How to tell if you should avoid gluten

Published: Tuesday, March 19, 2013 at 6:01 a.m.
Last Modified: Monday, March 18, 2013 at 3:48 p.m.

Q: Everyone is on the gluten-free bandwagon these days, but I can't figure out if it's something I should avoid or not? What's the story?

— Daisy F., Durham, N.C.

A: Gluten-free diets are more popular now because we've developed ways — some based in science and some using trial and error — to identify who has trouble digesting this protein found in wheat, rye, barley and countless processed foods (including soy sauce and ketchup!).

There are three conditions that make it necessary to avoid gluten or wheat: celiac disease, wheat allergy and gluten sensitivity. CD is an autoimmune condition in which eating gluten causes inflammation of the mucosal lining and the villi (tiny fingerlike tissue that help the body absorb nutrients) in the small intestine. People with this condition are vulnerable to malnutrition, anemia, osteoporosis, unexplained neurological syndromes and infertility, not to mention severe gastrointestinal upset. A wheat allergy triggers a histamine reaction in the gut, on the skin and/or in the respiratory system. Gluten sensitivity is neither autoimmune nor allergic, but it can cause gastrointestinal upset as well as bone or joint pain, muscle cramps, weight loss and fatigue.

More than 2 million people in North America have CD, and a large number of others have a negative reaction to gluten or wheat. For all these folks, eliminating wheat or gluten from their diet is essential for improved health. Their challenge is to find other sources for the nutritional bounty that 100 percent whole wheat, rye and barley contain: soluble and insoluble fiber, many B vitamins, protein and a wide range of essential minerals such as selenium, copper, magnesium, zinc and manganese.

Daisy, if you don't have unexplained skin irritation or rashes, cramping and diarrhea after eating, or chronic fatigue, chances are your body can handle wheat and gluten.

Email your health and wellness questions to Dr. Oz and Dr. Roizen at youdocsdaily@sharecare.com.

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