Best Test for Gluten Sensitivity a GF Diet Trial, New Journal Article Says

by Melissa Diane Smith

A group of Italian researchers has written in the most clear medical language so far that non-celiac gluten sensitivity exists and affects many more people than celiac disease. But gluten sensitivity lacks definitive blood tests to diagnose it, so the best test right now to determine it is seeing if there is relief in symptoms from a gluten-free diet trial.

In a recent article in Clinical Reviews in Allergy and Immunology, the researchers wrote:

Until only a few years ago, almost the whole of the scientific world maintained that gluten would provoke negative effects only in celiac disease and in cases linked to IgE-mediated [gluten or wheat] allergies, both of which are rare in adults and more frequent in the pediatric population. For this reason, patients who complained of abdominal symptoms (abdominal discomfort or pain, bloating or  abdominal distention, diarrhea) associated with wheat ingestion but who presented normal values of anti-tTG autoantibodies and absence of villous atrophy, or normal value of IgE against gluten or wheat, were counseled to continue to consume gluten because gluten was not considered as the cause of the symptoms. More recently, however, progress has been made toward the hypothesis that a form of gluten intolerance exists that’s different from celiac disease, defined as non-celiac gluten intolerance or gluten sensitivity, and it is estimated for every person who has celiac disease, there are at least six or seven people who have gluten sensitivity…

Experimental evidence, laboratory evidence, and clinical evidence all support gluten sensitivity that is not celiac disease. The researchers write:

…it appears the gluten sensitivity exists distinctly from celiac disease although it lacks definite criteria for a diagnosis. Until now, in the absence of one or more specific markers, once celiac disease has been excluded, the best available test for diagnosing gluten sensitivity is the “gold standard” of food sensitivity, e.g., gluten elimination diet for 2-3 months. If, with the gluten-free diet, remission of symptoms is obtained, a definitive demonstration of gluten sensitivity can be counted if the symptoms reappear upon open challenge (gluten reintroduction).

The evidence points to the idea that celiac disease and gluten sensitivity are distinct entities and that the immune system deals with gluten in different ways, possibly depending on genetic factors, the researchers say.


Bizzaro N, Tozzoli R, Villalta D, et al. Cutting-Edge Issues in Celiac Disease and in Gluten Intolerance. Clinical Reviews in Allergy and Immunology, Epub edition, 2010 Dec 23, DOI: 10.1007/s12016-010-8223-1.

Melissa’s Comments:

It’s nice to see this information so clearly spelled out in a major medical journal! We’ve reached a time when it’s not just me and a handful of other practitioners saying believe your body more than existing tests! Now medical journals are saying the same thing!

If your doctor is dismissing the idea that you’re gluten sensitive because you test negative on standard celiac blood tests, don’t take his word for it. Look at what medical journals like this one are saying. A gluten-free diet trial is the best test. That’s all you need to know. If you want to give the latest information to your doctor, just print out this article and hand it to him.

The most important thing is not whether your doctor is convinced that gluten sensitivity is real and is best determined by whether you respond positively to a gluten-free diet. The most important thing is for you to be convinced, so you can take matters into your own hands and improve your health.

Are you ready to trust what your body is telling you and take the leap into gluten-free living for good? Get my books Going Against the Grain and Gluten Free Throughout the Year to help you do just that.

Copyright © 2011 Melissa Diane Smith

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