Similar Symptoms, Different Severity

Two people can have the same symptoms after eating gluten — bloating, stomach pain, diarrhea — but have two different gastrointestinal (GI) diseases: Celiac disease and gluten intolerance, or non-celiac gluten sensitivity (NCGS).

“Celiac disease is an autoimmune disorder, whereas gluten intolerance is a sensitivity,” says Northwestern Memorial Hospital Clinical Dietitian Bethany Doerfler, MS, RD, LDN. “NCGS does not typically have a full negative impact on overall health like celiac disease can.”

Both celiac disease and NCGS are treated by not eating gluten. Someone with celiac disease must avoid gluten completely for their entire life, while someone with NCGS may see symptom improvement by simply reducing gluten and carbohydrate intake.

“Removing gluten from your diet if you don’t have celiac or a gluten intolerance will give you no health advances,” Doerfler adds.

Gluten-Free and Your Gut

You can’t seem to go to a grocery store or restaurant without encountering the phrase “gluten-free.” The global gluten-free products market size was estimated to be worth $17.5 billion in 2018. However, going gluten-free has not been scientifically proven to help with weight loss. In fact, many grains that contain gluten are also fortified with vitamins and iron.

“Gluten-free products are not required to be fortified with these same nutrients,” says Doerfler. “People with celiac disease therefore must work to incorporate adequate vitamin D, vitamin B12, calcium, magnesium, zinc, iron and fiber into their diet either with other foods like nuts and seeds, or supplements.”

Going gluten-free can also alter your gut microbiome, which helps with digestion, destroys harmful bacteria and helps control your immune system. And, gluten-free products can be higher in refined carbohydrates and sugars, like tapioca starch, potato starch and rice flour.

“That’s why we only recommend gluten-free diet therapy if really needed,” says Doerfler.