Going “gluten free” seems like a healthy idea, if we’re to believe all those labels on supermarket shelves and the many celebrities who don’t eat wheat.
Maybe you even know someone who swore off gluten — the protein found in grains like wheat, barley, and rye — because they found a gluten-free diet improved their mood, reduced bloating and inflammation, and relieved joint pain.
But who really benefits from a gluten-free diet? And should serial dieters give this health fad a try? Maybe not, if their system can tolerate gluten and they simply want to trim their waistline.
“A gluten-free diet is not a ‘lose weight quick’ trend for the average person,” says Joseph Claiborne, MD, internal medicine physician on the medical staff at Methodist Dallas Medical Center. “It’s an essential solution for those who suffer from celiac disease and gluten sensitivities.”
Researchers say about 1% of the U.S. population suffers from celiac disease, an immune disorder that damages the small intestine, and about 6% may have non-celiac gluten sensitivity. But it’s estimated that more than 20% of Americans have attempted to follow a gluten-free diet.
So why the huge discrepancy? Could others whose immune system can tolerate gluten benefit from doing without? Dr. Claiborne says getting a blood test is the first step.
“If you suspect you might have a gluten intolerance, the best solution is to get tested,” he says.
Up to 2 million Americans suffer from this chronic digestive disease triggered by eating foods containing gluten. Symptoms include excessive bloating, frequent constipation, diarrhea, chronic abdominal pain, skin reactions, iron-deficiency anemia, and joint pain.
Many people who have this genetic condition are undiagnosed or misdiagnosed and, as a result, at risk for long-term health problems.
“If it’s left untreated, celiac disease can damage the digestive tract and prevent the absorption of nutrients from foods,” Dr. Claiborne says. “That can lead to malnutrition and unwanted weight loss.”
What’s more, he adds, celiac disease can be associated with other autoimmune diseases like multiple sclerosis and Type 1 diabetes. Thyroid problems might also be related.
“It’s common for auto-immune diseases to run in pairs, so it’s possible celiac disease and thyroid problems can have similar symptoms,” Dr. Claiborne says. “I’ve seen instances where we placed a patient on thyroid medications and then their gluten intolerance symptoms went away.”
There’s no cure for celiac disease and no medications to treat it. The only effective treatment is adopting a gluten-free diet.
If your stomach bloats after eating a bowl of pasta or any glutenous foods, it might be a sign of a non-celiac gluten sensitivity.
While these symptoms may mimic celiac disease, gluten sensitivity is neither an allergic reaction nor an autoimmune disorder that damages the intestines. In fact, when tested, gluten-sensitive patients get a negative result, but their symptoms may still go away once gluten is removed from their diet.
“If your test results return negative, you can eliminate gluten on your own and check back in with yourself after a month or two to see if your symptoms improved,” Dr. Claiborne suggests.
Just be aware that going gluten-free may not be the answer for everyone. It’s likely to cost more and may not be any healthier. Gluten-free foods often contain more sugar and fat and less fiber and nutrients like iron and folic acid.
Foods containing wheat can also cause an allergic reaction. In patients with a wheat allergy, the immune system mistakes gluten as a disease-causing agent and creates an antibody to the protein.
That allergic reaction prompts the immune system to respond with an upset stomach, a rash, headache, congestion, hives or swelling, and even trouble breathing, also known as anaphylaxis.
“Wheat allergies are common in children who have immature immune and digestive problems,” Dr. Claiborne says. “Most children outgrow this allergy, but adults can develop it sometimes as a cross-sensitivity to grass pollen.”
The most effective way to determine whether you have celiac disease is to visit a gastroenterologist. Most primary care clinics are equipped to draw blood for testing, too.
“If certain antibodies in your blood are elevated, then a biopsy of the intestinal tract could confirm you have celiac disease,” Dr. Claiborne says. “There’s also a genetic test that provides the most accurate results in determining if a patient has celiac disease.”
But if you plan to get tested, don’t cut gluten from your diet beforehand or you’re likely to receive a false negative result.
And if you test negative, there are other options to help you figure out if you have a gluten sensitivity. For example, the Gluten Free Society provides an online assessment that you can take from home.
Overall, if cutting gluten from your diet makes you feel better, and improves your overall health, then keep it up. It means you’ve found a solution that works for you. From there, ask a doctor for help, Dr. Claiborne suggests.
“Once that gluten-free trial is over, check in with your primary care physician to help you navigate through the next steps,” he says.