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Without carefully checking, finding gluten in medicine is tricky

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Posted: Friday, December 13, 2013 9:20 am

Dear pharmacist: I heard your lecture on free “The Gluten Summit” last week 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

Answer: Being gluten-free myself (by choice), I am frustrated along with you. If you were going to eat gluten by choice, you would’ve eaten the stuffing, right?! 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 the ingredients and lubricate the mixture. These binders and fillers may be sourced from various ingredients.

The word “starch” is questionable, so call the manufacturer and ask if it came from wheat. Maltodextran may be extracted from wheat, corn, potato or rice. You have to find out.

Dextrimaltose may be from barley malt. Pre-gelatinized 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 big list of gluten-free medications.

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.

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 because the FDA does not require generic makers to match up the excipients. They only require them to 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 for each brand name, so don’t give up if the first generic maker uses gluten, keep investigating. Look at the “patient package insert” or go online. If that doesn’t help, contact the manufacturer directly.

This information is not intended to diagnose, treat, cure or prevent any disease. For more information about Suzy Cohen, visit her website at www.suzycohen.com.

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