Celiac Disease vs. Gluten Intolerance: What’s the Difference?

There’s been lots of buzz over the past several years among the health and wellness community about gluten. Is gluten bad for me? Why go gluten-free? How do I know if I have celiac disease? A quick Google search generates nearly 500 million articles detailing how to go gluten-free!

The goal of today’s post is to break down the differences between a gluten intolerance and true celiac disease since there’s a lot of confusion around the two! Let’s dig in. 

Celiac disease

Once rare, celiac disease now affects 1 in 100 people worldwide, with the number of people affected doubling every 15 years. Many physicians believe the condition is underdiagnosed, prompting many doctors to screen patients with severe digestive complaints for the disease. 

Unlike a gluten intolerance, celiac disease is an autoimmune disorder that results in damage to the small intestine. While celiac does not produce anaphylaxis, a potentially life-threatening allergic response that could result from, say, a wheat allergy, celiac disease can lead to severe—and potentially fatal—health complications if left untreated. 

So how do you know if you are gluten intolerant?

Symptoms may include stomach pain, diarrhea, bloating, nausea and vomiting, pale or foul-smelling stool, fatigue, weight loss, rashes, migraines/headaches, damage to the nervous system, mouth ulcers, and bone density loss, among others. Damage to the small intestine also undermines the body’s ability to absorb nutrients, which can lead to anemia, bone/joint pain, irregular menstrual cycles, and infertility.

To diagnose celiac disease, your doctor will likely administer what’s called a Tissue Transglutaminase Antibodies (tTG-IgA) blood test. There are other tests out there, but this is one of the more common tests performed. Importantly, you will need to have gluten in your system at the time of the test to get an accurate readout.

Gluten intolerance/sensitivity

Many people experience celiac disease symptoms despite negative tTG-IgA results and no evidence of intestinal tissue damage. These individuals would fall into the gluten intolerant category. An estimated 17 million Americans have a gluten intolerance, and surveys show as many as 100 million Americans avoid gluten.  

While the underlying cause for a gluten intolerance is still unclear, a growing body of research is pointing to changes in our food system and their impact on our microbiome and gut health as a possible explanation for the rise in food allergies and intolerances. 

While severe gluten intolerance is becoming increasingly common, obtaining a clear diagnosis can be difficult. Gluten intolerance can manifest in the same way as celiac disease, but with great variability in severity and duration. To determine whether you have a gluten intolerance, your health care provider may recommend an elimination diet for a couple of months, then reintroducing gluten gradually back into your diet and evaluating your body’s response. 

Gastrointestinal health plays a major role in hormonal balance, mood, cognitive function, and other aspects of general health and well-being, so determining if you’re gluten intolerant is just as important as figuring out if you have celiac disease—both can compromise your health over time! 

How to avoid gluten

Avoiding gluten can be tough! Gluten is insidious and lurks in many foods. One recent study found that as many as one-third of foods reported gluten-free at restaurants contained gluten. 

Certain foods are also more likely to contain gluten than others. Below is a helpful guide to help you go gluten-free.

Source: Harvard University

We hope this clears up some of the confusion around the difference between celiac disease, a gluten intolerance, and a wheat allergy, and why the distinctions are important. 

Because the more food knowledge we have, the better we can fuel our bodies and care for our health! 

– Meg and the Allergy Amulet Team 

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