Gluten: Intolerance v. Allergy?

Why you’re probably not allergic to gluten

One of the most common complaints I see each week is “I’m allergic to gluten”. Unfortunately, this misconception is fuelled by a number of fad diets.

First and foremost, it is important to understand that there is a big difference between an allergy and a food intolerance. The former involves your immune system and is a very serious medical condition that can result in anaphylaxis and death. In Australia, about one in 10 infants, one in 20 children up to five years of age, and two in 100 adults have food allergies.

A food intolerance does not involve the immune system. It is a food sensitivity that can cause a number of symptoms of varying severity such as digestive discomfort, headaches and sometimes rashes.

So, what is gluten? And what is the difference between a sensitivity and an intolerance?

Gluten is part of a family of proteins that is naturally found in a number of grains. It is made up of two main proteins called glutenin and gliadin. Gluten is also found in rye, spelt and barley. If you have coeliac disease, your immune system treats gluten as though it is an invader. Unfortunately, the lining of your gut also gets attacked in the process which can lead to serious immediate and long term consequences such as nutrient deficiencies, diarrhoea, bloating, fatigue, constipation and bowel cancer.

The piece that often gets missed when following a self administered gluten free diet is that most people haven’t actually removed gluten from their diet. What they have removed is just bread and pasta. You’d be surprised how many of the foods you eat contain gluten. Spend just one shopping trip reading the labels on your food and you will discover “may contain gluten” on dips, sauces, condiments etc. It’s everywhere.

There are THREE groups of people who benefit from removing gluten in their diet:

  1. Someone with coeliac disease. For them, eating gluten can not only make them feel terrible but it actually destroys their digestive tract as I have explained briefly above.
  2. Someone who has a fructan intolerance. In short, bread contains fructans which is one of the carbohydrates that someone with irritable bowel (IBS) can be sensitive to. Therefore, when they remove bread from their diet they experience less bloating, constipation or diarrhoea. Its not the gluten.
  3. We are now learning more about something called “non-coeliac gluten sensitivity”. In this case it is the gluten – they are sensitive to it, but its not causing damage to this person’s body. This is diagnosed after ruling out persons 1, 2 and other serious conditions.

When you should seek medical advice

So now think about your experience removing gluten from your diet. Do you think it was because you cut processed foods from your diet and ate mostly fresh foods? Perhaps you chose better quality snacks, or ate more regularly, or more mindfully? Or do you think this warrants a trip to the doctor for a blood test and a colonoscopy? or a perhaps you would benefit from a visit in my Canberra rooms to determine whether you potentially have a food intolerance?

Written by Miriam Pollak, CCHN Nutritionist