Got an issue with gluten? You’re not alone.
It’s estimated that up to 6 percent of the population suffers from some sort of gluten sensitivity, according to studies published in the journal Clinical Nutrition (1). Gluten is a protein found in some grains, including wheat, barley and rye.
On one end of the spectrum are people with celiac disease, an autoimmune condition in which eating gluten wreaks havoc on the body. It can cause everything from intestinal damage to anemia and osteoporosis (2).
Celiac disease should not be confused with a wheat allergy, or an extreme reaction to foods containing wheat (3). In some cases, a wheat allergy can lead to a life-threatening condition called anaphylaxis, which can cause swelling of the throat and difficulty breathing.
On the other side of the equation are those who experience non-celiac gluten sensitivity. If you’re in this camp, your doctor may have ruled out celiac disease and a wheat allergy, but you still deal with uncomfortable digestive issues after eating gluten.
Think you may need to go gluten-free? Let’s take a closer look at what gluten is and the common signs and symptoms of gluten intolerance.
What Is Gluten Intolerance?
If you’re gluten intolerant, your body reacts to the proteins found in gluten-containing foods in a way that can cause stomach, skin and other issues.
It’s not quite the same reaction as someone who has celiac disease or a wheat allergy, says Neal Malik, a registered dietitian nutritionist and the chair of the Department of Nutrition and Basic Sciences at Bastyr University.
Folks with those conditions experience a scary-sounding “systemic immune response” when they eat gluten, he says. “The body overreacts to something it has been exposed to and begins attacking itself,” he says. “In the case of celiac disease, the body’s immune system begins attacking healthy cells in the small intestine, causing damage to those cells. With a wheat allergy, there may be no damage to the small intestine, but instead a more generalized, whole-body response.”
People with gluten intolerance don’t have quite as extreme a reaction, he says.
Symptoms of Gluten Intolerance
While most of the population feels fine after feasting on bagels, pizza and other gluten-rich foods, people who are gluten intolerant may experience a range of not-so-fun symptoms, including:
“To quote the Roman philosopher Lucretius, ‘what food is to one may be bitter poison to another,’” says Malik.
Then there’s what researchers call “systemic manifestations” like headaches, joint and muscle pain, leg or arm numbness, and chronic fatigue (1). There’s even a gluten-induced condition called “foggy mind.”
People with gluten intolerance may also experience skin symptoms like acne, rashes and hives. Mouth ulcers may also be a problem, says Malik. “There is also a condition known as dermatitis herpetiformis that can occur,” he says. “Symptoms include the formation of watery blisters and pimples on the skin.”
If you’re gluten intolerant, you may experience discomfort anywhere from several hours to several days after consuming a food containing the offending protein. “This makes it all the more challenging for individuals and health professionals to discover the underlying cause of their symptoms,” says Malik.
How Is Gluten Intolerance Diagnosed?
If you want to find out whether gluten is causing your stomach pain or foggy mind, you need to cut it out of your diet.
Most physicians will recommend what’s called an “elimination diet,” says Kristin Koskinen, a registered dietitian nutritionist and owner at Eat Well, Live Well in Washington State. This involves banishing all foods containing wheat, barley and rye, as well as any oats that aren’t clearly certified as gluten-free, from your plate.
This may sound easy. All you have to do is stop eating bread, pasta, pizza and cereal, right? Yes, but you also have to be careful about not-so-obvious offenders. Foods like soy sauce, gravies and processed lunch meats may contain gluten. There are also salad dressings, meat alternatives and soups that contain surprise gluten.
You also have to watch out for non-food offenders. Some medications and supplements use gluten as a “glue” or binding agent, says Malik. “Many times, individuals will believe they have eliminated the trigger food from their diets, but not realize that they were consuming the offending food unintentionally,” he says. “Gluten is a perfect example of this since it is found in small amounts in so many foods.”
That’s why it’s important to have a physician, gastroenterologist or other health care professional oversee your elimination diet. Their job is to make sure you cut out enough, without cutting out too much. “If not planned properly, an elimination can lead to nutrient deficiencies,” says Malik.
Your doctor may also recommend testing for celiac disease or wheat allergies. Depending on the results, you may also need to undergo an intestinal biopsy. This is considered to be the most reliable and valid method for diagnosing celiac disease, says Malik.
If your physician does suspect you have an allergy or intolerance, then a gluten-free diet may relieve many of your symptoms, says Malik. There are also lifestyle changes you can make to help your gut. “Stress, anxiety, negative thoughts, depression, and physical inactivity may also lead to abnormalities in the gut,” he says.
While the symptoms of gluten intolerance are all over the place, fortunately, there’s an easy fix. “When we get rid of the gluten, the symptoms resolve,” says Koskinen.