Gluten gives many people gastrointestinal grief—this is probably not news to you. But there’s an increasing awareness that it can also cause a constellation of symptoms around the body that can be an incredible strain on your day-to-day wellness and long-term health. And it’s possible you may have a reaction to gluten with no GI symptoms at all. Read on to understand the range of gluten sensitivity symptoms.
“Gluten is made up of two proteins called gliadin and glutenin, and is primarily found in wheat, barley, spelt, rye, and triticale,” says Antoinette Liviola, a health coach with Parsley Health who specializes in gastrointestinal and autoimmune conditions. Gluten gives food elasticity and shape and is found overwhelmingly in highly processed foods like pasta, bread, crackers, tortillas, and cereal, as well as flour-based sauces and gravies.
For people who have celiac disease, an autoimmune disease, consuming gluten triggers an immune response that damages the small intestine, leading to severe nutrient deficiencies. If you have celiac, you cannot consume any gluten at all.
However, there’s a subset of the population believed to have non-celiac gluten sensitivity. While it’s not an autoimmune condition, “a person’s body and immune system is reacting to gluten in a negative way,” says Liviola.
You’re probably well aware of the GI symptoms of gluten sensitivity, including:
However, non-celiac gluten sensitivity can also cause non-GI symptoms. “Our gut lining is made up of tight junctions that hold together the intestinal wall. They are meant to open slightly to allow micronutrients of food to be absorbed into the bloodstream,” explains Liviola. Gluten, however, triggers the release of zonulin, a protein that signals these intestinal links to open up. Over time, the junctions can become looser, causing intestinal permeability that is casually known as “leaky gut.”
As that happens, molecules can enter the bloodstream that aren’t supposed to be there, which your body reads as foreign invaders. “This causes a constant state of inflammation in your body,” says Liviola. That’s why gluten may trigger body-wide symptoms far beyond the classic gastrointestinal woes.
Knowing the non-GI symptoms of gluten sensitivity can help you readily identify the cause of distressful symptoms and be ready to discuss them with your health coach. Because at the outset, these may not even seem related, or you may think you’re just under a lot of stress or simply need to get more sleep. But in reality, it can be rooted in your diet.
Decoding gluten sensitivity symptoms
These are some non-GI symptoms of gluten sensitivity Liviola sees among members:
Signs of gluten sensitivity can also be symptoms of many other conditions, so it’s important to watch out for them and know what’s normal for your body, but before you eliminate gluten on your own, talk to a health professional to get to the root cause of your issues.
How to get relief for symptoms of gluten sensitivity
First up: A proper diagnosis. At Parsley Health, your doctor would first rule out celiac disease through lab testing that looks for certain antibodies in your blood. Testing also looks for things like nutritional deficiencies and inflammation, which are both common among people with celiac disease and gluten sensitivity. If your doctor suspects you have celiac disease, they may refer you to a specialist to confirm the diagnosis through an endoscopy and/or an intestinal biopsy.
Assuming celiac is ruled out, “I advise members to eliminate gluten for at least 30 days to see if symptoms improve,” says Liviola. Elimination diets are considered the gold standard for identifying food sensitivities. Your health coach will work with you to implement the elimination diet and keep you accountable.
Liviola says she may also suggest food sensitivity testing to see if you have a reaction to gluten. Some members prefer to have a food sensitivity test in order to confirm their suspicion.
If you find gluten is not triggering symptoms, your doctor and health coach will continue to work with you to resolve your symptoms through advanced testing, lifestyle modifications, supplements, and medication as needed.
If you do discover a non-celiac gluten sensitivity, eliminating gluten from your diet can help bring down inflammation and ease both GI and non-GI symptoms, says Liviola.
If you have digestive symptoms, there’s often some awareness that gluten may be triggering your troubles. For instance, you’ll eat bread and feel bloated. “Other members will say they have no reaction to gluten. That is, until they take it out of their diet for a month, and then they notice a difference,” says Liviola.
Along with gluten elimination, Liviola often recommends that members take out two other inflammatory foods, dairy, and refined sugar. With the elimination of gluten and refined sugar, you will also be removing most highly processed foods from your diet, which can also influence how you feel.
Liviola encourages members to keep gluten out of their diet permanently, especially if they have gluten sensitivity or an autoimmune disease, however, it’s up to each individual to decide how to proceed. If they’d like, they can try to reintroduce gluten slowly after the 30 day elimination period. To do this, eat one serving of a gluten-containing food on day one, then two servings on day two, and three servings on day three. Then watch and wait. “Symptoms can arise three to four days later,” she says. Document how you feel. This will give you an indication of how much—if any—gluten you can comfortably tolerate.
At the outset, eliminating gluten-containing foods from your diet can seem incredibly tough. After all, gluten is found in so many foods, especially convenience foods. Removing it out means eating less processed, fresh food, much of which you prepare yourself, and diligently reading ingredient labels on food to ensure the food doesn’t contain a surprising gluten-containing ingredient.
Still, the results—improved symptoms, feeling better—make the effort worth it. “I find that most members end up sticking with a gluten-free diet. They said they assumed it would be really difficult, but it was easier than they thought,” says Liviola.
Having a health coach to partner with you on your new gluten-free lifestyle can make the transition even easier. Liviola regularly helps members through this transition. These are just a few ways to make it easier:
1. Shop smarter
While there are shelves of gluten-free foods available at the grocery store, these are not foods that you should create your diet around. When you’re building a gluten-free diet, Liviola suggests avoiding these for the most part. “These are still processed,” she says. Instead, your health coach will help you find foods you enjoy that are high-quality and organic that you can use to replace the things you miss on occasion. For example: Almond flour pasta or breads made with cassava flour.
2. Modify your usual restaurant order
If you’re ordering from a restaurant, Liviola suggests making servers aware that you have a gluten sensitivity so that they accommodate your dietary restriction. Also, avoid sauces, as these often contain flour as a thickener. Your health coach can help point you to gluten-free options in your area.
3. Balance your plate
When making dinner at home, play around with starchier vegetables to replace the grain on your plate, such as sweet potatoes or winter squash. The starch should take up one-quarter of your plate, with ½ non-starchy vegetables (asparagus, sweet peppers, green beans, broccoli) and the remaining quarter a lean protein.
Even if you don’t think that gluten sensitivity is a problem for you, Liviola says you should keep it on your radar: “It’s easy to think that if you’re not having a reaction now, gluten is not impacting you. But over time, it can trigger that intestinal permeability that leads to inflammation.”