Diagnosing Gluten Sensitivity / Gluten Intolerance
It is important to distinguish between celiac disease and non-celiac gluten sensitivity, also known as gluten intolerance, in order to ensure you get the right care. Your doctor can test for celiac disease with a simple blood test. If your test results for celiac disease are negative but you still have symptoms, you may then be diagnosed with non-celiac gluten sensitivity. Learn more about getting tested for celiac disease.
An important note on getting tested: you must continue to eat gluten. Going gluten-free before getting tested can affect your results. If youre already gluten-free but want to get tested, consider undergoing a gluten challenge.
Complete our celiac disease symptoms checklist and then share the results with your doctor to get the conversation about getting testing started.
Living With Gluten Intolerance
Fortunately, with gluten intolerance awareness at an all-time high, there are no shortages of gluten-free alternatives to your favorite foods, and today, transitioning into a gluten-free diet is easier than ever. Transitioning to a gluten-free diet will certainly help alleviate symptoms of gluten intolerance. However, simply removing gluten from your diet without following up with a doctor is not recommended.
For one thing, your doctor will want to determine if your reactions are being caused by Celiac disease, intolerance, sensitivity or an allergy. In order to test for all of these, gluten needs to be in your system, so do not eliminate gluten until after you have been tested.
If a Celiac test comes back negative, the next thing your doctor will want to do is have you follow an elimination diet and monitor the results. Its possible that gluten is not the real culprit and, by the process of elimination, your doctor or dietician may be able to find the real source of your symptoms. Its important to remember that gluten intolerance cant be confirmed or ruled out with one simple test. That being said, there are a number of factors that might indicate you are at a higher risk of gluten intolerance including genetic factors. Rather than trying to figure out if you have Celiac disease or gluten intolerance by yourself, you must involve medical health professionals to get a proper diagnosis.
Early Signs Of Gluten Intolerance: The Symptoms In Adults
Updated on / by Addison
Gluten intolerance is a complicated issue. Research continues to unveil new discoveries about reactions to gluten and how they affect peoples´ lives.
Using buzz words to sell food items is a popular tactic for gaining sales for companies. Phrases such as low fat, gluten-free, superfood, and all natural line the shelves of food stores.
Do these words apply to everyone in terms of benefiting health? Do people talk themselves into being gluten-intolerant because marketers make it sound like a healthy option, for example, or is eliminating gluten not necessary for everyone? Gluten intolerance is a serious and real issue, affecting many people.
Gluten is a protein that is commonly found in grains and wheat, among other foods.
Gluten gives bread dough its rubbery and sticky texture, and is also used as an ingredient in foods such as soy sauce, beer, and even pickles.
Gluten has always been a large factor in our diets, but it can cause severe health issues to some people.
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What Is Celiac Disease
Celiac disease is an autoimmune disorder thatâs triggered when you eat gluten. Itâs also known as celiac sprue, nontropical sprue, or gluten-sensitive enteropathy.
Gluten is a protein in wheat, barley, rye, and other grains. Itâs what makes dough elastic and gives bread its chewy texture.
When someone with celiac disease eats something with gluten, their body overreacts to the protein and damages their villi, small finger-like projections found along the wall of their small intestine.
When your villi are injured, your small intestine canât properly absorb nutrients from food. Eventually, this can lead to malnourishment, as well as loss of bone density, miscarriage, infertility or even neurological diseases or certain cancers.
If your celiac disease isnât better after at least a year without gluten, itâs called refractory or nonresponsive celiac disease.
Most people with celiac disease never know that they have it. Researchers think that as few as 20% of people with the disease get the right diagnosis. The damage to your intestine is very slow, and symptoms are so varied that it can take years to get a diagnosis.
Celiac disease isnât the same thing as gluten intolerance or gluten sensitivity. People with gluten intolerance may have some of the same symptoms and may want to avoid gluten. But they donât show an immune response or damage to the small intestine.
You Often Experience Rashes And Itchy Skin
Skin conditions associated with intestinal diseases are becoming more frequent.
New research suggests that NCGS can cause skin lesions similar both to eczema and psoriasis, particularly on the elbows, back of hands and knees.
In a study of 17 patients, a gluten-free diet greatly improved symptoms after just one month .
Research is in its early stages though, and its unclear if gluten is a direct cause of these conditions, or simply worsens them.
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How Will You Deal With Your Symptoms Of Gluten Intolerance
If you experience improvement on a gluten-free diet and plan to continue eating this way, you can feel confident that there is no risk in terms of nutrient deficiencies to removing gluten from your diet. If anything, my experience has shown me that people who eat gluten-free are more likely to increase their intake of essential nutrients, especially if they replace breads and other flour products with whole foods.
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Joint Pain Or Numbness
People experience joint and muscle pain for loads of reasons. Chronic joint discomfort, as well as tingling and numbness in the fingers, arms, or legs, are evident indications of a medical problem. It happens regularly in gluten-sensitive people for no obvious cause. But theres a theory that those with celiac disease have a genetically determined oversensitive or over excitable nervous system. As a result, they may have a reduced threshold for activating sensory neurons that produce muscle and joint discomfort.
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You Have An Autoimmune Disease
An autoimmune disease is the term given when your immune system mistakenly attacks and damages your own tissue.
There are more than 80 types, characterised by which tissues or organs in the body are damaged.
Gluten intake is consistently linked with numerous types, but whether its the cause remains to be seen. Its influence in Celiac disease is the obvious example, but research indicates gluten likely affects Hashimotos hypothyroidism and Graves disease, to name a few.
Some researchers speculate the potentially negative effect of gluten is to do with the effect that gliadin may have on gut health and function .
In any case, it seems gluten intolerance is more likely in those with an autoimmune condition.
How Is Gluten Intolerance Treated
Theres no cure for gluten intolerance. But most people find relief from symptoms by following a gluten-free diet. You should work with your healthcare provider and a dietitian to plan your diet.
You can also ask your healthcare provider about adding probiotics to your diet. Probiotics help increase the good bacteria in your gut. They may reduce symptoms of bloating, gas or constipation.
Some research suggests that taking certain enzymes may help you digest gluten. But experts are still investigating this treatment. Talk to your healthcare provider before taking any enzymes.
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Mental Symptoms Of Gluten Intolerance
The most common gluten intolerance symptoms in relation to mental health are:
Tragically, a large number of individuals suffering from gluten intolerance symptoms are diagnosed with various mental health disorders and receive psychiatric care, including medications. These are not only unnecessary but could add insult to injury, further harming an already weakened body.
It is incredibly important to seek the care of a highly-trained physician to help when complex, seemingly confusing physical or mental symptoms occur together. Only with the assistance of a good integrative physician may it be possible to pinpoint the original cause of a multitude of signs that may point to gluten intolerance. It is crucial to address the symptoms appropriately to promote healing and recovery.
What Can Cause Gluten Intolerance
Gluten intolerance is multifactorial. There are multiple genetic predispositions to gluten intolerance that cannot be changed such as HLADQ2/DQ8. But a lot of people with this genetic predisposition do not develop any form of gluten intolerance.
One of the big causes of many diseases is what is known as epigenetics, which can be thought of as what you bathe your genes in and what they make with that.
For example, even if someone has a genetic predisposition to CD, if they never eat wheat, they will never have CD. In contrast, if someone only has a small affinity to CD and they flood their system with wheat, they very well may be more prone to developing CD, WA, or NCGS. But the body is fickle, and everyone is different.
One other potential cause of gluten intolerance is intestinal permeability. When this occurs, the proteins from wheat may pass into the circulatory system and elicit an immune response resulting in CD, WA, or NCGS.
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Headaches And Brain Fog
Chronic headaches and the inability to think clearly are also common side effects associated with gluten intolerance. Interestingly, migraines seem to be more common among people with Celiac disease, IBD, and gluten sensitivity than in the control group, according to a 2013 study in the journal Headache.
What Causes Gluten Intolerance
The exact causes of gluten intolerance arent well understood. Some research shows that people may not be sensitive to gluten, but to a certain carbohydrate found in many foods. Their bodies dont absorb the carbohydrate as they should. It stays in their guts and ferments, causing sickness.
Other research suggests that wheat might affect the lining of some peoples digestive tracts. This lining usually keeps bacteria from leaking out of your intestines. But in people with a gluten intolerance, the lining may not work as it should, allowing bacteria into their blood or liver and causing inflammation.
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Getting A Proper Diagnosis Is Key
Getting a proper diagnosis is the first step toward feeling better and living a healthy life. Diagnosing celiac disease is pretty straight forward. A gastroenterologist will be able to make a diagnosis based on blood tests and a biopsy of the small intestine.
Diagnosing non-celiac gluten intolerance is a little trickier. Your physician will test you for celiac disease, wheat allergy and other things that might be associated with your particular symptoms. If you test negatively for those things, youll start a gluten-free diet. If going gluten-free for a while improves your symptoms, youll probably be diagnosed with non-celiac gluten intolerance.
If you think you might have a gluten intolerance, its important to keep gluten in your diet until you visit your physician. This is the only way the to test properly.
The Truth About Gluten Intolerance
Gluten is the glue that holds it all together, and its a protein found in wheat, barley and rye. Meaning its found in foods you probably eat every day – bread, pasta, crackers, cereals, salad dressings and more.
So what happens when your body has an intolerance or sensitivity to gluten? The results can be unpleasant, painful and downright dangerous to your long-term health. Heres what you should know about gluten intolerance.
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How Is It Diagnosed
It is essential to ensure first that a more severe condition, such as celiac disease or a wheat allergy, is not present if gluten intolerance is suspected.
Taking a blood sample, which is then analyzed to detect the presence of antibodies that could indicate celiac disease or a wheat allergy, can often do this. In some cases, other tests may also be necessary.
Once a doctor has ruled out a more serious condition, it can still be difficult for them to confirm whether gluten intolerance is present, as there are no tests for this.
The most common method people use to determine if gluten intolerance is present is to reduce or remove gluten from a diet and monitor changes in symptoms.
It can help for a person to keep a food diary to record what foods they are consuming and what symptoms they are having.
Diagnosis Of Autoimmune Diseases
There are well-known genetic links between CD and a multitude of autoimmune diseases, but type 1 diabetes is the most common one. Being diagnosed with either of the conditions can increase the risk of developing the other.
The missing link here can be found in the genetic code of patients. The genetic link between CD and autoimmune conditions such as type 1 diabetes is the HLA DQ2 and HLA DQ8 genes.
In my functional medicine training, we are taught that if your patient has an autoimmune disease, we must immediately test for the above-mentioned HLA DQ2/DQ8. Thats how strongly CD and other autoimmune diseases are associated.
According to the Celiac Disease Foundation, for people with celiac disease, the later the age of diagnosis, the greater the chance of developing another autoimmune disorder.
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You’re Losing Weight Without Trying
Involuntary weight loss is one of the primary symptoms of celiac disease, because when your intestines are damaged you aren’t properly absorbing the food you eat, says Megan Patrick, M.D., a family medicine physician at UCHealth.
While NCGS doesn’t damage a person’s intestines, it can still lead to eating less due to associating so many foods with pain, which in turn can cause weight loss, says De Latour.
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Your diet is one of the biggest factors in your energy levels, says De Latour.
You already know, for example, that eating junk makes you feel wasted while protein and veggies keeps you chugging all daybut that might extend to gluten, too. Many sufferers report their energy levels skyrocketing after giving up gluten, says De Latour.
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Physical Symptoms Of Gluten Intolerance
The most common physical signs of gluten intolerance include:
- Neurological problems
- Tingling, numbness, or other neurological problems
When the lining of the small intestine is attacked, the absorption of nutrients becomes increasingly difficult, leading to many vitamin and mineral deficiencies and the start of developing disease. When the diet is not corrected in a short amount of time, malabsorption becomes a chronic issue, causing the worsening of all associated signs. People now find themselves getting sicker and sicker, for seemingly no reason.
Fodmaps And Gluten Sensitivity
Recently, some studies have emerged that suggest that the relief of symptoms experienced by people with NCGS may not be due to the absence of gluten at all, but are instead caused by the inadvertent elimination of a whole other group of carbohydrates that are difficult to digest called FODMAPs fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.
FODMAPs are small-chain carbohydrates that are present in a number of foods, including wheat and barley but are also present in fruits, vegetables, teas, sweeteners, nuts, dairy products, and beans.
FODMAPs are difficult to digest. Instead of moving swiftly through your digestive tract, they tend to collect at the far end of the intestine, where they absorb water and ferment, leading to symptoms linked to IBS and other GI disorders, which are nearly identical to those of gluten sensitivity. Just like anything else, some people have a harder time digesting FODMAPs than others.
This would explain the many people who lack markers for Celiac disease and antibodies that would confirm a wheat allergy but still find relief from symptoms after eliminating foods that contain gluten. If you are in a similar situation, dont rely on luck to find out what your body is not handling well. Do a simple blood test for food sensitivity at home to avoid the guesswork and understand your body.
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How To Treat Gluten Intolerance
Eliminating gluten 100% from your diet means 100%. Even trace amounts of gluten from cross-contamination or medications or supplements can be enough to cause an immune reaction in your body. The 80/20 rule or we dont eat it in our house, just when we eat out is a complete misconception. An article published in 2001 states that for those with celiac disease or gluten sensitivity eating gluten just once a month increased the relative risk of death by 600%.
What Is The Low
Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols are simple sugars that the small intestine doesnt absorb very well. FODMAPs are often referred to in the context of the low-FODMAP diet. Foods that are high in FODMAPS are common culprits of stomach symptoms like bloating, constipation, and diarrhea similar symptoms to NGCS.
People often use this diet to get stomach symptoms under control and rule out foods that they suspect are bothering them. Wheat is particularly high in FODMAPS, and some researchers think it may be a cause of NGCS for some people. If your symptoms of gluten intolerance are mainly digestive-related and youve ruled out other medical conditions that may be causing them, this diet could help you determine which foods are affecting you.
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Signs You Have A Gluten Intolerance
Gluten intolerance can come in many forms, with the most serious resulting in a wheat allergy or Celiac disease. A wheat allergy is a type of immune response triggered by ingesting products containing wheat proteins such as gluten. Celiac disease, on the other hand, is an autoimmune disorder that damages the villi in the small intestine.
That said, symptoms of gluten sensitivity may not present immediately after consumption, rather an onset of symptoms often occur within 24 to 48 hours of ingesting gluten, says Abby Vichill, M.S., RDN, L.D. So, when it comes to investigating gluten as a cause of health issues, give yourself time to see if these symptoms arise:
