Dr. Tom O’Bryan DC, CCN, DACBN was interviewed on the Anxiety Summit by host of the Anxiety Summit, Trudy Scott, Food Mood Expert and Nutritionist, author of The Antianxiety Food Solution.
Gluten and anxiety: the testing conundrum solution
- How gluten damages the gut lining and why gut healing is key for brain health
- Alpha-gliadin and the limitations with current testing
- Cyrex array 3: 10 peptides and 3 types of transglutaminase
- Transglutaminase-6 and the brain on fire
- Cyrex array 5: cerebellum, myelin and other brain antibodies
- Cross-reactive foods: spinach, milk, coffee, chocolate
- Autism: testing kids and their moms
In season 2, Dr. O’Bryan presented on this topic: Gluten’s impact on the inflamed brain: reducing anxiety and depression
- “No human on the planet can digest gluten”
- Terminology and why it’s not called gluten intolerance but sensitivity
- Is gluten sensitivity just a fad and the recent FODMAPs research
- The multitude of diseases and symptoms caused by gluten sensitivity
- Gluten sensitivity as a contributing factor to psychiatric manifestations/anxiety/depression and new 2014 research from Italy
- Suicide rates in kids with celiac disease (even when they quit gluten
- We touched on the conundrum with testing
This interview goes deeper into testing and offers a solution to the conundrum.
Here are some gems from our interview:
The most common peptide from poorly digested wheat is 33 pearls long. It’s called alpha-gliadin, 33 pearls. It’s a big peptide. And 50 percent of people with celiac disease have alpha-gliadin elevated but the others don’t. But wait a minute. We know that celiac disease is a sensitivity to wheat. How come these other people don’t have elevated antibodies to the 33 pearl peptide? It’s because the immune system is fighting other peptides of wheat, not the 33. It might be the 17. It might be the 9. It might be the 11. It might be the 22. There are over 60 different peptides of wheat that have been identified to cause or trigger an immune response, over 60. And every lab in the country is only testing one called alpha-gliadin, the 33 pearl. Now that’s an important one to test but it’s not the only one to test.
So what happens when people have one of those peptides that the immune system is fighting that’s not the 33 and you do a blood test for gluten sensitivity. If your doctor orders the common blood test for gluten sensitivity and it looks for alpha-gliadin and it comes back negative and your doctors says you’re fine eating wheat. See, here’s the blood test. Well you can get a false negative meaning it says there’s no problem when there really is because your body’s fighting other peptides of wheat.
Here are the arrays that Cyrex offers. We covered parts of arrays 3, 4 and 5.
Gluten Summit gifts – register here and get these audio interviews:
- Natasha Campbell-McBride: The Critical Nature of Gut Health and its Impact on Children’s Brains
- David Perlmutter: Eliminating Gluten as the 1st Step in Preventing Brain Conditions.
Here is the link to the Certified Gluten-free Practitioner training we discussed
If you are not already registered for the Anxiety Summit you can get live access to the speakers of the day here: www.theAnxietySummit.com
Missed this interview or can’t listen live? Or want this and the other great interviews for your learning library? Purchase the MP3s or MP3s + transcripts and listen when it suits you.
You can find your purchasing options here.: Anxiety Summit Season 1, Anxiety Summit Season 2, Anxiety Summit Season 3, and Anxiety Summit Season 4.
My gastroenterologist ran a celiac test before my colonoscopy. I had been off gluten for almost 2 years, so the test read negative. I’d call it a poorly planned, inconclusive test – what does the educated community say?
Awesome summit goin’ on!
Gail – glad you’re enjoying the summit! Yes you would need to have been eating gluten
Hi Trudy. I just listened to your great interview of Dr. Tom O’Brien. I wish it was available for everyone to listen to. You asked about having to eat gluten for it to show up as a problem on a test but he didn’t answer. I don’t know about the Cyrex test, but when I discovered I had Hashimoto’s in 2005 it was hard for me to believe I had a problem with gluten because I was non-symptomatic. I’d go off gluten and couldn’t tell a difference. A naturopath told me about the stool test done through enterolab.com that I could order on myself. They also had a gene test for non-symptomatic gluten sensitivity done with an inner cheek swab as well as antibodies found in the stool to dairy, soy, egg whites and yeast. Enterolab did NOT recommend eating gluten if one had been off gluten because it could then generate an autoimmune attack for months like Dr. O’Brien talks about. As it turned out I had antibodies to soy, dairy, egg whites, gluten and also a gene from my mother and one from my father for non-symptomatic gluten sensitivity. I then avoided all of those substances. When Cyrex lab got up and running I had their test for cross reactivity – the only one I could afford. Quinoa, rice and some other ones showed up. After eliminating those substances, I finally got my energy back. I hope to have other tests from Cyrex, and also believe that REAL “health” insurance, that helps us “insure health” needs to pay for them. Hope this feedback is helpful.
Alezz
Very helpful thanks! and yes for the Cyrex test you do have to be eating gluten.
I hear you on the health insurance!
Thank you for another enlightening presentation Dr. O’Bryan, filled with invaluable clinical pearls, and another information-packed summit Trudy. Your summits are my favorite to tune in to each year. I had a few follow-up questions.
1) Do you need to be eating the cross-reactive foods in Cyrex Arrays 4 and 10 in order to obtain a reliable result about potentially problematic foods? I have been on the autoimmune paleo diet since 2013 with only one successful reintroduction (eggs) so I’m wondering if this will limit the accuracy of these Cyrex tests for me since many of the foods evaluated I do not include in my diet. I know for a positive intestinal biopsy in celiac disease, you need to be consuming gluten for six weeks prior so I was curious if these tests followed the same principle with the foods examined.
2) In my Master’s program in Human Nutrition and Functional Medicine, we recently discussed the Vojdani and Tarash (2013) study about gluten cross-reactivity. It was noted that eggs, soy, teff, tapioca, potato, quinoa, amaranth, hemp, sorghum, buckwheat, sesame, and oat cultivar tested no different than control—that is, the results for cross-reactivity were not statistically significant (p value exceeded 0.05). Also, it was problematic that they combined brewer’s yeast and baker’s yeast. The combination does appear to cross-react with alpha gliadin; however, brewer’s yeast comes from brewing beer and contains barley residue. Moreover, when a statistical analysis was performed (Table 2), the apparent impact of casein, coffee bean, instant coffee, and rice were not even close to having a p-value of statistical significance. The only foods close to statistical significance were corn, millet, and brewer’s yeast but NONE were statistically significant. P values were not evaluated for any other foods tested so it is difficult to put weight in those findings. Also, the effect sizes were not calculated which is another limitation. In the blogosphere, many people cite the full list of foods as tested as gluten cross-reactors when in reality these were just the foods that were tested in this study and statistical significance, a measure of high quality research, was not obtained. I was wondering if you could comment on this.
Vojdani & Tarash, 2013. Cross reaction between gliadin and different food and tissue antigens. Food and Nutrition Sciences, 4(1), 20-32.
3) I was told in 2009 that I have celiac disease on the basis of a positive anti-gliadin antibody IgG (AGA), which I believe tested at 12 if memory serves me right. However, my intestinal biopsy was negative for celiac disease, as were tTG, EMA, and DGP. At the time, I had been experimenting on and off with a gluten free diet and I did not consume the requisite four slices of bread per day for six weeks that is the recommended gluten challenge prior to biopsy. My mother does have celiac disease (positive tissue transglutaminase) and my sister has the dermatitis herpetiformis rash and is sensitive to gluten but has never been formally evaluated. I have been strictly gluten free since 2011 and on the paleo autoimmune diet since 2013 so I would never reintroduce gluten for the sake of acquiring a correct diagnosis. However, I’m wondering if you think my clinical picture more accurately reflects celiac or NCGS. In my coursework we also learned that anti-gliadin antibody is useless on its own due to low sensitivity (46-87%) and specificity (70-98%) (van der Windt et al., 2010).
Van Der Windt et al., 2010. Diagnostic Testing for Celiac Disease Among Patients With Abdominal Symptoms. The Journal of the American Medical Association, 303, 1738-1746.
Thanks again so much! I’m sorry if I posted this twice but it didn’t show up after submitting the first time around.
Ali
Thanks for the excellent questions. I’ll see if Dr Tom can respond for you
I would love to hear the answers to Ali’s questions also.
Where can we find the links to the paper and research articles that he mentioned that we can bring in to our doctor?
Thank you so much for this valuable information!
Heather
I’m hoping to get answers. I’ll post the paper here on the blog – thanks for catching that
Does Dr. O’Bryan’s gluten certification program provide continuing education credits for nurse practitioners?
Thanks
Sara
I’m pretty sure they do but best to check with them to make sure.
Dr. Tom O’Bryan’s talk was stunning to hear! For months I have been suffering from extreme symptoms of insomnia, weakness, continuous and concurrent infections, and the feeling that I am inflamed and hot all over my body, especially my brain. I have gone to a variety of healthcare professionals with no relief. I believe the Cyrex arrays 3,4 and 5 may give me some answers that I am so desperately seeking. Can anyone tell me how to find a healthcare professional who can order these tests? My primary care physician does not have an account and is not open to these kinds of things. I live in the general metro area of St. Louis, MO. Thank you.
Vicki
I’m looking into this and will post a link for you
Thank you Trudy and Dr. O’Bryan for a very informative interview. Where can I find the article Dr. O’Bryan mentioned during the talk? He mentioned it would be good information to take to doctors when talking to them about gluten testing, etc. Thank you!
Jill
I’ll post it here on the blog – thanks for catching that
Great talk, as always Dr Tom O’Bryan and Trudy. I always learn something new from you both.
Just a couple of questions. It was interesting to hear about the New England Journal of Medicine reporting that it is the first time in the history of human species that children will die earlier than their parents. What is the reference for this please?
Also it was interesting to hear Dr Tom O’Bryan discuss transglutaminases. I noticed he said that being positive for TG2 will indicate end stage celiac disease. If you have early stage celiac TG2 may not show up. Would this also be the case for TG3 and TG6, that it will only show up elevated on Array 3 if the person is ‘end stage’? I’m particularly interested in TG6 since I had an equivocal result for this. I did not think I had any particular brain ‘damage’ at the time but now thinking about it I do sometimes get headaches, I was diagnosed dyslexic when 20 yrs old particularly slow processing skills. I wonder how bad it is to have equivocal TG6 reading.
Thanks
Claire
I’ll ping Dr Tom’s team to try and get answers to both of those. Glad you enjoyed it!
Thank you
Wow, fabulous talk!! It’s this one that made it clear that I need to buy the whole package- such great information which I need to relisten to several times! I’ve been wanting to find a simplified comparison of the tests. Thank you Dr. O’Bryan!
And to you Trudy, thank you once again for a fantastic Summit!
JoAnn
Wonderful – isn’t he brilliant!? He explains things so well but it’s a lot of info! and hearing it over again will help
I had such fun coming up with these questions and prepping for the interview and learned a ton too!
Hello Dr. O’Brien. I thoroughly enjoyed your interview with Trudy! I get emails from you frequently and I have learned so much from them. You speak a lot on Gluten and I thought I had learned everything about Gluten. I was thoroughly surprised that there still is plenty to learn about the subject! Thank you for a wonderful and informative interview. I will await many of your emails and I am sure I will learn much more from you in the future.
Debi
Thanks for the super message for Dr Tom – I’ll make sure he sees it. Glad you enjoyed the interview – I had so much fun researching the Cyrex panels and coming up with our interview outline and questions. And I also learned so much. Always more to learn
Could you ask Dr. Tom O’Bryan if vitamin c ascorbic acid and mag and calcium citrate/citric acid is okay to take because I understand these are somehow connected to corn? Thank you so much, Adell
Where can i get these lab tests in Europe? Especially Germany? I would be so thankful if someone could help me with that
Thank you for this interview. However, how does one heal the gut when you have IgG markers showing what to eliminate form your diet, so you eat the alternatives and 3 months later you are intolerant to those alternate foods as well as the previous and so on… Let 15 yrs pass and you can’t eat any foods! How do you stop feeding the fire, creating antibodies while giving your body the fuel it needs to heal ( inc.taking supplements that may not absorb due to intestinal perm.) ? There has to be something beyond food that is triggering issues- no?
Niki
It could be an autoimmune issue, heavy metals, parasites, candida, SIBO and many other factors. I list these 60+ causes for anxiety https://www.everywomanover29.com/blog/60-nutritional-biochemical-causes-of-anxiety/ but many can apply for many conditions
Thank you for this informative and interesting interview.
Is it OK to eat spelt if you have gluten sensitivity (no Celiac) ?