the Elimination Diet
Once your 5-10 day elimination period is over, it’s time to start adding foods back in. Eat a lot of the re-introduced foods (3 servings a day). You’ll want to add one category at a time. Then, you’ll wait 2-3 days before adding another one. Depending on the foods and your body, you could notice an increase in sensitivity-based symptoms within minutes or hours, or possibly the next day. If you discover a sensitivity, eliminate that category again and wait until your body has recovered from the increased symptoms before you add another food.