Gluten sensitivity: learn how to "go against the grain" if you suffer from this common ailment.(ASK THE NATUROPATH: SUPPLEMENTS)(Disease/Disorder overview)

Q: I really enjoy Better Nutrition's "Go Gluten Free" column. Can you provide more in-depth information about how gluten intolerance and grain sensitivity can impact health?

--Julia T., Tucson, Ariz.

A: To begin with, wheat seems to be the most irritating of the gluten-containing grains. In fact, many folks are sensitive to wheat only, without having full-blown gluten intolerance. Overt gluten sensitivity, called celiac disease, celiac sprue, or gluten enteropathy, has many faces; the most well-known involves various forms of gastrointestinal distress: usually diarrhea, but occasionally constipation, oral or gastric ulcers, a shiny, raw-feeling tongue (glossitis), nausea after eating, and even vomiting. General symptoms can include malaise, weakness, unexplained weight loss, failure to grow (in children), and blunting of the fingertips (clubbing). The skin can become itchy or develop lots of tiny capillary breaks, and herpes-like blisters may occur, often in the mouth.

Vitamin and mineral deficiencies are common with celiac disease, especially the B vitamins (a lack of which can lower a person's ability to handle stress, as well as cause tingling and numbness in the extremities). The fat-soluble vitamins A, D, E, and K can also be in short supply. Bone density can be reduced because celiac disease causes calcium malabsorption. For those with celiac disease, part of the gluten molecule (gliadin) causes the immune system to destroy the absorptive surface of the small intestine, normally covered in a lush "brush border." These myriad tiny finger-like projections become abraded and flattened, thus greatly reducing the surface area for nutrient absorption. This is reversible once the offending substances ate removed. However, untreated, celiac can lead to osteoporosis, profound anemia, and seizures.

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Celiac disease is particularly prominent among those with Irish heritage. It is estimated that 3 to 6 percent of the Irish population is afflicted with celiac. Celiac is also more common in families with autoimmune conditions, especially autoimmune thyroid disorders, and mental illness, particularly schizophrenia. Although 40 percent of the U.S. population is thought to carry the celiac HLA-DQ2 or-DQ8 genes, only 1 percent ever has a triggering ...