Celiac Disease or Gluten-Free? What's the Difference?

by Dr. Daniel J. Heller

In our first gluten-free post, I introduced to you a few ideas about wheat and gluten allergy and sensitivity:

That wheat is probably a much bigger problem that gluten
That people who feel better going off gluten have probably benefitted, inadvertently, from cutting out all wheat;
And that the food marketing industry is partially responsible for the popularity of the gluten-free concept, as they’re quick to jump on fads and trends, even when (as is the case here) science and medicine may not support them.

There is a tricky concept to try to tease apart here. Celiac Disease is a serious and destructive illness. In the past, it frequently went undiagnosed, and the medical profession—dubious as always about any claims that food and diet could cause actual symptoms—minimized and pooh-poohed it. This story may be familiar to women who’ve found the medical profession unsympathetic to their request for help when their hormonal fluctuations are causing premenstrual symptoms.

Nowadays, though, there is increasing awareness of Celiac Disease, and of the many problems it may cause. Celiac Disease causes much more than just bowel or digestive problems: the autoimmune process involved seems to be related to many other autoimmune conditions such as Lupus and Rheumatoid Arthritis; Type I Diabetes; and Autoimmune Hypothyroidism. There are established tests for Celiac Disease. While a biopsy, or sample, of your intestinal lining is the gold standard for diagnosis, there are blood and genetic tests that can fairly reliably identify Celiac Disease. Given appropriate medical care, a diagnosis of Celiac Disease shouldn’t be missed very often nowadays. Learn more about celiac disease diagnosis.

Celiac Disease is still rare. Most of the people who feel better avoiding gluten are probably benefitting instead from the avoidance of wheat.

However—HOWEVER—there are important exceptions. It is possible to not have Celiac Disease, and still have a reaction to gluten, so avoiding it makes you feel better, and relieves or removes symptoms. If this is the case, you’d have to avoid wheat, too, but barley and rye and foods with hidden gluten in them would probably make you sick, too.

If that’s not confusing enough, someone in this situation may test negative for celiac; their doctor may tell them they’re fine; but they know they feel lousy when they eat gluten, and better when they avoid it. Or, it could happen that certain blood tests are positive, so your doctor orders a biopsy, but that doesn’t show celiac. Depending on your doctor, and to what degree he or she is an "inside the box" or an "outside the box" thinker when it comes to food and health, he or she may tell you that you don’t have Celiac Disease and that food has nothing to do with how you feel. Or, we hope, they’ll understand that the positive tests reflect a problem that hasn’t yet reached a critical stage, and that you’re better off avoiding gluten.

Here is my best advice. If you think a food is causing a problem for you, or better yet if you have any health problem whatsoever, read our information on food allergy and free accurate DIY food allergy testing. Then, do the food allergy test protocol as described. You can talk to your health care practitioner about whether Celiac Disease testing might be helpful in your case, and be sure to find out and mention whether you have any close relatives who have been diagnosed with celiac, since the condition has a strong genetic basis.

It helps to know when you don’t have celiac, and when you don’t need to stress out about gluten-free. And if you have Celiac Disease, it’s a life-saver to know and to follow a gluten-free diet for life.