 they have the right, as a Catholic in good standing, to receive holy communion (Canon 843), and that the Precious Blood must be made available to people with celiac disease if they request it, even if it is not offered to the rest of the congregation. Moreover, Catholic celiacs have the right to request that they receive communion in a separate chalice because the Precious Blood in the celebrants chalice has added gluten through the fermentum which is added in the rite of fraction and commingling during the liturgy of the Eucharist.
Several articles have recently appeared in Catholic publications regarding the development of extremely low-gluten hosts by the Benedictine Sisters of Perpetual Adoration of Clyde, Missouri. The gluten content of these hosts is reported as 0.01%. These hosts have been approved by the Catholic church for use at Mass. Dr. Alessio Fasano from the University of Maryland Center for Celiac Research was quoted in the February 15, 2004 issue of Catholic Review as declaring these hosts perfectly safe for celiac sufferers.
For many years patients with celiac disease have been told by celiac disease experts that they must avoid even trace amounts of gluten. People with celiac disease were told that there was no known safe amount of gluten. Yet here is a well known expert declaring that these low-gluten hosts are safe. Dr. Fasano did not return any phone calls or emails aimed at establishing just how he determined that .01% gluten was safe. So Dr. Don Kasarda, an international expert on gluten and grains was contacted. When he was asked about the safety of .01% gluten he described some of the early studies done by Dr. Catassi and his group that determined that 100 mg of gliadin (or roughly 200 mg of gluten) per day produced minimal morphological changes in the intestinal histology of celiac patients. He therefore thought that it might be reasonable to assume that if a low gluten host weighed about 0.5gm, then a person receiving the low gluten host could be receiving about 0.05 mg of gluten/gliadin per incidence of receiving communion. There is no way of knowing what long term exposure to this level of gluten could do to any given individual. The recommendation for the designation gluten-free in the U.S., Australia, and Canada is currently <0.001% gluten, whereas the European standard for gluten-free is <0.03% gluten. In Australia, some patients who do not respond to the standard European gluten free diet did respond to the lower gluten Australian gluten-free diet which suggests that there are some patients who require the stricter diet. But in patients without symptoms, there is no real way of knowing if long term exposure to low levels of gluten, as in receiving communion with a low gluten host, will cause damage.
Some celiac patients have reported getting ill from gluten by receiving communion from the priests chalice. I asked Dr. Kasarda what he thought about the safety of receiving Communion from the priests chalice vs. receiving the low gluten host. He agreed that taking communion from the priests chalice could conceivably result in a celiac receiving the same or even more gluten than the amount contained in these low-gluten hosts, although this would depend on a number of variables including how large the crumb was, how much was consumed ,and how long the fermentum was in the wine before it was consumed. Dr. Carol Semrad, from the University of Chicago agreed with Dr. Kasardas assessment that celiac patients should not receive communion from the priests chalice because of the possibly unacceptable level of gluten.
How a Catholic celiac chooses to receive communion depends then on a number of considerations. First, the safest form of receiving communion is for a Catholic celiac to receive the Precious Blood from a separate cup. The drawbacks to this form of receiving communion include the occasional mistake by the priest sometimes he may forget to use a separate cup or he may decide to pour some of the Precious Blood from his chalice into the separate cup (or into the other chalices designated for 