5 Reasons Why You’re Still Having Symptoms On A Gluten Free Diet
Have you followed the recommendation of a healthcare practitioner and completely changed your diet to be gluten-free? Only to realize it made no change in your symptoms.
You’re not alone. Many people jump on the gluten-free bandwagon with hopes that it will be a cure-all. In some cases, a gluten-free diet may have no effect on your health. However, there are many conditions that do improve significantly with a gluten-free diet.
What I see all too often is that people give up too quickly on the gluten-free diet. If they don’t notice an improvement in 2–4 weeks they ditch the diet and go back to how they were previously eating. This even includes celiacs! There are a lot of reasons why your gluten-free diet may not be working. In this post, I’ll address 5 of the most common reasons why.
1. Cross-reactive proteins
In the clinic, cross-reactive proteins are the most common culprit behind why one does not get better after starting a gluten free diet. Cross-reactivity occurs when your body mistakes seemingly normal foods for gluten.
Imagine that the gluten protein is shaped like a triangle. For the sake of this example, let’s also assume you’ve been tested and you have non-celiac gluten sensitivity. Your immune system is always on the lookout for triangle shaped gluten proteins because it knows you’re allergic to them. Cross-reactive proteins are proteins that also resemble triangles. This confuses your immune system. The immune system will react to these triangle shaped proteins as though they were gluten — causing similar symptoms to when you eat gluten.
Said in a more medical sense, your adaptive immune system makes antibodies that are specific to particular pathogens. If you’re allergic or sensitive to gluten, your body will have made antibodies that are specific to the gluten protein. Whenever you ingest gluten, the alarm bells go off and your immune system makes antibodies to fight gluten. The stomach pain, skin rashes, diarrhea/constipation, brain fog etc. you experience are the effects of your increased immune system attacking gluten.
Unfortunately, our immune system doesn’t have 20/20 vision. It’s a little nearsighted. It sometimes confuses other foods for gluten. If we refer back to our triangle example, the immune system increases inflammation to do battle with all food proteins that resemble a triangle.
This is a potential reason why you may not be getting better on a gluten-free diet. In fact, one study found that nearly 50% of those with a gluten allergy also had a dairy allergy or sensitivity. (2)
What foods cross-react with gluten?
At the time of this writing, there are 6 foods known to cross-react with gluten. (3, 4, 5, 6, 7, 8)
- Dairy
- Oats
- Yeast
- Rice
- Millet
- Corn
How do you know your immune system is creating cross-reactive proteins?
Unfortunately, you won’t be able to feel this. Instead, if you’re not noticing any change in your symptoms on a gluten-free diet, there’s a strong liklihood cross-reactive proteins are to blame.
In order to know (with certainty) which foods are triggering a reaction in your body, I recommend running a the array 4 blood test done by Cyrex labs. This test will determine exactly which foods your body is confusing for gluten. A more cost-effective option (though not as accurate) is to remove all of the cross-reactive proteins for at least 30 days. Then, reintroduce them, one at a time.
2. Cross-contamination & sneaky sources of gluten
Another common reason why people don’t get better on a gluten-free diet is that they’re not 100% gluten-free. Being 100% gluten free is more challenging than it seems. It’s far more than avoiding breads, pastas, and flours. Did you know that gluten is often found in cosmetics, vitamins, supplements, lipsticks/lip balms, play-doh, and even prescription medications?
To further complicate the issue, gluten isn’t always listed as gluten on ingredient lists. In this post, I go through (in great detail) all of the aliases gluten goes by on ingredient lists. To ensure you’re 100% gluten free, I recommend completely avoiding all of the ingredients found on that list.
Another common problem found in those new to the gluten-free diet is something called cross-contamination. Cross-contamination occurs when a naturally gluten-free food comes in contact with a food that contains gluten. This often occurs during the stage of processing or packaging. For example, oats are naturally gluten-free. However, if they are processed at a facility that also processes bread or other gluten-containing products, it’s likely that those oats have come in contact with gluten and are no longer gluten-free.
To best avoid this cross-contamination, ensure all of the grains your purchase are certified gluten-free. This guarantees your product has not come in contact with gluten. If you think this sounds neurotic, consider that a study of 22 naturally gluten-free products found that 7 of 22 samples contained more gluten than is allowed in the proposed rules for gluten-free labeling in the US (9)
3. Leaky gut
4. Latent celiac disease or another condition that resembles celiac disease
5. Duration
Originally published at Flourish Clinic.
