Is Gluten Sensitivity Legit?

In light of May being Celiac Awareness Month, I thought it was a perfect time to address celiac disease and gluten sensitivity. It remains a consistent request from patients, “Can I test to see if I am gluten sensitive?”  Typically, we perform a genetic blood test that indicates the presence or absence of the genes that contribute to having celiac (HLA DQ2/DQ8 Association). Even this test cannot always confirm whether someone is celiac or not, but instead gives one’s estimated risk for developing celiac disease. My point is that it is difficult to measure gluten sensitivity or celiac disease, and in many cases, I request that patients try a 4-6 week trial of a gluten-free diet to really determine their level of sensitivity. This is the gold standard for determining a clinical response to gluten consumption — the elimination diet. The vast majority of people feel better off of gluten, but if they do not experience any change in their symptoms, then they can go back onto gluten.

If you have seen a gastroenterologist for your GI symptoms, you know that there is often a dismissal of questions regarding gluten and how it contributes to GI symptoms. Moreover, besides ordering an endoscopy, there is little to no extensive follow up to try to determine why you have symptoms.

Recent research has put doubt in the minds of gastroenterologists about the non-celiac gluten-sensitive population. In 2011, Peter Gibson, a professor of gastroenterology at Monash University and director of the GI Unit at The Alfred Hospital in Melbourne, Australia, published a study in which they monitored patients’ GI symptoms over a period of one week (only one week!) while they rotated between 1 of 3 diets — the diets were high gluten (16 grams), low gluten (2 grams), and whey protein. The researchers found that the participants all had continued GI symptoms, regardless of the diet they ate. Their conclusion was that the patients’ continued symptoms while rotating through these diets were “psychological” because they had a full week off of gluten. Thus, their symptoms had to be from something else.

Ludicrous! We all know or have even experienced that when eliminating gluten it can take weeks, or possibly months, for symptoms to subside. This research fails to give us any information about gluten sensitivity. The gut is a fragile terrain, and removing the gluten for 7 days will often not tell us anything about someone’s condition.

As always if you want to give a gluten-free diet a try, it will never hurt you. You may even lose some weight, as you typically replace a lot of processed food and extra carbs with more fruits and veggies. So, give it a try, but be sure to allow 4-6 weeks before you make gluten a permanent fixture in your diet.