Gluten-free products that were once relegated to health food stores are now featured prominently in supermarkets across the country. That’s great for people who can’t tolerate gluten, but for people who are avoiding gluten just because it’s a health fad may want to think twice.

The connection between gluten and celiac disease

Gluten is a protein found in foods that contain wheat, rye, and barley. Celiac disease is an autoimmune disease in which eating gluten causes the body's immune system to damage the small intestine, which reduces its ability to absorb virtually all nutrients.

According to the National Institute of Health, three million Americans, or 1 in every 133 people, have celiac disease, but only about 5 percent of them have been clinically diagnosed.

A related condition called gluten sensitivity or non-celiac gluten sensitivity can cause symptoms similar to celiac disease, but without the intestinal damage.

What are the symptoms of celiac disease?

Symptoms of celiac disease can be different in each person. Common symptoms are diarrhea or constipation, vomiting and weight loss, malnutrition, anemia (low levels of red blood cells), tiredness or fatigue, bone or joint pain, depression, stomach bloating and pain, and short stature in children.

People who suffer from irritable bowel-like stomach problems, headaches, fatigue, numbness, and depression may have gluten sensitivity.

How is it diagnosed?

Celiac disease is diagnosed with blood tests. The results of the test may need to be confirmed with a biopsy of the small intestine. A biopsy is done during a procedure called an endoscopy.

How is celiac disease treated?

The treatment for celiac disease or gluten intolerance is to eat a gluten-free diet. Removing gluten from your diet allows the intestines to heal. Healing time is different for each person.

If you’re diagnosed with celiac disease, you’ll have to stay on a gluten-free diet even after you feel well because eating gluten can damage the small intestine, cause nutrient deficiencies and malnutrition, keep the immune system from working properly, and make it hard for the body to fight infections.

Avoiding gluten means more than giving up traditional breads, cereals, pasta, pizza, and beer. Gluten also lurks in many other products, including frozen vegetables in sauces, soy sauce, some foods made with natural flavorings, vitamin and mineral supplements, some medications, and even toothpaste. This makes following a gluten-free diet extremely challenging.

What if you haven’t been diagnosed with celiac disease?

If you think you might have celiac disease or gluten sensitivity, it’s best to see your healthcare provider before you go gluten free. Once a person has avoided gluten for a while, it becomes more difficult to establish if he or she has celiac disease, gluten sensitivity, or neither.

If you don’t have celiac disease or a gluten sensitivity, eliminating gluten from your diet can cause nutritional deficiencies. Fortified breads and cereals have become a major source of B vitamins in the United States. Although breads made with white rice, tapioca, and other gluten-free flours are becoming more common, they’re generally not fortified with vitamins.

In addition to nutrient deficiencies, gluten-free products tend to be more expensive than traditional products, so you could be needlessly wasting money on foods you don’t need in order to eat a healthy, balanced diet.