How to go gluten-free without losing your mind

It was the clumps of hair that I first noticed in March. Snaking down my ankles in the shower, then quietly curling up near the drain. Eventually, I began to dread looking down at my toes every time I showered. “It’s probably the change in weather,” said my mother nonchalantly, when I first told her about it. Three weeks later, when she saw stark-white slivers of my scalp through my thinning hair, she realised this was serious.

I had been living with PCOS (polycystic ovarian syndrome) since 2009, a common endocrine disorder that affects one out of five women, according to a 2016 study by Metropolis Healthcare. In 2012, I hired a personal trainer, lost four kilos and embraced shiny new eating habits. This followed a good four-year run of being medication-free and happy—until now.

Dealing with unusual hair fall is a bit like obsessing about what happened to Will Byers in Stranger Things. You soon start to relate to the paranoia of Winona Ryder’s character. Was the PCOS worsening? Was it some other hormonal uprising? Was there a government-sponsored monster in my walls, yanking my hair out? A string of doctor visits and routine blood tests left me no wiser.

Within a month, lethargy, an aversion to work (every day felt like Monday), aching joints and a mild bout of depression crept in. Finally, I met an endocrinologist, Dr Kamini Lakhiani, who suspected it was something thyroid-related and advised a thyroid antibodies or TPO test. Three days later, there it was—an ominous asterisk, silently screaming for attention, against an unusually high TPO level.

Strange condition

It took a paroxysm of Googling to wrap my head around the condition that ailed me. Hashimoto’s Thyroiditis (HT) makes your body produce high levels of antibodies, which prompts your immune system to attack healthy tissue (the thyroid gland in particular) resulting in excessive inflammation. Named after Dr Hakaru Hashimoto, a Japanese physician who discovered it in 1912, HT is the leading cause of hypothyroidism (an underactive thyroid gland).

Now, a quick science lesson. The thyroid is a small butterfly-shaped gland at the base of your neck, and the various hormones it secretes regulate things like your metabolism, brain development and menstrual cycles. Mess with it and even basic functions like digestion, go completely out of whack. Keep this up and soon, your thyroid gland will shut down.

I felt like the breath had been knocked out of me. How did this happen? No one can pinpoint a particular cause for HT: genetics, hormones, gender (women are seven times more likely to have it than men), environmental toxins (stress) and even leaky gut syndrome, all may have a role to play. The first step towards managing any autoimmune condition is drugs, but they only address the symptoms. While my doctor put me on a high dose of nutritional supplements and very little medication, I still had to find ways to correct my low ferritin levels (the hair fall culprit) and poor digestion.

I spent day after bleary-eyed day reading studies and journals on the subject. Then I finally stumbled upon my first clue. A gluten-free diet, it was reported, could help control the symptoms of HT. But due to a lack of studies researching the connection, doctors didn’t yet feel confident recommending this drastic change. At first, I too thought it was crazy, giving up bread, rotis and, oh god, croissants—it felt so… extreme.

bread

What is gluten?

Gluten is a protein composite found in wheat, barley and rye. It contains a particular peptide sequence that intolerant immune systems identify as a foreign invader. The immune system gets so riled up at this intrusion that it starts attacking healthy body tissue too, specifically the thyroid gland and the brain. An autoimmune disorder like mine is different from simple gluten-intolerance, since there’s also a genetic component to it. And over time, a poor diet, food sensitivities (including gluten), toxin overload (popping too many pills) and bacterial imbalances can put your intestines under constant stress and cause inflammation. Over time, intestinal barriers break down and undigested food particles freely roam into the bloodstream. Called leaky gut syndrome, this condition triggers autoimmune disorders, which in turn, further damage the gut lining. It’s a high price to pay for pastry.

doughnut

Frankenstein’s flour

I decided to pay a visit to Mumbai-based physician Rupa Shah, who has seen an increase in cases like mine. “[Your gut] has to absorb, process, digest, assimilate and eliminate—and it has to complete this cycle smoothly.” To help my stressed-out gut do this, she advised a plant-based, vegan, gluten-free diet. Some of her patients had seen results in just three months.

But why this sudden rise in gluten aversion? The problem is the wheat. The way we grow, process and eat this grain has changed drastically over the past few decades. “Whether it’s a whole grain bagel or multigrain bread—it’s all made from a product of modern agriculture called semi-dwarf wheat. The physiological effect on us is all the same,” explains cardiologist William Davis and author of Wheat Belly (Rodale Books; 2014). In order to keep up with increasing food demands, scientists have hybridized wheat grains and they now contain entirely new forms of gluten. Processing it further degrades wheat’s nutritional value as the 40 per cent that is junked contains over half of the concentration of vitamins and fibre.

Mumbai-based nutritionist Anju Venkat says we’re eating it all wrong too. “It’s only in the last 30 to 50 years that we have started eating wheat through the year, that too three or four times a day. It’s supposed to be a seasonal winter crop, meant for people in colder regions.”

wheat1

Getting rid of gluten

It was clear what I needed to do, so I said a tearful goodbye to pepperoni pizza and did a full kitchen cleanse. I removed all traces of gluten: I junked bread, pasta, oats and even my homemade cookies. Here’s something I learned quickly: if you can see it, you will eat it.

My biggest worry was breakfast (no toast!). But a little advance planning helped me work out options. I developed a taste for traditional Indian breakfasts, like poha, dhokla and green moong chilla. Lunch was easier. Kumud Dadlani, facilitator for Slow Food India, Western Region, highlighted all the locally available options. India has a natural abundance of gluten-free flours, such as sabudana (sago), rajgira (amaranth), kuttu (buckwheat), singhara (water chestnut flour), besan (chickpea) and makki (corn). Dadlani says, “These ingredients were seen as the poor man’s food and are labelled as ‘health food’ in tier 1 cities. For instance, someone eating a ragi dosa at an Udipi eatery may not even realise it’s a gluten-free dish.” My boyfriend’s mother, a Gujarati, introduced me to the joys of dal khakras and amaranth parathas. (Knead dough with boiled potatoes. Add garlic, shallots and salt, and you won’t even miss the regular stuff.)

For the first week or so, going off gluten feels like being kicked by a horse, repeatedly. My biggest side effects were irritability (I should’ve been quarantined), bloating, low energy and headaches. Many afternoons, all I desperately wanted was a nap. Ideally, it’s best to wean off gluten slowly, so you don’t shock your body like I did. But trust me, you will get used to it.

dhokla2

Living gluten-free

In just a month, I woke up with the energy of a baby gazelle that lasted me all day. I even lost a few inches. I felt lighter especially during my workout (three times a week) and could feel the difference post meals in particular (no beached whale syndrome). A few weeks later, under the guidance of Dr Shah, I went vegetarian and cut out dairy—the bloating vanished and my skin glowed. Three months after my diagnosis, I tested the levels of my thyroid antibodies again and now they were almost in the permissible range.

This was all the validation I needed. I started visiting my local market regularly and found cheap options for my evening munchies at good old kirana stores, like roast kurmura, nachni crisps and bajra puffs. Dr Shah advised juicing any combination of veggies and fruit in a 60:40 ratio for a mid-morning snack to combat gluten withdrawal.  I stocked up on clean snack bars (Mojobars.com) when I was travelling. I became more experimental with my cooking too. One night, I made cauliflower ‘rice’ (blitzed cauliflower, sautéed with garlic, salt and green chillies) with crispy peanut tofu. Everyone who tasted it wanted seconds.

Initially, going off gluten felt like the end of the world. But where I expected sullen withdrawal from my body, I got a healthier gut and a happier frame of mind. The suffering I dreaded was all in my head, but the rewards are abundantly clear and tangible. Every now and then, I do indulge in a slice of ciabatta or a coconut-raisin cookie, but I respect my limits. And the pizza cravings? I still have them, but nothing is  worth losing my hair over.

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