Arguably one of the most controversial health terms these days is "gluten intolerance." Researchers estimate that around 18 million Americans have a "gluten sensitivity."
The growing awareness of gluten, the protein found in grains such as wheat, rye, barley, and spelt, has born an endless vortex of gluten-free everything. Gluten-free desserts, gluten-free crackers; you probably could even find gluten-free gluten if you searched hard enough.
I'm kidding, of course. But what's the deal? Is gluten something you should avoid, or is it an overblown fad reminiscent of the "fat-free" movement that had little to no health merit?
Is gluten intolerance real?
One trial published in Clinical Gastroenterology and Hepatology studied people who thought gluten was causing them digestive problems. The gold standard for research is something called a randomized, double-blind, placebo-controlled, crossover trial, and gluten was put to this rigorous test—and this study checked all the boxes. For one week participants were given either a small amount of gluten or a placebo pill of rice starch. After only one week, those who were taking the gluten pills reported a significant increase in symptoms compared to those who took gluten-free placebo pills.
Another recent randomized control trial shared similar findings.
Is gluten intolerance an autoimmune condition?
To understand gluten intolerance, we need to understand autoimmune conditions. Many people think when we talk about gluten intolerance we are referring to the autoimmune condition celiac disease.
Celiac disease is really the extreme end of a broader gluten-intolerance spectrum. The other end of that spectrum is non-celiac gluten sensitivity (NCGS).
Check out this article on the autoimmune-inflammation spectrum to learn more about this subject.
What are the symptoms of gluten intolerance?
People in the study noticed:
- abdominal bloating
- intestinal pain
Because your gut is your "second brain," people with gluten intolerance can also experience:
- brain fog
Gluten test results: How to test for gluten
What most people don't realize is that there are about 24 different aspects of wheat that your body can be reacting to. Most patients who ask to be tested for gluten intolerance get a simple alpha gliadin lab. If it comes back negative you are told you are not gluten intolerant. You may want to then celebrate the good news by going to the Olive Garden and getting bread sticks, but not so fast.
Alpha gliadin and the common celiac lab Transglutaminase 2 are just two pieces of about a 24-piece puzzle.
More comprehensive labs could be incredibly helpful to know for someone who has reintroduced grains into their diet but still is unsure whether it's the grains that are contributing to their problems or not.
Gluten Cross-Reactive Labs:
This lab is looking for foods that do not contain gluten, but the body could "tag" them with gluten antibodies and read them as gluten. Sort of like the case of mistaken identity, molecular mimicry can wreak havoc on the person who has gone gluten-free but still has symptoms.
Some cross-reactive foods include:
- gluten-free grains
So what's the gluten verdict?Does gluten intolerance exist? Yes, for some individuals. Is everyone noticeably sensitive to gluten? No. Actually, a recent study in the journal Digestion found that 86 percent of people who thought they were gluten sensitive could actually tolerate it. My job as a functional medicine practitioner is to find out what foods your body loves and which ones it hates. We are all different, so will your food medicine be too.Related reads: