Saturday, March 26, 2011

Wheat's Wrong With You?

Part 1: My Shitty Knees

I’ve had knee issues for a long while. I remember being in gym class in high school and wondering if the other girls were in as much pain as I was. Freshman year of college I went to the doctor and found out I have a common issue where the cup my knee cap sits in is too shallow, so it is really easy for my knee cap to move around excessively. The doctor also mentioned the muscles around my knee weren’t holding the cap in place properly. The diagnosis, physical therapy and waiting until I ‘got older’. Yes, the doctor actually said I just had to wait until I got older so my muscles would naturally become less flexible. Thanks doc.

The physical therapy and a knee brace to use during exercise, took the edge off somewhat. Still waiting to see if ‘getting older’ helps, 6 years later no improvement thus far.

When I came to PC, I was completely unable to exercise, so the knee problems came back with a vengeance. Once I was out of training and living in my own house, I tried to get back on the exercise train, but it didn’t work this time. For over a year I’ve been taking 2-3 400mg ibuprofen and 2-3 500mg Tylenol a day, every day. On a bad day this might go up to 4-5 of each. If I’m traveling I would take one of each every 3-4 hours. It was the only thing that worked.

Evidently this is a lot of ibuprofen and Tylenol. After startling a few friends with the quantity of meds I was taking, I talked to the Peace Corps nurse. The nurse wasn’t worried about me taking 2 ibuprofenes a day, but evidently 3 is the tipping point where I need to take an additional medication, Ranitidina, to protect my stomach.

I never actually knew ibuprofen could be bad for your stomach lining causing a whole host of nasty side effects. Evidently I was the only one. Sucks for me.

Part 2: Gluten

I didn’t know much about celiac disease until one of the girls in my group in Peace Corps had it. Being the information junkie I am, I did quite a bit of googleing until I had familiarized myself with the topic. In people with celiac disease the immune system reacts abnormally to gluten (a protein in wheat, barley, and rye), causing small intestine inflammation and damage. According to a 2003 University of Maryland study, as many as 1 in 133 people have celiac, though it may be even more common since a large number of cases are undiagnosed. Don’t worry, I don’t have celiac.

Once I had gluten on my radar, I noticed it showing up from time to time in health and diet articles of varying reliability. Admittedly, going gluten-free is one of the newer fast weight loss fads, as can be seen with an increasing number of gluten-free products.

However I did notice that many of the health, not weight loss, focused articles mentioned another issue, wheat intolerance. It is basically a non-allergic, but still negative reaction gluten. People with celiac have very strong symptoms that can occur within hours of eating a small amount of gluten. Wheat sensitivity is a more difficult to detect because the symptoms take longer to manifest, sometimes 2-3 days.

What caught my attention was that aching joints was one of the most frequently listed symptoms. In addition to knee pain, I’ve also had unexplainable aches in my hips and pain in my hands severe enough I had become concerned I might have carpal tunnel.

I’ve also had inflammation problems. When I go for even a short walk my hands will swell painfully. Since coming to Paraguay I’ve also had such severe swelling in my legs that it felt like my calves were going to burst open. During my first summer in particular, I can’t tell you how many sietas I spent with my legs up in the air against a wall trying to get the inflammation to go down. When I googled causes of chronic inflammation, wheat and dairy issues always at the top of this list for dietary causes of inflammation.

Part 3: The Experiment

(Note: While there are scientific tests for celiac disease and wheat allergies, they are notoriously unreliable. Also they often don’t work for wheat intolerance because the effects are more subtle)

Here is what we know. I’ve been taking obscene amounts of ibuprofen to combat joint pain and inflammation. Ibuprofen causes digestive issues. Wheat intolerance causes joint pain and inflammation. Wheat intolerance stems from digestive problems. Did the Ibuprofen cause wheat intolerance? Hmm. So about a month and a half ago I decided to do an experiment called an elimination diet.

I couldn’t stop taking the ibuprofen cold turkey, but I could cut out wheat. So I did. After a week and a half I was down to 1-2 ibuprofen and Tylenol a day. I kept at it. Taking 2 of each became my new ‘bad day’ dose. Some days I didn’t take anything. I continued the experiment during my trip to Argentina. Twice I was in buses for 20-24 hours. I took meds twice during each trip, as opposed to my usual dose every 2-3 hours. Once we were in Argentina we had ice cream several days in a row. I was perplexed because the ache started to come back. Turns out most ice cream has gluten L. Very very sad news.

When I got back from Argentina phase 2 of the elimination diet started, reintroduction of wheat. From Monday to Thursday of last week I ate wheat. On Wednesday I started feeling occasional pain, but I chalked it up to walking Tucker twice a day. By Friday the pain was back. Today is Saturday and I’m fighting the urge to take ibuprofen. I stopped eating wheat again yesterday. I’m hoping that I don’t have to wait a week and a half again for the pain to subside.

Part 4: Conclusion

I currently have a wheat intolerance.

I don’t know if taking large quantities ibuprofen damaged my digestive system and caused the wheat intolerance. Maybe I’ve had a wheat intolerance all along and the hideous amounts of bread I had to eat with my host family during training pushed it to a new level and the ibuprofen exacerbated the effect. Maybe it’s a combination of the two.

The next step is to stop eating wheat again for a longer period of time, I’m shooting for 6 months. That should be long enough for any damage caused by the meds to heal. If the problems come back again when I introduce wheat again, then I probably really am wheat intolerant. We shall see.

Now why did you need to go through that huge TMI overshare? Because wheat intolerance often has a genetic component. If you’re related to me, which I assume most of my readership is, you may unknowingly be wheat intolerant as well. Even if you’re not related, many cases of wheat intolerance go undiagnosed.

For me it was worth the experiment to find out. I’m not at all happy I can’t eat bread, or cereal, or tragically, ice cream at least not for a little while. But I am happy to finally have a way to control my knee pain other that waiting to get older.

No comments: