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Significant amounts of gluten may be present in probiotics

WASHINGTON — Gluten-free labeling does not accurately reflect gluten content in probiotics, which may be significantly high, according to data released in advance of Digestive Disease Week.

Aiming to measure gluten levels in popular probiotics, Samantha Nazareth, MD, from Columbia/NY-Presbyterian, and colleagues used liquid chromatography-mass spectrometry analysis to evaluate 22 brands of probiotics based on popularity in the US market. They noted that 68% of the probiotics evaluated were labeled gluten-free.

Samantha Nazareth

They found that 55% of the probiotics evaluated contained gluten, of which 67% were labeled gluten-free. Gluten was present in 53% of the probiotics with gluten-free labels including 13% that exceeded the 20 parts per million threshold permitted by the FDA. Of the products that did not have gluten-free labels, 57% contained gluten including 29% that exceeded the FDA threshold. More than one gluten component (wheat, rye or barley) was detectable in 18% of all probiotics evaluated, two of which had gluten-free labels.

The researchers concluded that gluten may be present in significant amounts in probiotics, “especially if one considers the cumulative number of capsules consumed. [Gluten-free] labeling does not accurately reflect gluten content of probiotics, and [celiac disease] patients should therefore be advised of the potential contamination of probiotics with gluten, regardless of labeling.” – by Adam Leitenberger

Reference:

Nazareth S, et al. Abstract 108. Presented at: Digestive Disease Week, May 16-19, 2015; Washington, D.C. 

Disclosure: Nazareth reports no relevant financial disclosures. Please see the DDW faculty disclosure index for all other researchers’ relevant financial disclosures.

WASHINGTON — Gluten-free labeling does not accurately reflect gluten content in probiotics, which may be significantly high, according to data released in advance of Digestive Disease Week.

Aiming to measure gluten levels in popular probiotics, Samantha Nazareth, MD, from Columbia/NY-Presbyterian, and colleagues used liquid chromatography-mass spectrometry analysis to evaluate 22 brands of probiotics based on popularity in the US market. They noted that 68% of the probiotics evaluated were labeled gluten-free.

Samantha Nazareth

They found that 55% of the probiotics evaluated contained gluten, of which 67% were labeled gluten-free. Gluten was present in 53% of the probiotics with gluten-free labels including 13% that exceeded the 20 parts per million threshold permitted by the FDA. Of the products that did not have gluten-free labels, 57% contained gluten including 29% that exceeded the FDA threshold. More than one gluten component (wheat, rye or barley) was detectable in 18% of all probiotics evaluated, two of which had gluten-free labels.

The researchers concluded that gluten may be present in significant amounts in probiotics, “especially if one considers the cumulative number of capsules consumed. [Gluten-free] labeling does not accurately reflect gluten content of probiotics, and [celiac disease] patients should therefore be advised of the potential contamination of probiotics with gluten, regardless of labeling.” – by Adam Leitenberger

Reference:

Nazareth S, et al. Abstract 108. Presented at: Digestive Disease Week, May 16-19, 2015; Washington, D.C. 

Disclosure: Nazareth reports no relevant financial disclosures. Please see the DDW faculty disclosure index for all other researchers’ relevant financial disclosures.

    Perspective
    Joseph A. Murray

    Joseph A. Murray

    In the U.S., we now have reasonable labelling guidelines for foods; if the manufacturer wants to use a gluten-free label, they’ve got to have less than 20 parts per million. But when it comes to over-the-counter medications and supplements, it’s not at all clear that just because it says it’s gluten-free that it actually is. This is worrisome because a lot of people who have celiac disease continue to have symptoms and they look for things to help them, and one of those things are probiotics. It’s a very common practice among people with celiac disease to try probiotics, and if they’re not reliably gluten-free, you may be potentially doing more harm.

    Now we do need to work out how much gluten is present, and what is the gluten dosed – it may be too low to actually cause a problem. But the mere fact that there may be gluten contamination in probiotics, and certainly in probiotics that are labeled gluten-free, that’s a warning sign that we need to have more enforcement. In the field of celiac disease, we’d like to see the FDA really address the issue of gluten-contaminated over-the-counter medication and dietary supplements. They need to be better regulated than they are.

    • Joseph A. Murray, MD
    • Mayo Clinic Rochester, Minn.

    Disclosures: Murray reports various financial relationships with Alvine, AMAG, Bioline Rx, Enterohealth, Enteromedics, GlaxoSmithKline, Genentech, Glenmark, Ironwood and Torax.

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