Question:

I’ve heard people claim that gluten sensitivity isn’t real. Is that true?

Answer:

While we know very little about non-celiac gluten sensitivity (‘gluten sensitivity’) at this point in time, most experts in gluten-related disorders do believe it is a real condition. However, there may be experts with differing opinions.

We don’t have a disease definition yet for gluten sensitivity, so right now it is what we call a diagnosis of exclusion.

A diagnosis of gluten sensitivity is given when people experience similar symptoms as those with celiac disease when eating gluten, but who test negative for celiac disease and wheat allergy. These individuals then undergo an elimination diet under the supervision of an expert healthcare team to determine if gluten is at the root of their symptoms.

People with celiac disease develop auto-antibodies to gluten and experience damage to their intestines. People with gluten sensitivity experience neither of these celiac disease markers, however their symptoms can be quite debilitating and affect quality of life.

A gluten-free diet is recommended for people with a gluten sensitivity diagnosis, however we don’t know if eating small quantities of gluten can potentially lead to long-term health consequences, as is the case for people with celiac disease.

Your question probably arises from a research study that was reported in the media showing that gluten may not necessarily be the issue for all people with self-diagnosed gluten sensitivity, and that other food components may be at play for some of these individuals. This is preliminary research and we need to learn more. However, the majority of gluten-related disorders experts believe that gluten sensitivity is a real condition. We just don’t know much about it yet.

It is extremely important that people not self-diagnose as being gluten sensitive. All individuals who believe gluten may be problematic for them should see a gluten-related disorders expert healthcare team. This team can test for celiac disease and wheat allergy first. If these conditions are ruled out, then they can conduct an elimination diet to see what the problematic foods might be. It is highly recommended not to do an elimination diet on your own, as components of food can overlap making it very difficult to tease out the real issue. A healthcare team experienced in gluten-related disorders and conducting an elimination diet is the best route to go so that the real issue is identified.

Be well,

Rachel Begun, MS, RDN