Gluten has quickly become a hot topic in gut health, immune function, and overall wellness—and for good reason. While some people tolerate gluten just fine, many experience bloating, pain, and digestive discomfort after consuming or even contacting it.

So why has gluten “suddenly” become a problem, and how does it impact our health? The rise in gluten-related disorders is tied to factors like increased wheat consumption, higher inflammatory burdens from diet, and environmental changes. 

Health topics like gluten often swing between extremes, either overstating or downplaying its impact on the general population. It’s important to separate trends from evidence-based facts. My goal is to ground this article in the most up-to-date research. 

In this post, we’ll explore the gut-gluten connection to help you navigate the wave of information. While some people need to avoid gluten, others may not benefit from jumping on the gluten-free trend without proper evaluation.

What is Gluten?

Gluten is the main protein in wheat and other grains, making up about 80% of their protein content. It gives bread and baked goods their soft, chewy texture. A typical slice of bread contains about 2 grams of gluten—just a little less than the weight of a U.S. penny.

Gluten is just one component of wheat. Other proteins and carbohydrates in wheat and grains can also trigger immune reactions. We’ll focus on gluten in this article, but the reality is more nuanced.

Why Do Some People React to Gluten?

To explain why some people react negatively to gluten, Dr. Alessio Fasano highlights three key factors that help determine whether gluten proteins will cause a problem:

1. An Unhealthy Healthy Microbiome: People with a diverse, balanced gut microbiome are less likely to experience negative effects from gluten.
2. A Compromised Intestinal Barrier: If the gut barrier is functioning well, undigested gluten is less likely to trigger inflammation.
3. Immune System Dysfunction and Genetic Predisposition: Without a genetic predisposition or immune system dysfunction, gluten is less likely to cause disease.

There’s no single answer to why gluten causes problems for some people. Several hypotheses help explain this growing concern, and any combination of these factors may be involved:

Humans Don’t Fully Break Down Gluten

Although no one can fully digest gluten due to a lack of specific enzymes, the ability of our gut to quickly protect or repair itself after gluten exposure plays a crucial role in preventing health issues. If the gut lining is compromised or inflamed ( as in “leaky gut”), this may trigger an immune response or gluten-related disorder.

Environmental Factors and the Processing of Gluten

Modern wheat processing, including the use of pesticides like glyphosate, can irritate the digestive system and increase immune reactivity. Glyphosate also disrupts gut bacteria, potentially contributing to gluten intolerance in some individuals.

Rising Gluten Consumption

Today’s Standard American Diet (SAD) contains much more gluten than past generations. It’s not just in bread and pasta—gluten is hidden in many processed foods as a thickener or binder.

Gluten is found in soy sauce, salad dressings and sauces, processed meats, medications, supplements, seasonings, cosmetics, and body care products. These hidden sources can be surprising for those trying to avoid gluten!

Molecular Mimicry

Another theory suggests that the immune system confuses gluten with harmful pathogens, triggering heightened or autoimmune responses in sensitive individuals. Gluten’s structure resembles certain bacteria or even our own proteins, causing this confusion.

Gluten-Related Disorders

Gluten-related disorders can be confusing, especially with the terminology. Here, I’ll break down 4-5 gluten-related conditions to clarify the differences between them:

Also, any of these gluten-related disorders can develop at any age! I see patients wondering why they suddenly react to gluten after years of consuming it without issue, so just know the reality of the way the immune system works with adverse food reactions.

Celiac Disease

Celiac disease affects about 1-2% of the global population. It’s an autoimmune disorder where gluten triggers the immune system to attack the small intestine. This leads to symptoms like digestive discomfort, nutrient malabsorption, weight loss, and can also contribute to other autoimmune disorders.

Recent research shows that the immune response in celiac disease begins when gluten interacts with specific gut cells, triggering inflammation and autoimmunity. This aligns with Alessio Fasano’s “Triad of Autoimmunity:”

1. Genetic Predisposition - More than 98% of individuals diagnosed with celiac disease have either HLA-DQ2 or DQ8, which are responsible for up to 40% of the genetic risk of celiac disease. About 30-40% of the general population has these gene variants.
2. Environmental Trigger - We’ve explored some potential triggers including increased wheat consumption, environmental changes (such as glyphosate use), infections, and shifts in the gut microbiome.
3. Immune System Exposure - Simply put, this means that the immune system must come into contact with gluten by a person eating or contacting it.

Diagnosing celiac disease requires blood tests to measure specific immune reactions (tTG, DGP, EMA) and an intestinal biopsy to confirm the damage as long as the person is still eating wheat. Despite testing advancements, it is estimated that around 1.5 million people in the U.S. might be living with undiagnosed celiac disease!

Wheat Allergy

Wheat allergies cause classic allergic reactions through an immune response to wheat proteins, including gluten. Unlike celiac disease, this reaction involves a different (IgE-mediated) immune response. 

The classic signs of a wheat allergy include hives, swelling, itching, digestive symptoms, difficulty breathing, and, in severe cases, anaphylaxis. Symptoms typically appear within minutes to hours after consuming wheat proteins. 

A person might react in childhood or develop reactions later depending on many factors that overlap with those we explored above. Depending on the diagnostic method used, it is estimated that between about 0.5% - 1% of the global population has an allergic reaction to wheat. 

Skin prick tests and IgE blood tests are used for diagnosis, though they can yield false positives due to cross-reactivity with similar allergens like grass. Considering potential inaccuracy, food challenge tests are considered the gold standard for wheat allergy.

Non-Celiac Gluten or Wheat Sensitivity (NCGS or NCWS)

Non-Celiac Gluten Sensitivity (NCGS) affects 0.49-14.9% of the population. This broad range highlights the challenges in diagnosing it due to the lack of a gold-standard test. Symptoms resemble celiac disease—bloating, abdominal pain, and fatigue—without the autoimmune damage. 

NCGS is diagnosed by ruling out celiac disease and wheat allergy through elimination diets. It’s more common in adults, especially women, and may involve the innate immune system or intestinal permeability (aka, leaky gut). 

Although some blood markers may suggest NCGS, specificity is unclear, and self-diagnosis is common. Some researchers prefer the term "Non-Celiac Wheat Sensitivity" to account for reactions to other components of wheat and grains. 

Non-Celiac Wheat Intolerance

Wheat Intolerance refers to difficulty digesting wheat components without triggering an immune response. Often grouped with Non-Celiac Wheat Sensitivity (NCWS), it’s more accurately described as an intolerance.

One possible cause is that wheat contains FODMAPs, a type of carbohydrate that can cause gastrointestinal symptoms like bloating in some. While FODMAPs don’t trigger inflammation, they may contribute to digestive discomfort. 

A practical tip to help sort through this wheat reaction is that wheat and rye are relatively minor sources of FODMAPs. Symptoms are typically mild, and are limited to the digestive tract suggesting other mechanisms may be at play.

The Gluten-Free Diet: Pros and Cons

A gluten-free diet offers both benefits and challenges, especially for individuals with celiac disease or gluten sensitivity. Here are some key pros and cons of following a gluten-free diet.

 Pros of a Gluten-Free Diet:

• Symptom Relief for Diagnosed Reactions: A gluten-free diet is essential for those with celiac disease, wheat allergy, or Non-Celiac Gluten Sensitivity (NCGS) to prevent symptoms and gut damage
• Improved Gut Health: For sensitive individuals, removing gluten reduces inflammation and allows the gut to heal.
• Reduced Risk of Complications: In celiac disease and wheat allergy, strict adherence to a gluten-free diet can prevent serious health issues like malnutrition, anaphylaxis, and overall body burden or allostatic load.

 Cons of a Gluten-Free Diet:

• Nutrient Deficiencies: Gluten-free diets can lead to low intake of fiber, B vitamins, and iron, especially if not carefully planned.
• Many Foods Labeled Gluten-Free are Highly Processed: As such, navigating food labels becomes even trickier. Pro tip: If a food product comes in a package and touts labels like “gluten-free” or “sugar-free”, don’t assume that means healthy and dig further.
• Reduced Gut Microbiome Diversity: Long-term gluten elimination can reduce beneficial gut bacteria diversity, potentially affecting digestive health and immune resilience.

How to Approach Gluten in Your Diet

If you suspect gluten-related issues, testing is highly recommended before eliminating gluten from your diet. Proper testing can help diagnose celiac disease or wheat allergy, but you must be actively consuming gluten for these tests to be accurate.

Elimination diets are a useful tool for identifying gluten sensitivity, but they are generally more properly executed with professional guidance. Along with reducing gluten, you can support gut health by including probiotics, prebiotics, digestive enzymes, and anti-inflammatory herbs like in Cielo’s Horizon.

Final Thoughts 

A healthy gut microbiome plays a vital role in immune resilience. Disruptions to this balance, often caused by stress, infections, antibiotics, pain relievers, and other environmental factors, can make the gut more reactive to gluten. When the microbiome is diverse, and sources of inflammation are low, the body is better equipped to tolerate potential stressors.

Gluten-related disorders are complex and vary from person to person. Whether you’re struggling with digestive issues or considering a gluten-free diet, it’s crucial to base your decisions on proper testing and expert advice. Supporting your gut health holistically, with or without gluten, will help you maintain long-term wellness.

We hope this article helped shed some practical light and sifted through some of the noise surrounding gluten. For more wellness-related content, stay connected with us through our newsletter, and follow Cielo and Dr. Kenny on Instagram!