Wheat is fine for most people but a major problem for about one in ten. For women with gluten sensitivity, even a small amount can drive or worsen endometriosis, adenomyosis, migraines, thyroid disease, and some cases of amenorrhea.
The first step is to understand the difference between FODMAPs and gluten. FODMAPs are fermentable carbohydrates found in wheat and many other foods; they can cause digestive bloating. Gluten is a protein and it can cause inflammation and immune dysfunction.
FODMAPs can cause digestive bloating
The term FODMAP is an acronym invented by researchers at Monash University in Australia. It stands for fermentable oligo-, di-, and monosaccharides and polyols which are short-chain carbohydrates that can be difficult to absorb from the small intestine and cause irritable bowel syndrome (IBS). FODMAP-containing foods include wheat, legumes, certain vegetables, and fruit.
👉🏽Tip: Spelt is a cousin of wheat and a popular wheat substitute. Spelt contains gluten but not FODMAPs — so it is easier to digest than wheat.
Untreated, FODMAP sensitivity can contribute to problems with the microbiome, impair estrogen clearance, and activate mast cells — all leading to inflammation that can worsen period problems such as PMS.
The solution is usually to 1) temporarily cut back on FODMAPs and 2) work on the underlying cause of FODMAP sensitivity, such as stomach acid medication, underactive thyroid, and small intestinal bacterial overgrowth (SIBO).
With SIBO and a FODMAP sensitivity, it’s usually enough to just temporarily reduce wheat and other FODMAPS, without strictly avoiding any food.
Gluten can cause immune dysfunction
Gluten is not a carbohydrate like FODMAPs and does not cause digestive bloating. So, if bloating is your main symptom, refer to the FODMAP section above.
Gluten is a protein that can cause immune dysfunction, but only in people with gluten sensitivity.
👉🏽 Tip: Wheat, spelt, rye, barley, and possibly oats contain gluten. Rice, corn, millet, quinoa, or potatoes do not contain gluten.
The difference between celiac disease and non-celiac gluten sensitivity (NCGS)
Gluten sensitivity can take the form of either celiac disease or non-celiac gluten sensitivity. Of the two, celiac disease is more severe and can be diagnosed with a blood test.
👉🏽 Tip: If you’re already avoiding gluten, you might get false negative on the celiac test. That’s why it’s important to test for celiac disease before eliminating gluten.
Non-celiac gluten sensitivity (NCGS) cannot be diagnosed (or ruled out) by the celiac blood test.
Gluten-sensitivity does not usually cause digestive symptoms but instead can cause non-digestive symptoms such as:
- brain fog
- autoimmune disease.
How to know if you have gluten sensitivity
First, consider whether you or anyone in your family has any of the conditions listed above, especially Hashimoto’s autoimmune thyroid disease, which is strongly linked with gluten.
Next, speak to your doctor about a blood test for the “celiac gene” or “celiac genotype,” known as HLA-DQ2 and HLA-DQ8. Testing positive for a celiac gene means you have a 4 percent chance of developing celiac disease and an even higher risk of developing other autoimmune conditions such as autoimmune thyroid disease.
The other way to know if you have gluten sensitivity is just to try strictly avoiding it for at least eight weeks and see how you feel. Strictly avoiding means avoiding even trace gluten, which is different from just reducing wheat as you can do with FODMAPs. There’s no such thing as partially gluten-free.
👉🏽 Tip: If wheat causes digestive bloating, it’s likely to be a problem with FODMAPs. If wheat causes brain fog, psoriasis, autoimmunity, or migraines, it’s likely to be a problem with gluten.
How wheat affects periods
Some cases of amenorrhea (lack of periods) are the result of celiac disease or gluten sensitivity which is why every woman with unexplained amenorrhea should be screened for celiac disease. Of course, there are several other causes of amenorrhea, such as undereating, which have nothing to do with gluten.
Migraines can be worsened by gluten sensitivity (among other factors). One mechanism is that gluten sensitivity can lead to antibodies against the enzyme glutamate decarboxylase (GAD), resulting in high glutamate and low GABA. Read Natural treatment of hormonal migraines.
The inflammatory type of PCOS can be worsened by FODMAP-sensitivity, gluten, and/or dairy sensitivity.
Finally, endometriosis and adenomyosis may be driven to some extent by gluten sensitivity (among other factors). According to reproductive immunologist Dr Jeffrey Braverman, most women with endometriosis have the celiac genotype. Read Immune treatment for endometriosis.