Ten Reasons to get tested for Coeliac Disease BEFORE Going Gluten Free

Ten reasons to get tested for coeliac disease before going gluten free

As many people are aware – and just as many people aren’t – gluten is a protein that is found in the grains wheat, barley and rye (and their derivatives). A very similar protein, avenin, is found in oats, and can also cause a gluten-like reaction in some very sensitive people.

Gluten is the trigger behind the autoimmune disease known as Coeliac disease and is also a known gut irritant for some people with irritable bowel syndrome (IBS) or any of the inflammatory bowel diseases (IBD). For these people, eliminating gluten from their diets is crucial to improving both their gut and overall health. For others, it might be completely unnecessary.

Now, obviously, the reasons listed below are relevant for those who have access to testing for Coeliac disease, either by blood test or endoscopy. If you, for either medical, financial or geographical reasons, cannot be tested for Coeliac and you feel like gluten-containing foods set you off, then nobody can stop you from doing what you feel is necessary, using whatever resources you can find. However, I strongly urge anyone who feels like they have symptoms, either IBS-like or other, that are related to food to go and see their medical professional of choice.

So, here they are:

The top ten reasons to check with your doctor before you begin a gluten free diet

  1. Coeliac disease testing relies on a reaction to gluten: Coeliac disease (CD) is an autoimmune disease in which your immune system reacts to the presence of the protein gluten as it would to an infection – with an immune response that attacks your own tissue, damaging your intestinal lining, which can cause both symptoms of IBS (pain, gas, bloating) and reactions elsewhere in the body (joint pain, headaches etc). Tests for active CD rely on looking for specific antibodies, via a blood sample, or evidence of CD specific damage to the small intestine, via a gastroscopy/endoscopy. If you have already eliminated gluten from your diet, your test results will not be reliable, as any reaction may have disappeared and you could in fact be showing a false negative.
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  2. To differentiate between Coeliac disease and Non Coeliac Gluten Sensitivity (NCGS): If you suspect that the consumption of gluten containing foods precedes your IBS or any other symptoms, it is important to know which you have. If you have CD, you know that you must be careful down to the tiniest speck of contamination – less than 20 ppm, in the USA. It is unknown how “strict” those with NCGS must be, medically speaking, in terms of gluten contamination. It might be as strict as CD, less strict, or even dependent on the individual – but if you have ruled out CD, you can then work with your doctor to decide what’s best for your own case based on current medical knowledge.
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  3. Coeliac disease is genetic: If you have CD, one of your parents must be carrying the gene and may also have an active form of the disease, which can sometimes be silent. If you have children, it’s important to know what their chances are of developing CD in the future – this includes a blood test to check for genetic susceptibility (did you pass on the gene?) and a test for active CD, if you did.
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  4. Self-diagnosis can be very dangerous; you might miss the actual diagnosis! If you are having worsening digestive symptoms, gluten isn’t the only potential cause. It could also be ulcerative colitis, Crohn’s disease, or colon cancer. Each requires proper medical management, which might include a gluten free diet but it certainly won’t be limited to it. If you are not accurately diagnosed, the repercussions to your health could be severe, if an undiagnosed condition goes untreated.
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    Following on, if you go gluten free without any testing or medical advice, you will not get the chance to hear about other potential causes. Symptomatic malabsorption of fermentable carbohydrates is now thought to be much more common that NCGS, with a study showing that those with NCGS who began to follow a low FODMAP diet had significantly improved symptoms. This is not saying that those with NCGS don’t have a real problem, just that the culprit might not be the gluten in the wheat – it might be the fructans.
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  5. Coeliac disease doesn’t just cause digestive distress: The most commonly known symptoms of CD include gas, bloating, gut cramps and altered bowel movements etc. However, long-term, unchecked CD can lead to a whole host of issues, including (but not limited to), malnutrition, lactose intolerance, osteoporosis, infertility and even an increased risk of certain cancers. It’s definitely advisable to rule CD in or out and hopefully reduce your risk of developing one of the possible secondary health issues by following a strict gluten free diet with medical assistance as required.
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  6. Save money on healthcare: In some countries, only certain medical tests are covered by Medicare (or the equivalent) or private health insurance. Chances are that you are more likely to be financially covered for a science-based diagnostic test for CD than you are for any alternative-medicine-based tests, so why not try the standard tests first and see where they get you, before going down the potentially more expensive route. A proper medical diagnosis of CD (or any other food related illness) might also mean that your school/college/university has to provide you with suitable foods, saving you money and time on meals that you might otherwise have to prepare for yourself and bring from home.
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  7. Save money on unnecessary gluten free products: If you compared the grocery bills of two people who ate the same diet, except one of those people bought gluten free versions of the processed foods (bread, cereals, pasta, sauces, cookies etc), you will find that the gluten free person spends quite a bit more. If you don’t have a medical reason for buying gluten/wheat free products, you will save a decent amount of your weekly grocery bill by buying the normal versions of the products. This goes for FODMAPs, too, though we aren’t at the point of being a fad diet and most people are still finding out about it from their doctors/dietitians etc.
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  8. Just because it’s gluten free, doesn’t mean it’s healthy: Is a doughnut healthy? Not in my eyes. Is a gluten free doughnut automatically healthier? Definitely not. If you eliminate gluten by eliminating processed gluten-full foods and replace them with gluten free whole foods and the occasional gluten free grain like rice or corn then yes, your diet will likely be healthier than before. However, if you just replace your bagels and cupcakes with a gluten free version, you are doing nothing for your non-gluten-related overall health.
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  9. Social acceptance: It’s unfortunate but many people will judge those who are self diagnosed or follow what they perceive to be a fad diet. I try to educate waiters about fructose malabsorption and the fructans in wheat (if they ask, of course) when I order a gluten free meal – partly because I want to spread awareness of fructose malabsorption and FODMAPs but also because I want to distinguish myself from those who do follow “gluten free” as a fad diet and have my dietary requests taken seriously. It’s sad that I need to do this but necessary, which I’ll explain in #10.
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  10. Food safety and cross contamination: As I mentioned in #9, wait or kitchen staff (or, sadly, even family members) might take it upon themselves to decide exactly how gluten free your meal must be. If you don’t have a formal diagnosis of CD or NCGS from your doctor, these people are more likely to slack off with the meal prep safety and feed you contaminated food, which will ultimately affect your health and wellness. This unfortunately goes for many food intolerances, even nut allergies!

Fad gluten free (or anything-free) diets are a pet peeve of mine. I try not to be too zealous about certain things in life – I don’t want to annoy friends of mine who are not interested in digestive health, after all – but when it comes to “going gluten free” on a whim, I can’t always hold my tongue. To my friends and family, I do apologise. To my readers, though, I feel it’s something that should be put out on the internet again and again, to make as many people as possible aware of the dangers of uneducated dieting.

This article is written for educational purposes only and is not intended to replace a proper medical assessment. Please run anything written here past your own health care practitioner to make sure it is the right course of action for you.

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