The Link Between Gluten and Autoimmune Disorders: What You Need to Know

It is widely agreed among health and nutrition professionals that following a gluten-free diet is beneficial for individuals with autoimmune disease and chronic pain, especially joint and muscle pain. This is because non-celiac gluten sensitivity (NCGS) is considered an immune system-related disease, and its link to autoimmune diseases has been hotly investigated.1 Autoimmune conditions believed to be linked to NCGS, to name a few, are Rheumatoid arthritis, Hashimoto’s thyroiditis, Dermatitis herpetiformis, Psoriasis, Fibromyalgia, Ankylosing spondylitis, Spondylarthritis, Reactive arthritis, Reiter’s Syndrome, Dermatomyositis, and Lupus. 1,2 As research progresses, we learn that a clear connection exists between gluten (and similar proteins) mediated inflammation and the pain that manifests in our joints, muscles, and other body parts.2

I want you to understand that pain is never “normal,” nor should it ever be considered normal. Pain is a signal from our body that something is wrong, and we MUST listen when our body sends this message. You likely are to assume that the aches and pains you experience are just part of your illness or aging, but that is likely not the case. If your doctor has told you to eliminate gluten to help manage pain caused by an autoimmune condition, did so, and only experience temporary relief, it may be time to eliminate all grains from your diet.

Myth: Gluten is found only in Wheat, Barley, Rye, and Oats, and As Long as You Avoid These, You Are Safe.

False! Did you know that there are over 400 types of gluten, and the term “gluten” is not just a single protein that is only found in wheat, barley, rye – and sometimes oats.2 The protein that is referred to as “gluten,” known as gliadin, is only one trigger of the autoimmune inflammatory response in individuals with celiac disease or those with NCGS. A study conducted by Brestoff and Artis found that of the four hundred types of gluten proteins, forty are more damaging than gliadin, the protein that doctors commonly test for. 3 These other damaging proteins are found in different grains, so you may not be experiencing the relief you desperately need. Gluten proteins are found in all forms of grains, including rice, corn, and pseudo-grains (e.g., quinoa).2 Gluten proteins are found in all forms of grains, including rice, corn, and pseudo-grains (e.g., quinoa).2 Below is the “Primary Gluten Protein in Different Grains” table.

Primary Gluten Protein in Different Grains2

Grain	Primary Form of Gluten	Percentage of Total Protein
Wheat	Gliadin	69
Rye	Secalin	30-50
Barley	Hordein	46-52
Oats	Avenin	12-16
Millet	Panicin	40
Corn	Zein	55
Rice	Oryzenin	5
Sorghum	Kafirin	52
Teff	Penniseiten	11

Gluten, Intestinal Permeability, and Autoimmunity

There is still much to be learned about the role of NCGS in autoimmunity. We know that leaky gut is a nasty side effect of gluten/grain sensitivity. As defined by Dr. Osborne, a leaky gut is “a nasty situation that occurs when the protective barrier that keeps waste and bacteria in the intestine is breached, allowing the substances, along with partially digested food, to escape into the bloodstream – was originally discovered as a side effect of gluten sensitivity.”2 Leaky gut (or intestinal permeability) can be especially problematic for several reasons, especially since it is closely linked to autoimmune conditions. Let’s take a closer look at why leaky gut is so problematic.

1. Intestinal permeability compromises the lining of the gut wall. This allows food particles and foreign substances to leak directly into the bloodstream, flooding the immune system.2

2. The body produces antibodies that attack these “foreign substances.,” and recognizes food as a threat to the body. This results in systemic inflammation and the development of food allergies and sensitivities.2

3. Some leaked particles closely resemble tissues found in the body (gluten and thyroid antibodies), known as molecular mimicry.2 Over time, the body begins to attack its own tissues, muscles, joints, bone, cartilage, and nerves, leading to an all-out immune attack on the body.

4. The inflammatory damage caused by a leaky gut inhibits digestion. This leads to a depletion of our stores of vitamins and minerals, causing further pain and worsening symptoms.2

5. A chronic inflammatory state of the digestive system alters the ratio of good and bad bacteria, causing yeast overgrowth and small intestinal bacterial overgrowth (SIBO), which worsens our health.

6. The continual worsening in the integrity of the gut leads to persistent, chronic pain and inflammation and the development of additional autoimmune disorders.

A Functional Medicine Approach

The first step to healing from autoimmune disease and reducing pain is eliminating environmental triggers promoting gastrointestinal inflammation and permeability. Eliminating grains from the diet may be a solution for individuals suffering from chronic pain since gluten is a known contributor to inflammation, and all grains contain some form of gluten. However, if done incorrectly and without nutrition counseling by a qualified health professional, it can lead to an imbalanced diet with less-than-optimal nutrient density, exacerbating health concerns. Suppose you believe that eliminating grains from your diet is the right step. In that case, I highly suggest working with a Registered Dietitian Nutritionist (RDN) – bonus points if they have an integrative functional medicine/nutrition certification.

References

1. Non-Celiac Gluten Sensitivity: A Complex Diagnosis. The Institute for Functional Medicine. Published August 14, 2024. https://www.ifm.org/news-insights/nonceliac-gluten-sensitivity/ 

2. Osborne P. No Grain, No Pain. Simon and Schuster; 2016.

3. Brestoff JR, Artis D. Commensal bacteria at the interface of host metabolism and the immune system. Nature Immunology. 2013;14(7):676-684. doi: https://doi.org/10.1038/ni.2640