The truth about gluten
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.
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.
What is it?
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.
How to know if you’re sensitive
The symptoms of gluten sensitivity 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
- Leg numbness
- Muscle cramps
- Weight loss
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. 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 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.
Dr. Kristen H. Reynolds is the Medical Director at Aurora Wiselives Center for Wellbeing in Wauwatosa, Wis.
About 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.