Are you gluten intolerant? Spot the signs
Did you know that 1 in every 100 people in the UK is gluten-intolerant (1)? Gluten-intolerance falls into two categories; coeliac disease and non-coeliac gluten sensitivity. But how can you tell whether or not you're intolerant to gluten? Some people have gut symptoms after eating foods containing gluten, even if they don't have coeliac disease. We look at how to spot the signs that you're gluten intolerant, which foods are safe to eat (and which you should avoid) and what to do if you think you have a gluten-intolerance.
What is coeliac disease?
Coeliac disease is a serious auto-immune condition where the immune system attacks itself when foods containing gluten are consumed. This can cause damage to the lining of the gut, and over time it means that nutrients from food can't be properly absorbed. However you can be intolerant to gluten without developing the gut damage associated with coeliac disease – this is known as non-coeliac gluten sensitivity, and presents with similar symptoms. It's estimated that 99% of those who are intolerant to gluten or have coeliac disease are never diagnosed (2).
Spot the signs of gluten intolerance
There are many signs to look out for – unfortunately most of these could also be caused by other illnesses and conditions, so it's important to monitor your symptoms and keep a diary. This way you'll have a record of your symptoms to discuss with your GP.
Abdominal pain, bloating, flatulence, diarrhoea and even constipation are all signs that something is not right with your digestive system and could be indicative of gluten-intolerance. Try keeping a food diary after meals, to see if your symptoms worsen after eating foods containing gluten.
'Brain fog' or an inability to concentrate or focus on the task at hand (which could include memory issues) is a common sign of gluten-intolerance. It can be accompanied by feelings of tiredness or extreme fatigue, most commonly experienced after eating. Of course, fatigue could also be caused by poor diet, lack of exercise, sleep deprivation, stress or other conditions, so it can be hard to make a diagnosis based on this symptom alone.
Pain, swelling and inflammation
Fibromyalgia, or pain in your muscles, connecting tissue and joints, is often a sign of gluten-intolerance, and it may be accompanied by unexplained tingling or numbness. Joint pain can come and go but it can be debilitating.
Migraines, difficulty balancing, tingling or pain in the extremities or dizziness could all indicate an intolerance to gluten, yet again, all could be indicative of other diseases too. This is why a food diary can help you to link your symptoms to what you're eating. If you're eating a healthy, balanced diet yet experiencing neurological problems, it's time to see your GP.
Anxiety, depression and mood swings
We all get depressed or anxious from time to time (that looming presentation at work is enough to make anyone feel stressed), but if you find yourself feeling unusually anxious or depressed for no reason, or if your mood swings have been commented on by friends and family, a sensitivity to gluten could be the culprit. If you're unable to pinpoint any recent changes which could be responsible for your depression or anxiety, it's a good idea to see your GP.
Keratosis Pilaris, or 'chicken skin' can form on the backs of your arms and is usually caused by a vitamin A and fatty acid deficiency caused by a gluten-damaged gut that's unable to absorb nutrients.
How to test for gluten intolerance
If you've been experiencing some, or all, of the above signs over a period of a few months, hopefully you've also been keeping a food diary. If not, don't worry – an elimination diet can be helpful in establishing whether gluten is the cause of your symptoms. Eliminating gluten from your diet for a minimum of 2 to 3 weeks and then slowly re-introducing it gives you the chance to see how you feel both off it and on it. It can be difficult eliminating 100% of gluten from your diet – even trace amounts can cause a reaction in the gut, and with many products containing hidden gluten, we've come up with some gluten-free diet guidelines to help you out.
Gluten-free diet guidelines
- Wherever possible, buy from gluten-free ranges at your local supermarket or health food stores – these products are guaranteed to be gluten-free.
- Avoid beer and grain-based alcohol
- Steer clear of foods made from bran, wheat, rye, barley, enriched flour and bulgur (sorry, but this means no bread, pasta, cereals, cakes, cookies or crackers!)
- Be careful when buying processed foods as many can contain hidden gluten, including soy sauce, salad dressings, soups, ice cream, condiments, processed meat and even sausages! Buy gluten-free alternatives to your favourite foods, or, better yet, cook everything from scratch so you have total control over the ingredients
- Avoid oats as they can be contaminated with wheat
- Always check food labels for gluten warnings – many factories produce a range of products, some of which could contain wheat
- Avoid milk and lactose-containing dairy products as many people with coeliac disease are also lactose intolerant
- Beware – gluten can be found in many over-the-counter and prescription medications, as well as lip balm, toothpaste, vitamin supplements and more, so always check the labels
In case you're wondering, “What can I actually eat?” don't worry, there are plenty of foods you can still include in your diet. It's safe to eat carb-rich foods that don't contain cereals, such as tapioca, bananas, potatoes and chickpeas. Quinoa, buckwheat and amaranth as well as rice and corn are also safe to consume.
Next steps to take
If you suspect you're gluten-intolerant, we advise contacting your GP for a health check. You could always try an elimination diet, but it's best to seek medical advice, as you may be suffering from another condition and drastically changing your diet could make your symptoms worse. When you visit your doctor, take a written record of your food intake and symptoms to refer to, and make sure you leave your appointment happy with the advice you have been given. You won't usually be screened for coeliac disease unless you have symptoms - your GP will take a blood test to check for antibodies usually found in the bloodstream of coeliacs. If your GP fails to find antibodies in your bloodstream, you'll usually be referred to a specialist and may need a biopsy.
Whilst there's no treatment for coeliac disease or gluten-intolerance, changes to your diet and lifestyle can help you to manage your symptoms, and complications caused by the condition tend to only affect those who continue to eat gluten after their diagnosis. You'll need to ensure that your gluten-free diet is a healthy, balanced diet and an increase in the number of gluten-free foods available in supermarkets and health food stores should make this easier. For more advice on coeliac disease, you can visit the Coeliac UK website.
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