Let’s get these out there straight away:
1. There is gluten in ALL grains (not just wheat, barley, rye and oats). Currently, we only look for 33-mer gliadin in tests. Gliadin is just ONE type of gluten and 33-mer is just ONE type of gliadin. If you happen to be sensitive to that particular type of gluten, great. If not, you are told there is no problem. There is, in fact, gluten in every grain. Why should gliadin be the exception?
2. Some people can be sensitive/intolerant to these other gluten types instead of or as well as having coeliac disease so even if you test for gliadin antibodies, it’s more than likely you won’t find the problem. Corn, in fact, is a very common culprit and, in percentage terms of the amount of gluten it contains, is second only to wheat. But what do you think practically all so-called ‘gluten-free’ food is based on? Right: corn. My view is that the current ‘gluten free’ diet should be termed a ‘gliadin’ free’ diet; it is certainly not trulyglutenfree. Ooh, controversial!
3. There are several types of gluten illness. Broadly-speaking they fall into three categories. You can have a problem digesting gluten down (the enzyme problem), you can have Non-Coeliac Gluten Sensitivity (NCGS) and you can have Coeliac Disease (CD). Most people think that coeliac disease and gluten sensitivity are the same thing; they are NOT.
4. Gluten illness is largely a genetic problem; you either are or aren’t genetically sensitive to gluten. If you are, Coeliac Disease is likely to be just ONE of the manifestations of this gluten problem; there are hundreds of others and none of them include villi damage so you won’t confirm it by biopsy. Most gluten illness is somewhere other than the gut. If you are genetically predisposed, it is a matter of time before the damage is done if you continue to eat gluten; that’s why most gluten illness starts to show at age 35-45.
5. Some experts think most auto-immune disorders have gluten as a common denominator. In fact, people with type 1 diabetes and gluten sensitivity share the same genotype!
6. You don’t have to be eating gluten to test for gluten intolerance or sensitivity. You can now do a gene test via a cheek swab which is highly predictive of present problems or future predisposition to gluten problems. It can’t tell you definitely have it, but you can put the genetic predisposition and your symptom picture together and draw an obvious conclusion. Not everyone who has the genes will develop the problem, there is usually a trigger like stress, antibiotics, meds or whatever.
7. Tests like gliadin antibodies, transglutaminase antibodies and even the gold standard biopsy are far from infallible so a negative result does not mean no problem. Villi damage can be patchy and a some tests only show a problem with total villous atrophy. What about the earlier stages? Do we have to wait to get more ill before conventional testing shows us what we already know? Read the truth about gluten testing here.
8. You don’t have to have ‘typical’ coeliac symptoms to have coeliac disease. In fact, many experts are now calling for more acknowledgment of the fact that most coeliacs are not suffering gut problems and weight loss. Some are asking that people with conditions like osteoporosis, for example, should be routinely tested for CD, and I agree with that.
So, now we’ve got some of those myths put to bed, let’s look at the types of gluten illness that exist. Which have you got?