Thursday, July 26, 2007

Gluten Addiction?

It's probably been a couple of weeks now, but Kate asked a question about the potential for becoming addicted to gluten.  I mean, I think that many of us wish we could eat a juicy doughnut every once and a while, but Kate seemed to think that there is something more to it for some people.   Are some people Jonesin' for a doughnut for more reasons than that they smell good around 4:00?  I've read up on it while taking a break from getting ready for my dissertation defense and now that I've finished, it seems like a good time to share what I found.

 

First off, we know the incomplete digestion of gliadin produces peptide fragments that are also known as exorphins.  Where that name comes from, I don't know.  As I understand it, an exorphin will have comparable action but opposite effects to an endorphin.  They interact with the opioid receptors, the mu, kappa and delta receptors, which are located predominantly in the central nervous system (CNS) as well as in the digestive tract.

 

These are the same receptors that are involved with opium and its purified components morphine and codeine, as well as heroin, which is a semi-synthetic derivative of morphine.  Mu receptors generally are responsible for the analgesic effects, respiratory depressant, pupil constriction, euphoric and physical dependence properties.   Kappa receptors also affect analgesia, as well as sedation, physical dependences and dysphoria, possibly by inhibiting mu receptors.  Delta receptor action is poorly understood, at least when the book I was looking at was written.

 

An interesting side note that I hadn't been aware of before is the fact that the opioid receptors in the CNS become habituated, whereas the receptors in the digestive tract do not.   The consequence of this is that to get the same high, an addict needs to take more drug than they used to, but as they do so the effect of the drug on the gut becomes more and more extreme.   When you realized that morphine has been used to relieve diarrhea, it makes me think that perhaps they might need to be taking Alli to balance out the effects.

 

Biologically, these receptors are activated or deactivated by drugs but they are designed to function in response to chemicals that are made in the body rather than chemicals made in a poppy or a chemistry lab.   These endogenous ligands are called endorphins.  They are responsible runners high, where a person gains a boost of energy, mental acuity and relief from pain.   It isn't clear exactly how this works, because inhibition of runners high using opioid receptor antagonists does not produce the opposite of these effects.   Exorphins on the other hand DO cause the opposite effect of a runner's high: loss of energy, loss of mental acuity and the onset of pain.  That sounds like a pretty complete explanation of what I feel when I ingest gluten, I'd say.

 

This is where the speculation and anecdotal evidence begins.  I have found that my sensitivity to gluten has increased, rather than decreased as I have been on a gluten free diet.   That is, I now get terrible headaches when I eat gluten that I didn't notice having continually before.  My speculation is that a similar habituation process can occur with gluten that occurs with heroin.   When I ate gluten all the time, I needed more to get the same effect.  The difference is that heroin makes you feel good and gluten makes me feel bad.   Now that I am off gluten, I have become de-habituated, if that is a word, and am more sensitive.

 

Second, if gluten peptides are interacting with the same receptors that heroin does, is it unreasonable to assume that for some people they can be habit forming in a similar way.   I have often heard that heroin is relatively easy, though extremely messy, to get off of.  The withdrawal symptoms are painful and messy, but they end and then the former addict can go on with life.   However, approximately 25% of heroin addicts are never free of the craving, and must continue methadone treatment indefinitely. 

 

We do know that aside from the usual withdrawal symptoms, there is something called protracted abstinence syndrome that can last up to six months.   It includes depression, abnormal response to stressful situations, drug hunger, decreased self-esteem, anxiety and other psychological disturbances.   My book says "Long-term opioid craving might result from a pre-existing or an opioid-induced hypofunction of the endogenous endorphin system.  Therefore, to rehabilitate these addicts and keep them in a functional state, low levels of opioid may be necessary."   Could there be an "opioid induced hypofunction of the endorphin system" that causes a person to crave gluten forever?  I haven't found any research on it in the scientific literature, but it makes sense.  

 

It may be protracted abstinence syndrome that persists for up to six months, and you are giving in and having a slice of Poppa John's pizza within that time frame, thus re-entering the craving cycle, whereas if you just refrained a little longer, you could break out.  It may be that there is a persistent physical dependence similar to addiction.  Or, it may simply the case that no one sells a good gluten free donut.   Someone should do some fMRI studies on this, I think.  That isn't my bailiwick, though.

 

(Information taken from "A Primer of Drug Action" by Robert M. Julien, M.D. Ph.D. 1995.)

 

 

8 comments:

  1. thank you so much for doing this! i have all sorts of hypotheses, based on my graduate degree in public health (albeit not much biochem in there)and the work that i've done over the years with health education.

    for about three years i ran these diet classes at a local gym. the diet was low carb (but not the meat-orgy of atkins - this was much healthier) and prohibited sugar, wheat, and other refined carbs. one of things i saw as i taught more of the classes was that folks on the diet would go through a sort of withdrawal. it would be pretty horrific for a few days then taper off over a week or so. headaches, nausea, anger, crying.

    but those who made it through began to see big shifts in their living. arthritis clearing up, anxiety and depression lifting (i had many people actually taper off and stop using mood or arthritis meds)

    what i saw during this period was a big factor in my going back to graduate school in public health. and my graduate studies gave even more evidence. and now reading your post, i'm even more confident that we're actually in the middle of a huge drug epidemic of sorts, with refined carbs as the culprit - HFCS affecting some folks, gluten effecting others, etc.

    there is something about how they interact with the human system, the effect the insulin triggering has on the body, the resulting inflammation, the resulting shifts on neurochem.

    this just seems to be a huge new frontier in health and i am so glad not just for your new phd but that you are applying your skills and knowledge toward gluten :)

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  2. I don't know as much about High Fructose Corn Syrup and Insulin dependence. I've heard of things like that, but my doctoral work has involved making some small molecule drugs to fit into specific receptors. Insulin and refined carbs are part of a much more complex system that I don't have much experience with.

    In her new book (See sidebar) Carol Fenster quotes someone else who estimates that 10-15% of the population are gluten intolerant. I don't know where that number comes from, but if that is true, that is a lot of people who potentially fit into the scenario I described with exorphin addiction.

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  3. . . . i did a research paper for an environmental health class (refined carbs as environmental toxins) and then posted it on one of my blogs - http://datinggod.typepad.com/katherineturner/2007/03/refined_carbohy.html - if you feel to take a peek. pardon the typos - i actually posted a final draft before it was really "final" :) lazy, lazy :)

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  4. Hi ...great write up. There is a great book you might find interesting titled, The Mood Cure by Julia Ross. She is a nutritional psychologist with a clinic in San Francisco. I've been meaning to write about it...but as you know, it's hard to find the time. Very interesting stuff though...the theory that food is addictive. She really gets into it and even has a couple pages on gluten.

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  5. I am so glad you posted this as this applies to me.
    I suspect myself to be either gluten intolerant or worse, coeliac. Next week's allergy test will make things official but from my own observation, I am DEFINITE that I am.
    My symptoms are as severe as having a diarrhea, contispation, skin trouble, stomach cramp, vomiting, abnormal bloating, indigestion, loss of appetite, either excess gain weight or loss, fatigue, insomnia, depression, anxiety and worst off..addiction.
    Despite these hard to ignore symptoms, I have been consuming gluten on daily basis for almost 3 months now. Ofcourse this means my intestines are rotten away. Physically, even staying still hurts so in the morning when I am more sane, I hate gluten..infact I do not even want gluten! However, as the day progresses, my mind becomes weaker and gives in..so that in matter of fact all I have is gluten. Not just a little but LOADS until my body becomes physically too ill to take any more in. Plus this is easily done as I am living under unsupportive (more like gluten lovers) background and despite my symptoms or the facts I provide them..they do not believe me and instead shove me more of offender food. The addiction only gets worse and so are the symptoms. Depression is now out of control, insomnia is so bad I have only been able to sleep around 12 hours in 2,3 weeks. Gained more than 10kg within 2 weeks. But my stomach pain does go away whilst consuming gluten and so does my 'craving' for it. It is funny, isn;t it. Despite being the pain killer, it is also the main cause of everything.
    I MUST com off it if I am to continue on living but don't know how.

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  6. That certainly sounds like you need to stop eating gluten. My brother just doesn't eat the things that make him feel sick. When everyone else is eathing cake, he eats steak. It works for him, most of the time. I can't do that, myself. The best way I know of to stop eating foods with gluten is to make alternate foods that are gluten free.

    If everyone is eating spaghetti, you need some rice noodles. If you want toast for breakfast, you need your own bread. It is pretty tough to quit cold turkey, especially when you don't feel supported. If you need help finding recipes to make substitutes, let me know, and I'll send you some pointers.

    You can do it.

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  7. The immune systems of those with Celiac Disease are reacting severely to this protein, however there are thousands of people who suffer milder reactions to gluten and are unaware of the underlying cause.

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  8. I meet people all the time that know that their health would drastically improve if they stopped eating gluten and/or dairy, but for a combination of what I believe to be physiological, psychological, and social reasons can't eliminate gluten and/or dairy long-term. I believe that as the addiction is multi-faceted the treatment needs to be as well.
    I applaud you for putting this information out there, and for applying your wisdom and time to this very important and pervasive issue. It seems to me people are a bit embarassed to admit they have a gluten addiction, but as awareness of gluten intolerance and addiction spreads, more and more people will 'come out' about this and proper research and treatment will ensue...

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