Is Non-Celiac Gluten Sensitivity Just a Fad?

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Over the past few years, celiac disease awareness and the importance of eating a strictly gluten-free diet has grown tremendously.

This increased awareness can be partly attributed to better education about the autoimmune reaction that occurs whenever a celiac ingests wheat, barley, or rye.

Greater awareness has led to higher rates of patients being diagnosed.

Additional factors contributing to this raised awareness also includes popular personalities coming forward with their personal stories and a marketing explosion in gluten-free products.

However celiac disease is not the only reason why you might consider going gluten free.



The sudden rise in popularity of a gluten-free diet has resulted in many people beginning to question their own unresolved health issues and symptoms in connection with gluten.

As a result, some of these individuals have sought medical help and have been diagnosed with celiac disease, while others who suffer with the exact same symptoms have not.

In fact, many physicians will tell you that your problem isn't gluten if your celiac tests come back negative.

This is why many un-diagnosed individuals have chosen to place themselves on gluten-free diet without medical supervision, which is why there has been a huge upsurge in controversy surrounding those who go gluten free.

Some people, including doctors, have claimed that non-celiac gluten sensitivity does not exist.

But, is that true?

Is non-celiac gluten sensitivity just a fad?

Or is it a real medical condition?

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Are Gluten-Related Disorders Real or Imaginary?


In March of 2011, celiac disease expert Dr. Alesio Fasano and his research team at the University of Maryland School of Medicine's Center for Celiac Research published a landmark scientific study that resulted in gluten sensitivity moving from its questionable status to a distinct reality.

At that time, non-celiac gluten sensitivity was documented to be a real medical issue separate and distinct from celiac disease. In addition, the immune system responses for celiac, gluten sensitivity, and wheat allergies were found to be different from each other.

Dr. Fasano, the Director of the research center, estimates that non-celiac gluten sensitivity affects about “6 to 7 times more people than celiac disease” does.

He draws that conclusion from the amount of patients who came to his clinic for gluten testing before non-celiac gluten sensitivity was recognized.

Although these patients all had exactly the same symptoms, Dr, Fasano was sending away 6 to 7 times more individuals than he was diagnosing.


That translates into over 18 million people in the U.S. alone that have trouble with gluten, in addition to the 3 million with celiac disease – most of which are not yet diagnosed.

The assertiveness of the gluten-sensitive individuals that Dr. Fasano tested and sent away, led to his research study. If those patients had not gone on a gluten-free diet without his medical supervision, then returned to show him the beneficial results, he never would have known to look for a different type of immune response to gluten.

Gluten-Related Disorders are a Spectrum


Celiac disease, non-celiac gluten-sensitivity, and wheat allergy are all part of a spectrum that was labeled “gluten related disorder” by a multidisciplinary task force of 16 celiac disease specialists from 7 different countries.

These celiac professionals originally came together in 2011, before Dr. Fasano published his study on non-celiac gluten sensitivity, to produce a uniform definition for many gluten-related terms.

After combing through decades of PubMed studies, participating in the 14th International Coeliac Disease Symposium in June of 2011, and then entering into two later phone conferences to carefully correlate their recommendations, the task force eventually created a solid definition for celiac disease, classic celiac disease, and gluten-related disorders.


Celiac Disease: “A chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals.”

Classic Celiac Disease: “Celiac disease presenting with signs and symptoms of malabsorption. Diarrhea, steatorrhea, weight loss, or growth failure is required.”

Gluten-Related Disorders: This was the suggested umbrella term for all diseases triggered by gluten, including celiac disease.

Since “gluten intolerance” was often used in the scientific literature as a synonym for both celiac disease and non-celiac gluten sensitivity, the task force recommended that the term “gluten intolerance” no longer be used.

Because the scientific findings regarding gluten sensitivity is relatively new, their suggestion was to substitute “gluten-related disorders” instead.

Like a corn allergy, it is possible that some gluten-sensitive individuals are reacting to a different portion of the wheat, barley, or rye kernel, other than the gliadin protein.





Boundaries previously attributed to celiac disease were not clear.

There was confusion on behalf of the medical community regarding diagnostic criteria for celiac disease, as well as gluten-related conditions.

In addition, research scientists were using terms as they personally defined them, so the definitions lacked conformity across the scientific literature.

With so much scientific evidence available to support gluten-related disorders, the task force was able to correlate the various studies on gluten, and propose new definitions that would bring enough conformity with the research science community to eliminate the confusion.

Why the Controversy Over Non-Celiac Gluten Sensitivity?


The scientific community has recognized the existence of the gluten-related spectrum for many years now, even though the medical community has been slow to embrace it.

Same goes for reporters.

While most reporters today will give a token nod toward celiac disease patients, and claim the disorder is real, most of them still do not accept non-celiac gluten sensitivity. Articles will state that if you don't have celiac disease, you have no business going gluten free.

Medical professionals and organizations often wait to embrace facts once scientific studies have been replicated at least twice before accepting those findings as accurate. This often leads to a lack of knowledge among medical personnel, especially physicians, and results in confusion for reporters who often use out-dated medical information as the basis for their obnoxious claims.

In addition, this slow-to-move tendency within the medical community also results in long delays in diagnosis for suffering patients.

Gluten-Free Diet and Weight-Loss Claims


Unfortunately, the need to spread non-celiac gluten-sensitivity awareness is not helped when individuals make public, ungrounded claims, such as how a gluten-free diet is an excellent resource for weight loss.

While that does hold true in some cases, it is highly dependent on your food choices, portion sizes, metabolic condition, abnormalities, and physical damage that ingesting gluten has caused.

Overall, gluten-free products and recipes tend to be higher in carbohydrates, fat, sugar, and calories than the foods they replace, but for those who give up all grains, go Keto, or experience weight gain due to elevated cortisol levels and other stress hormones, a gluten-free diet can certainly be the means to reverse that unhealthy condition.

Like Keto, the idea behind a gluten-free diet is to restore health to those who are suffering with the effects of malnutrition, so sometimes, that health restoration does bring weight loss.

But that is not true for everyone.

Celiacs and non-celiac gluten sensitivity folks tend to gain about 30 pounds once they switch to a gluten-free diet. This holds especially true for those who were suffering from malnutrition before diagnosis.

When the body is unable to absorb the nutrients it needs from food, the metabolic rate sometimes drops dramatically, which is why many individuals with celiac disease and non-celiac gluten sensitivity are overweight when finally diagnosed.

Once adequate nutrition is restored, weight gain can quickly occur.

For those who are underweight, weight gain is a healthy sign. For those who are overweight, additional dietary methods must be implemented to achieve a healthy weight.

What You Might Not Know


In addition to the outdated and misinformation often presented in the media about gluten sensitivity and gluten-free diets, there is often confusion about gluten itself.

Gluten is a mixture of proteins found in wheat, barley, and rye, but the gliadin protein molecule is the most troublesome for celiacs. That may, or may not be true for non-celiac gluten sensitivity.

According to Dr. Fasano, gluten can trigger three different types of immune-system responses, depending on how the body reacts to the gliadin protein molecule as it sneaks past the intestinal barrier.

However, in every interview he has given about celiac disease or non-celiac gluten sensitivity, he has firmly stated that no one digests gluten.

No one.

In an interview with The Tender Foodie, he said that “Gliadin is a strange protein that our enzymes can't break down from the amino acids (glutamine and proline) into elements small enough for us to digest.”

The best that our digestive systems can do is to break the gluten down into peptides.

Ordinarily, peptides are too large to pass through the small intestine, but those with celiac disease produce an abnormal amount of zonulin. In a podcast interview with Chris Kresser, Dr. Fasano called zonulin a toxin that he and his research team found several years ago.

Zonulin causes the gate between the cells of your small intestine to leak.

This happens to everyone, but ordinarily the gate only stays open for a very short time. In the average individual, the intestinal wall quickly returns to normal, which keeps the peptides inside the intestinal tract.

With celiac disease, however, the gates become stuck in an opened condition for long periods of time.

Even with non-celiac gluten sensitivity or wheat allergy, the gliadin peptide has plenty of time to migrate through the intestinal wall and into the bloodstream before the walls close.

The presence of gliadin peptides in the bloodstream sets off an immune system reaction. The degree of reaction depends on:

  • How long the gates remain open.
  • Strength of the immune system response.
  • Number of white blood cells created.
  • How many peptides actually make it through the intestinal barrier.

When the doors stay open too long, it creates an atmosphere that confuses the immune system. Unlike the reaction that Dr. Fasano saw in the cases of gluten allergy or non-celiac gluten sensitivity, with celiac disease, the immune system starts to attack the intestinal wall, rather than the gluten molecule itself.

What is Non-Celiac Gluten Sensitivity?


As the word “sensitive” suggests, non-celiac gluten sensitivity (coined by Dr. Fasano) is a condition where a person reacts to ingesting gluten. As the gluten peptide travels throughout the bloodstream, the reaction can affect any body system or organ.

However, unlike the autoimmune response connected with celiac disease, non-celiac gluten sensitivity sparks a different immune system response.

With non-celiac gluten sensitivity, the body perceives the gluten peptide to be an enemy. It launches an attack against the peptide to protect the body from the foreign invader.

Although, the method of attack is similar to allergies, allergic responses use different antibodies than gluten sensitivity does.

Signs and Symptoms of Non-Celiac Gluten Sensitivity


The digestive system, central nervous system, bones, and skin are all susceptible to gluten. In fact, there are over 100 documented symptoms for non-celiac gluten sensitivity and over 300 for celiac disease.

A few of the symptoms for non-celiac gluten sensitivity are:

  • fatigue
  • brain fog
  • depression
  • anemia
  • joint pain
  • osteoporosis
  • sleeping difficulties
  • ADHD-like behaviors
  • fibromyalgia
  • irritable bowel syndrome (IBS)
  • gastrointestinal problems (diarrhea, constipation, cramping, adominal pain)
  • neurological disorders (ataxia, neuropathy, depression, dementia)
  • autoimmune thyroid disease
  • feet, leg, hand, and arm numbness
  • schizophrenia

Although these symptoms overlap with celiac disease, Dr. Fasano feels that the damage isn't as severe because those with non-celiac gluten sensitivity are not likely to experience the consequences associated with celiac disease.

Since non-celiac gluten sensitivity is not an autoimmune condition, left untreated, gluten sensitivity would not progress to additional autoimmune diseases, as celiacs do.

In addition, research performed by the University of Maryland Center for Celiac Research has also shown that gluten sensitivity does not spark intestinal inflammation, so malabsorption and malnutrition are not as big of a concern.

Non-Celiac Gluten Sensitivity's Role in Major Disease States


Dr. Gary Kaplan, Medical Director of the Kaplan Center for Integrative Medicine has been treating patients that suffer from a wide variety of conditions associated with non-celiac gluten sensitivity for years now.

He has seen patients dramatically improve once gluten is removed from their diet. Because of his clinical experience, he considers gluten to be a major factor in disease conditions, such as:

  • Irritable Bowel Syndrome (IBS)
  • Neurological disorders
  • Autoimmune thyroid disease
  • Schizophrenia

All of these conditions can be progressive and extremely disabling if not promptly treated.

Although, the University of Maryland Center for Celiac Research has not found malnutrition among those with non-celiac gluten sensitivity, that doesn't mean that gluten sensitivity is less serious. Neurological problems, thyroid issues, and gastrointestinal upsets can seriously affect your quality of life.

Keep in mind that each gluten specialist will have a slightly different viewpoint, based on what they have seen and experienced in their own medical practice.

How is Non-Celiac Gluten Sensitivity Diagnosed?


One of the major arguments against going gluten free without medical supervision is the potential for serious disease states and conditions to go untreated. Although, all gluten specialists agree that gluten-related disorders outside of celiac disease exist, they do not all agree on how to diagnose them.

After first testing for celiac disease and wheat allergies, both Dr. Fasano and Dr. Kaplan use an elimination diet to diagnose gluten sensitivities.

An elimination diet, in this case, is simply a gluten-free diet.

If the patient improves once gluten is removed from the diet for several weeks, and then regresses when gluten is reintroduced, the patient will be diagnosed with non-celiac gluten sensitivity.

However, Dr. Vikki Peterson, coauthor of the book, The Gluten Effect: How “Innocent” Wheat is Ruining Your Health, takes a slightly updated view regarding diagnosis.

Since she's been treating patients' gluten issues for over 17 years, and has had gluten sensitivity personally touch her family, she has quite a bit of data and personal experience with gluten-related disorders to draw upon.

Unfortunately, the average physician does not.

“Again and again we had patients describing how significantly their lives changed after discovering that they were gluten sensitive,” the Petersons wrote.

Since symptoms tend to be non-specific, and come attached to a variety of health conditions, these “common conditions are investigated first” by most physicians, and “sometimes the underappreciated disorders, such as gluten sensitivity go unnoticed.”

Although differences abound within the medical community, one thing most gluten specialist agree on is that ruling out celiac disease and gluten or wheat allergies should be done first.

That is what concerns Dr. Fasano the most.

Patients must be on a diet that includes gluten for celiac testing to be accurate. If a patient goes gluten free by themselves, a biopsy is likely to be inaccurate.

If tests for celiac and allergies all come back negative, that is when it points to the possibility for non-celiac gluten sensitivity.

Up until then, there is always the chance that you have celiac disease because classic symptoms like gastrointestinal upsets don't always manifest.

Non-Celiac Gluten Sensitivity is not an Imaginary Condition


Diet has always been an important factor in an individual's degree of health, so it shouldn't be a surprise that gluten can affect the physical body, the same as any other nutrient. Although celiac disease is now a well-known, widely-accepted, medical condition, it's not the most common form that gluten problems take.

Non-celiac gluten sensitivity is far more common than celiac disease, which can easily be seen in those who decide to cheat on their ketogenic diet with wheat-laden goodies.

Dr. Fasano feels relieved that he can now tell patients who test negative for celiac disease that their gluten symptoms are not imaginary. Nor is gluten sensitivity a fad.

In an interview he gave to Alicia Woodward, editor of Living Without magazine, he stated that those who test negative for celiac disease are not making things up. Despite their negative blood tests and biopsy, it's not all in their heads.

“There's no question about that,” he said.

Non-celiac gluten sensitivity does exist.

And Dr. Fasano is not alone in that medical assessment.

In addition to Dr. Kaplan and Dr. Peterson, there are many medical practitioners that have been treating gluten-related disorders unassociated with celiac disease for many years now.

“If you are constantly getting infections or have other immune or autoimmune disorders,” the Petersons write, “investigating gluten sensitivity is certainly worth your time.”


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