Should You Go Gluten-Free Even If You Don’t Have Celiac Disease?

By Brierley Wright, M.S., R.D., "Ask our Nutritionist,"September/October 2011

The bottom line on a gluten-free diet and celiac disease from EatingWell's Nutrition Editor.

Should you go gluten-free? Not without checking in with your doctor first. It’s important to test for celiac disease. If you test negative, but you are experiencing gastrointestinal symptoms (bloating, cramping, diarrhea, constipation) after eating wheat, rye or barley you could be “sensitive” to the gluten protein in them. The GI symptoms of “gluten sensitivity” (aka “gluten intolerance”) and celiac disease can be similar but, according to new, preliminary research published in the journal BMC Medicine, the immune system’s response is quite different.

With celiac disease, the immune system essentially targets the small intestine, flattening the tiny fingerlike projections, called villi, that line the gut and absorb nutrients from food, which can lead to malnutrition and weight loss. With gluten sensitivity, the immune system responds in a more urgent, nonspecific way—which is why people with gluten sensitivity have also reported having a “foggy mind,” depression, ADHD-like behavior, skin rash, anemia, joint pain and numbness in arms, fingers or legs. “Think of [the immune response of gluten sensitivity] as a SWAT team that responds immediately to any perceived threat and [that of celiac as] the investigative team that comes later with a long-term response,” says Alessio Fasano, M.D., study author and director of the University of Maryland Center for Celiac Research.

If you think you have a gluten sensitivity, speak with your doctor before eliminating gluten from your diet. A gluten-free diet is the only treatment recommended, but you should get tests for celiac and other forms of intestinal inflammation before changing your diet.