Low-gluten hosts: A doctor with coeliac disease responds

By Dr Paul Hanna

As a Catholic doctor with coeliac disease and student of the liberal arts, there are few things closer to my heart than safe communion for those with coeliac disease. I read The Catholic Weekly’s “God-gluten dilemma” with joy and wanted to add a few reflections from a medical perspective.

Firstly, although the Australian standard for gluten-free is the strictest around the world, the Catholic Church is still able to accommodate Australian coeliacs.

I reached out to the Coeliac Society of Australia to discuss low-gluten hosts. Although these contain some gluten, since they are so small in weight, they are probably safe.

To understand this, we have to review some numbers, so please bear with me.

Someone with coeliac disease can probably consume up to 10 milligrams (mg) of gluten a day safely, although some are more sensitive. That’s about 1/100^th of a gram. This is not much—just a few crumbs of ordinary wheat bread contain that much gluten.

However, a single low-gluten host does not weigh very much, about 33mg according to Tricia Thompson who runs the Gluten Free Watchdog out of the US.

After reaching out to various manufacturers, it seems that low-gluten hosts contain between 5-6 parts per million (ppm) to about 70 parts per million.

Imagine you could divide a single communion host into a million parts. If five of those parts were gluten, that would be 5 ppm. For comparison, regular white bread contains 124000 parts per million!

Let’s run the maths on the Cavanagh altar breads, which have the lowest gluten content at about 5-6 ppm. These would contain about 0.0002 milligrams of gluten per host, far below the safe limit of 10 milligrams per day.

Even low-gluten hosts with higher ppm should be safe since they are consumed infrequently, and the Coeliac Society of Australia agrees.

Coeliacs and Catholic parishes should consider the wide variety in gluten content of low-gluten hosts when making their purchase.

Even though the gluten in some of these hosts is so low, some people still react—why might that be? Firstly, it’s possible that they’re hyper-sensitive. They may choose to commune from the Blood of Christ only, like Laura from the previous article.

But it’s more likely that cross-contamination is to blame—during Mass, the Body of Christ is present under the accident of bread which still contains wheat. For example, during the fraction, when the priest breaks the Eucharistic bread, crumbs could fall into an open pyx containing a low-gluten host. This is not likely to be a significant amount but could be mitigated with careful positioning of the pyx.

Of course, any chalice that is to be used for coeliac communion should not undergo the rite of commingling, where an ordinary host is mixed with the wine. A separate and dedicated chalice is best.

It’s also important that the low-gluten host isn’t handled by the priest during communion, as that could introduce gluten.

The Australian Catholic Bishop’s Conference (ACBC) guideline on coeliac communion says the priest should hand the pyx to the communicant.

Finally, there is the issue of cleansing. The ACBC guideline states that cleansing should “occur in the customary way, avoiding any potential for cross contamination.”

It is possible that during cleansing, a priest may introduce small amounts of gluten to a chalice which could be an issue for future communion.

Further cleaning may mitigate this, or parishes who have the luxury of multiple acolytes could dedicate one person to handling coeliac communion and vessel cleansing. Coeliacs should discuss these issues with their parish priests.

Finally, the Coeliac Society of Australia recommends ongoing monitoring with your doctor just in case. This should allow coeliacs to remain safe while receiving the Body of Christ.