An introduction to gluten and eczema
Gluten intolerance and eczema are two conditions that may sometimes be seen to appear together.
Gluten intolerance results from sensitivity to this particular protein. Up to 70% of your immune cells reside in the gut and eczema is likely to be the result of low grade allergies and sensitivities which are manifested via the immune system.
It is plausible that dietary factors are having an influence on our immune system and both conditions. By understanding the processes involved, it is possible we can begin to manage our diet, which in turn can have a positive effect on our immune system.
What is eczema?
Eczema, also commonly referred to as atopic dermatitis, is a skin condition featuring dry, itchy, and inflamed skin.
The cause of eczema is not well understood but it is thought to have links with the immune system, digestive system and genetic predispositions. Atopic dermatitis is often associated with other allergies and asthma, especially in young children.
Eczema often improves with age but in other instances it has been seen to develop later in life. It seems changes in dietary patterns or immune function can have an influence at any time, positively or otherwise.
The most common symptom of eczema is extremely itchy skin. This arises as a result of increased levels of histamine (immune cells promoting a local response) in the skin and a this becomes long-standing, the itchy areas of skin thicken.
As with any itch, the normal response by the affected individual is to scratch the affected area. This can cause breaks in the skin which will bleed and leave room for infection and further inflammation.
Corticosteroid creams are often used in the treatment of eczema. These creams suppress the immune response by narrowing the blood vessels in the skin. This can help to reduce inflammation but don’t quite get to tackling the root of the problem.
From a naturopathic point of view, it makes sense to try and address the root of the problem – what is causing our immune system to overreact?
It is generally acknowledged that the digestive system is involved in some way; perhaps there are components of our diet which could be having an effect. Keeping this is mind can be effective in the treatment of eczema.
What is gluten intolerance?
Gluten is a protein found in grains such as wheat, barley and rye. It is a fairly large protein which requires specific enzymes to break it down in the body.
Gluten intolerance is topical – just think of the number of people who are intolerant of wheat. However, the mechanisms leading to gluten intolerance aren’t well understood. One theory is that the condition is due to a lack of the appropriate enzymes required to break down gluten in your small intestine. The result is that gluten travels partially undigested into the large intestine where it causes irritation and gives rise to nasty symptoms.
If this theory is correct then the addition of digestive enzymes designed to help breakdown gluten should help – this is currently of interest to scientists and companies producing supplements. However, the results are mixed and not clear-cut. This suggests something else may be going on.
Allergy or intolerance?
It is possible that the digestive enzymes responsible for breaking down gluten are doing their job fine, but instead, it is a component of gluten, exposed during the process of digestion, that we are reacting adversely to.
This is controversial too, as it isn’t clear how the immune system is involved in food intolerance. It is often assumed that the immune system is only involved in food allergies. Acute, type 1 allergies involve the release of immunoglobulin E (IgE) antibodies which produce a heightened immune response, such as what’s seen in a peanut allergy. These reactions can be life threatening.
The immune responses potentially occurring in food intolerance are now more carefully being considered. A low-grade immune response to the components of gluten breakdown, (or even the enzymes themselves!) may be occurring.
If the immune system is involved to a certain degree, it gives us some explanation as to why gluten intolerance is often related to other problems around the body, such as in the skin.
Microbiota is the term used to describe the diverse range of bacteria that inhabit your entire body. They reside in every part of our system including your gut and on your skin.
Gut bacteria is important for the health of our gut but more importantly our general health. Up to 70% of our immune cells are found in the gut, so an unhealthy gut can have an impact on our immune responses.
In Irritable Bowel Syndrome (IBS), research has implied that people affected may have distinctly different populations of bacteria present. Our microbiota has a mix of ‘good’ and ‘bad’ strains present. A number of factors can have an influence and imbalance (dysbiosis) can occur. By topping up the levels of good bacteria it is possible we can positively influence our immune and subsequent anti-inflammatory functions which can positively impact our skin.
Research on the benefits of prebiotics and probiotics for skin health are in early stages but results are looking hopeful.
Kassinen, A. et al (2007) The fecal microbiota of irritable bowel sundrom patients differs significantly from that of healthy subjects. J Gastroenterology 133(1) 24-33
Gluten intolerance and eczema occurring together
It has become apparent that people with coeliac disease and gluten intolerance have a higher incidence of skin problems than people unaffected by these conditions. This leads to the question of whether an intolerance to gluten could be responsible also for eczema. It seems the immune function has a big part to play in these conditions, although it is a complicated area.
If both conditions are occurring together, removing gluten (or in some cases other elements) from your diet has been found to have positive effects on the skin.
Treatment of eczema
Dietary triggers are thought to have an impact and are important to consider in the treatment of eczema. Gluten and dairy are likely instigators but this is not absolute and varies from person to person. Creating a personal food and symptoms diary is extremely helpful in trying to identify what might be having an influence.
Trying an elimination diet can be useful if you suspect gluten, or dairy for example are causing a reaction. Removing gluten or dairy from your diet if you are intolerant is likely to reflect positive effects in sensitive skin.
As we have discussed, eczema is often thought to be linked to a weakened digestive function so supporting this body system is key.
Start at the stomach to support the excretion of digestive juices and enzymes. Digestive bitters such as Digestisan support the digestive functions of the stomach and liver, helping to assist the breakdown of your meal before it reaches the intestines.