Zonulin! The wheat conundrum solved (well, mostly …).

At the May 2013 Institute for Functional Medicine (IFM) conference on “Energy” in Dallas, Texas, I heard one of the most clinically important lectures ever. IFM honored Alessio Fasano, MD, with its highest honor, the Linus Pauling Award. His lecture was remarkable, and I now finally understand why so many of my patients with chronic disease became healthier avoiding gluten, even if they apparently did not have an immunological response to wheat proteins. The standing ovation in appreciation of his remarkable work was most deserved. Following is my evolving understanding. I say evolving as there are still important areas needing to be researched. Fasano’s team discovered zonulin, which regulates the opening of the tight joints between enterocytes. They also discovered that zonulin is released by gliadin, one of the primary components of gluten. And therein lies a remarkable story. The following quote from Fasano says it all: