Could You Be Addicted to Gluten?

When a nutrition client of mine told me that she was literally scared to give up eating gluten, I was perplexed. When I think of eating gluten, I think of burning pain in my abdomen and a sore, swollen mouth from oral allergy syndrome, and want nothing to do with the stuff. But for some people, the mere mention of giving up gluten makes them want to “tear apart my office,” as one of my mentor nutritionists once said. She told of a client whom she convinced to give up gluten for a trial. The client lost 30 pounds, her terrible acne cleared up and her fatigue, depressed mood and hormone imbalances disappeared. Yet at the end of the trial, she chose her morning bagel over the obvious health benefits of giving it up. “I want to live life,” she said. For most of us, the choice to live a life free of fatigue, acne, weight gain and hormone imbalances over eating a bagel every morning would seem easy, so what was going on?

Gluten peptides can act as opiates

Humans lack the digestive enzymes to completely break apart gluten proteins, and as a result, what are called gluten peptides, or chains of amino acids that are the building blocks of proteins, are left in the digestive tract. Some of these peptides, called gluten exorphins or gluteomorphins, are similar to morphine and can fit into opioid receptors, which are present on nerve cells in the gut as well as the rest of the peripheral nervous system and brain (Arısoy & Üstün-Aytekin, 2018). Studies show that gluten peptides can not only enter the bloodstream (Costa et al., 2019; Severance et al., 2012), but pass the blood-brain barrier and attach to opioid receptors there, producing an opiate-like response that strongly promotes addiction (Zioudrou et al., 1979).

Gluten exorphins can mask gluten intolerance

Studies that have randomly tested large populations for blood markers of celiac disease show that most people with celiac have what is called asymptomatic celiac disease (ACD), in which there are no reported symptoms like diarrhea, abdominal pain and bloating, but blood tests and biopsies confirm they have celiac (Pruimboom & de Punder, 2015). In the gut, gluten exorphins can attach to opioid receptors and block pain signals caused by the inflammatory chemicals, swelling and bloating pressure seen in gluten intolerance (Rueda-Ruzafa et al., 2020). Opioids also slow gut motility, or the movement of intestinal contents through the GI tract, allowing time for water to be reabsorbed from stool in the colon and thus counteract diarrhea. 

Why are some people addicted to gluten while others aren’t?

Gluten exorphins, unlike other types of gluten peptides, can be broken down and made inactive by an enzyme called dipeptidyl peptidase-4 (DPP-4). However, some people may be genetically prone to make less DPP-4, or its production may be compromised by impaired gut function. High, regular gluten intake such as a daily bagel may use up all available DPP-4, leading to high levels of gluten exorphins (Pruimboom & de Punder, 2015). DPP-4 is also produced by the gut bacteria Lactobacillus lactis spp. Lactis, so dysbiosis could play a role in increased gluten exorphin levels and gluten addiction (Arısoy & Üstün-Aytekin, 2018).

How do you know if you have gluten addiction?

Gluten exorphins have a high affinity for DPP-4, meaning they will bind to it quickly and easily before other types of peptides, using up all the available enzyme. DPP-4 also breaks down other peptides, including substance P (SP), which causes acne (Toyoda & Morohashi, 2001) and eczema (Zhan et al., 2017). Gluten exorphins preferentially using up DPP-4 would increase SP, increasing risk of these skin disorders. Gluten exorphins and low DPP-4 levels could also cause anxiety (Pruimboom & de Punder, 2015) and depression  (Bilgic et al., 2013). Despite a lack of gastrointestinal symptoms, intestinal inflammation triggered by gluten causes impaired nutrient absorption, leading to fatigue and hormone imbalances. Other extraintestinal symptoms like migraines, sore joints or brain fog may also be present.

If you think you could be addicted to gluten, scaling down your gluten intake with the help of a nutritionist, and restoring your gut health with Alimental’s Gut-Skin Axis Restoration Program are here to help. Check it out here.

References

Arısoy, S., & Üstün-Aytekin, Ö. (2018). Hydrolysis of food-derived opioids by

dipeptidyl peptidase IV from Lactococcus lactis spp. lactis. Food Research International (Ottawa, Ont.), 111, 574–581. https://doi.org/10.1016/j.foodres.2018.05.068

Bilgic, B., Aygun, D., Arslan, A. B., Bayram, A., Akyuz, F., Sencer, S., &

Hanagasi, H. A. (2013). Silent neurological involvement in biopsy-defined coeliac patients. Neurological Sciences: Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 34(12), 2199–2204. https://doi.org/10.1007/s10072-013-1448-z

Costa, A. F., Sugai, E., Temprano, M. P., Niveloni, S. I., Vázquez, H., Moreno, M.

L., Domínguez-Flores, M. R., Muñoz-Suano, A., Smecuol, E., Stefanolo, J. P., González, A. F., Cebolla-Ramirez, A., Mauriño, E., Verdú, E. F., & Bai, J. C. (2019). Gluten immunogenic peptide excretion detects dietary transgressions in treated celiac disease patients. World Journal of Gastroenterology, 25(11), 1409–1420. https://doi.org/10.3748/wjg.v25.i11.1409

Pruimboom, L., & de Punder, K. (2015). The opioid effects of gluten

exorphins: Asymptomatic celiac disease. Journal of Health, Population, and Nutrition, 33, 24. https://doi.org/10.1186/s41043-015-0032-y

Rueda-Ruzafa, L., Cruz, F., Cardona, D., Hone, A. J., Molina-Torres, G.,

Sánchez-Labraca, N., & Roman, P. (2020). Opioid system influences gut-brain axis: Dysbiosis and related alterations. Pharmacological Research, 159, 104928. https://doi.org/10.1016/j.phrs.2020.104928

Severance, E. G., Gressitt, K. L., Halling, M., Stallings, C. R., Origoni, A. E.,

Vaughan, C., Khushalani, S., Alaedini, A., Dupont, D., Dickerson, F. B., & Yolken, R. H. (2012). Complement C1q formation of immune complexes with milk caseins and wheat glutens in schizophrenia. Neurobiology of Disease, 48(3), 447–453. https://doi.org/10.1016/j.nbd.2012.07.005

Toyoda, M., & Morohashi, M. (2001). Pathogenesis of acne. Medical Electron

Microscopy: Official Journal of the Clinical Electron Microscopy Society of Japan, 34(1), 29–40. https://doi.org/10.1007/s007950100002

Zhan, M., Zheng, W., Jiang, Q., Zhao, Z., Wang, Z., Wang, J., Zhang, H., & He,

S. (2017). Upregulated expression of substance P (SP) and NK1R in eczema and SP-induced mast cell accumulation. Cell Biology and Toxicology, 33(4), 389–405. https://doi.org/10.1007/s10565-016-9379-0

Zioudrou, C., Streaty, R. A., & Klee, W. A. (1979). Opioid peptides derived

from food proteins. The exorphins. The Journal of Biological Chemistry, 254(7), 2446–2449.