Eliminating gluten from the diet has become a hot topic in nutritional circles in recent years, and a lot of people extol the benefits of a gluten-free diet. Gluten is a protein primarily found in wheat, barley and rye. For some people, it can be problematic.
Katrina Plyler, a nutrition and exercise blogger at Katrina Runs for Food, is certainly one of them. Plyler says she had a surface level knowledge of gluten, but it was never important to her until one day when it became extremely important. That was the day Plyler was in her doctor’s office trying to talk him out of sending her to the hospital for dehydration. For months, she’d had some symptoms that had gradually increased in severity until she was no longer absorbing vitamins and nutrients from food.
Because she kept “a very detailed food diary in a good old-fashioned notebook,” her doctor was able to review her dietary intake over a few weeks before the symptoms started. Her doctor suggested trying an elimination diet to remove gluten.
Removing gluten meant taking out all the bread, pasta and other sources of gluten — including sauces and salad dressings, where gluten can sometimes lurk unexpectedly. Plyler spent the next four days eating a modified BRA(t) diet, “which consists of bananas, rice, applesauce and tea, with no toast or bread,” she says.
Five days later, “I felt like I had my life back. It was that simple,” she says.
A few weeks later, blood tests confirmed that Plyler was absorbing nutrients and vitamins again, and she received a formal diagnosis of Celiac disease after more blood tests and food challenges confirmed that gluten was triggering her symptoms.
Gluten Intolerance and Celiac Disease
Strictly speaking, gluten intolerance is different from Celiac disease, but the two can travel together. And anyone with Celiac has gluten intolerance.
In technical parlance, gluten intolerance is known as “non-Celiac gluten sensitivity,” says Liz Weinandy, a registered dietitian with the Ohio State University Wexner Medical Center in Columbus. “Gluten intolerance is when a person just does not tolerate gluten for whatever reason,” she says.
It might be related to Celiac, an autoimmune disease where eating gluten leads to damage inside the gastrointestinal tract, Weinandy explains. But in other people, consuming gluten triggers a variety of symptoms that aren’t Celiac disease, but can still be problematic. “With non-Celiac gluten sensitivity, you don’t see that same damage on the intestinal tract, but it does produce other symptoms,” she explains.
9 Symptoms of Gluten Intolerance
Symptoms of gluten intolerance can manifest in many different ways. Here are the nine most common signs of gluten intolerance:
— Gastrointestinal effects.
— Malabsorption of nutrients.
— Skin rash.
— Joint pain.
— Lactose intolerance.
— Chronic fatigue.
— Brain fog.
“Because my stomach symptoms started out very gradually, and because they coincided with an extremely stressful work situation, I attributed these symptoms to stress and assumed they would work themselves out when school let out for the summer,” Plyler says. “Instead, they got worse. Symptoms such as intense bloating, diarrhea and constipation are sure signs of gluten intolerance.”
Malabsorption of Nutrients
Over time, the effects of consuming gluten if you have a sensitivity can accumulate, and your stomach lining loses its ability to absorb essential nutrients from food. This can lead to low iron levels and other nutrient deficiencies, such as low levels of vitamin B12, zinc and copper.
Removing gluten can allow the lining of the gastrointestinal tract to heal itself, thus resolving symptoms and improving your body’s ability to absorb nutrients from the foods you eat.
Weinandy notes that a skin rash can sometimes signal a problem with gluten, and a family member of hers gets an ” eczema-like rash whenever he eats gluten.”
She says on several trials of taking gluten out of the diet and then trying to reintroduce it, the rash came back. “It’s amazing the difference.” There’s also some evidence that suggests removing gluten can improve symptoms of psoriasis and other skin diseases.
Headaches are one of those nondescript symptoms that can go along with a wide variety of medical problems or conditions. However, Plyler notes that “migraines that are combined with daily diarrhea, a low iron count and a skin rash paint a different picture. And if your migraine starts within an hour or two of ingesting food that contains gluten, it’s highly indicative of a gluten sensitivity.”
Joint pain has also been associated with gluten sensitivity, and it’s believed to be because gluten can cause an inflammatory response in the body. Inflammation that makes its way to the joints can cause arthritis-like pain.
This joint pain caused by gluten is sometimes misdiagnosed as rheumatoid arthritis. “After I eliminated gluten, I was shocked at how much joint pain I’d been having,” says Plyler. “When it resurfaced within hours of a gluten contamination, it was almost unbearable.”
Gluten sensitivity is also sometimes found in conjunction with lactose intolerance, or an inability to break down a sugar called lactose that’s found in milk and other dairy products. If you know you have trouble digesting dairy and have other symptoms on the list, it might be time to think about eliminating gluten.
Like migraines, chronic fatigue on its own is not a strong indicator of gluten intolerance because fatigue is associated with many other conditions. However, when chronic fatigue and gastrointestinal problems combine, that could signal gluten sensitivity. “If the body is not absorbing nutrients and essential vitamins, fatigue is sure to take over,” Plyler notes.
“Some medical experts believe fibromyalgia is a symptom, not a disease,” Plyler says. “Inflammation of the connective tissue is one of the strongest symptoms of a gluten intolerance. Essentially, the body thinks gluten is an enemy and will send out antibodies to destroy it. Those antibodies destroy the lining of the stomach and intestines. Just like with joint pain, the inflammation could present itself in any part of the body. If a doctor told you that you have fibromyalgia, try eliminating gluten and see how you feel.”
Weinandy says brain fog or frequent difficulty focusing, concentrating or “just an inability to think straight” is also sometimes associated with gluten sensitivity or Celiac disease. Again, inflammation seems to be the culprit in triggering this symptom.
Is It Gluten? Or Is It Something Else?
While many of the symptoms above can be associated with stress or other conditions, it might be worth talking to your health care provider about whether you’ve got Celiac or a gluten sensitivity if you’re experiencing some of these symptoms. “Many of these symptoms are not always really specific,” Weinandy says, “so that can make it harder to diagnose.”
There’s not currently a test for gluten sensitivity. Usually, sensitivity is determined via an elimination diet. However, you can be tested for Celiac disease. That process includes bloodwork and an endoscopy to look for damage to the lining of the small intestine.
Plyler adds that a single symptom might not mean you’re having problems with gluten, but “a combination may be a neon sign that gluten is causing the body to attack itself.” If that’s what you’re experiencing, it’s definitely time to speak with your health care professional.
If it looks like gluten might be the issue, Weinandy says, “we usually recommend to go ahead and take all the gluten out of the diet. That includes wheat, barley and rye. And I always tell people to make sure to read the labels. Gluten is a common allergen that has to be declared on the label.”
You might be surprised at what products contain it: It’s in everything from ketchup and salad dressing to soup and marinades. Often, if you have a gluten sensitivity, taking all the gluten out of your diet will make symptoms go away in just a few days. If you have Celiac, it might take a while longer for your gut to fully heal, so work with your doctor to determine the problem and how best to improve your symptoms.
Lastly, if you’ve been diagnosed with Celiac or non-Celiac gluten sensitivity, ideally you should speak with a registered dietitian who can help you adjust your meal plan to eliminate gluten without losing the good nutrients that come with the whole grains that contain gluten, such as fiber, vitamin D and the B vitamins.
Hollie Zammit, a registered dietitian with Orlando Health Cancer Institute in Orlando, Florida, says working with a dietitian can help you find the best way to eat for your body and your specific needs. “Genetics, age and gender play a huge role in how your body reacts to certain food items or diets. It’s also not helpful to compare yourself to anyone else — the human body is incredibly complex.”
What works for one person might not work for you, so contact a dietitian to find the best way forward for you and your body.
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