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Jane Anderson

Cross-Reactive Foods: The Reason You're Not Healing Gluten-Free?

By June 20, 2011

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Note: Since I wrote this in 2011, medical researchers have uncovered some evidence for potential cross-reactivity in corn. Read more here: Study Finds Some Evidence for Corn Cross-Reactivity in Celiac Disease.

Ever hear of the concept "cross-reactivity"? I hadn't until recently, when I started to see references to it on the various celiac disease boards I follow. According to the theory of "cross-reactivity," certain foods (including grains, dairy and processed foods such as chocolate) supposedly "mimic" gluten in your body, causing a glutening when you haven't consumed any gluten.

Just as this concept is getting more press, certain vendors are heavily promoting tests that purport to tell you whether your body is mistaking other substances (such as other grains) for gluten, and reacting accordingly.

Well, I've looked into this -- including into the medical references being used to back up the concept -- and I have to tell you that there's no strong scientific/medical backing for "cross-reactivity."

Yes, it sounds somewhat plausible ... it seemingly could explain why so many of us react to foods even though they're labeled "gluten-free." And I can relate to being frustrated because you're following the gluten-free diet very strictly but still having frequent reactions.

However, in my experience those who fail to heal on a gluten-free diet are not seeing "cross-reactivity" from other foods, nor do they have multiple "additional intolerances" to foods other than gluten. That's despite the fact that both these concepts are commonly discussed and endorsed on various celiac forums, and some medical practitioners are promoting them.

Instead, in my experience, those who are still suffering with celiac symptoms despite a "gluten-free" diet invariably are getting glutened by the tiny amounts of gluten in their "gluten-free" foods.

You may know that the term "gluten-free" has no legal meaning at the moment -- the FDA has proposed a definition, but has not finalized it (see my article on Gluten-Free Food Label Rules for more details).

Many of the gluten-free-labeled foods we see on grocery store shelves contain a tiny bit of gluten. Just as something can be labeled "fat-free" if it contains less than 0.5 g of fat per serving (it's not truly fat-free, it simply meets the legal definition for "fat-free"), something can be labeled "gluten-free" even if it contains some gluten.

Most manufacturers do keep their gluten-free labeled products below the proposed FDA standard of 20 parts per million of gluten, and many keep them below 10 parts per million. Both 20 ppm and 10 ppm are very small amounts of gluten, of course.

However, those small amounts of gluten are still more than enough to cause reactions in the very sensitive among us (and I'm one of these super-sensitives -- I react to far less than even 10 ppm). See my article on Glutened While Eating Gluten-Free, plus my blog post "Is It A Real Reaction? Or Is It All In Your Head?", for more information on this.

Sadly, many grains and many other ingredients common in processed foods such as chocolate frequently are contaminated with gluten. Most of these test below that proposed FDA standard of 20 parts per million ... but that doesn't help you if you react to less than 20 parts per million of gluten in your food. I've had to cut out almost all grains and almost all processed foods to reduce the level of gluten in my diet to a point where I feel perfectly healthy again.

Before you buy into the concept of "cross-reactive foods" or "additional intolerances," make sure you try the foods you suspect in their purest forms possible.

For example, if you seem to react to corn, buy some unhusked corn on the cob and husk and cook it yourself. If you think your problem is soy (which is almost always badly cross-contaminated with gluten due to the fact that it's grown in rotation with wheat), grow some organic edamame of your own and try it. If you seem to react to chocolate, buy some raw cacao beans, wash, roast and shell them yourself, and determine if you react to those.

If you don't react to these foods in their natural states, then your problem almost certainly is trace gluten.

It takes plenty of work to figure this out (especially if you're not in a position to grow your own foods!), but you'll eventually determine whether your problem is those foods, or whether it's gluten introduced somewhere in the food chain. Again, in my experience, the problem is almost always gluten.

It makes far more sense to me that those who continue to have gluten symptoms are reacting to the gluten in their diets, even though that gluten is at a very low level, than to other foods our bodies are mistaking for gluten -- especially since the molecular structure of these supposedly cross-reactive foods is completely different from gluten.

Your body knows the difference between gluten and other types of foods, and it knows when you've gotten that poisonous substance ... even if the package is labeled "gluten-free."

Comments
June 22, 2011 at 10:30 am
(1) NoGluten says:

I think raw food shops and catalogs carry cocoa beans

June 22, 2011 at 10:37 am
(2) JHL says:

Also consider SIBO (Small Intestine Bacterial Overgrowth), which can cause very similar symptoms and is common to those with Celiac Disease. This can be diagnosed with a hydrogen breath test administered at your gastroenterologist’s office.

June 24, 2011 at 11:19 am
(3) NoGluten says:

At least 3 websites focus on gluten home test kits and sharing results/experience, including how to rule in/out cross-reactivity.

Juno http://www.junonutrition.com
fee based, mainly for Raleigh, NC area, I think

http://www.glutenfreewatchdog.org/
fee based

http://www.glutenzap.com

July 10, 2011 at 11:09 am
(4) shauna says:

This has definitely been my experience as well: if you seem to react to everything, a common thread between them may be the most likely answer.

And with the growing number of people who are reporting reacting to all the grains they are trying, anecdotally, I think it’s really important for us to make sure we are testing out these assumptions ourselves! Because if we all think we are cross-reacting when it could actually be gluten cc, then we’re going to miss the solution to the problem if we don’t make sure we know.

I’m growing corn myself right now for just this reason….which may take a while longer to figure out. It turns out I’m a rather terrible gardener…I need to go for ‘corn growing, part 2′ for this to work. ;-)

July 27, 2011 at 1:02 am
(5) Samantha says:

It is very frustrating when something is marked “gluten free” when it clearly isn’t. Another reason if someone is eating gluten free and still feeling sick it can be from foods that contain acid. Some acidic foods still upset my mom’s stomach such as avocado, because even though it doesn’t have gluten, the acid still causes her stomach to get upset (this is due to her getting diagnosed late and her villi still needs to heal).

January 22, 2012 at 5:37 pm
(6) dots says:

I was glad I had the test for cross-reactive foods. I had two positive lactulose-mannitol urine leaky gut tests (one on dairy, the other off most all dairy except butter).

I did the blood leaky gut test before the cross-reactive foods test. The blood leaky gut test said I was leaky in different areas. I don’t understand it all. The cross-reactive blood test showed I was reacting to dairy fat proteins (no other dairy component). AND, that I was getting barley in my diet. I found it in a probiotic labeled 20ppm (Garden of Life Primal Defense – which has barley grass).

At around the same time I did a Metametrix stool analysis which said I was getting gluten (the barley grass!).

Did I have overt symptoms? No. However, I continue to heal from fibromyalgia by trying to heal my leaky gut and I’ve done so by eating no grains, no dairy; just real food, the best I can.

January 27, 2012 at 12:23 pm
(7) Sandy says:

With seasonal allergies, there are a lot of cross-reactions to foods. My son has Spring and Fall seasonal allergies and cannot eat fresh apples, melons (including cucumbers), tree nuts, wheat (Celiac disease), and drupes. I’m not sure why it is so unthinkable that those with Celiac may also have other sensitivities to foods…not as in actually damaging the intestinal lining, but at least in causing acute distress. I am finding that rice causes me distress as well as whole corn. Perhaps “cross-reactivity” would not be the right term, but having multiple allergies and multiple food intolerance is far from unheard of or unproven.

January 27, 2012 at 5:38 pm
(8) celiacdisease says:

@Sandy — There’s absolutely no doubt that people with celiac and gluten sensitivity can have other allergies, and that those other allergies can cause major distress! Cow’s milk is a common culprit, as is corn (as you know!), and there are plenty of folks out there with nut allergies and seasonal (respiratory) allergies, too. But there is no scientific basis for the concept of “cross-reactivity,” where your body reacts to other, completely different non-gluten proteins as if it’s reacting to gluten. If you’re having what feels like a gluten reaction, it very likely is a gluten reaction. If the reaction doesn’t feel at all like a gluten reaction, then it’s most likely due to something else.

April 3, 2012 at 11:07 pm
(9) jerry says:

Im allergic to gluten as it causes Asthma in me. Was having alot of problems with asthma recurrence and discovered COFFEE to be the
latest culprit that was triggering my asthma.

April 9, 2012 at 9:54 pm
(10) Robin Elliott says:

Jane,
I’ve been looking into the cross-reactive possibility of gluten intolerance. I have to tell you that it would be almost impossible for me to be getting any gluten in my diet. I cook completely from scratch and don’t eat out. Even though I feel good most of the time, there are times when I swear I have gotten into gluten. I have even started keeping a food diary to see if I have a problem with any other foods. I have found that coffee causes me to itch and be a bit fuzzy, cranky, and sleepy. I thought it was flavored syrups or creamers that I was adding. No. I went off coffee until I stopped having symptom and then drank an espresso that I made at home and only added milk and sugar. Within 30 minutes I started having symptoms. My sister and daughter has had similar experiences. So, I think there is quite possibly something to this cross-reactive stuff.

April 11, 2012 at 4:29 pm
(11) Robin says:

Here is a good web site explaining cross-reactivity of not gluten foods and gluten intolerance. I visual is found about 1/4 way down the page.

June 21, 2012 at 10:58 pm
(12) Ronit says:

maybe the definition of cross reactivity is somewhat wrong, but from my personal experience before I even heard about the cross-reactivity possibility I felt gluten like symptoms after eating Quinoa -which I cooked with no other ingredients and rice. The Quinoa made me feel suspiciously heavy and tired (but still not as much as gluten did) and rice caused a little of upset stomach(it happened twice). I believe that it takes time to the gut to heal and therefore react in different ways to different foods. For instance: I can eat in the morning 2 sunny side up eggs and everything will be fine but a boiled egg especially in the evening ..my gut doesn’t like it.
I stopped drinking coffee too and no more dairy because my stomach was restless because of it. …As you can see I eat almost nothing now :)
(I am on a GF diet for 4 months)

July 6, 2012 at 4:58 am
(13) Karen Mason says:

ALL grains contain gluten, some contain gliadin. Please see gluten free society for accurate information. My son and I react strongly to corn, rice, and millet also; in real life and in testing.

October 26, 2012 at 10:10 am
(14) Mary says:

Thank you for this article!

I have found that I react to corn, even fresh from the farm corn on the cob. I also have true allergies (confirmed by tests performed by a board-certified allergist) to peanuts, all soy, even organic and fermented, and some other legumes.

I have been wondering about cross reactivity to supposedly gluten free seeds, grains, and starches for some time. The idea that it might not be the grains themselves, but might be traces of gluten contamination, is definitely interesting information and worth investigating.

I make almost all my food from scratch, so it hadn’t occurred to me that there might be gluten contamination hidden in my buckwheat groats, or in my sorghum flour. I’m in the process of performing yet another elimination diet, so perhaps some answers will be found there.

Definitely interesting questions to explore. Thanks!

October 28, 2012 at 10:03 pm
(15) G-FreeJ says:

My personal experience…. I continued to seek help with my belief that I was gluten intolerant because I continued to have the same symptoms despite being on a gluten free diet and of course I couldn’t find a doctor that would diagnosis me. Yes, now I realized that part of it was because I was getting into some hidden gluten but the rest is because of these gluten cross reactants.
My new doctor tested me for the cross reactants last month… guess what? There were a lot of them and a bunch that I was creating antibodies against. Let me tell you it was shocking!
Here’s my list:
Yeast, eggs, corn, rice, teff, millet, sorghum, tapioca, hemp, and quinoa.

So you tell me… this was blood work not a skin test. It may not affect everyone but it does exist!

April 16, 2013 at 7:01 pm
(16) Mary says:

I don’t know about cross reactivity between gluten and chocolate- that is what i am trying to find out about. Both give me migraine. More precisely, I can tolerate chocolate except when there has been some inadvertent gluten in the near past.

Cross reactivity is a real phenomenon in allergy. See http://www.aafa.org/display.cfm?id=9&sub=20&cont=728 I learned that ragweed and melons cross react. This helped explain why I have no problem with melons except in ragweed season. It seems like the same phenomenon as being able to tolerate chocolate except when I can trace some gluten exposure. The most recent incident involved a hair conditioner sample that didn’t have an ingredient list. I liked it and when I sought to buy a bottle of it found the ingredient list contained wheat gluten. Ah ha. I had a possible explanation for a sudden inexplicable increased sensitivity to chocolate.

August 11, 2013 at 5:43 pm
(17) ADerifield says:

I believe you are wrong. I react to all grains equally – all of those so-called substitute GF breads, all of those substitute products and even glass noodles, if processed in the same factory as rice. I didn’t have even a brief period of recovery and instead, got only progressively worse until I gave up all grains. Even Dr Fasano recommends going grain free if one doesn’t recover on a diet free of wheat, barley and rye. How do you explain that?

August 11, 2013 at 6:00 pm
(18) celiacdisease says:

@ADerifield: I react to “gluten-free” grains, too — unless I can find some that are exceedingly well-protected from gluten cross-contamination. Those are *very* difficult to find, but when I find them, I can eat them without a problem.

You’re talking about this study from Dr. Fasano’s team: Study: Trace Gluten Responsible for Ongoing Celiac Symptoms. According to the researchers, the reason the diet used in the study works is because it eliminates the vast majority of trace gluten. Otherwise, your “gluten-free” grains likely will contain a few parts per million of gluten — gluten grains (wheat, for the most part, but also barley) are just too ubiquitous in our food supply for that not to be the case. And a few parts per million of gluten in our “gluten-free” bread is too much for some of us.

It’s possible your system does not react well to all grains, but in most cases, it’s the trace gluten, not the grains.

November 19, 2013 at 11:15 pm
(19) ARN says:

I came across your article in a Google search and I noticed it is dated in 2011. More information has come out since then, which I hope will help readers of this website. I have been hearing more lately about gluten cross-reactivity in the health websites that I subscribe to. There is a Jan 2013 paper where they investigated products that cross-react with gluten versus products that are typically contaminated with gluten. I just listened to Dr. Vodjani speak during an amazing web conference called “The Gluten Summit”. Dr. Vodjani has a paper where they tested foods likely to cross-react with some of the proteins in gluten. (see links below) Since going strict on the Paleo diet several months ago, I tried reintroducing the following foods individually and I felt bad – dairy (organic heavy cream, cheese from grass fed milk) and grains (fresh corn cooked on the grill no butter, gluten free organic corn chips, and plain white rice). I guess cross-reactivity may be the issue rather than an actual “allergy” to these foods. Gluten makes me feel the worst (so so awful), but now I know that dairy is pretty high up there too. Corn and rice are less dramatic, but I still don’t feel as well as I did before eating it. Haven’t tried to re-introduce any other grains.

gluten cross reactivity abstract: http://www.scirp.org/journal/PaperInformation.aspx?PaperID=26626

gluten cross reactivity full paper: http://file.scirp.org/Html/5-2700516_26626.htm

More information on cross-reactivity, celiac, gluten intolerance, autoimmunity (from my favorite health website): http://chriskresser.com/9-steps-to-perfect-health-1-dont-eat-toxins

The Gluten Summit: http://theglutensummit.com/

December 1, 2013 at 5:15 pm
(20) Ellen says:

I must say that I disagree. I did believe my many problems were due to cross-contamination with wheat gluten. And I have had many additional gluten attacks. And I did have a doctor tell me it was corn. And when I quit the corn, the big attacks (which I had begun having again) did stop.

Why am I so sure my other problems are exposure to corn and not wheat? Because one day I accidentally did eat wheat — and I mean I really ate wheat, from a buckwheat mix that I had picked up thinking it was buckwheat flour. I had a couple of bites of whatever it was, and it was great! Had that real wheat flavor and texture! I knew it was too good to be true, and it was… So, I expected a big reaction. The thing is, I had no reaction. None. (And I have verified that I am celiac.)

To me, that means that I have not been consuming small quantities of wheat gluten, or I would have had plenty of antibodies to have a real gluten reaction. So, that says to me that those small reactions I am always having are not from wheat. And that isn’t really surprising, as corn is much more difficult to avoid than wheat gluten is.

And just to be clear, I did once go back on wheat, deliberately, after I had been off of it for a few years. And it took a while for me to get a reaction. It came on gradually — the first day nothing, and then gas, and then more gas, and then eventually, full-fledged, agonizing, gut-emptying gluten attacks. No more wheat for me. It took weeks, maybe even a couple of months, for that reaction to build up to its worst form.

December 4, 2013 at 4:03 pm
(21) Nat says:

My husband has Dermatitis Herpetiformis and has been g/f now for 3 yrs, we have just learnt about this cross reaction, it sounds plausible, however because my husbands symptoms are itchiness(unbearable) and not gut rekated, its hard to know if he has eaten cross contaminated food, to be honest we also still don’t know how immediate the reaction is. For eg did he accidentally eat gluten one week ago or one day ago?
Anyway he is feeling mildly itchy at present 3/10, but has been abroad recently.

Really i have one question he has lost a bit of weight since going g/f, he can’t afford to lose anymore which he surely will if he cuts out dairy!

How about lactose free milk, its still dairy though?

He almost fell into a depression when i told him about the coffee and then we discovered it was probably instant coffee that was the culprit.
However if he needs to cut out dairy or grains to completely reduce the itchiness etc, well i dont know what we will do!
In all honesty its the increased risk of Lymphomas we really are concerned about and i know sticking to a gluten free diet reduces the risk of this happening.
Really hoping its cross contamination!

February 6, 2014 at 6:17 pm
(22) angel says:

I was dealing with eczema for years. Really bad on hands and some areas on chest and back. I had to do an elimination diet to figure it out. I did get an allergy test and peanuts was what came up. I was not eating peanuts but I was eating other nuts and seeds and i’m sure things processed with peanuts. So now I have to crack my own nuts and at the time I’m just eating Mac nuts because I can get them fresh where I live. Recently I had an outbreak after a while of being good and narrowed it to the quinoa i believe. I get a lot of stuff like that from bulk bins. Just letting people know that a lot of foods are processed together so what you think you are allergic to can actually be something else.

April 16, 2014 at 9:50 am
(23) The Gluten-Free Professor says:

Those of you discussing cross reactivity and whether it exists: The answer is YES. The scientific term is “molecular mimicry” and you can find tons of peer-reviewed data on this subject.

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