Hidden Food Additives & Gluten

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“Dear Pharmacist,

I heard your lecture on free “The Gluten Summit” last week and was shocked to find out I take gluten every day in my medicine, and I’m a Celiac. Can you write more about this food additive?”
–P.M., Austin, Texas

Answer: Being gluten free myself (by choice), I am frustrated with you. If you were going to eat gluten by choice, you would’ve eating the stuffing right?! It’s hard to exercise the necessary self restraint to pass up pies, bagels, bread, and traditional pasta, and some of you have to because of  your condition. I wish pharmaceutical companies would post their sources for ingredients, but this isn’t required yet. You have to do the digging.

Medications are not always gluten free. It’s the hidden sources of gluten that present the biggest challenge for Celiacs and those with gluten sensitivity. No one can fully digest this protein so that makes us all technically “sensitive” to some degree. Gluten may be an “excipient” which is an inactive ingredient used to absorb water, allow for disintegration and release of the the ingredients and lubricate the mixture. These binders and fillers may be sourced from various ingredients. Here are my key points.

Point #1: The word “starch” is questionable so call the manufacturer and ask if it came from wheat.  Maltodextran may be extracted from wheat, corn, potato or rice. You have to find out. Dextrimaltose may be from barley malt. Pregelatinized starch is another potential source of gluten depending on the source.  Dextrose is a sugar derived from corn, so it is gluten free. Sugar alcohols like xylitol are gluten free. Glycerin, lactose and cellulose are also gluten free. There are dozens more, so I’ve created a big list to help you check your vitamin labels and medications and learn what ingredients are gluten free, which are endocrine disruptors, which are derived from petroleum, and which come from bug juice, yes some do!

Point #2: Even if  your medication and all the excipients are gluten free, makers have the ability to change the ingredient list without advertising this. You need to constantly check the label, or contact the manufacturer.

Point #3: Let’s say you have a brand that is 100 percent gluten free, then one day, you switch to generic to save money. You may suddenly be ingesting gluten without realizing because the FDA does not require generic makers to match up the excipients, they only require them to match up the active ingredient (the drug portion).  I’m all for generics to save you money, I just want you to check the inactive ingredient list before switching. There are usually several generic makers of one brand drug, so don’t give up if the first generic maker uses gluten, keep investigating. Look at the “Patient Package Insert” or go online, if that doesn’t help, contact the manufacturer directly.

This is a MUST for any of you that are interested in health and suspect gluten may play an issue in it.