Going Gluten Free: What You Need to Do First

Gone are the days (I hope) that people believe that going gluten free is just the latest fad.

It’s undeniable that many people, for many different reasons, feel much better on a gluten free diet.

It is important that a person has a coeliac screen before going gluten free. The reason for this is that if they go gluten free and feel fabulous, they are likely to never let so much as a wheat cracker pass their lips again (which is great) – but this precludes ever doing a coeliac test again, as you need to be eating wheat in fair quantities for a coeliac blood test to be reliable.

So why does the coeliac test matter?

It matters because there IS a difference between being coeliac and non-coeliac gluten sensitive. Coeliac disease brings with it some well-documented significantly increased risks of things like bowel cancer and osteoporosis. Non-coeliac gluten sensitive doesn’t (though keep in mind research is in its early days).

So you need to know why you are going gluten free.

If you are coeliac, you need to be much stricter in order to avoid these risks. If you are non-coeliac gluten sensitive, you may choose not to consume gluten, but chances are, the occasional crumb from someone else’s toast is going to find its way into your butter, and that may not do you serious harm. If you are coeliac, this WILL do you harm, and you need to take extra measures to avoid it.

The second comment is this: non-coeliac gluten intolerance may be on the rise, but so is FODMAPS intolerance, which also causes digestive symptoms when bread is consumed. In one recent study of a group of patients with functional gastrointestinal disorders (e.g. irritable bowel syndrome), 60% had a FODMAPS intolerance! It is important we don’t label ourselves as “non-coeliac gluten intolerant” when it is actually a FODMAPs intolerance we have, as this creates confusion and scepticism about the concept of gluten intolerance, which doesn’t help the kid with autism, the kid with diabetes, and all the rest of the people with genuine non-coeliac gluten intolerance. This is a bit like the impact that “pescovegetarians” or fish-eating vegetarians have on the genuine vegetarian movement – it dilutes the concept and makes it much harder for genuine vegetarians to defend their stance.

By all means let’s get rid of the wheat and/or gluten out of our diets because it’s great for our health and makes us feel good.

But – let’s leave it at that and not use research that may not apply to us to convince others. Or, alternatively, get yourself tested – make sure you are not coeliac, which carries its own special health risks due to unintended ingestion of tiny amounts of gluten – and see if the reason you feel better without wheat is a FODMAPs intolerance, which may then lead you to realise you also feel a lot better on a true low-FODMAPs diet, which requires exclusion of more than just gluten-containing foods.

I do need to add the caveat that coeliac testing is not as straightforward as it appears to be either. But that’s the topic for another post.

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