Gluten intolerance and asthma

The incidence of people suffering with asthma in the U.S. continues to grow. Interestingly enough, so does the incidence of people being diagnosed with gluten intolerance. Because asthma can be an autoimmune reaction, the next question is - Are the two related?

According to a new study in the Journal of Allergy and Clinical Immunology, there is a strong correlation.

Source: 127, Issue 4, April 2011, Pages 1071-1073.

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Baker's asthma

Baker's Asthma dates back to an observation from 1700. Bakers exposed to large amounts of flour dust suffered respiratory symptoms that mimicked asthma. This was the first known historical connection between grain inducing asthma. The reaction was later discovered to be an IgE response. IgE is an acute antibody produced by the body's immune system. The antibody causes the release of immune chemicals called histamines. These histamines are responsible for the shortness of breath, wheezing, coughing, and other allergy symptoms.

Asthma is extremely common and on the rise

According to EPA statistics, approximately 8% of the U.S. population have asthma. The common thought is that asthma is caused by genetics, airborne allergies, and the over emphasis of hygiene (hygiene hypothesis).

The common medical solution is the use of steroid inhalers, and immune suppressing allergy medications. Many patients are told that the asthma is something they will have to medicate for the rest of their lives. The downside to this - chronic steroid use causes vitamin and mineral deficiency, bone loss, and contributes to diabetes. Allergy medications increase the risk for infection and reduce the immune systems ability to fight pathogenic invaders.

Skin testing for allergies is limited and incomplete & misleading

Many doctors perform skin testing for environmental allergies like dust, mold, pollen, etc. Unfortunately, food allergies are rarely looked at as a cause for asthma. If they are investigated, they are usually limited to wheat, soy, peanut, and milk. Measuring wheat allergy is not the same thing as checking for gluten sensitivity. This leads to a lot of confusion among patients. Additionally, skin testing can yield false negative results. Even more unfortunate is the fact that skin testing only measures on type of antibody. There are four more antibodies that contribute to allergy reactions. See the diagram above for more information on this.

Gluten free diet commonly improves asthma

In my practice, I commonly see patients who have been previously diagnosed with asthma. After identifying gluten sensitivity and/or other food allergies with advanced lab testing, these patients always show dramatic improvement. As a matter of fact, for most of them, medication becomes unnecessary.

These patients' immune systems are so busy fighting their food, that they don't have left over immune resources to fight the environment. Add to that the fact that gluten can induce inflammation in the lung tissue.

With more than 20 million cases of asthma, an estimated 30 million people with gluten sensitivity, and an estimated 1 million with people with celiac disease, wouldn't it be prudent to investigate the possibility of an overlap? Shouldn't doctors test for gluten sensitivity as a standard part of practice for every patient with asthma?