Gluten intolerance, or non-celiac gluten sensitivity, is a misunderstood disorder with little consensus on how to test for and diagnose it. This article will shed light on this serious disorder and help people with suspected gluten intolerance determine how to get a proper diagnosis. Please note that “gluten intolerance” and “non-celiac gluten sensitivity” are used interchangeably. Please see my disclosures and consult your doctor before changing your diet. This post contains affiliate links.
Experts estimate that 18 million people are affected by a disorder known as non-celiac gluten sensitivity, commonly called “gluten sensitivity” or “gluten intolerance.” People with gluten intolerance cannot eat gluten, a protein found in wheat, rye, barley, and sometimes oats.
It’s important to note that non-celiac gluten sensitivity may be a bit of a misnomer, as many people with gluten sensitivity actually have wheat sensitivity. This means they have an issue with various components of wheat, including but not limited to the gluten protein.
Gluten intolerance and celiac disease are not the same, although the treatment (a strict, life-long gluten-free diet) is the same.
Celiac disease is an autoimmune disease where a person’s immune system mistakenly attacks the healthy tissue surrounding the small intestine every time they eat gluten. It affects one percent of the population, although some studies say it affects closer to three percent. Most people with celiac disease don’t know they have the disorder.
Unfortunately, even though 18 million people have a “gluten intolerance,” most of the research about gluten disorders centers on celiac disease.
That said, one should not mistake a lack of research for lack of disorder. Gluten sensitivity is a real disorder that can have dire consequences if not treated properly.
In this article, I share the symptoms associated with gluten intolerance, how a person can determine if they have gluten sensitivity and the current treatment options.
Symptoms of Gluten Intolerance
People who suspect they cannot tolerate gluten often experience symptoms similar to those with celiac disease.
Many people with gluten intolerance experience classic gastrointestinal symptoms, such as bloating, gas, constipation, and diarrhea, while others experience less obvious symptoms, including but not limited to:
- Fatigue: Energy issues can result from chronic gut inflammation and lead to nutritional deficiencies, low iron levels or anemia, chronic fatigue, and feelings of low blood sugar.
- Thyroid disease: Hyper- and hypo-thyroid issues can be signs of gluten intolerance. Many people with Hashimoto’s or Grave’s disease cannot tolerate wheat.
- Skin conditions: While dermatitis herpetiformis, an itchy skin condition known as “celiac of the skin,” is a sign of celiac disease, other skin conditions such as keratosis pilaris, acne, eczema, and psoriasis have been helped with a gluten-free diet.
- Brain disorders: A wheat disorder often manifests in the brain through memory issues, depression, ADHD, migraines, anxiety, and autism. Dr. Tom O’Bryan wrote an entire book, You Can Fix Your Broken Brain, about the connection between gluten and brain function.
- Oral conditions: Many people don’t realize that inflammation in the gut can affect the mouth. Various mouth sores, cavities, canker sores, and geographic tongue may signal something isn’t right in the gut.
- Fertility issues: Gut issues caused by gluten can affect hormone regulation, which some say can lead to fertility issues, irregular menstrual cycles, and premature births.
- Joint and muscle pain: Many people in the gluten-free community who experience joint and muscle pain find their symptoms improve with the gluten-free diet.
On top of it all, anyone with an autoimmune disease, more likely than not, has an issue with wheat. Dr. Tom O’Bryan says in his pioneering book about autoimmune disease, The Autoimmune Fix, that gluten sensitivity is a precursor to celiac disease, autoimmune disease, diabetes, cancer, heart disease, and other serious conditions.
He says, “Excessive inflammation pulls on your chain, and wherever the weak link in your health chain is, that’s where the tissue damage will occur.” In other words, if your skin, for example, is where you’re genetically predisposed to disease, gluten sensitivity will reveal itself via a skin condition.
Dr. O’Bryan also says that anyone with an autoimmune disease, or early symptoms of an autoimmune disease, likely has a wheat sensitivity that will only worsen until the person removes gluten and wheat from their diet.
One of the leading autoimmune doctors in the world, Dr. Yehuda Shoenfeld, confirmed the strong role gluten plays in autoimmunity. He found that a gluten-free diet could ameliorate symptoms associated with non-celiac autoimmune diseases in nearly 80 percent of people with various autoimmune conditions.
How to Test for Gluten Intolerance
Before getting tested for gluten intolerance, it’s essential to first rule out celiac disease for several reasons I detail in my article, STOP! Don’t Go Gluten Free Until You Read This Article. I recommend getting tested for celiac disease using this reliable and convenient at-home celiac disease test.
Once a person has ruled out celiac disease yet still suspects they have an issue with gluten or wheat, it’s time to look to other diagnostic measures.
Unfortunately, diagnosing someone with gluten intolerance is challenging because there isn’t a firm consensus in the medical community on how to do it, nor specific biomarkers indicative of gluten intolerance.
(1) Elimination Diet: The gold standard way to test for and diagnose gluten intolerance is via an elimination diet, which should be implemented in people who have first ruled out celiac disease.
An elimination diet requires someone to remove gluten and wheat from their diet for at least four weeks (although six weeks is best), then slowly reintroduce it and carefully monitor and assess symptoms.
After 4-6 weeks, the person will slowly reintroduce gluten. For some, reintroducing gluten will hit them like a ton of bricks and make them feel awful, likely due to a phenomenon known as loss of oral tolerance. They may experience various pains, fatigue, or brain fog and even find new symptoms they didn’t notice before.
Others may feel fine at first, but after a few weeks or months, their symptoms may resume, whether it’s their thyroid acting up or their skin rash returning.
It’s wise to work with a nutritionist, dietician, or health coach to implement an effective elimination diet. They can also help determine what foods to eat during this elimination period.
If eliminating and reintroducing gluten doesn’t resolve symptoms, it’s important to consider other disorders such as candida, SIBO, Irritable Bowel Syndrome (IBS), and fructan intolerance.
(2) Diagnostic Tests: Several tests can help determine if a person has an issue with wheat, although there is no one gold standard test for diagnosing this relatively new condition.
Also, such tests are extremely costly and must be ordered by a doctor, many of whom are skeptical and may discourage patients from spending the money on them.
However, many say there is merit in testing, as it allows people to physically see if their body is making antibodies to wheat peptides – including gluten and non-gluten components.
Some experts recommend the Wheat Zoomer or Cyrex Array 3x test, but either test will run nearly $400 a pop, and the costs will most likely be out of pocket to the consumer.
When using either test, a person should consider the financial burden of taking the test once before and after the elimination period. Such expenses can add up.
Treating Gluten Intolerance
The only treatment option for gluten intolerance is a lifelong, strict gluten-free diet. People with gluten intolerance should avoid all gluten, even traces of gluten, due to cross-contamination.
There is no cure for gluten intolerance, nor can a person outgrow it. Dr. O’Bryan says that the immune system creates memory B cells for wheat, which means every time the immune system spots wheat, it will produce antibodies and become inflamed.
To get started on the gluten-free diet, please enroll in the Gluten-Free Made Easy Course I created in collaboration with Dr. Tom.
Additional Reading
- What Causes Celiac Disease and Can it Be Prevented?
- 10 Facts Your Doctor Doesn’t Know about Celiac Disease
- Should You Take the Gluten Challenge?
- What is Gluten and Why is it Bad for Some People?
- Is Yeast Extract Gluten Free and 20+ Other Confusing Ingredients
- Supplements for Celiac Disease and Gluten Intolerance
- Celiac Disease vs. Gluten Intolerance: What Do You Have?
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