May 27, 2015
Gluten in Probiotics Could Cause Problems for
Celiac Disease Patients

New York—Although probiotics often are used in an effort to improve gut health, they could have the opposite effect on patients with celiac disease, according to a new study.

In a study presented at this year’s Digestive and Disease Week in Washington, DC, investigators at the Celiac Disease Center at Columbia University Medical Center found that 12 of the 22 top-selling probiotics had detectable gluten. The study was also published in the journal Gastroenterology.

Evidence of benefits for probiotics is limited to a few clinical situations, according to lead author Samatha Nazareth, MD, a gastroenterologist at Columbia Medical Center, who added, “Many patients with celiac disease take dietary supplements, and probiotics are particularly popular. We have previously reported that celiac patients who use dietary supplements have more symptoms than non-users, so we decided to test the probiotics for gluten contamination.”

Celiac disease patients suffer pain, bowel symptoms, and an increased risk of cancer if they fail to eliminate gluten from their diets.

Investigators used liquid chromatography-mass spectrometry to detect gluten, a protein found in wheat, rye, and barley. While most of the probiotics that tested positive for gluten contained less than 20 parts per million of the protein, considered gluten-free by FDA standards, four of the brands, 18%, contained gluten in excess of that amount, the study finds.

With more than half of the 22 probiotics labeled gluten-free, the authors point out, two of the products did not meet FDA standards to make the claim and some others contained traces of gluten.

“We have been following reports in the scientific literature and news media on inaccurate labeling of nutritional supplements, and it appears that labels claiming a product is gluten-free are not to be trusted, at least when it comes to probiotics,” explained Peter Green, MD, professor of medicine and director of the Celiac Disease Center. “This is a potential hazard for our patients, and we are concerned.”

Whether trace amounts of gluten can cause problems in patients with celiac disease remains an open question, according to co-author Benjamin Lebwohl, assistant professor of medicine and epidemiology at the Celiac Disease Center.

“We know that most patients with celiac disease only develop intestinal damage when consuming more than 10 milligrams of gluten daily, and it is unlikely that contaminated probiotics can lead to that amount unless patients are ingesting mega-doses,” Lebwohl said. Still, he asked, “Why is there any gluten in these products? Why should the consumer pay any attention to gluten-free labeling on such products? And given the great consumer interest in probiotics, will regulatory bodies take action to protect the public?”


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