Gluten has been a hot topic for a number of years now, and most people are still really confused about the whole issue and trying to figure out the difference between celiac disease, gluten allergies and gluten intolerance or sensitivities. I wanted to try and clear things up a bit for you in a really basic way and help you figure out what you may need to consider if you feel like gluten may be bothersome for you.
What is Gluten?
Gluten is simply one protein that’s found within many different types of grains. Not all grains contain gluten, however many do.
Some Gluten Containing Grains
Some Gluten Free Grains
*Oats are a bit of a special case when it comes to gluten, and confusion often strikes when you go to buy oats and will find labels for both gluten-free oats and regular oats. The problem with oats is that while they don’t in and of themselves contain or grow with any gluten protein in them, they’re so commonly processed in facilities that process both gluten-containing grains and oats, that the cross-contamination levels are so high that many oat packages that aren’t labeled as being “gluten free” contain it as a processing byproduct. If you are trying to completely avoid gluten, it’s indeed best to look for oats that have been labeled “gluten free.”
Common Gluten Issues
Here are three common and confusing differences when patients are talking about issues with gluten.
Celiac Disease: Celiac disease is an autoimmune condition where basically your immune system gets confused and begins to damage the small intestinal cells because of your consumption of gluten containing foods. It can lead to huge levels of inflammation in your small intestines and can greatly limit your absorption of nutrients.
Long-term effects of continued consumption of gluten while being celiac are very serious and range from increased risk of certain types of cancer, osteoporosis, multiple sclerosis and heart disease.
Celiac disease isn’t all that common, with roughly 1% of people tested being diagnosed, however rates increase if you’ve got family members who have already been diagnosed as it’s genetic and positive test rates will go from 1% to 10% risk.
Symptoms: Like all conditions, sometimes patients present with what we would consider to be all of the “textbook” symptoms of a disease, and other times, they’ll present with very few symptoms.
I once had a patient who’s only symptom of celiac disease was fatigue, but on the flip side have had other patients where they presented with many of the most common symptoms.
Here are SOME of the symptoms that patients with celiac disease may experience, but this list is not exhaustive.
- Low Iron
- Low Energy
- Joint Pain
- Bone Loss
- Missed periods
- Weight Loss
- Stomach Pains
- Itchy Rash
- Numbness or Tingling
- Canker Sores
An Important Note on Celiac Testing: If you or your doctor are concerned that you may have celiac disease, it is ABSOLUTELY IMPERATIVE that you continue eating gluten until you’ve been tested for celiac disease. I have seen numerous patients in practice who always wondered about being celiac, but had unfortunately stopped eating gluten a long time ago because it was bothersome. In this case, to know for certain, you’d have to start consuming gluten in quite high amounts for weeks before testing, which is really challenging for most patients.
Gluten Allergy: All allergies are produced and mediated by IgE (immunoglobulin E) antibodies. This is completely different from the autoimmune reaction seen with celiac disease. An allergy is a typical reaction that you may think of when someone says they have a peanut allergy. It can be VERY dangerous and many patients may need to carry an epipen when diagnosed with any true allergy. Gluten allergy isn’t that common and has similar numbers as celiac disease does—affecting about 1% of the population. Allergies often come on quite quickly after consumption of the offending product.
- Mouth Tingling
- Throat Swelling
- Feeling flush
Gluten Intolerance/Sensitivity: This particular reaction type is mediated by IgG (immunoglobulin G) antibodies within the immune system and is likely what most people are dealing with when they have issues with gluten. While this particular reaction is generally much less dangerous than either of the above, it can still make you feel very miserable. IgG-mediated reactions can be a fairly immediate, but sometimes we can see reactions from certain food consumption cause symptoms up to a few days after you’ve eaten it, making diagnosis trickier.
Symptoms: Unfortunately this list gets big REALLY quickly, as we see so many symptoms associated with food intolerances or sensitivities in general. As you’ll note too, a lot of these symptoms are similar to those mentioned above.
- Migraine Headaches
- Low Iron
- Stomach Pains
- Canker sores
- Joint Pain
- Bumps on backs of arms
Could the symptoms I get be something other than gluten and how do I figure out if gluten is an issue for me?
There is the potential that you may have none of the above issues, only one, two, or even all three! It’s definitely nuanced to figure out what’s going on when it comes to your potential reaction to gluten containing foods.
There are also unfortunately many other conditions and issues that may lead to a lot of the symptoms/conditions mentioned above, and this is why it’s so important to chat with someone who’s got experience in dealing with these kinds of conditions so that they can help you piece together the direction you need to go and what to investigate.As mentioned above, it’s REALLY important that you’re tested for celiac disease BEFORE you stop consuming gluten, so it’s not advised to trial taking gluten completely out of your diet by yourself without proper assessment and testing.
If you’ve got any of the above symptoms and want to chat more about what to do, schedule an appointment with me and we’ll get things moving in the right direction. I have a huge practice focus on digestive concerns and feel really comfortable helping you sort out symptoms and their potential problems. There’s a LOT of things we can do to get you feeling better and back to your best self.