The gluten-free diet is everywhere. Celebrities promote or attack it, comedians make fun of it, television shows either add token gluten-free characters or just poke fun at it, newspapers and blogs everywhere ponder and debate it, and its label makes it onto an increasing array of products on grocery store shelves throughout the world.

Given its rapid rise, it isn’t hard to understand why there is a backlash. But please! This did not originate as a commercial diet, nor did originate from some doctor trying to make a buck off the phenomenon. Are there manufacturers and doctors-turned-authors trying to profit from this surging diet trend?

Of course — but please, don’t let these profiteers marginalize what is a serious health matter for many people.

Celiac disease is a serious life-long autoimmune disease. There is no cure, and the consequences of untreated celiac disease can be life-threatening. The ONLY treatment for celiac disease is a strict gluten-free diet.

With the growing gluten-free phenomenon and the predictable backlash to the widespread adoption of a gluten-free diet, it’s important for people to understand the difference between the common misconceptions and the critical reality of people who live with a serious medical condition.

If you or someone you know feels the impulse to roll one’s eyes at someone for “just subscribing to some fad diet,” please keep these common misconceptions in mind:

#1: Celiac Disease is a Serious and Well-Established Autoimmune Disease: Don’t Relate It To A Diet Fad

For people with celiac disease, the gluten-free diet is a 100% necessary doctor-prescribed treatment for a serious medical condition. A gluten-free diet is the ONLY treatment for celiac disease.

Celiac disease is a legitimate, serious and well-established medical condition. It has nothing to do with the gluten-free fad you might see promoted by Hollywood actresses or your friend’s friend who swears avoiding gluten cleared her skin or helped her lose weight.

It also has nothing to do with people adhering to the popular paleo diet. I’m not criticizing the paleo diet; I’m just making it clear that when most people choose to adhere to a paleo diet — which excludes a number of foods, including gluten — being gluten-free is a personal choice based on their own nutrition research. For someone with celiac disease, there is no CHOICE — going gluten-free is a serious medical NEED.

In addition, some recent research has cast doubt on the existence of a non-celiac gluten sensitivity. While this research isn’t conclusive — despite the knee-jerk reactions of many in the media — this research has NOTHING to do with celiac disease. It doesn’t in any way, shape or form reduce the legitimacy or severity of celiac disease. Non-celiac gluten sensitivity (NCGS) is a separate and distinct condition from celiac disease. Our current collective understanding of NCGS is primitive and evolving.

#2: Celiac Disease Is NOT a Food Allergy

This is vital for people to understand and it is one of the most common misconceptions I observe among people concerned with gluten as well as the public at large.

You can have a severe case of celiac disease, yet eat something with gluten in it and NOT experience an immediate, tangible reaction. Again, celiac disease is NOT a food allergy and often will not trigger what many perceive as the obvious and immediate symptoms of an allergic reaction.

However… just because you can’t feel it soon after you eat it doesn’t mean the damage isn’t being done.

Celiac disease is an autoimmune disease where ingesting gluten causes damage to the lining of the small intestine, and in some people, a systemic autoimmune response. This damage can occur gradually, and even when this damage occurs, it may not trigger perceptible symptoms. Sometimes it may cause symptoms not often associated with digestive disorders or gluten problems, like headaches or joint pain.

This nuance may help explain why millions of people are walking around with undiagnosed celiac disease.

Just because symptoms may not be immediate or obvious doesn’t mean the condition is somehow less serious.

Untreated celiac disease can cause a wide range of serious conditions, including cancer. In fact, people with untreated celiac disease have a much greater mortality rate than the general population.

#3: Even the Smallest Traces of Gluten Will Do Damage

If someone has celiac disease, she must remove all traces of gluten from her diet. I know this is a challenge at first, but someone with celiac disease cannot think to herself, “Oh, I’ve been so good this week. This one bite won’t hurt.”

For people with celiac disease, this is not about losing weight or avoiding a temporary reaction. This is about their long-term health and their mortality.

Someone with celiac disease cannot regularly consume even 1/164th of a single slice of bread (seriously!). This is why cross-contamination is so common and tricky to avoid.

No, restaurant servers, you can’t just pick out the croutons from the salad and call it gluten-free. No, you can’t just scrape the onion rings off the plate and call it gluten-free.

For more detail on how and why someone with celiac disease must be so vigilant in avoiding this pesky protein composite, please see my lesson: How Much Gluten Is Too Much Gluten?

Regarding the consequences of cross-contamination, read my lessons on the Gluten Contamination Elimination Diet and Refractory Celiac Disease Treatment.

Celiacs: Don’t Beat Yourself Up!

“Courage doesn’t always roar. Sometimes courage is the little voice at the end of the day that says I’ll try again tomorrow.”

– Mary Anne Radmacher

This will sound mildly contradictory to some of my warnings right above here, but you have to stay strong and positive. There is a steep learning curve to living a healthy gluten-free life, so please don’t beat yourself up if you make mistakes when you begin your journey to a healthier, happier life free from gluten.

While it is important to set concrete goals and remain as strict and vigilant as possible, don’t dwell on things like discovering a food you thought was safe isn’t. We will all make mistakes like this and we are working against the grain of conventional understanding.

Be vigilant and don’t make excuses, but stay positive and always, always move forward with your chin up!