Gluten Sensitivity

Your Guide to Understanding Gluten Sensitivity

Gluten sensitivity is now the biggest issue in the world of gluten intolerance. It might even currently be the biggest issue in the food industry! It certainly is far more common than celiac disease, yet it remains poorly understood.

If you react to gluten, then it is likely that you have a gluten sensitivity. But what exactly does that mean? And how is it different from any other reaction to gluten? Or is it different at all?

What is gluten sensitivity?

Gluten sensitivity really means exactly what it says. Anyone who is sensitive to gluten has a gluten sensitivity. However, most of the time when you see the words “gluten sensitivity,” people are referring to gluten reactions other than celiac disease.

Celiac disease is a very specific kind of damage caused in some people when they eat gluten. It can only be diagnosed by certain blood tests or by a gastroenterologist who sends a scope down through your mouth and into your small intestine. If this damage is not found, then you do not qualify for the diagnosis of celiac disease.

However, it’s important to realize that celiac testing does not rule out gluten sensitivity. These are two related but separate issues. The reason that this is so confusing is because doctors frequently imply that if you do not have celiac disease, you do not have a problem with gluten. This is completely false.

Only a small percentage of people who react to gluten have celiac disease. Millions more people react to gluten even though they don’t have a celiac diagnosis. These people have what has become known as gluten sensitivity or, more specifically, non-celiac gluten sensitivity (NCGS). Most people leave off the “non-celiac” part and just call it gluten sensitivity.

What symptoms are caused by gluten sensitivity?

This is one of my very favorite topics, because so many people make assumptions about the symptoms related to gluten sensitivity. I have tested thousands of people for it and have diagnosed hundreds of cases. And there is only one thing that they all have in common: when they walk into my clinic and tell me about their symptoms, I have no idea whether or not they have a gluten sensitivity until I test them for it. No kidding. I can’t tell a thing from their symptoms.

Why is that? Because there is no one symptom that defines a gluten sensitivity. In reality, there are many different symptoms that someone with a gluten sensitivity may have.

Digestive problems? Maybe, but not always. And if they do have digestive problems, is it diarrhea? Not necessarily. It could be constipation. Or just gas. Or just abdominal pain. Or it could be heartburn or even nausea and vomiting. But many people with gluten sensitivity don’t have any digestive problems.

Fatigue? This is fairly common, too, but certainly not a hallmark of gluten sensitivity. Chronic anemia? Sometimes. Brain fog? That’s another possibility. What about joint pain? Headaches? Both can certainly happen in gluten sensitivity.

How about skin problems such as acne, eczema, psoriasis, or itchy skin? All are relatively common, but they aren’t consistent from one patient to the next.

The list goes on and on. Neurological problems? Check. Behavioral issues? Check. Emotional problems? Yes. Malabsorption of nutrients? Definitely.

If you can think of a health problem, then there is a chance that a gluten sensitivity could be causing it. You can’t rule it out until you’ve actually ruled it out.

How do I know if I’m sensitive to gluten?

Figuring out whether or not you are gluten sensitive is a very sensitive topic. As I noted earlier, most doctors aren’t familiar with this issue. Doctors don’t especially like not knowing things, and they rarely admit when they don’t know something. So you may find yourself on your own when it comes to figuring out whether or not you have gluten sensitivity.

Having to sort this out on your own isn’t as bad as it sounds. You have a lot more knowledge about your body and your health than you probably realize. And most importantly, you know how you feel.

The first thing you should do is stop eating gluten. For how long? That’s highly debatable, because some people will feel better within three days, and for others it could take three months or even longer.

But most people will know within a month or so whether or not they are feeling better. If you feel better when you avoid gluten, then you feel better when you avoid gluten. That may sound repetitive, but it never ceases to amaze me how many people I meet who don’t trust their experience of their own health.

I’ll give you an example. I recently spoke at a gluten-free expo and one of the audience members asked me if she should eat gluten again. She wanted to do this so that she could get tested for celiac disease. I asked her how she felt when she eats gluten and she responded with an emphatic, “I feel horrible.” She didn’t want to eat gluten, but she felt that she should get tested to see if she had a reaction.

I then asked her what she would do if she got tested and the lab work came back negative. Would she eat gluten again? She did not have an answer for me. She was seriously considering that she might reintroduce gluten into her diet, even though she felt horrible when she ate it!

Unfortunately, she is not alone. I have heard the exact same thing many times in my career. You might call that behavior insane, but at the very least it’s sad when people can’t trust themselves to know how they feel. And it’s even worse when the medical system doesn’t support you by believing you.

If you stop eating gluten and you feel better, that is fantastic! I encourage you to continue feeling good! You have a gluten sensitivity. Avoid gluten and live a much healthier and happier life.

Are there tests for gluten sensitivity?

Let’s assume that avoiding gluten hasn’t made much difference in how you feel. Or maybe you think that you couldn’t possibly avoid gluten (you can, trust me) unless a medical professional tells you that you have to avoid it. What then?

Or what if you’ve been tested for celiac disease but the test results were negative? How do you know if you have a gluten sensitivity? Fortunately, there are tests that can help you sort this out. Unfortunately, most doctors don’t offer these tests. However, having run thousands of these tests, I can tell you with great certainty that they are extremely helpful for diagnosing gluten sensitivity.

It’s important for me to point out that not everyone is sensitive to gluten. I’ve met many people who assume that everyone has a gluten sensitivity. It’s certainly a far bigger problem than celiac disease, and it affects tens of millions of Americans, but it’s not the majority of Americans.

How do I know this? Because I test all of my patients for gluten sensitivity. Yes, you read that correctly. ALL of my patients. And I have for 15 years. How do I do it? With blood tests.

Gluten sensitivity blood tests are much like celiac blood tests, except that instead of looking for one particular type of damage, they look at a much bigger picture. These tests measure whether or not your immune system is reacting to gluten. Although you may assume that celiac tests do the same thing, they do not.

People who are gluten sensitive will have IgA or IgG antibodies against gluten. These can be measured in the blood. Most people do not have antibodies against gluten, but for the millions who do, they have a problem – and we call that problem gluten sensitivity.

As with celiac testing, if you are already avoiding gluten, then you’d have to start eating gluten again for at least a month and maybe longer in order to get an accurate test result. That may not be worth it.

How much gluten can I eat if I have a gluten sensitivity?

This is the area where I see the most confusion. Humans – being the savvy and creative creatures we are – like to take advantage of every loophole that we can find. And since the medical system is still way behind when it comes to gluten sensitivity, many people assume it’s not as important as celiac disease. In assuming that, they also assume they don’t have to take the diet as seriously.

I can tell you from experience that gluten sensitivity can easily be as important as celiac disease. People who are gluten sensitive always benefit from 100 percent avoidance of gluten. Anything less is cheating yourself of the benefits of being as healthy as possible.

Don’t lament not being able to eat gluten. Enjoy feeling good! There are millions of people who wish they knew how to feel better. If you are sensitive to gluten, you have found the key to your health. Rejoice and run with it. It will pay dividends for the rest of your life.

Dr. Stephen Wangen is the award winning author of Healthier Without Wheat. He is co-founder and Medical Director of the Irritable Bowel Syndrome Treatment Center (, the first clinic of its kind in the nation. Dr. Wangen, gluten-free himself, is an internationally recognized speaker and writer.

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