Free Course | Celiac disease and gluten sensitivity

Proliferation of humankind and spread all over the globe was primarily fueled by wheat energy.  Who would have imagined that wheat would be demonized as a killer grain in twentieth century? How did it come to pass that every self-respecting grocery store would stock shelf after shelf with gluten-free foods?

The answer: In the United States, we own and pride in our diseases.

We fiercely fight to protect our right to own our diseases – more than the gun lobby fights to protect the right to own guns. We must always have a disease of the decade or two. And these are the decades of gluten diseases. No self-respecting American can tolerate opposition to celiac disease and gluten sensitivity.

Until fifty years ago, the terms celiac disease and gluten sensitivity were known only to doctors. In 1960, in my third year at King Edward Medical College, Lahore, Pakistan, I considered these entities to be learned and remembered until I passed the examination in my pediatric course. I desired to be a surgeon and I did not think surgeons then were interested in such gut problems. In 1968, I arrived in the United States and saw little reason to ever open my textbooks to look for celiac disease and gluten sensitivity.

Celiac disease (sprue by another name) is an immune-inflammatory entity. It is believed to be caused by a family of gluten proteins in wheat, oat, barley, rye, and in smaller amounts in other grains. True celiac disease accounts for a relatively small number of individuals clinically diagnosed to have gluten sensitivity. It occurs in genetically predisposed people of all ages from middle infancy onward. Symptoms include pain and discomfort in the digestive tract, chronic constipation and diarrhea, failure to thrive (in children), anemia[2] and fatigue, but these may be absent, and symptoms in other organ systems have been described. Vitamin deficiencies are often noted in people with celiac disease owing to the reduced ability of the small intestine to properly absorb nutrients from food.

Most Gluten-free That Glitters Is Not Gold Majid Ali MD from Majid Ali on Vimeo.

How Did Celiac Disease Become a Darling of Disease-lovers?

Before I answer this question, let us consider the findings of a landmark study conducted by Italian researchers and published in the journal BMC Gastroenterology on November 18, 2014. The three graphs reproduced below from that study tell the story of how celiac disease has changed.

Disease onset was symptomatic in 610 patients (79%), while 160 celiacs showed a subclinical phenotype. In the symptomatic group the non-classical prevailed over the classical phenotype (66% vs 34%). Diarrhea was found in 27%, while other gastrointestinal manifestations were bloating (20%), aphthous stomatitis (18%), alternating bowel habit (15%), constipation (13%) and gastroesophageal reflux disease (12%). Extraintestinal manifestations included osteopenia/osteoporosis (52%), anemia (34%), cryptogenic hypertransaminasemia (29%) and recurrent miscarriages (12%). Positivity for IgA tissue transglutaminase antibodies was detected in 97%. Villous atrophy was found in 87%, while 13% had minor lesions consistent with potential celiac disease. A large proportion of patients showed autoimmune disorders, i.e. autoimmune thyroiditis (26.3%), dermatitis herpetiformis (4%) and diabetes mellitus type 1 (3%). Complicated celiac disease was very rare.

Our early primordial ancestors were fermenters. Throughout human evolution, some of those fermenting cells thrived in oxygen-poor nitches in the human body, serving many purposes, including food digestion. These were “good fermenters.” Our later human ancestors learned—experientially or intuitively, it seems—learned ferment foods to enhance their value. We can call it “good fermentation.”

Gluten-Free Foods for Heart Health from Majid Ali on Vimeo.

Every chronic disease begins with fermentation. This need not raise any eyebrows. Diseases involve inflammation with buildup of acids and alcohols. Fermentation, of course, is conversion of sugars into alcohols and acids. We can call it “bad fermentation.”

Then came the age of fermenting human cells—most notably during the last century—ushered in by the era of antibiotics, sugar abuse, and industrial pollutants. The modern epidemics of inflammatory, immune, and degenerative disorders are rooted in cellular fermentation. In a broader evolutionary context, I recognize these epidemics as evolution-in-reverse. This is “ugly inflammation.”

This article is a part of my series (begun in the early 1980s) on good fermentation.

Gluten Sensitiivity or Gut Fermentation With Leaky Gut State Majid Ali MD

Over 7 hours of discussions and suggestions only $49.95

Gluten-free Diet for Gluten Sensitivity

Glutens are two grain proteins – glutenin and gliadin enmeshed in starches – that cause a wide spectrum of clinical disorders in some individuals. One simple form is wheat intolerance. At the other end of the spectrum is the severe form of gluten-sensitive enteropathy (GSE) called celiac disease. In Part Three of this series, I include a very long list of celiac disease-associated conditions to define the scope of clinical problems associated with gluten proteins. I begin this three part series about gluten sensitivity by first summarizing my experience with gluten-related clinical problems:

1. The frequency of problems caused by wheat, rye, oats, and barley is increasing among people with chronic health issues.
2. Nearly all my patients with gluten-related symptoms ate bread and other gluten foods freely and without symptoms before they developed gluten sensitivity.
3. Gluten intolerance developed when the bowel became inflamed and “leaky,” leading to entry into the blood of undigested gluten proteins.
4. Gluten-free diet only partially improved health.
5. Gluten-sensitive individuals regained their health only after bowel-liver detox was achieved and other oxygen-related issues—mold allergy, mold toxins, thyroid-adrenal weakness, hormonal imbalance, anger, and deep disappointments that caused the leaky gut state—were addressed.
6. The recovery in some cases with severe stress, mold toxicity, and instability of the autonomic nervous system, and continuing stress was sometimes delayed or incomplete or both.
7. Complete elimination of gluten grains was usually helpful in the short-term but was necessary in the long run only for a small number patients.

Dr. Ali’s Leaky Gut Protocol

From the above summary, many readers with puzzling chronic health disorders might ask: should I try a gluten-free diet trial? My answer: absolutely yes. I suggest that such readers consider a six-week trial of Dr. Ali’s Leaky Bowel (DALB) Protocol, which includes gluten-free diet trial (described below) as well as elimination of dairy (except yogurt), and sugar. I also prescribe castor oil rubs and Nystatin to reduce the population of fermenting microbes. Nystatin, of course, requires a physician’s prescription. Fortunately, more and more doctors are willing to support this request from patients. The less effective alternatives to Nystatin are echinacea, astragalus, burdock root, goldenseal, pau d’arco, and oregano.

A Valuable Suggestion

I recommend that readers first consider all elements of Dr. Ali’s Leaky Gut Trial described in Part Two. Once clinical improvement is achieved with all elements combined, then one can eliminate some aspects to narrow down the negative effects of gluten proteins. If that is not possible, I suggest readers first conduct a four-week gluten-sugar-dairy-free trial. Trials limited to gluten-free diet sometimes are not as revealing.

The Oxygen (Dysox) Model of Gluten Sensitivity

Readers will note that my oxygen view of gluten sensitivity—and celiac disease, by extension—is radically different from other prevailing theories of the disorders. In past publications I marshaled evidence for the central—and fundamental—roles of oxygen-related factors in the cause of the leaky gut state. My colleagues at the Institute of Integrative Medicine and I have also published a series of clinical outcome studies in which we documented the role of bowel derangements caused by dysox (dysfunctional oxygen homeostasis) and healing with oxystatic therapies. This, in essence, is the Oxygen Model of Gluten Sensitivity.

Oxygen is the organizing principle of human biology and governs the aging process. I began my book Oxygen and Aging (2000) with these words and then I began a series of articles in which I marshaled evidence for the unifying oxygen model of disease. Specifically I presented oxygen models of inflammation, pain, liver injury, asthma, allergy, colitis, heart disease, stroke, kidney failure, cancer, and other disorders. This article outlining the Oxygen Model of Gluten Sensitivity is an extension of that work.

Gluten-free Diet

Gluten-sensitive persons need to avoid completely the following grains, in any form, for a period of at least six weeks to assess the effects of such elimination on their health:

1. Wheat
2. Rye
3. Oat
4. Barley

Other grains such as amaranth, buckwheat, quinoa, milo, teff, rice and corn contain small amounts of “bound gluten” that, in general, do not cause food incompatibility reactions in gluten-sensitive persons.

Spelt and Kumat are two types of ancient wheats that appear to be genetically different from the common variety of wheat. Many gluten-sensitive individuals can tolerate these grains well, especially when consumed sparingly. Both varieties are usually grown without pesticides. Spelt has a strong hull that protects its kernel. Teff, an Ethiopian staple, is a highly nutritious grain that contains more than ten times as much calcium as wheat and barley.

Suggestions for Snacks

Sunflower seeds, sesame seeds, pumpkin seeds, melon seeds, watermelon seeds, soy nuts (actually a grain), cashew nuts, macadamia nuts, pine nuts, Brazil nuts, chestnuts, pecans, and litchi nuts. Peanuts and walnuts are common causes of allergic reactions and should be eaten infrequently. For additional information, please read chapter 8 of The Butterfly and Life Span Nutrition (1992).

Evidence for the Oxygen Model of Gluten Sensitivity

In Part Three of this series, I present evidence of the Oxygen Model of Gluten Sensitivity under the following headings: (1) microscopic features of bowel biopsies:

(2) coexistence of mold allergy and mold toxins;

(3) association of antibodies against gluten proteins with gluten-sensitivity;

(4) the gluten-sensitivity-associated conditions; and

(5) incomplete healing with gluten-free diets alone.

Celiac Disease Diagnosis from Majid Ali on Vimeo.

Gluten Sensitiivity or Gut Fermentation With Leaky Gut State from Majid Ali on Vimeo.

18 Million Americans With Gluten Sensitivity. Majid Ali MD from Majid Ali on Vimeo.

A Prediction- Gluten Sensitivity Will Be Blamed for Nearly Every Chronic Disease Majid Ali MD from Majid Ali on Vimeo.

Corporate Gluten-Free or My Recipes Majid Ali MD from Majid Ali on Vimeo.

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One comment

  • Dear Dr. Ali,

    I understand that you are saying that the general issue of what is happening in the oxygen homeostasis of the body in question, and the general issue of the gut ecology of the patient in question, predominate over issues of gluten.

    But about the gluten and the bread we are eating some interesting issues came out in a recent article in the November 3, 2014 New Yorker article on gluten, the rise of the “gluten free” industry, and the massive number of people who are taking gluten out of their diets, “Against the Grain.” Sources cited in the article state that the wheat in the bread we are eating has undergone much genetic modification in the interests of increasing crop yields and ease of cultivation. However, the experts do not agree that this fact could have made any impact on our tolerance of gluten. According to this article, the US Department of Agriculture researcher, Donald Kasarda who has studied wheat genetics for decades “found no evidence that a change in wheat breeding practices might have lead to an increase in the incidence of celiac disease. “My survey of protein content in wheat in the U.S. over approximately the past one-hundred years did not support such an increase on the basis of historical data in comparison with recent data.'”

    1.) But, is the amount of protein in the wheat, or the amount of actual celiac disease– are these only issues which would affect our tolerance of the gluten in modern wheat (other than our rates of bowel ecology problems?)? Or are there other issues, such as the similarity or lack of similarity of modern wheat proteins to the protein of the wheats which were grown historically? Thus, if the amount of protein content in the wheat has not changed, could part of the trouble be that modern wheat protein is different enough to provoke immune reactions in our bodies that it did not provoke before–especially in the presence of high rates of gut ecology disturbance?

    According to “Against the Grain”, the as part of his research for the article, the author of it, Michael Specter, went to, “Mount Vernon, where Washington State University’s Bread Lab is situated. The lab is part of the university’s wheat-breeding program…”

    2.) How substantial has the change been to the genetics of the wheat we are eating? Why is it that the antique wheat I buy which is grown down in Sicily, grows six feet high and seems not to cause problems in most people who eat at my local macrobiotic restaurant–many of whom have problems with digesting wheat, but that the modern wheat, like the wheat that grows near my house which grows much smaller–less than half as high as the antique wheat, does seem to cause problems in many of these same people? Are the genes and the proteins in the two types of wheat–modern and ancient really the same? Why are your patients tolerating the antique grains better than modern grains? Could the the issue be simply the amount of gluten we tolerate when we have leaky gut syndrome, or could there be issues about how well we tolerate the proteins in the gluten of modern wheat as compared to the antique wheat?

    According to the author of the article, “The amount of gluten added to industrially made bread keeps increasing,” and the director of the lab at Washington State, Stephen Jones, ” has become acutely interested in whether that extra gluten may be at least partly responsible for the gastrointestinal distress reported by so many people.” The author writes about the common use in industrial bread of , “Vital wheat gluten , a powdered concentrated form of the gluten that is found naturally in all bread.” According to the article, “Vital wheat gluten increases shelf life and acts as a binder; because it’s so versatile. food companies have added it not only to bread but to pastas, snacks, cereals, and crackers, and as a thickener in hundreds of foods and even in some cosmetics.”


    4.) Even if the amount of protein in the wheat has not changed, could not a large increase of wheat gluten in our diet be exacerbating the gut ecology problems you are writing about? And if there is an increase in those problems–such as leaky gut syndrome, could not a large increase in a difficult to digest protein be a factor in why, as the article says, “Nearly twenty million people contend they regularly experience distress after eating products that contain gluten, and a third of American adults say they are trying to eliminate it from their diets.”?

    Chronic fatigue syndrome, candida, chemical sensitivity. Are we just creating diseases out of some collective neurosis? Or do we realize that something has gone wrong in our bodies, and like the “Blind Ones” in the Sufi tale of “The Blind Ones and the Elephant”, see only part of the beast? Is it rather than that these things don’t exist, that they represent an incomplete view of our problems?

    Isn’t that what you are telling us? But could it be that our decision en masse to avoid modern bread also has some roots in just what is going into that modern bread?

    In the New Yorker article the author seems to be trying to make a case against the existence of gluten intolerance, but he does decide to stop using the common bread additive “vital wheat gluten” when he makes his own homemade bread–citing that when subjected to heat the modern wheat protein in it becomes a rubbery, indigestible mass. He does make a point that the modern wheat gluten is less tender, and is tougher and stronger than the gluten of the antique wheat–that is why it is added to give more structure and rising power to the bread. Thus, he himself, concludes that he should not be using “vital wheat gluten” in his own bread, after the researcher at Washington State University, Stephen Jones shows him what the cooked “vital wheat gluten” additive is like after being subjected to heat. Jones comments to the author on his experiments trying to destroy “vital wheat gluten” by leaving it in Coke, ” The stuff is simply indestructible.”

    5.) If there is a lot of leaky gut syndrome in the population, as you are saying, is not the “indestructible” wheat gluten which has been put into our diet in ever increasing amounts, more likely to end up in our blood through the leaky intestinal barrier, and raise havoc with our immune systems?

    6.) Are we really wrong to know that something is wrong with the bread we are eating, and that we feel better if we don’t eat it?

    Despite the fact that the author of “Against the Grain” seems to be siding with the experts he cited in the article– the expert from the U.S. Department of Agriculture, and the expert on celiac disease from the Mayo Clinic–experts who seem to be inferring that the problem with gluten intolerance is all in people’s heads, the author of “Against the Grain” does, almost unwittingly, make a successful case against the industrial breads we are eating, and not on the grounds of just a very high content of modern wheat gluten–a much higher content of gluten than was in the bread which was historically eaten.

    Serious questions about what is in the bread we are eating are raised when the author mentions the number of additives that are being used in bread –other than the vital wheat gluten– chemicals like” acetone peroxide, chlorine, and benzoyl peroxide”, which, according to the author, are “masked as ingredients under the term ‘bleached.’ ” The author mentions other additives– “Optional ingredients are also permissible in products called bread: shortening, sweeteners, ground dehulled soybeans, coloring, potassium bromate…and other dough strengtheners (such as bleaching agents and vital gluten).'”

    It is interesting that the author mentions Potassium bromate as a common bleaching agent for flour used in making bread. Potassium bromate has been the subject of a campaign by Dr. David Brownstein to raise people’s awareness, because, according to Dr. Brownstein, potsssium bromate blocks the action of thyroid hormone.

    7.) Though, you are no doubt right that a third of all Americans may be wrong about WHY they are avoiding bread and other gluten containing products, can we conclude that they are wrong about avoiding bread and other gluten containing products when we read about the amount of modern wheat gluten they contain, how indigestible it becomes when cooked, and all the other chemicals, including a thyroid hormone blocking chemical, which are hidden in what is labelled simply as “bread”?

    8.) Isn’t proper function of the thyroid hormone essential for metabolizing oxygen and keeping our bodies in oxygen homeostasis? Should we really be eating breads which are bleached by a thyroid hormone blocking chemical?

    Are we–a third of all Americans– who are taking gluten (or in my case, modern wheat, and foods with added gluten and flours and breads with bleaching agents and chemical additives) out of our diets, really just trying to hang on to our illnesses in a massive collective psychosis, or is it like other recent plagues of illness which we were also told by the experts didn’t exist– chronic fatigue syndrome, candida, fibromyalgia and chemical sensitivity–we know things aren’t right with our health, we know something is making us sick–we don’t understand exactly what is going on–why we have these symptoms when we eat certain foods, but we know that something is terribly wrong, and are searching for the cause?


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