Should You Do a Gluten Challenge?

You will find that doing this with a health care professional trained in gluten intolerance and elimination diets will give you much better results than doing it on your own.

It's very important to have a negative presumptive diagnosis for celiac disease before beginning this challenge. Doing a challenge before your blood draw can skew results if you have ingested no gluten because the standard test looks for a certain level of antibodies, which will be produced in lower amounts if you are avoiding gluten. If you are doing a challenge when you have your blood draw, eat 2-4 pieces of toast several hours before you go in for your test to stimulate antibody production so it shows up on the test.

Testing negative for celiac disease does not mean that you do not have gluten intolerance. The test for celiac disease can only indicate that you have the autoimmune disease; it cannot diagnose non-celiac gluten intolerance nor any of the other conditions that could be caused by your body's adverse reaction to gluten.

There is another problem with the standard test: it frequently returns a false negative. This means that you can have tested negative for celiac disease,and even have a negative biopsy result, and still have an autoimmune response to compounds in wheat.

[Note: There is a serum antibody test that indicates gluten intolerance, regardless of celiac disease. The AGA, or anti-gliadin antibody, is present in a sensitive person in response to a protein in wheat, barley, rye, spelt, and oats that are not gluten-free. Another related test is the TGA. Do ask your physician or health care provider about having these tests done. Additionally, there are genetic testing kits available that will detect genetic vulnerabilities to gluten, which are a good idea as well.]

Eating more fresh vegetables and fruits will definitely improve your health, whether you're gluten intolerant or not. Go visit Simply Fresh, Northcote, North Shore, Auckland, and buy the freshest and the best produce you can find outside your garden. If Simply Fresh is outside your neighborhood, find a fresh produce market near you, and enjoy your naturally gluten-free fresh deliciousness today!

But here's the thing . . . .

Getting a diagnosis can be next to impossible. Gluten, and other grain lectins such as wheat germ agglutinin, can adversely affect organs and tissues anywhere in the body, with little evidence to link the damage to wheat consumption. Furthermore, acute symptoms vary considerably from chronic symptoms.

For example, eating a huge plate of wheat pasta would put me in the emergency room, but eating just a little gluten every day would suppress my thyroid hormone and progesterone production, while increasing my estrogen production. In me, this leads to chronic exhaustion, excessive menstrual bleeding (menorrhagia), and hormonal migraines.

While my scenario may not apply to anyone else, it does illustrate a couple of problems with getting a diagnosis.

My acute symptoms are primarily intestinal, while my chronic symptoms are hormonal and neurological. A month-long gluten challenge would address the intestinal issues, allowing a reprieve from symptoms; however, my hormonal and neurological issues would not have sufficient time to correct themselves. Additionally, it only takes a little gluten to aggravate my hormonal disruptions, so even a long-term challenge would not allow for a significant correction in my hormones.

This means that for those with hormonal, neurological, psychological, autoimmune, and organ damage, complete recovery may take years. In some cases the damage is irreparable.

In fact, you may continue having symptoms throughout your challenge. If you do, you either need to simply watch for changes in the kinds of symptoms you're experiencing, or you need to extend your challenge to allow your symptoms to subside a little.

If you have type II diabetes and take insulin, you may be able to end your dependence on insulin. You must work closely with a health care professional, and never reduce your own prescription medications (including insulin) without a doctor's supervision.

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Nevertheless, if you find that you have a gluten intolerance, you would be wise to avoid gluten altogether. Since your body has developed a sensitivity to gluten, you will feel better and be healthier if you do not expose yourself to this sensitizing agent.

Doing a Gluten Challenge

But here's the thing . . . .

Gluten masquerades as innocuous ingredients such as modified food starch and hydrolyzed vegetable protein. Avoiding gluten, especially in the United States, can be very difficult if you try to eat the way you always have.

Eliminating gluten requires more than just not eating bread and pasta. During the period of elimination, you will find the time spent cooking from scratch gives you better, quicker results than trying to use canned soups, boxed dinners, seasoning packets, and other prepackaged items that you have always used and may believe to be free of gluten.

Condiments like regular ketchup, yellow mustard, vinegars except malt vinegars, mayonnaise (but not Miracle Whip salad dressing), tamari (but not most regular soy sauces), pickles and pickle relish, individual herbs or spices (but not spice blends), and Lawry's Seasoned Salt are gluten-free and safe to use.

Avoid sausages and ground meat blends; beer, ale, and malt beverages like wine coolers; other sauces and condiments; soups; seasoning blends, and most breakfast cereals. Lipton Soup and Dip Mix, versatile blend that it is, has gluten, so you must avoid it for your challenge.

Do not consume anything with wheat, barley and barley malt syrup, rye, spelt/dinkle, kamut, tritacale, durum/semolina/emmer, bulgur, couscous made from wheat, einkorn, farina, fu (found in Asian markets, often labeled as fu-fu flour), graham, matzo, panko, mir, seitan (used in vegetarian meat substitutes), or wheat berries, nut, bran, germ or germ oil. Wheatgrass and barleygrass have no gluten naturally because the sprouting seed breaks down the gluten protein into simpler compounds to nourish the new growth.
The Celiace Sprue Association has an excellent reference page on grains here.

So, How Do You Do a Gluten Challenge?

(If you are gluten-intolerant, you may want to learn to make these and other treats from scratch. The gluten-free mixes will work well while you eliminate gluten, so you don't feel entirely deprived.)

Don't forget to avoid flouring your baking pans or using baking spray with flour in it.

Eat fruit for dessert, or buy high-quality chocolates, making sure there's no gluten in them. Dark chocolate rarely has gluten, while milk chocolate, for whatever reason, tends to have some gluten in it, often in the form of crisped rice or floured nuts.

Eat like this for at least five weeks, without cheating. Eight to nine weeks would be preferable, and give you better results, especially if you have reason to believe that gluten negatively affects your hormones or your neurochemicals, causing bipolar, schizophrenia, depression or other psych issues. If you eat gluten during the challenge, even just a little, the results will be invalid and you will have to start over. Finding out what will make you healthy and feel good is worth making a short-term sacrifice, don't you think?

When you reintroduce gluten, make sure you plan for a big day of eating gluten. Have pancakes for breakfast, a white-bread sandwich for lunch, and a plate of pasta for supper. Keep eating gluten-based foods at every meal until you identify definite symptoms or determine that you have no symptoms.

What To Watch For

Everyone is different, so there is no one symptom to look out for. Watch for change: change in how you feel, change in how you react to food, change in your bowel habits, change in your mood, change in your energy levels including exhaustion, insomnia, need for more sleep than usual, and restless sleep.

The most frequent kind of change occurs in the digestive system: bloating, cramping/griping, stomach issues like heartburn, sour stomach, GERD (acid refllux) nausea, diarrhea, constipation, vomiting, etc. Not everyone experiences digestive issues, however.

You should notice some kind of change even if you had no symptoms before you did the challenge. Do watch carefully for non-quantifiable changes such as moodiness, roller-coaster emotions, anxiety, hyperactivity or restlessness, racing heart, difficulty breathing, changes in your skin, changes in your menstrual cycle, hot flashes, insomnia, fatigue, depression, pain, numbness, muscle tics or cramps, inflammation, or changes in mobility. Learn how to determine which symptoms to watch for during and after your gluten challenge here.

What does it mean if you did a gluten challenge and had no change? This could mean several things.

First of all, it could mean that you are not sensitive to gluten. If that's the case, great! You can continue to eat wheat as you always have. Be advised, however, that wheat has a chemical known as WGA that is toxic to most people.

Secondly, it may mean that you were still getting gluten in your diet. Gluten is well-hidden in many foods, particularly in prepared foods available in the United States. Look closely at your prescriptions and OTC medicines for gluten sources. Look for modified food starch or barley malt syrup in your foods or beverages, or for wheat starch in your baking powder. Malt beverages are cleverly disguised as wine coolers. Don't forget to read every label. Ask questions. Try the challenge again, and make sure that all gluten sources are eliminated. Check out the list of hidden gluten sources on the grocery shopping page.

Thirdly, it might mean that your body needed more time to adjust to your challenge diet. Try the challenge again, and give yourself an extra few weeks or even an extra month before re-introducing gluten. This is

Once you have begun a consistent gluten-free diet, your body will begin readjusting itself. It could take up to a year for everything to normalize; the endocrine and nervous systems are complex and delicately balanced, but they can and will normalize once the sensitizing agent is removed.

There is no lab test at this time to diagnose non-celiac gluten intolerance, and there has been little research done on it. Most of the evidence we have comes from the experiences of gluten intolerant individuals, making any conclusions highly subjective.

This means that you can work with your health care practitioner to design a highly personalized treatment plan just for you (or your loved one). With so much health care today becoming "one size fits all", this personalized approach tailored just for you can give you the opportunity to participate actively in your own treatment.

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Find out what symptoms you can expect when you do your challenge here.

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