How to Test for Gluten Sensitivity

September 16, 2019

For a while there, it seemed like everyone was hopping on the gluten-free bandwagon.  But then, a backlash began and there was talk in the media that the gluten-free diet was just a fad and that non-celiac gluten sensitivity (NCGS) doesn't exist.  This has had potentially damaging effects because not only does NCGS absolutely exist, it is actually much more prevalent than celiac disease.

I work for 5 different Functional Medicine clinicians in 4 different offices -- all of them say they have seen the following scenario story SO MANY times:  someone suspects they have a sensitivity to gluten, their Primary Care doctor orders bloodwork to test them for celiac, it comes up negative, so they continue eating gluten -- but then, still sick, they come into one of our offices and are taken off of gluten (all of the doctors I work for take all of their patients off of gluten because it is such an inflammatory food group) and they start to feel better.  Why would this happen if they were negative for celiac?  

- Blood:  the bloodwork used to test for celiac only looks for antibodies to 2 of the components of wheat, Transglutaminase-2 and Alpha-Gliadin.  If you're producing antibodies to those 2, you have celiac -- easy.  But wheat is made up of more than 50 components, all of which can be reacted to, so this is not a great test for those with NCGS, as they could be sensitive to any of the other 48 components of wheat.

- Endoscopy:  endoscopies are very intrusive and only look at a tiny portion of the intestine.  I've heard a negative endoscopy for celiac compared to dipping a cup in the ocean and, if it doesn't come up with any fish in it, assuming there are no fish in the ocean.

This makes NCGS very difficult to diagnose.  But continuing to eat gluten when you are sensitive to it can lead to autoimmunity, cancer, and just about anything else.  So what are you supposed to do?  There are 2 options: 

(1) You can do an elimination diet and leave gluten out 100% for 3-4 weeks, and see how you feel.  Then add it back in and see if you notice anything (and by "anything" I mean headache, fatigue, congestion, feelings of depression and/or anxiety, acne, eczema, attention or focus issues, bloating, constipation, diarrhea, etc.).  If you do, you're sensitive to gluten and can judge for yourself, by the severity of your symptoms, how much of it you tolerate (if any).

(2) You can run the Cyrex Array #3 blood test, which tests for 24 components of wheat -- more than 10x what the standard blood testing analyzes.  A sample of the results are below -- anything in the yellow or red column means you have a gluten sensitivity (and yes, I have seen these come up as all green several times -- those lucky people!). 

This person would have come up negative for celiac with the standard blood testing, as they are not sensitive to the 2 components of wheat that are tested for.  But, as you can see, they are extremely sensitive to gluten.

I believe that figuring out if you have NCGS or not is one of the most important things you can do for your health.  The Cyrex test isn't cheap ($400) but some have had luck getting a decent portion of it covered by their insurance (mine covered the whole thing).  Many Naturopathic or Functional Medicine doctors can order it for you (or I can).