Celiac v. Gluten‑Free

“Gluten” has become a buzzword over the past several years, causing some confusion between what eating gluten-free means and who needs to be eating that way. The most common reason for eating gluten-free is due to celiac disease, followed by having a nonceliac gluten sensitivity/intolerance, then just personal preference. It is important to properly determine the cause of gluten issues through a health-care practitioner, as celiac disease and gluten sensitivity require different treatment approaches.

Celiac disease is a chronic auto-immune disorder triggered by gluten ingestion. It leads to damage of the intestinal lining villi, which causes symptoms of diarrhea, fatigue, weight loss, bloating, and anemia.[i] In some individuals, it may also be linked to infertility. The signs and symptoms may vary between children and adults. Mild cases do not show any symptoms and may be diagnosed later in life.

The only way to manage this condition is to follow a strict gluten-free diet.[ii]

Having one auto-immune disease increases your risk of developing others, so it important to manage this condition properly.[iii]

Gluten sensitivity is a reaction to the protein gluten (found in wheat, ancient grains, and barley) that can cause a wide range of symptoms such as gastrointestinal issues, headaches/migraines, brain fog, joint pain, and mental-health concerns.[iv] People with gluten sensitivity have problems digesting gluten; however, it is milder than celiac disease and does not produce an auto-immune reaction. Some individuals may have higher immunoglobulin G (IgG) antibodies to gluten on food-sensitivity testing. This is linked to the weakening of tight-cell junctions in the small intestine, causing food and immune particles to circulate through the bloodstream, leading to “leaky gut.”

Debunking “Gluten-Free”

Can We Self-Diagnose Gluten Intolerance and Celiac Disease?

Celiac disease can be tested through blood serum. People with celiac disease who eat gluten have higher-than-normal levels of certain antibodies in their blood. The measure used for this is IgA antitransglutaminase antibody.[v] Genetic testing and an intestinal biopsy can also confirm this diagnosis. For this to be accurate, the patient must consume gluten daily for at least two weeks before the test is taken.

Diagnosing gluten sensitivity involves using an elimination diet, in which a person removes gluten from their diet, monitors their symptoms, and slowly reintroduces gluten to see if their symptoms return.[vi] In addition to this, IgG (immunoglobulin G) food-sensitivity testing may reveal a sensitivity to gluten if elevated. A combination of both subjective symptoms from an elimination diet, food sensitivity testing, and ruling out celiac disease through blood testing suggest nonceliac gluten sensitivity. An allergist may test for a wheat allergy, but not gluten. Allergy testing assesses an IgE reaction, which is different from IgG (food sensitivity).

Is There a Difference Between Wheat and Gluten?

Gluten is a protein found in many grains, including wheat. Wheat is simply a grain that contains gluten. Not all grains contain gluten, and wheat is not the only grain that has gluten. Some individuals may be sensitive to the wheat grain, which means they tolerate ancient grains such as spelt and kamut; these grains do still contain gluten. Both gluten and wheat sensitivity may be tested on through an IgG food-sensitivity panel.

Why Would Some Rice and Oats Products State “Gluten-Free”?

Rice and oats are naturally gluten-free; however, they can get cross-contaminated during processing and may end up containing trace amounts of gluten. If you are celiac, you could react, and you should consider purchasing certified gluten-free products. In Canada, the Canadian Celiac Association (CCA) has a certification program called the Gluten-Free Certification Program (GFCP). The GFCP is a voluntary program that verifies that products meet strict gluten-free standards.[vii]

Can Beer Be “Gluten-Free”?

For celiacs, gluten-free beer is an alternative to regular beer. Some beers are rice-based and may cause confusion in the gluten-free community. Rice-based beers do contain less gluten since they are not wheat-based, but also consist of barley which contains small amounts of gluten. Someone with a gluten sensitivity may be able to tolerate these beers.

Can You Become Nutrient-Deficient by Consuming a Gluten-Free Diet?

Yes, it is possible to become nutrient-deficient on a gluten-free diet. Nutritional deficiencies can occur in individuals with celiac disease and gluten-sensitivity because of both low intake and poor absorption. Once the intestine has had a chance to heal, nutrient absorption improves, but intake may remain a problem. A review of the literature indicates several nutrient inadequacies associated with a gluten-free diet. These include B vitamins (as wheat is often fortified), vitamin A, magnesium, calcium, iron, and fibre.[viii] It is important to consult with a qualified health-care practitioner versed in nutrition to ensure that you are consuming the proper amounts of nutrients, or supplementing in the form of vitamins (ex. B-complex, multivitamin).

Adopting a gluten-free lifestyle may come with benefits such as improved energy, focus, weight loss, and better digestion. However, it is important to determine the reason for doing so to ensure sustained health. Working with a naturopathic doctor can help you discover the causes of your gluten issues, so you can feel better over the long term.

Dr. Kaitlyn Zorn, HBSc, ND

A Guelph naturopathic doctor who uses a blend of modern science and traditional healing therapies to treat the whole person. Her journey has helped her develop an interest in brain health, pain management, and critical illness relief.

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