Surprising Things You Probably
Don’t Know about Gluten Sensitivity

by Melissa Diane Smith

Non-gastrointestinal symptoms are far more common than you might think.

When Miranda Hughes told her friends what a huge difference a gluten-free diet made in her health, her friends assumed Miranda had suffered from digestive troubles – gas, bloating, irritable bowel, diarrhea, or maybe constipation – that cleared up when she stayed away from gluten. But that wasn’t the case. Miranda didn’t have any gastrointestinal symptoms at all.

For Miranda, eating gluten, a protein found in wheat, rye, barley, and most oats, affected her psychologically and neurologically. Very quickly after eating gluten-containing food – i.e., wheat-based bread – she would get a foggy brain, have difficulty concentrating, experience tingly arms and legs, and become depressed. For years, doctors encouraged Miranda to take anti-depressants for the long-term battle she had with low moods. To her amazement she found that when she cut gluten out of her diet, her depression, recurrent lack of mental focus, and other baffling symptoms that she thought she would always have simply went away – and they continued to stay away as long as she strictly avoided gluten.

“I’ve learned firsthand about the incredible health benefits of the gluten-free diet,” Miranda says. “I feel focused, positive, and healthy. The diet has really given me a new lease on life.”

The Prevalence of Non-Digestive Symptoms

The gluten-free diet was initially designed as treatment for people with celiac disease, an autoimmune reaction in the gut to gluten. We now know that the diet is also therapeutic for a much larger percentage of people who have non-celiac gluten sensitivity, a non-autoimmune reaction to gluten that causes symptoms similar to or identical to those associated with celiac disease but that does not lead to the gut damage that characterizes celiac disease.

Perhaps because celiac disease is a reaction to gluten in the small intestine, most people automatically assume that reactions to gluten involve digestive problems. Those types of symptoms are actually the exception rather than the rule. Research has revealed that:

  • Almost 50 percent of new patients diagnosed with celiac disease today do not have gastrointestinal symptoms. In adults, some common presenting symptoms include anemia, bone disease, or neurologic symptoms.
  • Children older than three who are diagnosed with celiac disease are more likely to have nongastrointestinal conditions, including type 1 diabetes, thyroid disease, Down syndrome, iron-deficiency anemia, short stature, or mood disorders.
  • Individuals with non-celiac gluten sensitivity have a prevalence of non-gastrointestinal (GI) symptoms, such as headache, foggy thinking, joint pain, and numbness in the legs.
  • Many other non-GI, gluten-related diseases appear to benefit from a gluten-free diet, including schizophrenia, epilepsy, multiple sclerosis, autism spectrum disorders, and skin conditions including dermatitis and psoriasis.

Gluten Elimination the Best Test

Given the amazingly wide variety of conditions associated with celiac disease and gluten sensitivity, and the fact that there is no definitive medical test for gluten sensitivity, how do you know if the gluten-free diet could be therapeutic for you? Most researchers now agree that the best test is to try eliminating gluten from your diet and see if any of the symptoms you’re experiencing – gastrointestinal or not – resolve. If they do resolve, you have firsthand proof that a gluten-free diet is your best medicine.

One big caution, though: You might not notice a difference in how you feel going gluten free if you have silent celiac disease – a condition in which there is damage to the gut but few or no clear-cut symptoms. If you have a condition that is a common complication of celiac disease, such as iron-deficiency anemia, osteoporosis, infertility, or an autoimmune disease, it’s best to act from a place of knowledge and get the blood tests to screen for celiac disease first before eliminating gluten from your diet. Determining if you have celiac disease or not makes it much easier for your doctor to knowledgeably monitor and effectively treat those conditions.

Copyright © 2013 Melissa Diane Smith

Selected References:

Rampertab SD, Pooran N, Brar P, et al. Trends in the presentation of celiac disease. American Journal of Medicine, 2006;119;355.e9-355.e14.

Sapone A, Bai JC, Ciacci C, et al. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Medicine, 2012;10:13.

Smith MD. Going Against the Grain. New York: McGraw-Hill, 2002.

Telega GT, Bennet TR, Werlin S. Emerging clinical patterns in the presentation of celiac disease. Archives of Pediatric and Adolescent Medicine, 2008;162:164-168.

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