Gluten Intolerance Symptoms: How to Know If You're Sensitive to Gluten
Key takeaways:
Gluten intolerance happens when your body is sensitive to gluten, which is a protein found in the grains of wheat, barley, and rye.
Gluten intolerance is not the same as a wheat allergy or celiac disease, but these conditions may have overlapping symptoms.
Some people are more likely to develop gluten intolerance than others. The best way to treat this condition is by following a gluten-free diet.
With gluten becoming a very popular subject in the media over the past decade, the idea of gluten intolerance has become much more debated.
But, how do you know if gluten is really the source of your problem? This article will explain everything you need to know about gluten intolerance, including what it is, what you can do about it, and everything in between.
What is gluten?
Gluten is a type of protein found in the grains of wheat, barley, and rye. It gives these grains structure, flexibility, and holds them together. Without gluten, foods like bread and pasta would fall apart much more easily. Or, they may have a stiff, hard texture rather than one that is flexible and slightly chewy.
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Common food sources of gluten include:
Most bread products, like sliced bread, bagels, English muffins, pastries, and more (unless certified gluten free)
Traditional pastas
Traditional doughs and crusts
Crackers
Flour tortillas
There are also many less obvious food sources of gluten, such as couscous and processed lunch meat.
What is gluten intolerance?
Gluten intolerance is when your body does not respond well to gluten. It is also referred to as gluten sensitivity or non-celiac gluten sensitivity (NCGS). In gluten intolerance, the gluten protein may pass into your colon undigested or only partially digested. This can lead to a set of uncomfortable symptoms that you experience after consuming gluten.
Gluten intolerance symptoms
According to the Celiac Disease Foundation, common symptoms of gluten intolerance may include:
Constipation or diarrhea
Excessive bloating
Abdominal pain
Headaches
Bone or joint pain
Fatigue
Unexplained mood changes
“Brain fog,” or having trouble thinking clearly
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What causes gluten intolerance?
We aren’t sure why people develop gluten intolerance. According to some research, factors such as intestinal inflammation, a weakened intestinal barrier, and changes to the gut microbiome may all play a role. It may also be something you are born with. Other research suggests that consuming a class of carbohydrates called FODMAPS may contribute to its development. Still, other researchers suspect gluten intolerance to be caused by several other things, including other parts of wheat. Though, this has not been proven.
Like with many conditions, it is possible that some people who believe they suffer from gluten intolerance may actually be experiencing the placebo effect. This is when a person expects a positive health outcome based on anticipation of an intervention. For example, if you believe you have gluten intolerance and follow a gluten-free diet as a result, your symptoms may seem to improve even if gluten intolerance was not the actual root cause.
Ultimately, fearing gluten because of media reports or other messages or thinking you have a gluten intolerance without a proper diagnosis may lead you to believe you have symptoms — even if there is no actual condition.
What’s the difference between gluten intolerance and celiac disease?
Celiac disease is an autoimmune condition. When people with celiac disease eat gluten, their body creates an immune response that attacks the small intestine. This makes it difficult for their gut to absorb nutrients. And it can lead to serious health problems, including malnutrition. celiac disease can be diagnosed by testing for certain antibodies in your blood, and by doing an intestinal biopsy. These tests cannot diagnose NCGS, though.
Until recently, having a gluten intolerance was not known to cause long-term damage to your gut lining. But, a study from 2016 found that people with gluten intolerance may have a weakened intestinal barrier. This may lead to inflammation and an immune response.
One of the other main differences between gluten intolerance and celiac disease is that people with gluten intolerance can often tolerate gluten in small amounts or in certain forms. But, people with celiac disease cannot. Gluten intolerance is also estimated to be much more common than celiac disease.
What’s the difference between gluten intolerance and wheat allergy?
Because wheat is one of the major sources of gluten, it can be easy to confuse symptoms of gluten intolerance with those of a wheat allergy. However, these are very different conditions.
All allergic reactions, including those to wheat, involve the immune system. In an allergy, your immune system responds to what it thinks is a foreign substance that must be removed from the body. It then releases antibodies known as immunoglobulin E (IgE), which trigger a range of symptoms, including the possibility of a life-threatening condition known as anaphylaxis. But, a trained doctor can help diagnose a wheat allergy with a skin-prick or blood test.
While having a gluten intolerance is less severe than a wheat allergy, there are no formal tests or bloodwork that can diagnose gluten intolerance. Instead, it can only be diagnosed based on your reported symptoms and by ruling out other conditions.
And because the two conditions can share many common symptoms, it is important to first rule out a wheat allergy before assuming a gluten intolerance.
Who is most likely to get gluten intolerance?
Adults are more likely than children to develop a gluten intolerance. Though, it may also be likely to be born with it. And while it is possible for almost anyone to develop a gluten intolerance, some people may be more likely to.
These people may include:
People with irritable bowel syndrome (IBS)
People with dysbiosis, which is an imbalance of gut bacteria
How is gluten intolerance diagnosed?
As mentioned, there are no specific labs or biomarkers to diagnose gluten intolerance formally. It can only be subjectively diagnosed by your self-reported information.
The process of diagnosing gluten intolerance usually involves the following:
First, ruling out a wheat allergy and celiac disease. This may include blood and/or skin prick tests and an upper endoscopy procedure if needed (for celiac only).
Next, following an elimination diet or “gluten challenge” that removes gluten from your diet for a period of time. A healthcare provider then assesses symptoms and re-introduces gluten to watch your reaction.
If a provider can make a clear correlation between gluten and your symptoms, then they can diagnose you with gluten intolerance, or NCGS.
But, it can be tricky for healthcare providers to distinguish between gluten intolerance and other gut-related disorders, such as IBS. So, they may order more testing and watch for symptoms.
Is it common to be gluten intolerant?
Research estimates a non-celiac gluten sensitivity to occur in up to 6% of the population. This makes it more common than celiac disease, which is estimated to affect about 1% of the population. Though, many cases are undiagnosed.
How is gluten intolerance treated?
If a healthcare provider determines that you have gluten intolerance, avoiding gluten is the best way to limit and/or get rid of your symptoms. This can be tricky since gluten is found in various foods and food products. As mentioned above, more obvious sources of gluten are things that have wheat, barley, or rye. Yet, many people don’t realize how many other foods have gluten.
Which foods contain gluten?
The table below shows more examples of foods that contain gluten and ideas for appropriate substitutes.
| Less obvious foods that contain gluten | Gluten-free substitute |
|---|---|
| Couscous | Brown or white rice |
| Cracked or durum wheat | Rice or coconut flour |
| Faro | Quinoa |
| Graham flour (and graham crackers) | Almond flour |
| Kamut | Buckwheat |
| Semolina | Corn or potato products |
| Spelt | Amaranth |
| Seitan | Organic tofu |
| Bulgur | Sorghum |
| Processed lunch meats | Freshly carved meats |
| Oats (Oats themselves do not contain gluten, but they are often processed in a facility that produces gluten-containing grains and may be a source of cross-contamination.) | Certified gluten-free oats |
In addition, below is a table of other ways that gluten can hide in the food supply and their gluten-free alternatives.
| Common foods with gluten as an ingredient | Gluten-free substitute |
|---|---|
| Barley malt and malt vinegar | Balsamic, red wine, apple cider, or rice vinegar |
| Beer | Wine or spirits |
| Meat or vegetable broth | Certified gluten-free broth or bone broth |
| Brewer’s yeast | Nutritional yeast |
| Some salad dressings | Dressing made with naturally gluten-free ingredients like olive oil |
| Many veggie burgers | Certified gluten-free burgers |
| Some seasonings and spice mixes | Raw spices or homemade spice mixes |
| Soba noodles | Noodles made from beans or lentils |
| Soy sauce | Tamari sauce |
| Sauces and gravies | Sauces/gravies made without wheat, and cornstarch |
| Some medications and supplements | Certified gluten-free varieties |
| Other grain products like crackers, cereals, granola, baked goods, flour tortillas, croutons, energy bars, etc. | Grains like rice, quinoa, corn tortillas, granolas and energy bars made with gluten-free oats and/or nuts, nut or rice crackers, baked goods made with gluten-free flours, and certified gluten-free cereals |
Remember that just because something is labeled wheat-free does not automatically mean that it is gluten-free. Many other grains also contain gluten. The safest bet is to look for the certified gluten-free label. Regulated by the FDA, this label means that the food is either naturally gluten free or has less than 20 parts per million (ppm) of gluten.
Is gluten intolerance considered a gluten allergy?
No. There is actually no such thing as a gluten allergy, according to the American College of Allergy, Asthma, and Immunology. Instead, a gluten allergy is often confused with a wheat allergy, gluten intolerance, or celiac disease.
Are there any health risks associated with gluten-free diets?
The recent trend and popularity of gluten-free diets has led many people to assume that these diets are healthier than ones that have gluten. But, there are no proven benefits of following a gluten-free diet unless you have a medical need to.
In some cases, following a gluten-free diet could actually be less healthy for you. What’s more, some studies show that avoiding gluten may lead to negative health effects for people without proven gluten-related disorders. This is because gluten is found in many whole grains. Research shows that whole grains have many health benefits, including a lower risk of cardiovascular disease, cancer, and diabetes. So, avoiding gluten without needing to may interfere with these benefits.
In addition, foods that are developed to have no gluten are sometimes highly processed and less nutritious compared to the original product that naturally contains gluten. People following a long term gluten-free diet may struggle to get enough vitamins and minerals, such as iron, fiber, and more.
Finally, since this diet restricts many foods, it can become difficult to take part in social events. This may lead to disordered eating habits for some people, which comes with more health risks.
How do you flush gluten out of your body?
If you have been accidentally exposed to gluten, you may want to do what you can to quickly remove it from your body. It is a good idea to drink a lot of water to help move things along in your digestive tract, which may also limit negative symptoms.
Other things that may help with symptoms of gluten exposure include taking digestive enzymes that support carbohydrate digestion and eating a variety of other foods that naturally help support detoxification. These include foods, such as fruits, cruciferous vegetables, and whole grains.
The bottom line
Gluten intolerance, or NCGS, is a tricky condition that can easily be misdiagnosed. It is best to work with a licensed practitioner to rule out wheat allergy and celiac disease and try other interventions — such as avoiding FODMAP foods — before assuming gluten intolerance. Also, make sure your symptoms aren’t due to the placebo effect.
If you do have gluten intolerance, avoiding gluten is the best solution. Thankfully, it has become easier in recent years because of advances in food science. Just be sure you have a medical reason for avoiding gluten to prevent any possible health risks.
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