Celiac and its close relative, gluten sensitivity, are serious disorders that need clinical diagnosis.
Gluten-free diets have been in the news and popular media for the past several years, picking up in popularity as they do. The increased interest also means gluten-free food offerings are becoming more common in stores and restaurants.
Seeing all the hubbub may have you wondering if you should eat gluten-free. The established research indicates that a gluten-free diet is helpful only for those who have a gluten-related medical disorder, particularly celiac disease or non-celiac gluten sensitivity.
Perhaps there have been times already when you chose to skip gluten for a bit and noticed a change in yourself. More energy, a clearer mind, things of that nature. Does that mean that you should be tested for celiac disease or gluten sensitivity?
It might mean just that.
Of course, there are plenty of other food sensitivities that could be causing your digestive issues. Due to that, it’s wise to start by keeping a food and symptom diary. There are apps to help you do that, or you can record it in a notebook or a google document.
A food and symptom diary is a simple document where you record the date, what you ate, and any symptoms you might experience, from stomachaches to muscle pain and headaches. It can also be wise to notate particularly high-stress days or days when you were particularly active or inactive.
After at least a month of tracking, patterns can start to emerge that may indicate celiac disease. Take your data to your primary care doctor or set up an appointment with a GI specialist to discuss your concerns and what you’re noticing in your food and symptom diary.
Remember that during this time, you should avoid changing your diet substantially. Even if you think gluten is what causes all of your health issues, cutting it out before seeing a specialist can actually make it impossible to get a diagnosis.
Though an official diagnosis of celiac disease or gluten sensitivity may seem trivial to some, having it on paper can help you access extra resources. It can also carry more weight with those in your life who may otherwise be inclined to view a gluten issue as not a big deal.
Further, celiac disease, and potentially gluten sensitivity, are lifelong diseases that do elevate the risk for certain diseases down the line. Things like type 1 diabetes, multiple sclerosis, infertility/miscarriage, or intestinal cancers are more likely if you have celiac. A formal diagnosis means your medical team knows to look out for these things.
Finally, celiac often causes secondary nutritional deficiencies that might go unnoticed but can cause things like bone density issues and anemia. Being diagnosed by a specialist also means they can help you manage and repair these nutritional deficiencies.
Symptoms
You may experience a variety of symptoms if you have a gluten issue. The most commonly known and widely experienced are typical gastrointestinal distress symptoms, things like diarrhea, cramps, pain, gas, bloating, nausea, vomiting, and the like.
However, not all people will experience these classic symptoms and can be living with celiac disease and several severe side effects without knowing the root of their issues. Non-classic symptoms can include the following:
- Unexplained iron-deficiency anemia
- Depression
- Delayed puberty
- Mouth ulcers
- Peripheral neuropathy (tingling or numbness in the limbs)
- Ataxia (brain degeneration)
- Alopecia (patchy hair loss)
- Osteoporosis or osteomalacia
- Liver disorder or fatty liver
- Other nutritional or mineral deficiencies
If this list is looking familiar, again consider following the food and symptom diary mentioned above. Charting symptoms and how they may or may not coincide with certain foods is the first thing your doctor will want from you in pursuing the correct diagnosis.
Other Indicators
There are plenty of other reasons someone may want to or should be tested for celiac disease or seek a diagnosis of gluten sensitivity. To begin with, celiac disease is a genetic disorder and passes through families. Anyone with first-degree relatives who have a diagnosis of celiac should consider getting checked themselves.
Type 1 diabetes can, as mentioned above, can be a side effect of celiac disease. However, it can be easier to see diabetes than celiac disease because diabetic symptoms are fairly uniform and celiac symptoms are not. Type 1 diabetes is a good indicator that an investigation into celiac disease would be a good idea.
Another group of diseases that commonly associate themselves with celiac are autoimmune thyroid disorders, meaning any disease wherein the immune system attacks a person’s thyroid. Hashimoto’s disease and Grave’s disease are two such disorders.
In Grave’s disease, the attacks on the thyroid cause it to create too much thyroid hormone while in Hashimoto’s, the attacks have the opposite effect. Too much thyroid hormone and too little thyroid hormone can make life very uncomfortable.
Research shows a significant overlap between autoimmune thyroid disorders and celiac disease. Emerging research even suggests there may be a connection such that eating gluten-free may help some autoimmune thyroid disease sufferers.
Celiac disease or gluten sensitivity can also be mistaken for IBS due to the gastrointestinal upsets that occur and the fact that eating low-FODMAP foods (as one does for IBS) removes a significant amount of gluten from the diet. If you have an IBS diagnosis, particularly if you still experience symptoms while eating a low-FODMAP diet, looking to pursue a celiac or gluten-sensitivity diagnosis is likely a good idea.
Other disorders that can put you at increased risk of celiac disease include the following:
- Asthma
- Multiple sclerosis
- Primary biliary cirrhosis (progressive liver disease related to the build-up of bile)
- Down syndrome
- Turner syndrome
- William’s syndrome
While none of the disorders or syndromes listed in this section are guarantees of celiac disease or gluten sensitivity, there is enough overlap that investigating the possibility is worth doing.
What if I just went gluten-free?
Overall, eating a strictly gluten-free diet is really only recommended for those with a medical diagnosis of celiac disease or gluten sensitivity and, as discussed above, skipping an official diagnosis may cause you more medical issues down the road.
While just skipping straight to eating gluten-free isn’t a great idea, there is a larger swath of the population at risk for celiac or gluten sensitivity than are aware of it.
If you have any of the disorders or syndromes above or experience the symptoms of celiac disease or gluten sensitivity regularly, consider discussing it with your health care provider, whether before or after you start a food and symptom diary. While eating gluten-free can be difficult, living with the symptoms and side effects of eating gluten when you shouldn’t is much worse.
Sources:
https://www.questdiagnostics.com/home/physicians/testing-services/condition/celiac/who-tested/
https://www.webmd.com/digestive-disorders/celiac-disease/celiac-disease-symptoms
https://www.cureceliacdisease.org/faq/who-should-be-tested-for-celiac-disease/
https://celiac.org/about-the-foundation/featured-news/2016/09/9-reasons-you-should-be-tested-for-celiac-disease/
https://www.niddk.nih.gov/health-information/endocrine-diseases/graves-disease
https://www.niddk.nih.gov/health-information/endocrine-diseases/hashimotos-disease
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6182669/
https://www.medicinenet.com/primary_biliary_cirrhosis_pbc/article.htm
