Celiac disease is an autoimmune condition in which the body reacts negatively to the gluten in wheat, rye and barley. There are many symptoms that lead people to believe that they might have celiac disease, but most people who are sensitive to gluten do not test positive for celiac disease. Celiac disease occurs in less than .5% of the US population and affects one in 133 people. Recent studies suggest that non-celiac gluten intolerance is more than 30 times as likely as celiac disease, affecting more than 15% of the population, or one in seven people.
How is Gluten Sensitivity Tested?
Laboratory testing for gluten sensitivity is only one of several aspects that must be taken into account to determine if you are sensitive to gluten. Other important factors include: the history of your current illness, how you feel after eating gluten-filled foods, family history and past medical history. At this time, the most conclusive way to determine gluten sensitivity is to do an elimination diet (see below).
However, there are several different ways that doctors can quickly determine gluten sensitivity. All of these tests are based on measuring the levels of anti-gluten antibodies in blood, stool or saliva. The antibody test for blood is commonly referred to as IgG, while the IgA antibody test is used for saliva or stool. IgG and IgA are the different molecular antibodies that are normally found in each of these tissues. High levels of these antibodies indicate that a person is sensitive to gluten. If you test positive for gluten sensitivity on any one of these tests, you would likely benefit from cutting gluten out of your diet. Unfortunately, there are various factors that may contribute to low-level test results in a person who actually has gluten sensitivities. For example, if history of present illness, family history, past medical history or symptoms indicates problems with gluten, you should opt to go ahead with an elimination diet to confirm sensitivity even if your tests are negative.
An elimination diet entails removing all gluten-filled foods from your diet for a minimum of one month, but ideally three months. During the elimination phase, track any changes in symptoms and note any improvement in otherwise unnoticed areas like sleep, energy, concentration, memory, libido, skin condition and/or recovery after workouts. After the determined amount of time has passed, challenge your body by eating several servings of gluten in a single day and note any new symptoms or changes in symptoms that occur over the next 72 hours. Decreased or complete resolution of symptoms during the elimination phase and/or new or increased symptoms during the challenge phase constitutes a positive test for gluten sensitivity.
Who should be Screened for Gluten Sensitivity?
People who have had a previous diagnosis of any of the following conditions should be screened for gluten sensitivity:
- Hypothyroidism, particularly Hashimoto's autoimmune thyroiditis
- Grave's Disease
- Lupus, SLE or CREST syndrome
- Sjogren's syndrome
- Addison's Disease
- Autoimmune hepatitis
- Type I Diabetes
- Myasthenia gravis
- Pernicious anemia
- Raynaud's phenomenon
- Rheumatoid arthritis
- Down's syndrome
- Osteoporosis/ osteopenia
Also, people suffering from the following conditions should consider screening for gluten sensitivity. When in doubt always contact your family practitioner or naturopathic physician to confirm the necessity of screening tests.
- Multiple Sclerosis
- GERD, IBS, Chrons Disease, Ulcerative Colitis and other inflammatory disorders of the gastrointestinal track
- Type II Diabetes
- Syndrome X
Lastly, if you experience digestive problems after consuming gluten, like upset stomach, flatulence, gas, bloating or chronic diarrhea or constipation, you should be screened for gluten sensitivity. However, most people with gluten sensitivity do not experience symptoms immediately following eating it and are unaware their symptoms are related to gluten at all. Common symptoms associated with gluten sensitivity include:
- Joint pain
- Chronic fatigue
- Anxiety or depression
- Learning disabilities and dyslexia
- Eczema or other skin rashes
- Mouth sores
- Anemia of unknown origin
- Unexplained weight loss
- Difficulty losing weight
- Dental disorders