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I can't seem to tell the difference between Celiac and gluten sensitivity. They are supposed to be different but I can't tell how. I've asked my GP and GI but t

I can't seem to tell the difference between Celiac and gluten sensitivity. They are supposed to be different but I can't tell how. I've asked my GP and GI but they seem to think they are exactly the same. Anyone following any specific diet for one vs the other. Its all very confusing.

megaman22 9y ago
One is definitely a real condition. The other... well, there's reason to be skeptical - whether it is actually gluten or whether it is psychosomatic. I'm more than half suspicious that most of the self-reported benefits of avoiding gluten are really benefits of also slashing carb intake.
- aaronblohowiak 9y ago
  Slashing carb intake’s benefits are psychosomatic? How do you figure ?
  - phil21 9y ago
    It's psychosomatic in that people think it's cutting gluten that is making them feel better - when in fact it may be simply reducing carb intake that is the primary cause. It's much like how I observe folks on Atkins where it really works - but the magic isn't so much the ketosis itself - they are just unknowingly drastically reducing calorie intake. The real "body hack" of any diet is the one on the brain, imo.
    - eropple 9y ago
      I dunno about that. I've monitored calorie intake while keeping to an under-40g allotment of carbs per day. I was still eating north of 2500 calories a day (which was less, but not that much less, than before--about a 300 calorie deficit per day), working an office job, and exercising less than I should. One day a week was a cheat day, where I not only permitted myself but frankly demanded that I put all sorts of high-calorie horrible things into my face. I'd regularly end up around 4000-5000 calories every Saturday (until I stopped liking those things--also an interesting side effect). I lost fifty freaking pounds. Off Chipotle salad bowls and shawarma salads (and I was already eating those things, just...now sans rice). Ketosis does some weird stuff.
      - eclipxe 9y ago
        Don't know why you got down voted - I had the same exact experience.
      - ryanmerket 9y ago
        I’ve been seeing this for years. Started Keto off/on since 2010 and always lost weight. Never count calories. The science will catch up eventually.
    - TACIXAT 9y ago
      My brother and I are celiac. Atkins diet was how my dad found what not to eat back when going gluten free wasn't a thing. As someone who had a ton of health problems and solved them by cutting out foods, it's not in our heads. I used to starve myself because not eating is what felt best. Now I know what not to eat and feel great.
      - beaner 9y ago
        It wasn't in your heads. But I think his point is that it may be in others'.
    - erikpukinskis 9y ago
      I thought psychosomatic meant a physical change that’s caused by the mind? I think you’re just talking about false attribution.
- cpuguy83 9y ago
  Gluten free does not mean carb free or even carb reduced. What it does tend to mean is less processed food and more whole foods.
  - stephen_g 9y ago
    Both my father and my sister are coeliac, and find a lot of packaged gluten free foods (biscuits, breads, cakes, etc) have more sugar than the normal versions to compensate for frankly generally tasting worse... Fresh food is fine, but in general people deciding to go gluten free because it's trendy and "healthy", without having done a proper elimination trial or having coeliac disease, aren't actually making a good choice.
    - ryanmerket 9y ago
      You forgot having active anti-bodies in their feces. I don’t have celiacs but I have done a fecal test and it showed sensitivity to gluten, oat, potato, and bean.
- abecedarius 9y ago
  Some "gluten-sensitive" people (e.g. me) will request a GF meal because it's a relatively standard checkbox choice that can be accommodated without extra overhead, unlike a FODMAP diet; it's not that we imagine we're kinda sorta celiac. And wheat does stand out among foods found to disagree with me. (By antibody test if you're going to bring up the psychosomatic. Yes, mind-body issues happen but they seem to be overused to dismiss people's experience.)
- dcx 9y ago
  I'm pretty much certain there is something to gluten sensitivity. Starting from when I was a teenager I used to have stomach cramps and diarrhoea about twice a week. This went on for 10+ years. Being a kid I assumed this was just a thing some people have, and never really spoke about it to anyone. The day I stopped eating bread and other large portions of gluten was the day this issue went away in full. I have since taken the blood test for celiac and it came back negative (my doctor said soy sauce in my diet should be enough to set off the test, although to be fair he was not 100% confident on this point). Any time I try reintroducing bread, egg noodles, etc., the cramps come back like clockwork. I can take unlimited rice and gluten-free bread without triggering symptoms. My suspicions are that (1) there is a sub-celiac-diagnosis level of irritation which people are experiencing and addressing by cutting out gluten, and (2) maybe many people are not comfortable being vocal about their digestive issues in public? The medical industry has a big track record of treating unknown disorders as psychosomatic and writing off sufferers until they are lucky enough to figure out that particular disease. Consider that IBS is a disease of exclusion and how poorly understood gut bacteria is right now. It's not always going to be reliable, but it is worth listening when a ton of people complain and proceed to vote with their wallets as well.
sitharus 9y ago
Coeliac disease is a genetic autoimmune disorder where your immune system attacks the small intestine causing atrophy of the villi which leads to lack of nutrient absorption. It’s diagnosed by the presence of anti-Gildain antibodies in the blood and an intestinal biopsy showing the atrophy of the villi. Gluten sensitivity is a condition where ingestion of gluten causes digestion problems and sometimes intestinal distress. The diagnosis is by elimination diet. There’s some research that suggests this is due to FODMAP digestion issues with the gut bacteria and it may be resolvable by removing and slowly reintroducing FODMAPs. In both cases the solution is a gluten free diet. All traces of gluten must be removed from the diet. That’s everything that contains wheat, barley, rye and oats, along with everything derived from those grains and anything that has been in contact with those grains. You’ll have to read a lot of labels, and only eat out at restaurants that are known to have a proper allergy control policy. Also if coeliac specify when ordering as diet-fad gluten free people cause a lot of problems. I have coeliac disease, feel free to ask anything.
- unwind 9y ago
  My understanding is that oats only contain gluten due to cross-contamination by other grain during processing. In Sweden you can buy special "pure oats" that are gluten free due to more careful handling.
  - colmvp 9y ago
    Yeah this is my understanding too. Quaker Oats for example wrote: "Yes, oats are naturally gluten-free. However, during farming, transportation and storage, gluten-containing grains like wheat, rye, barley and spelt may be unintentionally introduced." Just like Sweden, in North America you can buy gluten free oatmeal that's made specifically to not include cross contaminates.
  - sitharus 9y ago
    For the most part cross-contamination is the major issue, but it’s a bit more complex than that. Oat proteins are similar to the giladins in wheat that trigger coeliac disease. Certain oat cultivars are more similar than others. This means that some varieties of oats and some coeliac sufferers are not compatible. I can’t eat oats. Originally oats were considered gluten containing until a new more sensitive enzyme-based gluten test was developed which does not trigger for non-contaminated oars. Unfortunately enzymes aren’t how coeliac disease works.
BjoernKW 9y ago
Freakonomics Radio recently had an interesting episode on this: http://freakonomics.com/podcast/demonization-gluten/ http://freakonomics.com/podcast/demonization-gluten/
- borne0 9y ago
  That was interesting, thanks. The story about the red cross food delivery of wheat made me think of whenmy first symptoms were, and it was when I was working at Domino's as a young man and practically lived on pizza... Unfortunately that was 12 years prior to diagnosis! Life has been much much better since .
codesnik 9y ago
maybe because other one isn't about gluten at all? http://bigthink.com/paul-ratner/its-fructan-not-gluten-thats-causing-stomach-problems-says-new-research http://bigthink.com/paul-ratner/its-fructan-not-gluten-thats...
InclinedPlane 9y ago
Celiac is an auto-immune disorder, an allergy. Celiac sufferers who consume even small amounts of gluten will have their digestive system more or less shut down for a period of up to several days afterward. Gluten sensitivity is similar to lactose intolerance (and is closely related to FODMAP sensitivity and IBS), for those folks consuming gluten leads to digestive problems. Just as many people with lactose intolerance can consume some lactose if they are careful the same is true for many people with gluten sensitivity, but also the severity of symptoms vary greatly and some people find that playing russian roulette with their gut is too dangerous so they seek to eliminate it from their diet entirely.

megaman22 9y ago

One is definitely a real condition. The other... well, there's reason to be skeptical - whether it is actually gluten or whether it is psychosomatic. I'm more than half suspicious that most of the self-reported benefits of avoiding gluten are really benefits of also slashing carb intake.

aaronblohowiak 9y ago
Slashing carb intake’s benefits are psychosomatic? How do you figure ?
- phil21 9y ago
  It's psychosomatic in that people think it's cutting gluten that is making them feel better - when in fact it may be simply reducing carb intake that is the primary cause. It's much like how I observe folks on Atkins where it really works - but the magic isn't so much the ketosis itself - they are just unknowingly drastically reducing calorie intake. The real "body hack" of any diet is the one on the brain, imo.
  - eropple 9y ago
    I dunno about that. I've monitored calorie intake while keeping to an under-40g allotment of carbs per day. I was still eating north of 2500 calories a day (which was less, but not that much less, than before--about a 300 calorie deficit per day), working an office job, and exercising less than I should. One day a week was a cheat day, where I not only permitted myself but frankly demanded that I put all sorts of high-calorie horrible things into my face. I'd regularly end up around 4000-5000 calories every Saturday (until I stopped liking those things--also an interesting side effect). I lost fifty freaking pounds. Off Chipotle salad bowls and shawarma salads (and I was already eating those things, just...now sans rice). Ketosis does some weird stuff.
    - eclipxe 9y ago
      Don't know why you got down voted - I had the same exact experience.
    - ryanmerket 9y ago
      I’ve been seeing this for years. Started Keto off/on since 2010 and always lost weight. Never count calories. The science will catch up eventually.
  - TACIXAT 9y ago
    My brother and I are celiac. Atkins diet was how my dad found what not to eat back when going gluten free wasn't a thing. As someone who had a ton of health problems and solved them by cutting out foods, it's not in our heads. I used to starve myself because not eating is what felt best. Now I know what not to eat and feel great.
    - beaner 9y ago
      It wasn't in your heads. But I think his point is that it may be in others'.
  - erikpukinskis 9y ago
    I thought psychosomatic meant a physical change that’s caused by the mind? I think you’re just talking about false attribution.
cpuguy83 9y ago
Gluten free does not mean carb free or even carb reduced. What it does tend to mean is less processed food and more whole foods.
- stephen_g 9y ago
  Both my father and my sister are coeliac, and find a lot of packaged gluten free foods (biscuits, breads, cakes, etc) have more sugar than the normal versions to compensate for frankly generally tasting worse... Fresh food is fine, but in general people deciding to go gluten free because it's trendy and "healthy", without having done a proper elimination trial or having coeliac disease, aren't actually making a good choice.
  - ryanmerket 9y ago
    You forgot having active anti-bodies in their feces. I don’t have celiacs but I have done a fecal test and it showed sensitivity to gluten, oat, potato, and bean.
abecedarius 9y ago
Some "gluten-sensitive" people (e.g. me) will request a GF meal because it's a relatively standard checkbox choice that can be accommodated without extra overhead, unlike a FODMAP diet; it's not that we imagine we're kinda sorta celiac. And wheat does stand out among foods found to disagree with me. (By antibody test if you're going to bring up the psychosomatic. Yes, mind-body issues happen but they seem to be overused to dismiss people's experience.)
dcx 9y ago
I'm pretty much certain there is something to gluten sensitivity. Starting from when I was a teenager I used to have stomach cramps and diarrhoea about twice a week. This went on for 10+ years. Being a kid I assumed this was just a thing some people have, and never really spoke about it to anyone. The day I stopped eating bread and other large portions of gluten was the day this issue went away in full. I have since taken the blood test for celiac and it came back negative (my doctor said soy sauce in my diet should be enough to set off the test, although to be fair he was not 100% confident on this point). Any time I try reintroducing bread, egg noodles, etc., the cramps come back like clockwork. I can take unlimited rice and gluten-free bread without triggering symptoms. My suspicions are that (1) there is a sub-celiac-diagnosis level of irritation which people are experiencing and addressing by cutting out gluten, and (2) maybe many people are not comfortable being vocal about their digestive issues in public? The medical industry has a big track record of treating unknown disorders as psychosomatic and writing off sufferers until they are lucky enough to figure out that particular disease. Consider that IBS is a disease of exclusion and how poorly understood gut bacteria is right now. It's not always going to be reliable, but it is worth listening when a ton of people complain and proceed to vote with their wallets as well.

sitharus 9y ago

Coeliac disease is a genetic autoimmune disorder where your immune system attacks the small intestine causing atrophy of the villi which leads to lack of nutrient absorption. It’s diagnosed by the presence of anti-Gildain antibodies in the blood and an intestinal biopsy showing the atrophy of the villi. Gluten sensitivity is a condition where ingestion of gluten causes digestion problems and sometimes intestinal distress. The diagnosis is by elimination diet. There’s some research that suggests this is due to FODMAP digestion issues with the gut bacteria and it may be resolvable by removing and slowly reintroducing FODMAPs. In both cases the solution is a gluten free diet. All traces of gluten must be removed from the diet. That’s everything that contains wheat, barley, rye and oats, along with everything derived from those grains and anything that has been in contact with those grains. You’ll have to read a lot of labels, and only eat out at restaurants that are known to have a proper allergy control policy. Also if coeliac specify when ordering as diet-fad gluten free people cause a lot of problems. I have coeliac disease, feel free to ask anything.

unwind 9y ago
My understanding is that oats only contain gluten due to cross-contamination by other grain during processing. In Sweden you can buy special "pure oats" that are gluten free due to more careful handling.
- colmvp 9y ago
  Yeah this is my understanding too. Quaker Oats for example wrote: "Yes, oats are naturally gluten-free. However, during farming, transportation and storage, gluten-containing grains like wheat, rye, barley and spelt may be unintentionally introduced." Just like Sweden, in North America you can buy gluten free oatmeal that's made specifically to not include cross contaminates.
- sitharus 9y ago
  For the most part cross-contamination is the major issue, but it’s a bit more complex than that. Oat proteins are similar to the giladins in wheat that trigger coeliac disease. Certain oat cultivars are more similar than others. This means that some varieties of oats and some coeliac sufferers are not compatible. I can’t eat oats. Originally oats were considered gluten containing until a new more sensitive enzyme-based gluten test was developed which does not trigger for non-contaminated oars. Unfortunately enzymes aren’t how coeliac disease works.

BjoernKW 9y ago

Freakonomics Radio recently had an interesting episode on this: http://freakonomics.com/podcast/demonization-gluten/ http://freakonomics.com/podcast/demonization-gluten/

borne0 9y ago
That was interesting, thanks. The story about the red cross food delivery of wheat made me think of whenmy first symptoms were, and it was when I was working at Domino's as a young man and practically lived on pizza... Unfortunately that was 12 years prior to diagnosis! Life has been much much better since .

codesnik 9y ago

maybe because other one isn't about gluten at all? http://bigthink.com/paul-ratner/its-fructan-not-gluten-thats-causing-stomach-problems-says-new-research http://bigthink.com/paul-ratner/its-fructan-not-gluten-thats...

InclinedPlane 9y ago

Celiac is an auto-immune disorder, an allergy. Celiac sufferers who consume even small amounts of gluten will have their digestive system more or less shut down for a period of up to several days afterward. Gluten sensitivity is similar to lactose intolerance (and is closely related to FODMAP sensitivity and IBS), for those folks consuming gluten leads to digestive problems. Just as many people with lactose intolerance can consume some lactose if they are careful the same is true for many people with gluten sensitivity, but also the severity of symptoms vary greatly and some people find that playing russian roulette with their gut is too dangerous so they seek to eliminate it from their diet entirely.