Knowledge vs. Understanding in the World of Gluten

freeimages.com/dragansasicIn my recent blog, “No Cookie For You,” I briefly mention how the practice of consciously considering gluten is different than passively knowing facts about gluten consumption and celiac disease. Here I explore that idea and dig deeper — beyond gluten consumption — all the way through to the surface: gluten contact.

1) Gluten Uncertainty Principle

A few weeks ago, I was out to dinner and asked the waitress if a certain side that came with my entree was gluten-free. Her reply: “How sensitive are you?”

My first reaction was to be surprised — isn’t asking whether a meal is gluten-free a yes or no question? But her question isn’t uncommon. I told her that I needed the meal to be absolutely gluten-free or else I would have significant medical consequences. She went into the kitchen to double-check with the chef, and returned to tell me that my choice of meal was indeed gluten-free. So I ordered.

When it arrived I confirmed, as I always do: “This is gluten-free?” She nodded a doubtful nod, and left the table. Without taking a bite, I watched her walk over to the manager to have a short discussion, who then came over to me.

“Is there a gluten question?” She asked me.

I repeated, “This side is gluten-free?”

And the manager told me that there is no gluten in the ingredients, but it is fried in the same oil that is used to fry other gluten-containing foods. A crucial tidbit to include when stating that something is gluten-free.

Could the chef not have known that cross-contamination can be just as harmful? Did he just not care? Was he annoyed at yet another gluten-free customer?

Or perhaps he was just very busy. The natural reaction to “is that gluten-free?” is generally to look at the ingredients, not to think beyond the box about how it’s cooked or where the food is manufactured/grown. Perhaps although the chef knew on some level that “gluten-free” goes beyond ingredients, his natural reaction was to consider the ingredients.

This can be detrimental to celiacs. Having knowledge vs. applying that knowledge to actual situations is very different; the same way that having an equation memorized for a math test can feel very different from reading a word problem that calls for the application of that equation. (And also calls for you to understand that it calls for the application of that equation.)

There is a certain amount of reasoning that must be applied to things memorized. Memorizing Celiac + Gluten = Bad isn’t enough when there are french fries and fried chicken on the menu and only one fryer in the kitchen.

2) Covering A Reaction to Makeup With Makeup

The other day I was having photos taken and informed the makeup artist that I need to use gluten-free eyeshadow, which I brought with me. She asked what happens if I use regular eyeshadow, and I told her that I get swelling and scaly patches on my eyelids and around my eyes… which I used to cover with more makeup. (Sure, you can retouch my photos, but you can’t retouch my eyelids.)

She replied that my skin was just dry because of my makeup remover. Maybe she was trying to interpret my issue using knowledge from what’s within her own experience — applying an “equation” she knew as a makeup expert to an actual situation involving makeup and bad skin. If I were to apply knowledge from my own experience to a situation involving makeup and bad skin, I come to a different conclusion because I am considering the gluten in that makeup. The same way the chef should have considered the contaminated oil the fries were fried in.

When I discovered a few years ago that my skin issues ceased when I started wearing gluten-free makeup, I discussed it with a dermatologist. She told me that I stopped being affected because I stopped eating gluten, not because I stopped wearing it.

If her argument is that gluten intolerance is a gastrointestinal issue that only causes damage when ingested and not when used topically, I understand that. (I won’t bring up how much lipstick we ingest…) The damage caused by ingesting gluten is not limited to gastrointestinal issues, so celiac disease may indeed manifest in the form of skin issues when gluten is ingested.

However, wouldn’t celiacs do well to assume that gluten can cause contact dermatitis and come into contact with it as little as possible? After all, peanut allergies cause issues for some people when peanuts are ingested but can also cause allergic contact dermatitis. Internal and external triggers are not mutually exclusive when dealing with food intolerances.

Our skin absorbs into our bodies what we put on it. We know that celiac disease is a gastrointestinal issue, but we don’t yet know if it’s only a gastrointestinal issue. To passively assume that gluten is only an issue when ingested means that we are not actively seeking the knowledge necessary to support that claim.

Experimenting on myself is certainly not the most scientific way of doing things. But in the absence of scientific proof (and a sample size >1), I fall back on logic. If I see that something is causing my skin to react badly, I will stop using that thing. Much like if I feel better when I don’t eat gluten, then I will stop eating gluten.

It surprised me that when I first went to my dermatologist with the scaly patches around my eyes, she didn’t do more research about my condition. After all, the more you know, the more you’ll know. Now my dermatologist seems more open to the idea that my skin issues were in fact a reaction to gluten, even if she isn’t sold on the idea of it being the fault of the eyeshadow.

Though we may not know conclusively the relation between glutenous beauty products and skin issues, we can use reason and understanding to form a hypothesis. From there, we can embark on the path to conclusive knowledge.
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Originally published on The Huffington Post.