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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 Free recipes: Gluten-Free Recipes Where can I buy gluten-free stuff? Support this site by shopping at The Celiac.com Store.

Hidden Gluten In Processed Food?how Do I Spot It, Or Is It A Myth?
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Hi! I started eating gluten free about a month ago and have some questions about avoiding gluten in processed foods. I know, avoiding processed food is a good idea in general, but when I do partake, is a food safe if it doesn't say "wheat" "barley" or "rye" in the ingredient list, or is it really more compicated than that? My understanding is that any product with wheat MUST include in on the ingredient list on the label or with a "contains wheat" or, if cross contamination is a concerned, a warning to the effecgt that it may contain traces of wheat. And though I understand that barley and rye don't have to be listed so clearly, they typically are. Does that all sound right?

With this in mind, two products have me wondering in the past few weeks "Where's the gluten":

I read that Resse's peanut butter cups are gluten free, but holiday items (like the trees) have gluten. I bought some of the trees for my kids stockings, and I don't see any wheat in the ingredients or warning that it is there. Is there really gluten there, and if so, where is it hiding on the label? It's bothering me that I can't identify it...

I liked to eat oatmeal for breakfast, but I heard cross-contamination is a problem with most brands, so I've been planning on getting some that was certified gluten free. But I have noticed that there is no warning on regular containers of oatmeal, not even a statement saying it may contain traces of wheat. If cross-contamination is so common, how can they not say that on the label? When I mentioned this to my Gastroentronologist a couple week ago, he said that oatmeal was fine and I shoudn't worry about it at all. Is that right? Is croos contamination of oatmeal just a concern for people super sensitve to gluten? Or is my gastroentronologist misinformed?

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No. All the Celiac organizations recommend gluten-free oatmeal. In fact, it is usually recommended that a person with Celiac not eat oatmeal for at least 6 months as a small percentage react to it like gluten.

There is no law in the US that forces a company to say if something may accidentally have a gluten ingredient in it. If they add wheat, they must disclose this. Rye is rarely on anything except rye bread. Barley ( malt) is usually disclosed because it is a distinct ingredient.

Remember, your GI has had no diet training and, unless he is in a Celiac Center or has a child with Celiac, has no idea about gluten in food. A sad fact of life.

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When it comes to processed foods, if "gluten-free" isn't stated on the package, I call the company if I truly want to eat it. It's just not worth getting glutened.

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My digestive disease doctor didn't know about any connection between oatmeal and wheat either. Until you can get some glutenfree oats there are substitutes for hot cereal...for a similar consistency to oatmeal you might try Kasha which is roasted Buckwheat Groats or else Cream of Buckwheat (don't be intimidated by the name since buckwheat is actually a fruit and you should see the words glutenfree on the boxes). I am a big fan of quinoa flakes as a hot cereal which also should say glutenfree on the box...for a thicker consistency add less water to it but it does thicken up quite a bit on standing with the water amount recommendation on the box.

In regards to hidden barley there is a product called Rice Dream milk which uses a barley enzyme and doesn't mention it on the containers. You wouldn't know it because it says Gluten Free on it, and the ingredient involving use of the barley in it is partially milled brown rice. The company says they extract the barley and test but barley testing can supposedly be very inaccurate. I suggest you never use this product as I have heard of quite a few people (including myself) having reactions to it.

Best to read everything on all packages. Quite a few times I checked all the ingredients while in the store then got home and later saw some little small writing on it that says processed on equipment which also processes wheat.

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In Canada I'm fairly certain cross contaminates don't have to be mentioned. If they knowingly put in wheat or other glutinous grains the law says that have to label it as containing them in an obvious way.

So while you might look at 2 different packages of, oh, nuts, and one says 'May contain traces of wheat' while the other one doesn't, that doesn't mean the one package is necessarily safe.

My GI told me to not even try oats, saying my intestines were too bad to even risk the gluten free ones. My sister has noticeable issues with oats but not wheat, (her blood test for celiac is negative...lets not get into testing and families etc here, just explaining my background), and I don't have a discernable gluten reaction, so it's a no-brainer for me to avoid them completely, at least until my intestines show healing. I have wondered about oat cross contamination in otherwise gluten-free flours though. I've seen at least one post in the forums about someone blaming traces of oats for their reactions to gluten free flours.

"The company says they extract the barley and test but barley testing can supposedly be very inaccurate."

I know this is off-topic, but I've wondered if this were a possibility myself when I started to wonder about how gluten is measured. Barley's 'gluten' doesn't have the same exact structure as wheat gluten. Do you have a reference or anything about that?

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Neither the US nor Canada require "may contain" warnings. Canada has a policy that says they may be used only if, despite best efforts to clean/separate, a real risk still exists.

Contamination can happen at any point on the supply chain, not just at the final production facility. In the case of oats, this happens at every step of the way, because oats and wheat are grown on the same farms, harvested with the same equipment, etc. Commercial oats may contain as much as 1% wheat from unintentional sources.

In the US, look for oats labeled gluten-free. In Canada, look for "certified pure oats," or "uncontaminated oats." There are no "gluten-free" oats in Canada, as Health Canada considers oats to be a gluten grain.

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REESE'S Peanut Butter Trees Ingredients

Peanuts, Milk Chocolate (Sugar, Cocoa Butter, Chocolate, Nonfat Milk, Milk Fat, Lactose, and Soy Lecithin, PGPR, Emulsifier), Sugar, Dextrose, Chocolate, Nonfat Milk, Contain 2% or Less of: Vegetable Oil (Cocoa Butter, Palm, Shea, Sunflower and/or Safflower Oil), Salt, Whey (Milk), Milk Fat, Soy Lecithin, TBHQ (Preservative), Vanillin, Artificial Flavor.

Purely guessing: I would say the dextrose - nothing else contains gluten .. unless it is manufactured in a gluten facitity/uses gluten starch to stop it sticking in/on the machinery/contaminated by not being separated ..

... If they say it is there, you can only accept it ..

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I would say the dextrose - nothing else contains gluten

Dextrose is pure sugar and is gluten-free. Other gluten-free sweeteners include aspartame, brown sugar, corn syrup, fructose, glucose, lactose, maltitol, maltose, mannitol, saccharin, sorbitol, stevia, sucralose, sucrose, and xylitol.

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Ingredients can vary by country also, so it is important verify the ingredients for the country where they are bought.

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