What To Do if You Suspect Gluten Problems

How to Diagnose Gluten Intolerance

Symptoms of gluten sensitivity include irritable bowel type symptoms such as bloating, abdominal pain, and changes in bowel habits, as well as systemic manifestations such as brain fog, headache, fatigue, depression, joint and muscle aches, numbness in the extremities, skin rash, or anemia. I previously discussed why people who suspect they might be gluten sensitive should not go on a gluten-free diet. But if that’s true, what should they do?

The first thing is a formal evaluation for celiac disease, which currently involves blood tests and a small intestinal biopsy. If the evaluation is positive, then a gluten-free diet is necessary. If it’s negative, it’s best to try a healthier diet with more fruits, vegetables, whole grains, and beans while avoiding processed junk. In the past, a gluten-free diet had many benefits over the traditional American diet because it required increasing fruit and vegetable intake—so no wonder people felt better eating gluten-free: no more unhealthy bread products, no more fast food restaurants. Now, there is just as much gluten-free junk out there.

If a healthy diet doesn’t help, then the next step is to try ruling out other causes of chronic gastrointestinal distress. In a study of 84 people who claimed gluten caused them adverse reactions (they’re referred to in the literature as“PWAWGs,” People Who Avoid Wheat and/or Gluten), highlighted in my video, How to Diagnose Gluten Intolerance, about a third didn’t appear to have gluten sensitivity at all. Instead, they either had an overgrowth of bacteria in their small intestine, were fructose or lactose intolerant, or had a neuromuscular disorder like gastroparesis or pelvic floor dysfunction. Only if those are also ruled out, would I suggest people suffering from chronic suspicious symptoms try a gluten-free diet. If symptoms improve, stick with it and maybe re-challenge with gluten periodically.

Unlike the treatment for celiac disease, a gluten-free diet for gluten sensitivity is ideal not only to prevent serious complications from an autoimmune reaction, but to resolve symptoms and try to improve a patient’s quality of life. However, a gluten-free diet itself can also reduce quality of life; so, it’s a matter of trying to continually strike the balance. For example, gluten-free foods can be expensive, averaging about triple the cost. Most people would benefit from buying an extra bunch of kale or blueberries instead.

No current data suggest that that general population should maintain a gluten-free lifestyle, but for those with celiac disease, a wheat allergy, or a sensitivity diagnosis, gluten-free diets can be a lifesaver.

For more on gluten, check out Is Gluten Sensitivity Real? and Gluten-Free Diets: Separating the Wheat from the Chat.

Some food strategies that may help with irritable bowel symptoms are covered in a few of my previous videos, such as Kiwifruit for Irritable Bowel Syndrome and Cayenne Pepper for Irritable Bowel Syndrome and Chronic Indigestion.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Jeremy Segrott/ Flickr

  • Thea

    I’m just realizing that like some of the videos, sometimes the blog posts are a series. I’ve seen two blog posts in a row on the same topic before. I don’t remember if there’s been three or not before this one. But I really like it. It allows us to really explore an issue.

  • WFPBRunner

    Great advise Dr. Greger. After being diagnosed with a gluten sensitivity (which was a long time coming) and being off the stuff for years I was unable to get a celiac diagnosis because of the length of time I hadn’t eaten gluten. There just aren’t enough MDs that think diet is an important component of disease. So patients flounder looking for cures on their own. And one of the first solutions we read about is giving up gluten. So everyone who suspects they have gluten issues the take away message is GET TESTED BEFORE YOU STOP EATING IT!

    • Thea

      WFPBRunner: Your post is so helpful. It really helps me to understand at a personal/emotional level why Dr. Greger’s makes great sense. Thank you.

      • WFPBRunner

        Thank you Thea. There are definitely some who just give it up because they think there is inherently something wrong with wheat/gluten. And they need to rethink their motivation. But I would venture to guess the majority are like me. I had a number of autoimmune issues. And the various doctors looked at me and just said “of that’s autoimmune.” And I would leave thinking ok well that is strange. It wasn’t until my doctor wouldn’t replace my eardrums again that I hit the books and decided I was going to learn all I could about inflammation and autoimmune disease. What I found after reading a ton of articles after many days was that I could maybe “cure” myself by changing my diet. And it worked! And after many years MDs are actually coming around. They are saying to me “you know, with those health issues it sounds like you have celiacs disease.” But too late to find out if indeed I do. I discourage healthy people all the time from giving up gluten.

        • Thea

          You did the best you could with the information and the experts that you had. You can’t beat yourself up over that, especially since you found a way to relieve your suffering on your own. You should be very proud of that!

          • WFPBRunner

            And my hearing is better than my kids! Yeah!

        • Rhombopterix

          was there anything in particular besides a WFPB approach? How were you with legumes before the diet change?

          • WFPBRunner

            You are talking about the FODMAP you mention below? A few years back I developed IBD (positive diagnosis from endoscope) which lasted about 1.5 years and is now completely gone. When my Gastroentrologist handed me the list of food I couldn’t eat I had a good laugh. I said you know I am a sugarfree, gluten free, no processed food vegan right? There would have been nothing left for me to eat and that just didn’t seem healthy. I eat a ton of beans. I tried everything. i tried to find something that made it better or worse. No pattern developed. It finally just went away.

          • Rhombopterix

            Good one. The body’s ability to repair is awe inspiring fer sure. Glad that happened for you.

            So difficult to see a loved one suffer…when she is being so disciplined and positive too. I hope Dr. G takes on some of the subtleties that seem to go along with the FODMAP story(ies).

  • Ilana

    In the US, those tests can be very expensive. For people living paycheck to paycheck, trying a gluten free diet first can be less expensive in the short term and will see if they feel better. (Even if they aren’t actually sensitive.)

    • WFPBRunner

      Ilana I respectfully disagree. Having done it exactly how you recommend I am now unable to get a correct diagnosis without going back on gluten for a period of time and I am not willing to do that. Why is it important to have a diagnosis of Celiacs? Or not? Because there is a big difference between having a stomach ache and damaging your ability to absorb nutrients and eventually dying only to find out you had celiacs. Celiacs is a very serious disease which makes it necessary to have a gluten free kitchen etc. An intolerance is a much different animal.

      • Ilana

        I completely agree that getting tested is the right way to go about it, but most of America can’t afford their medical bills to begin with, let alone a biopsy and blood tests.

        • WFPBRunner

          a positive blood test is positive for celiacs. A negative blood test means you need to do further testing. And once you give it up the tests aren’t accurate.

          • Ilana

            I’m not really sure what your response means. It furthers my point that Dr Greger is recommending a lot of tests that, while obviously of great worth, are unaffordable for many people.

          • WFPBRunner

            Aw. It only becomes more expensive if you have a negative blood test.

          • Thea

            Ilana: I’m with WFPBRunner on this: I don’t understand where you are coming from. I think you are making a huge assumption when you say that most of America can’t afford a blood test. America is spending money on health care. What better way than to spend that money on high priority needs, especially when the consequences of failing to do so are so high? You wrote that this test would be unaffordable for many people. I don’t know you figure that. Every single person I know has at least super basic health insurance and can afford a blood test. I’m not saying everyone in the world can. But surely the very first step would be try to get an accurate diagnosis and only if someone is so poor that they can’t get the diagnosis would it make sense to potentially doom them to the consequences of not knowing their problem for the rest of their life. That seems like a more sensible approach to me.

          • Paul

            Because many folks still can’t afford “Obamacare” prices. Also there is no limit on increasing premiums by the insurers. My premium went up 18% on January 1 of this year. I’m fortunate I can afford Obamacare because in my age group it’s not cheap. My mid-range plan is 638$ a month, and I’m still on the hook for a lot of services with copays and deductibles. My plan stipulates that if I have an emergency requiring an ambulance ride to a hospital, if I’m not admitted from the E.R. as an inpatient and simply examined and released, I’m on the hook for 500$ for the ambulance ride. It’s cheaper to take a taxi to the E.R. if I’m at all conscious.

            At any rate, the “health care” system in this country is a travesty, it’s the joke of the imperialist core, and we need nationalized service akin to an NHS-type program. Obama just approved 1$ trillion for “upgrading” our nuke arsenal. Not the nuke plants, the weapons, which of course is going straight into the pockets of the nuke weapons corporations. Gotta have a demon, these days it’s Mr. Putin and Russia. That money would have gone a long way towards insuring everybody, probably for many years!

          • Julie

            My friend’s husband just lost his job (and health insurance). The cheapest health insurance for an unemployed couple in the state of Maine is $750.00 per month!!!! Affordable??

          • Paul

            Horrifying. But hey, saber-rattling Russia, DPRK, and Iran takes precedence over people’s health!

          • peseta11

            Paul, I think class issues, when they relate to health, need to be addressed here– if we can do it without overemphasizing WHO rather than WHAT can begin to resolve the current mess. (Political parties, as James Madison took pains to say, are part of the problem.)

  • Dawn

    Dr. G, What do you think about the advice those of us with autoimmune disorders such as Hashimoto’s are sometimes given to avoid gluten. There seems to be a percentage of Hashimoto’s sufferers that have their antibody levels go down to normal from just this one change… I unfortunately was not one of them.

    • WFPBRunner

      Hi Dawn,
      My TSH didn’t go down until I became completely WFPB. Giving up gluten didn’t change the numbers. (and I never ate the SAD-I am from the land of fruit and nuts-California)

  • guest

    Celiac disease and gluten intolerance appear to be Western diseases and even that seems to be mostly among caucasians. This is just a casual observation, so I may be wrong. Has anybody seen reliable data on global prevalence of these two conditions? Thanks

    • AlanTobey

      I’ve read stories (but not seen definitive studies) indicating that genes implicated in nonceliac gluten intolerance are more prevalent among people whose ancestors lived in Northern Europeand islands and coastlines — where only barley but not wheat could be grown. However, I doubt this is an exclusive factor.

      • Mike

        That’s interesting. My friend told me to try Barley as I might tolerate it better, but doesn’t it also contain Gluten? Then again perhaps for me it’s the wheat, not the gluten. It still could be neither…… I haven’t done enough tests. I just know that currently even when I included gluten free oats I had more constipation.. I even soaked them.

        • Shirley Lawrence

          If you are constipated, try using some coconut oil on your stomach area and then spray on some magnesium oil. Using it regularly, you should see a difference in your bowel situation. The magnesium allows moisture to collect in your bowels which helps to soften the stool. Studies are showing that we are all very deficient in magnesium. Study up on it sometime – you’ll be amazed how deficient we all are.

    • Benjamin Richardson

      There is some hard data, yes.

      From “Systematic review: worldwide variation in the frequency of coeliac disease and changes over time” – http://www.ncbi.nlm.nih.gov/pubmed/23782240

      “Coeliac disease (CD), originally thought to be largely confined to Northern Europe and Australasia and uncommon in North America and the Middle East, is now recognised to be equally common in all these countries. It is still thought to be rare in the Orient and Sub-Saharan Africa”

      From “World perspective and celiac disease epidemiology” – http://www.ncbi.nlm.nih.gov/pubmed/25925915

      “In Europe and the USA, the mean frequency of celiac disease (CD) in the general population is approximately 1%, with some regional differences, the reasons for which remain elusive. A similar disease prevalence has been found in other countries mostly populated by individuals of European origin, e.g. Australia and Argentina. In Western countries, a true rise in overall CD prevalence of CD has been documented. CD is a common disorder in North Africa, the Middle East and India; however, the diagnostic rate is low in these countries due to low availability of diagnostic facilities and poor disease awareness. ”

      and

      “In many developing countries, the frequency of CD is likely to increase in the near future given the diffuse tendency to adopt Western, gluten-rich dietary patterns.”

      From “Celiac disease from a global perspective.” – http://www.ncbi.nlm.nih.gov/pubmed/26060103

      “Celiac disease (CD) is one of the commonest lifelong disorders in countries populated by individuals of European origin, affecting approximately 1% of the general population. This is a common disease also in North Africa, Middle East and India”

      and

      “The majority of patients with CD are still undiagnosed all over the world”

      Fascinating stuff. Disclosure, I am celiac!

  • Amy

    Thank you so much for this article Dr. Granger. I took my son to a holistic doctor who is well respected in our area. She did an ALCAT Food Sensitivity Test and my son showed up negative for gluten but showed severe intolerance for wheat and cabbage. He also showed moderate intolerance for fructose, iceberg lettuce and butternut squash and mild Casein intolerance (as you mentioned happens frequently above). He showed no actual allergy to wheat, just the intollerance. Would you recommend Gluten free for him or is there a better way?

    • Thea

      Amy: I’m no expert, but if I understand you correctly, you are saying that your son is intolerant for wheat, but not gluten. So, why would you go gluten-free? By going gluten free, your son would miss out on some really great grains like (I think) barley and spelt. And some product have just the gluten in them. If your son can take those, then he can enjoy some transition foods like gluten-based “peperoni” (that I so enjoy).
      .
      Also, I’ll point out that for an intolerance, it sounds like it is a good idea to go down the path of eating a whole plant food diet (I don’t know what your son’s current diet is) and the re-challenging with wheat? in the future. Perhaps some of your son’s sensitivities will clear up in the future and he will be able to enjoy healthy foods like cabbage and wheat berries. Just some thoughts for you.

  • ksrunner

    I second the question posed by Dawn: what about the impact of gluten on those suffering from autoimmune disorders? There are a fairly significant number of “experts,” albeit some of whom come from a Paleo-type background, who strongly recommend that autoimmune patients avoid gluten. I greatly respect Dr. Greger and his work, so I am curious where he stands on this particular issue.

    • WFPBRunner

      Ksrunner. Dr. Getger doesn’t always have an opportunity to reply so I believe from the blog posts and various videos he is saying absolutely see if it makes a difference just get tested first.

  • irah

    Some doctors tell me that Gluten is a problem because it crosses the Brain-Blood barrier. See – http://www.drperlmutter.com/tag/blood-brain-barrier/
    Having just gone vegan, I don’t want to try removing another whole set of foods on a myth. Have you seen any concrete evidence for or against the gluten brain arguments

    • David J

      Personally, I would not rely on what Dr. Perlmutter says. He makes unsubstantiated grandiose claims, and seems to have a poor reputation among various knowledgeable MDs who have nothing to sell e.g. Dr. Katz (Yale U), Dr, Mirkin (a now retired sports doctor interested in nutrition who is not a vegan and pushes no products). E.g. here’s Mirkin’s opinion of both Wheat Belly (Davis) and Grain Brain (Perlmutter):

      http://www.drmirkin.com/nutrition/forget-grain-brain-and-wheat-belly-eat-whole-grains.html

      You might be interested in reading this expose before deciding what to believe:
      http://nymag.com/scienceofus/2015/06/problem-with-the-grain-brain-doctor.html

      Personally I would not remove wheat without solid evidence you cannot tolerate it. I thought I was wheat sensitive (tested negative for celiac) and stopped for about 3 weeks (after being tested for celiac!) but later found out my problem was a poor gut microbiome, probably from having intravenous antibiotics 4 times in 5 years, and then PPIs for acid reflux. A month on a good probiotic (they vary greatly in quality) and upping my prebiotics/resistant starches (e.g. potato starch, heated and cooled rice, green bananas) corrected my long standing problem (about 2 years). Wheat had nothing to do with it. I love wheat so was very thankful, that was not my issue!

      Good luck with your vegan diet!

      • irah

        Thank you David. There is so much opinion and information it is overwhelming.At least I can put the gluten issue to bed for now.

    • WFPBRunner

      Irah good strategy. Having just gone WFPB you should give it more time and see how you feel. Statistically (see blog) you probably don’t have an issue with wheat/gluten.

  • Momo Vegg

    My big question about gluten is should I avoid it with autoimmune thyroiditis? Everywhere I read on the internet it tells me I should but out all gluten. I find that I have swelling/scalloping of the tongue, which does get better if I eliminate all gluten. Is this coincidental or is there real science with a gluten-autoimmune thyroid connection??
    Thanks in advance.

  • Betty

    How is it harmful if a person goes gluten free when they aren’t gluten sensitive etc?

    • Betty

      Never mind, I found his other article. Oops. :-)

    • Julie

      I don’t see it as a problem. So you cant eat wheat, spelt, barley or rye. There’s still quinoa, amaranth, buckwheat, teff, millet, rice, wild rice and gluten-free oats which all are loaded with nutrition.

  • Lsegall

    In the book I co-authored with Dr. Shari Lieberman, The Gluten Connection (Rodale, 2007), we identified a lab (stool) test for gluten sensitivity. It is done at Entero Labs in Dallas. Blood tests are not always accurate.

  • AngelGirl7

    I have a gluten and a sugar allergy. I don’t know or care what you call it, because doctors have told me I just need will power, and I’m imagining things. Judge for yourself. Before weight (and I have the pictures to prove it): 343 pounds. Current weight: 138 pounds. Yeah, I have lost over 200 pounds… and kept it off since May, 2009. I WAS diagnosed pre diabetic, with IBS, post traumatic stress syndrome (hit by a drunk driver, husband killed, had multiple reconstructive surgeries), thrombocytopenia, high cholesterol, asthma, varicose veins, osteoarthritis of the feet and knees, and a bunch of other conditions. Now I am 67 and take NO meds. I exercise regularly and work part time. I USED TO watch TV and eat all day – always flour and sugar. To lose weight, I was on doctor supervised fasts, saw therapists, joined gyms multiple times, went to a hypnotist, went to a chiropractor, had hands laid on me at church, saw nutritionists, joined Weight Watchers, NutriSystems, and went on dozens of diets. I’d lose for a while – until I had my first taste of flour or sugar. Then I started again. I could not stop once I started. Yet I craved what I was allergic to. Then I found a 12-Step program for people like me. You would be surprised to find out how many of us there are. The theory is – if you can’t stop – why get started. So I abstain completely from flour and sugar. And I live a sane, happy, healthy life with no cravings. I don’t know what causes it. I suspect genetic modification of the the food supply. But I don’t know. I just know it works.

    • Rhombopterix

      I just forwarded this . food for thought, thanks

    • Julie

      AngelGirl7 your story is inspiring and I bet it could help lots of people. Wheat and sugar can both stimulate appetite. Wheat always makes me hungry and after ditching wheat and gluten, working on controlling my weight is a distant memory.

  • Vicky

    I do seem to have a gluten intolerance – nothing major, but the moment I eat gluten, within a few hours my hips and some finger joints ache. I’ve had a hip replacement and do have a lot of arthritis in my family. I figured this out by avoiding gluten for a couple of weeks, then eating something with gluten. Major pain and discomfort within a day. This has happened several times where I may have eaten gluten unknowingly. Same with tomatoes and grapefruit.

  • Rhombopterix

    I hope you will someday soon re-address the FODMAP issues that dog some people (FODMAPITDSP) My poor wife…we’ve gone gluten free and she got a small benefit like Vicky below. She has always been a healthy eater and went WFPB for my sake after my horror show. Now she minimizes legumes and takes galactosideases before meals…which do help her.

    BUT I don’t understand why we are not able to establish a good substratum of healthy bugs inside her. I’ve done this and it changed me back into the beast I was meant to be. Why/how/what steps can we take to address this horrible suffering? It has taken a terrible toll from the sweetest angel this side of the Far Pavilions.

    • Julie

      Probiotics and fermented foods–you don’t mention these but I thought I’d mention them as they are essential to getting and keeping the healthy bugs thriving. http://www.culturedfoodlife.com/about-me/

      • Rhombopterix

        Sounds like a good thing to try. Thanks

        • Rhombopterix

          OOPS, that link you gave is for raw milk and kefir and other crap! Sneaky. NO THANKS Julie. I took my “like” back but I still like you :)

          I do wonder, however if there is a benefit from eating fermented foods like sour kraut? Maybe the process “predigests” and helps encourage the good bugs?

          I have read some papers about probiotics. I don’t believe they actually can do any good. I have this impression that there is a “wall” of bugs…a constant exposure to bacteria in nature. We select for them, good or bad by adjusting our diets.

          My girl must keep tweeking until we can establish the right conditions for the good guys to move in. I think.

          • Julie

            No! She has recipes for NON DAIRY kefir too!!! Fermented veggies and kombucha are vegan. In fact Charzie a vegan who posts on nutritionfacts is the one who let me know about this fermented food website. Here is the recipe for kefir using almond milk, or whatever non-dairy milk you wish. http://www.culturedfoodlife.com/non-dairy-kefir-wants-a-date/

          • Rhombopterix

            If the Vege-nater told you then count me in! So you mix the kefir grains with veg-milk and make a kind of fermented drink? There’s a local place that sells cheese starter cultures here…would that work? I never considered making fermented foods with dairy bacteria.

            Pretty tasty I take it? We do indulge in sour kraut but not much…too salty but yummy in small doses. I wonder what femented foods could do for her (my woman-thing).

          • Julie

            Fermented foods seem to really help many people with digestive/intestinal issues. Give it a try and see if it helps her. Important to start slow, maybe a eating a couple tablespoons per day at first.
            I don’t know about cheese starter cultures–good question! I do know that kefir grains have dozens of healthy probiotics and are a tried and true method for fermenting non-dairy milks. The cultured food for life website sells kefir grains. I got mine from another site, http://www.yemoosmarket.com/collections/cultures-milk-kefir-grains

          • Rhombopterix

            I’ll see what is available here in NZ. so far just sour kraut and kimchie at $15/lb….nah.

            Julie, are there any scientific reviews or proper studies of the relationship between eating fermented foods and IBS or similar?

          • Julie

            http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886445/

            Try making your own fermented veggies! Charzie is a pro at this!
            In the middle of this link are some how-to videos that may help you get started. http://www.culturedfoodlife.com/20-ways-to-get-cultured/

    • Thea

      Rhombopterix: I saw your post just before going to a 1 week nutrition/vegan conference. At the conference, I had the opportunity to listen to a talk from Dr. Klaper on Leaky Gut and Probiotics. I’m thinking that’s not the exact condition your wife has, but I went to listen to the talk hoping I could pick up something that might be helpful to you as the talk is about how to restore a healthy gut. I think Dr. Kaper has various versions of the lecture for sale and I *highly* recommend watching the whole talk if you can. But here are *some* of my notes. Maybe this will give you some clues.
      ——
      .
      > Leaky gut = foreign proteins “leaking” into the bloodstream. This is a problem that may: incite auto-immune disease, allergic responses (like hay fever, asthma, and hives), and ulcerative colitis.
      .
      > There is a test for leaky gut called the “intestinal permeability test”
      .
      > Leaky gut is FIXABLE! It may take a bit of time, but it can heal itself. Here’s the steps:
      1) stop injuring it (ex: no soft drinks/phosphorus acid, no coffee/tea which have some antibacterial oils, no foods with herbicides/pesticides, no alcohol, no antibiotics (which means no animal products too), no sugar as food, others?)
      2) remove allergenic foods such as dairy and wheat
      3) help repair the lining with ??? This part I probably did not copy down right. So, please do research before doing this: quercetin 250-500 mg 2x/day and glutamine 25-500 mg 2x/day – for about 6-12 weeks
      4) and then re-establish good bacteria with a good probiotic pill such as Ultimate Flora – be sure to get one that is not grown on dairy. Also, can do test to make sure whatever you get is really alive.
      .
      Other notes:
      > do diary yogurt
      > don’t rely on foods like kimchee since you don’t really know what is in there. It won’t hurt. But it’s not a guarantee to fix the problem for something like leaky gut
      > take probiotic pills on an empty tummy – about 1 hr before meal or 2 hours after /just before bed = great
      > *****!!!!: It’s not that everyone needs a probiotic pill or food. It’s helpful for fixing a problem, but once you have a healthy gut, just eating whole plant foods is all you need to do.
      .
      To repeat: No one should rely on these notes. These notes give great hints on how to move forward. But I had to take a lot of notes for an hour plus from someone who was speaking very, very fast. Best to hear the talk for yourself if you can. Dr. Klaper’s website is: http://www.doctorklaper.com Rhombobterix: I’m hoping your wife can find a way to fix her problem. Best of luck to both of you!

      • Rhombopterix

        How thoughtful of you. I’ve copied and forwarded…we will compare with what we are doing now and give it a try. Understood… Klaper’s the man on this one. I haven’t listen to him for some years now so it will be a timely catchup. I like his presentation style. Although he will never be the artist that Doug Lisle is!

        We did start including just a tbs dose of yogurt. Experimenting with non-diary milk culture and water-kefir too. Some real improvement but, yeah like you say…fix the problem then WFPB. I was luckier than her…mine cleared up on its own.

        Hug and a kiss to you, Sug.

        • Thea

          Happy I might have helped!
          .
          Please Note: I was just reviewing what I wrote and I realized there was a typo. It previously said, “do dairy yogurt”. It should have said “no dairy yogurt”. Dr. Klaper was very clear that there were several reasons why dairy yogurt was a bad idea. Sorry for the confusion.

          • Rhombopterix

            I was a little surprised to see that. We never took a pledge. If she gets some benefit that is good enough reason. I am looking at his webpage now…are you talking about his DVD on digestion?

            As for me, I eat parts of animals and some of their spin-offs when I feel it will do me some good. I’ll define good in this app :)

          • Thea

            Rhombopterix: Here is a free excerpt of a talk that looks similar to the one that I watched from the website. Below the free excerpt are two links/ideas on how to get the entire talk.
            http://doctorklaper.com/videos/curing-leaky-gut-syndrome/

  • B. Recht

    I am confused: if I have gluten intolerance, I avoid gluten and especially the wheat, wheat caused me Ulcerative colitis. So why encourage to eat whole grains? All available grains have a specifc type of gluten in them but the wheat gluten is the one that effects most people horrendously. What was done to the wheat grain? is it a hybrid and hence it contains all kinds of chemicals ?
    I can eat Spelt and dont feel so foggy and bloated as I do with wheat. Mind you I eat organic only and still feel the difference.

    • Tom Goff

      You do know that spelt is a type of wheat?

  • Rhombopterix

    I suspect that a lot of commercial bread is made with rancid lipid. Before I made my own bread (oil-free), I remember getting an upset stomach after eating some bread. But the same brand, different loaf…no problem. At first I wondered if I too was gluten-sensitive. but think about it. I can’t see the gluten or other ingredients varying much but oil will go off fairly quickly under the right conditions. How else could the same brand of bread cause such a range of reactions from one loaf to the next. And what are the symptoms of eating rancid fats?

    Gee would bread manufacturers trade the customer’s health for cost savings by using old, rancid oils? I don’t know but i suspect the answer is yes they would.

    I don’t know about regulations on this. Are there any sort of mandatory testing protocols in the QA system on lipids to ensure that dangerously degraded oils are detected before they are used? Can a regular citizen ask for this sort of information?

    btw/ one time i forgot to add the sugar and the bread rose just fine. Now I only use whole meal flours, water, yeast and a little salt

  • Brillo

    Don’t forget FODMAP, Dr. Gregor.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388522/

  • salbers

    Dr Greger’s gluten advice fits my modus operandi exactly: Don’t guess, TEST. Then be guided by the results.

  • Kathy Tyler

    My gluten sensitivity doesn’t produce gastrointestinal problems, but I get heart palpitations every time I eat it. At least, I do when I eat wheat. I haven’t tried reintroducing barley or rye. I have tried three times to add wheat back in and each time I got the heart palpitations. My migraines have also become fewer and farther between since giving up gluten.

  • Benjamin Richardson

    One additional piece of really important advice –

    In those potentially final days of eating gluten before gaining a reliable diagnosis that confirms or eliminates the need for a life-long gluten free diet, do absolutely make sure to enjoy a really, really well made croissant. If you must subsequently go gluten-free you may well be able to find agreeable gluten-free substitutes for everything else – biscuits, cakes, bread, pizza, scones. There are no gluten-free croissants that deserve to be called croissants.

    Please gluten-free-o-sphere, someone tell me I am wrong :-P

  • Matt K

    If one eats whole plant foods while avoiding wheat, is that acceptable? The Okinawans in Japan have the longest longevity statistics and because much of their food consumption was in sweat potatoes and legumes, I imagine the amount of wheat they ate was rather low.

    • Julie

      There’s no need to eat wheat, so sure a WFPB diet without wheat is fine. Consuming wheat, rye and barley is hardly necessary for being healthy. Most gluten free grains like amaranth, millet, quinoa, buckwheat, wild rice etc. are even more nutritious than wheat.

  • Mike

    Hi,

    I’m currently suffering from extremely bad IBS, distension and constipation. Through diet I have improved very slowly, but I’m still living in a debilitated state. I think I have damaged my pancreas as food is not being digested properly. Enzymes help me as well, suggesting my pancreas may not be functioning at 100%. I know stress is part of it too and I have cut out most grains because when I include them I get a lot more problems. Gluten sensitivity is indeed incredibly complicated. I think it might be the case that those with compromised gut health simply can’t tolerate gluten amongst other things. I am still a little suspicious of it, but I think once I heal my gut, I could probably include wheat again in moderation. One thing is for sure, is that I can’t say wheat is promotes ‘good gut health’ – if it seems that sensitive people get issues with it..?

    I think I also have fructose intolerance as when eating pineapple and mango, dates, or red apples, I start to get upper left abdominal pain (the same region as the pancreas right?) I have previously had a serious sugar addiction, including binging – I wonder if I over stressed the pancreas to a point where it ‘gave out’ and developed a resistance to sugar/fructose as an attempt to protect itself. Does this sound plausible?

    • B. Recht

      This is from my experience after reading many medical sites explaining the Gluten problem, this is what I have discovered: when eating wheat and other gluten food, the insulin spirals out of control. Wheat creates craving for more of the same, in fact it creates a vicious circle of craving for wheat then sugar. I cant recall exactly but something is triggered in our brain that causes this effect. Search on Mercola.com until you fond what you are looking for.
      I had Colitis and was told by the doctor that I will have to live with it for life and eventually it may develop to rectal cancer. Great news, I thought coming from a professional. I went home and started searching for answers. 18 months later there was no sign of colitis in my bowels.
      Wheat and gluten is a tricky problem, people still cannot grasp that it is ADDICTIVE. It took me 10 months to overcome this addiction because it is a trigger in the brain. No problem for the last 2 years.
      Mercola is a great website to start searching.
      Global Healing Centre has plant based products and they are working for me, I take them daily.
      I take 2-3 tsp of Vit. C which is buffered from Life Extension.
      With that I use a cleansing regime from Dr. Sircus who recommends Bi Carbonate of Soda. I lost 4 kg over 4 weeks and feel amazing. In fact the more I take it the less my body aches. I also cook with it. Be sure to get the Bob Mills product.
      Good luck and perseverance is the key!

      • Mike

        Familiar with Mercola but at times its the antithesis to Nutritionfacts.org – It’s a paleo bias website from a guy who is definitely more about selling products than Mr Greger and that’s why I trust NF more. I do like some of Mercola’s stuff but I’m not entirely convinced. I do agree wheat seems addictive though. And the smell too! it’s strange how freshly baked bread drives me nuts.

        I have no real way of knowing for sure though, because I ate wheat for most of my life, why did I only get a problem now? It doesn’t make a lot of sense to me. I think there are other factors, and that wheat simply might become an irritant due to other damage that has been done?

        • B. Recht

          I understand how you feel, I have been there… I used to be constipated for days until I woke up to the fact of Gluten, yes this delicious addictive wheat, but now I eat far more greens than ever before. In fact I find that the less I eat the better my bowels function and elimination is faster. People tend to eat far more than in the past because the food is DEVOID of nutrients and we are still hungry. I take pure harvested Spirulina because it contains many bio available nutrients and it is satisfying.
          There is a short pdf somewhere, I cant recall where I downloaded it from called “the dark side of wheat’, explaining many of the problems people suffer from. Keep in mind that wheat today is not what it was a decade ago. So many of our health problem especially cancer suddenly appear because of the use Roundup/Glyphosate. So this may be the answer as to why you feel different after all these years: Chemicals accumulate in our organs until one day the body cant take it any more and expresses itself with a disease, and the doctors have no clues about, so they invent a name. Everything begins with the food we eat!
          Wheat addiction is yet another addiction like sugar, coffee, meat, etc. Once you decide that you know and accept this knowledge, it will be easier to deal with it. Food has a psychological connection to how we feel.

          Listen to Bruce Lipton explaining the connection of Epi-genetics, fascinating knowledge.

          Check also http://www.ihealthtube.com

          Self education takes time but it is so rewarding…! besides, only I know my body better than anyone else.

          • Mike

            Sorry if I didn’t all ready mention but I’ve only eaten gluten 2 or 3 times in six months. It was hard to tell if I was reacting because I’m reacting to everything. My hunch says I do however, so for now yes I am avoiding it. I cannot afford my diet currently though… it’s far too expensive to not eat any rice or grains at all… until I get back into work that is…

          • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377866/

            http://www.ncbi.nlm.nih.gov/pubmed/25701700
            Are the two above 2015 studies the nail in the coffin on the whole controvery? If not tell me why. Gliadin led to increased intestinal permeability in all patients studied, whether celiac or not. Gluten led to statistically significant brain fog and depression in a double blind, placebo and crossover trial.
            OOps first posting and posted in wrong spot. Hope Dr. Greger will answer this question.

  • Chana Kaminker

    Is there any truth to what I’ve heard about gluten possibly exasperating Hashimoto’s?

  • michael

    Confusing. First part he says unless you test positive for celiac, a gluten free diet is unnecessary. At end he says if you’re celiac, “OR A WHEAT ALLERGY OR A SENSITIVITY DIAGNOSIS, gluten-free diets can be a lifesaver”

    Which one is it?

    “The first thing is a formal evaluation for celiac disease, which currently involves blood tests and a small intestinal biopsy. If the evaluation is positive, then a gluten-free diet is necessary. If it’s negative, it’s best to try a healthier diet with more fruits, vegetables, whole grains and beans while avoiding processed junk.”

    Then at the end he says: “No current data suggests that that general population should maintain a gluten-free lifestyle, but for those with celiac disease, a wheat allergy, or a sensitivity diagnosis, gluten-free diets can be a lifesaver.”

    Which one is it???

    • Tom Goff

      I think that you may be overinterpreting this. In the first part he says
      “The first thing is a formal evaluation for celiac disease, which currently involves blood tests and a small intestinal biopsy. If the evaluation is positive, then a gluten-free diet is necessary. If it’s negative, it’s best to try a healthier diet with more fruits, vegetables, whole grains, and beans while avoiding processed junk.”
      Then he writes
      “If a healthy diet doesn’t help, then the next step is to try ruling out other causes of chronic gastrointestinal distress.” and then “Only if those are also ruled out, would I suggest people suffering from chronic suspicious symptoms try a gluten-free diet.”
      Perhaps I am a bit slow on the uptake but I really don’t see a contradiction.

  • B. Recht

    I WOULD HIGHLY RECOMMEND, from my own benefits to do the cleansing with Bi carbonate of Soda until you good a difference. Absolutely harmless and cheap.
    When avoiding Wheat/gluten try potatoes, rye, brown rice. I cook everything now with a bit of bi carb.

    • Tom Goff

      I would be very careful about this approach. Dr Sirkus is an acupuncturist and a “doctor of oriental and pastoral medicine”. I do not even know what “pastoral” medicine is, let alone where he got these particular “qualifications” from.

      Nor am I aware of any significant evidence that sodium bicarbonate helps in diabetes. Is there any in the scientific literature?
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3224469/

      Also you write that when avoiding gluten, people should try rye – I like rye bread very much but it contains gluten and is therefore not suitable for people who are sensitive to gluten.

  • B. Recht

    I read the link you provided and few things dont stack up for me, I will mention 2, otherwise there is too much to unpick: Bi carb was administered to a condition of diabetes, Bi Carb would in my opinion probably prevent getting to this stage, as each person at different stages of their life has a different digestive system. 2/ why would one give a young child bi carb in the first place? unless they are obese and suffer from reflux and their body is already ‘polluted’ with chemicals.
    Interesting though and coming from oncologists: the fact that cancer patients are given Bi carb to help them cope with the killer toxin prior to them receiving chemo therapy because the drug in the chemo treatment is an agent orange derivative. And they also say that most patients die from the treatment NOT from the cancer per se. 68% who responded to a survey said they would never do it themselves nor give it to their families.

    But, I find Dr. Sircus to be a human being of high integrity and honesty and his protocols are simple and working for those who take the responsibility of their health into their own hands instead of absolving themselves and give in to the pharma. Have you heard of Epi genetics and Bruce Lipton? Our thoughts are an amazing tool for our consciousness but it depends what we choose to do with it.

    Rye – contains gluten as do many other grains including Oats however it is another type of gluten, which most european can digest as they have for centuries. Its the Wheat that has it gene altered and sprayed with bromine and other chemicals or else the profits will be low and share holders will be unhappy.

    I am of the opinion that people from european descent should continue with their ancestors diet, myself included. People from Asia should never adopt western diet of dairy for example, just as we ‘white men’ should not drink soy, etc. each culture should observe their own ancestral dietary recommendations. It is only later in life where the body cannot cope with the onslaught of toxins and starts giving up.
    But confusion reigns… and money speaks all languages.

  • soulsista

    Look up FODMAPs. I was formally diagnosed with Celiac by endoscopy, but still had chronic indigestion, gastritis, fatigue, and joint pain despite strict gluten free and a follow up endoscopy that showed my villi was healed. I was placed on a FODMAP free diet, and I improved dramatically. I posted a longer response with more detail on a previous blog, but this appears to have a different audience based on the comments. This site will not let me repost my comment on this blog, but I am commenting here because understanding FODMAPS improved my life so much, I want others to benefit if it is appropriate for your situation.

  • Ronald Green
  • Two studies seem to not being acknowledged. One demonstrates increased intestinal permeability in all subjects in the study of gliadin,
    The other, including crossover, had statistically increased incidence of brain fog and depression from gluten. I am a long time fan Dr. Greger, but think we need to address these two studies.
    Also are you familiar with the Seignalet protocol of the Wahls protocol? Dr. Seignalet collected data on 2500 volunteers over 20 years. The data he collected is very valuable in relation to the 91 diseases that it helped. ( no grains and no dairy ).

    http://www.ncbi.nlm.nih.gov/pubmed/25734566

    http://www.ncbi.nlm.nih.gov/pubmed/25701700

  • Nicola

    this is not a gluten problem, but I could not find a listing for this exact topic so I am posting here in hopes of getting some input. I have recently been diagnosed with a NICKEL ALLERGY. Because my symptoms are severe, I was told to go on a low nickel diet. This is a DISASTER for me as I am a gluten free vegan. Now ALL my favorite foods are prohibited. After 12 days, I am starting to see some relief, but I am told it takes 1-2 months to know for sure so I am trying to stick it out. Basically the low nickel diet prohibits chocolate (the highest in nickel of all foods) beans, seeds, nuts, oatmeal, virtually every whole grain, and many vegetables. The ideal low nickel meal? A Big Mac….white bread made from refined flour and MEAT. No thanks. I already am feeling weak from lack of protein, etc. The other frustrating thing is that there are many medical websites which lists foods that are either high or low nickel. However, these lists often contradict each other. One list says no carrots, another says they are OK. I can barely find any sites that list exact amounts for each food item. I would like to know this, for instance to see if I could possibly eat a TBS of flax. The one source I found which listed amounts, only did so for a few foods I like, instead ASSUMING people were going to eat the recommended white flour, white rice, dairy and meat diet.
    Does anyone know anywhere I can find lists that do contain estimates of amounts for each food? I am also wondering about my supplements. This website said NO vitamins, NO minerals, NO supplements…..except vitamin C!!! What? how can I meet my nutritional needs doing low nickel and being a gluten free vegan AND taking no supplements? I have called all my supplement companies and only ONE has done a detailed analysis which includes nickel. The government does not require this info be made public which is a problem. There are allegedly over 15 million Americans with a nickel allergy. Not all are severe enough to require the low nickel diet but still I would think it would be nice to have this info accessible. I have already been told by a few folks on this diet that it is impossible to do it while being a gluten free vegan. I do not want to eat meat or dairy, so I would like to find a way. I can tell you I am MISERABLE on this diet. Of my top 10 favorite foods, 9 are now prohibited. I have a kitchen full of food I can not eat. I am already thin, and have lost even more weight this 2 weeks. I would not wish this diet on anyone.

  • Tabot

    My wife is a type 1 diabetic and has gastroparesis. She is mostly wfpb and that has helped but she still has problems that cause her to need pharmaceuticals like domperidone. We tried going off gluten but that didn’t really help much. Has anyone had any experience with this condition? What has helped you?