{"id":32049,"date":"2025-06-09T17:27:45","date_gmt":"2025-06-09T22:27:45","guid":{"rendered":"https:\/\/wholehealthchicago.com\/blog\/?p=32049"},"modified":"2025-06-09T17:27:49","modified_gmt":"2025-06-09T22:27:49","slug":"non-celiac-gluten-sensitivity","status":"publish","type":"post","link":"https:\/\/wholehealthchicago.com\/blog\/2025\/06\/09\/non-celiac-gluten-sensitivity","title":{"rendered":"NON-CELIAC GLUTEN SENSITIVITY: UNRAVELING THE MYSTERY"},"content":{"rendered":"\n

Here\u2019s a diagnosis that doctors only started thinking about as recently as the 1980\u2019s and now, decades later, although there are now plenty of gluten free items available both in grocery stores and on restaurant menus,\u00a0doctors are still arguing about its existence. Many don\u2019t even mention it to their patients with irritable bowel syndrome.<\/p>\n\n\n\n

\u201cWhy the controversy?\u201d, you ask.<\/p>\n\n\n\n

The main symptoms of non-celiac gluten sensitivity (NCGS) include\u00a0gastrointestinal issues like bloating, abdominal pain, diarrhea, and constipation, as well as non-GI symptoms such as fatigue, brain fog, headaches, and joint pain.\u00a0In his book, \u201cDangerous Grains\u201d, James Braly, M.D.\u00a0 lists 200 symptoms associated with gluten (no typo, 200!). These symptoms are similar to those of celiac disease, which actually damages the small intestine but NCGS does not. Both conditions, celiac disease and NCGS cause intestinal hyperpermeability, which I have written about here<\/a>.<\/p>\n\n\n\n

First, what exactly is gluten?<\/p>\n\n\n\n

Gluten is a family of proteins found in many grains, most commonly wheat. The two most well known of these are glutenin and gliadin, and when gluten causes health problems, it\u2019s the gliadin causing trouble. On the plus side, gluten gives our wheat products their great texture and taste. The perfect croissant (and you know what they taste like) just can\u2019t be managed with gluten-free flour.<\/p>\n\n\n\n

The current guesstimate places roughly 20% of the population believing they are intolerant to gluten. Note: \u201cbelieve they are intolerant\u201d is not the same as \u201cdefinitely intolerant\u201d, which in itself is part of the problem. More about that later.<\/p>\n\n\n\n

Let\u2019s begin with the \u201cdefinitely intolerant\u201d group first. Celiac disease <\/strong>is an autoimmune condition, found in 1% of the population. In this situation, the gluten molecule triggers your immune system into creating an antibody that slowly destroys the lining of your intestine. In time, as you lose your ability to absorb important nutrients, you lose weight and develop potentially fatal vitamin deficiencies. The process is extremely slow, with the average person developing complications of celiac disease eleven years before they\u2019re diagnosed.<\/p>\n\n\n\n

Over those 11 years, main symptoms are digestive (bloating, gas, poor appetite, chronic indigestion, changes in bowel movements), but also a variety of unrelated symptoms (depression, fatigue, skin rashes, hair loss, weight loss, muscle cramps, easy bruising, changes in periods) caused by malnutrition.<\/p>\n\n\n\n

One reason it takes so long to diagnose is that testing is complicated. Although now there are simple screening blood tests, the gold-standard test is to biopsy cells lining your small intestine. The procedure is done in the outpatient department of a hospital by a gastroenterologist who inserts a gastroscope into your stomach and then threads a delicate tube into your intestine and obtains a cell sample.  If celiac disease is present, the intestinal cells show a characteristic flattening, evidence of damage by the antibodies to the gluten molecule.<\/p>\n\n\n\n

Treatment is avoiding gluten grains and the countless gluten containing foods. Once these are completely eliminated, your intestine heals, malabsorption reverses, and your health is restored.<\/p>\n\n\n\n

Okay. That\u2019s celiac disease. Often overlooked, often hard-to-diagnose, but totally noncontroversial.<\/p>\n\n\n\n

NOW THE CONTROVERSY<\/strong><\/p>\n\n\n\n

AND IN THIS CORNER\u2026.Non-celiac gluten sensitivity (NCGS)<\/strong><\/p>\n\n\n\n

Because so much has been written in popular health books and online, far more people are avoiding gluten than necessary. Believing gluten to be \u201cunhealthy\u201d, people go \u201cgluten-free\u201d. Actually, gluten, a protein, is neither healthy nor unhealthy although some people certainly can be sensitive to it. NCGS <\/strong>is definitely no autoimmune disease and does not require the complete abstinence from gluten that celiac disease requires. On the other hand, it is harder to diagnose than celiac disease because there are no consistently reliable diagnostic tests.<\/p>\n\n\n\n

Thus, a frequent patient-physician conversation goes something like this:<\/p>\n\n\n\n

Patient: \u201cDoctor, all those chronic symptoms, my bloating, my diarrhea, my fatigue, my joint pains, all went away when I gave up wheat.\u201d<\/p>\n\n\n\n

Doctor: \u201cBut your blood tests for gluten sensitivity were negative. Your biopsy for celiac disease was negative. You don\u2019t have gluten intolerance.\u201d<\/p>\n\n\n\n

Patient: \u201cBut I\u2019ve read\u2026\u201d<\/p>\n\n\n\n

Doctor: \u201cLook, you don\u2019t have gluten intolerance. You\u2019re being ridiculous. Going gluten-free is just the latest \u201cfad\u201d diagnosis. Eat all the wheat you want.\u201d<\/p>\n\n\n\n

Patient: \u201cMy chiropractor (or acupuncturist, nutritionist, food allergy test, medical intuitive) says I should give up gluten.\u201d<\/p>\n\n\n\n

Doctor: \u201cNonsense. Gluten grains form the base of the healthy food pyramid. You\u2019ll probably end up malnourished without them.\u201d<\/p>\n\n\n\n

I\u2019ve lost count of the number of patients who\u2019ve related variations of this to me.<\/p>\n\n\n\n

This patient has \u201cclassic\u201d non celiac gluten sensitivity.<\/strong><\/p>\n\n\n\n

Dr. Braly\u2019s Dangerous Grains<\/em> is not exaggerating at 200 conditions. Over the many years, I have been suggesting a temporary trial of going gluten free, some patients have been able to go off their blood pressure meds, their anti-inflammatories, mood stabilizers and ADD meds. Note: \u201cSome\u201d. Not the majority, but enough to warrant GF a trial.<\/p>\n\n\n\n

One patient recently told me how she\u2019d been trying to get pregnant and was scheduled for in vitro fertilization (IVF). A nutritionist suggested that she try going completely gluten free. Six weeks later, and after two years of trying, she ambled into her fertility specialist\u2019s office, proudly harboring her very own embryo and all without his help.<\/p>\n\n\n\n

If you think you might be sensitive to gluten but aren\u2019t sure, try this elimination-reintroduction test:<\/p>\n\n\n\n

    \n
  1. Eliminate all sources of gluten for at least three weeks<\/strong>. You\u2019ll need to read labels, if you eat food with labels. Or build your menu on vegetables, fruits, and lean protein and you\u2019ll end up healthier in the process. If you rely on packaged foods, shop the gluten-free section at Whole Foods.<\/li>\n\n\n\n
  2. At the end of three weeks, if you\u2019re gluten sensitive you\u2019ll be feeling better<\/strong>. I realize \u201cbetter\u201d sounds vague, but it can be anything: better digestion, more energy, crisper mental clarity, easier breathing, a rash that clears up, less achiness in your muscles and joints. Conversely, if you don\u2019t feel an iota better after gluten elimination, you\u2019re likely not sensitive to it.<\/li>\n\n\n\n
  3. If you\u2019re feeling better, make doubly sure it\u2019s gluten by reintroducing gluten into your diet. <\/strong>If symptoms return, you\u2019re probably gluten-sensitive.<\/li>\n\n\n\n
  4. People who feel better off gluten need to differentiate between celiac disease and non-celiac gluten sensitivity.<\/strong> Ask your doctor to test your blood for gluten antibodies. If the result is negative, you need no further testing. If positive, keep eating gluten until instructed to stop. Your doctor will recommend a small-intestine biopsy to confirm celiac disease, and quitting gluten before the biopsy will invalidate the test.<\/li>\n<\/ol>\n\n\n\n

    AND NOW—IN THE OTHER CORNER\u2026.OVER RELIANCE ON GOING GLUTEN FREE: You may, by going gluten-free, be depriving yourself unnecessarily of a lot of good food and not contributing a single thing to your health and well-being. <\/strong>This was the subject of a very interesting book, \u201cThe Gluten Lie\u201d by Alan Levinovitz, Ph.D. who believes too many people are literally backing themselves into a corner \u2018nutrition-wise\u2019 trying to follow one nutrition fad after another.<\/p>\n\n\n\n

    Unless you have specific symptoms that vanish when you go gluten free (and return when you reintroduce gluten), don\u2019t expect any magic to happen in your body when you go gluten free. Even though the \u201cgluten-free\u201d section is larger than in the past, it\u2019s still small compared to the rest of the store. The \u2018GF\u2019 items on the menu of a high end restaurant tend to be disappointing. If you\u2019re prone to obsessive thinking, you\u2019ll be subjecting yourself to a lot of unnecessary stress as you ponder, \u201cCan I eat that?\u201d or \u201cI wonder if that contains any gluten.\u201d You may find yourself receiving fewer dinner invitations as host\/friends despair trying to prepare a meal for you that will single your main dish and dessert as \u2018GF\u2019.<\/p>\n\n\n\n

    In\u00a0clinical studies of \u201cgluten avoiders without celiac\u201d, actual symptoms induced by gluten challenged ranged from 10% to 40% of patients. All the others had been avoiding gluten unnecessarily<\/strong>. In other words, going gluten free (or even reducing gluten) must do something positive for your health, otherwise you\u2019re\u00a0doing\u00a0a disservice to your body. To make a food \u201cgluten-free\u201d, manufacturers often add more sugar and more fat; not surprisingly, people who go GF occasionally are surprised to find themselves gaining weight.<\/p>\n\n\n\n

    Anyway, if every time you eat a goodly portion of gluten (obviously more than a cookie), you feel ill, and you\u2019ve tested negative for celiac, consider yourself to have non celiac gluten sensitivity and generally reduce your exposure. Remember non celiac is not like an allergy, so if you get a craving for a slice of Lou Malnati\u2019s, the price may be bloating and diarrhea.  If you can\u2019t tell a difference, with or without, then your deprivation is unnecessary.<\/p>\n\n\n\n

    \u00a0If you need some guidance with all this, see our nutritionist, Olivia Darrow,<\/a> and save yourself unnecessary grief.<\/p>\n\n\n\n

    <\/p>\n\n\n\n

    Be well,<\/p>\n\n\n\n

    David Edelberg, M<\/em>D<\/p>\n","protected":false},"excerpt":{"rendered":"

    Here\u2019s a diagnosis that doctors only started thinking about as recently as the 1980\u2019s and now, decades later, although there are now plenty of gluten free items available both in grocery stores and on restaurant menus,\u00a0doctors are still arguing about its existence. Many don\u2019t even mention it to their patients with irritable bowel syndrome. \u201cWhy […]<\/p>\n","protected":false},"author":4902,"featured_media":32051,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[197,29,2333,2760,43],"tags":[1115,30,3009,3011,1395,3008,3010,1118,1739,3007],"class_list":["post-32049","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-allergies-food-sensitivities","category-digestion","category-functional-medicine","category-holistic-health","category-nutrition-nutritional-supplements-vitamins-herbal-remedies","tag-celiac-disease","tag-digestive-health","tag-gluten-controversy","tag-gluten-elimination-test","tag-gluten-intolerance","tag-gluten-sensitivity-diagnosis","tag-gluten-symptoms","tag-gluten-free-diet","tag-leaky-gut","tag-non-celiac-gluten-sensitivity"],"yoast_head":"\r\nNon-Celiac Gluten Sensitivity: Symptoms and Diagnosis Guide<\/title>\r\n<meta name=\"description\" content=\"Non-celiac gluten sensitivity causes bloating, fatigue, and brain fog. 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