Is “Gluten Sensitivity” Real or Imaginary? A Critical Look

By Kris Gunnars BCs

Celiac disease, the most severe form of gluten intolerance, only affects 0.7-1% of people (1).

However, there is another condition called “non-celiac” gluten sensitivity (2).

It involves an adverse reaction to gluten, in people who do not have celiac disease.

This condition frequently comes up in discussions about nutrition, but is highly controversial among health professionals.

This article takes a detailed look at gluten sensitivity and whether it is something you really need to be concerned about.

What is Gluten?

Before we continue, let me briefly explain what gluten is.

Gluten is a family of proteins, found in cereal grains like wheat, spelt, rye and barley. Of the gluten-containing grains, wheat is the most commonly consumed, by far.

The two main proteins in gluten are gliadin and glutenin, of which gliadin appears to be the biggest offender (34).

When flour is mixed with water, the gluten proteins cross-link to form a sticky network that is glue-like in consistency (5).

The name glu-ten is actually derived from these glue-like properties.

Gluten makes the dough elastic, and gives bread the ability to rise when heated by trapping gas molecules inside. It also provides a satisfying, chewy texture.

Bottom Line: Gluten is the main protein in several types of grains, including wheat. It has certain properties that make it very popular for making bread.

There Are Several Different Gluten-Related Disorders

There are numerous disease conditions that are related, either directly or indirectly, to wheat and gluten (6).

The best known of these is called celiac disease (7).

In celiac patients, the immune system mistakenly thinks the gluten proteins are foreign invaders, and mounts an attack against them.

Additionally, when exposed to gluten, the immune system starts attacking natural structures in the gut wall, which can cause severe harm. This “attack against self” is why celiac disease is classified as an autoimmune disease (8).

The condition “non-celiac” gluten sensitivity (referred to here as gluten sensitivity) is of a different nature than celiac disease (12).

Then there is also wheat allergy, which is relatively rare and probably affects under 1% of people (14).

Adverse reactions to gluten have been linked with numerous other diseases, including a type of cerebellar ataxia called gluten ataxia, Hashimito’s thyroiditis, type 1 diabetes, autism, schizophrenia and depression (15161718192021).

This does not mean that gluten is the main cause of these diseases, only that it may make symptoms worse in a subset of people who have them.

In many cases, a gluten-free diet has been shown to be helpful in controlled trials (real science), but this needs to be studied a lot more.

Bottom Line: Several disease conditions are related to wheat and gluten consumption. The most common ones are wheat allergy, celiac disease and non-celiac gluten sensitivity.

What Exactly is (Non-Celiac) Gluten Sensitivity?

Put simply, people with gluten sensitivity experience symptoms after ingesting gluten, and respond positively to a gluten free diet, after celiac disease and wheat allergy have been excluded.

People with gluten sensitivity usually do not show any changes in their gut lining, or antibodies against the body’s own tissues, which are some of the key features of celiac disease (12).

This is one proposed diagnostic criteria for gluten sensitivity (23):

  1. Gluten ingestion rapidly causes symptoms, either digestive or non-digestive.
  2. Symptoms disappear quickly on a gluten-free diet.
  3. Reintroducing gluten causes the symptoms to appear again.
  4. Celiac disease and wheat allergy have been ruled out.
  5. A blinded gluten challenge test should be done to fully confirm the diagnosis.

Gluten sensitivity has numerous symptoms. According to studies, these symptoms include bloating, flatulence, diarrhea, stomach pain, weight loss, eczema, erythema, headache, bone and joint pain, chronic tiredness, fatigue and depression (2526).

According to some studies, gluten sensitivity is most common in adults/middle aged people, and much more common in females than males (29, 30).

Bottom Line: Gluten sensitivity involves adverse reactions to gluten in people who do not have celiac disease or wheat allergy. No good data is available on how common it is.

Gluten Sensitivity is Real, But There Are Many Unanswered Questions

Gluten sensitivity is more than just some made up nonsense.

There are hundreds of papers in the literature on this. Just try typing “gluten sensitivity” into PubMed or Google Scholar.

There are also tons of scientists and medical doctors, including many respected gastroenterologists, who are convinced that this is real.

True, there is no evidence that everyone needs to avoid gluten, and there is definitely a “fad component” to the gluten-free trend.

However, gluten (or wheat) sensitivity IS a real thing, and it does cause problems in many people.

Unfortunately, this condition is incredibly complicated, and very few clear answers have been discovered yet.

If you are personally convinced that wheat/gluten causes you problems, then there’s no reason to sit around and wait.

If it makes you feel bad, just avoid it. Plain and simple. There is no nutrient in there that you can’t get from other (often much healthier and more nutritious) foods.

Just make sure to choose real foods that are naturally gluten free, not gluten-free products. Gluten free junk food is still junk food.