Celiac vs. Non Celiac Gluten Sensitivity

The majority of people are self-diagnosing their gluten sensitivity. Is this valid? Are people over-diagnosing their problems with gluten? Is there such a thing as gluten sensitivity apart from celiac disease?

Gluten Free Without a Celiac Diagnosis?

For a long time most doctors would say that you shouldn't start a gluten free diet without a confirmed celiac diagnosis because gluten was only an issue in those cases. Observant clinicians have disagreed and finally in 2011, a great study was published by some big names in the gluten field showing that gluten-related disorders come in at least two forms, celiac disease and non celiac gluten sensitivity (NCGS). Search Gluten and BMC Med. 2011 Mar 9;9:23.

A Bit of History Is Helpful

To better understand the diagnosis problem a short history is helpful. The first writings about the intestinal problems related to diet were in the first century A.D. The specific cause was unknown until the 1940's when gluten was finally identified. In 1980 it was generally accepted that about 1:5000 people had celiac disease. By 2003 that number had changed to 1:110 based on blood tests that are known to correlate well with positive intestinal biopsies. At that time most experts considered celiac disease to be the only form of gluten sensitivity.In 1998 a neurologist in England, M. Hadjivassiliou, began publishing studies about gluten sensitivity and the neurological implications. By 2002 or so, he departed from talking about celiac disease and began to reference certain types of brain disorders that he could identify with imaging studies. He would do imaging studies on people who had problems like migraine headaches, identify the brain lesions, put people on a gluten-free diet for about a year and then redo the imaging studies. He found that about 7 in 8 people had a reversal of the brain lesions along with a resolution of symptoms.

More Than Celiacs Benefit From a Gluten-Free Diet

So now we have excellent and varied scientific information about gluten sensitivity that supports what many of you have known all along, that is you don't have to have a celiac diagnosis to suffer adverse effects from dietary gluten and therefore, you will greatly benefit from a gluten-free diet too. If you are gluten sensitive and continue to eat gluten, you are subject to a wide range of autoimmune and other disorders that increase your risk of death at every age from whatever people die from the same as a celiac patient.

Lab Tests Can Help

We recommend lab testing to learn if you are a candidate for a gluten-free diet. Our favorite test for some time has been a Cyrex Labs Array 3 that tests for 24 different antibodies instead of the medical standard of 1 or 2. You can read more about this by searching OVitaminPro using gluten blog in the search box.

Time To Look For a New Doctor?

The important take away from looking at the 700 or so articles about Non-Celiac Gluten Sensitivity is that this is a real thing in the absence of a positive tTG IgA test. This is tissue transglutaminase immune globulin A, a type of immune reaction to the presence of gluten. This is the only test that doctors who about 25 years behind in their research will recommend. If you are having weird symptoms (Gluten Sensitivity Quick Facts) and your doctor runs a one antibody test and tells you gluten isn't your problem or even part of your problem, it is time to do some doctor shopping.

Zonulin

Another way to diagnose NCGS is to look at blood levels of zonulin. According to some researchers, this is a good biomarker specific to NCGS. Zonulin has to do with how good the tight junctions are being maintained between the intestines and the blood supply. The zonulin story is interesting and I will talk about this another time.

I am waiting for the cure myself as I have been gluten free for many years. So far this can be managed by going gluten free which means reading labels and being careful when you eat out.

Just know that you can have significant gluten problems without the classic celiac markers. Non celiac gluten sensitivity is real.