One of the biggest villains of the modern diet that gets blamed for many of our gut-related (and other) issues is gluten. Gluten simply refers to two main types of protein called gliadins and glutenins that are not by default bad for health but if ingested can cause inflammation and other conditions in some. They are often found in grains, such as wheat, barley, and rye.
What makes gluten so special is that it results in a wide array of symptoms that are easily confused with other health conditions and as a result, people sensitive to gluten can go undiagnosed for years.
There are over dozens of conditions that can be linked to gluten. Some of these are caused by gluten, while others are simply made worse by consuming gluten. Consumption of gluten can lead to inflammatory response and tissue damage that is not limited to intestines. Depending on the gluten-related disorder, your symptoms could vary significantly. For example, in patients with celiac disease, the major complaints include bloating, diarrhea, intestinal pain and gas. People with gluten apaxia on the other hand suffer from unsteadiness, poor coordination, difficulties with balance and walking, tremors, muscle stiffness or spasms, and problems with speech and eye movements. With dozens of other gluten-related conditions, the list of possible symptoms can get extremely broad. Thus, any person experiencing autoimmune condition, gut related issues or allergies should rule out the negative effect of gluten on their body.
When classifying gluten related disorders, medical professionals tend to focus on several major categories. One way to look at them is to categorize celiac disease, dermatitis herpetiformis and gluten ataxia as autoimmune responses; wheat allergy is the allergic reaction; and nonceliac gluten sensitivity is non-autoimmune-allergic disease. Let’s explore some of the major gluten-related disorders:
- Wheat allergy – Wheat allergy is an immune response to proteins found in wheat. Symptoms can be categorized two ways: immediate reactions like skin reactions, respiratory problems, GI symptoms and delayed response that can emerge days after consuming wheat. Diagnosing allergies is a fairly standard procedure, conducted by skin pricking or a blood test.
- Celiac disease – the most known gluten-related disorder, is an autoimmune disorder that primarily affects the small intestine. It is triggered by the consumption of gluten, a protein found in wheat, barley, and rye. When individuals with celiac disease consume gluten, their immune system responds by attacking the lining of the small intestine, leading to inflammation and damage to the villi—the tiny, finger-like projections responsible for nutrient absorption. Celiac disease can be identified by presence of transglutaminase antibodies in blood tests or biopsies of the small intestine, where these antibodies can be found. However, starting a gluten-free diet prior to getting diagnosed could affect the lab results and mislead you.
- Non-celiac gluten sensitivity – his condition is diagnosed among people who don’t have celiac disease or wheat allergy, but develop symptoms when consuming gluten. NCGS is a condition in which individuals experience symptoms similar to those of celiac disease when consuming gluten-containing foods. However, unlike celiac disease, it does not involve the same autoimmune response or damage to the small intestine. Since there are no biomarkers that can definitely identify NCGS, first you need to rule out other conditions like celiac disease and wheat allergies.
- Gluten ataxia – is a neurological condition associated with the ingestion of gluten. It primarily affects the coordination and balance functions of the body. Common symptoms include unsteadiness, poor coordination, difficulties with balance and walking, tremors, muscle stiffness or spasms, and problems with speech and eye movements. Some individuals may also experience cognitive impairments or nerve damage.
- Dermatitis herpetiformis – DH, also known as Duhring’s disease, is a chronic skin condition characterized by a persistent itchy rash. It is considered the skin manifestation of celiac disease and is closely associated with gluten sensitivity.
While all of these conditions are related to gluten intolerance, they are distinct problems that appear as stand alone disease or in a bundle. In addition to disrupting digestion, a gluten intolerance can also lead to headaches, brain fog, joint and muscle pain, fatigue, and general skin problems. In case of malabsorption, it can lead to significant nutritional deficiencies, such as minerals, iron, certain vitamins, etc. Almost a quarter of the population suffers from the condition, however, a vast majority – 80 percent – are undiagnosed. This could partially be explained by the fact that many people experience no visible symptoms. For example, there is evidence that in case of asymptomatic celiac disease, gluten particles have opioid effects and thus, mask the symptoms, delaying the diagnosis of the disease. There is still ongoing research about what are the underlying mechanisms what make gluten so harmful for certain people.
Is Gluten-free Diet the Solution?
It is well established that gluten can be extremely bad for our bodies and awareness about this topic increases day after day. However, with rising interest in gluten-free diets, people often fall prey to various myths and misconceptions surrounding the gluten free diet. Every person following a gluten free diet should be aware of these myths about gluten-free products:
- GLUTEN FREE DOES NOT AUTOMATICALLY MEAN HEALTHY – yes, it’s true that when a product is advertised as gluten-free it doesn’t contain gluten and thus, won’t provoke gluten sensitivity or allergic reactions, however take into account that not everything that’s gluten-free is healthy.
Many people assume that gluten-free products are automatically healthier or better for weight loss. However, this is not necessarily true. Gluten-free products can still contain high amounts of sugar, unhealthy fats, and refined grains, genetically modified corn, etc. It’s essential to read labels and choose gluten-free options that are also nutritious and balanced.
- EVERYONE SHOULD CONSUME GLUTEN FREE PRODUCTS – people are inclined to think that since gluten provokes immune response in certain individuals, it should be bad for everyone. As a result, there are people who advocate a completely gluten free diet for all.
While there could be some benefits to eliminating gluten, sometimes doing that results in many unnecessary barriers and restricts food choices, causing a much larger harm than consuming gluten. So, unless you know how to properly follow a gluten free diet or have a specific medical condition, such as celiac disease, non-celiac gluten sensitivity, or wheat allergy, there is no need to follow a gluten-free diet.
- GLUTEN FREE IS GREAT FOR EVERYONE’S DIGESTION – this point goes hand in hand with myth #2. For people who are free from gluten intolerance or sensitivity, eliminating gluten does not automatically translate into better digestion. Actually, for them, foods with gluten-containing foods can be a source of a healthy and well-balanced diet.
This is especially true considering that many gluten-free products lack such important nutrients as fiber, B vitamins and iron. Manufacturers also often use refined flours and starches, which can result in lower nutritional value. Thus, a gluten free diet does not automatically translate into a healthier diet or digestion.
4. GLUTEN FREE MEANS WHEAT-FREE: it’s true that wheat is a source of gluten and you should eliminate it if you want to lead a gluten free life. However, people often made a mistake of assuming that a “wheat-free” product automatically means gluten-free.
Gluten is a protein that can be found in wheat, barley and rye, so ensuring a gluten free diet means reading all the labels carefully and eliminating all potential sources of gluten, not just wheat.
5. GLUTEN FREE FOOD LEADS TO WEIGHT LOSS – this sounds like something you would expect after eliminating gluten from your diet, however, losing weight is all about your overall behavior and diet rather than eliminating a specific food source or nutrient. Thus, removing gluten from your diet alone does not guarantee weight loss. Weight loss occurs when you create a calorie deficit by consuming fewer calories than you burn.
Some gluten-free products may even be higher in calories than their gluten-containing counterparts due to added fats, sugars or additives. Also, gluten-free products, such as bread, pasta, or baked goods, can be denser and higher in calories compared to their gluten-containing counterparts.
This difference in texture and composition may lead to larger portion sizes or overconsumption, which can affect weight management. So, never assume that gluten free will automatically mean healthy and low calorie.
6. FINALLY, GLUTEN FREE DOESN’T EQUAL TO TASTY – this is sad, but true. Over time companies have tried to develop alternatives to products containing gluten, however, absence of gluten can affect both texture and flavor, leaving you disappointed and craving for gluten.
This is often true with many diets that require you to eliminate a certain product, however, this is a cost people have to pay to live a life free of gluten sensitivities and intolerance.
Knowing about these myths can help you make healthier and better choices and improve your diet, as well as well-being. In addition to these misconceptions, one should also be aware of some gluten-free traps and practical tips to ensure truly gluten-free life:
– cross-contamination – gluten can appear on surfaces of various surfaces and cooking utensils and cause contamination of gluten-free foods/utensils with gluten. Thus, preparing gluten free meals requires additional care and handling. However, nothing can prevent cross-contamination with 100% certainty. Since severe allergic response can be life threatening, it is important to be aware of possible symptoms and have an EpiPen at hand if needed.
– hidden sources of gluten – there are very specific types of food products we imagine when talking about gluten, however some sauces, condiments, dressings and processed foods could also contain gluten as a thickening agent, so check the labels even when it seems very unlikely to be used.
– different countries could have different thresholds and regulations for gluten content, so something labeled as gluten free in one country could be labeled as non-gluten free in another. Standards vary and you need to take that into account.
– be aware that significantly changing your diet will also affect your gut microbiota composition, which can cause another cascade of gut issues. Supplementation could be important as you transfer to gluten-free diet.
I hope this article brings to your attention some of the important topics to consider when starting a gluten-free life. When struggling from gluten-related diseases, there is no better way to manage your symptoms than by removing this protein from your diet. This goes without doubt. However, do not fall into the trap of thinking that a gluten-free diet automatically means a healthy diet. Common myths, misconceptions and traps are here to alert you of the importance of conducting proper research and substituting gluten with nutrients that will actually benefit your body.
If you suffer from gluten and gut-related problems and would like to explore possible solutions, I invite you to join the Healthy Gut Institute here. It is an effective 6-week program that will help you health your gut in a comprehensive and holistic way.
To your symptom-free life,
Dr. John Dempster, ND