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Do you suffer from Celiac’s Disease or gluten reactivity? If you do, you should know that it isn’t only food you need to restrict to avoid reactions. Even the medication you take on a daily basis can contain trace amounts of gluten–enough to cause a reaction for many patients. But the options for gluten-free medications ate rare on the commercial market. That’s why many pharmacies are turning to gluten free compounding instead.
In this short guide, we’ll help you break down the nuances to gluten sensitivities (including misconceptions). Then, we’ll outline how gluten free compounding may help you avoid trace sources of gluten.
What is Gluten Sensitivity or a Gluten Allergy?
Approximately 3 million people throughout the United States have a legitimate gluten sensitivity issue. This usually presents as either Celiac’s Disease or Non-Celiac Gluten Intolerance. Both are legitimate and extremely serious medical conditions that cause pain, bloating, and digestive upset.
For patients with true allergies, even a molecular amount of gluten can spur on cramping, diarrhea, constipation, gas, and general discomfort for days. Responses can start as little as 15 minutes after eating the offending product or taking the gluten-containing pill, while others may not react for as much as four days.
Gluten: Trend or Tragedy?
There’s so much misconception around gluten. Although a small number of people really do experience gluten sensitivity and gluten allergies, the rate is quite small. Surprisingly, nearly 30 percent of Americans admit to shopping for gluten-free products. They seem to tolerate gluten fine, yet still avoid it.
What exactly is happening here? Why would people shop for gluten-free products if they don’t have an allergy?
The answer lies in the fact that bread (and more specifically, breads that contain gluten) have erroneously been connected to weight gain and poor health.
Though it’s true that eating too many carbs and not exercising enough certainly can cause weight gain, this is less of an issue with gluten and more of an issue with calories in, calories out. Of course, weight loss and weight gain is also influenced by everything from genetics to lifestyle, too.
To further confuse the matter, some people do react to other substances in gluten-containing foods. Short-chain triglycerides called FODMAPS are known irritants for patients with:
- Irritable Bowel Syndrome (IBS)
- Irritable Bowel Disease (IBD)
- Crohn’s Disease (CD)
- and other gastrointestinal upsets
For these patients, avoiding anything sourced from wheat may be beneficial–including gluten-containing medications.
The most important step to take is to have your doctor work to find the source of your issues rather than self-diagnosing a gluten issue.
When Gluten Strikes: How Gluten Free Compounding Helps
You’ve determined that you have a legitimate gluten sensitivity. Or, your doctor recommends that you cut out all sources of gluten to lessen symptoms from a condition like IBD or IBS. You’ve changed your diet, now it’s time to check and alter your medications, too.
Your pharmacist can run your medications through the system and bring up their MSDS or pharmacology sheets. These information sheets contain extremely in-depth technical information about what exactly is inside your medication. If gluten or gluten-containing fillers are present, they will be able to identify them from the sheet alone.
If your pharmacist identifies that your medication contains gluten, he or she will evaluate it for gluten free compounding.
Gluten free compounding allows the pharmacist to re-create commercial medications without the offending gluten (or perhaps without any fillers at all). Compounding can also reformulate medications to make them easier to take or use, or to combine multiple medications.
When compounding your medications, your pharmacist takes all of the base substances in your medication and then removes anything that may be harmful. Then, he or she can combine the substances back together into a liquid, a pill, a patch, a cream, or some other delivery method altogether.
What Medications Contain Gluten?
Surprisingly, the list of medications that contain either gluten or trace amounts of gluten is quite extensive. That’s because gluten is an excellent filler; it’s a protein that becomes stretchy like a web when manipulated.
This is why bread is kneaded to make it softer and denser.
In a medication, gluten holds all of the other substances together into one cohesive pill, patch, or substance. Unlike other potential allergens, the FDA has no required law to label whether pills contain gluten or gluten-sourced substances. It’s up to your pharmacist to investigate your medication on an individual level to see if they contain gluten.
Certain medications may be more likely to contain gluten or gluten-sourced substances if they contain specific ingredients. These will be listed on the MSDS or pharmacology data sheet, and are usually listed as:
- Wheat
- Pregelatinized starch
- Dextrates/Dextrin
- Dextrimaltose
- Caramel coloring
- Barley malt
Essentially, anything with a filler or coloring sourced from a gluten-containing plant is a problem. Furthermore, the above list is far from exhaustive. If you’re not sure whether your medication contains gluten, ask your pharmacist to pull the data sheet for it.
What About Non-Prescription Medications and Supplements?
If you rely upon non-prescription medications and supplements, your pharmacist may be able to use gluten free compounding to better suit you, too. Surprisingly, gluten is extremely common in vitamins and health supplements. This is because those who do not have a gluten sensitivity or allergy really can benefit from the nutrition found in gluten-containing plants, like wheat protein or wheat germ oil.
Unlike prescription medications, the FDA does require that all over-the-counter products be marked clearly if they are gluten-free. This labeling makes it significantly easier to identify which commercial products are safe and unsafe.
That said, those with a gluten allergy should never rely upon labeling alone. Some patients find that even substances grown or sourced near gluten are enough to trigger an attack. Your pharmacist can pull the ingredient lists and MSDS for many over-the-counter products, too, and will help you to make an informed decision about OTC products.
Need information about your medications? Your pharmacist is standing by to take your call. Informative patients make better choices about their health in nearly all cases, so you should never be afraid to ask for clarification or investigation. Reach out to your pharmacy today for more information on your medications and gluten free compounding.