To Gluten Free Or Not To Gluten Free

The Gluten-Free Craze

The Diane Rehm Show | NPR


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So gluten sensitivity, like the other guests mentioned, is a really patient-driven diagnosis. This is really something I've seen in clinics so often. I have a patient come in telling me, I feel bloated. I feel I don't have energy, my mind is clouded. I have body pains.



These are often patients diagnosed with irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia. If they tell me I talked to my friends, I looked up on the internet, I started a gluten-free diet and I feel great. And as the guest mentioned, it's probably they're getting a healthier diet, you're avoiding all the carbs, the pasta, the bagels et cetera. You're avoiding processed food because gluten is actually present in a lot of processed food as a preservative so you're leading a healthier life and that might be what's helping.



But there's no test to look for this. We do have tests for celiac disease, which is a blood test and a biopsy of the small bowel. We do have a test for the wheat allergy that occurs in children and most children outgrow that wheat allergy, which is a skin-prick test. But we don't have a test for gluten sensitivity because we don't really know what it is.



Is it a true sensitivity? Is it something or part of a wide spectrum of gluten disorders or is it due to switching to a healthier diet? If you're eating protein and fruits and vegetables and avoiding the pasta and the bread and all this, you're going to feel better. Your nutrient status is going to be better. You are avoiding the carbs and carbs are the favorite food of the bacteria. The same way we love bagels and donuts the bacteria in our gut just loves it, too.



And when they're exposed to carbs, they ferment the carb and they produce gases and that gas is going to make you feel bloated. It's going to give you diarrhea or constipation. Your blood sugar is going to increase, which increases the insulin level and suddenly, your blood sugar is going to drop and you're going to feel fatigued and like you're not doing well and mind is foggy. So there might be multiple reasons why there's this gluten sensitivity.



And Katherine Tallmadge, would you advise someone who comes in to you feeling that way to do more than just exercise or eat a healthy diet? Might you advise them not to include gluten in the diet?



The quick answer is no, but -- because first of all, you have to get tested while you're eating gluten. I would want to count out any other diseases.