The Truth About Gluten Sensitivity and Ways To Limit It In Your Diet

Gluten is a big source of health problems for people who have celiac disease – a disease where the small intestine is very sensitive to gluten. It’s becoming common for people who haven’t been diagnosed with celiac disease to eliminate gluten from their diet because it makes them feel better.

Many people wonder if going gluten-free is just another diet trend. The answer is no. There are people who have celiac disease and can’t eat it; people who have no problem eating it; and people who fall in the middle and can eat it but are sensitive to it.

Gluten sensitivity is a reaction to gluten that doesn’t show up in celiac disease tests, even though it’s a real thing. Scientists from around the world are working on a new classification system for gluten related illnesses that’ll include celiac disease, wheat allergy, and non-celiac gluten sensitivity (NCGS).

What Is Gluten and Why Does It Cause Trouble

Gluten is a protein found in wheat and a few other grains like rye and barley. People who have celiac disease, about 1 in 100 people in the U.S., have an immune reaction to gluten when they eat it.

The immune reaction triggers an attack on their small intestine. These attacks can damage the body’s villi, finger-like projections that line the intestine and help digest and absorb nutrients into the body.

Diagnosing celiac disease starts with taking a medical history and blood tests for antibodies to gluten. Sometimes a biopsy of tissue from the small intestine is done to confirm the diagnosis. But neither test will show NCGS, unfortunately.

How to Know If You Are Sensitive to Gluten

Roughly 1 in 20 people have symptoms of gluten sensitivity. The symptoms can be similar to those of celiac disease, or can be vaguer and show up outside of the gut, like:

  • Behavioral changes such as cloudy thinking and irritability
  • Bone or joint pain
  • Eczema or psoriasis
  • Fatigue
  • Leg numbness
  • Muscle cramps
  • Weight loss

There’s also a special case for people with irritable bowel syndrome (IBS). They are four times as likely to have celiac disease, and about 40 percent of them have problems with gluten that improve when they go on a gluten-free diet.

The Growth of Gluten Sensitivity

The cause of gluten sensitivity isn’t well understood, but it’s something people often inherit. It may also be caused by environmental factors like physical trauma or emotional stress; viral, bacterial, or fungal infection; or surgery or pregnancy.

Scientists don’t know exactly why there’s a growing problem with gluten intolerance, but they have several theories:

  • Wheat has changed. In the U.S., wheat has been engineered to have 50 times the amount of gluten it had 50 years ago. Europe and other countries have banned the import of genetically modified wheat from the U.S. [1].
  • Our entire diet has changed. We eat way too many processed foods, including sugar that damages the gut lining.
  • We’re exposed to more chemicals and herbicides used in growing crops. Substances in the pesticide Roundup found on wheat might contribute to the rise in gluten sensitivity and celiac disease.

Tips for Limiting Gluten in Your Diet

Whether you need to limit gluten in your diet, or you want to, it’s a good idea to do some research to help you understand it. At the end of this article are several resources you can check out. You should also consider talking to your doctor or consulting a dietitian.

It’s best to do lab work to rule out celiac disease before eliminating gluten; once gluten has been eliminated, the celiac test won’t be reliable.

Here are good basic starters for limiting gluten:

  • Avoid all foods containing wheat, barley and rye (and oats unless certified gluten-free).
  • Read labels carefully. Gluten can turn up in cold-cuts; soups, candies, and soy sauce (look for wheat-free Tamari as an alternative). Be aware of ingredients such as starch, modified food starch, hydrolyzed vegetable protein (HVP), hydrolyzed plant protein (HPP), texturized vegetable protein (TVP), binders, fillers, excipients, extenders, malt and natural flavorings, all of which may indicate the presence of gluten unless the label says they are from a non-gluten source.
  • Enjoy pancakes, muffins, pizza dough, and bread gluten-free. Make them at home from mixes or find them in the grocery store. But don’t go overboard with packaged, processed foods even if they’re gluten-free.
  • Beware of gluten hidden in nonfood products you use every day: stamps and envelope adhesive, Play-Doh, shampoo/conditioner, skin care products, medicines, and vitamins.
  • Focus on whole foods, such as chicken, fish, grass-fed beef or bison; vegetables and fruits; nuts and seeds. The Mediterranean diet offers a good template for eating this way. Learn more about it here.

What to Do If You Think Gluten Is Causing You Problems Right Now

It’s important you do something about celiac disease and gluten sensitivity because they can result in malnutrition. Over time there can be serious medical consequences, including anemia, infertility, bone loss, psychological or neurological conditions, and even cancer.

Currently the only treatment for celiac disease is life-long avoidance of gluten.

Gluten resources:

References

[1] Sapone et al.: Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Medicine 2012 10:13

Meet the Author

Kristen H. Reynolds, MD is the Medical Director at Aurora Wiselives Center for Wellbeing and the Program Director of Integrative Medicine at Aurora UW Academic Medical Group in Wauwatosa, WI.

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The information presented in this site is intended for general information and educational purposes. It is not intended to replace the advice of your own physician. Contact your physician if you believe you have a health problem.

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