Celiac disease is an autoimmune disorder that causes damage to the small intestine when gluten is ingested. Gluten is a protein found in wheat, barley and rye. When someone with celiac disease eats gluten, their immune system reacts by attacking the small intestine. This damages the villi, which are small finger-like projections that line the small intestine and absorb nutrients from food. Damaged villi lead to poor nutrient absorption, causing symptoms like diarrhea, abdominal pain, bloating, weight loss, fatigue and anemia. The only treatment for celiac disease is following a strict lifelong gluten-free diet. This means avoiding foods and drinks containing wheat, barley, rye and sometimes oats.
Should celiacs avoid alcohol?
Many types of alcohol are made from gluten grains and are not safe for people with celiac disease. However, there are some gluten-free alcohol options that are considered safe in moderation. Here is a breakdown of what celiacs should avoid when it comes to alcohol:
Avoid:
- Beer – Most beer is made from barley and is not gluten-free. Some specialty gluten-removed or gluten-reduced beers may be okay in moderation for some celiacs, but they are risky due to potential cross-contamination.
- Wheat beers – These contain high levels of gluten and should be avoided.
- Grain alcohols – Bourbon, whiskey, scotch, rye and grain vodkas are made from gluten grains and unsafe for celiacs.
- Flavored alcoholic beverages – These often contain undisclosed barley or wheat-derived ingredients.
- Coolers and ciders – Malt beverages and hard ciders contain gluten.
- Wine coolers – These frequently have added barley malt.
- Communion wafers – These thin unleavened bread wafers served at Communion contain wheat.
Generally Safe in Moderation:
- Wine – Most wine is made from grapes and is gluten-free. Be sure to check labels for additives.
- Distilled spirits – Vodka, gin, rum and tequila are generally gluten-free, but check labels.
- Gluten-free beer – Sorghum, buckwheat or gluten-free grains. Verify gluten-free status.
- Hard liquor – Brandy, cognac and champagne are safe if gluten-free.
- Gluten-removed beer – Verify gluten ppm is under 20 ppm.
Even though these types of alcohol are gluten-free, those with celiac disease should still drink in moderation. Alcohol can irritate the digestive tract, potentially worsening symptoms and intestinal damage. Heavy alcohol use also leads to poor absorption of important nutrients.
Cross-contamination Risks
Cross-contamination is a concern when choosing gluten-free alcohol options. If the alcohol is produced at a facility that also handles gluten-containing grains, it could pick up traces of gluten during production. This is especially true for beer. Here are some tips to avoid cross-contamination when selecting gluten-free alcohol:
- Check manufacturer websites for information on dedicated gluten-free facilities and protocols.
- Look for a certified gluten-free label from organizations like the Gluten-Free Certification Organization (GFCO).
- Ask your bartender at restaurants about ingredients and preparation procedures.
- Check your alcohol with a home gluten testing kit if concerned about contamination.
- Stick to sealed bottles and cans whenever possible rather than draft beer.
- Inform facilities of your celiac disease and work with knowledgeable staff.
- Contact the manufacturer with any gluten-free labeling questions.
Being diligent about verifying gluten-free alcohol and cross-contamination risks is important to avoid accidental exposure for celiacs. When in doubt, avoid.
Gluten-Free Mixers
Beyond the type of alcohol itself, celiacs also need to consider mixers and garnishes with gluten-free cocktails and drinks. Here are some gf-friendly options:
- Fruit juices – Orange, cranberry, pineapple juice.
- Sodas – Sprite, ginger ale, seltzer water.
- Purees – Muddled berries, peach, mango or other fruits.
- Syrups – Grenadine, simple syrup.
- Dairy – Lactose-free milk, coconut milk.
- Fresh fruits/herbs – Cucumber, mint, lime, lemon.
- Olives, pickled veggies – No batter coatings.
- Salt, pepper, spices – Ensure no maltodextrin.
Avoid malt beverages, beer or ale as mixers. Also double check flavored syrups, garnishes and citrus wedges for cross-contamination. When ordering at a bar, ask about ingredients and preparation. It’s safest to request gluten-free mixers and garnishes.
Effects on Health
Moderate alcohol consumption is thought to have some health benefits, including improved cholesterol levels and reduced risk of heart disease and diabetes. However, those with celiac disease should be cautious about potential added health effects of alcohol. Here are some considerations:
- Can exacerbate liver problems – Some celiacs have concurrent liver issues, alcohol can make this worse.
- Impact nutrient absorption – Alcohol impacts the digestive tract’s ability to absorb vital nutrients.
- Severe reactions – Some react strongly even to vodka or gluten-removed beer.
- Drinking on an empty stomach – Can cause blood sugar spikes and drops.
- Can increase intestinal permeability – May cause leaky gut symptoms.
- Interacts with medications – Consult your doctor.
- Masks symptoms of gluten exposure – Avoid using alcohol to self-medicate.
Those newly diagnosed with celiac disease should take special precaution, as the intestines are more vulnerable right after eliminating gluten. It’s ideal to avoid alcohol in the first 3-6 months after diagnosis to allow healing. After that, moderation is key. Limit drinks to 1-2 per day for women and 2-3 for men at most.
Types of Alcohol Celiacs Should Avoid
To summarize, here are the key types of alcohol that are unsafe for people with celiac disease:
Beer
Nearly all conventional beer contains barley malt, making it unsafe for celiacs. Gluten-removed beer may be tolerated by some in moderation, but has risks. Most mainstream beers have gluten and must be avoided completely, including:
- Ales
- Lagers
- Pilsners
- Stouts
- Porters
- Wheat beers
- Malt beverages
Look for beers verified gluten-free and avoid beer unless 100% confident it is celiac-safe.
Grain Alcohol
Grain alcohol refers to distilled spirits derived from gluten grains. These include:
- Bourbon
- Whiskey
- Scotch
- Rye
- Grain vodka
As the gluten protein is distilled out, some celiacs may be able to tolerate these in moderation. However, there is still a risk of contamination. Opt for spirits derived from grapes, potatoes or sugar cane instead.
Flavored Alcoholic Beverages
These trendy flavored malt beverages, wine coolers and ciders may seem harmless, but often contain hidden sources of gluten, including:
- Flavored vodka and rum drinks
- Hard lemonade, hard iced tea, wine coolers
- Hard ciders
- Coolers
- Pre-mixed cocktails
Always check labels carefully for gluten-based ingredients. Avoid ambiguous flavorings like “natural flavors” that could potentially indicate gluten. Opt for pure distilled spirits with fruit juice or gluten-free mixers.
Communion Wafers
For Catholics with celiac disease who wish to partake in Holy Communion, the thin unleavened bread wafers served are not safe. Even wafers with the lowest amounts of gluten can damage the intestines. Work directly with your church to find a gluten-free alternative that aligns with traditions and religious doctrine.
Safe Gluten-Free Alcoholic Drinks
While being vigilant about avoiding gluten is necessary when living with celiac disease, it is still possible to enjoy an occasional drink safely. Here are some of the best gluten-free alcoholic beverage choices:
Wine
Most wines are produced from grapes and are inherently gluten-free. Some exceptions include certain dessert wines, flavored wines, and wine coolers. Always double check labels for ingredients. Standard red, white, rosé, sparkling and dessert wines are generally safe.
Vodka
Distilled from potatoes, vodka is safe for celiacs as long as no gluten additives are present. Opt for reputable brands and always check the label for other ingredients. Vodka sodas with gluten-free mixers make a simple gluten-free cocktail.
Rum
Most rums are distilled from sugar cane molasses and safe for those with celiac disease. Flavored rum may contain undisclosed ingredients so opt for plain rum. Fun gluten-free drinks are rum and coke, mojitos or daiquiris.
Tequila
Derived from the blue agave plant, most pure tequila is gluten-free. As with other spirits, steer clear of flavored tequila drinks and opt for 100% agave tequila. Margaritas are a popular gluten-free cocktail choice.
Gin
This classic spirit is usually distilled from juniper berries and other botanicals, making it a gluten-free choice. Be sure to avoid any flavored gins that may contain malt additives. Gin and tonics are a tasty option.
Gluten-Free Beers
Sorghum, buckwheat, rice or corn-based beers are options for celiacs, but double check gluten content. Due to production processes, even gluten-removed beers can be risky. New craft gluten-free beers made in dedicated facilities are safest. Drink in moderation.
Hard Cider & Wine
Some hard ciders and fruit-based wines are gluten-free, like those made from apples or grapes. But avoid malt beverages. As usual, check labels closely for gluten-free verification.
Liquor & Liqueurs
Most vodkas, gins, rums and tequilas are safe. Brandy, cognac and champagne are also gluten-free alcoholic picks. Flavored liqueurs may have undisclosed ingredients so opt for flavors made with fruit, herbs or sugar rather than grains.
Being Cautious
While there are definitely gluten-free alcoholic options available for celiacs, being overly cautious is advised. Trace amounts of gluten can trigger reactions in sensitive individuals. Exposure to gluten through cross-contamination poses a serious risk when dining out or choosing specialty beverages.
The best approach is to research brands extensively, ask questions when ordering out and know your personal tolerance levels. While it may seem limiting, taking precautions allows those with celiac disease to enjoy an occasional drink safely and responsibly.
