The Paleo diet is by nature a gluten-free diet. It is healthy, free of refined grains of any type including all wheat, rye and barley products. I would argue that it is a healthy choice for anyone. However, there is a significant portion of the population that absolutely should be on a gluten-free diet – those who have celiac disease and those who suffer from gluten intolerance. Are you one of these people? How do you find out?
In this post I’ll provide some background on celiac disease and gluten intolerance and some information on how to find out if you suffer from either of these ailments.
About Celiac Disease & Gluten Intolerance
Being gluten-free is not just a fancy new health fad. An estimated 1% of the U.S. population suffers from celiac disease. Celiac disease is an autoimmune disease of the small intestine which is caused by the gluten protein found in wheat, barley and rye products. In people suffering from celiac disease, the gluten protein damages the villi lining of the small intestine. This damages digestion and prevents the body from absorbing necessary nutrients. Common symptoms of celiac disease include:
- Diarrhea
- Abdominal pain
- Bloating
- Cramping
- Acid reflux
- And long term – anemia (iron deficiency) and nutrient deficiency
- Studies also show that untreated celiac disease can have an impact on mental and emotional health
Celiac disease is often misdiagnosed as another illness. It is not unusual for fibromyalgia, chron’s disease, chronic fatigue syndrome, and irritable bowl syndrome to actually be celiac disease misdiagnosed.
Gluten intolerance or gluten sensitivity is evident in as much as 10% of the population. Individuals with gluten intolerance experience many of the same symptoms as those with celiac disease, the one difference is there is no demonstrable damage to the villi of the small intestine. Regardless of the state of the small intestine, their symptoms can be as sever as those suffered by a celiac.
How do I find out if I have celiac disease or gluten intolerance?
Great question! And it took me some time to find out as I struggled to figure out how to solve my son’s health issues. You see, most doctor’s don’t seem to consider these symptoms worthy of deeper exploration for what could be causing them. I heard several explanations for my child’s issues including stomach bug, acid reflux, etc. I was even told to give him prilosec! (By the way, the box clearly says “not for children under 18″ on it.) I just felt intuitively that it had to be something he was eating. And it was – several somethings. But I digress…
The IgG test
The easiest way to discover if you have are having an intestinal reaction to gluten is to visit a naturopathic doctor (ND) and get an IgG blood test. This is a very simple blood test that involves pricking your finger and smearing it on a card. This test looks for intestinal response to a food, not a standard histamine response that you would get with an allergy test. It costs around $130 plus the office visit. Unfortunately, insurance generally won’t cover the cost of the tests. However, I think the results are priceless and a good deal at $130.
The IgG blood test looks for an intestinal immune response to a wide variety of foods. It rates the immune response on a scale of 0-6. 0 is no response and 6 is a very high level of re-activity. Moderate to high levels of reaction to wheat, rye, barley, and spelt are very strong indicators of gluten intolerance and/or celiac disease. If you react this way, then you should pursue a gluten free diet. There are other blood tests available including a range of more detailed blood tests that look for reaction to other grains from Cyrex Laboratories. These require a blood draw, are significantly more expensive, and provide a different set of results that are more detailed. However, the IgG is a great place to start.
The test also provides results for other items including beans, nuts, dairy, a range of vegetables, meats, etc. We eliminated soy, dairy and beans from our diet based on the results of tests of our household.
Stomach Biopsy
The most definitive way to discover if you have celiac disease is to have a stomach biopsy. During this biopsy the doctor takes a sample of the stomach lining and it is examined for damage to the villi. Needless to say this is a lot more painful and more expensive than the simple IgG test I suggested above.
The No Cost 30 Day Test
The other way to see if you are sensitive to gluten is to take the 30 day challenge. Eliminate all gluten products from your diet for 30 days and see how you feel. If you feel better on day 30, if your digestion, thinking and overall health has improved, then it’s a good bet that you will benefit from a gluten-free diet. The down side of this approach is that you’ll miss out on the opportunity to test for sensitivity to other foods like beans, nuts, dairy, etc. that you get with the IgG test.
One thing to keep in mind – if you do the 30 day test, don’t immediately follow it with the IgG test. You should be eating your regular current diet prior to taking the IgG test to get the most accurate reading.
Gluten-Free vs. Paleo Diet
Once you’ve decided that you’re ready for (or need) a gluten-free diet, then you should start exploring what that will encompass. All Paleo Diets are gluten-free by nature, but not all gluten-free diets are Paleo. When my family first switched to a gluten-free diet, we replaced wheat based grains with gluten-free grains like rice, quinoa, millet, and sorghum (no amaranth – one of us reacts to that too!) In fact, if you work at it, it is possible to completely replicate the nutrition poor, junk food based average western diet with a gluten-free version. While you may tolerate this better, it may not serve your nutritional needs very well.
I will point out that this was a very good first step for my family. Huge, drastic changes to diet can be difficult for some people to implement and can be difficult to “impose” on one’s family. Going from gluten to gluten-free before transitioning to paleo may work well for you. However, if you’re someone who just likes to rip the band-aid off quickly, I’d suggest going straight to a Paleo diet.
The Paleo Diet is a sub-set of the gluten-free diet. It eliminates all grains (gluten-free or not) based on the premise that refined grains only came into the human diet in the last few thousand years and we’re really not very well adapted to eat them. It also eliminates beans, dairy, and sugar which are substances that many people react to in the IgG test.
Regardless of whether you go gluten-free or gluten-free Paleo, moving to a diet free from gluten can significantly improve your overall health. For people who are gluten-intolerant or celiac, it can be very helpful for all members of the household to go gluten free. My family’s optimal gluten-free health was achieved when I, the last holdout, eliminated the last loaf of bread from our house. Why? Because for a celiac or extremely gluten sensitive person, 20 parts per million of gluten can cause a reaction and cause illness. To give you an idea of what that means, a single bread crumb contains 200 parts per million of gluten.
Give the 30 day challenge a shot and see how you feel!
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which is a fantastic book full of gluten-free, but not necessarily paleo recipes. I’ve modified the recipe so it meets the requirements of my paleo diet. In the original it also uses cranberries instead of cherries, but cranberries are quite unpopular in my household.
