According to the National Foundation for Celiac Awareness, as many as 18 million Americans have some form of gluten intolerance. Could you be one of these people? Here are three questions you should ask before you consider going gluten-free.
Question One: Do you have any of these symptoms?
The blogger Gluten Dude created this graphic summarizing the symptoms of Celiac Disease and gluten intolerance. If you have any of these symptoms, especially the symptoms in red, you should consider being tested.
The National Foundation for Celiac Awareness maintains a list of medical conditions associated with Celiac Disease. Celiac Disease is related to a number of other conditions, including migraines, Type 1 Diabetes, osteoporosis, thyroid disease, rheumatoid arthritis, anxiety, depression, and unexplained infertility. If you have any of these conditions or if you have a family history of any of these conditions, you should consider being tested for Celiac Disease.
Question Two: Do you need a medical test?
Dr. Rodney Ford, author of The Gluten Syndrome, has an extremely helpful handout that explains the blood tests for Celiac Disease and Gluten Intolerance. I have had clients print out this list and take it to their doctor when they wanted to be screened for gluten issues.
If you have an autoimmune disease or a family history of any disease associated with Celiac Disease, I think it’s important to be screened for Celiac Disease. However, it’s possible for your blood results to be “positive” for an immune reaction to gluten but “negative” on the tests for intestinal damage. Although this means you (probably) don’t have Celiac Disease, that’s the pattern that is being called non-celiac gluten intolerance. There’s a lot of controversy around this issue, because even some medical doctors disagree whether people who don’t have Celiac should adhere to a gluten-free diet. Here’s one point of view: Whether you have Celiac Disease or gluten intolerance, the treatment is the same: a gluten-free diet. Does it matter if your test results say you have one or the other? The treatment is the same.
There are some people who choose to forego medical testing all together. These people will try eating gluten-free as an experiment, and see how they feel, without medical testing. People differ greatly in their need for a medical diagnosis around gluten issues. If you remove gluten from your diet and you feel better, do you need a medical test to prove it? Only you can answer that for yourself.
Before you decide to forego the testing route, there’s one important thing about the blood testing that you should know. The standard blood tests for gluten intolerance require you to be eating gluten for the test to be accurate. If you go gluten-free without testing and later decide that you want to be tested, you will have to go back on eating daily gluten for at least six weeks before your results will be valid. There are a lot of people in the gluten-free community in this position- they would like to go back and be tested, but they cannot put themselves through the discomfort of a six-week gluten challenge. If you think gluten is a problem for you, I hope you will seriously consider having the blood tests run before experimenting with the gluten-free diet. If you respond well to a gluten-free diet, you may not want to go back.
If you won’t listen to me, listen to Erica, author of Celiac and the Beast:
I cannot urge you ENOUGH to get properly tested for celiac disease before going gluten-free. There are too many people who are preaching the fad dieting aspect of living gluten-free that it is actually hurting people getting properly diagnosed for celiac disease.
Question Three: Are you willing to commit to being 100% Gluten-Free?
There is no such thing as a “low gluten” diet. For people with Celiac Disease, it’s a medical necessity to eat 100% gluten-free all the time. Even when they don’t have any symptoms, gluten is silently damaging their bodies and putting them at increased risk for disease and death. For a person with Celiac Disease, cheating with gluten is like eating poison.
It might seem a little different for people with gluten intolerance. They may feel that they can “get away with” eating gluten some of the time, because they don’t always react badly to it. I think that if you decide to go gluten-free, you should seriously consider whether you can make the commitment to going completely gluten-free.
For most other diets, it’s possible to be successful by following the 80% rule. If you can stick to the diet 80% of the time, you will be successful. But when we are talking about damage to your intestines and immune reaction in the body, I’m not sure why you would want to damage your intestines and cause your immune system to react 20% of the time. That’s why I think the 80% rule doesn’t work for the gluten-free diet. When gluten is a problem for you, you’re going to react to it whenever you eat it, even if you cannot feel the damage.
There’s also a larger social issue related to cheating with gluten. When you request a gluten-free meal in a restaurant, you’re asking for some specific special treatment that’s actually pretty difficult for them to comply with. When your server sees you eating from the bread basket or having a bite off of someone else’s plate, they get the impression that this gluten-free stuff isn’t really serious. Why should the restaurant go through all the effort to make sure your food does not come in contact with gluten in the kitchen when you’re going to dip your fork in it at the table? For people with Celiac Disease, it’s hard enough for them to receive a safe meal in a restaurant. It actually hurts the gluten-free community when you cheat, making it more difficult for everyone to get a truly gluten-free meal.
A gluten-free diet might be the right diet for you. Or it might not. At least now you are informed. You know what gluten is, and you know what questions to ask. There are about a gazillion gluten-free resources on the web… I have barely touched on them. I have been living gluten-free for over seven years. I’m more than happy to help you decide whether gluten-free is the right path for you.
This post is Part Two of my series about the gluten-free diet. Part One discusses the difference between Celiac Disease and Gluten Intolerance, and whether the gluten-free diet will help you lose weight.