The Gluten-Free Diet: Facts and Myths

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Published August, 2021


Gluten-free diet and celiac disease (CD):

Gluten-free diet and non-celiac gluten sensitivity (also known as “gluten sensitivity”):

If you think you may have a gluten-related disorder (CD or NCGS) it is very important to have testing done before removing gluten from your diet. Otherwise testing may not yield valid results.


“A gluten-free diet is healthier.”

“A gluten-free diet is good for weight loss.”

“Surely a few crumbs of bread can’t hurt.”

Symptoms which could indicate the need for a gluten-free diet
Symptoms of celiac disease and gluten sensitivity are similar and may include: recurring abdominal pain, chronic diarrhea/constipation, tingling/numbness in hands and feet, chronic fatigue, joint pain, unexplained infertility and low bone density (osteopenia or osteoporosis). There are approximately 200 potential symptoms, many of which are also symptoms of other conditions.

What to do if you think gluten may be causing your symptoms
Consult with your personal physician/health care provider before giving up gluten. This is very important because the standard blood testing done as a first step to diagnosing these conditions is not meaningful unless gluten is being consumed for a significant period of time before testing. It is also important to consult with your healthcare provider in order to evaluate other possible causes of symptoms.

How are celiac disease and non-celiac gluten sensitivity diagnosed?
The first step is a panel of blood tests looking for an antibody response to gluten. If these tests are positive, the next step is an endoscopy. If the endoscopy shows the intestinal cell damage characteristic of celiac disease, this is considered the gold standard of celiac disease diagnosis.

There is currently no specific diagnostic test for non-celiac gluten sensitivity; instead, it is a “rule out” diagnosis. Consequently, the celiac disease testing described above would be done. In addition, wheat allergy and other potential causes of symptoms should be ruled out. If all of these conditions have been ruled out and the patient responds positively to a gluten-free diet, then the diagnosis of non-celiac gluten sensitivity may be made.

How many people have gluten-related disorders?
It is estimated that approximately 1 in 100 people worldwide have celiac disease. The prevalence of non-celiac gluten sensitivity is not established but may be significantly higher.

The majority of people with gluten-related disorders remain undiagnosed.

What is a gluten-free diet?
Gluten refers to the proteins found in wheat, rye and barley which cause an adverse reaction in people with gluten-related disorders. On a gluten-free diet, these grains and any foods or ingredients derived from them must be removed from the diet. This includes the obvious breads, pastas and baked goods made with gluten-containing flours, but may also include less obvious foods such as sauces, salad dressings, soups and other processed foods, since these can contain small amounts of ingredients derived from gluten-containing grains. ( Oats are inherently gluten-free, but there can be cross-contact with wheat or barley during harvesting or processing. See our article:Are Oats and Oat Flour Gluten-Free?The safest oat products are those that have been certified gluten-free. While products labeled gluten-free should comply with the FDA definition of containing no more than 20 ppm of gluten, this is not third-party verified. GFCO’s standard for gluten-free is 10 ppm of gluten or less. Consult with your physician or dietitian before adding oats to your gluten-free diet. 

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