Welcome to Fuck Yeah, Science! where we talk about the science behind various illnesses and conditions in a way that’s totally liberal arts major friendly. Understanding exactly what’s going on behind you or a loved one’s condition is extremely important because knowledge is power and power lets you take over the world. Uh, I mean, take control of your life and set you on a path for success. Today we’ll be looking at celiac disease.
Whether you have celiac, someone you know has it, or you’re just wondering why the fuck all these stores are now selling shitty little loaves of bread for $6, celiac disease is pretty rad. To study that is, not so fun to have. celiac disease in an autoimmune disorder like rheumatoid arthritis and lupus, and frankly if you’re going to have an autoimmune disorder, this is the one to have. Autoimmune disorders are when your immune system attacks your body for shits and giggles. For example, in rheumatoid arthritis, the immune system attacks tissue in the joints and lupus can effect joints, skin, kidneys, brain, and other organs. Most autoimmune disorders are treated with some nasty medications like steroids, immunosuppressants, and even medication that is traditionally for malaria.
We can go into more detail about other autoimmune disorders later, but for now let’s stick to celiac. Celiac disease occurs when your immune system sees gluten in your small intestines and get’s all pissed off about and destroys the intestinal lining. Rude. Like, Jesus Christ, I don’t set the building on fire when someone I don’t like walks through the door.
First, for those who do not know, gluten is a protein that is found in wheat, barley, rye, spelt, and like some other shit too that no one’s ever heard of (samolina, triticale, kamut, those sound like countries not grains.) Gluten means glue, because it’s what makes dough stick together and is important in helping bread rise. Why can gluten cause an autoimmune response and not some other protein? Idk. Why can’t it be a protein only found in snails or something nasty like that? I couldn’t find a source that wasn’t pseudoscience bullshit. If you find an article that talks about why gluten can trigger an autoimmune disorder while other proteins can’t, please let me know. But don’t bother sending any articles that blame processed food or gluten overdoses, there’s plenty of other shit we eat way too much of on a daily basis and while intolerance to those things are increasing, such as fructose intolerance from too much high-fructose corn syrup, none of them are causing autoimmune issues. I mean, gluten is added to tons of food that don’t need it, such as using wheat as a thickener or barley malt as a sweetener, but so is dairy and a host of preservatives.
Symptoms of celiacs can vary immensely. Usually there’s some sort of digestive issue. Some people have diarrhea, nausea, vomiting, etc. I used to get stomach cramps that were sometimes so bad I couldn’t walk. I would take that any day over vomiting though. However, I didn’t often have stomach cramps, most of my problems were from nutritional deficiencies caused by malabsorption, meaning I wasn’t getting important vitamins and minerals like iron, zinc, vitamin B, and calcium because my intestines were too destroyed to function properly. The main problems I had were joint pain, headaches, mouth ulcers, easy bruising, and stunted growth. Other symptoms include nosebleeds, fatigue, hair loss, seizures, rashes, and depression and anxiety. I hoped that my depression and anxiety would go away or get better with going gluten free, but alas, in my case it was not a symptom of celiacs, though I certainly feel worse after I get traces of gluten. See previous post for more information on the intersection of physical and mental illnesses.
Ok, so now for the part on how exactly this stupid little protein makes me so goddamned sick. I’m gonna keep it simple here because honestly, there are parts of this I don’t understand. My knowledge of the digestive system is purely from a 100 level physiology class. So your small intestine is the part of your digestive system that comes after the stomach and does pretty much all the nutrient absorption. To be most effective at absorbing shit (not literal shit, that comes later,) you’ve got to have lots of surface area, so not only is it ridiculously long and coiled up, it also has these things called villi. See below image.
In people with celiacs, when gluten goes into the villi and gets absorbed, immune system cells, called B Cells, decide to make antibodies. A few genetic factors as to why this happens have been discovered, but I won’t get into any of that. Usually antibodies are only made to target invaders like viruses or damaged cells. Antibodies are specific to one target, though some can stick to similar targets, and they basically just flag the cell, be it infected or healthy, for T-cells to come and destroy. In this case, the target is an enzyme that breaks apart gluten. Enzymes are proteins that break apart things, generally other proteins. Without the enzyme to break apart gluten, the gluten triggers creation of more antibodies and the problem snowballs. Then to make it all worse, when the T-cells come in and destroy the enzyme, they cause inflammation of the villi. Same thing happens when you have a cut that gets infected and it swells and feels hot and itchy. Except it’s not just a little cut, your small intestine is 20 feet long and 1 inch in diameter.
BUT, celiac disease isn’t the only autoimmune disorder triggered by gluten. I mean, I have heard of people with other autoimmune disorders say that going gluten free helps them, and maybe it does, there hasn’t been conclusive research, but personally I think it’s always worth a try. There’s this really cool disease (once again, cool to study, awful to have,) called gluten ataxia that I just found out about while doing research to write this article. See people, knowledge is power. I am one step closer to world domination. Ataxia is a rare disorder that is marked by loss of voluntary muscle control. Gluten ataxia is super super rare, like between 0.0000966% and 0.0003024% of the US population, meaning less than 10,000 people compared to millions with celiacs. It’s a lot like celiacs, immune system getting all pissed off and attacking shit because it hates gluten, except instead of attacking the intestinal lining, it attacks the cerebellum.
This is your cerebellum. A really basic rule of thumb for brain anatomy is the farther back/down something is the more boring yet important it is. The brain stem keeps your organs functioning, especially heart and lungs. The cerebellum is for movements and balance, hence damage causing ataxia. Not only does it help you walk, it’s also needed for speaking and swallowing. Fun fact, the main cause of death in Alzheimer’s patients is from choking or dehydration because they can’t swallow due to damage to the cerebellum.
There’s not much research on gluten ataxia, and it’s still not a recognized medical problem by all physicians. Then again neither is celiacs, but it’s only a few nutcase doctors that don’t believe in it still. Sorry for the divergence, I just can’t pass up a chance to talk about brains.
So what should you do about gluten? Well, if you think you have a problem, I encourage you to get tested. To get an accurate result, you have to be tested before going gluten free. First they do a blood test, then a biopsy. Technically they say you should be scoped have a biopsy to know for sure that it’s celiacs because the blood test isn’t very accurate, but to be honest, I just got the blood test. If you really want to have a microscope go down your throat and all the way to your intestines and then a bit of your intestines cut out, go ahead. Personally, I preferred to just go gluten free and see if that helped. Now if you go that route, keep in mind that feeling completely better can take like 3-6 months in kids and up to 3 years for adults. Also, cheating occasionally or accidentally getting traces of gluten is just as bad as eating it everyday. Your immune system doesn’t care if it was just one donut, remember, it fucking hates gluten and is going to destroy everything if it sees some.
If you know someone with celiacs, take them seriously. Don’t be an asshole and tell them something’s gluten free when it’s not. Don’t cut the gluten free pie with the pie cutter you just used on the normal pie. Don’t be all like, “well just pull the croutons out of the salad,” or “can’t you just like pull the cheese off the pizza and eat that or something?” Don’t be that person; everyone fucking hates that person. You wouldn’t tell someone with a peanut allergy to pull the peanuts out of their brownie. Just because a food issue isn’t immediately life threatening, doesn’t mean it’s not dangerous.
While I do cheat with some of the things I’m not supposed to eat (mainly snickers bars, if anyone has found good dairy free chocolate please let me know,) I really can’t emphasize enough how bad it is to get traces of gluten if you have celiacs. Even if you do not feel sick, continued damage of the intestines increases your risk of cancer. This is because healing from damage means increased cell replication. The more your cells replicate, the more likely it is for the DNA to get all fucked up and lose the genes that keep the cell from going rogue. Also, you’ll continue to have nutritional deficiencies which can lead to anemia, miscarriage or infertility, osteoporosis, and increased risk for bone fractures.
Be healthy, my gluten free lovlies. If you have any questions on gluten free/ allergen free cooking and baking, or on science, please feel free to ask. You can leave a comment. I love answering science questions and while I mostly know just brain stuff, I can probably figure out other human biology stuffs too. Don’t ask me about chemistry or physics, that shit’s boring as hell. If you have a request for the next Fuck Yeah, Science! should be on, leave a comment and if it sounds interesting, I’ll do it.