Top 5 Reasons You Didn’t Get Better on a Gluten Free Diet

February 19, 2020 Ruth Dana

Gluten is a protein that is found in wheat, barley, rye, spelt, triticale, and oats. It is well known as the culprit in Celiac disease, which is an autoimmune condition triggered by gluten. However, it may also trigger other digestive disorders (i.e. IBS), inflammatory conditions (i.e. obesity, diabetes) and autoimmune conditions (i.e. Crohn’s disease, rheumatoid arthritis). 

Other symptoms and conditions that may be triggered by gluten sensitivity include:

  • Bloating
  • Abdominal pain
  • Brain fog
  • Autoimmune conditions 
  • Thyroid conditions–hypothyroidism, Hashimoto’s, or Graves’ disease
  • Chronic pain
  • Peripheral neuropathy
  • Dizziness/vertigo
  • Ataxia
  • Muscle weakness
  • Chronic fatigue
  • Unexplained rashes
  • Joint pain

If you are considering trying to jumpstart your health by going gluten free, I am happy for you! But I have seen this done wrong so many times! I even “did it wrong” myself before I was a naturopathic doctor! I’ve spent countless hours in seminars, with patients, and pouring over research so that you don’t have to and you can enjoy an easier pathway to better health with a gluten free diet! 

Not everyone “needs” to be gluten free, but a gluten free diet can be healing for almost anyone with an inflammatory condition (which are many of our modern day, chronic illnesses). And for some, it’s crucial to do it right, even if it isn’t easy. It can be much easier to avoid wheat than to live with a condition that can improve substantially with a GF diet. 

If you don’t avoid these mistakes, you may end up frustrated and wasting a lot of time, money and energy, and I don’t want that for you! I want you to thrive and be happy and healthy, truly enjoying as many days in this life as possible! So please read on and avoid these mistakes! 

1. You Didn’t Get Appropriate Lab Work First

There is a spectrum of seriousness when it comes to the risks of eating gluten. Some people may not notice a huge difference if they eat it or not. These are usually people with no autoimmunity/autoimmunity in the family, and no genes making them more susceptible to gluten sensitivity/Celiac disease. But for those that do have a predisposition for sensitivity, it may pose a substantial threat and should usually be strictly avoided, “110%”. It’s nice to know where you lie on that spectrum, and getting the right labs can give you the conviction you need to do what you need to do.

The problem with going gluten free before getting lab work is that you could end up healing a lot but still having a lot of questions, and you can’t very effectively test antibodies to wheat/gluten when you haven’t been consuming it, because the antibodies will only form and circulate in your blood for anywhere from three to around 50 days (depending on the type of antibody). It’s best to know what happens when you eat gluten while you can still get tested without posing undue risks to your new health gains by backsliding. This could be a lifelong change for you if you are willing to value your health over wheat! 

The appropriate lab work can help shed light on which, if any of the following underlying issues apply to you:

  • Celiac disease (CD), in which case you’d need to be extremely strict about avoiding all gluten
  • Non-Celiac Gluten Sensitivity (NCGS), in which case this can be just as serious as Celiac disease if you have another autoimmune condition or significant health challenges
  • Other autoimmunity that is triggered by wheat/gluten. This is arguably a progression of NCGS, but not necessarily. Some of the other issues listed here can progress into autoimmunity. But there are also specific antibodies that are directly related to gluten that will attack tissues in the brain or joints or skin, not just the gut!
  • Wheat Allergy (IgE reaction) which can cause anaphylactic type reactions such as sneezing or swelling. I have seen this in patients who were not aware that wheat directly caused their symptoms. 
  • Blood sugar regulation issues such as prediabetes, diabetes, hypoglycemia or metabolic syndrome (many foods with wheat are high glycemic and spike your blood glucose)
  • Intestinal dysbiosis, or “bad bacteria” in your gut (examples include SIBO, C. Diff, etc) that are thriving on processed foods/gluten and other easily fermentable foods (FODMAPS) 
  • General inflammation. There is evidence that gluten is inflammatory no matter what, and so are many convenient and processed foods, so removing gluten may help reduce your overall inflammation, improving symptoms such as pain or metabolic problems such as obesity
  • Intestinal permeability. A. Fasano’s study found that gluten can increase a protein called zonulin which basically causes what some people call “leaky gut syndrome”, and some individuals are more genetically susceptible to this process. Your intestines are meant to keep proteins which have not been digested into smaller amino acids out of your bloodstream. With intestinal permeability, zonulin cuts into the meshwork called “tight junctions” that keep the cells in the gut tightly joined together so that larger proteins do not enter the bloodstream where the immune system may recognize them as foreign, triggering inflammation and sometimes multiple food sensitivity. 

Also, if you feel terrible and don’t know why, please get a proper diagnosis, even if you believe you will heal! This will help guide whether or not diet is likely to help. And it will protect you so that you will have easier access to care that you need in the event of a possible flare of your condition even if it were to substantially improve. See the appropriate specialist as soon as you are able, because if you do the work, you may get better surprisingly fast!

2. You Went 80-99% Gluten Free

I see this ALL. THE. TIME. No more excuses guys. In the wise words of Hall and Oats, if I’ve recommended 110% and you’re giving me 99%, “I can’t go for that, no, no can do.”

This can honestly be the equivalent of doing nothing different for some people. That was the case for me, and I have never even found antibodies to gluten on the very extensive lab work I have had done (but I do have a genetic predisposition to CD!). This can occur for a few reasons. 

  • A) It can trigger intestinal permeability. Don’t eat a “little gluten” if you want your gut to heal and not let foreign proteins into your bloodstream. Chad Larsen, DC, ND, taught me that eating gluten just a little in hopes that it will only cause a “little damage” is like hoping to only get a “little bit pregnant”. You either have a leaky gut, or you do not. There’s no in between. You can heal from it through avoiding gluten if it is the trigger, but it needs to be 100%.
  • B) It can trigger auto-antibodies that tag tissue in your body, triggering your immune system to attack those sites, and sometimes this can be felt before it can be detected on labs, especially if they weren’t super thorough. Autoimmunity is also often linked to intestinal permeability anyway, so this goes back to that, too. Work on healing, not on trying to get away with just “a little bit” of anything. A little gluten can lead to a lot of progression of autoimmunity. 

If you need or want to really see what “health gains” are possible on a gluten free diet, go big! Educate yourself at sites like Celiac.com. Read labels, even on cosmetic products. If you are out and about, use the app called “Find Me GF” and go to places with good ratings and tell your server you have a severe allergy and need to avoid all cross contamination. 

3. You Ate a Lot of Foods that Cross-React with Anti-Gliadin Antibodies

There is research that shows that the protein structure in some foods are similar to gliadin, the breakdown product of gluten that most often triggers autoimmunity, and that this may cause  “cross reactivity” where your immune system (if prone to react to gluten) sees them as a similar threat. These foods include: soy, dairy, corn, yeast, millet, and oats.

Oats are of particular concern because they have proteins very similar to gliadin that can easily trigger reactions, whether or not this shows up on labs or not. They are also commonly contaminated with gluten, so if you do venture to eat them, make sure they are gluten free oats. But if you have a high risk for gluten sensitivity and autoimmunity, I’d recommend avoiding them all together. If you feel attached to oats, you can always try adding them back in when you are feeling well and see if your new baseline of health holds up or if the oats have to go for good.

Dairy is another one of these foods that is inflammatory in nature anyway, and whether or not you have antibodies to it, it can again be worth avoiding, especially considering the risk of cross reactivity. 

You can either get labs to see if you are reacting to these (and maybe other foods, as well), or eliminate then reintroduce them strategically. See my upcoming “Free Guide for Gluten Sensitivity Testing Done Right” for details!

4. You Replaced Wheat With the Inflammatory, Processed Food Munchies 

Please seek counseling if it feels emotionally challenging to avoid wheat and overcome the need to self-soothe with junk food. It will be worth it! The goal of a gluten free diet initially needs to include “healing” from gut or systemic inflammation. It is challenging for the body to heal on a diet of processed foods that spike your blood sugar. A better option is to concentrate on nourishing foods, especially because if you have damage in your gut, it can be hard to get nutrients from your diet, anyway. Give yourself the best chance at success. 

I recommend trying something along the lines of a Whole30 Diet or an Autoimmune Paleo diet, but talk to your naturopathic doc to see what is most appropriate for you!

5. You Did Not Get Help For Underlying Infections and Digestion Problems

With or without abdominal pain and symptoms, if you are having issues with gluten or autoimmunity, there may be suboptimal conditions in your digestive system that either created or continued to trigger the problem. You should talk to your licensed naturopathic doctor about ruling these in or out, as well as what supplements/medications may be appropriate for you based on your individual symptoms or underlying infections.

Addressing the root cause and supporting weakened systems are some of the main focuses of naturopathic medicine, and that is what makes it so powerful at restoring health and optimizing wellness! 

Please keep in mind that it may save a lot of your time and energy if we can work together through all of the above together, so please contact me to see if we can make a great team to help you meet your health goals!

2 Comments on “Top 5 Reasons You Didn’t Get Better on a Gluten Free Diet

  1. Please help. I have IBS and fibro and migraines. I have a naturopath. What blood test should I get. Saw a gastroenterologist for along to me.. need help at all!

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