066 Could You be Gluten Sensitive Even if you Tested Negative?

The Investigation

Chances are you know someone with a gluten sensitivity despite reports that only 6-7% of the population suffer from it. That’s because testing is tricky and false negatives can make people think their health issues are caused by something else. In this episode, I want to break down what’s going on and help you determine if a gluten sensitivity might be at the root of your health mystery.

Understanding Gluten Intolerance

Gluten is a protein found in wheat, rye, barley and oats. A person with gluten intolerance cannot digest the protein portion of these grains which triggers an immune response to what the body deems a foreign substance. This immune reaction causes inflammation in the digestive system and damages the lining tissue which, in turn, can cause symptoms like fatigue, bloating, diarrhea, constipation, gas, and cramping. The compromised lining can leave the person more susceptible to bacteria, parasites, and funguses.

Overtime, if a person who has a gluten intolerance continues to eat gluten, their small intestine may also become damaged which leads to malabsorption of nutrients. This can cause fatigue and weight gain. And, the person will be at an increased risk of insomnia, osteoporosis, hormone imbalances, inability to deal with stress, and mood swings. Over time, additional issues may arise like lactose intolerance, depression, leaky gut syndrome (leading to higher susceptibility to infections and other illnesses.)

Gluten Intolerance is the Root Cause of Many Health Issues

Symptoms of Gluten Intolerance

There are many symptoms that could be the result of a gluten intolerance. How many from this list can you check off?

• Weight gain
• Unexplained fatigue
• Difficulty relaxing, feel tense frequently
• Unexplained digestive problems
• Female hormone imbalances, (PMS, menopausal symptoms)
• Muscle or joint pain or stiffness of unknown cause
• Migraine like headaches
• Food allergies/sensitivities
• Difficulty digesting dairy products
• Tendency to over consume alcohol
• Overly sensitive to physical and emotional pain, cry easily
• Cravings for sweets, bread, carbohydrates
• Tendency to overeat sweets, bread, carbohydrates
• Abdominal pain or cramping
• Abdominal bloating or distention
• Intestinal gas
• “Love” specific foods
• Eat when upset, eat to relax
• Constipation or diarrhea of no known cause
• Unexplained skin problems/rashes
• Difficulty gaining weight
• Anorexia
• Bulimia
• Rosacea
• Diabetes
• Osteoporosis/bone loss
• Iron deficiency/anemia
• hronic fatigue
• Candida
• Hypoglycemia

If you checked off 4 or less it is very unlikely that you have a gluten sensitivity. If you scored between 5 and 8 there may be a reason to suspect it. If you scored 9 or higher there can be a good chance that you are gluten sensitive.

What is a Gluten-Free Diet?

Gluten-free means avoiding all foods containing gluten, including wheat, rye, spelt, bulgar, semolina, couscous, kamut and some oats. Gluten can be hidden in processed foods and thickened products such as sauces and soups so read labels carefully. While this can be an adjustment at first, eating gluten free if you are sensitive will make a huge difference in your health.

What’s the Difference between Celiac and Gluten Sensitivity?

Celiac disease is an extreme intolerance to gluten where eating gluten will actually damage the lining of your intestines and cause mal-absorption along with many other symptoms such as all types of GI issues, skin issues, headaches, arthritis, depression and the list goes on and on.

A gluten sensitivity is when you do not have full-blown celiac and your intestines are not completely damaged but eating gluten makes you feel worse and can often cause very similar if not the same symptoms of those with celiac disease.

What are the Problems with Celiac Testing (and Why is it so Hard to Get a True Answer)?

Testing for this is very tricky because the occurrence of false negatives is often likely. The only way to get a true celiac test is to go to the GI doctor and have a biopsy. Your intestines are lined with hair like structures called villi and in healthy intestines; they stand straight up like a shaggy rug. When a person has celiac disease, gluten causes damage to the intestines and the villi lose their integrity and become flattened. The biopsy looks at the state of the villi and only if they are flattened can there be a true celiac diagnosis. Once gluten is removed from their diet, the villi can be revived fairly quickly and thus the intestines will heal.

Patients who already started a gluten free diet prior to their biopsy can often get a false negative because of this. To get a proper diagnosis, the patient should eat gluten (equivalent to at least 1 slice of wheat bread) every day for 30 consecutive days before the biopsy

There is also a blood test that can identify the antibodies the body produces against gluten. Some GI doctors use this as a celiac test. The problem here is that the gluten antibodies are produced in significant numbers only if the person has a good functioning immune. With a weak immune system, antibody production will be low and lead to a false negative result.

Furthermore, there are several types of antibodies that can be tested such and some of the main ones include IgE, IgG and IgA. IgE shows an immediate response and this often comes out negative unless someone has an anaphylactic shock type reaction to the food which is far less common. IgG and IgA are the delayed antibodies and are more likely to be found through testing because gluten-containing foods take several hours to several days to show symptoms and inflame the immune system.

Testing for Gluten Sensitivity

When a celiac test is negative but someone feels worse after consuming gluten (this can happen from 1-72 hours post consumption) they most likely have a sensitivity to gluten. The reason the other tests are negative is because gluten reactions vary in strength. The easiest way to describe this is if you think of a spectrum from 0 to 100 with 0 being no sensitivity and 100 being extremely sensitive. If someone is all the way at 100 it would equate to celiac disease and/or extreme intolerance and often result in a positive biopsy but anything below that would not show up on those tests. So the problem is what if you are at 95? or 85? These cases would show up negative for celiac but as you can see from the example, 95 is still very high on the spectrum and the person would have a pretty severe sensitivity to gluten with all the same symptoms.

Testing for sensitivities is also tricky because people can react to gluten through various allergenic pathways and being able to find a possible reactive pathway is the way to see a true result. The major proven pathways include an...