Is it dangerous to self-diagnose a gluten-free diet?

  • Article by: KEVYN BURGER , Special to the Star Tribune
  • Updated: July 7, 2013 - 6:36 PM

Seeking a healthier lifestyle, more people are becoming glued to gluten-free products. But is self-diagnosing dangerous?

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FILE - This Nov. 11, 2008, file photo, shows gluten-free frozen pizza, just one of hundreds of items at Gluten Free Trading Co. in Milwaukee. Schools, restaurants and anyone else serving food are more vulnerable to legal threats over food sensitivities after the Justice Department determined that severe food allergies can be classified as disabilities under federal law. People who suffer from celiac disease don't absorb nutrients well and can get sick from the gluten found in wheat, rye and barley. Celiac is a diagnosed illness that is more severe than gluten sensitivity, which some people self-diagnose. Millions of people are buying gluten free foods because they say they make them feel better, even if they don�t have a wheat allergy.

Photo: M.l. Johnson, Associated Press - Ap

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One morning last fall, Erin Warhol began her day by reading a magazine article about gluten intolerance. What she read stopped her from eating her typical breakfast of two slices of whole-wheat toast.

“I saw that this was something I needed to explore,” said the 48-year-old Stillwater woman. “I passed on the bread, and within 48 hours I felt a dramatic difference.”

For people diagnosed with celiac disease, consuming gluten — a protein found in wheat and a few other grains — creates stomach misery and sometimes permanent intestinal damage.

It’s estimated that just 1 percent of Americans have the autoimmune disorder, while another 6 percent of the population is considered gluten-sensitive.

Yet the number of people seeking gluten-free alternatives is skyrocketing. Restaurants and food producers are feeding the demand by making room on menus for new items and adding wheat-free products to grocery stores. At the same time, some celebrities have been razzed for promoting the trend as a dieting option.

Clearly, gluten has people’s attention.

“More patients are coming in with this as a concern,” said Dr. Cynthia Sherman, a gastroenterologist at Minnesota Gastroenterology. “They’ve Googled it and self-diagnosed.”

That said, some health experts say going gluten-free might be dangerous for people who haven’t been properly diagnosed.

Taking the test

Sherman said that the first step she takes when gluten intolerance is suspected is to order a blood test. She often then performs what she calls the gold standard — an endoscopic biopsy of the small bowel. It’s an outpatient procedure, which takes 15 minutes and requires no laxatives.

The biopsy shows whether the villi, the microscopic finger-like structures that line the small bowel, are flattened and damaged, a sure sign that the patient has celiac disease.

“This damage limits their absorption of nutrients,” Sherman said. “They could be eating the healthiest diet available, but getting none of the benefits.”

Eliminating gluten can allow the villi to heal and return to normal. Sherman said that some people alter their diet, feel better and move ahead, without seeing a physician. She called this a dangerous solution.

“If it is celiac disease, going gluten-free makes it difficult to establish the diagnosis,” she said. “By eliminating gluten, the lining can heal and return to normal so it looks like they don’t have the disease. But this is a lifelong issue with long-term health ramifications. It should be diagnosed by a doctor, and the patient should be followed by a health practitioner.”

Carolyn Denton, licensed nutritionist at the Penny George Institute for Health and Healing, sees many clients who have self-diagnosed and changed their diet.

“They start eating gluten-free products and they feel better. They might drop weight and have fewer stomachaches or less joint pain. But then they feel worse again,” Denton said.

“They are eating gluten-free products, but when wheat is removed, it is often replaced with corn byproducts, and many people have a corn sensitivity, too. All of a sudden they’re reacting to that.”

‘Devastating’ effects

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