Are you wondering if you suffer from gluten intolerance symptoms? I hope to help you determine if you’re experiencing a gluten sensitivity and then help you through a new world of gluten-free cuisines. Being gluten intolerant shouldn’t stop you from living a healthy, happy life.
Don’t view your newly discovered allergy, intolerance or sensitivity as a harbinger of darker days. I’ll help you restore hope. I’ll try to keep this as comprehensive yet accessible as possible.
Use the following index to skip to your desired section:
- What Is Gluten?
- What Is Gluten Intolerance?
- What Are Gluten Intolerance Symptoms?
- Is Gluten Intolerance A Wheat Allergy?
- What Is Celiac Disease?
- What Are Common Celiac Disease Symptoms?
- What Is A Gluten Allergy?
- What Is Gluten Ataxia?
- Can Adults Develop Food Allergies or A Food Intolerance?
Specifically, I hope to help you understand the difference between symptoms of a wheat allergy and gluten intolerance symptoms. Many mistake these to be the same, but they’re not! Please note this guide does not use the words wheat and gluten interchangeably as they are not the same thing. Also, it is possible to experience celiac disease symptoms but test negative for celiac disease, which you’ll sometimes see spelled coeliac disease or coeliac sprue disease, or with the clinical label gluten enteropathy. You may also see it abbreviated as CD.
Additionally, you may see the term gluten allergy used, although the terms gluten intolerance, celiac disease, non-celiac gluten sensitivity (NCGS) or wheat allergy are all more accurate and meaningful than that layman term.
What Is Gluten?
Gluten is not a protein itself but rather a protein composite, composed of the proteins glutenin and gliadin (in wheat), secalin (in rye) and hordein (in barley), which are elastic proteins in the protein family known as prolamins. This unique protein composite is insoluble in water and comes from the endosperm (see the accompanying picture) within the seeds of grass-related grains.
Gluten's Origin: Endosperm
Gluten exists in the grass-like grains wheat, barley, rye, kamut and spelt. It provides an elasticity and glue-like capacity to hold its flour products together and provide them with a chewy texture. Some argue that other grains, including rice, corn and oats, contain some form of gluten, even if they do not share the profile of peptides associated with any form of gluten sensitivity.
Others argue that the peptide sequences in these grains do not have the unique qualities that define gluten as it is widely understood, particularly as it is understood in wheat. For the sake of studying gluten intolerance, these other grains are considered safe as their protein profiles do not match the profiles of the troublesome grains. Oats, however, usually must be avoided because oats are often harvested and processed alongside wheat and thus may be cross-contaminated. You can see how defining this complex protein composite in a concise manner can be challenging.
While western civilization has come to rely on gluten not only as an important nutritional protein but also as a utility for obtaining a desired texture and elasticity in foods, in recent years some substantial and controversial studies suggest our bodies may not tolerate and digest this unique protein composite as well as everyone had always assumed. It is worth noting that some people believe this applies to everyone, and not just people suffering from some degree of sensitivity.
One key point to consider is that this protein composite is in more foods and products than you may realize. If you think removing gluten from your diet involves just not eating bread and baked goods, I’m afraid you’re mistaken. It is often used in sauces, flavorings, flavor enhancers and even as a binder or filler in vitamins and supplements. Adapting a gluten-free diet requires more than just removing wheat products from your lifestyle.
I’ve read many vague and inaccurate answers to this question, so I’ve written my own guide to this deceptively simple topic: What Is Gluten?
What Is Gluten Intolerance?
First you must separate gluten intolerance into three distinct categories: Celiac Disease, Non-Celiac Gluten Sensitivity and a Wheat Allergy. (Technically, a wheat allergy is not an intolerance to gluten). I’ll get to that in a bit.)
Celiac Disease occurs when the proteins in gluten (glutenin and gliadin) trigger your immune system to overreact with strong and unusual anitbodies. Over time, the reaction caused by these antibodies wears down the villi that line the walls of your intestine (this process is called villous atrophy). These finger-like tiny hairs grab and absorb nutrients as foods pass through your lower digestive tract. As celiac disease symptoms slowly destroy these villi, you become less and less able to process any nutrition from your food. This sets off a domino-effect of increasingly serious health problems. Celiac disease is also associated with leaky gut syndrome, also known as a intestinal hyperpermeability. Undigested proteins and toxins move through the intestinal wall and into the bloodstream. This may be the cause of conditions like dermatitis herpetiformis, a nasty gluten intolerance rash.
Non-Celiac Gluten Sensitivity is currently a little more difficult to pinpoint. Basically, individuals who suffer from NCGS suffer very similarly to people with Celiac Disease, but the blood test which identifies and diagnoses celiac disease returns as negative. The only way to confidently diagnose NCGS is through a gluten free diet (I’ll write more about NCGS in the future as it is an interesting topic, which more directly addresses the controversy around the term gluten allergy symptoms).
Recent research and current gluten intolerance statistics suggest that 10% to 15% of the population may suffer from some form of intolerance to this troublesome protein complex, and yet a vast majority of these individuals have not yet been properly diagnosed. Furthermore, even patients who test negative for celiac disease may suffer from some form of undiagnosed non-celiac gluten intolerance.
Wheat allergy symptoms is the third category. The triggers of wheat allergy symptoms are fundamentally different from the triggers of celiac disease symptoms, but some might inaccurately refer to these symptoms as gluten allergy symptoms. This is a histamine response to wheat, much like a peanut allergy or hay fever. Wheat allergies manifest themselves in a wide variety of ways that can be different for different people. Some people experience hives while others might experience stomach pain. A wheat allergy, unlike celiac disease, is considered a Type 1 Hypersensitivity.
A wheat allergy may also sometimes occur as a cross-reactive condition related to an Oral Allergy Syndrome (OAS), which some people refer to as Pollen Foods Allergy Syndrome. This can also cause stomach pain that might be interpreted as gluten intolerance.
What Are Gluten Intolerance Symptoms?
It may help you to have a more succinct gluten intolerance symptoms checklist. I will try to provide you one here, but keep in mind how there are over 250 documented symptoms of a gluten sensitivity and their manifestation varies greatly from person to person. With this list I think I have isolated both the most common symptoms and the most important symptoms you should know about right away. Some symptoms are rare and even counter-intuitive (for example, gluten intolerance and weight gain goes against the grain of what most doctors expect). Please let me know if you feel I have missed something obvious or important.
- Abdominal Distention
- Abdominal Pain and Cramping
- Alternating Bouts of Diarrhea and Constipation
- Anemia
- Arthritis
- Attention Deficit Disorder (ADD)
- Bloating (see Gluten Intolerance Bloating)
- Bone Density Loss
- Borborygmi (stomach rumbling)
- Constipation (see Celiac Disease Constipation)
- Stunted Growth and Failure to Thrive
- Depression, Anxiety and Irritability (see Celiac Depression)
- Dermatitis Herpetiformis
- Diabetes
- Diarrhea
- Fatigue
- Low Ferritin Symptoms
- Malodorous Flatulence
- Malodorous Stools
- Gluten Ataxia
- Grayish Stools
- Hair Loss (Alopecia)
- Headaches and Migraines
- Hypoglycemia
- Infertility (see Gluten Intolerance and Pregnancy)
- Joint pain
- Juvenile Idiopathic Arthritis
- Lactose intolerance
- Mouth sores or mouth ulcers
- Nausea
- Numbness or tingling in the patient’s hands and feet
- Osteoporosis
- Peripheral Neuropathy (including either a tingling or sensation of swelling your toes and fingers)
- Sjogren’s Disease
- Steatorrhea (high lipids in the stool, which may cause the stool to float)
- Teeth and Gum Problems
- Turner Syndrome
- Vitamin and Mineral deficiencies
- Vomiting
- Unexplained Weight loss
- Urticaria
I hope this gluten intolerance checklist helps you, but again, do not try to diagnose yourself with a list you find on the Internet. Always consult a professional because this is a very serious condition. For a more focused list designed to help you work with your doctor in diagnosing a possible case of celiac disease, use my Celiac Disease Symptoms Checklist.
One condition with a controversial connection to gluten intolerance is Autism. Many people feel a gluten-free, casein-free diet (often abbreviated as GFCS diet) helps reduce the manifestations of autism or Autism Spectrum Disorders (ASDs). Some people strongly believe autism itself should be counted among the many signs of gluten intolerance. However, the support for this hypothesis is mostly based on anecdotal evidence, with several recent studies indicating little to no connection between gluten and autism. Put simply, the hard science is weak here, but many people are still staunch supporters of treating autism with a gluten-free, casein-free diet.
Is Gluten Intolerance A Wheat Allergy?
Even though it occurs as a reaction to proteins in wheat, Celiac Disease is not a wheat allergy. A wheat allergy — like most well-known allergies — involves the response of white blood cells called basophils and mast cells to something called Immunoglobulin E (or IgE for short). A wheat allergy is type 1 hypersensitivity, but celiac disease is not. In laymen terms, this is a traditional allergy where you develop antibodies to an allergen, in this case wheat. Believe it or not, you can have a wheat allergy and not have Celiac Disease (or gluten intolerance), and you can have Celiac Disease and not have a wheat allergy. They’re two completely different responses in your body.
In a vast majority of cases, gluten sensitivity symptoms will be systemic and will be a result of consuming gluten over a period of time. But symptoms of a wheat allergy will manifest themselves more like you perceive a typical allergy: quickly and with single exposure. Being gluten intolerant can be frustrating as this autoimmune disease can be subtle and insidious.
For example, if you eat a large, dense piece of gluten-rich bread and have immediate reactions, you are more likely experiencing wheat allergy symptoms rather than symptoms of gluten intolerance.
I know this can be confusing, but think of a wheat allergy reaction as similar to the way a person might react to cats if he or she is allergic to them. If he pets the cat and breaths around the cat, then he will almost immediately start having watery, itchy eyes and begin sniffling and sneezing.
In contrast, gluten intolerance symptoms manifest themselves more like a nutritional deficiency, with symptoms that sometimes arise slowly over time. The symptoms can be severe and serious, but in most cases they’re systemic, not immediate like symptoms of wheat intolerance. To make this even more confusing, people frequently refer to this condition as gluten allergy symptoms. General gastrointestinal distress or separate digestive disorders are also triggered by gluten intolerance. For example, some symptoms of Candida may develop as a result of gluten intolerance.
What Is Celiac Disease?
The cold clinical definition to a celiac sprue disease diagnosis is this: Positive antibodies to the proteins glutenin and gliadin, tissue transglutaminase, and intestinal endomysium, along with the verified presence of HLA-DQ2 or HLA-DQ8 genes. Fun, huh? Such an explanation doesn’t exactly insinuate celiac symptoms.
Celiac Disease is caused by the inflammatory interaction of gliadin — a gluten protein in wheat and other grains such as barley and rye — and the enzyme tissue transglutaminase. This inflammation flattens the lining of the small intestine and thus impedes your small intestine’s ability to absorb nutrients.
If you and your doctor (or natural physician) determine your problems are distinctly a result of consuming gluten, you may be diagnosed as having celiac disease. Celiac disease is an autoimmune disorder of the small intestine. It can rear its troublesome head at any point from infancy to old age. Currently, celiac disease is believed to be inherited. However, as it has often gone misdiagnosed or undiagnosed in the past, you may have gluten intolerance in your family and not realize it.
Thankfully, people are becoming more sensitive and aware of gluten intolerance in children so gluten intolerance symptoms in children are now much more likely to be diagnosed than they were just ten years ago. Gluten intolerance symptoms in adults, however, are still somewhat nebulous as they often dovetail with conditions such as ulcerative colitis, Crohn’s disease, lactose intolerance and yeast intolerance. And because adults too often grow accustomed to some discomforts, celiac disease symptoms in adults often go left untreated.
It is important to recognize that clinical tests (a blood test and/or an intestinal biopsy) can determine to some certainty that you have coeliac disease, but inconclusive or negative results in these tests do not necessarily mean you’re free from wheat gluten intolerance. In fact, most people experiencing legitimate and significant sensitivity symptoms have officially tested negative for Celiac Disease. These individuals are categorized as Non-Celiac Gluten Sensitive, or NCGS.
The only way to deal with this disease is a strict gluten-free diet. Thankfully, gluten-free foods are much more widely available than they were a decade ago.
Update: Please note that information on gluten intolerance vs celiac disease is undergoing quite an evolution right now. Please see gluten intolerance test for more. For example, testing for steatorrhea, or excess fat or lipids in one’s stool, has become part of a more rigorous gluten intolerance test and examination of one’s gluten sensitivity.
What Are Common Celiac Disease Symptoms?
Because it is difficult to test conclusively, many people will be diagnosed based on a wide variety of screenings and observations. The most common symptoms are gastrointestinal problems (or gastrointestinal distress) such as diarrhea, flatulence, gas and bloating. Other symptoms may include joint pain, fatigue and headaches but many other peripheral symptoms may also lead to a celiac disease diagnosis or non-Celiac gluten sensitivity, such as gluten ataxia. (I don’t want to make everyone reading this paranoid so over time this site will provide a wide range of essays on different ways people have come to evaluate gluten intolerance symptoms.)
Keep in mind that currently there are an estimated 250 or more symptoms related to gluten intolerance or celiac disease and many of these symptoms may overlap with other diseases and conditions. While you will often see celiac disease symptoms such as constipation, diarrhea, gas, bloating, fatigue and joint pain mentioned as the most common celiac disease symptoms, keep in mind that such symptoms can occur with dozens of other diseases and ailments as well. Always consult a medical professional rather than attempt to diagnose yourself. In some cases, these may manifest as silent celiac disease symptoms and go undiagnosed for years.
Some believe the most accurate way to identify and diagnose your condition is to use an elimination diet, a strict diet in which you completely eliminate gluten and all foods containing gluten for a significant period of time, then use careful record-keeping and observation to compare your symptoms before the elimination period to your symptoms after the elimination period.
But gluten-free diets can be difficult for the uninitiated, so doctors often like to evaluate a patient’s condition thoroughly before prescribing a gluten free diet. More importantly, however, if you remove this frustrating protein composite from your diet for a significant amount of time, your doctor will have difficulty testing your for celiac sprue disease because your body may not have the antibodies triggered by our least favorite toxic protein.
So it is important you discuss allergy and intolerance testing with your doctor before you attempt to isolate your symptoms with any kind of elimination diet.
What Is A Gluten Allergy?
As I discuss on my gluten allergy symptoms page, defining a gluten allergy has been a surprisingly tricky matter for me. When I first began this website, I avoided using the term at all. Why? Because it is technically incorrect. Celiac disease and gluten intolerance are not allergies. An allergy is a Type 1 Hypersensitivity and involves IgE antibodies (Immunoglobulin E) and a histamine response. While a wheat allergy is an allergy, celiac disease and a non-celiac gluten sensitivity are not allergies.
However, an overwhelming number of people in the real world use gluten allergy in place of any of these other terms. You find it in major media outlets, in discussion forums and on gluten-free blogs. When I researched how often people use different terms to search the internet and when I researched the occurrence of different phrases in all news outlets, I found the term gluten allergy used far more often than celiac disease, gluten intolerance or gluten sensitivity.
The term gluten allergy can also be misleading because to most lay people it implies an immediate response to consuming gluten. One of the most dangerous and insidious aspects of gluten intolerance is how silent celiac disease symptoms can occur or how people can have asymptomatic celiac disease (meaning, they don’t experience any apparent symptoms at all). For many people the term gluten allergy implies you should experience an immediate and tangible reaction to eating food with gluten. This is inaccurate, and if people with a gluten intolerance think they can eat gluten without consequence because they don’t have an immediate and obvious reaction, over the long-term they could be making a deadly mistake.
You can read more about distinguishing these different terms in my guide to gluten intolerance vocabulary. I discuss some practical uses of the phrase gluten allergy in that guide. (Basically, you take advantage of people’s familiarity with food allergies to get your point across quickly when necessary.)
What Is Gluten Ataxia?
As a term for a condition, gluten ataxia is a relatively new designation. Ataxia itself is a neurological dysfunction where a person experiences reduced coordination and muscle control. The three basic categories of ataxia are cerebellar ataxia, sensor ataxia, and vestibular ataxia. Gluten ataxia is essentially cerebellar ataxia where gluten has been determined to be the trigger.
Gluten ataxia was initially discovered and verified with the examination of the cadavers of individuals who suffered from ataxia in their lives. Upon examination, the same antibodies that are triggered in celiac disease and gluten intolerance were found at the base of the cerebellum, the part of the brain that governs motor control. Further studies indicated that reduced gross motor control could result from untreated gluten intolerance.
I expand on this specific topic in a separate post: Gluten Ataxia.
Can Adults Develop Food Allergies or A Food Intolerance?
Too many adults develop a belief that once they reach adulthood, they have a full understanding of their sensitivities and allergies. It is also possible that you’ve either ignored or misread your gluten intolerance symptoms or wheat allergy symptoms. Celiac sprue disease is infamously under-diagnosed and diagnosis takes some study and thought. There isn’t a simple single test to give you an outright answer and the best and most comprehensive research on the matter has only become widespread in recent years. While sometimes a simple blood test (an antibody level profile testing for AGA and Anti-tTG) may indicate whether you have celiac disease, if you test negative you may still experience problems with this potent protein composite. When this happens, you may be suffering from NCGS
Adults experiencing unexplained joint pain, anemia, infertility or osteoporosis should discuss the possibility of gluten intolerance with their primary care physician. I encourage you to explore my in-depth articles on silent celiac disease symptoms and celiac disease symptoms in adults for more on adult-onset gluten intolerance.
I hope this helps you gain a basic understanding of gluten intolerance. In the coming months, I will provide multiple perspectives to evaluating different kinds of sensitivities and I will begin rolling out some great ways to handle being gluten intolerant and living gluten free, including some fun gluten-free recipes for the gluten intolerance diet.
For example, check out our comprehensive Gluten-Free Pantry or our first collection of Gluten-Free Bread Recipes.
Thank you for visiting and please return to Gluten Intolerance School soon!
_____________________________________
_____________________________________