I have found the single best ways to determine if you have an issue with gluten is to take it out of your diet for at least 30 day and then reintroduce it. Please note that gluten is a very large protein and it can take months and even years to clear from your system so the longer you can eliminate it from your diet before reintroducing it, the better.
The best advice that I share with my patients is that if they feel significantly better off of gluten or feel worse when they reintroduce it, then gluten is likely a problem for them. In order to get accurate results from this testing method you must elimination 100% of the gluten from your diet.
Another way to determine if you are gluten sensitive is to ask your doctor to order the following tests:
- IgA anti-gliadin antibodies
(these are found in about 80% of people with Celiac disease)
- IgG anti-gliadin antibodies
- IgA anti-endomysial antibodies
- Tissue Transglutaminase antibodies
- Total IgA antibodies
- Genetic testing (HLA DQ2 and HLA DQ8)
- Intestinal biopsy (for celiacs)
I’d like to mention that one potential problem with testing is that gluten is made up of several hundred peptides and gliadin is made up of 12 different sub-fractions. Most modern day testing focuses on only the alpha-gliadin (one of the twelve sub-fractions) and therefore there is considerable room for error and false negative tests. There is a new laboratory (Cyrex Lab) that has recently opened that is testing for these sub-fractions and may help to minimize false negatives.
At the end of the day, I tell my patients that your body knows better than any test. If you feel better when you take gluten out of your diet or feel worse when you add it back in and you have a negative test result – you still have an issue with gluten and don’t eat it!
I often get a lot of comments from readers when I write about giving gluten up for 30 days to test for gluten sensitivity. I am not referring to testing for celiac, yes the gold standard to diagnose celiac disease is still an intestinal biopsy and identifying celiac is important since it’s an autoimmune disease. However, for those who suspect that they have gluten intolerance rather than celiac, the single best way to determine gluten sensitivity is to remove it from your diet and see how you feel without it and how you feel when you add it back in.
How to treat gluten sensitivity and celiac disease?
Eliminating gluten 100% from your diet means 100%. Even trace amounts of gluten from cross-contamination, medications or supplements can be enough to cause an immune reaction in your body. The 80/20 rule; or “we don’t eat it in our house, just when we eat out” is a complete misconception. A Lancet article published in 2001 states that for those with celiac disease or gluten sensitivity, eating gluten just once a month increased the relative risk of death by 600%.
I tell my patients that even though the outward manifestation of eating gluten may be mild bloating or headache, inside their body, their immune system is being stimulated and the effects may last for three to six months.
For many, simply removing 100% of gluten from their diet isn’t enough. The damage that has been caused to the gut lining must also be healed. Additionally, I often find that there are other infections in the gut such as parasites, Candida, bacterial overgrowth, and bacterial imbalances that need to be addressed and corrected. For some, there may be a need to go completely grain-free due to the cross reactivity of gliadin sub-fractions in non-gluten grains.
When in doubt, go without. You’re not missing any vital nutrients by not eating gluten. In fact, you may be saving your life or the life of someone you love.