Should You Go Gluten-Free?

Gluten, the protein found in grains like wheat, barley, and rye, often gets villainized by the health industry. Gluten-free diets are often associated with improved digestion and other health benefits. Those with gluten-related disorders can’t have even trace amounts of gluten.

Key takeaways:
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    Gluten is a protein found in grains like wheat, rye, barley, and other foods you may not expect.
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    Gluten-free diets are a necessity for people diagnosed with autoimmune responses to gluten, like celiac disease and other gluten-related disorders.
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    Common symptoms of gluten-related disorders include abdominal pain, GI disturbance, joint pain, and mood imbalances.
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    There are specific tests you can ask your healthcare provider about to see if you might benefit from a gluten-free diet.

However, do people without gluten disorders benefit from a gluten-free diet? And what exactly is a gluten-free diet? These questions, and more, are explored in this article.

Gluten is a protein found in grains like wheat, barley, and rye (among others). If you’ve ever made bread, you’re familiar with kneading, or the process of pushing the dough around to intentionally produce gluten. Why would you want to produce gluten? Well, gluten helps foods hold their shape and gives bread and other baked goods their chewy, yet fluffy, texture. Foods that are delicious for some can be highly problematic for others because of gluten.

Although gluten is naturally found in grains, it can often be found in foods you wouldn’t expect. Naturally, gluten-free oats are often processed in factories that also process other grains, making them a prime target for something called “cross-contact”. Cross-contact occurs when a food that doesn’t contain gluten is exposed to gluten-containing food, making it unsafe for those with gluten-related disorders.

Selvi Rajagopal, M.D., a specialist in internal medicine and obesity at John Hopkins shares that gluten “can also be added to foods during processing for texture [because it] can be used as a binding agent and for flavoring, so you can sometimes find it in foods you wouldn’t expect…like soy sauce, ice cream, and certain medications, beauty products, and dietary supplements.”

Some people think all carbohydrate-containing foods also contain wheat and can be under the misconception that gluten-free means eating carb-free, however, this isn’t the case. Lots of carbohydrate-containing foods like beans, potatoes, rice, and oats don’t contain any gluten (as long as there is no cross-contact!).

Safe gluten-free flours and starches

If you’re interested in trying a gluten-free diet to see if your signs and symptoms improve, here is a list of safe, gluten-free grain and flour alternatives.

  • Amaranth;
  • Buckwheat;
  • Almond meal (flour);
  • Coconut (flour);
  • Millet;
  • Pea (flour);
  • Potato;
  • Quinoa;
  • Rice (brown, white, and wild);
  • Teff.

As long as the packaging states “gluten-free,” these ingredients can allow those who are gluten-free to enjoy bread, pasta, cereals, and other baked goods. In addition to gluten-free grains/products, those on the gluten-free diet can enjoy fruits, vegetables, dairy, eggs, and animal products (if these are a part of your diet). Here is a great resource for more details on how to check if a food is gluten-free.

Signs and symptoms of gluten intolerance

There are many tell-tale signs of possible gluten sensitivity. If you are suffering from any of these signs or symptoms after ingesting gluten-containing foods, you might want to see your doctor to run the appropriate tests to know for sure if you have an issue with gluten.

Gastrointestinal problems

  • Abdominal pain;
  • Bloating;
  • Diarrhea/constipation;
  • Nausea/vomiting;
  • Heartburn/acid reflux;
  • Flatulence;
  • Pale or floating stool (fatty stool).

Emotional issues

  • Fatigue;
  • Headache;
  • Anxiety/depression;

Inflammation problems

  • Rashes or dermatitis;
  • Joint pain, arthritis flares;
  • Neuropathy or nerve pain.

Female reproductive issues

  • Irregular cycles;
  • Flared or worsening PMS symptoms (cramps, mood changes, back pain, headaches, etc.).

Specific to children

  • Slow growth;
  • Short stature;
  • Delayed puberty;
  • Failure to thrive.

Who does a gluten-free diet help?

Gluten-free diets are essential for people managing signs and symptoms of gluten intolerance. If you or anyone you know think a gluten-related disease might be an issue, please see your doctor to get appropriate testing.

Although this diet was originally developed for those with gluten-related disorders, some people with other gastrointestinal problems have reported significant improvements in their symptoms.

People with IBS (irritable bowel syndrome), UC (ulcerative colitis), and Crohn’s Disease have all reported improved health when eating a gluten-free diet. In addition to those with GI issues, people suffering mild GI discomfort and mood changes (like fatigue, anxiety, depression, and focus issues) after ingesting gluten also report improvements when going gluten-free.

If you suspect a gluten sensitivity, your doctor or gastroenterologist can run very specific tests to know for sure. A combination of blood tests and biopsies will confirm a diagnosis.

Here is a list of some of the tests your doctors may recommend:

Genetic tests

Looking for specific associated genes that indicate a gluten issue.

Antibody tests

Antibodies are proteins produced in response to a substance that causes an immune response (like fighting bacteria for example). If your body is fighting gluten thinking it is a threat, this can be a sign of gluten sensitivity.

Radiology findings

Like small-bowel dilation, vascular changes, and wall thickening.

Intestinal biopsy

This is the definitive diagnostic tool when celiac disease is suspected. During a biopsy, a gastroenterologist (GI specialist) takes samples of the intestinal wall and looks at them under a microscope for changes that indicate celiac disease.

A study published in BMC Gastroenterology states that “the incidence of gluten-related disorders (GRDs) continues to increase and its global prevalence is estimated at approximately 5% of the population” – that’s 390,000,000 people worldwide!

The 5 major gluten-related disorders which may make eating gluten-free your diet of choice:

Celiac disease (CD)

An immune response to the presence of gluten. Over time, this immune response damages the lining of the small intestines, preventing proper nutrient absorption. This is considered an autoimmune disorder.

Dermatitis herpetiformis (DH)

Also known as Duhring’s disease; a chronic skin condition caused by an autoimmune reaction to gluten.

Gluten ataxia (GA)

Another autoimmune disorder related to gluten causes ataxia or motor issues that cause problems with muscle control and spasms.

Wheat allergy (WA)

Like any other allergy, this is the result of the immune system mistaking wheat for a disease-causing agent like a virus or bacteria.

Non-celiac gluten sensitivity (NCGS)

This can have similar signs and symptoms of celiac disease, but there is no damage to the small intestines. The immune system can still be involved, however, this is not considered an autoimmune disease. NCGS is interchangeable with terms like “gluten sensitivity, gluten hypersensitivity, and non-celiac gluten intolerance” as these terms refer to the same condition.

Each of these conditions has a wide range of clinical manifestations. This means 2 people with the same diagnosis can have very different signs and symptoms. These differing presentations are why testing and medical support are so important.

Trying a gluten-free diet

Gluten isn’t an inherently “bad” aspect of food, many people can tolerate it just fine with no negative effects. It can, however, cause some people to experience gastrointestinal pain, headaches, joint pain, and mood changes, negatively affecting their quality of life.

If you have any of the signs and symptoms discussed in this article, it could benefit you to try a gluten-free diet to see if you notice improvements. If you do notice improvements after eating gluten-free, you may want to consider visiting your doctor to explore tests to look for gluten-related disorders.

Either way, just know, going gluten-free doesn’t mean robbing your diet of the foods you love, it just means replacing them with foods that will make you feel better.

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