Ask Dr. Julie / Health / Health & Wellness / Healthy Eating

Got Celiac or You’re Not Sure?…A Quick 411 on the Basics of Gluten Sensitivity

Celiac disease is something that is getting a lot of press in recent years. So, how do you know if you have it?

There a few ways that celiac disease can be diagnosed. Two most common ways are:

One is via endoscopy and colonoscopy and your doctor would take a biopsy and send it in for evaluation.

Another option is to check blood levels of celiac disease antibodies. These are immune markers that show that your own body is reacting to the substance gluten that you are exposed to. What’s important to keep in mind is to have your doctor check your baseline immune cells so that if it’s running low level, your doctor will need to interpret the celiac results with a grain of salt since if your baseline immune levels are low, a high normal or low/borderline level might actually be positive. So have your doctor check.

If you have celiac disease, that means that your body is already seeing cellular and physiological changes because of the gluten and you should avoid that.

Another version of gluten intolerance is when you are sensitive to gluten and your body has symptoms or reactions to gluten but you have not developed cellular change or any antibodies. Gluten sensitivity is not the exact same thing as celiac disease but in both cases, you should avoid gluten if your body is not reacting well to it.

Many people think gluten is only in bread and pasta but that’s not true. There is gluten in even things like ketchup and mustard and soy sauce and many other foods that are prepared with flours or other ingredients. So, the important thing is to make sure that you ask at restaurants and when you buy foods to ask and make sure that the foods are gluten-free and read labels of products you’re buying; it needs to say gluten-free. If you’re not sure, check with the store salespeople or your doctor.

There is a common misconception that all gluten-free foods are healthier.

That is NOT true.

Many of the gluten-free foods have extra sugar in it since they have to put extra things to make it taste better like extra rice flour or tapioca flour or extra sugar, etc. So, I always tell my patients to try to avoid gluten naturally if they have gluten ingestion issues.

For example, spinach naturally doesn’t have gluten. But, gluten-free crackers are not necessarily healthy because it’s a processed man-made food.

Similarly, quinoa is naturally gluten-free and it has a favorable protein content amount so that it’s not sugary. It’s a healthy alternative to gluten-containing grains like wheat and barley. Those with gluten problems should avoid wheat and barley, but other safe options are corn, polenta, potatoes, and rice.

Many of my patients ask about how extreme they need to be about avoiding gluten if they have celiac disease versus being gluten-sensitive.

For those with celiac disease, because they already have antibodies, my general recommendation is to avoid gluten wherever and whenever they can in anything that their body comes into contact with.

For those without antibodies and those who have negative biopsies from gastroenterological work up but they don’t feel well or have gut issues when they eat gluten, try to avoid it whenever you can but you don’t have to worry as much about gluten in shampoos, lotions, etc. Having said that, if you can avoid it, it’s best that you do but if it’s too costly, the most important part is to avoid ingestion if you know gluten bothers you.

At the end of the day, this issue should be discussed with your doctor. You should confide your concerns with your doctor so he or she can work you up and help guide you in your decisions on what your best course of action should be in optimizing your health and minimizing food sensitivity exposures.

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