Is Gluten Sensitivity Real? | Chris Kresser
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Is Gluten Sensitivity Real?

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is gluten sensitivity real, is gluten intolerance real
Sources of gluten can cause episodes of intolerance for those who are sensitive to it. istock.com/ChristianJung

You’ve probably seen the recent glut of sensational headlines in the media proclaiming that non-celiac gluten sensitivity is some kind of widespread collective delusion—simply a figment of the imagination of anyone who claims to experience it.

These stories point to a new study which found that a group of patients with irritable bowel syndrome (IBS) were not sensitive to gluten. (1) The researchers who performed this study had previously published a paper showing that IBS patients were sensitive to wheat, and that removing wheat from their diet led to an improvement of symptoms.

Gluten sensitivity: real diagnosis or collective delusion? Read this to find out.

However, in this new study, the authors specifically isolated gluten and found that there was no difference in symptoms between the patients eating high-gluten diets and those eating low-gluten diets.

This is a significant finding, but to claim that it proves that non-celiac gluten sensitivity doesn’t exist is both inaccurate and irresponsible. It’s a great way to get clicks and generate attention, but it’s an extreme distortion of what the study actually found.

Why This Study Doesn’t Disprove Gluten Sensitivity

First, this study examined the effects of gluten in a specific population: people with irritable bowel syndrome. Even if it is true that gluten sensitivity is no more common in people with IBS than in people without IBS (which is premature to conclude on the basis of a single study), it does not overturn the large body of evidence that links non-celiac gluten sensitivity to a variety of health problems ranging from allergies to schizophrenia to autism spectrum disorders. (2, 3, 4, 5)

Second, this study does not suggest that people with IBS—or anyone else with gluten sensitivity—should feel free to start chowing down on wheat. In fact, it suggests the opposite. For the first week of the trial, all patients were put on a gluten-free diet that was also low in FODMAPs (a class of carbohydrates present in wheat, as well as other foods).

After this lead-in period, the participants were assigned to one of three groups: a high-gluten diet, a low-gluten diet, and a placebo. Those on the high gluten diet were given 16 grams per day of purified wheat gluten; those on the low gluten diet were given 2 grams per day of purified wheat gluten plus 14 grams per day of whey protein isolate; and those on the placebo diet were given 16 grams per day of whey protein isolate.

The majority of participants experienced a significant improvement of symptoms during the 7-day gluten-free, low FODMAP lead-in period. But there was no difference in symptoms between the high gluten, low gluten, or placebo groups during the subsequent treatment period. In other words, patients did react adversely to wheat, but they did not react to isolated gluten.

This of course suggests that something other than gluten in the wheat was causing the problems patients experienced. We now know that there are several compounds in wheat other than gluten that could be to blame. These include not only FODMAPs, but also agglutinins (proteins that bind to sugar), prodynorphins (proteins involved with cellular communication), and additional proteins that are formed during the process of wheat digestion, such as deamidated gliadin and gliadorphins (aka gluteomorphins). (6)

Another possibility is that both the placebo and low-gluten groups were reacting to the whey protein. Whey is >99% casein- and lactose-free, which is what most people who are sensitive to dairy react to.

However, it is certainly possible for people to react adversely to whey, and in my experience this is more common with patients with digestive problems. If some of the “placebo” and low-gluten patients were, in fact, sensitive to whey, then that would invalidate the results of the study.

How to Find out If You’re Sensitive to Wheat, Gluten, or Both

This study showed that for people with IBS on a low FODMAP diet, eating isolated gluten does not cause symptoms. But one might ask: who cares? Do you eat isolated, purified gluten? Do you know anyone who does? I doubt it. People eat wheat—not gluten. And as both this study and numerous other studies have demonstrated, there are several components of wheat other than gluten that cause problems.

In practical terms, this study still supports the idea that patients with IBS should avoid wheat, because it contains FODMAPs and possibly other compounds that make them feel worse. What this study does tell us is that it’s possible that IBS patients may be able to tolerate other non-wheat products that contain gluten, presuming they are low in FODMAPs and other compounds that they may react to.

Here’s the best way to determine if this is true for you:

  1. Remove all gluten-containing foods and products from your diet for 60 days.
  2. At the end of the 60 day period, cook up a bowl of barley, eat it, and see what happens.
  3. A few days later, eat a piece of wheat bread.

Barley is a gluten-containing grain that is low in FODMAPs. If you react to it, that suggests you’re intolerant of gluten or other gluten-like compounds. If you don’t react to barley, but you do react to the wheat bread, that suggests you are intolerant to something in wheat specifically.

You may be able to safely consume gluten-containing products other than wheat—though it’s worth pointing out that many of these products (primarily grains and processed foods) would not be foods you should be consuming regularly anyways.

Is “Non-Celiac Wheat Sensitivity” a Better Label?

If there’s an important takeaway from this study, it’s this: non-celiac wheat sensitivity may be a different clinical entity than non-celiac gluten sensitivity. The former would be used to describe patients that are intolerant of wheat, but are able to eat other gluten-containing foods without symptoms. The latter would apply to patients who are sensitive to any food or product that contains gluten, including wheat.

In fact, this distinction was originally proposed by researchers in response to another study which found no effects of gluten in patients on a low FODMAP diet. (7)

Now I’d like to hear from you. Are you ready to give up on the idea that you’re gluten sensitive after reading this study? Why or why not? Have any of you already done the experiment that I suggested above? What did you discover?

Please share your comments with me below—and share this article with your friends if you think it might help clarify this issue for them.

362 Comments

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  1. Wondering… I hear and read so much about the negative effects of gluten… my main question is if a person is someone who does not exhibit any outward signs of discomfort when eating gluten, how do you know if is bad for you? Is it bad? And if it is like this for this person, does it make sense of being low gluten? Or even a small amount of gluten is bad for a person’s gut. Thanks!

  2. I have dermatitis herpetiformis. Would this be a wheat or gluten issue? No obvious digestive issues with gluten. Been tested and scoped for celiac. Suspected IBS but have no major issues with FODMAP foods. So assuming I have other food sensitivities. Did a blood test and eggs are very high. Casin and gluten just barely over into the moderate zone. Kidney beans were the only other thing quite high. Anyway, I have on and off digestive issues, DH, high thyroid antibodies(not on meds) and hydrenditis supperativa. What is the issue?? Thank you in advance.

  3. I have indeed done the gluten challenge and strictly avoided it for 2 years. I only ate whole grain bread from the time I was about 12. I really liked it. Gradually as I aged I became more and more fatigued and suffered terribly with brain fog. It was the brain fog that made me make a change. I suffer from obesity despite a whole grain low fat diet!! When I removed wheat and pasta within 10 days the brain fog completely lifted and the fatigued vanished. I was full of energy. Yet I still suffered from food sensitivities from tomatoes, onions, and eggs. Dairy too has been a problem. My sister came across the description of fructose malabsorption. The description of the disorder from sufferers and medical professionals totally described what was going on with me. A diet of low fodmaps avoiding high fructose foods and fructans (in wheat and onions) solved all my digestive disorders promptly. I now eat small amounts of sourdough leavened bread with no added yeasts where the fructans and gluten are apparently greatly reduced by the natural fermenting process. I still am working on the weight thing, but my digestion and energy is so greatly improved I don’t really care anymore.

  4. There is no wheat grown and/or turned into flour in the United States that is genetically modified. Sadly, most of the gluten free food you’re eating is very unhealthy. Generally you’re better off eating nutritious whole grain wheat products. What you should be avoiding is products that are made from high glycemic index white flour.

    • Maybe there’s not much ‘gluten free food’ that is supposed to be a substitute for wheat products that are good for you, but I eat tons of gluten free foods that are great for me, like fruits, veggies, meats and healthy fats. Maybe the gluten free food you eat is bad for you, but mine is great!

    • Steve, you are assuming that people who cut gluten from their diet all go and eat those highly processed, high sugar gluten free products. That is a pretty broad assumption that does not extend to a lot of people.
      Additionally, how is continuing to consume wheat, when you know it causes inflammation in the case of those with sensitivities, a wise thing to do? It’s like asking for something like cancer in the long-term. Absurd!

  5. I have found the level of accuracy of this wonderful study (LOL )to be in direct corrolation to Monsantos wheat farmers. They>> who m ever they are want us to consume their yummy GMO Wheat till we die. Unfortuntly our deaths my come much early and the pain an and agony is off the charts. I say we in responds to this study have a good laugh and focus on our food supply that is nothing but poision unless you are organic and wild meat. buying spring water. Yes folks lets wake up and stop buy their food- we are supplying the devil with everything they need to continue this made ness. (True I cant spell)

    • That article is BS:

      All of the data are wrong:

      “Celiac disease was excluded either by absence of the HLA-DQ2 and HLA-DQ8 haplotype or by a normal duodenal biopsy (Marsh 0) performed at endoscopy while on a gluten-containing diet in individuals expressing the HLA-DQ2 or HLA-DQ8 haplotype.”

      Note the AND when discussing haplotypes, there is no evidence here to say they excluded those with HLA-DQ2 OR HLA-DQ8. Here they state they excluded those with HLA-DQ2 AND HLA-DQ8 as well as those with HLA-DQ2 OR HLA-DQ8 haplotype that also had a biopsy to confirm Celiac disease.

      “7% of the study subjects DID respond to eliminating the gluten proteins from their food, yet the authors chose to say ‘No Effect of Gluten….”

      I don’t think you understand how statistics work.

      “37% of the patients in their study DID have an elevated immune reaction (antibodies) to the gliadin peptide of gluten … This clearly suggests a sensitivity to the protein with the immune system response”

      Again, I don’t think you understand how statistics work. Also, I’m not sure where you’re getting 37% as that would equate to 14/37 patients in the study and this number is not mentioned in correlation with any result anywhere in the paper. Even if it was, this doesn’t ‘clearly suggest’ anything. By your same logic, with data in the study I could say that ~35% (13/37) of those on a no gluten diet have elevated gliadin, so CLEARLY no gluten causes an immune system response, but I won’t because that is junk statistics and junk science. The paper itself says: “There was no apparent trend for those patients who had elevated scores on any biomarker with those who demonstrated a gluten- or whey-specific symptom response.”

      I could go on but I won’t, this article is not surprising coming from someone who makes their living off promoting NCGS on a blog by another person who makes their living off of promoting NCGS.

  6. I KNOW there is such a thing as being sensitive to gluten. I was so itchy all over my skin, had blisters on my elbows and knees , brain fog, forgetful, pain in bones etc. I was flying home from a holiday which was a five hour flight. I could not sit still. The itchy skin drove me crazy. I got home and went to the Dr. He did tests for liver cancer and also did allergy tests. They couldn’t find anything wrong but I started getting anxiety attacks because we couldn’t figure it out. Dr said it has to be some kind of allergy.
    I finally started to realize if I did not eat bread, pasta and also no dairy,it would improve. This is eight years later and at times it doesn’t bother me as much but if I eat to much bread and dairy I start getting itchy and then it takes 3-4 weeks to go away. It is real. I know!!

    • Really? You KNOW its gluten? Did you isolate gluten and only eat that and not other things contained in bread, pasta, and dairy. How do you know its not something other than gluten that is in those foods as well? (hint, hint, you don’t)

      • Duh. Jamie. Are we who remove wheat and gluten from our diets and then experience wonderful relief from lifelong health issues somehow missing something? WTH is wrong with making these choices ourselves and making our own decisions and choices about this subject without picking apart language and minutiae in every study blah, blah. Am I somehow missing some fantastic nutrient because I choose not to eat the garbage that is on the shelves in the grocery I USE? Just like everyone else uses stores or farms where they live. That was all I eliminated (along with GMO corn) but I am not really missing anything in these foods but enjoying the better health. Is that not worth something?

        I found out as a child that stepping into the road without looking can be very dangerous. I found out as an adult after suffering from many painful physical and emotional issues that eating wheat and probably gluten was dangerous for me and my health/future. This is what you call LIFE and a reasonable, deductive thought process. I didn’t need to pick a “study” apart to figure out either one. Have a good day.

        • Well said Janet. I went though pretty much a very similar situation as yours. Now I stopped eating gluten products and eat 95% whole foods instead of packaged foods and feel a huge difference in how I feel. We are the best judges when it comes to our health and body.
          Be kind to yourself however you feel is best.

        • Excellent point. I found out a long time ago that empirical observation STILL WORKS! Form a hypothesis. Test it. If it works, use it. If it doesn’t, try another. And stop assuming that your truth should be everyone’s! I’m not gluten sensitive, per Se. But like mentioned above, too much wheat, and I’m itchy, and around my small joints I break out like a mild version of poison oak. And let’s not talk about brain fog and sugar cravings. I have Lupus, and wheat, dairy and corn call all quickly cause a flare. I control my symptoms with diet alone. So… It doesn’t have to be “gluten sensitivity.” It could well be GMO, or heck – could be the fabulous Roundup they spray on wheat 3 days before harvest to get a higher release of the grain from the stalk. IT DOESNT MATTER! Eat. Don’t eat. Observe. Make a decision. Feel better. Or don’t. END OF STORY…

      • Does it really matter? This is why I consider many scientists to be very well-educated idiots. If wheat causes a problem for you, don’t eat it. Doesn’t matter if it’s gluten, gliadin, agglutinins, etc. It’s like arguing which is better: Beating yourself over the head with a hammer or a pick axe? “We’ll ya know the pick axe has a tapered edge which is more likely to pierce the brain case, but the hammer is more likely to cause subdural hematoma. Let’s do a double blind placebo controlled RCT to…” Or how about just don’t hit yourself over the head with anything.

        • David, your response made me laugh out loud! I needed that.
          I am working with a nutritionist who thinks I have a wheat sensitivity. I have always said I’d rather jump off a cliff than go on a gluten free diet. But, looks like I’m going to give it a try and see what happens. After twelve years of trying to figure out what’s causing my digestive woes, I figure what the heck. I’ve tried everything else.

      • Jamie sounds like he is trying to prove his knowledge but is missing the point. All the replies were PERFECT !

    • You may want to look into a skin condition called “Dermatitis Herpetiformis.” It is the skin version of Celiac Disease, and Celiac Disease can be diagnosed by actually testing for IgA antibodies near the blisters. No need to do the duodenal biopsy. But of course, you need to be eating gluten again and wait for your skin to act up, in order to get tested. 🙁

  7. Hi Steve,

    great piece, i am sick of being judged as being another one of those people who suffer from one of these rare fad digestive issues. The thing is now some of my other friends have been diagnosed and are starting out a GF diet, something i have had to deal with for over 2 years. Their is a lot of uncertainty out their and for me personally everyday i am still unsure if half the foods i am eating are GF free.

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