If you have celiac disease and have not improved on a gluten-free diet, you are not alone. About 30% of people don’t improve – including myself. There are a few reasons why this is happening, but today I’ll be talking about cross-reaction.
This is must know information if you have celiac or gluten-sensitivity, so listen up!
A study done to see the recovery and healing of small intestinal mucosa of celiac patients on a gluten-free diet after a median of 16 months showed that of the 465 adult celiacs tested, only 8% has histological ‘normalization’, 65% were in remission, 26% had no change and 1% deteriorated. (1)
A few years ago there was a study done to find out why people don’t improve on a GF diet, and to identify cross-reactivity between gliadin and gluten-free foods that are commonly recommended for people on a GF diet. (2)
When people remove gluten from their diet, they almost always replace it with gluten-free foods like corn, rice, millet etc, but this is a big mistake, and cross-reaction is why. My first year gluten-free I basically lived on corn tortillas, corn pasta and cheese. Whoops.
How Cross Reaction Works
With celiac disease or gluten sensitivity, the body has an immune system reaction to gluten and thinks its a foreign invader, and so it tries to kill it by making antibodies against gluten (gliadin).
Forming antibodies is a complicated process. The antibodies only recognise short sequences of amino acids, and not the entire protein. Theres only a certain number of amino acids, so some sequences repeat themselves in other foods.
This means that the gluten antibodies can recognise the amino acid sequence in another food, so they think you are eating gluten (even though you’re not) and create an inflammatory immune response.
So you’re body still thinks you are eating gluten, even though your not.
I’ve personally experienced this reaction when eating oats and rice.
Top Cross Reacting Foods
Dairy is definitely a problem for people with celiac. They tested not only whole milk but also other peptides in milk like Alpha and Beta caseins, casomorphins, milk butyrophilin and whey, which all tested very positive for cross reaction. Doesn’t matter if the milk is organic or raw, these same proteins are still there – it’s milk itself. (3)
“Milk, casein and milk-containing products such as milk chocolate should be thought of as containing gluten-like peptides, at least in individuals whole symptoms fail to improve significantly on a GFD.”
They tested pure brewers yeast from a supermarket, and they “do not know” whether this is a result of cross-reaction or if it’s because of impurities or contamination of the commercial product.
As this article points out, brewers yeast is often a byproduct of beer and is not gluten-free (although sometimes can be made from beet sugar).
Brewers yeast and bakers yeast is the saccharomyces cerevisiae species of yeast – also the type used to make nutritional yeast, and that is in kefir and kombucha. The cross-reaction could be happening because of antibodies to saccharomyces cerevisiae in people with celiac. (4)
I tried kombucha and had a terrible reaction and didn’t go much better with kefir – although I am alcohol sensitive too so that would have played a role.
Many people who can’t eat dairy and those eating a healthy plant-based diet often use nutritional yeast – but it’s unclear whether this type of yeast is a cross-reactor. It could very well be, but we can’t make any real conclusions on this until we have more information.
Oats have always been a bit of a controversial thing for people with celiac – I’ve written about this before. The biggest issue with oats is contamination – most oats are grown in the same areas as wheat, rye and barley. They’re processed in the same facilities as wheat, they are transported in the same trucks and kept in the same silos. So regular oats are extremely cross-contaminated with wheat and should never be eaten by anyone with gluten-sensitivity. (5)
Besides the contamination issue, oats also contain a protein called avenin, which causes an gluten antibody cross-reaction. To make it even more confusing, not all oats contain this protein – but it’s almost impossible to find out which oats contain it and which don’t. More info on that here.
So it’s best to steer clear of oats, certified gluten-free or not.
Millet, corn and rice also are cross reactors
So the cross reactors found were: dairy of all kinds, brewers yeast and bakers yeast, oats, millet, corn and rice.
Tested But Aren’t Cross Reactors
Apparently theres been conflicting reports about whether people with celiac react to coffee. When fresh espresso was tested there was no reaction. When instant cafe latte was tested there was a strong reaction, some from the milk and some from gluten contamination – instant coffee is contaminated with traces of gluten, but fresh coffee beans seem to be safe. I don’t drink coffee but do use it in doing coffee enemas with no ill effect.
Milk chocolate obviously reacted, but pure cocoa (and cacao products) are fine.
Sesame, buckwheat, sorghum, hemp, amaranth, quinoa, tapioca, teff, soy, egg and potatoes are safe.
Because celiac reactions don’t always manifest straight away as physical symptoms, but can still be doing damage to the intestines, I find the “if in doubt, leave it out” approach best until there is much more research done into this.
My personal approach is to exclude dairy, yeast (including nutritional yeast and kombucha), oats, millet, rice and corn from my diet at this time. None of these items are needed or contribute to a healthy diet, so I am happy leave them out.
It’s hard to completely verify these finding since this is the only test of it’s kind done. Another questionable factor is who did the study – it was done by Cyrex Labs, who also have a test for sale that tests for cross-reactivity.
One more point – just because they had these results in a lab setting doesn’t mean it’s happening in all people with celiac or gluten-sensitivity all the time. But since I react to these foods anyway, I know for me the best choice is to leave them out.
Read and understand for yourself
You can read the full paper here and read their testing methods and conclusions for yourself. It’s definitely worth a read and taking the time to understand this concept. Also worth a read is this article with some good points about the test.
Why aren’t I getting better on a Gluten-Free diet?
As I mentioned, there are several reasons why people don’t improve on a GF diet. Besides cross-reaction, the other two main reasons are hidden gluten still in the diet (you may think you are 100% GF but check, double-check and then check again, never assume any food is GF no matter how long you’ve been eating it) and not addressing the root cause of celiac – gut dysbiosis and leaky gut. I’ll be talking more about healing gut dysbiosis and leaky gut soon.
(2) “Cross-Reaction between Gliadin and Different Food and Tissue Antigens,” January 2013
(5) “Gluten Contamination of Commercial Oat Products in the United States,” New England Journal of Medicine, Vol. 351, No. 19, 2004