Signs of Gluten Intolerance: Meaning, Causes, Treatment
What do bread, pasta, beer, and baked goods all have in common? Besides treats enjoyed by many, they’re also common sources of gluten. Other usual gluten suspects include soup, gravy, and crackers.
So, what’s the big deal? Why does it matter if a food or beverage contains gluten?
Research suggests that about 6% of Americans are gluten intolerant. Also, about 1% of the U.S. population suffers from celiac disease (a negative immune reaction to gluten).
What is Gluten?
Gluten is a protein often found in barley, rye, wheat, and other grains. There are numerous gluten tolerance foods to avoid if you suffer from sensitivity.
Meaning of Gluten Intolerance?
Suppose your test for celiac disease came back, and it’s negative, but you’re still ailing from gluten-related symptoms. In this case, you may have non-celiac gluten sensitivity (NCGS), also known as:
- Gluten intolerance or
- Gluten sensitivity.
You might be intolerant if you feel sick or experience negative symptoms after eating or drinking something containing gluten.
What are symptoms of gluten intolerance? We’ll get into more detail later, though bloating, nauseousness, and fatigue are easy-to-notice signs of gluten intolerance. But a gluten intolerance test can give you a more conclusive answer.
The Most Common Symptoms of Gluten Intolerance
A. Symptoms of celiac disease
The most serious type of gluten intolerance, celiac disease, impacts about 1% of people, primarily women.
Celiac disease is an autoimmune condition that provokes many symptoms, like abdominal pain, fatigue, and irritability. In the long run, it can damage the digestive system.
Below are some of the most common symptoms of celiac disease:
- Constipation, diarrhea, and bad-smelling feces
After consuming gluten, people with celiac disease experience inflammation in their small intestines.
This inflammation harms the gut lining and results in inadequate nutrient absorption, leading to constipation, diarrhea, and strong digestive discomfort.
While diarrhea may not seem like a big deal once in a while, if it’s frequent, it can lead to substantial health issues, like dehydration, fatigue, and a loss of electrolytes.
Furthermore, the lack of proper nutrient absorption in people with celiac disease can cause pale and bad-smelling feces.
Common among individuals with autoimmune conditions, fatigue is typical for those with celiac disease.
Chronic pain, interrupted sleep patterns, and psychological issues (like depression) are believed to contribute to tiredness in people with celiac disease.
Also, celiac disease might be associated with an increased risk of anemia. Iron deficiency impacts the body’s capacity to produce healthy red blood cells, resulting in less energy and tiredness.
- Skin problems
If you have celiac, gluten can cause skin reactions.
For example, dermatitis herpetiformis (DH) is a red, blistering condition that can manifest on the skin as a reaction to gluten ingestion.
Even though individuals with celiac disease generally react adversely to gluten, some don’t show any symptoms. At the same time, some people won’t display digestive symptoms but may develop skin reactions.
Therefore, diagnosis can be difficult.
That said, a gluten-free diet has been demonstrated to improve skin problems, such as:
- Alopecia areata: Characterized by non-scarring hair loss, alopecia areata is an autoimmune condition that occurs in men and women.
- Chronic urticaria: Hives, rash, or welts that come and go for longer than six months.
- Psoriasis: A skin condition that generates scaly or red patches, most typically on the elbows, knees, and scalp.
- Anxiety or depression
According to WHO (World Health Organization), depression affects about 5% of grown-ups worldwide. Symptoms include sadness, hopelessness, or listlessness, impacting the quality of your daily life.
How do digestive issues influence your mood? Individuals with digestion problems, such as celiac disease, tend to be more susceptible to anxiety and depression.
While these behavioral health issues aren’t the same, they can occur separately or together.
There are a few theories about how gluten intolerance can prompt depression, such as:
- Shifts in gut microbiota: Boosted amounts of harmful bacteria combined with fewer healthy ones can negatively influence your central nervous system, increasing the chance of depression.
- Gluten exorphins: During the digestion of certain gluten proteins, peptides known as gluten exorphins are formed. The peptides may disrupt the central nervous system, which can risk depression.
- Irregular serotonin levels: Commonly referred to as the happiness hormone, serotonin helps cells communicate. Decreased levels of serotonin, or unstable levels, have been linked with depression.
Beyond Celiac, an online educational platform, notes that anxiety and depression are commonly reported in patients with celiac disease before they’re diagnosed.
Furthermore, some research shows complete remission of anxiety and depression with a gluten-free lifestyle, especially in younger people.
- Numbness or tingling of the feet or arms
In an article for the Chicago Celiac Disease Center, Dr. Kourosh Rezania notes that celiac disease often manifests as diarrhea during childhood.
However, in adults, celiac disease accompanies symptoms such as numb and tingling feet or arms (neuropathy).
Tingling limbs are typical in people with diabetes or vitamin B12 deficiency. Neuropathy can also be instigated by regular alcohol misuse or toxicity.
Moreover, some studies imply that individuals with celiac could be more prone to develop limb neuropathy, which specific antibodies could cause.
- Unexpected weight loss
Unexplained weight loss or gain can be concerning. While the numbers on the scale can shift for various reasons, it might be due to undiagnosed celiac disease when pounds are dropped unexpectedly.
For instance, in a study of celiac patients, two-thirds lost weight within six months before their diagnosis. But what’s the connection to celiac disease?
Unanticipated weight loss could occur due to digestive issues and poor nutrient absorption associated with untreated celiac disease.
Furthermore, Mayo Clinic notes that malnutrition can occur if your small intestine cannot absorb nutrients. Undernutrition can lead to weight loss and anemia. In kids, it can yield slow growth and shorter stature.
- Iron deficiency
Different forms of anemia include vitamin deficiency, aplastic, and sickle cell anemia. However, iron deficiency anemia accounts for 50% of these cases.
Low iron levels cause fatigue, dizziness, and trouble concentrating.
Other symptoms of iron deficiency include:
- Feeling weak
- Pale skin
- Dark circles under the eyes
- Shortness of breath
As touched on earlier, celiac disease often causes poor nutrient absorption. Therefore, less iron is sponged up from food.
Iron deficiency is often one of the first signs of celiac disease.
A study published in Nutrients explains that close to 50% of celiac patients have less iron stored in their bodies, and about 30% are iron deficient.
- Muscle or joint pain
Arthritis Health, a medical source on arthritis, reveals that when people have celiac disease, their immune system goes into action and causes inflammation.
People may not notice external inflammation, like swelling, but it can appear as muscle or joint pain. In other words, individuals with celiac disease experience inflammation that can lead to joint pain.
- Autoimmune conditions
Celiac disease is an adverse immune response to gluten.
For example, if you eat wheat, barley, or rye, the protein in these foods triggers an immune response within the digestive tract. Your immune system bombards the lining of the small intestine after gluten consumption.
Moreover, this autoimmune disorder makes you more prone to other autoimmune disorders, like autoimmune thyroid disease. And if that’s not enough, autoimmune thyroid disorders can make you more susceptible to emotional or depressive conditions.
Celiac disease is an autoimmune condition characterized by many symptoms, such as constipation, diarrhea, fatigue, pain, anxiety, depression, weight loss, and more.
B. Symptoms of non-celiac gluten sensitivity (NCGS)
NCGS is less severe than celiac disease, but it can still wreak havoc in your body after eating gluten.
Below are some of the most typical symptoms of NCGS:
- Anxiety and depression
Anxiety is no stranger to the general population, affecting about 30% of people worldwide.
Being anxious usually involves feelings of agitation, nervousness, and worry. At times, there may even be a sense of impending doom.
People with gluten intolerance tend to be more prone to anxiety and depression. In one study, 40% of individuals with gluten sensitivity expressed that they often experienced anxiousness.
Furthermore, an article titled Mood Disorders and Gluten: It’s Not All in Your Mind!, published by NIH, explains that a gluten-free diet can effectively improve behavioral health issues like anxiety or depression.
The evidence suggests that gluten exposure may spur feelings of anxiety and depression in those who are sensitive to it.
One study revealed that 87% of individuals with suspected NCGS encountered bloating.
Being bloated is one of the most typical troubles among people who are intolerant or sensitive to gluten.
When you’re bloated, your belly is full of gas, usually occurring after eating. While there are many reasons a swollen-feeling tummy can occur, it’s a common symptom of NCGS.
- Brain fog
Brain fog is an uncomfortable sensation of being unable to think clearly. Individuals with brain fog describe it as feeling cloudy, forgetful, or having difficulty thinking. Also, someone might have mental fatigue when encountering a foggy mind.
In a Beyond Celiac investigation, 90% of survey participants with NCGS reported brain fog. This analysis, among other studies, indicates that brain fog is one of the most common signs of gluten sensitivity.
This symptom may be a reaction to antibodies in gluten, but the exact cause isn’t yet known.
- Constipation and diarrhea
For people with NCGS, eating foods that contain gluten can activate digestive issues, leading to a backed-up bowel system or watery stools.
According to a study published by NIH, more than 50% of people with gluten sensitivity experience diarrhea, while 25% experience the discomfort of constipation.
While constipation and diarrhea are occasionally expected, especially while traveling or trying new foods, ensure you test for gluten sensitivity if they happen often.
Migraines are somewhat common, as they affect about one in six adults in the USA. However, it’s another case if you’re experiencing them often without an apparent cause.
You may be sensitive to gluten if you’re getting headaches regularly, especially after eating. It’s worth getting tested and speaking to a doctor because changing your diet can positively affect your well-being.
Beyond Celiac explains that abdominal pain is a common symptom of NCGS. The pain can vary from mild to severe, and it can be temporary or more chronic.
Furthermore, the ache in your stomach could be caused by constipation or bloating after eating gluten.
Likewise, your joints may be impacted by gluten sensitivity. Joints are where two bones meet, like the ankles, elbows, and knees.
You might experience joint pain due to inflammation when you’re gluten-sensitive. It could hurt to bend or move your joints because they’re stiff. And you’ll likely notice a dull aching feeling.
Non-celiac gluten sensitivity (NCGS) is a type of gluten intolerance that can cause anxiety, brain fog, fatigue, and other issues. Usually, a non-gluten diet should be highly beneficial in alleviating negative symptoms.
C. Symptoms of wheat allergy
A wheat allergy provokes the body’s immune system to react to certain proteins in wheat, such as gluten or other compounds.
Wheat allergy is typically more common among kids than grown-ups. It’s estimated that about 65% of children will outgrow their wheat allergy by 12.
Below are some of the most common symptoms of a wheat allergy.
Anaphylaxis is a life-threatening and severe allergic reaction that must be dealt with immediately.
Symptoms of anaphylaxis include difficulty breathing, swelling, and hives (among more).
Usually, this condition quickly occurs after eating wheat, but it can take up to an hour to appear.
Treatment generally includes the use of epinephrine. However, don’t hesitate to contact emergency medical care.
- Digestion problems
Studies indicate that individuals who are allergic to wheat usually convey that they experience diarrhea, nausea, and stomach cramps.
Wheat allergies can also trigger other digestive issues, such as bloating, indigestion, and pain.
The above digestive issues materialize because of the body’s immune response, which is provoked by the wheat allergen.
- Skin rash
Wheat allergies are known to cause hives. Hives appear as a rash accompanied by redness, itching, and inflammation.
Generally, this response arises quickly and subsides with time.
If you’re allergic to wheat, you may notice the following:
- Runny nose
- Nasal congestion
Interestingly, the above symptoms are seen in people with Baker’s asthma. And Baker’s asthma is an allergic condition that occurs due to breathing in bread flour.
Likewise, a study of 162 workers at a bread factory found that nearly 90% had symptoms of Baker’s asthma, like congestion.
Wheat allergy may cause mild to severe reactions. If anaphylaxis is a threat, ensure you have an emergency plan in place.
Causes of Gluten Intolerance:
According to Cleveland Clinic, the exact causes of gluten sensitivity aren’t fully understood.
What we do know is that:
- Unlike celiac disease, gluten sensitivity doesn’t have the intestine damage or typical markers used for diagnoses of that autoimmune disorder.
- Unlike a wheat allergy, gluten sensitivity doesn’t have the traits of an allergy.
At a glance, a gluten-free diet often relieves irritating symptoms, suggesting they’re triggered by the gluten protein or other compounds in gluten-containing grains.
Possible causes for negative symptoms:
- Gluten: Some people sensitive to gluten grains seem to respond negatively to gluten. But many don’t react the same way when they unknowingly eat pure gluten. More research is necessary.
- Fructans: A gastroenterology study reported that the trouble with wheat is its fructans (complex carbohydrates). Fructans ferment in your large intestine, which can potentially cause bloating, cramping, constipation, gas, and pain.
- Amylase Trypsin Inhibitors: Amylase trypsin inhibitors may contribute to gluten sensitivity. But, at this time, there’s not enough conclusive research.
- Genetics: While there are genetic combinations that increase the risk of celiac disease, these don’t seem to have much influence on developing gluten sensitivity. There needs to be further research.
Treatment for Gluten Intolerance:
- Go gluten-free. Most people find relief from symptoms by changing their lifestyle with a glutenless diet.
It’s best to work closely with your healthcare provider and a dietitian to create a meal plan.
2. Try probiotics. You may want to take probiotics, as they help promote good bacteria in your gut. They can also reduce symptoms of bloating, constipation, and gas.
3. Try enzymes. Some research indicates that taking certain enzymes can help with gluten digestion. But experts are still analyzing this treatment.
Important note: Remember, a gluten-free diet is the only reliable treatment. Probiotics and enzymes are supplemental and only to be taken under a doctor’s supervision with diet change.
Are gluten intolerance and gluten sensitivity the same?
According to Beyond Celiac, an organization promoting awareness of celiac disease, gluten intolerance and gluten sensitivity are the same. But gluten sensitivity is considered more medically accurate, while gluten intolerance is more widely recognized in the mainstream.
To better understand what gluten intolerance is, we also need to take a look at celiac disease.
Are gluten intolerance and celiac disease the same?
Celiac disease and gluten intolerance are different. Two people can have similar symptoms after eating gluten, such as bloating, but this doesn’t mean they have the same health issue.
In an article for Northwestern Medicine, Bethany Doerfler (MS, RD, LDN) explains the difference. She notes that celiac disease is an autoimmune disorder. In contrast, gluten intolerance is a sensitivity.
Symptoms of gluten intolerance don’t have as severe of an impact on one’s health as celiac disease. According to Austen Gastroenterology:
- Celiac disease can cause lasting damage to the small intestines, while gluten sensitivity doesn’t.
- Celiac disease often results in leaky gut (or increased intestinal permeability), while gluten sensitivity doesn’t necessarily.
Leaky gut is when bacteria, toxins, and undigested food proteins seep through the gastrointestinal (GI) barrier and into the bloodstream.
Are gluten intolerance and gluten allergy the same?
The above terms aren’t the same. An allergy means your body’s immune system overreacts to a trigger, such as wheat.
Wheat allergies are associated with a positive IgE lab test. Those with gluten-related symptoms who test negative for celiac disease (or a wheat allergy) may have a gluten sensitivity.
Top Foods containing gluten:
Grains that include gluten:
- Wheat varieties (such as spelt, durum, couscous, semolina, graham flour, farina, farro, emmer, and seitan)
Foods that usually contain gluten:
- Some breakfast cereals
Foods that may contain gluten:
- French fries
- Processed meat
- Salad dressing
Before munching on any of the above foods, check the ingredient list or ask your restaurant server about gluten-free options. Some restaurants may even have menus that alert you to gluten intolerance foods to avoid.
Alcoholic beverages that contain gluten:
- Dessert wines
- Malt beverages
- Wine coolers
Gluten-free varieties of these drinks do exist. Also, many distilled alcoholic bevies are gluten-free but do your homework before you say, “Cheers!”
The following products can also contain gluten:
- Herbal supplements, medications, and vitamins.
- Lip balms and lipgloss (which can easily be ingested).
- Playdough (which kids can accidentally eat).
- Communion wafers at one’s church service.
If you’re ever questioning whether a food or item contains gluten, you can:
- Ask your server about ingredients.
- Alert restaurant staff to any gluten intolerance.
- Read food labels.
- Buy food or drinks made specifically to be gluten-free.
- Research gluten intolerance foods to avoid (and make a list to refer to).
- Use gluten-free products to avoid unpleasant signs of gluten intolerance.
Can gluten intolerance be cured?
There is no known cure for gluten intolerance. The only treatment is a gluten-free diet. But on a positive note, a recent study suggests gluten intolerance may not be permanent.
This occurrence happens when gluten is unknowingly spread to a food or product during production or meal prep.
You can do your best to avoid this by preparing meals or reading food labels. If a label says that the item may contain gluten or was prepared in a plant with it, head this warning!
Q: Can you trust gluten-free labels?
A: According to Beyond Celiac, since 2014, all FDA-regulated packaged food manufacturers who use the gluten-free label must comply with strict FDA guidelines.
Q: Can you eat gluten-free grains (such as soy flour)?
A: Technically, yes, if the grain is gluten-free, you should be good to go. But grains are considered at higher risk because of possible cross-contamination during production.
Q: What about gluten intolerance and breastfeeding?
A: If you’re a mom diagnosed with gluten sensitivity or celiac disease, you must maintain a gluten-free meal plan while breastfeeding.
Q: What are some gluten-free options for kids?
A: Try snacks such as:
- Scrambled eggs
- Cucumber sticks
- Cream of rice (make sure it’s gluten-free!)
- Gluten-free mac and cheese
- Fruit salad
- Frozen grapes
- Apple slices
Q: Can you live comfortably if you’re intolerant to gluten?
A: By no means does gluten sensitivity mean you can’t enjoy the same treats and life you once did. Research to understand what you can substitute your foods, products, and drinks with so you don’t miss out!
Q: How to test for gluten intolerance? Who does the test?
A: Usually, your doctor will test for celiac disease and a wheat allergy first. If those return negative, you can work together to narrow down the cause. This can be done via diet and symptom tracking. Also, you can test for gluten intolerance using an at-home kit. Just be sure to follow up with your physician to discuss the gluten intolerance test results. (As mentioned above, your doctor will also want to make sure you don’t have celiac disease.)
Signs of gluten intolerance are often uncomfortable and affect one’s well being, so arming yourself with knowledge and awareness is key! Nowadays, you can prioritize your health and improve your diet, test for gluten intolerance, and work closely with a doctor all from the comfort of your own home! Info on this ailment continues to change as the medical world does more research, so be sure to stay tuned as we continually update our content!
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