QUAERITUR: Celiac Disease revisited

From a reader:

My husband has Celiac Disease. The communion is wheat. What is he to do?

You have options.

First, you can tell the priest(s) at the parish about the condition and ask if your husband could receive only the Precious Blood.

Otherwise, you if the priest would consecrate a gluten-free host (or low-gluten), obtained from an approved maker, in a small separate pyx, for your husbands Communion.

I did this at a Mass on Sunday morning, as a matter of fact.  A woman explained the problem and had a pyx with a gluten free host.  No problem.  She came up first at Communion.  After she received, I went back to the altar for the ciborium with the normal Hosts.

If you explain the situation to the priest(s), I am confident that some accommodation will be made.  Go ahead and call the priest at your parish for an appointment to talk about it.  You could offer to buy the hosts, if the parish does not have them already.

It may be that others in the parish have this condition and some arrangement has already been worked out.

You might also want to point out this information from the USCCB on the matter.  Another of my posts on this and also low-alcohol altar wine HERE  In that, there are addresses for places which make gluten free or low gluten hosts.

About Fr. John Zuhlsdorf

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35 Comments

  1. rcg says:

    Fr, I have read about this in other places. It seems that some people are more sensitive to wheat gluten than others, so it drove me to this question:

    Is there a ‘minimum’ amount of the host one should receive? I expect not, considering the concern with cleaning the Paten, etc. But just wondered if a person could also ask for a mere crumb if there were no hosts with minimum gluten in them.

  2. Allan S. says:

    Part of the fallout of all my surgeries and treatments includes having devloped a severe allergy to wheat gluten. As a person with this issue, here are some of the options made available to me by the various Parishes where I find myself for Mass:

    1) Low-gluten hosts
    2) Priest will give me a very small fraction from the host (like what gets put into the Chalice). Remember – the fullness of the Body and Blood of Our Lord is present in even the smallest particle; the quantity of accidents received means nothing.
    3) Receive under the species of Blood alone, proceeding to the sanctuary when the EMHCs receive (I know, I know….)
    4) Receive infrequently.

    Recently, however, I have started receiving “normally”, having decided that I will simply accept the terrible rash and blisters and offer it up as a small price to pay. And…it hasn’t happened. I continue to react when gluten finds its way into my diet…but never from Holy Communion.

    Interesting…. All praise and glory to Our Lord Jesus Christ!

  3. Gil Garza says:

    For your readers who are unaware: “Gluten Free” and “Low Gluten” aren’t interchangeable.

    Gluten is a constituent part of wheat. It is the glorious part of wheat that allows baked goods to hold their shape. Flours may be high gluten, used to bake pizza dough, medium gluten “All Purpose Flour” containing about 12% gluten and low gluten “Cake Flour” with just enough gluten to keep the bread from crumbling. Wheat without gluten ceases to be wheat, just as wine without alcohol ceases to be wine.

    “Gluten Free” flours are not made from wheat. Most commonly they are made from Rice or Millet Flour. A truly “gluten free” flour would be invalid matter for the Sacrament as wheat flour is required. Low gluten wheat flour would be valid and most likely be acceptable to anyone with all but a severe gluten insensitivity. However, those with Celiac disease would have to choose to receive from the Chalice instead as any amount of gluten would cause intestinal disaster.

    Hope this helps!

  4. bvb says:

    I may be terribly mistaken, in which case I’m sure Fr Z will graciously correct me in his brilliant red, but I seek to recall that while low gluten hosts are wonderful, gluten-free hosts are invalid matter, as they need to contain at least some wheat, and hence gluten.

  5. MichaelJ says:

    According to the cited document,
    “Hosts that are completely gluten-free are invalid matter for the celebration of the Eucharist”.

  6. cdnpriest says:

    We have a family at our parish with Celiac disease. We have the father come up to receive from a separate, small Chalice (he can’t receive from the main Chalice because of the commixion rite: when the small particle of consecrated Host is added to the Chalice). He then gives the same to his immediate family members (he is instituted as an EMHC for this).

    I am a bit confused about Father’s use of the term “gluten-free” hosts though. Our chancery office has made it very clear to us that gluten-free hosts are invalid matter. They must contain some amount of gluten to be considered “bread” and thus to be consecratable. Thus low-gluten hosts are fine, but not gluten-free ones.

    I am a bit concerned about the fact that gluten-free hosts are still being used in some places. Unfortunately, our local liturgical store adds to the confusion, since it sells both types of hosts. (Since they sell to protestants as well as Catholics). This is why Catholic parishes were warned by our diocese to make sure to buy the low-gluten ones if we buy our hosts from that store.

  7. cdnpriest says:

    I’m sorry. I posted before checking Father Z’s previous posts on the matter. They were very clear as to what constitutes valid matter for the Sacrament.

    Please do read Father’s previous posts before posting (unlike what I did — Mea culpa!), as they will answer many of the questions that were asked in the comments.

  8. Dr. K says:

    Gluten-free = invalid host.

  9. MichaelJ says:

    I do not pose this question to diminsh the severity of the problem, but I really do not understand how bad this is..
    Some people say that some who suffer from celiac disease will experience an immediate, severe, and life-threatening reaction to the exposure to any amout of gluten. I cannot (again, not trying to diminish the severity) find any documented cases of this happening though, unlike with other food allergies say shellfish or peanuts.

    Is there a maximum safe exposure level to gluten for those suffering celiac disease?

  10. frjim4321 says:

    I think the confusion is around fact that most low gluten hosts have such a small percentage of gluten that they are called by some “gluten free.”

    To argue that entirely gluten free hosts are valid matter would be tantamount to saying that rice cakes and/or Pringles are valid matter. I don’t think many would argue for that.

    We are always careful that the presider’s cup goes to a specific communion station for this purpose; since all the communion cups are matching a allergic person could go to the “mingled” cup by mistake, so that one always goes to the left side.

    We have a couple gluten intolerant personal and a D.S. man who will only partake of the cup, so we are careful to keep the cups separate.

  11. NoTambourines says:

    MichaelJ–

    There are short- and long-term consequences for celiacs who ingest gluten. Some people become violently ill (Montezuma’s revenge) within 24 hours, but the longer term threat is the havoc that the gluten wreaks on the small intestine and the rest of the body. The damage can eventually progress to cancer, and gluten ingestion in celiacs has even been tied to miscarriages. Some celiacs develop a skin rash called dermatitis herpetiformis. Wikipedia has a telling picture of a biopsy (under a microscope):

    http://en.wikipedia.org/wiki/Coeliac_disease

    I don’t have classic celiac disease, but was always a sickly child, and when I quit gluten, I was able to drop prescriptions I had taken for years. I know when I’ve accidentally ingested gluten — it has pretty immediate effects.

    It truly upset me when I realized Holy Communion would be impacted, but thankfully, my parish has been kind enough to provide low-gluten hosts for those of us who need them. I tolerate them fine; a celiac friend still can’t use them. So, it depends on the person.

    The challenge with food allergies and autoimmune issues is explaining to others that something so harmless and wholesome for others is poison for us. Also, when people think “allergy,” they often do think of peanut allergies or bee stings — sudden, overwhelming symptoms. Celiac disease and gluten intolerance are more insidious and often take years to pin down among other diagnoses and medicating secondary symptoms rather than the cause.

  12. mamajen says:

    I think Fr. Z used the term gluten-free (as many others do) referring to the licit extremely low-gluten hosts approved for Catholic mass. He has been consistent in saying that actual gluten-free hosts that do not contain wheat are prohibited.

    There are varying levels of gluten sensitivity among celiacs, and wheat allergy (another thing altogether) is very real as well. Even if a celiac does not feel unpleasant symptoms from consuming a bit of gluten, it can still be wreaking havoc on their intestines, where the problem originates from. Some cannot even use cosmetics and toiletries that contain gluten. Celiac disease is a serious concern because it can increase the risk of cancer if left untreated. There are some people who are not celiac and simply “gluten sensitive” and they can sometimes tolerate small amounts of gluten…but for those diagnosed with celiac it’s best to take it seriously.

    I’m glad to see priests trying to understand this and accommodate people as best they can. For a time I suspected I was celiac or gluten sensitive, and I was made fun of by family members who basically thought I was jumping on board the latest trend. That made it all the more difficult to stick to my guns and do what I thought was best for my health.

  13. Scott W. says:

    I’d say don’t forget to let your husband make the final choice among the options presented him and don’t grief him for whatever choice he makes.

  14. acardnal says:

    Dr. K, you are correct. Gluten Free = Invalid Matter.

    Some products, however, advertise their wheat hosts as “gluten free”, but they actually have a trace amount of gluten in them. Here is a USCCB suggested supplier: http://glutenfreehosts.com/gluten_free_hosts.html

    So, the appropriate research is necessary to ensure some gluten remains in the wheat host before using at Mass.

  15. robtbrown says:

    frjim4321 says:

    I think the confusion is around fact that most low gluten hosts have such a small percentage of gluten that they are called by some “gluten free.”

    To argue that entirely gluten free hosts are valid matter would be tantamount to saying that rice cakes and/or Pringles are valid matter. I don’t think many would argue for that.

    Your point is well taken with gluten free hosts. Two solutions to the problem are: 1) Those with Celiac receive only from the chalice; or 2) Put small pieces of a gluten free (also consecration free) host in the chalice then give Communion using a Communion spoon. Both of course accompanied by only “The Blood of Christ”.

  16. frjim4321 says:

    Robert Brown, (2) would work for byzantine but I don’t see any advantage for us.

    Unfortunately many of those who are allergic to gluten are also allergic to the mold that grows on the skins of grapes.

    Now this brings up the question of the difference between mustum and Welch’s grape juice. I have known priests to say mass using Welch’s (and then go out for dinner and order a couple Grey Goose on the rocks, but that’s another matter) and I’ve always wondered if that was valid matter. I don’t think “ecclesia supplet” applies in the case of invalid matter.

    Similarly I’ve often seen priests at a concelebrated funeral be distributed hosts from the tabernacle which clearly invalidates their concelebration.

    Now if Welch’s is usable for a priest who is an alcoholic I would suspect that it would work for a person with celiac disease but that is an “if” statement. For the time being I don’t think that Welch’s and mustum is exactly the same.

    But, if the celiac person was able to tolerate Welch’s, and if it has been approved for alcoholic priests, that could be a solution.

  17. frjim4321 says:

    I don’t think “ecclesia supplet” applies in the case of invalid matter.

    Actually I’m rather certain about it.

    If a well-meaning priest says mass with a rice cake, it was not valid.

  18. dcs says:

    I have known priests to say mass using Welch’s (and then go out for dinner and order a couple Grey Goose on the rocks, but that’s another matter) and I’ve always wondered if that was valid matter.

    Pasteurized grape juice (e.g., Welch’s) is definitely not valid matter. On the other hand, one can even squeeze a grape into the chalice if necessary: http://www.newadvent.org/summa/4074.htm#article5 – ‘for it is said by the same Pope Julius, in the passage quoted in the argument: “If necessary, let the grape be pressed into the chalice.”‘

  19. oldcanon2257 says:

    Catholic priests in Western countries have no idea how lucky they are.

    In many other parts of the world, especially in Asia, many bishops and priests were/are imprisoned in communist jails for years, in many cases, decades, just for being Catholic bishops and priests loyal to the Catholic Faith and to the Holy Father. For example, Cardinal Kung Pin Mei of China, Cardinal Nguyen Van Thuan of Vietnam, et al. were kept in solitary confinement for a long time. So, in those cases, since supplying valid matter for those bishops/priests to say Mass would be next to impossible, I really feel for them because there’s no way for them to consecrate validly during their years in communist prison. How could any priest go even one day without saying Mass, since the Holy Sacrifice of the Mass is what the priesthood is all about?

  20. gloriainexcelsis says:

    Father has a pyx with a low-gluten host for one member of our congregation. He also has a second chalice consecrated on the altar for my daughter and another family with a couple of members who can’t take the low-gluten. They wait until the rest of the people have received, then kneel at the altar rail. God bless Father. He makes two trips up to the altar, one for the pyx and then for the chalice to accomodate those with the problems. Just a note of interest. Father decided to bring back the altar rail cloth. Before Holy Communion the servers position it over the altar rail for those receiving, who put their hands under the cloth as in “the old days.” After Communion the servers put the cloth back over the railing. The server accompanying Father still uses the paten, however.

  21. amsjj1002 says:

    I’ve never heard of this before a couple of years ago, can anyone tell me when this was first discovered (or whatever the appropriate word is). I’ve read a lot of Church-related stuff about England and America during 18th century, but never heard of this. Did they use different things to make hosts back then?

    Sorry to sound stupid, but I’d appreciate further info on this. thanks for your help!

  22. Clinton R. says:

    Isn’t there an important issue being overlooked? The host only retains the accidents (appearance) of bread. The consecrated host no longer is bread, but is the Body and Blood of Our Lord. So I am really puzzled how the Most Precious Body and Blood of the Lord can cause those afflicted with Celiac’s to become ill?

  23. Andy Lucy says:

    ” The host only retains the accidents (appearance) of bread. The consecrated host no longer is bread, but is the Body and Blood of Our Lord.”

    Because one of the physical accidents of bread is the presence of gluten in the wheat flour. The concept of the Real Presence does not mean that the accidents of bread and wine go away… nor does the presence of the accidents of the matter lessen the real nature of the True Presence, in fact, without those accidents, the matter would be invalid for consecration.

    Or, so I understand… of course, I could be wrong.

  24. StWinefride says:

    @ClintonR. the Eucharistic Species, the bread and the wine, retain after consecration not only their appearance “but also the natural quality of bread, which is to support and nourish the body” (Catechism of the Council of Trent – page 252).

    To illustrate this, what would happen if someone drank a huge amount of consecrated wine – would they get drunk? (assuming they would get drunk on the same amount of unconsecrated wine?). I have never tested this out (!) but my understanding is that a person could get drunk on a large amount of consecrated wine.

    Please correct me, someone, if I’m wrong.

  25. Jana Parma says:

    I am overly sensitive to the plant wheat. Eating any, gluten free or not, gives me breathing problems for days afterwards. It’s not celiac which often confuses people. I talked to the priest about it and after explaining about low-gluten hosts not being sufficient he let me know I could receive the precious blood. It was very awkward at the next mass because the deacon, who was holding the cup of the precious blood, stopped me from receiving and started to question me about why I didn’t receive the precious body. He went on to tell me that I could have asked for low-gluten hosts. I had to explain that the whole plant was a problem, not just the gluten. He finally let me receive but he looked at me suspiciously the whole time.

    That was during the Easter season and I haven’t received since because I don’t want an inquisition every time I receive and I end up holding up the line. It’s so awkward. Any advice?

  26. Ellen says:

    Jean, talk to the priest (and deacon) beforehand. There’s a woman in my parish who can’t receive the Host and she always receives the Chalice. She simply goes up at the end and priest gives her communion. It’s simple.

  27. LisaP. says:

    Michelle,

    With Celiac disease, there is a malfunction in the immune system. The immune system mistakes the gluten for an invader, like a virus, and develops an antibody that actually destroys the villi in the intestinal lining. So my understanding is that even if a small amount of gluten is digested, it kicks the body into spinning out the antibody attack and the intestines get attacked. It’s not the amount of gluten that is the deciding factor, is the amount of immune reaction to the gluten.

    Ongoing small exposures won’t drop you on the spot but they can hasten death from malnutrition or nutritional deficiency — we can’t live without a functioning intestine. Consider how serious illnesses like scurvy or anemia can be and you’ll see that even if there isn’t an immediate hazard to life, there can be a serious diminution in health if your intestines are unable to adequately process nutrition.

    Autoimmune diseases include some forms of thyroid disease, where the body attacks the thyroid; rheumatoid arthritis (not osteo, from wear and tear, the kind even children can get); juvenile diabetes, where the body destroys part of a person’s pancreas; lupus; and MS, where the body destroys the neuron insulation. They are not the same as allergies, and while all have been present for centuries many are seeing a huge increase not just in diagnosis but in prevalence in Western countries in recent decades.

    If that helps!

  28. LisaP. says:

    Jana,
    That’s a shame, I’m sure the deacon meant well but it must have been harsh to run into the “food police” at Mass. I’ve heard others talk about the difficulties of having a problem with wheat rather than gluten, like some have issues with milk proteins and not lactose, people are so used to hearing about gluten free or lactose free and they think that’s the whole story for everyone. Maybe a second talk with the priest asking him to pass on that a parishioner is taking the chalice this way? They don’t need to understand why or engage in lengthy consultations on your medical diagnosis, the priest just has to direct them to allow it. Another problem with allowing anyone but the priest to distribute. . . .

  29. LisaP. says:

    I’m so sorry, I mean MichaelJ, not Michelle, got my folks mixed up!

  30. Precentrix says:

    @St. Winifride:

    Apparently it is possible to get drunk on the Precious Blood. As noted by a priest in Westminster after an academic Mass for students in London attended by rather a lot of non-Catholics – he had to consume three chalices. I won’t name him because it was around ten years ago and I can’t remember – Father probably can’t either!

    Or rather, the contents of three chalices. Eating the chalice itself might be tricky.

  31. VexillaRegis says:

    @Precentrix: !!!!!! I really hope he had a driver or that his vicarage was in the same building!

  32. Scott W. says:

    If you are wondering about the “accitdents” of bread and wine, perhaps it is time for an introduction to Aquinas: http://www.amazon.com/Aquinas-Beginners-Guide-Edward-Feser/dp/1851686908/ref=cm_cr_pr_pb_t

    Dr. Feser is great and has an excellent blog: http://edwardfeser.blogspot.com/

  33. Giuseppe says:

    At a previous church, the pastor had consecrated a whole host of hosts that were low-gluten and kept them in a ciborium in the tabernacle. If someone requests a low-gluten host, Father went to the tabernacle, removed that ciborium, and gave the communicant a pre-consecrated host. He started doing that a few years ago when visitors (it’s a parish in a touristy area) would come to the communion line and explain their situation. Thus, he’d never be caught off guard if surprised by a Celiac. I thought it was clever. (And the ciborium, I might add, stands out in a gorgeous dark bronze color.)

  34. Tantum Ergo says:

    Thank you Dr. K,
    This was important. “Gluten-free = invalid host.”

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