Gluten, gluten, gluten! Such a hot topic these days.
I thought it would be a good idea to address the gluten issue. This post should help you to understand what gluten is, what types of adverse reactions people can have to it, and what testing for adverse gluten reactions looks like. Hopefully by the end of it, you will have a better idea as to whether or not you should be among the growing group of people who go gluten-free!
Simply put, gluten is a protein found in wheat, barley and rye.
There are different types of reactions we can have to gluten. The first (and most severe) occurs for those with an autoimmune condition called Celiac Disease. With celiac, gluten can cause potentially-threatening damage to the intestinal lining due to an abnormal immune reaction. These individuals need to completely avoid gluten for the duration of their lives.
The second is a gluten allergy in which the body generates an overreaction of the immune system to gluten. Allergic reactions to gluten or wheat are the same as a peanut or bee sting allergy in that all allergies can range from mild to potentially fatal.
The third is gluten sensitivity (better described as non-celiac gluten sensitivity). Individuals with non-celiac gluten sensitivity experience similar symptoms to those with celiac, but they lack the intestinal damage and antibodies that occur in celiac individuals.
If you think you are gluten sensitive it might be related to experiencing symptoms like abdominal pain, bloating, diarrhea, constipation, headaches, bone or joint pain, chronic fatigue, “foggy mind”, depression, and/or ADHD-like behavior.
When it comes to testing for negative reactions to gluten, some are easier to test than others. Celiac and allergy testing can be done by a physician. Testing for the last reaction, a non-celiac gluten sensitivity, is probably part of why the topic seems so controversial: there are currently no validated, recommended methods to test for non-celiac gluten sensitivity. There are current methods used, but nothing is 100% definitive like a blood test yielding a positive or negative.
If you think you are non-celiac gluten sensitive, it is very important you meet with a physician to first rule out celiac (a lifelong condition) or wheat/gluten allergy. If both are negative, the doctor will likely supervise you through a process called an elimination diet test. It would begin with something like 14-30 days of avoiding all gluten entirely. Then gluten would be re-introduced to the diet once and then avoided again for about 3 days to wait and observe any potential reactions. The test progresses similarly from here until conclusions are made.
Initiating your own gluten free diet before being evaluated by a physician can complicate the doctor’s ability to properly diagnose your gluten-related condition. Let’s say you have been avoiding gluten for 6 months, your body will not be producing antibodies or other agents that a physician would likely be testing for. It may appear as if you don’t have a poor reaction to gluten falsely, just because you’ve been avoiding it.
Being tested under the care of a physician is also the best way to avoid negative consequences of self-diagnosis such as disordered behavior or unhealthy preoccupation around food choices. Trust me, it’s sad missing out on real-deal Soul Mac, Easy Baked Chicken Parm, Peanut Butter Chip & Chocolate Chunk Cookies, and this grilled PIZZA I’m about to share with you tomorrow if you don’t have to!
If you have been diagnosed with celiac, a wheat allergy, or non-celiac gluten sensitivity, certainly select gluten free options. If not, break out the gluten and start cooking. I suggest you start with the mac and cheese, chicken parm, or cookies mentioned above. Or hold on for the pizza recipe tomorrow!! Keep in mind, I’m not endorsing that wheat be the basis of every meal, every day. Like all foods, it should be enjoyed among a variety and balance of other foods.
You may certainly benefit from a gluten free diet, but you will never know if this is truly appropriate for you if you are not evaluated by a physician before starting a gluten free diet on your own. Listen to your body and consult a physician if you have gluten-related diet concerns.
Additional Resources:
- Celiac Disease Foundation (on celiac) (on non-celiac gluten sensitivity)
- National Foundation for Celiac Awareness (on celiac) (on non-celiac gluten sensitivity)
- U.S. National Library of Medicine (on Celiac Disease)
- Food Allergy Research & Education (on wheat allergy vs. celiac)
- American College of Allergy, Asthma, and Immunology (on wheat allergy)
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