I recently received this email from a follower of my Facebook page, The Coeliac Hub:
I was wondering whether you could ask adult coeliacs if they receive Holy
Communion or opt not to. I was diagnosed with coeliac disease 4 years ago, but I haven’t received Holy Communion for the last 3 years. The reason for this is that the hosts we buy are ‘gluten reduced’ not gluten-free. I also feel uncomfortable receiving Holy Communion after the mass finishes in the sacristy, as I feel that the priest does not have time for us!
I would like to know what others think about this.
An anonymous follower
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Before I ask the questions posed in the email above, I decided to read up about the matter a little more. Although I am no expert of Church issues, I will be as objective and impartial as I possibly can in this post based on what I have learnt.
Many of us wonder whether hosts made from gluten free ingredients are valid matter for Communion in the Roman Catholic Church. After all, other Christian religions use hosts that are not wheat based. However, when I searched for more information about this I came across a document issued by the Vatican titled Circular Letter to all Presidents of the Episcopal Conferences concerning the use of low-gluten altar breads and mustum as matter for the celebration of the Eucharist, dated the 24th of July, 2003.
According to this document,
1. Hosts that are completely gluten-free are invalid matter for the celebration of the Eucharist.
2. Low-gluten hosts are valid matter, provided that they contain a sufficient amount of gluten to obtain the confection of bread without the addition of foreign materials and without the use of procedures that would alter the nature of bread.
3. Mustum which is grape juice that is either fresh or preserved by methods that suspend its fermentation without altering its nature (for example, freezing), is valid matter for the celebration of the Eucharist.
They go on to say that
a person affected by coeliac disease, who is not able to receive Communion under the species of bread, including low-gluten hosts, may receive Communion under the species of wine only.
Consecrated wine is safe for a Catholic coeliac to consume provided that it has not come into contact with any wheat. However, it is important to remember that gluten is highly soluble in alcohol.
There are a few problems for coeliacs in this scenario.
1. Although most coeliacs can tolerate the level of gluten in gluten reduced hosts, some cannot. People’s levels of sensitivity to gluten varies tremendously, and it also matters if the person has a one-time exposure or whether gluten is consumed every day over a period of weeks or months.
Hosts being sold as gluten reduced in Malta are at the level of less than 100ppm of gluten. According to the Coeliac Association of Malta each host contains less than 0.04 mg of gluten. They also go on to say that each host can be split in 2 making the gluten consumption even less.
But is it really safe?
Please bear with me in this long explanation but it is important for a coeliac to understand how much gluten is ‘safe’.
A 2007 study led by Dr. Alessio Fasano, found that people who consumed 50 milligrams of gluten each day had renewed villous atrophy after 90 days, while those consuming zero gluten or 10 milligrams of gluten each day did not. The doctor and his colleagues concluded that most people with coeliac disease can handle up to 10 milligrams of gluten each day without adverse effects. This is the study on which the safe limit of 20ppm gluten for coeliacs was based. However, drawbacks of this study are that the authors chose people to participate whose intestines were well-healed. Because their intestine was healed it is likely that participants were less-sensitive to gluten cross-contamination than people who hadn’t healed on the gluten-free diet. Even so, one person in that study who was consuming 10 milligrams of gluten per day — not 50 milligrams, the highest level — developed a full “clinical relapse” and dropped out of the study due to intolerable symptoms.
We must also remember that a person who follows a gluten free diet that includes products labelled as ‘gluten-free’ (and so fall within the 20ppm threshold) is consuming about 6 to 10 milligrams of gluten each day as part of those “gluten-free”-labelled grain products, depending on how many of these products one consumes daily. It is important to mention that according to Coeliac UK,
The term ‘gluten-free’ implies no gluten, but in practice a zero level does not exist. It’s impossible to eat a zero gluten diet, because even naturally gluten-free cereals such as rice can contain up to 20ppm or 20mg/kg of gluten.
The US Food and Drug Administration (FDA), concluded that for the most sensitive coeliacs, intestinal damage begins at 0.4 milligrams of gluten per day, while symptoms begin at 0.015 milligrams of gluten per day. The agency based those conclusions on various studies, including two case studies involving recurrent symptoms in people who consumed communion wafers once each week. This would mean that for the most sensitive coeliacs, the gluten reduced host that contains 0.04 mg of gluten is not suitable.
2. The Vatican did not take into consideration the fact that if the host is broken over the wine, it will be contaminated with gluten. So, the priest’s Chalice is not a safe option to drink from. Neither is any other Chalice that the priest pours some wine from his chalice into- although new Norms dated March, 2004 for distribution of Holy Communion prohibit pouring consecrated wine from one vessel to another. More than one chalice can be filled at the altar and if one is kept free from gluten crumbs, that would be fine.
3. Some people are unable to drink the wine due to alcoholism or sulphite allergy.
Other issues that people with coeliac disease can face are shyness, dislike of special treatment, and fear of people speaking behind their backs. Also, some parents of coeliac children are not happy for their children to drink alcohol which is understandable. The email I received shows the isolation and anxiousness felt by a fellow coeliac due to this issue. I have also read comments on mostly US based social media groups that during the distribution of the Holy Eucharist, some coeliacs present themselves with their hands crossed over their chest, indicating to the priest or the Extraordinary Minister of Holy Communion that they wish for a blessing only instead of receiving the wine or gluten reduced host. However, according to an article from catholicdoors.com, the practice of blessing individuals during Holy Communion should be, not only discouraged, but discontinued. According to the same website, considering the fact that the entire Congregation is blessed by the priest at the dismissal about five minutes after the distribution of the Holy Eucharist, there is no need for anyone to receive a blessing during Communion.
So, to conclude
people who are doing well on the gluten-free diet and can handle gluten free labelled products, without symptoms or intestinal damage should be able to handle the gluten reduced hosts. However, people who continue to have symptoms, and whose intestinal damage hasn’t healed completely despite eating a careful and strict gluten-free diet, may need to drop all potential sources of trace gluten from their diets. It is advisable to visit your doctor to discuss whether these hosts are suitable to be consumed by the individual as every person’s sensitivity level is different. Keep in mind that more research is needed to definately decide what the safe level of gluten is for coeliacs.
The Coeliac Association of Malta had sent me a clarification of the ideal process of receiving Holy Communion to minimise risk. Please click on this link for the article :
Clarification from the Coeliac Association of Malta regarding Holy Communion for coeliacs
How can one buy gluten reduced hosts in Malta?
To buy gluten reduced hosts in Malta, one must submit an individual request to the Archbishop to be given permission to use these special hosts. This request must be accompanied by a document issued by medical authorities, certifying that the person suffers from coeliac disease. Contact the Coeliac Association Malta for more information on how to purchase these hosts.