Dr Tom O’Bryan: Gluten Sensitivity and Coeliac Disease

Prof Tom O'Bryan

Dr Tom O’Bryan

Over the last few years, we have seen the correlation of Gluten Sensitivity as a common initiator of multiple pathologies.  From Attention Deficit Hyperactivity Disorder to Hepatocellular Carcinoma, from Migraines to Recurrent Pancreatitis, from Cardiomyopathy to numerous autoimmune diseases. The association of sensitivity to this protein of wheat, rye and barley has been linked with the initial manifestation of multiple pathophysiologies including a variety of autoimmune conditions. Just read the literature and your jaw will drop at the multitude of systemic symptoms associated with Gluten Sensitivity. We have written on these conditions in our article – what you do not know about coeliac disease.

Yet many Nutritional Therapists consider this as a rare condition and because of poor investigative testing often miss the early signs in their patients. Exclusion becomes the strategy of choice.

International Seminar

On March 5th 2011, Dr Tom O’Bryan travelled from the US to present a seminar at The Royal Society of Medicine, London on “Gluten Sensitivity and Coeliac Disease”.

Access seminar resources Missed a seminar? Read about our purchase option

You can now buy the seminar for only £30.00 and go through the presentation, at your own leisure, providing 6 CPD credits.

Just call +44(0)8450 760 402 to order and a link will be sent to you for the following:

  • Seminar slides used by Dr O’Bryan
  • Audio files of the recorded presentation to listen on a mobile device (MP3)
  • A collection of handouts from the seminar
  • Professional product information and protocols


9.30 – 11.00 Systemic Complications of Gluten Sensitivity: Enteropathy to Dementia.For every patient with classic symptoms of the Gluten Sensitive Enteropathy Coeliac Disease, there are 8 with no GI symptoms. The list of extra-intestinal manifestations are throughout the entire body. We will review the literature on the many manifestations of Coeliac Disease and Gluten Sensitivity.
11.30 – 1.00 The Conundrum of Validating Gluten Sensitivity and Coeliac Disease: You Suspect It’s There, Serology is Negative, What’s Next?The average Coeliac patient has seen 5 different Health Care Practitioners and has suffered with the same presenting complaints from 8-11 years before receiving the correct diagnosis. This is the average, not the exception. How could that be? One major cause of this is ‘false negatives’ testing results. We will review historic testing recommendations and current testing options.
2.15 – 3.30 Arresting and Reversing the Increased Morbidity and Mortality of Gluten Sensitivity/Coeliac DiseaseGreater than 30% of the Coeliac population does not heal on a gluten-free diet. And those who do rejuvenate their villi still demonstrate increased intestinal permeability years afterward. We will review the dietary and nutritional protocols that  address this situation.
4.00 – 5.30 Grand Rounds: Protocols, Case Histories, Round Table Discussions


But there’s been a Conundrum. The patient feels better and functions better avoiding gluten, yet current testing options to confirm this sensitivity to gluten are often negative. The reason for this is the serology is highly Sensitive and Specific when the patient has total villous atrophy. Anything less than total villous atrophy, and the Sensitivity of the test drops dramatically, (depending on the study you read) to as low as 27%.

Dr. Tom O’Bryan is an experienced lecturer and provocative and workshop leader specialising in coeliac disease & gluten intolerance, and a clinician par excellence in treating chronic disease and metabolic disorders from a Functional Medicine perspective. His expertise in finding the root cause of the malady or syndrome sets him apart. Tom will describe the mechanisms, the investigations – and yes, will discuss the use of a new salivary marker for Gluten Sensitivity as well as other investigations worthy of a functional approach and a pathological approach to gluten sensitivity. There has already been one substantive paper published on this mechanism.

  • Bonamico M, Nenna R, Montuori M, Luparia RP, Turchetti A, Mennini M, Lucantoni F, Masotti D, Magliocca FM, Culasso F, Tiberti C.. First salivary screening of celiac disease by detection of anti-transglutaminase autoantibody radioimmunoassay in 5000 Italian primary schoolchildren. J Pediatr Gastroenterol Nutr. 2011 Jan;52(1):17-20. View Abstract

The mucosal tissues are the first line of contact for the gluten proteins, the effects of this antigenic trigger may remain silent and or local, but many patients presenting with diverse symptoms have the indications of gluten reactivity but are unwilling to make the significant decision to avoid it without great support and evidence. Tom will teach the pathophysiology in a manner that will highlight evolving science and key strategic interventions other than the gold standard ‘gluten avoidance’. Investigations, interpretations and applications will also be discussed with suggested strategies and effective lifestyle changes.

Nutritional Therapy for the repair of barrier defects, limiting cytokine activation, improving inflammatory markers represents a significant opportunity for specialisation and effective therapeutic intervention.

Coeliac disease is, a unique example of autoimmunity, since early serological diagnosis and dietary treatment can revert the autoimmune process and can prevent its severe, sometimes life-threatening complications. Therefore, the common wisdom among experts in the field supports the notion that individuals affected by coeliac disease should be treated, irrespective of the presence of symptoms and/or associated conditions.


It is possible that the different onset time among coeliacs is associated with the microbiome—that is, the community of bacteria or microbes which live in the digestive tract. This bacterial ecology  varies among different people and even in the same individual over time. It appears these microbes can have an effect on the genes which are active in their host. Therefore, someone genetically predisposed to coeliac disease may have been able to handle gluten for a long time, but upon a shifting of the microbiome, and a subsequent activation of the gluten intolerance gene, the symptoms of coeliac disease will appear.[1]

This also leads to altered gut permeability, suggesting early diagnosis may allow for bacterial manipulation and gut permeability repair to reduce symptoms or possibly reverse the damage to preventing coeliac disease. The role of SIgA in the mucosal barrier and management of coeliac disease is also coming under scrutiny.[2]

[1] Sánchez E, Donat E, Ribes-Koninckx C, Calabuig M, Sanz Y. Intestinal Bacteroides species associated with coeliac disease. J Clin Pathol. 2010 Dec;63(12):1105-11. Epub 2010 Oct 23. View Abstract

[2] De Palma G, Nadal I, Medina M, Donat E, Ribes-Koninckx C, Calabuig M, Sanz Y. Intestinal dysbiosis and reduced immunoglobulin-coated bacteria associated with coeliac disease in children. BMC Microbiol. 2010 Feb 24;10:63. View Abstract

Continuing Professional Development

CPD Approval Credits/hours
British   Association for Applied Nutrition and Nutritional Therapy
British Association for Applied Nutrition and Nutritional Therapy
NNA naturopathic nutrition association Naturopathic Nutrition Association 6

Attendees at the Dr Tom O’Bryan Seminar, Fascinated by the presenters information

Public Lecture

On the Friday 4th March prior to the main lecture at the RSM, Tom will be giving a public lecture to explain in a more simple manner the skills and updated science he will be teaching the following day. Practitioners attending the main lecture and workshops will then be added to a web link to identify them as having undertaken additional training in the management of gluten sensitivity so that members of the public seeking additional support can find them.

Dr Tom O’Bryan

A graduate of the University of Michigan and the National College of Chiropractic, Dr.O’Bryan is a Diplomate of the National Board of Chiropractic Examiners, a Diplomate of the American board of Clinical Nutrition, and a Certified Clinical Nutritionist with the International and American Association of Clinical Nutritionists. He is a Certified Applied Kinesiologist. He is a Certified Practitioner in Functional Biomechanics from the Motion Palpation Institute. He is a member of the Institute of Functional Medicine, the International and American Association of Clinical Nutritionists, the American Chiropractic Association, and numerous other professional organisations. Dr. O’Bryan is a practicing graduate of the Institute For Functional Medicine’s hallmark program Applying Functional Medicine in Clinical Practice. He was recently selected as one of 5 nationally recognised presenters on 21st Century Endocrinology: Thyroid and Adrenals as Sentinel Organs for his presentation on the widening web of coeliac disease and thyroid dysfunction at the 2007 International Symposium for Functional Medicine.