You’ve been tested for celiac disease and the results are negative. Still, you have terrible GI symptoms after most meals, not to mention the persistent itchy eczema on your hands. Your doctor recognizes that you could have a non-celiac gluten sensitivity and recommends that you follow a gluten free diet. Sounds simple, right? Just eliminate gluten. But as many of you already know or are finding out, gluten is in almost everything, which makes following a gluten free diet, well, not so simple. Accidental exposure is probably inevitable, so wouldn’t it be nice if there was a magic anti-gluten pill?
Obviously, there is no magic pill that can replace the effectiveness of following a gluten free diet for treating celiac disease or a gluten intolerance. There are a group of products available that can be useful tools while following a gluten free diet. Available over-the-counter, these products contain enzymes that specifically target the breakdown of gluten. They are meant to be used with low levels of gluten ingestion only, and are not meant to replace a gluten free diet. In other words, the best use for these is for accidental or unavoidable ingestion, such as at a business lunch with no gluten free options or dinner at Aunt Mildred’s house.
These products are not appropriate for the intentional ingestion of foods containing gluten. Being human, there are times when your will power wanes and you want to treat yourself to a hunk of crusty sourdough bread. But there is no evidence to suggest that the enzymes are thorough and accurate enough that they will break down all of the gluten from that bread. If you have celiac disease, the immune response will possibly be lessened by taking these enzymes, but damage to the lining of your small intestine will still happen. If you have non-celiac gluten sensitivity, even if your symptoms are alleviated by taking these enzymes, you should consider the negative impact gluten has on your body before using them as a free pass to eat gluten.
There are plenty of these products available. All of them contain proteases (enzymes that break down proteins) that are gluten-specific, often indicated as ‘dipeptidyl peptidase IV or DPP IV’ on the label. In addition to the gluten-specific proteases, many of the products contain other proteases, plus a blend of enzymes to help break down starches, sugars and fats. Work with your doctor or nutritionist to decide if this approach is right for you.
To sum up:
- The best use for these enzymes is for incidental, low level exposure.
- These enzymes are not appropriate for intentional consumption of foods containing gluten and are not meant to replace a gluten free diet.
- Consult a doctor or nutritionist who is an expert on celiac disease and gluten intolerance to help you decide if one of these products might be appropriate for you.
Erin Hugus, MS, CN has a Master’s degree in Nutrition from Bastyr University. Erin is an expert in Diabetes care and is passionate about empowering people with realistic strategies for optimal health. She takes great pleasure in her time spent in the kitchen and loves cooking nourishing meals for her family.
Murray JA, Scanlon, SA. Update on celiac disease – etiology, differential diagnosis, drug targets, and management advances. Clinical and Experimental Gastroenterology 2011:4 297–311.