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      Frequently Asked Questions About Celiac Disease   09/30/2015

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to FREE Celiac.com email alerts   What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease? - list blood tests, endo with biopsy, genetic test and enterolab (not diagnostic) Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes Where can I buy gluten-free stuff? Support this site by shopping at The Celiac.com Store.

How Strict Does A Gluten Free Diet Need To Be?
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Since my blood tests for celiac were negative, the doctor told me I do not have celiac disease but may just have a wheat or gluten intolerance. She said that I should try cutting back on wheat a bit and see if that helps my symptoms.

My question is, will just "cutting back" be enough to give an improvement, or do I need to cut it out totally. My Doc says some people can tolerate small amounts, so it shouldn't be necessary to cut it out all together - she only recommends that to people who test positive to celiac.

For those of you who are gluten intolerant but not celiacs, have you found a difference from just cutting back a bit?

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No, cutting back will not be enough. If you are still ingesting gluten, and if it is causing your problems, you will continue to have problems. If you have a wheat or gluten intolerance you should be just as strict as if you were diagnosed celiac. Those tests have a high false negative rate.

What you could do is eat gluten free for three months and then try gluten foods again and see if you have any reactions.

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When I was figuring out my own gluten intolerance I found that cutting out obvious gluten was enough to see improvements in my symptoms but they didn't clear completely. Once I got some advice from here and other bits and pieces on the internet- I completely stopped all gluten for a month and saw a lot of improvement. Last month I started to see how much I could have without a reaction. I found that I could have a single kitkat mini bite with a slight cramp and nothing else. So the next week I tried two of them (they are about half a cm cubed once you eat the chocolate off it). That caused the usual problems. So, I don't have to worry too much about cross contamination but it's not worth it to eat obvious sources in any amount. So as Dixiebell suggested go completely gluten free for a few months then reintroduce in small amounts to find your threshold.

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When I was figuring out my own gluten intolerance I found that cutting out obvious gluten was enough to see improvements in my symptoms but they didn't clear completely. Once I got some advice from here and other bits and pieces on the internet- I completely stopped all gluten for a month and saw a lot of improvement. Last month I started to see how much I could have without a reaction. I found that I could have a single kitkat mini bite with a slight cramp and nothing else. So the next week I tried two of them (they are about half a cm cubed once you eat the chocolate off it). That caused the usual problems. So, I don't have to worry too much about cross contamination but it's not worth it to eat obvious sources in any amount. So as Dixiebell suggested go completely gluten free for a few months then reintroduce in small amounts to find your threshold.

Just because you don't react with obvious symptoms to small amounts of gluten does NOT mean you 'got away with' eating that. You could develop any number of autoimmune conditions which are related to gluten intolerance (like RA, MS, thyroid problems, sjogren's, lupus, etc., etc.). Of course your doc won't tell you those are related to gluten consumption, but you will get symptoms of those conditions if you continue to eat less than your 'threshhold' amounts of gluten. If you obviously react to gluten at large amounts, you will still react to smaller amounts, but you may not recognize your symptoms as gluten related.

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Just because you don't react with obvious symptoms to small amounts of gluten does NOT mean you 'got away with' eating that. You could develop any number of autoimmune conditions which are related to gluten intolerance (like RA, MS, thyroid problems, sjogren's, lupus, etc., etc.). Of course your doc won't tell you those are related to gluten consumption, but you will get symptoms of those conditions if you continue to eat less than your 'threshhold' amounts of gluten. If you obviously react to gluten at large amounts, you will still react to smaller amounts, but you may not recognize your symptoms as gluten related.

thanks for the replies everyone :)

I was under the impression that if you have celiac disease, gluten damages the villi of the intestine, but if you are non-celiac gluten intolerant, you don't actually get the physical damage to your intestines, it just makes you feel unwell. Likewise, if you are celiac, then eating even small amounts of gluten WILL cause damage (and can lead to other autoimmune diseases like you mentioned), but if you don't have celiac disease, you don't have an autoimmune disorder only a food intolerance, so how can eating gluten lead to the other illnesses?

Sorry if that makes no sense, it's hard to explain what I mean. Am I wrong?

I'm so confused ><

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Lots of people have all the symptoms of celiac but test negative for it. The tests are not 100%. They have a high false negative rate. These people eat gluten-free and their symptoms resolve.

Gluten can also damage other organs (brain, skin, bladder, liver, nerves, etc.) not just the intestine.

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My celiac panel blood tests were negative in 2008 (minor GI problems) and this January. I had the endoscopy and 1 biopsy in May, and it was negative. The tests were flawed for various reasons, but I was still left with not knowing what I have. I do have the HLA-DQ8 gene, like about 12% of the population. It would be good for you to go completely gluten-free to see what effects that has on you. I am more sensitive to gluten now than when I ate the offending complex molecule. I am also healthier overall. If you have celiac or gluten sensitivity, then the best test is how you feel after going gluten-free.

I got the flu a year ago, and a couple of weeks later started the GI, joint, mood, lethargy, and muscle ache symptoms. I went gluten-free, actually gluten-lite a few weeks later because I read that can help joint inflammation. Amazingly, my GI problems resolved in a few days, the brain fog in a week, and the joint problem subsided after a couple of months. It wasn't until I went completely gluten-free in January that my joint, GI, and rashes began to disappear. I sometimes wonder if doctors had ever tested the rashes I had for a few decades for DH, and I went gluten-free, if my thyroid and other problems might not have happened. :)

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thanks for the replies everyone :)

I was under the impression that if you have celiac disease, gluten damages the villi of the intestine, but if you are non-celiac gluten intolerant, you don't actually get the physical damage to your intestines, it just makes you feel unwell. Likewise, if you are celiac, then eating even small amounts of gluten WILL cause damage (and can lead to other autoimmune diseases like you mentioned), but if you don't have celiac disease, you don't have an autoimmune disorder only a food intolerance, so how can eating gluten lead to the other illnesses?

Sorry if that makes no sense, it's hard to explain what I mean. Am I wrong?

I'm so confused ><

_____________________________

I believe you are correct. The blood tests for antibodies though can be incorrect. If you wanted to know if you had a gene for Celiac than you would also know if you could ever have a chance of developing it. I would recommend gene testing if anyone in your family has Celiac or other autoimmune diseases. I know gene testing isn't fool proof either but it is still pretty good. I know many people on this site say just go gluten free and be done with it. Well for me being completely gluten free is major change in someones life and I wouldn't do it unless I had too. I have too because I am a diagnosed Celiac but if I were just gluten intolerant I would eat based on my symptoms. But that is just my opinion and not shared by all.

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Since my blood tests for celiac were negative, the doctor told me I do not have celiac disease but may just have a wheat or gluten intolerance. She said that I should try cutting back on wheat a bit and see if that helps my symptoms.

My question is, will just "cutting back" be enough to give an improvement, or do I need to cut it out totally. My Doc says some people can tolerate small amounts, so it shouldn't be necessary to cut it out all together - she only recommends that to people who test positive to celiac.

For those of you who are gluten intolerant but not celiacs, have you found a difference from just cutting back a bit?

I'm gluten intolerant; tested negative for celiac and don't have the genes. Seriously, try going entirely gluten free. I probably wouldn't have but for the encouragement to do so that I got here to do it thoroughly and properly, and omg did it change my life! So many random, bizarre symptoms totally resolved. I will eat like I have celiac disease for the rest of my life, no question. I could never go back to feeling like that and getting glutened is awful now. Plus, I think psychologically it's easier being all or nothing about it.

The first time I got glutened was via frying oil. It was maybe 3 weeks into being gluten free. My fries were cooked in the same oil as a breaded product. I knew this in advance but thought I'd be fine as I don't have celiac disease and I made sure not to eat any random crumbs, just the fries. Ha! I was so sick.

I have a friend with celiac disease and I'm actually a lot more sensitive than she is. About the damage it does - I really don't know. But I do know that I get bad neuro symptoms if I eat gluten (mostly balance related) and they've resolved on a gluten free diet. That fits with research findings. Whether I test positive or not, I'm not going to risk doing more neuro damage because that scares me way more than any short term satisfaction I'd get from eating something gluten-y.

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