Gluten Sensitivity vs. Celiac - Ask a Nutritionist

Transcript:

BRITNI: Hello and welcome to Dishing Up Nutrition's midweek segment called “Ask a Nutritionist”. My name is Britni Vincent and I am a Registered and Licensed Dietitian at Nutritional Weight & Wellness. On today's show, I will be answering a couple of questions related to gluten. How do you know if you have a gluten sensitivity and when should you get tested for celiac disease?

What is gluten?

Great questions. Very common. And I think this will help a lot of our listeners out. So first off, I want to talk about gluten and what it actually is. You know, I think we've all heard the word gluten, and a gluten free diet has become a lot more common in recent years, but you might not understand what exactly it is.

Well, gluten is a protein found in wheat, barley and rye. And if you've ever baked bread or watched dough stretch, that elasticity comes from gluten. It's what gives bread that chewy texture and why gluten is just so common in our food supply.

How do you know if gluten is problematic for you?

But for some people, gluten can cause a lot of issues. So how do you know if gluten is bothering you? Let's start with some of the common symptoms. You know, in this instance, gluten intolerance and gluten sensitivity are often used interchangeably, but on today's show, I am going to refer to it as gluten sensitivity. So one of the biggest clues that you might have a gluten sensitivity is persistent digestive issues.

So think bloating, gas, diarrhea, or even constipation. And they might not happen right after you eat gluten. And so that's the, what's tricky about figuring out what is causing your digestive symptoms. Sometimes it can be a delayed effect. So I would just keep that in mind as you are trying to pinpoint what your specific triggers are.

And so these type of digestive symptoms, they can occur because gluten can increase the permeability of your gut. This is commonly known as leaky gut. So when your gut is more porous than it should be, that allows unwanted things like undigested food particles and toxins to seep from your intestinal tract into your bloodstream.

This creates a lot of inflammation and that your body responds to that inflammatory response with all sorts of unpleasant symptoms. But I do want you to keep in mind that gluten sensitivity is not always about digestive symptoms. In fact, some people don't experience digestive issues at all when they have a gluten sensitivity.

They may experience more headaches, joint pain, or skin problems like eczema or psoriasis. And if your gut is inflamed, it is common that it manifests through your skin because your skin is actually your largest organ. So you might be listening to this thinking, hmm, I've had some unexplained fatigue, brain fog, or skin issues.

What is the difference between gluten sensitivity & celiac disease?

Maybe it's worth considering whether or not gluten is playing a role. And this goes on to the question of when should you get tested for celiac disease? And what is the difference? Gluten sensitivity is, you know, one thing, but celiac disease is a serious autoimmune disorder where eating gluten causes your body to attack its own small intestines, specifically attacking your villi in your small intestine.

These are finger like structures that absorb your nutrients, and celiac can lead to all sorts of complications like nutrient deficiencies because your body can't absorb the vitamins and minerals from your food. So here is a very shocking statistic for you. About 80 percent of people with celiac disease go undiagnosed.

It's a huge number of people who are likely dealing with symptoms like digestive issues, anemia, or even osteoporosis without knowing the root cause. And I do want to mention, if somebody in your family, especially your immediate family, has celiac disease, I would recommend you get tested, even if you don't necessarily have these symptoms.

I've had some clients over the years, and that's how they've realized that they have celiac, is just because a family member tested positive for it. So then they got tested and they didn't necessarily have these more common symptoms. So that would be an important thing to also keep in mind. And if you suspect celiac, I would definitely talk to your doctor about testing.

And getting tested for celiac disease isn't always straightforward. The gold standard is a biopsy of your small intestine. But before that, your doctor would do a blood test to check for antibodies. And if that's positive, then likely a biopsy would follow that. But it is super important to know that you have to be eating gluten when you get tested.

If you've already cut gluten out of your diet, the test might give you a false negative because your body isn't producing those antibodies anymore. So if you do suspect celiac disease might be a possibility for you, you know, it might be tempting to avoid gluten right away, but I would recommend getting tested just to rule that out.

I know continuing to eat something that might be causing the discomfort is not ideal, but it is important to get an accurate diagnosis. It is time for me to take a really short break. And when I get back, I'm going to talk more about gluten sensitivity.

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Some symptoms to watch out for with gluten sensitivity

So I talked about celiac disease, and now I'm going to dive a little bit more into gluten sensitivity. So let's say you do get tested for celiac disease, and you are negative, but you still feel crummy when you eat gluten. Or, you know, maybe you haven't even connected your symptoms to gluten specifically, but you have a lot of those digestive symptoms or headaches, joint pain.

It would be worth exploring. And that's where the gluten sensitivity comes in. So unlike celiac disease, gluten sensitivity doesn't cause that autoimmune response, but it can still make you feel really uncomfortable and miserable. Your symptoms can still be pretty severe, and a gluten sensitivity will still create damage to that villi in your small intestine.

It's not going to be as severe as it would with celiac disease, but gluten sensitivity can also create nutrient deficiencies because of that. Other symptoms could be digestive symptoms of bloating, constipation, diarrhea could also be joint pain. Some people are more affected with their mood from gluten than they are digestively.

And fatigue can also be another big symptom of gluten sensitivity. Unfortunately, there's not necessarily a definitive test for gluten sensitivity like there is celiac disease. You can get tested for it, but it's definitely not the end all be all. So the best way to figure out if gluten is a problem for you is just eliminating it.

Think about doing a little experiment with yourself. So for three weeks eliminate gluten 100%. If you could do it longer than three weeks; that's great; but I would say a minimum three weeks. And I do say 100%, because you might think that a piece of regular toast once a week is not a big deal, but for some people with a gluten sensitivity, that does create enough inflammation to wreak havoc.

So then you're just not getting a clear answer whether or not gluten is an issue for you. So eliminate that gluten 100 percent for at least three weeks. And if symptoms improve, well, then you have your answer your body just does not tolerate gluten.

Where do we find gluten?

So what this means: specifically eliminating bread, pasta, baked goods, you know, really anything with flour. Gluten sneaks into other things like soy sauces, sometimes some other sauces, dressings, and there's other surprising foods out there that it can sneak into.

Which foods are naturally gluten free?

But the great news is eating a diet that is in whole, real foods is naturally gluten free, so that would be animal proteins, including dairy if tolerated, eggs, meat, fish, vegetables, starchy vegetables like squash, sweet potato, regular white potato, and other starches like quinoa, wild rice, and beans are all naturally gluten free.

And then the healthy fats, all of those healthy fats: butter, olive oil, nuts, seeds, those are also all going to be naturally gluten free. I will say I have followed a gluten free diet for over a decade now, and I promise you I do not feel deprived. I eat delicious food every single day. And what really helped me when I started to eat a gluten free diet, is I thought about what are the meals that I really love that are naturally gluten free?

I personally enjoy Asian flavors and typically Asian food is naturally gluten free if you just swap soy sauce for coconut aminos or Bragg’s liquid aminos. And so that could be stir fries, curries. I mean, the options are almost endless, and we have a delicious egg roll in a bowl recipe on our website and some really yummy stir fry recipes you can find at weightandwellness.com. And actually all of our recipes on our website are gluten free. So that can be a wonderful resource.

Check Out Some of Our Recipes!

Limit gluten free products

I do know it might be tempting to go out and buy all the gluten free products because there are lots of them nowadays, but I want you to keep in mind, they are often even more processed and higher in carbohydrates than their gluten containing counterparts. So, you know, it's nice to have them available for special occasions, but on the day to day, it really is best to focus on a diet of real food.

When should you get tested or try eliminating gluten?

And you might be wondering, when is the right time to get tested or try eliminating gluten? I'd say if you've been dealing with chronic digestive issues, fatigue, skin issues, or even brain fog, it really is worth looking into gluten, especially if you've tried other things, modifying other parts of your diet or taking a probiotic, but that hasn't necessarily eliminated your symptoms.

If you're concerned about celiac specifically, talk to your doctor before eliminating gluten. They can help guide you through that testing process. And for everybody else, if you're curious or just suspect that gluten might be an issue, I encourage you, give it a try, you know, do that experiment on yourself for three weeks.

And at the end of the three weeks, you're going to have your answer if gluten is an issue for you or not, and it's much more motivating to stay away from it if you know that when you eat gluten, you might get diarrhea or a headache or whatever your specific symptoms might be, and do remember t's important to try to replace gluten containing foods with those healthy balanced alternatives, like I was mentioning: vegetables, animal proteins, healthy fats, and a gluten free diet should not be a doubt about deprivation.

It really should be about fueling your body in the best way possible while still enjoying really delicious food. Whether you're dealing with digestive problems, skin issues or unexplained fatigue, gluten might be worth investigating. If you think celiac disease might be a possibility, get tested while you're still eating gluten.

And if not try eliminating gluten for a few weeks and just see how your body responds. And as always, if you're unsure, don't hesitate to make an appointment with myself or one of the other dietitians on staff. We are here to help you figure out what works best for your body individually.

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