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Alyssa Simpson RD, CDE, CLT
Alyssa Simpson

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Sibo Doctor Approved
certified gastrointestinal nutritionist
Sibo Doctor Approved
certified gastrointestinal nutritionist

Curious About the Gluten-Free Diet? How to Decide if It’s Right for You.

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Going gluten-free is really trending these days. It seems like over the past few years, you see “gluten-free” everywhere. Many restaurants have gluten-free menus. You see the gluten-free label all over the place at the grocery store. Even fast food and pizza places are cashing in on the rising popularity of the gluten-free diet.

What is gluten? And why are so many people giving it up?

What is gluten?

In short, gluten is a protein. Although technically, it’s a family of proteins, called prolamins. You find these proteins in certain grains including wheat, rye, and barley.

Gluten is actually really helpful when it comes to things like bread. It’s very elastic. The gluten helps increase the strength and rise of the bread. So, if you enjoy a fluffy loaf that isn’t crumbly, you have gluten to thank.

In fact, gluten is so helpful in baked products, food producers will often add in extra — called vital wheat gluten. It even helps extend shelf life.

Gluten is a naturally occurring substance. That means it’s not something cooked up in a lab. It sounds pretty great, right? But if it’s natural and helpful, what’s the big deal?

The Dark Side of Gluten

I’ll get right to the point. Gluten is hard to digest.

When you digest your food, your body uses a variety of chemicals to break everything down into a safe and usable form. Some of these chemicals come in the form of protease enzymes. These enzymes are tasked with breaking down proteins.

And with most of the proteins you eat, they do a very efficient job. But with gluten — not so much. Gluten is resistant to the enzymes that break down proteins. So sometimes, gluten doesn’t get fully broken down before it enters the small intestine.

This is where the problems start.

When portions of these proteins (called peptides) aren’t fully broken down, they can pass through the wall of the small intestine and enter the bloodstream. This is what happens when someone has “leaky gut”.

Once these peptides are roaming freely through the blood, they can wreak havoc. The immune system recognizes that they don’t belong there and it flies into action. While this is generally a good thing, sometimes this process goes awry.

These peptides can confuse the immune system because they are similar to some of the proteins in your body tissues. And if the immune system gets confused, it may start to attack parts of your body along with the gluten-derived peptides. This can result in an autoimmune disease.

This is a worst-case scenario when it comes to gluten. There are a few specific reactions to these proteins, and the grains from which they come.

Different Reactions to Gluten

If you experience symptoms after eating gluten, it doesn’t necessarily mean you have an autoimmune disease. There are a few different types of reactions when it comes to gluten.

Celiac Disease

When a person has an autoimmune response to gluten, it often results in celiac disease.

Celiac disease occurs when the body mistakenly attacks the small intestine. This condition is fairly well-researched and is thought to affect about 2 million people in the U.S., and about 1% of the global population. Although it’s estimated that 97% of celiac disease goes undiagnosed.

But many people with celiac probably don’t even know they have it.

Symptoms of celiac disease include:

? Bloating

? Chronic diarrhea

? Constipation

?  Gas

? Lactose intolerance caused by the damage done to the small intestine

? Bulky, loose, greasy, and bad-smelling stools

? Nausea or vomiting

? Abdominal pain

These symptoms can also indicate other issues, including IBS. So don’t diagnose yourself quite yet! If you think you may have celiac disease, talk to your practitioner about getting tested. Remember that the vast majority of celiac cases do go undiagnosed, and therefore untreated. So if you even think it’s a possibility for you, I highly recommend you find out for sure.

Celiac diagnoses often don’t happen until a patient develops a secondary issue like osteoporosis, anemia, or another autoimmune disease.

As of now, there really aren’t any treatments for celiac disease. But strict adherence to a gluten-free diet usually keeps symptoms at bay and calms the autoimmune response.

Wheat Allergy

A wheat allergy is not actually a reaction to gluten. It’s an abnormal immune response to the wheat itself, or rather some of the other proteins in wheat. So those with a wheat allergy may be able to eat other gluten-containing grains.

A wheat allergy is completely separate from celiac disease, although it is possible to have both conditions at the same time. Wheat allergies are most common in children. And many kids outgrow them over time.

Symptoms of a wheat allergy include:

?  Nausea — ranging from mild to severe

? Cramps

? Diarrhea 

? Nausea or vomiting

? Nasal congestion

? Headache

? Swelling, itching, or irritation of the mouth or throat

? Hives, itchy rash, or swollen skin

? Difficulty breathing

? Anaphylaxis — a potentially life-threatening immune response

A wheat allergy can be diagnosed with a skin-prick test from an allergist.

FODMAP Intolerance

If you’ve been following my blog for a while, you probably remember that we did a whole month all about FODMAPs. You can read the first of those articles here.

And if you’re really on the ball, you may be thinking, “but Alyssa, FODMAPs are carbohydrates and gluten is a protein.”

And you’re right — huge bonus points by the way.

Yes, FODMAPs and gluten are two entirely different things. But, they do coexist in a variety of foods. So it’s not always easy to tell which one you have the problem with.

Whether you are on a gluten-free diet or a low FODMAP diet, you will be cutting out some of the same foods including barley, wheat, and rye. And yes, it is possible to have issues with both gluten and FODMAPs.

Non-Celiac Gluten Sensitivity (NCGS)

Some people are sensitive to gluten without having an autoimmune reaction or an allergic reaction. I talked about the differences between these types of reactions a few months ago. If you’d like more info on food sensitivities, intolerances, and allergies in general, click here.

NCGS is basically what’s left for someone who reacts to gluten, but tests negative for both celiac disease and wheat allergy. It’s estimated that NCGS affects up to 6% of the general public.

NCGS Symptoms:

? Headache

? Joint pain

? Fatigue

? Bloating

? Abdominal pain

? Diarrhea or constipation

? Acid reflux

?  And more…

Who should be on the gluten-free diet?

If you have any of the above conditions, you would benefit from a gluten-free diet. If you have celiac, going gluten-free is a MUST because eating gluten causes your body to continue to damage your small intestine.

Gluten is not a dietary requirement. If you choose to eat gluten-free, it shouldn’t have any adverse effects. Most of the nutrients you get from gluten-containing foods like B vitamins, zinc, iron, potassium, and fiber can be easily replaced by eating a diet rich in whole foods.

A gluten-free diet won’t hurt you. But not getting a proper diagnosis can.

If you’re experiencing any of the symptoms listed in this article, it’s important that you contact a qualified practitioner to do some digging into what’s really going on.

In my practice, I use a variety of diagnostic tools to make sure that I understand the root cause of my patients’ symptoms. Then I can design personalized protocols that address each patient’s core issues.

If you’re tired of dealing with symptoms and have not gotten the answers you need, click below to book a consultation. Let’s work together to get you feeling your best!

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