Gluten – which means “glue” in Latin – is a family of proteins found in cereal grains like wheat, rye, and barley. It is created when two cereal proteins, glutenin, and gliadin, join together. This bond is what makes dough elastic, allows baked goods to rise, and gives bread its chewy texture.
Although gluten is one of the most widely consumed proteins around the world, and humans have been eating wheat (and gluten) for at least 10,000 years, the rate of gluten-related disorders has quadrupled since 1950. And, as of yet, no one can explain with certainty why we are seeing a sudden rise of sensitivities to gluten-based foods.
To say that gluten is a complex and controversial topic is a huge understatement. Depending on whom you ask, gluten is either perfectly healthy for the vast majority of people, or it is entirely unfit for human consumption.
Whether the uptake in gluten intolerances can be attributed to widespread use of GMOs, our genes, or various environmental triggers is still a matter hotly debated. What we do know is that gluten intolerance is a real condition and that it is clinically distinct from other gluten-related disorders.
The Difference Between Celiac Disease, Wheat Allergy, and Gluten Intolerance
Affecting 1% of the population worldwide, celiac disease is an autoimmune disorder. When someone with celiac disease eats even small amounts of gluten – 50 milligrams, the equivalent of a single crouton – it triggers an immune response by producing autoantibodies that attack the lining of the small intestine. Damage to the tissues of the small intestine prevents nutrients from being properly absorbed by the body, which can lead to malnutrition, infertility, lactose intolerance, and even cancer. While some people are asymptomatic, there are 300 known symptoms of celiac disease. To be diagnosed with celiac disease, you will need to submit to a blood test, and if antibodies in your blood indicate you have this condition, you will need to undergo an endoscopic biopsy to confirm a diagnosis.
Also an immune system response, wheat allergies occur when the body reacts to one or more wheat proteins as if they were harmful. But, unlike celiac disease, wheat allergies do not cause damage to the intestines and its symptoms are in line with other allergic reactions: sneezing, runny nose, nausea, rashes, bloating, and watery eyes. Wheat allergies can be diagnosed through a skin test or a blood test.
The least understood of the gluten-related disorders is gluten intolerance, or more formally, non-celiac gluten sensitivity. While it shares many of the symptoms of celiac disease, gluten sensitivity doesn’t incite inflammation in the small intestine. Unfortunately, there are no reliable tests to determine gluten sensitivity and it is only diagnosed once celiac disease and an allergy to wheat have been ruled out first.
Symptoms of Gluten Intolerance
Researchers believe that, of the gluten-related disorders, non-celiac gluten sensitivity is the most prevalent, affecting up to 6% of the population. It is more common in women and in young to middle-aged adults.
The symptoms outlined below usually occur after eating gluten-rich foods, will subside when gluten is eliminated from the diet and will return if gluten is once again consumed:
1. Digestive Issues
Occurring in 68% of cases, abdominal pain is by far the most common symptom of gluten intolerance. It can include one or more of the following: stomach cramping and pain, feeling bloated and gassy, diarrhea, nausea, and constipation.
2. Skin Problems
Irritated and inflamed skin is another sign of gluten sensitivity, occurring in about 40% of patients. It may manifest itself as eczema (red, itchy, dry skin) or erythema (rashes, bumps, and lesions).
3. Chronic Headaches
Intense throbbing or pulsing pain in one area of your head after eating is also indicative of sensitivity to gluten.
4. Unexplained Fatigue
When the body isn’t properly absorbing vitamins and nutrients from food, this can often lead to chronic fatigue.
On the flip side, a sensitivity to gluten can also be marked by an unusual increase in activity: being in constant movement, acting impulsively or aggressively, as well as being easily distracted.
Nutrient deficiencies are not an uncommon side effect of gluten intolerance and anemia – or an iron deficiency – co-occurs in about 20% of people who are unable to properly digest gluten.
Loss of interest, feelings of hopelessness, low energy, changes in sleep, mood swings, and anxiety have been linked to people suffering from gluten intolerance.
8. Bone and Joint Pain
Eating gluten-laden foods when you have sensitivity can cause inflammation to rear its ugly head and cause a myriad of aches and pains throughout the body.
9. Brain Fog
A type of mental fatigue, the “clouding of consciousness” denotes a decline in awareness of oneself and one’s environment in the mind. Inattentiveness, forgetfulness, confusion, and an inability to “think straight” are among the signs of this mild cognitive impairment.
10. Numbness in Hands and Feet
Temporarily losing feeling in the hands or feet on occasions where pressure on nerves causes a part of the body to “fall asleep” is perfectly normal. However, in 20% of cases of gluten intolerance, numbness in the body’s extremities persists and has no obvious cause.
11. Muscle Spasms
Malabsorption of minerals – particularly potassium, magnesium, and calcium – can cause sudden, involuntary muscle contractions.
Defined as a lack of muscle control during movement, ataxia is an irreversible neurological condition that affects balance and coordination. Gluten ataxia occurs when antibodies mistakenly attack the cerebellum, the part of the brain responsible for motor control. It can present itself as slurred speech, involuntary eye movements, difficulty performing fine motor skills (such as writing or buttoning a shirt), an unsteady walk, and troubles swallowing.
13. Unexplained Weight Loss
Another effect of gluten intolerance is a sudden or gradual loss in body mass, despite eating habits staying the same, and is likely due to nutrient malabsorption.
14. Canker Sores
Canker sores – small lesions in the inner cheek and gums – are another sign of undiagnosed celiac disease or gluten intolerance.
There is evidence that gluten sensitivity may be an underlying cause of fibromyalgia – a condition characterized by widespread musculoskeletal pain, sleep disturbances, fatigue, memory and thinking impairments, and depression. A small study involving 20 fibromyalgia patients found that all symptoms improved dramatically after consuming a gluten-free diet over the course of several months. Furthermore, when eight of the patients in the study began consuming gluten when they began to feel better, they experienced a complete return of symptoms. Eliminating gluten from their diets once again brought their fibromyalgia back into remission.
16. Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) shares many of the gastrointestinal symptoms of both celiac disease and non-celiac gluten sensitivity, and for some patients with IBS, symptoms have improved while on a gluten-free diet. One study (link opens a PDF) found that 40% of IBS patients who subsisted without gluten experienced significant reductions in abdominal pain, bloating, fatigue and had much better stool consistency.
The Final Word
Bear in mind that many of these symptoms are non-specific, meaning that they are not exclusive to gluten intolerance and are present in many other diseases and conditions.
If you suspect you are suffering from an intolerance to gluten, see your doctor before attempting to eliminate gluten from your diet since gluten needs to be present in your body to obtain accurate blood tests for celiac disease and wheat allergies.
According to a survey by The NDP Group, one in three Americans believe that going gluten-free is generally healthy, regardless if you have a sensitivity to gluten. As it stands, there is no evidence that gluten is inherently bad for us, and going gluten-free “just because” can actually be detrimental to health.
Cutting out all gluten-based foods without the supervision of a physician or nutritionist can lead to a loss of valuable nutrients and an increased intake of sugars and fats. And, as with any elimination diet, it can be inconvenient, difficult, and costly to maintain. Going gluten-free will also require a lot of hypervigilance because there are an abundance of foods that contain gluten beyond the more obvious cereal grains.