Simona asked about her daughter’s scoliosis, and I advised that she cease eating wheat, since auto-antibodies to wheat are associated with development of scoliosis. In her response she mentioned the difficulty of convincing her family to give up wheat:
I have been trying to convince my husband to avoid wheat and gluten altogether, unsuccessfully, he sees it as extreme and unnecessary caution…. The only thing that could be changed besides introducing liver is eliminating the sourdough bread sandwich for lunch.(and obviously focusing on gluten-free cakes) Easier said than done.
This is the almost universal response: people love wheat!
In my first response to Simona I cited a paper that looked at wheat-induced auto-antibodies in rheumatoid arthritis patients. That was an interesting paper in several respects, but one of them was the reaction of the four patients with wheat autoimmunity to the results.
The clinical features of the four cases positive for IgG or IgA anti-tTG were as follows: The first case (female, 63 yrs) positive for IgA anti-tTG antibody suffered from rheumatoid arthritis, type II diabetes mellitus, iron deficiency anemia and gastric indigestion without symptoms of malabsorption. She denied any gluten sensitivity on her diet. Her esophagogastroduodenoscopic biopsy showed mucosal atrophy with no elongated crypts or infiltration of inflammatory cells in the lamina propria. The remaining three cases positive for anti-tTG antibodies had interstitial pneumonia, a herniated lumbar disc, and mild scoliosis, respectively. They all denied any malabsorption symptoms or gluten sensitivity. [1]
These four people were poisoning themselves with wheat; all had indisputable signs of autoimmune damage from wheat; and yet all insisted that they had no sensitivity to wheat.
In the book we mention one reason for this: wheat proteins digest to opioid peptides which stimulate the same receptors as morphine and heroin. [2,3,4] Wheat is pleasurable to consume and, quite literally, addictive.
Of course, morphine is famously effective at pain relief. It’s possible that wheat has the same effect. That may be another reason that people with painful conditions, like arthritis, feel better when eating wheat, and reject the idea they have wheat sensitivity.
Conclusion
One reason chronic diseases are so rarely cured is that in many cases, essential curative steps make people miserable for a time, while steps that aggravate the disease make people feel better.
This happens in chronic bacterial infections of the brain, where sugary drinks relieve a bacteria-induced cognitive hypoglycemia, making people feel better, but also enable the bacteria to proliferate and worsen the infection.
I was for years a poster child for bad eating:
- I used to love French bread and, when I was too busy to fix a meal, would eat a whole baguette with cheese.
- For years I drank a lot of colas because it temporarily made my brain more functional and happier.
Perhaps my purpose in life is well described by this poster:
Maybe my story can help scare your family straight, Simona. I’d hate to think my illness did no good at all!
References
[1] Song KS, Choi JR. Tissue transglutaminase autoantibodies in patients with IgM rheumatoid factors. Yonsei Med J. 2004 Oct 31;45(5):960-2. http://pmid.us/15515214.
[2] Zioudrou C et al. Opioid peptides derived from food proteins: The exorphins. J Biol Chem. 1979 Apr 10;254(7):2446-9. http://pmid.us/372181.
[3] Huebner FR et al. Demonstration of high opioid-like activity in isolated peptides from wheat gluten hydrolysates. Peptides. 1984 Nov-Dec;5(6):1139-47. http://pmid.us/6099562.
[4] Fukudome S, Yoshikawa M. Opioid peptides derived from wheat gluten: their isolation and characterization. FEBS Lett. 1992 Jan 13;296(1):107-11. http://pmid.us/1309704.
via this link:
When I switched to a mostly-paleo diet, giving up wheat seemd like the most radical part of it. For years, bread and butter (or margarine!) was one of my favorite foods. Virtually everyone I’ve ever suggested this to thinks it unbelievably radical.
I think bread has been a favorite food for a lot of people who went on to develop chronic diseases. But of course giving up wheat is a radical idea. Or, as a dietitian wrote to me today, an unprofessional idea. (Actually, it was criticizing dietitians who advise high wheat consumption that was considered unprofessional, but that amounts to something similar.)
Paul,
Perhaps I am missing something here, but what how can we be sure that wheat was the definite cause of the problem in these people?
Hi Todd,
We can’t. But with detectable autoantibodies, we can be sure that wheat was a problem. There undoubtedly were other causes of the various pathologies, but wheat was one of the causes. Possibly the main factor in some.
Best, Paul
I gave up wheat back in December of 2009. I’m working towards weaning myself off my other gluten free grains as well. I sometimes actually have dreams of yeast rolls and cupcakes, but it turns out I value joints that bend more than donuts.
I personally didn’t notice a difference after giving up wheat. But before I started eating paleo I was eating pretty healthy anyway, with relatively low amounts of wheat because I was trying to eat a nutrient rich diet. Also, my age may have played a role in this.
We on the internet give doctors hell for giving drugs to patients rather than insisting that patient change their diets.
But the truth is most people would rather pop a pill than eat healthy.
True, Jake. But even patients who will eagerly follow doctors’ dietary advice don’t get any help. My wife had acid reflux for a time and none of her doctors suggested probiotics or dietary changes — only PPIs. She hates pills and is always looking for dietary therapies.
I’m hoping you can give me some insight, I recently found your site and was excited when I read this post today. My almost three year old son developed arthritis in his knees a few months ago. He also has fevers and warmth in his knee joints as well. Previously he had chronic ear infections cured by removing dairy products from his diet. We ate the typical SAD until one month ago we went completely grain free and greatly increased our meat, healthy fat and vegetable intake. He also takes cod liver oil, probiotics and eats a lot of coconut. He has tested allergic to many things including wheat, dairy, eggs, nuts, shellfish and a few other random things. He seems to have good and bad days and there are definitely more good days than when we were eating the wrong foods, but his knees are still swollen and he has a hard time walking.
I’m just wondering if you think we are on the right path. It just seems like we should be seeing more improvement with the swelling. The fevers and the hotness are gone except when we try a new food that he reacts to. Do these things just take time, or am I missing something? We are willing to do whatever it takes because we have seen the effects rheumatoid arthritis can have on the body.
Thanks
Monica
Hi Monica,
That’s very unfortunate. I feel for your son. Certainly it’s very important to figure this out.
Recovery does take time. Wheat autoantibodies typically take 3 to 6 months to disappear but in some people linger as long as 12 months. You should see a gradual fade in symptoms. But that doesn’t mean that you shouldn’t keep looking for faults that you can fix.
Food allergies imply a leaky gut that is letting toxins and bacteria into the body. I have never had food allergies except for a three year period when my gut was damaged. With a damaged gut, you can be allergic to almost anything, since all plant foods and many non-human animal proteins can excite an immune response.
So you should look at our “healing bowel disease” series. I would definitely consider a fecal transplant and some other techniques.
On general principles, you need optimal vitamin D and low omega 6 to keep down allergies.
A leaky gut invites infections. C. pneumoniae is known to cause arthritis, and it enters the body when the gut is damaged by infecting immune cells in the gut and then being carried to sites of inflammation. So this is a possibility for us to watch out for. Unfortunately C. pneumoniae infections are slow to cure. I think the best thing is to optimize diet and nutrition first, get the gut in as good health as possible, and then look at possible infectious issues last. Again, vitamin D optimization is crucial. Have you tested his 25OHD level? I would get a thyroid test too.
So, yes, I do think you are on the right path. Keep trying to get everything about diet and nutrition right, and hopefully he will keep improving.
Hi Paul! Do you have any information as to the “dose” of these opiod peptides one gets from wheat? This is one of the issues I have with some of these sorts of discussions. I’m reminded of the Seinfeld where Elaine fails a drug test because she’s been eating poppy seed bagels. Funny comedic schtick, but the quantity of “elicit” drug in whole poppy seeds is not on the order of anything that would be mind altering, let alone detectable on a drug test.
As I’ve shared on my blog, you’re talking to a former bulimic/binge eater here. Wheat stuffs were certainly staples of my binge foods of choice. Yet now I can eat wheat in modest quantities w/o any urge to binge or anything like that. So I’m wary of the whole pharmaco-active angle of various foods.
Hi Monica,
I’m on low dose pulsing antibiotics for RA. If you need a MD who is open to using antibiotics for arthritis, you can request a list from The Roadback Foundation at http://www.roadback.org
I traveled ~10 hours by car to see someone experienced. I’m doing well, with minimal joint pain. It’s been a little over two years since I started Doxycycline on MWF.
And, not to give the impression that the antibiotics were the only solution, I’ve made major diet changes, working on gut health, and hormone imbalances.
Your son can beat this!
Michelle
Hi CarbSane,
Well, even before looking at dosage it’s clear that the opioids from normal levels of wheat consumption have observable physiological effects in many people. E.g., prolactin secretion, http://www.ncbi.nlm.nih.gov/pubmed/15698850, and triggering of schizophrenia (citations in our book) are attributed specifically to wheat opioids.
I don’t have time at the moment to chase papers and get detailed numbers, but in this paper (http://ajpregu.physiology.org/cgi/content/full/297/4/R1154) 10-6 M of opioid growth factor is active. If wheat opioids have the same binding affinity, and gluten is about 10% of the mass of wheat and opioid peptides 1% of gluten, then 400 g/day wheat consumption would produce 0.4 g/day opioids. If these are distributed locally over a 2 kg bowel, then concentrations could reach 10-4 M, and systemically over an 80 kg human 10-6 M, before they are cleared. If it takes longer than 24 h to clear them (which I doubt, but in some people it could), then concentrations could really build up.
It’s hard to assess dosage/concentrations in vivo. People don’t really know where the opioids go. The prolactin paper I cited above tested whether the opioids were acting inside or outside the brain; it was outside. That’s not much to go on as far as localization/concentrations.
It is not surprising that it’s difficult to convince people to avoid wheat when there is so little support from the larger health establishment in America. The sheer amount of nutritional misinformation out there is extremely suspect.
I am a healthy 20 year old premed majoring in biochemistry that has taken an interest in nutrition over the past year and I have inevitably come to the same conclusions that you have made in your book. I have to thank you for compiling so much information and advice, logically and coherently, and without a money-making agenda. After following a paleo-style diet for about six months now, my acne has cleared up, I have much healthier looking skin and hair, and have dropped down to single digit body fat. I also have much less “brain-fog” and more energy. It makes me feel uneasy as to how easily I could still be eating the standard american diet, with only health problems years down the road to serve as a wake-up call. Your book is years ahead of its time, and refreshingly science-based.
Thank God for the internet. There is no other way the truth could get out.
Monica,
After reading your post & your son’s symptoms I just wanted to inquire as to if you’ve had him tested for Lyme, or other Tick borne diseases? The symptom picture can involve many things but your post lists some of the classic markers.
I do hope that he is much better soon.
Best Wishes,
Deborah
Thank you everyone for the great suggestions and encouragement! He has not been tested for Lyme disease however I heard that the testing was not very accurate, is that true? Also if he had Lyme what would we do differently? Would he need antibiotics such as the low dose that Michelle suggested? It seems like there are so many possibilities I want to make sure we consider them all!
Thanks,
Monica
This post hits so close to home. When my Mom was born, they had a hell of a time finding a formula she could stomach–not sure why she wasn’t breastfed. In college, she had ulcerative colitis. Ever since I can remember (I’m in my late 20s) my Mom has had serious digestive issues–ulcers, GERD, hiatal hernia, etc. And when I was in high school she developed severe rheumatoid arthritis. Most recently, she had to have spinal fusion surgery due to degeneration of her bottom 2 discs (and they found some bone thinning, not surprising). She knows I have severe problems with wheat and other grains and my Dad has given them up…But she is ridiculously stubborn and as you say addicted. She says to me what would I eat for breakfast? Cereal is easy! Or…you’re young. I’ve been eating this way for a long time without problems (ha!!!), it’s too hard for me to change. I asked her whether she’d rather live without grains or die eating them without knowing her grandkids etc. She slowly seems to be coming around, but it is a huge battle. Thanks for calling attention to this. I’ll be buying your book for my iPad as soon as the kindle version is released.
Hi Monica,
None of the tests for chronic pathogens are perfect, but if you get a positive test then it definitely makes a case for antibiotics.
I like this Lyme doctor’s blog: http://lymemd.blogspot.com/. Reading his archives may give you some idea of the complexities in treating infectious diseases.
Good luck!
Great, I put a link to this post on our facebook page. Furthermore I wrote a post on grains. I hope it puts extra weight on the scale: http://bit.ly/cyKHre.
Thanks again for all the information. We have not done any other testing besides routine blood tests and a stool culture that came back positive for blood. We are still waiting to talk to the doctor to see what else was found in the stool, but he said the most significant thing was the blood. Do you think that is common with leaky gut, or should I be more concerned?
I think I will ask for a vitamin D test next time we go in and I also looked at the Lyme disease blog and that is definitely something we will pursue if this does not work out.
Thanks
Monica
Hi Monica,
Blood in the stool is not a sign of leaky gut, it is a sign of ulcerative colitis or some wound in the gut lining. It is definitely something to look into.
Thank you for your quick response. Sorry for so many questions but I was wondering if you thought frequent use of ibuprofen could cause blood in the stool. Our orthopedist had us use therapeutic levels for a couple months to see if it would bring down the swelling. My son has a lot of pain and is unable to walk without it, but with this revelation I think we will take him off and research some natural pain killers. Any suggestions?
Thanks
Monica
Paul, thanks for your reply and the links. I gotta say, 400g of wheat sounds like an awful large consumption. I’m looking at the label on hubby’s loaf of foccacia, and assuming all carbs are wheat, the entire 14 oz loaf contains ~200g. Are there folks consuming two loaves of bread or the equivalent per day? Perhaps, but I doubt many. Here’s where my skeptical side comes out to play with the whole food addiction thing. I wonder why blood levels of these opiods are not measured to see. If they are not detectable …. ?? This is something that bugs me. After all, nicotine is addictive, but I don’t know too many people (anyone) who become addicted to, say, eggplant and cauliflower!
Hi Monica,
I think the ibuprofen may well be the cause of the bleeding. See http://www.sciencedaily.com/releases/2005/11/051101075630.htm.
I don’t know about natural pain killers. Surely the doctors have alternative pain medications.
Hi CarbSane,
The average American gets 23% of 3700 calories per day from cereal grains, or 850 calories per day, equal to 250 grams of wheat flour. So I should have used that number instead of 400 grams. This is all just order of magnitude anyway.
There’s been active research on wheat opioids in schizophrenia, I would have to look to see if they are detecting opioids in serum. However, the strongest activity of these peptides is going to be binding to gut receptors. There can be significant effects without detectable blood levels. Blood levels could depend on leaky gut, on impaired lysosomal disposal / Golgi recognition, or other individual factors. But even if opioids enter the blood, they might not stay long — might quickly find a receptor.
I haven’t heard of eggplant or cauliflower addictions either, but many people experience great difficulty giving up wheat.
Monica,
For arthritis pain, Shou-Ching suggests this product:
http://www.amazon.com/dp/B000MWO3IG
Massage the lotion over the pain area. When he sleeps or is active, spread it on a gauze pad and tape it over his knee or other pain sites. This is much safer than oral, systemic painkillers.
Paul and Carb-Sane,
When I gave up wheat, I immediately developed an addiction to dark chocolate! It was surprisingly hard to kick.
Todd,
That’s fascinating, because chocolate can also stimulate opioid receptors … see e.g. http://www.ncbi.nlm.nih.gov/pubmed/20833967 … Maybe the chocolate was the methadone for your wheat addiction … CarbSane, this may interest you: evidence that opioid receptors are involved in obesity: http://www.ncbi.nlm.nih.gov/pubmed/18396272.
Paul,
Yes that’s the way I looked at it. I can also remember some dairy cravings.
Dear Paul,
Specialists don’t know what are the causes of the malformation of the spine (idiopathic or congenital or functional)
“The term “congenital scoliosis” refers to a spinal deformity caused by vertebrae that are not properly formed. This occurs very early in development–in the first six weeks of embryonic formation and often before the mother knows she is pregnant, and the cause is not known. […] Although congenital scoliosis is often discovered during the infant or toddler period, in some children it does not appear until their adolescent years.” (Scoliosis Research Society)
We can only speculate at this point (lack of nutrients necessary for bone health) and be hopeful that it is not going to get more severe as she grows.
Does diet influence the development of scoliosis in the first 5 years of life (a period of rapid spinal growth)if the malformation is present at birth?
I don’t know.
Thanks, simona. Was your daughter’s scoliosis congenital?
My guess is that even congenital scoliosis can be greatly improved later in life.
We don’t know. The chiropractor says it’s mild and that it can be corrected by weekly manipulation after which the body/spine is going to readjust.
I don’t have a strong case for wheat cessation to convince my husband.
Simona, One thing I recommend is Esther Gokhale’s book Eight Steps to a Pain-Free Back. It’s really a posture book and has great tips for how to cultivate good posture in daily living.
Best, Paul
What a great post. The image of the poster moved me actually – I’ve been struggling with gut-related problems for some years, founded mainly in coeliac disease. The poster made me think about the fact that without that experience, I wouldn’t have been able to help my wife with her health problems, or protect my young children. Thank you.
“I used to love French bread and, when I was too busy to fix a meal, would eat a whole baguette with cheese.”
Ditto.
After reading “Life Without Bread” a few years ago, I ate less bread/pasta, but without reinforcement I would gradually relapse until something like low carb would get my attention and cause me to rein in the addiction. I hope I’m on the wagon for good now, but still look longingly at the crusty baguettes as I pass by them.
Really good blog Paul.
Q: I have been suffering from osteoarthritis for about 2 years now and for the past several years have not eaten virtually any grains. The arthritis has become much worse over the past year even though I have kept to a very paleo, wheat free diet. Are there any other known triggers that worsen arthritis?
Thanks! Keep up the great writing.
Hi Fred,
I think arthritis not caused by food toxins is usually due to bacterial infections in the joints. The Road Back Foundation is a good resource, http://www.roadback.org/.
I would try doxycycline, see if that helps. Optimize diet and follow our four steps to help immunity.
Note that chronic infections take long-term protocols, often combination antibiotic protocols, to defeat. Short-term (3 week) antibiotics won’t do it.
Shou-Ching had joint stiffness go away when she started vitamin K2. That could be a factor too.
Best, Paul
Aside from removing wheat , you also need to eliminate the “Nightshade”, group of vegetables especially white potatoes and tomatoes ………they can cause a lot of joint aches and pains for people who are prone to any kind of arthritis . 🙂
Back in the day I used to cook up 2 POUNDS of whole wheat pasta, and we would eat the whole thing! (Two teenagers, two adults). Most of the carbs we ate were wheat based, which is not surprising since my husbands family is of Italian origin, and all of my forbears were German wheat farmers living in Russia. (Can you say speatzle?)
Desperately looking for migraine relief, I made the decision to try a low carb diet about 4 years ago. I thought at the time I would have to find a way to work in some noodle products. However, I found the wheat cravings subsided very quickly. Indeed, that is one of the things I came to really appreciate about a low carb approach–freedom from food cravings.
Fast forward, migraines were improved but not eliminated. I’m implementing Paul’s suggestions for micro nutrients and a ketogenic diet with 200 cals of safe starches. Preliminary results are good. But an interesting side effect has developed. I have had hip pain for about ten years. Doc said it was mild osteoarthritis. Like migraines, it improved but did not go away on low carb. So here I am, adding 200 calories of starch largely from potatoes, and I start to feel really stiff in the morning, and hip pain becomes much worse than previously. Finally put 2 and 2 together, and decided there might be something to that old canard about nightshades and arthritis. Guess I’m on the rice bandwagon.
Paul, I think it is interesting that you seem to lump rheumatoid and osteoarthritis together as probably being infection based.
Hi Kate,
Well, I don’t trust medical diagnostic categories much, if the cause of the ailments is not known. If the symptoms are similar, I’m willing to believe the causes may be similar.
Infections can be tricky because they can present with different symptoms depending on where the infection is and which pathogens are involved.
Your experience is interesting. Since all plants contain toxins, it’s possible to get immune sensitization to almost all of them. We had a post earlier discussing people who were sensitive to sweet potatoes but not potatoes.
Best, Paul
Dear Paul – thanks for this fascinating series of posts. I have suffered from osteoarthritis for years, although my impression has always been that it is largely due to cartilage loss rather than inflammation (which seems to be primary in RA). There is alot of scientific literature on this, although I realize that data can often be ignored or misinterpreted (a convincing theme of this site). Can you tell me if you have found evidence that parasites and inflammation are involved in OA specifically? Also, on another topic, I have recently been struggling with acid reflux, and you mentioned that Shou-Ching had struggled with this for awhile (and gotten rid of it?). I would love to learn more about her experience and any advice about dietary modifications that would help. Thanks very much, Kyle
Hi Kyle,
Well, I haven’t looked much into the literature for osteoarthritis so I may be mistaken and maybe there are clear diagnostic criteria for detecting a distinct disease process.
Malnutrition does lead to osteoarthritis but I haven’t looked into the mechanisms. That doesn’t preclude an infectious origin since everyone gets infections and malnutrition affects immunity.
Re acid reflux / GERD, I did put some advice in a comment. See http://perfecthealthdiet.com/?page_id=781#comment-16159. I’ll have to elaborate in a post at some point.
Best, Paul
Paul,
I’m rather late to this thread, but could you explain how auto-antibodies lead to scoliosis? I see the correlation, I just don’t understand the possible mechanism.
I’m curious because I have (idiopathic) scoliosis myself, and I ate a stupendous amount of wheat as a child and adolescent. I also have two young nephews who are bread-devourers. I feel I might be able to make a better case to my brother re: their wheat reduction/elimination if I could also articulate this danger.
Hi Advocatus,
Here’s a 5-part series arguing the case:
http://celiacnurse.com/part-1-of-5-part-series-is-there-an-association-between-scoliosis-and-a%20gluten-intolerance/
Best, Paul
What?s Happening i am new to this, I stumbled upon this I’ve discovered It positively helpful and it has helped me out loads. I am hoping to give a contribution & assist other customers like its aided me. Good job.
Does anyone have any opinions on a 100% rye sourdough, would that be safe carbs or still better avoided?
Hi George –
Better avoided, but still much healthier than any wheat bread.
In this post, http://perfecthealthdiet.com/?p=1963, I showed data from a study comparing rye with wheat in mice. Mice eating rye were much healthier.
Hi Paul,
My mother’s doctor tells her that she has high blood pressure and a slightly elevated thyroid. She eats homemade Greek fries in olive oil almost every day and indulges in icecream. Since potatoes are a safe starch and icecream is high fat and therefore a heart friendly food, she thinks her diet is not to blame. She indulges in bread only on occasion.
Any thoughts?
Des
Paul,
What do you think about bread that has low wheat content e.g. dark German rye breads or whole grain breads? Being a German (living in Taiwan for years now – and drinking high mountain tea 🙂 it is tough for me to imagine a life without bread. Not that I eat a lot of it but I do love it once in a while.
Best regards from Tapei,
Stefan
Hi Stefan, well, rye bread is much healthier than wheat bread, so if you have to have a vice, that is a relatively benign one.
Dear Paul, thank you for your prompt reply and thanks for all the great info you help people with to get healthier.
Hi Paul,
I’ve read your book and I feel like your diet would be easier for me to try, than a low carb Paleo diet. I’ve had problems gaining weight, I’ve been able to get it to 138, at one time I was 125 lbs. Mostly due to chronic IBS, that my doctor thought was celiac or gluten intolerance. I was tested negative though, blood tests and 2 different biopsies. I have a few questions, please excuse me if they’ve already been answered before.
If I do the PHD as prescribed in your book, how long do think it can take to heal from IBS or gluten intolerance?
Is gluten free bread ok in moderation even though they have vegetable oils?
Should I go 100% gluten free, including regular beer and do I need to worry about cross contamination eating out?
Thank you!