Does Gluten Cause Inflammation? What the Science Says

Yes, but Not for Everyone

Medically reviewed by Jay N. Yepuri, MD

Gluten is a naturally occurring protein found in some grains, such as wheat, barley, and rye. Many popular foods, including baked goods, cereals, and pizza, are commonly made with these grains. The digestive system can't completely break down gluten, though that's not a problem for most people.

But if you're sensitive to gluten, your immune system overreacts in a big way. The result is inflammation, which can lead to serious side effects.

This article discusses what research says about the connection between gluten and inflammation. It also covers what you need to know about going gluten-free.

The Science Behind Inflammation Caused by Gluten

Gluten is mostly made up of gliadin and glutenin proteins and is part of the prolamin superfamily of proteins. In people who are susceptible, these proteins trigger an inflammatory response from the immune system. Some people have a genetic or environmental predisposition to have issues with gluten.

For example, the risk of having celiac disease (a gluten-related immune disorder) is higher if you carry certain variants of the HLA-DQA1 and HLA-DQB1 genes. They're part of a family of genes called the human leukocyte antigen (HLA) complex that help the immune system know the difference between foreign invaders and the body's own proteins.

In people who are sensitive to gluten but don't have celiac disease, it may be that gluten proteins, combined with other components of wheat, trigger an inflammatory immune response.

Types of Gluten Intolerance

Several conditions are related to gluten. Symptoms are similar, but there are distinct differences among them.

Celiac Disease

Celiac disease is a serious autoimmune disorder that affects about 1% of the world's population. In celiac disease, the body sees gluten as a foreign invader. It produces antibodies that, while attempting to attack gluten, end up attacking healthy tissue, especially in the small intestines. That makes it hard to absorb nutrients from food.

Symptoms can include:

• Diarrhea, constipation

• Stomach pain, bloating, vomiting

• Migraines, joint pain

• Chronic fatigue

In addition to malnutrition, long-term complications may include:

• Anemia (a low number of healthy red blood cells)

• Infertility

• Neurological conditions

• Osteoporosis (chronic bone-thinning)

• Skin problems

• Development of other autoimmune diseases

Diagnosis of celiac disease is reached through blood tests and endoscopy (a tube with a camera is inserted down the throat to look for the damage caused by the condition) with biopsy (a sample is removed and examined by a pathologist in the lab ).

There's no cure for celiac disease. Since gluten is the trigger, people who have it should take care to avoid foods that contain gluten.

Gluten Sensitivity

People with gluten sensitivity also have a bad reaction to gluten. They might have some of the symptoms of celiac disease. However, gluten sensitivity doesn't involve the high levels of antibodies and damage to the intestines seen in celiac disease. A sensitivity to gluten is not a true allergy.

Other names for gluten sensitivity are non-celiac gluten sensitivity (NCGS) and gluten intolerance. People with gluten sensitivity should consider a gluten-free diet.

Many things can lead to similar abdominal symptoms, and it's not always gluten. Poorly digested carbs that ferment in the gut (FODMAPS, short for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) can produce the same symptoms. So can some food allergies.

Wheat Allergy

A wheat allergy is a type of food allergy in which your immune system overacts to wheat. This can cause symptoms such as hives, sneezing, or runny nose. You might also have gastrointestinal symptoms similar to gluten sensitivity and celiac disease. Less commonly, a wheat allergy can cause anaphylaxis, a severe, life-threatening allergic reaction.

Many foods contain both gluten and wheat. Because the symptoms can overlap, it can be difficult to tell whether you're reacting to gluten or wheat. However, an allergy test can confirm whether you have a wheat allergy.

Dermatitis Herpetiformis

Dermatitis herpetiformis is an autoimmune disease triggered by gluten. It causes skin symptoms, including an itchy, inflamed, blistering rash. It can also cause gastrointestinal symptoms similar to celiac disease. Most people who develop dermatitis herpetiformis also have celiac disease. A skin biopsy can determine whether you have it.

What Does Inflammation From Gluten Feel Like?

Not everyone experiences a reaction to gluten in the same way. If you have gluten sensitivity, you'll probably feel symptoms soon after eating gluten. For those with celiac disease, it may take 48 to 72 hours for symptoms to start.

After you eat something with gluten, you may experience symptoms such as:

• Bloating, gassiness

• Abdominal discomfort or pain

• Diarrhea, constipation

• Vomiting

• Headache

• Muscle and joint pain

• Fatigue

Some people report brain fog (feeling mentally drained) from gluten.

Over time, you might start to notice that you're losing weight. Atypical signs of gluten intolerance are:

• Hair loss

• Mouth ulcers

• Infertility

• Failure to thrive and delayed puberty in children
  

How to Prevent Inflammation From Gluten

The inflammatory response is the body's way of fending off harmful pathogens. But an overblown inflammatory response and chronic inflammation are also harmful.

If gluten is the culprit, eliminating gluten from your diet can prevent the inflammatory response. This is especially crucial for people with celiac disease since inflammation damages the intestines and other healthy tissues.

Should You Go Gluten-Free?

If you have celiac disease, a strict, lifelong gluten-free diet is the main therapy. People with dermatitis herpetiformis or gluten sensitivity also benefit from avoiding gluten. But for some people with gluten sensitivity, the diet may not have to be as strict or lifelong. If you're allergic to wheat, you should avoid it, but you can have other grains that contain gluten.

Eliminating gluten in these conditions may ease inflammation, which causes the symptoms and complications.

Gluten doesn't provide essential nutrients. But it is found in many foods that are part of a healthy diet, and there's no need for most people to avoid it. The potential downsides of a gluten-free diet include:

• Low intake of folate, iron, thiamin, riboflavin, niacin, and calcium

• Gluten-free products often have added fat and sugar

• Not getting enough fiber, which can lead to digestive problems like constipation

• Wheat replacements may have less fiber and protein than wheat and may be higher on the glycemic index (GI) (a measure of how carbohydrates affect blood sugar)

• Decreased number and variety of beneficial gut bacteria, which can affect the immune system
  

Summary

Gluten is a protein found in a variety of grains. The digestive system can't completely break down gluten. For most people, that's not a problem and there's no benefit to a gluten-free diet.

If you have celiac disease, gluten causes severe inflammation and damage to the intestines. You must avoid gluten to control inflammation and the potential for serious complications.

If you have gluten sensitivity, you might have many of the same symptoms as someone with celiac disease but without the damage to the intestines. Avoiding gluten can help you avoid a bad reaction.

If you have a bad reaction after eating grains, it's worth seeing a healthcare provider. Getting the right diagnosis can guide any dietary changes.

Read the original article on Verywell Health.