What is gluten intolerance?
Gluten intolerance, also known as non-celiac gluten sensitivity (NCGS), is a condition in which people experience digestive symptoms after ingesting gluten. Gluten is a protein found in wheat, barley and rye. In people with gluten intolerance, the immune system reacts to gluten by causing inflammation in the small intestine. This can lead to symptoms like diarrhea, abdominal pain, bloating and fatigue. Unlike celiac disease, gluten intolerance does not cause long-term damage to the small intestine. However, the symptoms of gluten intolerance can significantly impact quality of life. It’s estimated that 6-10% of the population has gluten intolerance.
What are the symptoms of gluten intolerance?
The most common symptoms of gluten intolerance include:
– Diarrhea
– Abdominal pain
– Bloating
– Gas
– Fatigue
– Headache
– “Brain fog” or trouble concentrating
– Numbness or tingling in hands and feet
– Joint pain
Symptoms typically begin hours or days after consuming gluten. The severity can vary between different people. Some only experience minor digestive discomfort, while others have severe diarrhea and abdominal cramps. Many symptoms are similar to irritable bowel syndrome (IBS), which makes gluten intolerance challenging to diagnose.
What causes gluten intolerance?
The exact cause of gluten intolerance is unknown. There are several theories about what leads to adverse reactions to gluten:
– Increased intestinal permeability – This is also known as “leaky gut.” Gluten may cause temporary increased permeability in the intestinal lining, allowing contents to “leak” into the bloodstream and trigger inflammation.
– Immune system activation – Gluten peptides may directly stimulate the innate immune system and cause release of inflammatory chemicals like cytokines.
– Imbalanced gut microbiome – An altered microbial environment in the intestines may promote inflammation and intolerance to gluten.
– Non-gluten wheat components – Some individuals may react to other wheat components like amylase trypsin inhibitors, which can activate the innate immune system.
– FODMAPs – Gluten-containing grains also contain FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols). These carbs may cause digestive issues in sensitive people.
Genetic factors, stress and gut infections may also play a role in developing gluten intolerance.
How is gluten intolerance diagnosed?
Gluten intolerance can be challenging to diagnose definitively. There are no blood tests or biomarkers available like there are for celiac disease. A doctor will typically diagnose it by:
– Taking a thorough medical history of symptoms and family history.
– Ruling out celiac disease and wheat allergy with specific tests.
– Having the patient trial a strict gluten-free diet for several weeks to see if symptoms improve.
– Reintroducing gluten after a period of elimination to confirm that symptoms worsen again.
This process can help confirm gluten is the trigger for gastrointestinal and other symptoms. A gastroenterologist is the type of doctor who can best evaluate and diagnose gluten intolerance.
Gluten intolerance vs. celiac disease
Although gluten intolerance shares symptoms with celiac disease, there are some key differences:
| Gluten Intolerance | Celiac Disease |
|---|---|
| – Negative celiac disease blood tests | – Positive celiac disease blood tests |
| – No intestinal damage | – Intestinal villi damage |
| – Can consume moderate gluten | – Requires complete gluten avoidance |
| – Not an autoimmune condition | – Autoimmune condition |
| – Symptoms may come and go | – Chronic symptoms |
The biggest distinction is that celiac disease causes autoimmune damage to the small intestinal lining, while gluten intolerance does not. Those with celiac also require a strict 100% gluten-free diet.
What is the treatment for gluten intolerance?
The primary treatment for gluten intolerance is adhering to a gluten-free diet. For most individuals, removing gluten from the diet helps relieve symptoms like diarrhea, abdominal discomfort, and bloating.
Many people find they feel significantly better within a few weeks of going gluten-free. However, it can take several months for the intestines to fully heal for some. Strictly avoiding gluten-containing grains like wheat, barley, rye and triticale is advised. Reading ingredient labels is important, as gluten can hide in many packaged foods.
In some cases, a low FODMAP diet may also be recommended to alleviate digestive symptoms. FODMAPs are certain carbohydrates that can ferment in the gut and cause gas and bloating. Gluten-free replacement foods high in FODMAPs can sometimes exacerbate symptoms.
Identifying and avoiding other food intolerances, like dairy or eggs, may also help improve gastrointestinal symptoms for some individuals. Working with a dietitian knowledgeable about gluten intolerance can help tailor an elimination diet plan to identify problematic foods.
Are supplements helpful for managing gluten intolerance?
While no supplement can fully cure or treat gluten intolerance, some supplements may help manage certain symptoms:
Probiotics: Probiotic supplements contain live beneficial bacteria to help replenish and diversify the gut microbiome. They may reduce inflammation and restore proper gut permeability.
Digestive enzymes: Supplements with digestive enzymes like amylase, lipase and protease can help break down gluten and reduce immune reactions. They are taken with meals.
Deglycyrrhizinated licorice (DGL): DGL supplements contain licorice root extract to help coat and soothe the intestinal lining. This may decrease discomfort from gluten exposure.
Quercetin: This antioxidant flavonoid compound may help stabilize mast cells and reduce histamine release related to food intolerance reactions.
Methyl B12 and folate: These activated B vitamins support energy levels and neurological function which are often impaired in gluten intolerance.
Always consult a doctor before taking supplements, especially if you have underlying health conditions or take medications. While supplements can complement a gluten-free diet, they should not replace medical treatment if needed.
What are the best supplements to take for gluten intolerance?
Some of the top-rated supplements to consider for managing gluten intolerance include:
1. Align Probiotic
– Contains Bifidobacterium lactis bacteria clinically shown to help restore digestive balance
– Can boost immunity and improve gut barrier function
– May reduce bloating, gas and abdominal discomfort
2. Digest Gold Enzymes
– Provides all key digestive enzymes including amylase, lipase and DDP-IV protease
– Breaks down gluten, carbs, fats and proteins for better tolerance
– Reduces immune reactions to undigested foods
3. DGL from Zhou Nutrition
– Uses high quality deglycyrrhizinated licorice (DGL) extract
– Soothes intestinal lining and fights inflammation
– Relieves indigestion, cramping, nausea and heartburn
4. Seeking Health Optimal Quercetin
– Enhanced bioavailability from sunflower-sourced quercetin
– Stabilizes mast cells and reduces histamine release
– Supports healthy immune function and antioxidant activity
5. Pure Encapsulations B12 + Folate
– Activated forms of methyl B12 and folate (5-MTHF)
– Counteracts fatigue and supports energy metabolism
– Essential for neurological health, circulation and red blood cell formation
Always introduce supplements gradually and monitor symptoms to assess tolerance. A comprehensive gluten elimination diet and targeted supplementation can greatly improve quality of life for most with gluten intolerance.
What foods should you avoid with gluten intolerance?
It’s important to avoid all sources of gluten in your diet if you have gluten intolerance. Foods to eliminate include:
– Wheat – bread, pasta, crackers, baked goods
– Barley – beer, malt vinegar, malt flavoring
– Rye – cereals, bread
– Triticale – hybrid of wheat and rye
– Oats – often cross-contaminated with gluten
You should also scrutinize ingredient labels and avoid foods containing:
– Malt
– Modified food starch
– Hydrolyzed vegetable protein (HVP)
– Soy sauce or teriyaki sauce
– Some salad dressings, stock cubes, imitation meats
– Beer and grain-distilled liquor
Since gluten can hide in many unexpected products under vague ingredients, purchasing certified gluten-free foods is recommended when possible. It’s also wise to avoid oats unless they are certified gluten-free, as regular oats are often cross-contaminated.
Being vigilant about gluten avoidance is necessary, but nonetheless, a gluten-free diet can be very healthy, diverse and enjoyable with proper substitutions. There are many natural, nutritious gluten-free options to choose from including fruits, vegetables, lean proteins, dairy, legumes, nuts, seeds and gluten-free whole grains like rice, corn and quinoa.
What are good gluten-free food substitutes?
Adopting a gluten-free diet certainly takes some adjustment, but there are now many tasty substitutes for common gluten-containing foods:
– Gluten-free bread – Look for loaves made with rice flour, tapioca starch, sorghum flour and xanthan or guar gum. Brands like Canyon Bakehouse, Schar and Franz offer good options.
– Gluten-free pasta – Try pastas made from lentils, chickpeas or rice. Barilla and Banza make popular gluten-free pasta varieties.
– Gluten-free crackers – Flackers, Mary’s Gone Crackers and Blue Diamond Nut Thins all offer crunchy gluten-free crackers.
– Gluten-free cereal – Environkidz, Nature’s Path, Kind and Erewhon all produce gluten-free cereals using ingredients like rice, corn and millet.
– Gluten-free baked goods – You can substitute gluten-free flour blends from Bob’s Red Mill or King Arthur in most recipes for muffins, cookies, etc.
– Gluten-free beer – Brands like Omission, Redbridge, Ghostfish and Glutenberg provide gluten-removed and crafted gluten-free beer.
– Gluten-free soy sauce – Coconut aminos are a great alternative to soy sauce in Asian recipes. Or use tamari sauce, which is traditionally gluten-free.
Exploring international aisles can uncover naturally gluten-free items like corn tortillas, rice paper wraps, 100% buckwheat soba noodles and legume-based pastas. Creativity and an open mind for new options are key for success with gluten-free cooking.
What grains are gluten-free?
Many healthy and nutritious gluten-free grains are available, including:
– Rice – Brown, white, basmati, wild, etc. Rice flour is commonly used as an all-purpose gluten-free flour.
– Corn – Whole cornmeal, popcorn, corn flour and masa harina from corn can be used in cooking.
– Sorghum – Sorghum flour and grains offer a hearty, high-fiber and gluten-free choice.
– Millet – Tiny millet grains have a mildly sweet flavor. The flour adds texture to baked goods.
– Buckwheat – Despite the name, buckwheat is gluten-free and has an earthy, nutty taste. Kasha is toasted buckwheat.
– Quinoa – Technically a seed, protein-rich quinoa cooks up fluffy like a grain.
– Amaranth – Similar to quinoa, amaranth is another protein source with a peppery flavor.
– Teff – This Ethiopian grain flour makes a wonderful addition to bread and baking recipes.
– Wild rice – Actually a marsh grass, mineral-rich wild rice adds texture and flavor to meals.
– Oats – Look for certified gluten-free oats to be safely tolerated, if not sensitive to avenin proteins.
Tapioca, arrowroot and nut flours like almond meal can also substitute for wheat flour in recipes. There are endless possibilities for creating delicious gluten-free recipes using alternative whole grains and flours.
What are the health risks if gluten intolerance is left untreated?
Although gluten intolerance is not as severe as celiac disease, leaving it untreated can potentially lead to complications like:
– Nutrient deficiencies – Chronic diarrhea and malabsorption of nutrients can lead to deficiencies in iron, folate, calcium, vitamin D and other nutrients.
– Neurological symptoms – Around 30% of those with untreated gluten intolerance experience issues like depression, anxiety, brain fog and peripheral neuropathy.
– Osteoporosis – Impaired calcium and vitamin D absorption may accelerate bone loss and increase fracture risk.
– Anemia – Iron deficiency is common and can cause anemia, fatigue, weakness and shortness of breath.
– Migraines – There appears to be a link between migraines and gluten intolerance that improves when gluten is removed.
– Skin conditions – About 25% develop issues with skin rashes, alopecia or eczema that clear with a gluten-free diet.
– Lactose intolerance – Damaged villi in the small intestine can reduce lactase and lead to secondary lactose intolerance.
– Autoimmune disease – There is an association between untreated gluten intolerance and developing autoimmune hypothyroidism, rheumatoid arthritis or type 1 diabetes.
The best way to avoid complications down the road is to strictly follow a gluten-free diet and identify other food triggers that may be causing symptoms. Consult your doctor to monitor for nutritional deficiencies or other problems.
What vitamins and minerals should I supplement if I have gluten intolerance?
Some supplements to consider if you have gluten intolerance and malabsorption issues:
– Iron – Required for anemia prevention and oxygen transport. Take 30 mg per day.
– Calcium citrate – Up to 1,200 mg daily depending on dietary intake to support bone health.
– Vitamin D – Crucial for calcium absorption and modulation of immune responses. Take 2,000-4,000 IU.
– Magnesium glycinate – Important for energy, muscle and nerve function. Take 300-400 mg.
– B Complex – All B vitamins help convert nutrients into energy and should be supplemented.
– Vitamin A – Take up to 10,000 IU to maintain eyesight, immune health and skin.
– Zinc picolinate – 30 mg daily helps heal the gut lining and balance immunity.
– Probiotics – Restore healthy gut flora and digestive enzyme production.
Consult your doctor to determine specific dosing based on your lab results and dietary intake. Proper medication and nutrition can prevent nutrient deficiencies.
Conclusion
Gluten intolerance can significantly disrupt quality of life and lead to complications if left unaddressed. Removing gluten from your diet and taking targeted supplements can help control symptoms and prevent long-term issues. Be diligent in reading labels, choosing dedicated gluten-free products and cooking with versatile gluten-free ingredients. With an accurate diagnosis and commitment to a gluten-free lifestyle, you can feel healthy and energized again and reverse the effects of gluten intolerance.
