For the Catholic with celiac disease, the most painful aspect
of living on a strict gluten free is the inability to receive
the host, or bread, at Communion. Catholics believe that the bread
is transformed into the Body of Christ. This transformation and
the reception of the Body of Christ, called the Eucharist, takes
place at Mass. It is the center around which the religious life
of a Catholic revolves. To be suddenly denied this by virtue of
having celiac disease is devastating to many Catholics.
Because the Catholic Church states that Communion bread must be
made of only wheat and water with "sufficient gluten to attain
the confection of bread," the only option for the Catholic
celiac has been to receive Communion under the species of wine
alone. According to Catholic doctrine, the whole of Christ is
contained in the Precious Blood alone. As such, the person who
receives Communion this way is still receiving the whole sacrament.
Since part of the rite of the Mass includes placing a small piece
of bread into the wine, the person with celiac disease needs to
arrange for a separate chalice into which no bread is put. The
priest is required to do this, as each Catholic in good standing
has a right to receive Communion. At churches where Communion
is offered to the congregation under both species, this might
not be a problem, as the chalices that are brought out to the
congregation generally do not have bread in them. As this is not
universal, each individual should become aware of the procedures
in her own parish.
Although receiving the Precious Blood alone provides a satisfactory
theological answer, many Catholic celiacs still feel a deep sense
of loss and isolation by being denied the ability to receive the
Body of Christ in the form of bread as they have since childhood.
Likewise, parents of celiac children are troubled by having their
child receiving Communion differently from other children or by
having their child drink wine.
Now there is another choice. The Benedictine Sisters of Perpetual
Adoration in Clyde, Missouri, have developed a Communion host
that is extremely low in gluten. They have worked for ten years
on this project. The host is made from gelatinized wheat starch.
The hosts have been tested for the presence of gluten. According
to the Sisters, they were tested to a level of 0.01% gluten. At
that level, the lowest that could be tested, no gluten was detected.
This means that there is less than 0.01% gluten in one of these
hosts; however, it is not known how much less. The Secretariat
for the Liturgy of the United States Conference of Catholic Bishops
has stated that these meet the requirements of the Code of Canon
Law and may be validly used at Mass with permission of the persons
pastor. They are manufactured by hand in a separate facility from
the ordinary wheat hosts and are shipped separately from the wheat
hosts so that there is no danger of cross contamination.
I spoke to Sister Jeanne Patricia Crowe, Pharm D, R Ph. of Immaculata
College in Pennsylvania. Sister Crowe (who is in a different order
from the nuns who developed the host and has no relationship with
them) does not have celiac disease herself, but she has a particular
interest in it and often speaks at celiac conferences. She weighed
these hosts on an extremely accurate pharmaceutical scale, and
then calculated how much gluten would be in one IF it actually
were 0.01% gluten. The result was approximately 32 micrograms;
a quarter of a host would have about 7 micrograms of gluten. For
those (like me) who are little shaky on the metric system, 7 micrograms
is 7/one millionths of a gram. To put this into perspective, a
very small bread crumb contains about 10 milligrams, or 10/one
thousandths of a gram--substantially more.
But, of course, the question in everyones mind is, "Is
this safe?" The answer from the experts is, "Probably."
Alessio Fasano MD of the Celiac Center at the University of Maryland
has stated that the gluten free hosts are safe for people with
celiac disease; however, he has not explained why. I have attempted
to contact him, but he has not responded to me or to another person
who has been researching this.
In 1993, Dr. Catassi published a study showing that the lowest
level of gluten that produced a visible change in the biopsies
of celiac volunteers was 100 milligrams of gliadin (equal to 200
milligrams of gluten) a day. Some experts have extrapolated from
that to state that the maximum amount of gluten a celiac should
ingest in a day is 10 milligrams. Clearly, the amount of gluten
in one of these hosts is significantly lower than that, which
suggests that it is a safe amount, However, no studies have been
done on this, so it is impossible to know if there are any risks
or dangers of long term exposure to this level of gluten.
I also spoke to Michelle Melin-Rogovin from the University of
Chicagos Celiac Disease program. She told me that no one
knows how much gluten is safe, and that in the Real World, we
are all probably ingesting some low level of gluten. She stated
that she could not say that it would be safe for someone to use
these hosts, but that it might be considered an "acceptable
risk" that would be a valid decision for some. She recommended
taking only a quarter of a host once a week at most. She also
suggested that it would be wise for someone choosing to do this
to check her antibodies beforehand and then several months later.
She would not recommend someone who had elevated antibodies to
use these hosts.
I realize that the policy of our support group and, therefore,
of this website is to advocate that a person with celiac disease
should do her utmost to avoid any consumption of gluten. As such,
this article may seem to be in conflict with this message. As
a Catholic celiac myself, however, I understand the deep sorrow
that not being able to have the Body of Christ can cause. In the
past four years, I have come to accept my gluten free life; I
live fully and joyfully and eat very well. But the one issue that
has continued to be painful and difficult to live with has been
my loss of the ability to receive the Body of Christ at Mass.
I also realize that non-Catholics may find it hard to grasp how
vital the sacrament is for us, and why even those of us who are
scrupulous to avoid any other source of gluten may choose this
as an acceptable risk, and I hope they will look at it without
judgement. I felt it important to gather as much information as
I could about the low gluten host so that each person can make
her own decision. The latest issue of Gluten Free Living also
contains an article on the low gluten hosts, with comments from
experts on celiac disease regarding their safety for someone on
a gluten free diet.
My mentor in college once told me, "For the rest of your
life, you will be making decisions based on insufficient information."
That certainly applies to life with celiac disease! Whether or
not one decides to accept the use of the low gluten host or to
allow ones child to receive it is a personal decision. Having
had to make it myself, I know how difficult it is. If anyone would
like to speak to me personally about the low gluten host or the
logistics of using it in a way that avoids cross contamination,
please feel free to call or to email me.
The low gluten hosts can be purchased from:
Congregation of Benedictine Sisters of Perpetual Adoration
Altar Breads Department
31970 State Highway P
Clyde, Missouri 64432
Phone: 1-800-223-2772