What is Non-Celiac Gluten Sensitivity? A reaction to gluten containing foods that present non-specific symptoms in individuals who have had Celiac ruled out as a diagnosis.
Intolerance to these trigger foods may show up abruptly in life following a gastrointestinal infection, after taking medications, surgery, or other traumatic experiences.
Symptoms:
| Abdominal pain | Joint pain |
| Bloating | Headaches |
| Constipation | Brain fog |
| Diarrhea | Fatigue |
| Depression | Anxiety |
| ADHD-like behavior | Cognitive difficulties |
| Nausea | Numbness of extremities |
| Skin rash |
How to diagnose:
Diagnosing NCGS still remains uncertain due to fact that there are no biomarkers for diagnosis. Rule out Celiac diagnosis, wheat allergy, and GI conditions such as Small Intestinal Bacteria Overgrowth (SIBO).
Possible Lab Abnormalities with NCGS:
- IgA, IgG, and IgM may be slightly elevated in NCGS patients but may not show as elevated as individuals with Celiac.
- Elevated serum levels:
- Lipopolysaccharide-binding protein (LBP)
- Soluble CD114 (sCD14)
- Fatty Acid Binding Protein (FABP2)
Labs to order if you have Celiac Disease:
| Anti-tTG IgA (or IgG in case of IgA deficiency) (helps monitor compliance/response to GF diet) | Antinuclear antibodies to check for other autoimmune diseases |
| Bone density scan (recommended in adults 12 to 18 months after being gluten-free) | Complete blood count (CBC) (check for anemias) |
| Ferritin, folate, B12, zinc, copper, and vitamin D3 (info on possible anemias, deficiencies, and bone health) | Comprehensive metabolic panel (electrolytes, calcium, blood sugar, liver and kidney function) |
| TSH + TPO and thyroglobulin antibodies (screen for Hashimoto’s) |
Nutrient Deficiencies:
Eliminating foods from your diet puts you at risk for nutrient deficiencies. It is important to eat a diverse diet and supplement when needed. Some potential vitamins and minerals at risk for deficiency include: Vitamin A, vitamin B6, vitamin D, vitamin K, folate, vitamin B12, calcium, copper, iron, phosphorus, selenium, zinc, riboflavin, magnesium.
Grocery Tips:
Build your grocery list: Grains and flours that are gluten-free and considered “safe” to eat include rice, wild rice, corn (maize), sago, soy, potato, tapioca, beans, sorghum, quinoa, millet, buckwheat, arrowroot, amaranth, teff, Indian ricegrass and uncontaminated oats (labeled as gluten-free oats).
Choose naturally gluten-free foods include milk, 100-percent fruit or vegetable juices, vinegars (except for malt vinegar), fresh fruits and vegetables, butter, eggs, lentils, peanuts, seeds, tree nuts, fresh fish and shellfish, poultry and meat, honey and cooking oils.
When choosing alcoholic beverages, select hard liquors like vodka and gin, wines and gluten-free beers.
Read the labels: Start by looking for the label to say “gluten-free”. Under the FDA rule, a food can be labeled gluten-free when the unavoidable presence of gluten in the food is less than 20 parts per million.
A food labeled gluten-free may contain wheat starch if the food contains less than 20 parts per million of gluten. If you have a severe gluten sensitivity, do not eat foods containing wheat starch that are not labeled gluten-free.
When a product is not labeled gluten-free, look for these in the ingredient list: wheat, rye, barley, oats, malt (unless a gluten-free source is listed, such as corn malt) and brewer’s yeast. If these ingredients are listed, don’t buy it.
References:
https://celiac.org/about-celiac-disease/related-conditions/non-celiac-wheat-gluten-sensitivity/
- Uhde, et al., (2016). Intestinal cell damage and systemic immune activation in individuals reporting sensitivity to wheat in the absence of coeliac disease. BMJ Journals, 65(12), 1930-1937. doi:10.1136/gutjnl-2016-311964 (http://gut.bmj.com/content/early/2016/07/21/gutjnl-2016-311964.full)
https://gluten.org/2019/10/17/nutrient-deficiencies/
https://celiac.org/gluten-free-living/what-is-gluten/sources-of-gluten/
