Is Celiac Disease Reversible?

by Jordan Reasoner

Is Celiac Disease Reversible?

Until a few thousand years ago, we thought the world was flat.

Around 240 B.C., Eratosthenes broke new ground when he came up with an initial estimate of the Earth’s circumference… later supported in physical theory around 330 B.C. by Aristotle.

Since then, we’ve traveled to the moon and recorded beautiful footage of our round planet…

But there are still people that believe the world is flat (… Google “Flat Earth Society”).

As new ideas present themselves, we’re given the rare opportunity to grow into the next higher level of thinking. Medical research is a constantly evolving frontier and it’s our responsibility to take a step back to review our beliefs whenever new discoveries come to light.

Every evolution of medical research gives us a new lens to look at what we already know…

And Until Recently, We Thought Autoimmune Disease Wasn’t Reversible


We’re just beginning to understand why the immune system would attack healthy tissue… and in the beginning, we used to think that autoimmune diseases couldn’t be reversed once the immune condition “turned on.” (Big thanks to our show with Chris Kresser for helping me understand this in better detail.)

Here’s my crack at explaining how it relates to Celiac Disease…

Back when autoimmune conditions were first recognized over a hundred years ago, we thought it had everything to do with non-self antigens (like virus or bacterial infections). In fact, the condition was originally thought to be an infectious disease explained by the “Molecular Mimicry” theory, in which outside bacteria and viruses invade our body and look so similar to our own healthy tissue that the immune system wages war on both.[1]

It was thought to be the worst kind of mistaken identity…

The “Molecular Mimicry” theory goes something like this:

  1. A non-self antigen enters the body
  2. The immune system mounts an attack against it, producing antibodies
  3. The non-self antigen looks so similar to specific proteins in the body that it causes a cross-reaction to healthy tissue
  4. The immune system attacks the non-self antigen AND its own tissue from that point forward

It’s important to point out that in this model, even if the non-self antigen (bacteria or virus) triggering the attack is removed, the autoimmunity never turns off. So, the body continues to produce antibodies and attack healthy tissue even though the initial trigger is gone.

In the case of Celiac Disease, gluten is the non-self antigen and the “Molecular Mimicry” autoimmune process might look something like this:

Molecular Mimicry Theory of Celiac Disease

Here’s what new research is revealing…

Molecular mimicry has been shown in animal autoimmune models to INITIATE the autoimmunity. In other words, it’s a part of the development of autoimmune disease in animals.  However, recent human studies have shown that molecular mimicry is actually an EFFECT of human autoimmune disease, and not a cause of the autoimmunity.[2]

Why is that important?

It tells us that molecular mimicry is definitely a factor in the progression of pre-existing conditions that trigger autoimmune disease, but something else is responsible for triggering it in the first place.

In Celiac Disease, we know that gluten is a non-self antigen that finds its way inside the body and causes cross-reaction… but this evolution in thinking shows this to be only an effect of other pre-existing conditions.

So, What Else Could Be Confusing the Immune System?

Another theory suggests that non-self antigens come into our body and damage healthy tissues during active infection, exposing it to the immune system. The body sees these newly exposed areas as “non-self,” leading to the development of immune attacks against that tissue.

This mechanism usually goes by the name “Bystander Effect.” [3]

The “Bystander Effect” theory goes something like this:

  1. A non-self antigen enters the body
  2. The non-self antigen damages healthy tissue in the body
  3. The damage exposes parts of the healthy tissue that shouldn’t be exposed
  4. The body attacks the newly exposed areas as if they are not self

Again, with this model, even if the bacteria, virus, or gluten that damaged the tissue is removed, the autoimmunity never turns off. So, the body continues to produce antibodies and attack the exposed tissue even though the initial trigger that damaged it is gone.

In the case of Celiac Disease, gluten is the non-self antigen damaging healthy tissue and the “Bystander Effect” autoimmune process might look something like this:

Bystander Effect Theory of Celiac Disease

New research into these theories isn’t making this any more clear. Both the “Bystander Effect” and “Molecular Mimicry” don’t explain the pre-existing conditions that lead to the autoimmune process…

But Both Theories Do Suggest Once Autoimmunity Turns on, There’s No Stopping It

However, the latest evolution in autoimmune research indicates there might be another way…

Researcher Alessio Fasano, M.D., has been on the forefront of recent autoimmune and Celiac Disease research. In 2011, he published a paper titled “Leaky Gut and Autoimmune Diseases” introducing a new theory that suggests prevention and reversal of autoimmune disease is possible.

He presents the idea that three pre-existing conditions must all exist together in order for autoimmune diseases to develop.[4] They are:

  1. A genetic predisposition to autoimmunity (In the case of Celiac Disease that’s the HLA DQ2/DQ8 genes)
  2. An exposure to the environmental trigger (in Celiac Disease – that’s gluten)
  3. Increased Intestinal Permeability (Leaky Gut)

Fasano’s theory is part of the new evolution of research implicating leaky gut as the key element to autoimmune disease. Applying Fasano’s “Leaky Gut” theory of autoimmunity to Celiac Disease boils down to this…

People with the genetics for Celiac Disease that have a leaky gut and eat gluten will develop autoimmunity and subsequent intestinal damage. The increased intestinal permeability allows the environmental trigger (gluten) to become exposed to the body and trigger the genetic predisposition.

Combined with what we learned in my last article in this series, it might look something like this:

Leaky Gut Theory of Celiac Disease

Fasano’s new theory suggests that autoimmunity can be stopped and even reversed by removing the environmental/genetic trigger interaction and fixing leaky gut. This is groundbreaking in that it’s the first theory to present a pathway for autoimmune reversal

But when I say autoimmune reversal, I don’t mean, “someone with Celiac Disease can eat gluten again.” To me, autoimmune reversal means that the tissues in the body go back to the way they were before the autoimmune process “turned on” in the first place, and normal health is restored.

So for Celiacs, that means the gut tissue heals, intestinal permeability is restored, and the finger-like villi become fully functioning again.

So, Removing Gluten Should Reverse Celiac Disease, Right?

The new research tells us this: if you have Celiac Disease, you have leaky gut. Even more explicit than that, you can’t develop Celiac Disease at all without having excessive permeability of the small intestine…

But what isn’t so clear is how the conventional Celiac Disease treatment plan fits into it…

According to this theory, here’s how a Gluten-Free Diet should help Celiac Disease:

  1. Remove 100% of gluten from the diet
  2. Zonulin levels decrease
  3. The Tight Junction’s restore normal function
  4. Leaky gut stops
  5. The autoimmune antibodies drop
  6. The autoimmune response shuts off
  7. Intestinal damage heals

But it Doesn’t Exactly Work that Way…

In the first post of this series, I pointed to new research suggesting the small intestines of up to 60% of adults never completely heal from Celiac Disease despite following a Gluten-Free Diet. [5] And another study found that only 8% of adult Celiac Disease patients eating a Gluten-Free Diet reached histological “normalization,” meaning their gut tissue completely recovered to that of a healthy person. [6]

So, what’s the missing piece of this equation?

Whether the latest evolution of research stands the test of time is irrelevant, what is relevant is that Fasano’s theory of autoimmunity opened the door to understanding where the Gluten-Free Diet fails to fully treat Celiac Disease and what needs to be resolved to reverse it.

In the next post of this series, I reveal which step of the process is broken and why the Gluten-Free Diet fails to reverse Celiac Disease.

About the author

Jordan Reasoner Jordan Reasoner is a health engineer and author. He was diagnosed with celiac disease in 2007 and almost gave up hope when a gluten-free diet didn’t work. Since then, he transformed his health using the SCD Diet and started SCDLifestyle.com to help others naturally heal stomach problems. You can check out his story here and find him on Google+, Facebook or Twitter.

The Specific Carbohydrate Diet Works

{ 26 comments… read them below or add one }

Jamie March 2, 2012 at 1:57 pm

Thank you thank you. I wish I could give you a big hug and a kiss. I am so sick of people and doctors thinking that a gluten free diet is good enough. Well it’s NOT enough!!! Thanks and eagerly awaiting next post ! :O

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Jordan Reasoner March 2, 2012 at 2:21 pm

Thanks Jamie :-)

You rock!

Jordan

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Pawan March 2, 2012 at 2:46 pm

Thank you for your blog post. This makes so much sense. From my own experience of being gluten free for 4 yrs, I’ve realized that I am just doing patch-work and that the disease underlying is not being healed (as evidenced by a new auto-immune disease). Your blog post helps me understand my own experience much better. Thanks a lot for this excellent explanation! Thank you! Thank you!! Can’t wait for your next blog post….
hugs,
Pawan

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Jordan Reasoner March 5, 2012 at 9:26 pm

Thanks @Pawan, much appreciated! I’m so happy that you’re feeling more confident about what happened to your body :-)

Jordan

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ryan bowley March 2, 2012 at 3:02 pm

It should be made more clear that this research and your opinions at this point in time are not facts and much more research is needed before it should be presented in such a way. I really think overall what you guys are doing is great however sometimes it boarderlines on misinformation.

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Maureen March 2, 2012 at 3:02 pm

Thank you so much for this great article. Can’t wait for more to come. Too bad doctors dont ‘get it’ when we tell them that gluten free works for them but there could be another missing link. However, eating gluten free has dramatically changed my life for the better – I don’t mind the once in awhile episodes, it is better than everyday!

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Michelle March 3, 2012 at 12:17 pm

Thank you for the info. It is honestly a bit over my head, but I am wondering if you have looked at using low dose naltrexone to treat autoimmunity. It is an off label use of a drug that multiplies the body’s own endorphin production…not sure how it would impact the celiac process but it is doing amazing things for ms and many other diseases.

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Jordan Reasoner March 5, 2012 at 9:27 pm

Hi @Michelle – I have used LDN for my Celiac Disease and thought it helped. I wrote one of my first blog posts about it back in 2009, here’s the link:

http://scdlifestyle.com/2009/11/the-scd-diets-tag-team-partner/

Jordan

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MGH March 6, 2012 at 10:55 am

clamoring for the next post! you elucidated and broke down those first two theories into plain english better than anyone else i’ve ever read, and i’ve read quite a bit! a unique skill and so wonderful that you are putting it to good use.

it is worth saying, without responding to anyone specifically, that the diet based approach can be scary to discover when the doctors you trust are telling you the *exact* opposite. for anyone who feels immediately skeptical or threatened it helps to remember that the doctors, who no doubt have the best of intentions, are working only from theories themselves; there is no deep understanding of AI diseases in the mainstream medical field and needless to say a cure is nowhere even near the radar. Even the most establishmentarian doctor would admit that immune-suppressing drugs and tnf antibodies etc are just band-aids.

I write this as a 10 year Crohn’s sufferer (dealer-wither? i hate ‘sufferer’) who loved his dietary routine deeply and was relieved when my doctor told me to ‘eat whatever i want, it doesn’t matter’. only problem was i stayed sick until i made the fundamental and difficult changes to my diet!

you guys are doing great work and helping more people than you probably realize. i found out about your site from ‘crohnsdad.com’ and think he is a godsend as well. thanks so much!

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Jordan Reasoner March 6, 2012 at 11:13 am

@MGH – thank you so much for the kind words, I really appreciate it. Helps me stay motivated to get the rest of this series going (got lots more coming)!

Also, great points about diet – you rock man :-)

Jordan

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Alan March 11, 2012 at 10:12 am

I think you are right on target that all prolamins need to be eliminated for healing to happen, but I’m wondering if that “elimination” is enough. I suspect that adding key “leaky-gut” healing elements is necessary as well – such as bringing vitamin D up to therapeutic levels, bringing zinc levels up if deficient, adding proline proteins (gelatin/bone broth/colostrum PRP) and re-populating gut flora with beneficial bacteria (SCD yogurt/lacto-fermented veggies/key probiotics). LDN fits in there as well. Thoughts?

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Jordan Reasoner March 13, 2012 at 11:08 am

Great points Alan – stay tuned, we’re nearing the prescriptive portion of the series… just a few more posts to go.

Jordan

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amanda March 14, 2012 at 8:55 pm

Hi I was diagnosed last year with celiacs and im still so ill that im struggling to maintain. Any health I can barely eat. Is there a doctor you can suggest to see for leaky gut or someone who looks at celiecs the way you do. I feel like I know more then the doctors

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Steven Wright March 15, 2012 at 7:10 am

@ Amanda – All the people I would recommend to help you, as a first step will put you on either SCD or Paleo autoimmune diets (basically the same thing) so get started this week with our free guide to SCD (http://www.scdlifestylebook.com/free.php). Then as far as people who can help via the internet check out chriskresser.com. Good Luck you can do it, hang around the blog and facebook for a ton of like minded people to support you.

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Shannon March 16, 2012 at 1:46 am

I have several autoimmune diseases and it was clear to me after being gluten free for 6 months that wasn’t going to be good enough. I started a Paleo diet a few weeks ago, and getting use to another way of eating…and trying to focus on what I can eat, and not what I’m missing… like carbs and dairy. I also have to follow a low oxalates diet. It’s alot to follow all three diets, but I’m determine to fix my leaky gut. Thank you for this article – it helps me know I’m on the right path to healing.

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Danielle March 30, 2012 at 12:55 am

Thank you for posting this. I am a 21 year old college student who was diagnosed with Celiac Disease a year and a half ago after three tests confirmed it. I am struggling with eating gluten free on a college student’s tight budgets. I am currently eating completely gluten free with parental financial support for the special (and extremely costly) foods. However, I am still very ill and feel worse than I did while eating gluten. I cannot wait for the rest of the posts after reading the previous ones. Hoping I can end this pain and feeling so sick all of the time.

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Leonie April 17, 2012 at 7:17 am

wow!! this is soooo me. I had a positive biopsy for celiacs two years after I stopped eating gluten without doing a challenge… I am also now intolerant to eggs and dairy..thanks to leaky gut. MUST do something about healing it!

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susan September 27, 2012 at 9:13 am

I am not suprized that what you say is the case. I have been gluten free and do herbs for relief, I believe that quercetin and guaifenesin help very much, also Echinacea these help with inflammation and allergic response which I felt that wheat caused to the gut. I also take licorice, burdock and dandelion as a tonic for pain. My experience was a downhill spiroll of muscle pain and chronic fatigue syndrome,, I was diagnosed with fibromyelgia. The brain pain and depression lifted with a celiac diet. I eat a lot of beans with turmeric, very comforting. I also think a vegitarian diet is very healing to the system especially if you can start healing from this insidious desease. Jordan I am so impressed with your research.

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Martin December 11, 2012 at 10:57 am

So far the best summary of leaky gut theories I have seen. Thank you!

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Jordan Reasoner December 12, 2012 at 2:50 am

You’re welcome Martin – thank you for the feedback man!

Jordan

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Dennis January 5, 2013 at 11:16 am

Both my wife and I have celiac but have made great progress in 7 years with a GF diet, magnesium shots and supplements as well as B shots and numerous other supplemnets including quality acidophilus. As health care practitioners also, we see tons of issues with celiac and non-celiac folks around gluten and wheat intake and the resulting cascade of inflammatory symptoms. It is clear that a GF diet isn’t enough and that MOST of the medical community remains sound asleep about the disease itself and the opportunistic diseases that emerge! Thank you very much, Jordan for sharing your personal journey and modeling, and your brilliant connecting- of- the- dots for so many others, including me! Bravo!

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kiran January 22, 2013 at 11:07 am

Thank you so much for informative article. I am suffering from stomach unrest & fatigue ,acid reflux for many years ,now I have understood mechanisam for the same
With Best Regards
kiran

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jennifer lewis February 8, 2013 at 9:42 pm

Dear Jordan,
Thank you so much for the work you are doing! I THOROUGHLY appreciate your engineering approach to this complex problem. I am a mom and also an engineer (chemical)…trying to heal my 4 year old celiac as fast as I can, and her two non-celiac sisters also with intestinal inflammation. I have a theory….I suspect copper toxicity is the pre-existing condition that sets off autoimmunity. I am going to post 2 websites that I have been “stuck-on” for a few months now. Maybe you could give them a read and see if you think this theory is a possibility or just plain crazy. We have copper in water supply, moms pass down to babies in-utero and maybe breastfeeding. With each generation, the copper load passed down to babies gets worse. Could explain increasing autism, ADHD, and autoimmune disease rates. Here are the websites that I have found to be most insightful.
http://www.holistic-back-relief.com/copper-toxicity.html
http://www.drlwilson.com/Articles/copper_toxicity_syndrome.htm
I believe this same pre-existing condition may contribute to other autoimmune conditions l(MS, Diabetes type 1, thyroid disease), autism and cancers as well. I am going to submit hair samples to 1 of Dr. Wilson’s practioners and see what their recommendations are for de-toxing. I have stacks of test data and observations. If you think there is something to this, I would be very happy to discuss more. I will continue to follow you on FB… thank you for your work!

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Jen Lewis February 8, 2013 at 9:55 pm

One more thing on theory I just sent you… We know copper gets absorbed in intestines … Could be why autoimmunity starts with leaky gut. We are copper corrode in pipes with standing water. There is water in GI Tract. When copper is not bound to ceruloplasmin it does damage. I wonder if it can oxidize and produce CO at very very low levels… Could make someone very fatigued. When I read about chronic low level CO poisoning, I see a lot if ties…. Like ADHD. No need to post this on your website. I just wanted to share my idea with another engineer interested in celiacs. I am going to continue to pursue my theory and will let you know if I have any significant findings. I wonder if someday, the same protocols for Wilson’s disease could be used to help people diagnosed with autoimmune conditions. I believe the copper needs to come out, but very carefully. Thanks for listening! Jen

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Marina February 26, 2013 at 10:16 pm

Thank you so much for this information! I have been diagnosed wih celiac disease last May and was doing well on the gluten free diet for a couple of months and then all of the sudden I started feeling sick again. My gastroentrologist performed another endoscopy and saw no improvement at all. My tTG levels are over 200 and my doctor suspects that I have refractory celiac disease. I have been following the scd diet since January and I feel on and off. Do you think that I can fully heal if I have the refractory celiac disease? I am a bit freaked out because I have a 1 year old son and I want him to have a healthy mom. I often refer to your site and I find it helpful

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Sara Hamilton August 30, 2014 at 11:55 am

Thank you so much for the info! I just got done reading your other article on the dangers of gluten. Loved it!

But just a quick sidenote on this one. Eratosthenes didn’t “break new ground” realizing the earth was not flat. The prophet Isaiah acknowledged that fact around 700 BC. Obviously just not everyone paid attention!

Isaiah 40:22 (KJV) “It is he that sitteth upon the circle of the earth, and the inhabitants thereof are as grasshoppers; that stretcheth out the heavens as a curtain, and spreadeth them out as a tent to dwell in.”

Btw, everything else he prophesied historically came true. There is so much to learn about our diet, health, love, mental clarity, inner peace, financial prosperity, and every other aspect of life. We tend to follow every trend, read every new book, and look up to these philosophers; yet we don’t pay attention to the truth that has been there all along! It has changed my life like I could never describe so I couldn’t just close this out without clarifying! Thank you for all you do! :)

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