Dear Pharmacist: I heard your lecture on "The Gluten Summit" 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
Dear P.M.: 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 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 found in the "excipient," which is an inactive ingredient used to absorb water, allow for disintegration and release of the ingredients, and lubricate the mixture. These binders and fillers may be sourced from various ingredients.
Here are my key points:
No. 1. The word "starch" is questionable, so call the manufacturer and ask if it came from wheat. Maltodextrin 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!). I also posted a list of gluten-free medications. Go to DearPharmacist.com.
No. 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.
No. 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 it, because the Food and Drug Administration does not require generic makers to match up the excipients. The FDA only requires they 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. Just keep investigating. Look at the patient package insert, or go online. If that doesn't help, contact the manufacturer directly.
This is not intended to treat, cure or diagnose your condition. Go to DearPharmacist.com.