Is gluten intolerance really an allergy, or is it more a diet and lifestyle choice like low-carb or Paleo? The easy answer is that it’s both, one or the other, or even a combination of the two. According to the National Foundation for Celiac Awareness (NFCA), there are two types of gluten intolerance in the medical world: those with celiac disease and those with non-celiac gluten sensitivity.
The big difference between the two is that people with non-celiac gluten sensitivity have many similar symptoms as those with celiac disease—but they don’t have the same antibodies and intestinal damage as celiac patients. Researchers at the NFCA state that non-celiac gluten sensitivity is an “innate response” of the immune system, which means it’s not antigen specific. Celiac disease is antigen specific.
What’s the deal with the gluten-free craze?
According to the Center for Celiac Research & Treatment, about 18 million people in the U.S. are gluten sensitive, which is about 6% of the population. Just like celiac disease, there’s no “cure” for gluten sensitivity, but a gluten-free diet can alleviate symptoms. There also are no definitive tests that reveal if you have gluten sensitivity, although there are tests that may help. A doctor, often with the aid of a medical assistant, can help you rule out other possibilities such as irritable bowel syndrome (IBS) until gluten sensitivity is the prime suspect. Common symptoms of both celiac disease and gluten sensitivity include:
- abdominal pain
- feeling “foggy”
- joint pain
- leg numbness
However, if you plugged all of these symptoms into a Google search, you’d likely come up with a big range of possible diseases. Different people respond to gluten sensitivity in a number of ways, which is why it’s important that only a physician make the diagnosis.
Should you change your “bread and butter?”
For many years, celiac disease was an “all or nothing” disorder, and some doctors misdiagnosed patients. One person can have gluten intolerance, or even celiac disease, and still enjoy a beer with little discomfort while just the thought of a lager can send another person running for the bathroom.
Within wheat, there are a lot of different factors. Gliadins and glutenins are two major components of wheat, and within those two components there are more, smaller components. A person might be sensitive to any one of these “parts” of wheat. The current testing for celiac disease and gluten intolerance can only screen for two components—which is why there really isn’t a comprehensive test to determine if someone is intolerant (unless they “luck out” and are intolerant to one of the two components doctors can test for).
If you suspect that you have gluten intolerance, a doctor can test you for celiac disease by the means of a celiac blood test, an endoscopy and/or a sample of your intestinal tissue. In many cases, a medical assistant will be helping the physician, usually a primary care doctor or a gastroenterologist, with these tests. If you don’t test positive for celiac disease on either the blood tests or the endoscopy, you almost certainly don’t have celiac disease. Yet, that doesn’t mean that you don’t have a problem with gluten. So far, there are no recommended methods to test for non-celiac sensitivity, even though some practices offer saliva, blood or stool testing. if you’re “just” gluten-intolerant, the only way a true diagnosis can be made is by a process of elimination. This might involve experimenting with your diet under the supervision of a doctor.
When gluten-free just makes you feel better
Celebrities like Miley Cyrus and Gwyneth Paltrow jumped on the gluten-free bandwagon, and there’s no denying that these two celebs look very slender and fit. USA Today recently reported that 29% of Americans want to lower their gluten intake. Some people say it “just makes them feel better” while others think it’s a great tool for weight loss.
Famed tennis player Andy Murray went on a strict gluten-free diet for three months, but stopped when he lost more weight than he would have liked, reports The Guardian. Cutting out “bad” carbs like processed white bread in favor of healthier options is probably good for most people, so maybe the gluten-free craze isn’t so crazy after all. Whether you’re interested in a gluten-free diet for weight management or because you think you have gluten sensitivity, always go see a doctor before making a big diet or lifestyle change.
Sandra Mills is a freelance writer who has a passion for healthcare and education. Sandra has written several articles on medical assistant certificate training as well as other college healthcare training programs.
The posts on this blog are for information only, and are not intended to substitute for a doctor-patient or other healthcare professional-patient relationship nor do they constitute medical or healthcare advice of any kind. Any information in these posts should not be acted upon without consideration of primary source material and professional input from one's own healthcare professionals.