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Why should I reduce my gluten intake if I don't have coeliac disease?

Lawless Village IPA and gluten-free cupcakes

By Sarah Guilford-Jones MRPharmS GPhC

It seems to be quite fashionable to go gluten-free at the moment, but is it just a fad, or could there be something in it? If I do not have coeliac disease, how can reducing my gluten intake help me? Some new research about the effects of gluten in those without coeliac disease is emerging, and while it’s too soon to draw any real conclusions, it’s certainly something to watch.

There are many people who avoid gluten without actually knowing what it is, and for these people, while it certainly does not do any harm, it doesn’t necessarily benefit them to go gluten-free, other than that by doing so they are avoiding gluten-containing foods such as cakes, breads and biscuits which are usually high in calories and fat.

But some 1% of the population in the UK have coeliac disease, for which there is no treatment other than cutting out gluten (Coeliac UK). However, a UK study saw 13% of people who tested negative for coeliac disease still suffered from some of the symptoms, such as bloating, constipation and diarrhoea, and some also suffered from mouth ulcers, tiredness, depression, skin rashes and confusion (or ‘brain fog’) (Aziz et al). This condition, known as Non-Coeliac Gluten Sensitivity (NCGS) doesn’t have any particular diagnostic test the same way that coeliac disease does, but a diagnosis is arrived at after a specialist has ruled out coeliac disease or certain other conditions. Most of these people reported improvement in their symptoms after cutting out gluten.

Researchers in Sweden found that some people with psoriasis saw an improvement in their symptoms when they cut gluten out of their diets (Michaelsson et al). Other research has shown improvements in mood, fatigue and memory in some people after going gluten-free (Peters et al). Research is ongoing in these areas. However, there are other studies that did not show this link, so it’s not possible to draw any real conclusions as yet.

It’s important to consult a doctor before going gluten-free if you have these symptoms, to rule out any other conditions. In some cases, the gastrointestinal symptoms (bloating, constipation and diarrhoea) may be caused by other additives rather than the gluten (some people report being unable to tolerate store-bought bread but can tolerate homemade bread, for example).

Coeliac UK’s website is a valuable resource for those wishing to learn more about gluten sensitivity.

Have you gone gluten-free? How has it affected you?

References:

Aziz I, Lewis NR, Hadjivassiliou M, Winfield SN, Rugg N, Kelsall A et al. A UK study assessing the population prevalence of self-reported gluten sensitivity and referral characteristics to secondary care. Eur J Gastroenterol Hepatol. 2014; 26: 33-9.

Coeliac UK: https://www.coeliac.org.uk/coeliac-disease/myths-about-coeliac-disease/ (accessed 26 January 2017).

Michaelsson G, Ahs S, Hammastrom I, Pihl Lundin I, Hagforsen E. Gluten-free Diet in Psoriasis Patients with Antibodies to Gliadin Results in Decreased Expression of Tissue Transglutaminase and Fewer Ki67z Cells in the Dermis. Acta Derm Venereol. 2003;83: 425-429.

Peters SL, Biesiekierski JR, Yelland GW, Muir JG, Gibson PR. Gluten may cause depression in subjects with non-coeliac gluten sensitivity. Aliment Pharmacol Ther. 2014;39(10): 1104-1112.



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