Heroin, Oxycontin, and a whole wheat bagel

For a substantial proportion of people who remove wheat from their diet, there is a distinct and unpleasant withdrawal syndrome. Here are the comments of Heart Scan Blog reader, Scott, from Texas:

Hello Dr. Davis,

I've been experimenting with diet, converging upon a Paleo type diet, but I keep running into problems. I have isolated the problem to cutting out wheat.

Sugar, rice, fruit, corn, potatoes, etc. are relatively ok to add or remove from the diet, but cutting out wheat in particular brings on a moderate headache with heavy fatigue all day long. This resembles the wheat withdrawal symptoms I found on your blog. As I write this, I'm on day 8 of wheat-free. I consume a fair variety of meat and veggies each day with a moderate amount of white rice for carbs. Perhaps a bowl of corn flakes with milk and half a bar of dark chocolate a day. I've learned from experience over the past 5 months or so that none of these foods affect the withdrawal. It's purely wheat.

My question is, what is the range of times for withdrawal symptoms that you've heard from different people? Has there been anyone who never recovered from the wheat withdrawal symptoms even after many months?

It's very tough to get work done like this, and even though my body and head feel much healthier in general, my sinuses have cleared, don't have to take a big nap after I eat, etc., I don't want to go down a path where this is the way things are going to be forever. 



People who have never experienced wheat withdrawal pooh-pooh the effect. But, for about 30% of people, wheat withdrawal is a real, palpable, and sometimes incapacitating experience.

Beyond removing an exceptionally digestible carbohydrate that yields blood sugar rises higher than nearly any other known food (due to the unique amylopectin structure of wheat-derived carbohydrate), wheat withdrawal is a form of opiate withdrawal, somewhat like stopping heroin, Oxycontin, and other opiates. Stop eating whole wheat toast for breakfast, whole grain sandwiches for lunch, or whole grain pasta for dinner, and the flow of exorphins, i.e., exogenous morphine-like compounds, stops. You experience dysphoria (sadness, unhappiness), mental "fog," inability to concentrate, fatigue, and decreased capacity to exercise. It is milder than withdrawal from prescription opiates. Unlike withdrawal from more powerful opiates like heroine, there are, thankfully, no seizures or hallucinations. There are also no deaths.

In my experience, most people get through with wheat withdrawal in about 5 days. An occasional person will struggle for as long as 4 weeks. Thankfully for Scott, I've never seen it last longer than 4 weeks. (Interestingly, people who survive the withdrawal syndrome are often prone to a peculiar re-exposure phenomenon that I will discuss in future, i.e., they get sick upon re-exposure.)

The modern dwarf mutant variant of Triticum aestivum (that our USDA urges us to eat more of) contains greater proportions of gluten proteins compared to wheat pre-1970; glutens are the source of wheat-derived exorphins.

Incidentally, a drug company should be releasing a drug in the next year that will contain naltrexone, an oral opiate blocking drug, for a weight loss indication. They claim it is a blocker of the "mesolimbic reward system." I say it's a blocker of wheat exorphins.

Comments (27) -

  • Tree

    1/25/2011 1:50:08 PM |

    Celiac disease is often noticed by people who go off wheat for health reasons, then when they try to eat it again, it makes them sick.  

    For the record, Corn Flakes contain barley malt which has the same protein, gliadin, as wheat.  I have celiac and the "formula" is no wheat, barley or rye because they are so closely related and have the same "gluten" protein.

  • Martin Levac

    1/25/2011 1:55:45 PM |

    Isn't it interesting. They treat obesity by fixing the "mesolimbic reward system" because they believe eating too much "food" makes us fat. But then you say wheat isn't food, it's a drug.

    Are we really eating too much "food"?

  • Emily Deans, M.D.

    1/25/2011 2:15:16 PM |

    A heroine is a very different concept than "heroin."  And withdrawal from oxycontin or heroin is unlikely to cause hallucinations or seizures (Trainspotting babies on the ceiling notwithstanding) - though it is exceedingly unpleasant, it is not typically medically dangerous.  Perhaps you are thinking withdrawal from alcohol, barbituates, or benzodiazepines, all of which can cause hallucination, seizures, or death if done without medical supervision.

  • Anonymous

    1/25/2011 2:35:18 PM |

    I have celiac and had similar problems when I first went off gluten.  It took me about a month to stop reacting.  I get quite ill whenever I accidentally am exposed to gluten, say at a restaurant.  My symptoms are migraine and flue like aching in my joints, plus severe fatigue.  None of my doctors thought I might have celiac by the way, because I am slightly overweight (BMI 25) and didn't have severe digestive symptoms, but there is recent research showing that many patients present with migraine as their only celiac symptom.

  • Dr. William Davis

    1/25/2011 2:47:15 PM |

    Oohh. Thanks for catching the typo, Dr. Deans. Fixed.

    By the way, I've seen plenty of hallucinations and seizures with opiate withdrawal, as well as benzodiazepine withdrawal. Or, perhaps it was combination addictions that were at fault.

    That, however, was not the point.

  • Emily Deans, M.D.

    1/25/2011 3:11:53 PM |

    I think the point was well-made - just didn't want anyone to fear that wheat withdrawal was medically dangerous (quite the opposite).  I've had a few cases where I was able to stop night (carb - typically bread) binging with (off-label) use of naltrexone - pretty telling, I would say.

  • Dr. William Davis

    1/25/2011 10:21:46 PM |

    Dr. Deans--

    I am VERY impressed you knew of this effect.

    I have tried this, too, in people who are, despite their best effort, unable to resist temptation to consume this drug-disguised-as-food called wheat.

  • Anonymous

    1/26/2011 12:24:48 AM |

    My health improved dramatically after I stopped eating wheat, grains, and other carbs, I even had a cataract disappear.  But it required nine months before I could adjust to the low carb way of eating. It's worth all the trouble, no more high blood pressure or diabetes medicine.  Most of my arthritic pain is gone, I am able think more clearly. Lost 30 pounds. No more allergies or indigestion.
    Thank you for writing this blog!

  • DK

    1/26/2011 4:08:13 AM |

    I was able to stop night (carb - typically bread) binging with (off-label) use of naltrexone - pretty telling, I would say.

    Nothing at all particularly telling I would say. Other than telling that opioid receptors are part of the reward circuit. Which is obvious and not disputed by anyone. Naltrexone main use is in treatment of alcohol dependence. Using your logic ethanol is an agonist of opioid receptors. Which is self-evidently not true. The effects are indirect.

  • Might-o'chondri-AL

    1/26/2011 5:30:17 PM |

    Question here:

    Is the "craving" for wheat due to psychoactive tri-peptides derived from wheat protein ?  If that is the molecule that "dopes" our opiod receptors then decreasing levels of tri-peptides as the day progresses will make some look for their wheat "fix".

    Naltrexone @50mg was FDA approved (1984) in 1984 opiod addition; to block receptors. I think the doctors here are referring to single evening doses of 3 to 4.5 mg.
    for screened patients.

  • BWR

    1/27/2011 3:08:46 AM |

    Here's what I don't understand: Why is it that entire countries of people who eat bread by the basket, like Spain, have exceptionally low levels of heart disease? This is a sincere question. I want to do what's right for my heart, but it seems to me that a naturally occurring sample size of several million people is pretty compelling. What am I missing?

  • Anonymous

    1/27/2011 8:25:08 AM |

    Jack LaLane on sugar:

    http://www.youtube.com/watch?v=LJVEPB_l8FU

  • Jonathan Byron

    1/27/2011 1:56:02 PM |

    Milk and dairy products are also a source of endorphin-like chemicals. Would it make sense to try to kick a wheat habit by temporarily drinking more milk?

  • Anonymous

    1/27/2011 3:42:20 PM |

    BWR

    It is possible that Spanish bread is made from a much healthier wheat variety.

    The devil is on the details.
    From a HSB comment May 24, 2010
    Here in France, Einhorn( Triticum monococcum) has been cultivated since the 9 th millennium BC in a small area of Haute Provence. It is called petit epeautre and it is truly delicious! It has very little gluten.
    There is much regulation in the cultivation in order to protect the genetic purity of this ancient grain. Like wines it has a AOC (appelation d'origine controlee

    Please note: Higher Mg and Lysine in einkorn

    Modern wheat has had much of the Mg bred out
    http://petitepeautre.com/nutritiona.html

    Scandinavian Journal of Gastroenterology
    http://www.einkorn.com/toxicity-of-einkorn-gluten/

    Same for casein in milk where A1 milk can be a serious problem and the casein is similar to gluten
    http://www.guernsey.net/~wgcf/PageMill_Resources/Acres_Woodford.pdf

  • Dr. William Davis

    1/27/2011 4:37:27 PM |

    Hi, BWR--

    There are some unanswered questions with this thing called wheat. As the anonymous commenter pointed out, there may be differences in strains grown worldwide. While 99% of all wheat grown today are dwarf variants of Triticum aestivum, there are pockets of agricultural adherence to older cultivars.

  • revelo

    1/27/2011 8:41:02 PM |

    I am perfectly willing to believe than many people cannot tolerate wheat. But this obsession with villifying wheat discredits Dr Davis's very valuable promotion of regular heart scans and other diagnostics, as well as D3, Iodine and other supplements.

    It isn't just the Spaniards. My own ancestors are a mix of French, German and English, and I don't seem to have any problems with wheat, rye, barley, to speak nothing of oats. Furthermore, I believe a heavy grain diet is precisely why I am able to keep my weight down and my test results good. I experimented with going to a somewhat more paleo diet recently and the result was to DECREASE my insulin sensitivity when I went back to eating oats. Now that I'm back to eating mostly oats, my insulin sensitivity has returned to normal. Worse, the paleo diet caused a surge in uncontrollable hunger. One particularly bad day, I ran through a dozen eggs, a pound of meat, another pound of nuts and all sorts of other food before my appetite finally settled down. I never had these uncontrollable appetite problems with my usual mostly oats diet, nor did I have problems when I used to eat mostly pasta (though I was younger then and had higher metabolism than now).

    Appetite is the key. If a food sends appetite soaring, then it doesn't matter how healthy that food is by itself--it will make you fat and thereby reduce insulin sensitivity and thus destroy you in the end. Conversely, if a food depresses appetite, then assuming it isn't absolute poison (like arsenic), eating that food will allow you stay lean, and by staying lean you stay insulin-sensitive (assuming you also do some daily exercise), and that is the ultimate key to avoiding most health problems, from what I understand. For some people, wheat and oats may very well be the keys to appetite suppression, and it is thus a disservice to condemn these foods for everyone.

  • Anonymous

    1/27/2011 10:47:13 PM |

    what do you make of this new study citing adverse effects of a high fat diet?

    http://www.ajcn.org/content/early/2011/01/26/ajcn.110.002758.abstract

  • Onschedule

    1/28/2011 1:21:46 AM |

    @revelo,

    In his practice of Cardiology, Dr. Davis has apparently observed great results with a good number of his patients that choose to avoid wheat. Apparently, an impressive enough effect, in his opinion, to make the statements that he does. These observations, and the recommendations he makes based upon them, hardly "discredit" his professional advice.

    It may be true, as you suggest, that not every single person will have a problem eating wheat, but a person's weight (or appetite) is not the only indicator of potential heart-health related issues. While wheat might not make everyone fat, it may still provoke immune response, inflammation, surge in blood glucose and triglycerides, etc.

    Anecdotally, thanks to Dr. Davis' advice regarding wheat, my 68 year-old mother lost 15% of her bodyweight in four months, without exercise, and without any other change in her diet except to replace the pastas and breads with eggs, vegetables, and meats. She had always taken great pride in the "healthy" foods she ate, but over the past twenty years had very slowly gained weight and a bloated appearance. She started crying during our last visit because she is so happy to "recognize" herself again in the mirror, and is wearing clothes that haven't fit in over a decade. I stopped eating wheat one year ago. Since then, I've dropped from size 34 to 28 pants and get compliments weekly concerning how young I look; I feel great and lab results (blood tests, radiology) are unbelievably improved.

    Wheat avoidance may not indeed be necessary for everyone; but, it's done wonders for *all* of those around me that have given it a good chance.

  • reikime

    1/28/2011 3:53:27 AM |

    Jonathan,
    Subbing milk for the wheat wold NOT work as milk produces a morphine- like substance called caseomorph and wheat produces gliadimorphs. Two different types of exogenous morphines.

    This is one of the rationales for the gluten free- casein free diet that seems to greatly help some children on the autistic spectrum.  Sorry to be a spoilsport!

  • reikime

    1/28/2011 3:55:31 AM |

    oops!  typo alert ...sorry
    Subbing milk for the wheat would NOT work as milk...

  • Might-o'chondri-AL

    1/28/2011 7:55:05 AM |

    reikime,
    thanks for the answer.

  • reikime

    1/30/2011 12:39:45 AM |

    You're welcome Might-.

  • Olive Kaiser

    1/30/2011 3:13:16 AM |

    Check out www.theglutensyndrome.net

    I get folks who contact me from my site who have strange neurological symptoms when they either withdraw from gluten/wheat the first time or  flip flop on and off too much. I have a page on temporary adverse effects from going gluten free.

    Our 23 year old nursing student daughter experienced a very strange neurological effect from a 6 week gluten challenge after being strictly gluten free for 6 months.  Ischemia/reperfusion injury is a possibility, and gluteomorphin withdrawal also.  Her story is on the site.  For sure she is very strictly gluten free now, and doing fine 6 years after the experience. http://glutensensitivity.net/cases.htm#ztop

    In the book, "Mendel in the Kitchen, Nina Federoff, a strong proponent of GMO technology, relates how wheat was genetically altered by the 1950's by both x ray irradiation and chemical mutation, and the gluten levels were raised far above older varieties. The wheat today is not the same as our ancestors, at least not here in the States.

    FYI, a new lab (www.Cyrexlabs.com)  has just opened 2 weeks ago with much more complete gluten syndrome testing.  They are testing many more antibodies than previous standard panels, and expected to turn up many more folks with gluten syndrome.  They also teach that gluten can damage multitudes of tissues by molecular mimicry between gluten related antibodies and look alike innocent tissues all over the body.  The villi, which have been the gold standard target tissue in the celiac community, are turning out to be just one of many possible sites of damage.  

    Many folks have gluten/wheat related antibodies, but their main target of autoimmune tissue damage is in places other than the villi, such as the heart, nerves, organs, joint lining, etc.  Villi as the target tissue is found in relatively a few folks, and that is the tissue damage that has gotten most of the attention.

    Dr. Aristo Vojdani, PhD, Immunology, and others have accumulated a lot of research to support these theories, and they fit the gluten syndrome community like a glove.

  • Jonathan Byron

    1/30/2011 3:39:54 AM |

    >> "Subbing milk for the wheat wold NOT work as milk produces a morphine- like substance called caseomorph and wheat produces gliadimorphs. Two different types of exogenous morphines."

    Right, but is the fundamental problem generally the morphine-like effect, or is it some other antigen specific to gliadins? My wife has hashimoto's thyroiditis, and the smallest trace of wheat, barley, or other gliadin grains quickly makes her miserable... she can feel her thyroid swell, she gets cold, she has other problems. Dairy does not have this effect. Since cutting out gluten from grains, her T3, T4, and TSH levels have returned to normal, while her anti-thyroid antibody level has dropped to very near normal.

    I am willing to consider that with some conditions (like autism), both gluten and milk can be a problem. It is not clear to me that if gluten is a problem then milk must also always be a problem. If the casomorph proteins allows some people to quit wheat with fewer withdraw symptoms due to the substitution of endorphin-like molecules, that could be a good thing.

  • reikime

    1/30/2011 10:37:28 PM |

    Jonathan,

    The issues your wife has with gliadin really dont seem related to the morphine like responses some people have with gluten and /or dairy.

    Sure some people that have a wheat/gluten intolerance can ingest dairy just fine...that said, if the microvilli are damaged from wheat and not healed yet, you are much more likely to have a problem with dairy.
    The tips of the villi are where lactase is produced.
    Also, if one is subject to the effects of gliadiamorphins, IMHO one would likely be sensitive to caseomorphins, because the unhealed intesine is permeable.. ie leaky gut syndrome. This allows proteins into the bloodstream that would normally not be there. (and to wreak havoc)

    Willing to say I may be wrong, though. Anyone?

    I spend alot of time on celiac  research issues, so naturally this is where my brain goes!  lol

  • Dr Charles Parker

    3/22/2011 1:02:56 PM |

    Great to see that others have identified gluten as a potential pathogen/allergen that can significantly contribute to both mind and body deterioration through compromised immune dysfunction. I know you, Dr Davis, often think of the heart as the canary in the coal mine, and I see the brain as a canary partner showing first signs of impending acute deterioration.

    This link will take you to a series of interviews I did with Dr Peter Osborne on similar issues as discussed in this posting:

    http://www.youtube.com/watch?v=dJCZmNzkRNA&playnext=1&list=PLD61FCED98A4A5C66

    Hope this helps encourage more discussion and awareness, and thanks for your excellent work!
    cp

  • Carb Flu « The Paleo Spot

    9/16/2012 4:53:03 PM |

    [...] The first couple of weeks without grains and sugars were not pleasant.  In the beginning, I had a headache nearly every single day.  By body was detoxing and coming off the caffeine, carbs and sugars.  I was crazy tired.  For several days, I was so ravenous I wanted to gnaw my arm right off my body (would somebody please pass the sea salt…?)  If this lifestyle is sooo healthy, why have I been feeling like I’ve been run over twice by a dinosaur?  The answer is simple and thanks to in-depth research before starting my journey, it is something that I anticipated would happen – I have been experiencing the classic symptoms of Low Carb Flu. [...]

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Erectile dysfunction and coronary plaque

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Treat the patient, not the test

Treat the patient, not the test

"Treat the patient, not the test."

That is a common "pearl" of medical wisdom often passed on during medical training.

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Robb Wolf's new Paleo Solution

Robb Wolf's new Paleo Solution

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Comments (16) -

  • Carlos

    9/20/2010 10:24:56 PM |

    Does he subscribe to Cordain's anti-saturated fat view of nutrition? That is one of the biggest issues I have with Cordain's take on paleolithic nutrition. The biggest problems with speculations on paleolithic nutrition is the extinction of the megafauna that were the basis of human global expansion. Fatty acids in modern deer doesn't tell us anything about fatty acids in mammoths, cave bears, and aurochs.

  • LInda Middlesworth

    9/21/2010 2:46:19 AM |

    It is so sad that Robb is making money off of telliing people to eat the same SAD (Standard American Diet) that is killing Americans. The SAD diet is the same diet to promote heart disease, diabetes, obesity, cancer, etc.
    and all other chronic diseases that plague western countries. Only animal foods have cholesterol so stop eating them. Go Plant BASED! goveg.com

  • kellgy

    9/21/2010 4:52:22 AM |

    Dr. Davis, I'm not sure if you meant to, but the book you have linked is for Cordian's Paleo Diet not Wolf's Paleo Solution.

    Here is Wolf's link: http://robbwolf.com/

    I've been interested in studying the paleo diet for a little while now. Since I am following some of the principles on my low carb/sugar regimen, it can't be too much of a stretch. The health benefits are probably a great improvement over the SAD and vegetarian diets I have tried in the past.

    Eating foods that readily provide nutrients for lean muscle mass development gives you a competitive edge on the health continuum.

    Maybe I'll take a dive on the upcoming release.

  • Dr. William Davis

    9/21/2010 1:53:50 PM |

    Oops!

    Thanks for catching that, Kellgy.

  • Anonymous

    9/21/2010 2:27:42 PM |

    How old is Robb?  It says former research biochemist but he looks like he's 27?!!  Guess that's what paleo does for ya.

  • Diane

    9/21/2010 4:42:44 PM |

    @Linda- Actually, consuming animal based foods isn't what the SAD diet means. SAD is more about processed foods (largely grain-based) which is what the Paleo diet does NOT promote consumption of. The reality is that Robb doesn't make money by telling people to go out and buy whole, real food. None of us who promote a whole-food diet benefit in the pocket from it.

    A Paleo diet is actually largely plant based, though it clearly involves animal foods to a large degree. We eat TONS of plants.

    If you knew anything about cholesterol, you'd know that eating it actually isn't killing us. Processed grains and sugar will go way farther to damaging our health than a hunk of pork belly any day.

  • Diane

    9/21/2010 4:43:22 PM |

    Oh, Robb is around 38, I think...

  • Sandy Sommer RKC

    9/21/2010 7:03:33 PM |

    Linda, You may want to check and then re-check your facts. Wolf's ideas are the antithesis of SAD. I'm 49 years old, 8.5% body fat, eat no grains at all...None.....Have very low blood pressure....great blood chemistry and unlimited energy.

  • Drew

    9/21/2010 9:07:21 PM |

    @ Linda, quality meat (grassfed, wild, etc) is not bad. Humans have been consuming meat for 2.5 million years. Hell, the Inuit have a diet that contains about 95%+ animal products, and they don't suffer from the level of chronic diseases we do. If you actually do your research on the subject, you'll see that meat is not the source of all our problems. "The Vegetarian Myth", written by a former vegan, is a very good book I hear.

  • Drew

    9/21/2010 9:10:20 PM |

    @ Carlos, actually, Cordain's stance on saturated fat has softened quite a bit. He is actually releasing a revised version of his book, The Paleo Diet, in which some of stuff on saturated fat is revised.

    Robb Wolf tends to be saturated fat agnostic. He weighs the pros and cons in the book, and provides good info and research to back it up.

  • Dr. William Davis

    9/21/2010 11:53:07 PM |

    Drew said it well: Saturated fat varies in composition, depending on what mix of fatty acids it contains, e.g., stearic, lauric, and myristic.

    It also matters whether saturated fat keeps the company of exogenously generated advanced glycation end-products.

    Saturated fat, in and of itself, is not that bad. But it can keep the company of other things. In other words, saturated fat has served as a surrogate marker for these other things. Unfortunately, it means that, for years, the data have been distorted by these other measures.

  • Adolfo David

    9/22/2010 1:51:49 AM |

    Linda
    Go meat-eating! And read please.

    Cholesterol bad? What stupidity!

    Vegetarians are so so ignorants...

  • Anne

    9/23/2010 1:50:10 PM |

    Just catching up with the posts since I've been on holiday. Just posted in the Fred Hahn bit as I've been doing Slow Burn for over three years now. I have also been following a Paleo diet for over four years ! Wow, two of the things that have been most influential for my health and well being you posted on Dr Davis ! Wish I could have taken part in discussions while I was away. Never mind...I couldn't agree more with both the Slow Burn weight lifting technique and the Paleo way of eating....they both help me with my health problems: osteoporosis, atypical type 2 diabetes (thin and not insulin resistant) and congenital heart valve defect.

  • Carlos

    9/23/2010 5:05:07 PM |

    Drew: I'll be keeping an eye out for the updated PaleoDiet. Thanks for the heads up.

  • Dean Deleo

    9/24/2010 6:04:01 PM |

    Vegetarians are silly.

    That Paleo makes alot of sense

  • lala

    10/18/2010 4:06:25 AM |

    Thanks for your post and welcome to check: here
    .

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