What are symptoms of gluten allergy or intolerance

Direct-to-consumer test kits are available that test stool or a finger-prick blood sample for various food sensitivities, including gluten. However, the testing methods used own not been proven to reliably identify food allergies, food intolerances, or gluten sensitivity.

Test kits such as Everlywell (pitched on the TV series "Shark Tank") test for IgG antibodies, which are a poor indicator of food intolerance. Allergy professional organizations in Europe, Canada, and the United States warn that numerous people without food allergies or intolerances will test positive with these kits, which could lead to unnecessarily restricting healthy foods and won't assist diagnose a food intolerance.

EnteroLab gluten sensitivity testing is marketed directly to consumers, using a stool sample.

Enterolab's stool testing looks for antibodies to gluten directly in your intestinal tract. However, its testing protocol, developed by gastroenterologist Kenneth Fine, MD, has yet to undergo exterior scrutiny and verification.

What's more, Dr. Fine has come under considerable criticism from other physicians and from people in the celiac/gluten-sensitive community for failing to publish his research and results. As a result, few physicians will accept EnteroLab testing as proof of gluten sensitivity.


Labs and Tests

Before gluten sensitivity can be diagnosed, celiac disease must be ruled out.

What are symptoms of gluten allergy or intolerance

Physicians generally being this process by using a panel of celiac blood tests to glance for the antibodies that indicate the condition. There is some evidence that two of those tests—the AGA-IgA and the AGG-IgG—could indicate non-celiac gluten sensitivity as well. However, there is currently no blood test that is specific for gluten sensitivity.

Alessio Fasano, MD, head of the University of Maryland Middle for Celiac Research, says that the AGA-IgA and AGA-IgG blood tests only serve as surrogates and that there is no specificity there.

The fact that about half of gluten sensitivity patients tested negative for these antibodies makes those two tests much less useful as tests for gluten sensitivity, notes Dr. Fasano.

How Celiac Disease Is Diagnosed


Gluten Sensitivity vs. Gluten Intolerance

Gluten sensitivity is sometimes mistakenly referred to as gluten intolerance. In 2012, top celiac disease researchers met in Oslo, Norway, to develop a standard way of speaking about celiac disease and other gluten-related disorders.

There, researchers sure that gluten sensitivity, not gluten intolerance, is the most precise way to refer to the condition. To study more about the Oslo meeting and the current definitions for conditions related to celiac disease, visit our glossary.


Gluten Sensitivity

Part 3: Family and Related Conditions

Includes answers to:

  1. Does having a family member with celiac disease make you more susceptible to non-celiac gluten sensitivity?
  2. If I own non-celiac gluten sensitivity now, does that mean I would develop celiac disease if I continued to eat gluten?
  3. Are there any conditions that appear to be related to non-celiac gluten sensitivity?

Part 4: Future Areas for Research

Includes answers to:

  1. Does having non-celiac gluten sensitivity increase your risk of developing other autoimmune disorders?
  2. We know that peripheral neuropathy can be associated with celiac disease.

    Is there a similar relationship between non-celiac gluten sensitivity and other neurological conditions?

  3. When will we know more about the long-term complications of non-celiac gluten sensitivity?

If you own been suffering from symptoms after ingesting gluten, it may be possible that you own non-celiac gluten sensitivity (‘gluten sensitivity’ or sometimes referred to as ‘gluten intolerance’).

Gluten sensitivity is a disorder where one cannot tolerate gluten and experience symptoms similar to those withceliac disease yet lack the same antibodies and intestinal damage as seen in celiac disease.

A diagnosis distinguishing between celiac disease, a wheat allergy and gluten sensitivity is significant, a fact highlighted in arecent study showing the impact correct diagnosis has on long-term treatment.

What are symptoms of gluten allergy or intolerance

Your doctor can run the test. It’s significant to not go gluten-free prior to laboratory tests, so that tests for celiac disease can be precise. If your celiac disease tests come back negative but you’re still feeling symptoms you may own non-celiac gluten sensitivity.

Before going gluten-free, finish ourceliac disease symptoms checklist and share the results with your doctor.

Part 2: Testing and Diagnosis

Includes answers to:

  1. How can I get tested for non-celiac gluten sensitivity?
  2. I’m already gluten-free and I feel much better than I did when eating gluten. Can I just assume that I own non-celiac gluten sensitivity?
  3. Are there any dangers to a untrue diagnosis of non-celiac gluten sensitivity?

Common Symptoms of Non-Celiac Gluten Sensitivity:

  1. Headache

  2. Joint pain

  3. Brain fog

  4. Bloating, gas or abdominal pain

  5. Nausea

  6. Numbness in the legs, arms or fingers

  7. Diarrhea or constipation

  8. Fatigue

Learn more aboutNon-Celiac Gluten Sensitivity.

Today we are increasingly hearing terms such as gluten intolerance, wheat allergy and coeliac disease.

On top of this, the words wheat and gluten are often used interchangeably too, even though there is a extremely clear difference between the two substances.

What are symptoms of gluten allergy or intolerance

So what do they actually mean and how are they different?

Gluten is a component of wheat and is also a protein that is found in some other grains too, including spelt, barley and rye. It’s also what gives yeast-based dough its elasticity. Because gluten is found in a variety of grains, people who react to gluten (including those with coeliac disease, which is actually an autoimmune response triggered by gluten, as we’ll see below) need to avoid not only wheat, but also other gluten-containing grains and any foods that contain them.

A reaction to wheat can be completely diverse from a reaction to gluten.

In fact, those with a true allergy to wheat are often not reacting to the gluten, but to some other part of the plant. Researchers own actually identified 27 diverse potential wheat allergens (1), of which gluten is one type. Albumin and globulin proteins may be particularly common triggers (2).

Let’s glance more closely at the difference between wheat allergy, coeliac disease and gluten intolerance.

Other Conditions

A gluten-free diet may also be beneficial for other conditions.

These include inflammatory bowel diseases such as Crohn’s disease and other digestive conditions or symptoms such as irritable bowel syndrome or excessive bloating and gas. There’s increasing evidence that following a gluten-free diet may be beneficial for some people with other types of autoimmune disease too.

Alternatives To Wheat and Gluten Grains and Flours

The following are alternatives that are both wheat and gluten-free: maize (corn), corn flour, potato, potato flour, rice flour, soya beans, soya flour, buckwheat, millet, tapioca, quinoa, amaranth, sorghum, arrowroot, chickpea (gram) flour and lentil flour.

Chickpeas, beans and lentils are excellent fillers and can be added to soups and gravies, while wheat-free pasta and rice noodles are a grand alternative to standard wheat pasta.

«Gluten-Free» and «Wheat-Free» Foods

Now let’s glance at why understanding the difference between these two terms is significant, depending on which of the above conditions/symptoms you may have.

‘Wheat-free’ foods are free from any components of wheat, including other proteins that people with a wheat allergy can react to.

But foods that are just labelled ‘wheat-free’ may still contain other gluten-containing grains or substances derived from them, and are not necessarily gluten-free.

‘Gluten-free’ foods own to be free of gluten from any of the gluten-containing grains (more accurately, they own to contain less than 20 parts per million of gluten – a extremely tiny amount). Once again, these grains include rye, barley and spelt as well as wheat. Oats can also contain little amounts of gluten via contamination from other grains. Therefore oats also need to be avoided on a gluten-free diet, unless they are specifically labelled ‘gluten-free’, indicating that the oats own been processed in facilities that eliminate risk of contamination with gluten.

However, ‘gluten-free’ doesn’t necessarily mean the food is free from other wheat components.

So if you own a wheat allergy and you’re buying packaged or processed foods, it can be wise to glance specifically for ‘wheat-free’ and not just gluten-free – or thoroughly check the ingredients list to make certain the food you’re buying doesn’t contain other wheat components.

Wheat Allergy

A true wheat allergy should not be confused with gluten intolerance or coeliac disease. A food allergy is caused by the immune system producing IgE antibodies to a specific food protein or proteins.

Symptoms tend to happen fairly soon after eating the food, from seconds up to two hours. When the food protein is ingested, it can trigger a range of allergy symptoms from mild (such as a rash, itching, or sneezing) to severe (trouble breathing, wheezing, anaphylaxis). Wheat allergy symptoms may also include abdominal pain, diarrhoea and other digestive disturbances. A true food allergy such as this can be potentially fatal.

Allergy to wheat is thought to be more common in children, who may ‘grow out of’ it before reaching adulthood.

But it can also develop in adults.

Those with a wheat allergy may still be capable to consume other gluten-containing grains; although in some cases these will need to be avoided too.

Gluten Sensitivity/Intolerance

Many people who do not own coeliac disease can still experience uncomfortable symptoms when they consume gluten. This is known as non-coeliac gluten sensitivity or gluten intolerance. Researchers continue to debate just how numerous people are truly sensitive to gluten, but the number has been estimated to be approximately 6% of the population.

As some of the symptoms of coeliac disease, gluten intolerance and even wheat allergy can overlap, it is significant to be tested by your doctor to determine which of these may be causing your symptoms.

In Summary

Understanding the difference between wheat and gluten can assist avoid any unnecessary symptoms that may be brought on by ingesting the incorrect foods.

Confusing wheat and gluten may own less of an impact on people with non-coeliac gluten sensitivity/intolerance, or wheat sensitivity/intolerance, but it can own more serious consequences for those with a true wheat allergy and coeliac disease.

Clearspring’s Range of Gluten-Free Products

The Clearspring promise is to provide great-tasting, yummy foods that support excellent health and provide optimum nutrition.

We desire to give our customers who need to avoid gluten or wheat the chance to own great-tasting food and to be capable to cook with confidence. This has inspired us to launch a range of gluten-free ingredients, from meal staples such as soya protein, rice and vegetable pastas to seasonings, sauces and garnishes. These are tasty, nutritious alternatives perfect for those on a gluten-free diet but equally yummy for the whole family.

Coeliac Disease

According to the Coeliac Society (www.coeliac.org.uk), coeliac disease is a well-defined, serious illness where the immune system attacks the body’s own tissue, when gluten is eaten.

This causes damage to the lining of the little intestine and means that the body cannot properly absorb nutrients from ingested food. Generally diagnosed by a gastroenterologist, it is a digestive disease that can cause serious complications, including malnutrition and intestinal damage, if left untreated. Coeliac disease is not a food allergy or intolerance; it is an autoimmune disease where the sufferer must completely avoid gluten from every grains – not just wheat.

The Coeliac Society states that one in 100 people in the UK is thought to own coeliac disease, but only 24 per cent of these people are diagnosed.

This leaves almost half a million people in the UK who could own coeliac disease but aren’t yet diagnosed (www.coeliac.org.uk/coeliac-disease/myths-about-coeliac-disease).

Reading The Ingredients

If a label on a packaged food doesn’t explicitly state ‘gluten-free’ or ‘wheat-free’ then you may need to glance through the ingredients to check.

What are symptoms of gluten allergy or intolerance

But it’s not enough to avoid anything that lists the expression ‘wheat’ (or when looking for gluten-free products, the words ‘wheat’, ‘barley’, ‘rye’ or ‘spelt’). Products such as gravies, soya sauce, salad dressings and casseroles can contain derivatives of wheat or other gluten grains that are harder to identify and can also be listed under diverse names. The following should every be avoided: durum wheat, spelt, kamut, couscous, bran, wheat bran, wheat germ, farina, rusk, semolina, wheat starch, vegetable starch, vegetable gum, malt extracts, vegetable protein, cereal filler, cereal binder and cereal protein.

References

1.

Sotkovský P et al.

What are symptoms of gluten allergy or intolerance

A new approach to the isolation and characterization of wheat flour allergens. Clin Exp Allergy. 2011 Jul;41(7):1031-43.

2. Mittag D et al. Immunoglobulin E-reactivity of wheat-allergic subjects (baker’s asthma, food allergy, wheat-dependent, exercise-induced anaphylaxis) to wheat protein fractions with diverse solubility and digestibility. Mol Nutr Food Res.

What are symptoms of gluten allergy or intolerance

2004 Oct;48(5):380-9.

Getting a gluten sensitivity diagnosis isn't a straightforward process. Medical research lends support to the thought that non-celiac gluten sensitivity is a genuine condition, but there are physicians who do not believe in its existence. Furthermore, there is no consensus on how to test for gluten sensitivity or what results of tests used by some when working toward a diagnosis actually mean.

Keep in mind that most physicians recommend you undergo celiac disease testingfirst if you suspect you are reacting to gluten.

However, if your celiac disease test results are negative, gluten sensitivity tests may provide you with evidence that your body is mounting a response to gluten.


Could it be FODMAPs?

The science on gluten sensitivity is evolving and we’re learning new information on the condition regularly. New research suggests that gluten alone may not be responsible for the symptoms produced by the condition currently called gluten sensitivity. Instead, it is showing that perhaps FODMAPs, a group of poorly digested carbohydrates, may be the cause of the symptoms instead.

It is also significant to note that wheat, barley and rye — gluten-containing grains — are every high in FODMAPs.

Beyond Celiac encourages you to study about the low-FODMAP diet by downloading the free webinar, “Is Gluten Really the Problem? The Role of FODMAPs in Gluten-Related Disorders,” featuring Dr. Sue Shepherd, the creator of the low-FODMAP diet.


Gluten-Free Diet and Gluten Challenge

Because there is no blood test or other biomarker tests that can diagnose gluten sensitivity, the best method is using a symptom questionnaire and a gluten challenge.

The criteria developed by the Salerno Experts' Panel is primarily used for research, but it can be used in a clinical setting:

  • Eat a normal gluten-containing diet for at least six weeks and rate your symptoms on a numerical rating scale.
  • Go on a strict gluten-free diet for at least the next six weeks (preferably with consultation of a dietitian).

    What are symptoms of gluten allergy or intolerance

    You rate your symptoms weekly. Response to the gluten-free diet is defined as a greater than a 30% reduction in one to three of your main symptoms in at least three of the six weekly evaluations.

  • See your doctor for a gluten challenge: In a research setting, this is done with a double-blind, placebo-controlled crossover challenge. For a clinical setting, it could be single-blinded and you wouldn't know whether you've been given gluten, but the doctor would.

For a gluten challenge, you take a dose of 8 grams of gluten (or placebo) daily for one week while otherwise maintaining your gluten-free diet.

The gluten (or placebo) is provided in an edible such as a muffin, bar, or bread. You report on your symptoms with the questionnaire.

There is a one-week washout period, followed by a challenge again, this time with the opposite dose (placebo or gluten) and reporting of symptoms. Likewise here, if there is a variation of 30% between the gluten and placebo, it can indicate gluten sensitivity. If not, other causes of the symptoms should be explored.

For a gluten challenge, you take a dose of 8 grams of gluten (or placebo) daily for one week while otherwise maintaining your gluten-free diet.

The gluten (or placebo) is provided in an edible such as a muffin, bar, or bread. You report on your symptoms with the questionnaire.

There is a one-week washout period, followed by a challenge again, this time with the opposite dose (placebo or gluten) and reporting of symptoms. Likewise here, if there is a variation of 30% between the gluten and placebo, it can indicate gluten sensitivity. If not, other causes of the symptoms should be explored.


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