Phlegm and Celiac Disease

ILLUSTRATIONS BY RYAN SNOOK. PHOTOGRAPH BY JEFF MINTON (GROOMER: STEPHANIE NICOLE SMITH)

The year 2019 will be remembered for a lot of things, but one I will remember well is how many times I was sick with a respiratory cold last year. On hand, I have had 8-10 colds just last year alone starting in January. I went home to Ontario last Christmas and came back with a cold, this bugger did not go away for weeks. I was told by many patients and friends of mine in town that it is a longer cold and will go away soon, so beside what my conscious was telling me to do, I did not go see a doctor. Then I went to Arizona…almost missed my flight and had to run through the airport to catch the plane. This is when I thought to myself, something is terribly wrong.  It felt like I had a chunk of bubble gum stuck in my air passage, and I could not catch my breath through my nose or mouth. Coughed up a bunch of phlegm and kept running, because, I was NOT going to miss this flight. Long story short, I met a not so happy customs lady that clearly did not understand the words, “I have 10 minutes to get on my flight.” I got on the plane and had an amazing trip hiking, exploring and coughing up about 10 pounds of phlegm.

Why the drawn out story? Because I want you to learn from my mistake, if you have a productive cough for more then a week…go see a doctor! I got back from the trip, 5 weeks after the cold had begun, and was diagnosed with bronchitis. I have never had bronchitis before in my life. I was placed on two rounds of antibiotics, because the first round didn’t touch it; and I’m sure you can imagine how much my gut loved this…not really.

Gross photo, I know. This is what was coming out of my nose after getting back from Peru.

For 11 months after the first cold in January, that turned into bronchitis five weeks later, I have had cold after cold, and was lucky enough to come home with a souvenir from Peru, a sinus infection. I have woken up with phlegm in my throat and nose every morning since and have been woken up coughing in the night due to nasal drip. It was not until I decided to go back on the hypoallergenic diet for a month that I was finally phlegm free! Then I went back to eating grains, processed foods and a bit of dairy and, BAM, it was back. This had me thinking, can my gut health as a celiac (or those of you who are not celiac), have an effect on my respiratory system? 

Now, as celiac disease is an autoimmune disease of the small intestine and can indirectly effect the whole body, I knew I could not be far off with this assumption, considering 70-90% of your immune system is housed in your gut. So I started researching, and I am here to give you the results! Needless to say, I was right…

There have been many cases of people within the world with chronic pulmonary conditions, being diagnosed with celiac disease and after going on a gluten free diet, the pulmonary symptoms decreased and improved. Even though having respiratory issues with celiac disease is a rare case and is an atypical symptom, if you have a leaky gut (intestinal hyperpermeability), there is a chance your brain, lung tissue, skin and blood vessels are effected and can lead to edema in the body.

One of the top reason’s for repeat infections and illnesses of the respiratory tract such as pneumonia, bronchitis, and sinus infections could be due to damage of the gut lining. If your gut lining is damaged, your immune system is compromised and this can lead to development of any infection especially if you are exposed to bacteria and viruses.

Putting this into relation of a celiac, if we consume just a crumb of gluten, our gut lining will be damaged due to the villi flattening which in turn damages the immune system and can increase the likelihood of infections throughout the whole body, not just the respiratory system.

Another reason for infections of the respiratory system could be due to malnutrition that is commonly seen in inflamed celiac’s who have ingested gluten. If the villi are flattened in the small intestine, the vitamins, minerals and nutrients that are essential to help fight off infections will not be absorbed. 

One major nutrient that is typically not absorbed with celiac disease is iron. If iron is not being absorbed, anemia can occur within the body and if there is not enough red blood cells transferring enough oxygen in the body, people can feel short of breath even with minimal exertion. This is something I can relate to because one symptom that I experienced growing up was anemia; I was always short of breath. Today, knowing that I am celiac and eating a gluten free diet, I am happily no longer anemic after years of trying to correct it. Instead, I am on the boarder of no longer being iron deficient (yay!) and my iron levels are increasing due to a gluten free diet and my gut lining healing. 

However, I think why I am not 100% healed and having chest infection after chest infection along with many other symptoms in my body, is due to consistent accidental exposure to gluten when going out to eat and traveling. I know I have had gluten exposures because in the year 2019, the Tissue Transglutaminase Antibodies (tTG-IgA) in my blood have stayed high and the iron levels have been fluctuating all year.

Currently for the last 3 days, I have gone back on a grain free, dairy free and whole food diet (pretty much a paleo diet), and today I did not wake up having to clear my throat of phlegm in the morning! I am excited to see how many more lingering symptoms will decrease with this diet change.

It has been said that going on this type of diet helps to decrease inflammation within the body. However, doing this diet for a few days to a week will not be enough time to fully correct and heal your body. This is a diet that needs to be followed for 6 months to a year, because it takes this long for the gut lining to heal and function properly again.

In conclusion, 14-20 breaths a minute is normal, but if you have a chronic cough, constantly clearing your throat, or have post nasal drip, you may want to see if grains or gluten is the cause. This is not to say you have celiac disease but you may have some inflammation within your body that needs to be corrected and needs time to heal.

References: 

https://glutenfreern.com/the-relationship-between-the-respiratory-system-and-celiac-disease-ep028/

https://www.researchgate.net/publication/236066468_Hemoptysis_in_patients_of_celiac_disease_with_disproportionately_severe_anemia_Tip_of_the_iceberg

https://thorax.bmj.com/content/57/1/91

https://www.pediatriconcall.com/pediatric-journal/view/fulltext-articles/986/J/0/0/521/0

https://www.ncbi.nlm.nih.gov/pubmed/18603176

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