new member packet 2024                    DIGESTIVE HEALTH:



By Barbie Cervoni MS, RD, CDCES, CDN, a  registered dietitian and certified diabetes care and education specialist.  Published on March 21, 2023.


Table of Contents

·       How It Develops; Symptoms:  Digestive Symptoms; Neurological Symptom; Skin Disorders; Bone &  Joint Symptoms; Dental Issues

·         Diagnosis

·         Causes of  Celiac Disease Development

·         Treatment:  A Strict Gluten-Free Diet

·         Long-Term Complications

·         Prevention?

·         Talking to a Knowledgeable Provider or Dietitian

·         Maintaining a Gluten-Free Diet

                   Foods to Avoid

                   Diet Tips

                   Frequently Asked Questions  (FAQ’s)

             How Many Celiac Patients Don’t Follow a Gluten-Free Diet (GFD)?

             Consequences of Not Treating Celiac Disease

    What Should you Do When You Accidentally Eat Gluten?

    What Triggers Celiac Disease Later in Life?

    Celiacs Should Follow a STRICT Gluten-Free Diet

             Irritable Bowel Syndrome  (IBS)

    Foods that May Trigger IBS Attacks

    Low FODMAP Diet

   What Makes Gluten Intolerance Different from Celiac Disease?

             Living with Celiac Disease:  A Guide to the Gluten-Free Lifestyle

             Gluten-Free Meal Planning

             Create a Gluten-Free Pantry

             GF Grains & Flours

             GF Alternative Binders and Thickeners

             GF Condiments, Sauces and Seasonings


    Protecting Yourself from Possible Gluten in Medication.  Look for Wheat Starch

   Gluten in Vitamins and Supplements



Protecting Yourself from Possible Gluten in Medication – Look for Wheat Starch

       Currently, there is no law mandating that drug manufacturers disclose the source of these excipients in any public record or database, so we must rely on calling the manufacturer to obtain information.

       Some drug companies are transparent with their information, while others either give incomplete or even false information. Often, you are told that the company does not use any gluten in the manufacturing of their product, but they won’t guarantee that it’s gluten-free.

       As a consumer, how do you protect yourself when trying to obtain information regarding the gluten status of a drug when the information you are receiving is either incomplete or questionable?  By looking at the excipients, you can get a pretty clear picture of the potential for contamination.  It is highly unlikely that any excipient other than starch will contain any measurable amount of gluten.

       As mentioned earlier, the most likely source of gluten contamination will come from starch. It is highly unlikely that any excipient other than starch will contain any measurable amount of gluten.

       When the excipient listed for the product contains the single word “starch,” it can come from any starch source. In the food industry, plain starch must be derived from corn, but this regulation does not apply to the pharmaceutical industry.

       A second type of starch is pre-gelatinized starch. This is primarily derived from corn, but it can be derived from any source. A third type of starch is sodium starch glycolate. This is primarily derived from potato, but occasionally derived from corn. Like pre-gelatinized starch, sodium starch glycolate can be derived from any starch source. Often times, the ingredients are actually listed as corn starch, which makes it easy to identify the source.

       Finally, there is the rare occasion when you see the words “wheat starch.”   By using the two FDA websites mentioned above, you can frequently find the source of the starch.

       Using the information provided above, you can make an educated decision to take that product or look for a substitute. If you are told by the company that they do use gluten in their product, ask them to disclose what the source of the gluten is.

       If they tell you they use wheat starch, naturally you would avoid using the product. If they tell you it is derived from a wheat source, the chances are that they are referring to one of the sugar alcohols, also known as polyols.         These are highly processed sugars that contain no wheat gluten, and therefore cannot cause a reaction. Examples of these sugar alcohols are mannitol, sorbitol, sorbitan, maltitol, xylitol, lactitol, erythritol, and hydrogenated starch hydrolysates. Another misrepresented ingredient is wheat maltodextrin, or plain maltodextrin.


Gluten in Vitamins and Supplements

       Vitamin and mineral therapy can be used in addition to the standard gluten-free diet to hasten a patient’s recovery from nutritional deficiency. However, certain ingredients in vitamins and supplements – typically the inactive ingredients – can contain gluten, so extra care must be taken to avoid any gluten exposure.

       There is a variety of nutritional deficiencies associated with celiac disease, primarily caused by the inability of the damaged small intestine to properly absorb enough of the nutrients our bodies need. People recently diagnosed with celiac disease are commonly deficient in fiber, iron, calcium, magnesium, zinc, folate, niacin, riboflavin, vitamin B12, and vitamin D, as well as in calories and protein.1

       Deficiencies in copper and vitamin B6 are also possible, but less common. A study from 2002 by Bona et. al.2 indicated that the delay in puberty in children with celiac disease may partially be due to low amounts of B vitamins, iron, and folate.

       Patients with celiac disease frequently report non-specific dermatological issues, including dry skin, easy bruising, brittle nails, and thinning hair. Zinc deficiency is particularly associated with these skin lesions. Iron, zinc, and fat-soluble vitamins are most often deficient in patients with newly diagnosed celiac disease.3

       After treatment with a strict gluten-free diet, most patients’ small intestine recovers and are able to properly absorb nutrients again, and therefore do not require supplementation. For certain patients however, nutrient supplements may be beneficial.

       The quality of gluten-free products on the market today also poses some challenges to thriving on the gluten-free diet. Though the gluten-free market has grown immensely over recent years, and is still growing, many gluten-free products are not enriched and have lower amounts of folate, iron, thiamin, niacin, fiber, and riboflavin.

       Furthermore, studies show that patients on a gluten-free diet tend to consume a higher amount of calories from fat, and less from carbohydrates. Following a strict gluten-free diet while maintaining proper nutrition can be very challenging.




       Celiac disease is an autoimmune disease in which the body mistakenly attacks itself, damaging the lining in the intestine after ingesting gluten.

       People with celiac disease must avoid all gluten, a protein found in wheat, rye, barley, and certain oats. The only treatment for celiac disease is following a strict gluten-free diet.

       This article discusses celiac disease's symptoms, causes, diagnosis, and treatment.                           



How Does Celiac Disease Develop?

       About 2 million people in the United States and 1% of the worldwide population has celiac disease. However, many people have not been diagnosed.1 People predisposed to celiac disease usually have a family history or specific genes that increase their risk of developing it.

       Celiac disease occurs mostly in people who have a genetic predisposition to the condition, due to abnormalities in the human leukocyte antigen (HLA) genes (opens in new tab) that are located on chromosome 6.  These genes code for HLA proteins, whose function is to bind bits of infectious pathogens, like viruses, and alert the immune system to the invaders' presence. Mutations in these genes can cause the body to mistake its own tissues as a threat and attack them. 


Causes of Celiac Disease

       Multiple factors can increase the risk of developing celiac disease. People who have first-degree relatives with celiac disease are at increased risk.  People who develop celiac disease also are likely to have one of these two main genes: HLA-DQ2 and HLA-DQ8.   However, not everyone with these genes develops celiac disease.

       Celiac disease occurs more often in people assigned female at birth.  It is also more common in people with other health conditions, such as:

       Of the 30% of people who have the HLA-DQ2 and HLA-DQ8 genes, about 3% develop celiac disease.


When Do Symptoms Usually Appear?

       Celiac disease can develop at any time, and symptoms are highly individual. Children may experience symptoms as soon as gluten is introduced to their diet, while others may not have symptoms for many years. Some people also get misdiagnosed due to unconventional symptoms, while others can have celiac disease without any symptoms.


What Are the Symptoms of Celiac Disease?

       Because celiac disease is a systemic (body-wide) condition that impairs the body's ability to absorb nutrients, symptoms can affect any body system.   Celiac disease manifests in a diverse range of symptoms, making it challenging to diagnose.   Some people experience digestive symptoms, while others experience symptoms affecting other parts of the body.

       This wide range of symptoms includes:

      Children with undiagnosed celiac disease may experience weight loss, failure to thrive, short stature, and delayed puberty.

       Other symptoms may include:


Who is at a Greater Risk?   Anyone can develop celiac disease, but you may be at a higher risk if you:


When Should you see a Doctor or Go to the Hospital?

      You should always feel comfortable discussing your health concerns with your medical provider, especially if you have symptoms impacting your quality of life.  If you are seriously concerned about the possibility of celiac disease, your provider will assess your risk factors and investigate further if necessary.   If you suspect you may have celiac disease or are experiencing persistent symptoms, make an appointment with a reputable digestive-tract-disease specialist known as a gastroenterologist (GI). 

       Do not start eating gluten-free until after you have been tested for celiac disease, as doing so can affect your results.   You may even be able to find GI at a medical center that specializes in celiac disease and gluten intolerance (not necessarily in Houston).  Before your appointment, try to keep a log of your symptoms and what you eat.      

       See your healthcare provider if you or your child has had diarrhea or digestive discomfort for two weeks or more. You should see your healthcare provider before you try a gluten-free diet as that can change the test results.

       All first-degree family members (parents, siblings, and children) of people diagnosed with celiac disease should be tested, as their risks increase to a 1 in 10 chance, even for those with no symptoms.

       Celiac disease can masquerade as many, many other conditions. However, having some (or many) of these symptoms doesn't mean you necessarily have celiac disease—it just means you should consider being tested for the condition.

       To make a diagnosis, your doctor may perform a combination of blood tests, genetic testing, and a biopsy of the small intestine. Early diagnosis and intervention of this autoimmune disorder can prevent long-term complications by making lifestyle changes, following a gluten-free diet, and taking vitamins and dietary supplements to counter any deficiencies.


How is celiac disease treated?

       If you are diagnosed with celiac disease, your provider will likely recommend that you follow a strict gluten-free diet for the rest of your life. This type of diet will help treat or prevent many of the symptoms and other health problems caused by the disease. Your provider may also provide medication to treat or prevent dermatitis herpetiformis, corticosteroids for severe inflammation that is not responding fast enough to the diet, and nutritional supplements to replace any serious deficiencies.


Dermatitis Herpetiformis

       People with untreated celiac disease may have dermatitis herpetiformis, an itchy blistering rash that usually occurs on the buttocks, back, scalp, elbows, and knees.



       To get diagnosed with celiac disease, you should discuss your symptoms with a healthcare provider or gastroenterologist. They will likely draw blood to check for antibodies associated with celiac disease, as well as do an endoscopy. During the endoscopy, a healthcare provider may also perform a biopsy by taking a small sample of your intestine to be analyzed in a lab.

       Diagnosing celiac disease can be complex, but it should begin with a thorough patient history and physical examination. A combination of any of the following suggests celiac disease:

       In many cases, celiac disease can be difficult to confirm, because other serious gastrointestinal conditions, such as inflammatory bowel disease and ulcers, cause similar symptoms. These other diseases can be ruled out through additional testing, which can include the checking of stool samples for signs of blood, as well as imaging tests.

       If a patient does not suffer from malnutrition, doctors should consider that the person's gastrointestinal problems might be the result of a very common condition called irritable bowel syndrome [IBS], which frequently results from intolerance to one or more FODMAPs. One particular FODMAP to which people are often intolerant is lactose, the kind of sugar that's in milk, but there are other types of FODMAP intolerance that cause dietary distress following the ingestion of other things, such as beans and grains. 



       If you suspect you have celiac disease, you should not stop eating gluten before your tests.   Avoiding gluten can impact your results.


How Is Celiac Disease Treated?

       The only treatment for celiac disease is following a strict gluten-free diet. The best way to adhere to and fully understand gluten-free eating while ensuring you have an adequate intake of essential vitamins and minerals is to work with a registered dietitian specializing  in celiac diseases.                                                                                                                                                                                                                                                     

       While medications and vaccines have been investigated, no alternative treatment to a gluten-free diet exists.


Maintaining a Gluten-Free Diet

       Eating a gluten-free diet may seem overwhelming initially, but once you understand the fundamentals and know what ingredients to avoid, it should become second nature. Many foods are naturally gluten-free, including:7

       Variations of your favorite gluten-containing foods, such as pasta, are also available in gluten-free forms. There is a variety of bean-based pasta on the market and gluten-free pasta made from corn or other types of gluten-free grains.

       Get used to reading food labels for possible gluten when you shop or use products for cooking at home.


Foods to Avoid

       If you have celiac disease, you must avoid all foods containing gluten. Gluten can be found in wheat, rye, and barley. Wheat includes spelt, kamut, farro, durum, and products like bulgur and semolina.   Triticale, a wheat and rye hybrid, also contains gluten. Products containing these ingredients include bread, cereals, bread crumbs, crackers, bars, cookies, cakes, pastries, and frozen pizza.

       While oats are naturally gluten free, it's important to check labels for gluten-free certification to ensure they have not been cross-contaminated, meaning they have come into contact with other gluten-containing products during processing.

       Other food sources that contain gluten are processed products that use malt, malt extract, and brewer's yeast. Colors, flavors, starches, and thickeners can also contain gluten and are often added to processed foods. You may need to avoid hot dogs, candy, condiments, sausages, ice cream, salad dressing, and soups; read labels for possible gluten.


Diet Tips

       Gluten free does not mean grain free. Gluten-free whole grains provide important vitamins and minerals, including B vitamins, iron, magnesium, zinc, and selenium. Whole grains also provide a rich source of fiber, which helps balance the digestive system. Familiarize yourself with:


       You also don't need to spend much money on gluten-free foods by focusing on eating naturally gluten-free foods. Create meals based on vegetables, lean proteins, and healthy fats. Nutrient-dense carbohydrate choices may include regular and sweet potatoes, beans, peas, corn, and squashes.

       If you want to find gluten-free options that are portable, quick, and comparable to your favorite snack foods, know that there are plenty of options in that area, too.



       When preparing gluten-free foods, it is important to avoid cross-contact. Cross-contact occurs when foods or ingredients come into contact with gluten, generally through shared utensils or a shared cooking/storage environment. In order for food to be safe for someone with celiac disease, it must not come into contact with food containing gluten.

Places where cross-contact can occur:

Easily contaminated foods:


If In Doubt, Go Without!

       When unable to verify ingredients for a food item or if the ingredient list is unavailable do not eat it. Adopting a strict gluten-free diet is the only known treatment for those with gluten-related disorders.


1.     According to the FDA, if a food contains wheat starch, it may only be labeled gluten-free if that product has been processed to remove gluten, and tests to below 20 parts per million of gluten. With the enactment of this law on August 5th, 2014, individuals with celiac disease or gluten intolerance can be assured that a food containing wheat starch and labeled gluten-free contains no more than 20ppm of gluten. If a product labeled gluten-free contains wheat starch in the ingredient list, it must be followed by an asterisk explaining that the wheat has been processed sufficiently to adhere to the FDA requirements for gluten-free labeling.


What kinds of foods can I have?

       Look for the “Gluten Free” label. If it doesn’t have that, you’ll have to look at the ingredients. Wheat, rye and barley are obvious forms of gluten to avoid.   Oats do not have gluten, but they are often cross-contaminated with gluten, so it’s best to avoid oats unless it’s specifically stated that it doesn’t have gluten.

       There are many sources of gluten that it’s not at all obvious that it contains gluten. Soy sauce contains wheat unless it’s specifically made without wheat. Look out for malt, it’s usually made from barley and contains gluten.

       If the label says “May contain wheat” or “Processed in a facility that also processes wheat” use caution, as there is a high risk of cross-contamination.

       If gluten-free ingredients are used in a fryer that is used for gluten-containing ingredients, the food isn’t going to be gluten-free.

       Rice is gluten-free—even glutinous rice! In this case “glutinous” doesn’t refer to gluten, but to the rice being sticky. Buckwheat is, despite the name, not at all related to wheat and is gluten free. Sorghum is another gluten-free grain. Have it as an alternative to rice;  I like the flavor.



Generally, a gluten-free diet (GFD) is recommended for all patients with CD.  Immune stimulation occurs with the ingestion of gluten; therefore, all food components containing gluten and its derivatives must be eliminated from the diet.  Although this diet restriction and its compliance are challenging for most patients, adhering to GFD has shown improvement in symptoms and it promotes duodenal mucosa healing.  A study by Rubio-Tapia et al. showed mucosal recovery in about 35% and 66% of patients in two to six years after starting a GFD, respectively, with 82% of patients improving symptomatically.

Several studies tried to conclude a safe threshold for daily gluten intake. Catassi et al. showed that chronic exposure to small amounts of gliadin can cause a dose-dependent relapse of their symptoms, for example, the group that received 10 mg gliadin per day had minimal mucosal changes in jejunal histopathology, whereas another group that consumed 50 mg gliadin per day showed a significant histomorphology mucosal change. However, the debate on the tolerable threshold of gluten ingestion is still controversial.

Different studies showed that in some patients, complete resolution of symptoms and mucosal recovery could not be achieved even with a  GFD. These GFD non-responders might have gluten contamination or other concomitant pathologies including small-bowel bacterial overgrowth, lactose intolerance, functional bowel disorders, and microscopic colitis.

Several studies suggested that a strict GFD may help standard GFD non-responding CD patients. The concept of gluten contamination elimination diet (GCED), strict-GFD, was developed to remove the smallest amounts of gluten from the diet. The strictest dietary regimen focuses on the use of naturally gluten-free products rather than processed gluten-free food. In a study by Hollon et al. on 17 patients who did not respond to original GFD, the patients were started on a GCED and 82% of them were symptom-free after three to six months of GCED.


Refractory Celiac Disease refers to cases still showing continuous clinical symptoms and signs as well as histological evidence of villous atrophy despite adhering to a strict GFD for at least 12 months. Many clinicians recommend maintaining a lifelong strict GFD for all CD patients. Prolonged inflammation and mucosal damage in CD patients can contribute to an increase in lymphoproliferative disorder and can affect overall mortality. The risk of the development of malignancies such as enteropathy-associated T-cell lymphoma (EATL) has been reported.  This T-cell lymphoma originated from intraepithelial T-cells of the small intestine, which may result from higher and prolonged exposure to gluten and mucosal inflammation. Cases of small bowel adenocarcinoma are also reported in CD patients, but the exact pathogenesis is still unknown.

The GFD is still questionable in some patients, so the GFD approach should be targeted and individualized by patients. The data on GCED are limited in the current literature, but it is worth considering in patients who are non-responsive to traditional GFD. In addition to psychological problems, prolonged GFD can cause vitamin B deficiency and therefore, repletion regimens are required.

And while Rajagopal told John Hopkins that "there's no scientific evidence" that discontinuing gluten causes withdrawal, she said there is anecdotal evidence of trouble adjusting to a gluten-free diet. "Some people report feeling dizziness, nausea, extreme hunger, and even anxiety and depression when they suddenly go from eating a lot of gluten to being gluten-free," she said. "These symptoms usually go away after a few weeks on a gluten-free diet, but talk to your health care provider if they persist."


You may become deficient in other nutrients.

When you stop eating gluten, it's important to make sure you're getting enough whole grains, fiber, and other nutrients in your diet from other sources, say the experts at Johns Hopkins Medicine. "Getting enough whole grains in your diet is especially important if you're at risk for heart disease or diabetes," they write, noting that whole grains help reduce cholesterol levels and regulate blood sugar, and that certain foods that have gluten in them also contain "important vitamins and minerals, such as B vitamins, iron, and magnesium."

      Rajagopal said that for people who don't have celiac disease, removing highly processed foods from their diets, rather than those containing gluten, may be enough to resolve their symptoms—and points out that "a gluten-free label doesn't necessarily make a food healthy.  Some processed gluten-free foods contain high amounts of unhealthy ingredients such as sodium, sugar and fat. Consuming these foods can lead to weight gain, blood sugar swings, high blood pressure, and other problems."   


Long-Term Complications of Celiac Disease

       Untreated celiac disease is associated with long-term complications, including:

       It can also reduce quality of life, especially in people experiencing symptoms daily.


Can You Prevent Celiac Disease?

       Although researchers continue to search for ways to prevent celiac disease, currently, there is no proven method for prevention. Investigations into environmental risk factors have not uncovered a way to prevent the condition before it occurs.

       NexVax2, a desensitizing vaccine that works to restore the body's immune response to gluten, was being tested in clinical trials. Still, it has yet to be approved by the Food and Drug Association (FDA).

       Early detection and treatment can reduce the risk of complications, but researchers acknowledge that diagnosing celiac disease can be challenging.  Since celiac disease is genetic, it's important for family members to be screened for it, as well.


Frequent Symptoms

       The symptoms will vary considerably from person to person and are also significantly different for children and adults. Even symptoms in men and women may differ.

       Generally speaking, these are the most common celiac symptoms by age:




Abdominal pain and bloating


          X (chronic)










Weight loss















Iron-deficiency anemia*



Bone or joint pain; arthritis*



Bone loss*



Dermatitis herpetiformis 

       (a skin rash)*



Mouth ulcers*






Peripheral neuropathy*



Anxiety or depression*



Irregular menstrual cycle*






Pale, foul-smelling, or fatty

       (floating) stool



Mood changes, irritability



Damage to dental enamel

       (permanent teeth)



Slowed growth, short height, delayed puberty, failure to thrive



Attention deficit hyperactivity

     disorder (ADHD)




*Approximately half of adults with celiac disease have some of these non-digestive symptoms.


Digestive Symptoms

       Not everyone who's diagnosed with celiac disease experiences digestive symptoms, but many do. Still, these digestive symptoms can be subtle, and you might not necessarily associate them with celiac disease.

       Chronic diarrhea is one hallmark symptom of celiac disease, and it appears to affect half or more of those newly diagnosed. Frequently, the diarrhea is watery, smelly, and voluminous, and floats rather than sinks.

       However, plenty of people with celiac disease tend to have constipation rather than diarrhea, and some see their symptoms alternate between the two.

       Digestive symptoms can include diarrhea, constipation, heartburn, bloating, flatulence, nausea, and even vomiting in certain circumstances. People with celiac disease often are diagnosed with irritable bowel syndrome.

       In addition, other types of digestive symptoms can appear. For example, flatulence and excessive gas are common, as is abdominal bloating (many people describe themselves as looking pregnant). It's also common to have abdominal pain, which can be severe at times.

       Additional digestive symptoms of celiac disease can include heartburn and reflux (some people already have been told they have gastroesophageal reflux disease or GERD), nausea and vomiting, and lactose intolerance.

       Undiagnosed people with celiac disease sometimes develop pancreatitis or gallbladder disease, and many already have been diagnosed with irritable bowel syndrome (those IBS symptoms often lessen or disappear completely following a celiac disease diagnosis).

        In addition, not everyone loses weight as with undiagnosed celiac disease. In fact, many people find they gain weight prior to diagnosis. Some people report being absolutely unable to shed excess pounds, no matter how much they diet and exercise.


Neurological Symptoms

      Many people with undiagnosed celiac disease experience extreme fatigue that prevents them from performing everyday tasks and impacts their quality of life. Generally, fatigue seems to creep up on you, making it easy to blame it on getting older (as opposed to a treatable medical condition).

       At the same time, insomnia and other sleep disorders are very common in people with celiac disease. You're exhausted during the day, but then can't fall asleep or stay asleep at night.

In addition, many people with celiac disease get "brain fog" due to gluten. When you have brain fog, you have trouble thinking clearly. You might have trouble coming up with the right words to carry on an intelligent conversation, or you might misplace your car keys or fumble other common household tasks.4

          Some people newly diagnosed with celiac disease already have diagnoses of migraine headaches; in many cases (but not all), these headaches will lessen in severity and frequency or even clear up completely once you adopt a gluten-free diet.

       Psychological symptoms such as depression, anxiety, attention-deficit hyperactivity disorder (ADHD), and irritability occur frequently in people with undiagnosed celiac disease. In fact, long-diagnosed people with celiac disease often can tell they've been exposed to gluten when they become irritable—that symptom can appear within hours of exposure and linger for several days. In small children with celiac disease, sometimes irritability is the only symptom.

       Peripheral neuropathy, in which you experience numbness, a sensation of pins and needles, and potentially weakness in your extremities, is one of the most frequently reported neurological symptoms of celiac disease. In extremely rare cases, people are diagnosed with gluten ataxia, which is brain damage characterized by the loss of balance and coordination that's due to gluten consumption.

       Restless legs syndrome has also been reported as a common symptom of celiac disease.


Skin Disorders

       You might see signs of celiac disease in your largest organ: your skin. Up to one-fourth of people with celiac suffer from DERMATITIS HERPETIFORMIS (a.k.a. "the gluten rash"), an intensely itchy skin rash.

       People with celiac disease also may have a variety of other skin problems, including psoriasiseczemaalopecia areata (an autoimmune condition where you lose your hair), hives, and even such common problems as acne and dry skin. There's no firm evidence that gluten ingestion causes or contributes to these skin problems, but the gluten-free diet helps clear them up in some cases.

       If you have dermatitis herpetiformis plus positive celiac blood tests, you have celiac disease—no further testing required.

       Although dermatitis herpetiformis can form anywhere on your body, it is most frequently seen on extensor surfaces (areas of skin on the outside of a joint) such as the elbows, knees, buttocks, ankles, groin, lower back, and back of the neck.

The rash can be intensely itching and is often accompanied by a burning sensation.

The rash has distinctive reddish-purple, fluid-filled bumps.  The blisters can be as small as a pinhead or as large as a quarter-inch in size.

A dermatitis herpetiformis rash tends to come and go. During outbreaks, a person may be unable to resist scratching, which can leave behind purplish marks on the skin that can last for weeks or months.

It usually takes several days for the rash to heal, during which new bumps often develop nearby.

People with severe dermatitis herpetiformis often have continuously reddened, speckled skin where scar tissue has developed.


Treatment for DH

     Currently, the only long-term treatment for dermatitis herpetiformis {DH}is a gluten-free diet. 

The oral antibiotic dapsone may provide short-term relief but can cause significant side effects in some people, including nausea, vomiting, dizziness, blurred vision, insomnia, ringing in the ears, and anemia.  For this reason, dapsone is used sparingly to help bring the rash under a control.


Bone and Joint Symptoms

       Bone and joint issues such as osteoporosis, joint pain, bone pain, rheumatoid arthritis, and fibromyalgia also occur with regularity in those with celiac disease.

       It's not clear what the connection is; it may involve nutritional deficiencies related to the fact that celiac causes intestinal damage, which makes it difficult for you to absorb vitamins and minerals. In some cases, the gluten-free diet can alleviate pain from these conditions.


Dental Issues

       People with celiac disease often have terrible teeth and problematic gums. In adults with undiagnosed celiac disease, frequent cavities, eroding enamel, and other recurring dental problems can signal the condition. Children with undiagnosed celiac might have spots on their new teeth with no enamel, delayed eruption of their teeth (either baby or adult), and multiple cavities.

      Canker sores (also known as aphthous ulcers) occur in both adults and children with undiagnosed celiac disease (and in those already diagnosed who ingest gluten accidentally). These painful mouth sores frequently crop up on the inside of your lips in areas where you've had a very minor injury (such as a scratch from a sharp piece of food, a utensil, or your teeth). Once they start, they can take up to a week to subside.

       It's also not unusual to identify celiac disease in a person who haperiodontal disease or badly receding gums. In some cases, the gluten-free diet can help to reverse some of the damage that's been done.


Rare Symptoms

       You can find lists of over 200 different symptoms of celiac disease. It's actually very common to experience marked improvement in other, minor ailments you never would have imagined were related to celiac disease when you adopt a gluten-free lifestyle.

       It is now rare that children present with severe symptoms. These include chronic fatigue, very low blood pressure, electrolyte imbalances due to fluid loss in diarrhea, and abdominal obstruction.  In very

unusual adult cases, the first obvious sign that a patient has unrecognized celiac is non-Hodgkin lymphoma. Fortunately, this type of cancer is very rare, even in people who have had celiac symptoms for years but remained undiagnosed.


Complications/Sub-Group Indications

       People with celiac disease are at risk of developing malnutrition. You are unable to absorb enough nutrients due to the damage to your digestive tract. This can result in anemia and weight loss.

       Children with undiagnosed celiac disease often fall behind the growth curve, and this delayed growth or "failure to thrive" may be the only symptom of celiac disease in a child. If the child gets diagnosed prior to puberty and begins a strict gluten-free diet, she often can make up some or all of the height. Adults with longstanding undiagnosed celiac disease often are quite short.                                

       Osteoporosis, in which your bones become thin and weak, frequently appears in concert with celiac disease. When you have celiac you can't absorb the nutrients needed to keep your bones strong.

       Celiac disease can affect your hormones and other functions of your endocrine system, which controls everything from your reproductive system to your moods. In fact, celiac disease is found in 2% to 5% of patients with either thyroid disease or type 1 diabetes. The consequences can include poor absorption of thyroid hormone medications.  It is unclear whether these disorders stem from similar underlying causes or whether one leads to another.

       Reproductive health issues can be seen in celiac disease, including infertility in both women and menskipped periodslate puberty, and early menopause.  Women with celiac are significantly more likely than other women to experience pregnancy problems and repeated miscarriages.

       Celiac disease has differing effects on cancer risk. It may lower your risk of breast cancer, but raises the risk of cancer of the small intestine (a rare type of cancer), carcinoid tumors (a rare, slow-growing type of cancer that can occur in the digestive tract), and gastrointestinal stromal tumors (another rare form of cancer). It's not clear whether people with celiac disease have an increased risk for colon cancer.


A Word From Verywell

       Celiac disease is a lifelong condition. To avert long-term complications, you must follow a strict gluten-free diet.  However, you'll probably be pretty happy to learn that doing so generally resolves most or all of your symptoms. You may even notice many minor health complaints disappearing once you're diagnosed and on a gluten-free diet.



·       What protein causes symptoms of celiac disease?

       A protein called gluten causes damage to the small intestine that eventually leads to celiac disease symptoms. Gluten is a protein in a variety of grains—among them wheat, barley, rye, durum, semolina, spelt, farina, and farro. Gluten helps foods hold their shape, which is why it's key to the formation of foods like bread and pasta.19


·       How soon do celiac disease symptoms appear after eating gluten?

       Certain symptoms of celiac disease can occur very quickly after eating gluten. In one study, 92% of people with the condition experienced an increase in interleukin-2, a protein associated with the immune response, within an hour of eating gluten. The most common symptoms in this group were nausea and vomiting, rather than the diarrhea, bloating, and abdominal pain most often associated with celiac disease flares.  The symptoms may appear


·       How does celiac disease affect the skin?

       Celiac disease can cause a variety of skin conditions, including psoriasis, an itchy rash called dermatitis herpetiformis, and blisters.   Some people also develop canker sores inside their mouths.


·       What does a celiac disease bowel movement look like?

       Stool caused by celiac disease tends to be loose, foul-smelling, and pale.  It also contains a lot of fat, which is known as steatorrhea. It's a sign your digestive system isn't breaking down the food you eat properly and your body isn't absorbing the nutrients it needs.


·       Are celiac disease symptoms different for children than for adults?

       Children, including babies, are more likely than adults to have diarrhea, vomiting, bloating, and other digestive symptoms. Only a third of adults with celiac disease have diarrhea and most are more likely to have anemia, fatigue, and bone and joint problems such as pain, arthritis, and osteoporosis.


·       How does removing gluten from the diet eliminate symptoms of celiac disease?

       When you stop eating foods that contain gluten, you prevent further damage to the villi in your small intestine that are responsible for your symptoms. Doing so will not repair the damage already done but it will prevent flare-ups of symptoms. Many people with celiac disease say they start feeling better within days of cutting gluten from their diet.


·       What are the symptoms of non-celiac gluten sensitivity?

       People who have non-celiac gluten sensitivity (NCGS) have symptoms similar to those of celiac disease but do not test positive for the condition. The same is true for non-celiac wheat sensitivity (NCWS), which is an allergy to wheat. Among the common symptoms of both, which occur when gluten is eaten, are diarrhea or constipation, abdominal pain and bloating, headaches, joint pain, inability to focus and concentrate, and persistent tiredness.

·       What are the symptoms of silent celiac disease?

       Silent celiac disease is an informal term for asymptomatic celiac disease. It's different from classical celiac disease and non-classical celiac disease in that a person doesn't experience overt symptoms as a result of damage to the cilia in the small intestine. That said, people who have asymptomatic celiac disease say they notice they feel better overall and have fewer mild digestive issues such as bloating and gas when they stop eating gluten.



       Celiac disease is caused by specific genes, eating gluten, and possibly by some other triggers such as childbirth, surgery, stress, or other autoimmune disorders. However, medical science is still working to understand the roles of these potential causal factors.

       So far, neither breastfeeding nor when gluten is introduced to a baby's diet have been shown to play roles in childhood celiac disease.  It's usually not clear what triggers celiac later in life.




·       Does stress cause celiac disease?

       Yes, it appears that stress plays a role in triggering celiac and some other auto-immune disorders.    In one study, people with celiac disease reported stressful life events in the year before their diagnosis.  Pregnancy was a common stressor.


·       What foods cause celiac disease?

       Any food containing gluten can trigger celiac disease in a genetically susceptible person. Bread, pasta, pizza, and other foods made with wheat or some other grains may immediately come to mind.  But gluten is in less obvious places, including:

o   Malt (in beer and vinegar)

o   Brewer's yeast

o   Lip balm

o   Nutritional supplements  (Although many supplements have good labels re gluten-freeness)

o   Play dough

What Triggers Celiac Disease Later in Life?

       Factors that trigger celiac disease later in life are not yet understood, but some trends have emerged. Some people report symptoms developing soon after:

       Researchers are also looking into whether some viral illnesses might trigger some cases of celiac.


How Celiac Disease Is Diagnosed


Gluten Exposure

     It's hard not to be exposed to gluten due to the widespread use of wheat and other gluten-containing grains in the Western diet. They're in:

       With more awareness of celiac disease and non-celiac gluten sensitivity, a wide array of gluten-free products now exist. That makes it easier to avoid problem foods.


Early Gluten Exposure

       Experts can't say for sure whether early gluten exposure triggers celiac disease in some children who carry the genes.

       Ongoing research is examining whether feeding patterns in the first year of life make a difference in developing celiac. So far, they've found no associations with breastfeeding or when gluten is first introduced to the diet.

       Weak evidence suggests that if a genetically prone child eats a lot of gluten around the time they're weaned from the breast or bottle, it might increase their celiac disease risk.


Celiac Disease Risk Factors

       Besides genetics, health-related risk factors for celiac disease include having:

        The disease is also more common in people assigned female at birth (AFAB) and in people of northern European ancestry.

        Some people contend that the rise in celiac disease and non-celiac gluten sensitivity is tied to genetically modified wheat. However, genetically modified wheat isn't on the market anywhere, so it can't be causing the increase.




       Celiac disease is caused by specific genes, eating gluten, and possibly by some other triggers such as childbirth, surgery, stress, or other autoimmune disorders. However, medical science is still working to understand the roles of these potential causal factors.

       So far, neither breastfeeding nor when gluten is introduced to a baby's diet have been shown to play roles in childhood celiac disease. It's usually not clear what triggers celiac later in life.




·       Does stress cause celiac disease?

       Yes, it appears that stress plays a role in triggering celiac and some other autoimmune disorders.  In one study, people with celiac disease reported stressful life events in the year before their diagnosis. Pregnancy was a common stressor.


·       What foods cause celiac disease?

        Any food containing gluten can trigger celiac disease in a genetically susceptible person. Bread, pasta, pizza, and other foods made with wheat or some other grains may immediately come to mind.

       But gluten is in less obvious places, including:

o   Malt (in beer and vinegar)

o   Brewer's yeast

o   Lip balm

o   Nutritional supplements  (although labels should help you avoid gluten and wheat)

o   Play dough




       Information and self-education ideally expedite the entire process, but there are dangers of not adapting your diet after you obtain a diagnosis.

       "Constant exposure to gluten can make the disease progressively more aggressive," said Joseph Shami, M.D., a gastroenterologist with Gastroenterology Associates of New Jersey. "[Symptoms range] anywhere from general malaise to abdominal pain, headaches, rashes, joint pains, diarrhea, weight loss, anemia, confusion. There has been one published report of a fatal case. However, fatal diseases can develop from untreated celiac disease."

       In the long term, untreated CD can foster malnutrition and lead to osteoporosis. There's also a connection between untreated celiac disease and certain types of cancer, such as a rare non-Hodgkin lymphoma called enteropathy-associated T-cell lymphoma (EATL) and adenocarcinoma of the small intestine.

       Neurological consequences of untreated celiac disease include gluten ataxia and peripheral neuropathy. Ataxia can emerge as the disease damages the cerebellum, resulting in a loss of coordination. Peripheral neuropathy is the numbing and tingling of body parts.   These two conditions, numbness and clumsiness, can compound each other and could lead to dangerous falls. With osteoporosis in the mix, the consequences can be dire.

       Celiac disease is a shape-shifting disease that is sometimes even invisible.  Open and honest communication with your healthcare professional  team (physician and dietitian) is essential in diagnosing the condition before it can cause damage to the small intestine and beyond.

       If you don't have a doctor you see regularly, you should find one, especially if you're experiencing symptoms. Fortunately, telehealth makes it easy to connect with a doctor who can answer your questions and evaluate your situation. Many physicians offer video visits, which are a good way to see a doctor quickly. And if follow-up testing is required, you've established a relationship.





-- Good For You Gluten Free --


       I was reading an article that shared this fun fact: 20 to 50% of people with celiac disease don't follow a strict gluten-free diet.  This number felt high to me, but after I did some digging, I think it's more accurate than I'd like to admit.

       So why is the rate of non-compliance with the GFD so high?

       The only treatment for the autoimmune disorder is a strict, lifelong gluten-free diet.

        Every time a person with celiac disease eats gluten, a protein found in wheat, rye, and barley, their immune system becomes confused and attacks the healthy tissue surrounding the small intestine.

       For some people, this leads to a slew of painful and annoying symptoms, including gastrointestinal disorders, serious skin disorders, growth issues in children, chronic fatigue, low bone density, various brain disorders, and more.

       One expert suggests the rates of non-compliance with the gluten-free diet might be as high as 20 to 50 percent. This number sounded high to me, so I did a little digging and found a few other data points that suggest the rate of non-compliance is just as high or higher.

·      Researchers analyzed six studies about gluten-free dietary compliance; they found that adherence rates ranged from 45 to 90 percent. In other words, 10 to 55 percent were non-compliant!

·      survey of adults with celiac disease found that only 65 percent admit to “fully” adhering to the gluten-free diet, 31 percent say they are “partially” adhering, and 4 percent admit they don’t adhere to the gluten-free diet at all.

       While many people with celiac disease can’t imagine eating gluten ever again; for others, compliance is not an easy feat and one influenced by a number of environmental and socioeconomic factors.


Why Low GFD Adherence Rates?

       Dietary adherence among celiac patients can be influenced by several factors, including:

·       The high burden of strict compliance.

·       The complexities of label reading and keeping up with sometimes contradictory dietary guidelines.

·       The high cost of gluten-free food.

·       Lack of availability of gluten-free food.

·       The low perceived benefits, especially for those with asymptomatic celiac or less impactful symptoms when they eat gluten.

·       Age at diagnosis.

·       Lack of support from family, friends, or even a local celiac group.

       Below, I discuss what I see as the three main reasons why some celiac patients choose not to follow a gluten-free diet, of course, at the risk of their health outcomes.


Reason #1: High Burden Associated with a Gluten-Free Lifestyle

        One reason people with celiac disease are not fully compliant is likely due to the high burden associated with following a strict gluten-free diet.

       Full compliance requires individuals to turn their lives upside-down, and several studies conclude that a gluten-free diet may lower one’s quality of life despite helping to improve their health outcomes.  This is why a gluten-free diet is a Catch-22 for celiac patients.

       On the one hand, if they want to feel physically better and put their symptoms into remission, they must follow a strict gluten-free diet.

        On the other hand, strict adherence can significantly reduce their quality of life. For example, people with celiac disease must learn how to read food labels for hidden gluten, plan their meals ahead of time, learn how to cook, and significantly reduce their reliance on eating out.

       They are also forced to discuss their disorder repeatedly when they eat at restaurants, attend professional and social events, and travel – no more spontaneous weekend getaways or planning a dinner on a whim at a friend’s house.

       Such experiences can feel humbling, isolating, embarrassing, and even attention-seeking, even though people with celiac disease don’t want to bring attention to their disease time and time again. Who wants to discuss their “disease” with every waiter they meet?!?

       Furthermore, people with celiac disease fear being put in situations where they have little control over the preparation of their food, making the burden too heavy for some.

       It’s in these moments when they need to decide if they want to advocate for what they need, not eat at all, or take a risk by eating what’s provided and hoping for the best. Some will even willingly cheat on their “diet” to fit in and not make a fuss.  (Please don’t!)

      In a survey of single British people, 44 percent said they perceive those on a gluten-free diet as “high-maintenance,” which might as well be a code word for “undateable.”  Understandably, some people sensitive to what others might think of their dietary restrictions wouldn’t want to bring attention to it on a first date.

        Plus, it can still go wrong even when someone advocates for what they need. An inmate with celiac disease died because prison officials didn’t take her diet seriously despite her pleas for a safe meal.

       Many people eat out and still get accidentally glutened. One study found that approximately 18 percent of celiac disease patients were found to have gluten traces in their stool.


Reason #2: High Cost of Gluten-Free Food

       The high cost of gluten-free food may also affect a person’s ability to fully comply with the gluten-free lifestyle. Most gluten-free products cost 2-3 times more than their non-GF counterparts, which can be a deterrent for those struggling to make ends meet.

       One study found that people with celiac disease that come from “an affluent background” and have a “university education” are more likely to adhere to a gluten-free diet, likely because of their ability to seek nutrition help and pay for gluten-free food.

       Another study found that people from high-income backgrounds also experienced better overall health outcomes and fewer symptoms.


Reason #3: Low Perceived Benefits

       Another reason some celiac patients don’t fully adhere to the gluten-free diet is they don’t have symptoms bothersome enough to incentivize them to do so, or they may not have any symptoms in the first place (asymptomatic or silent celiac).

       Sixty percent of children and 41 percent of adults diagnosed with celiac disease are asymptomatic (without any symptoms) even though they experience the same intestinal damage (villous atrophy) as symptomatic celiacs.

       Without symptoms, it’s understandable why this segment of the celiac population may not feel they need to tackle a burdensome gluten-free diet, given they don’t feel there are any symptoms to alleviate.




Celiacs SHOULD Follow a Strict Gluten Free Diet

      This article offers insights into why some people find a gluten-free diet too difficult to follow in the way it needs to be followed.   However, it’s not an article giving people with celiac disease permission or justification for eating gluten.   In fact, a gluten-free diet is absolutely necessary for people with celiac disease and should not be ignored.

       Doctors and nutrition professionals should strongly encourage people with celiac disease to fully comply with a gluten-free diet despite the high burden and high costs associated with the lifestyle.

       Even people with asymptomatic celiac put their lives at risk every time they eat gluten because regardless of symptoms, gluten damages their body, impairs nutrient absorption, creates persistent inflammation, and eventually, like a leaky faucet, leads to irreparable damage, health complications, and early death.

     Of course, celiac patients must carefully balance dietary vigilance with quality of life. They must not restrict themselves beyond what is necessary.

       For example, there’s no need for someone with celiac disease to go on endless elimination diets, or the FODAP diet, which are meant to be temporary. They must avoid diet culture fads like keto, paleo, and no-carb diets that restrict their diet beyond what’s necessary.

        To encourage dietary vigilance, gluten-free dietitians and nutritionists should be careful not to push or promote the elimination of all grains, dairy, sugar, and other foods. They also should be mindful of their stance on oats, as there are many alarmist calls for celiac patients to steer clear of oats, even if they’re labeled “gluten-free.”

       Eliminating gluten is one thing, but adding another food group to avoid the mix is an unnecessary restriction that should only be encouraged when other interventions fail or when the patient has a proven allergy or intolerance to that food.  Beyond gluten, another common allergen is dairy, then soy.

        Finally, eating gluten despite having celiac disease is someone choosing to harm their body deliberately, and that’s not okay.  While these people should not be judged or admonished, interventions should be considered to help them correct their ways.

       Understandably, they may need to seek nutrition coaching or mental health counseling to help them “do” gluten free in a way that works for their lifestyle. This is a treatable disorder that requires ongoing nutritional and mental health support.

       The bottom line is that it’s important that people with celiac disease are mindful of what’s at the end of their fork.

       The food they eat (and don’t eat) can help them live a long, healthy life free from disease, or it can slowly chip away at their health, force them to live in a prolonged state of mortality, and even lead to an untimely death.

       The choice is personal, but the truth is most people need to consider if they’re willing to pay now or pay later.




By Sarah Bence; Updated on November 08, 2023

Medically reviewed by Melissa Nieves, LND



Table of Contents

       Gluten intolerance and celiac disease are different conditions with similar symptoms. Celiac is an autoimmune disease in which the body's immune system destroys the lining of the small intestine when you consume gluten. Gluten intolerance is when you react negatively to gluten but do not have autoimmune markers, which are indicated on blood tests. The only way to differentiate gluten intolerance from celiac is with proper diagnosis and testing.   In this article, learn more about gluten intolerance and how it differs from celiac disease.

Gluten Intolerance, Non-Celiac, and Sensitivity: Terms to Know 

       Gluten intolerance is also known by the terms "non-celiac gluten sensitivity" or "gluten sensitivity." All of these terms refer to the same condition.

       When someone reacts negatively to gluten but does not have the autoimmune response that is characteristic of celiac disease, nor the allergic reaction that is characteristic of wheat allergy, they may be diagnosed with gluten intolerance (non-celiac gluten sensitivity).  


Gluten Intolerance

·       Not autoimmune

·       No damage to small intestine

·       No identified biological markers

·       Symptoms triggered by consuming gluten

·       Treated with a gluten-free diet


Celiac Disease

·       Autoimmune

·       Causes damage to small intestine

·       Genetic

·       Symptoms triggered by consuming gluten

·       Treated with a gluten-free diet



       Gluten intolerance shares the same symptoms as celiac disease. These symptoms can be gastrointestinal and non-gastrointestinal.

       Symptoms of gluten intolerance include:

       Everyone's experience of gluten intolerance is different. For some people, the first signs of gluten intolerance are bloating or diarrhea after a big pasta meal. For others, it may be fatigue, brain fog, or depression that comes on gradually and is more challenging to associate with eating a specific meal.


Causes and Risk Factors of Gluten Intolerance

       Scientists and medical providers don't fully understand the cause of gluten intolerance, and this is an active area of research. According to some researchers, gluten intolerance results from an immune response in some people when they consume gluten.2 However, not all scientists agree.


If You Think You Have Gluten Intolerance: Self-Guided Questions

       If you think that your body is having a negative reaction to gluten, consider starting a symptom diary. In it, record what you eat and the symptoms that result.

       Self-guided questions to ask yourself regarding gluten intolerance and celiac disease include:


Common Intolerance-Causing Gluten Foods 

       Gluten is a protein found in wheat, barley, and rye; it is prevalent in the Western diet.  Most people consume gluten every single day in varying amounts.

Here are some of the most common gluten-containing foods:


How Providers Diagnose Gluten Intolerance 

        The only way to differentiate gluten intolerance from celiac disease or wheat allergy is to go through the proper diagnostic process to rule out those conditions first.

       Testing typically involves the following:

        People with gluten intolerance will test negative on blood tests and biopsies. However, they still have a suspected response to eating gluten.

       If you have a negative blood test, your healthcare provider may guide you through an elimination diet or gluten challenge to confirm that your symptoms are truly coming from eating gluten and not something else. A dietitian and gastroenterologist specializing in gluten-related disorders can help you with this.


Continue Eating Gluten Before Testing

       Celiac disease tests only work accurately if you have gluten in your system, so continue eating gluten before getting tested. If you go gluten-free before testing, you may get a false negative result.

         For accurate testing, you would have to start eating gluten again, which could cause symptoms. For this reason, some people with gluten intolerance may not know if they have celiac disease or not.


Treatment for Gluten Intolerance Side Effects

      As with celiac disease, the only medical treatment for gluten intolerance is to follow gluten-free diet.   However, the degree of strictness of this gluten-free diet may differ for people with gluten intolerance vs. people with celiac.

      People with celiac disease must avoid all cross-contact with gluten since microscopic amounts can trigger an autoimmune response and damage the small intestine, even without symptoms. This means using clean cutting boards and utensils, clean water to boil gluten-free pasta, uncontaminated frying oil, and more.

       People with gluten intolerance do not have the same internal damage when they eat gluten. As such, minimal gluten consumption is acceptable up to the point that it causes symptoms.   For this reason, someone with gluten intolerance may be able to tolerate amounts of cross-contact.



How to Eat Less Gluten (Plus Gluten-Free Alternatives)

        Going gluten-free doesn't mean you must cut out your favorite foods. These days, there are many gluten-free alternatives on the market for your favorite breads, pastas, cakes, cookies, and more.

       Gluten-free foods will probably taste different from what you're used to, but for most people, it's worth feeling better.

       There are also many hidden sources of gluten, from ingredients including (but not limited to) the following:4

        You will have to learn how to read labels and recognize gluten-containing ingredients.

       It's normal to struggle to adjust to a gluten-free diet. It is hard to learn an entirely new way of eating and living. Consider seeing a dietitian who specializes in the gluten-free diet to help you with this process.







Foods That May Contain Gluten

       These foods must be verified by reading the label or checking with the manufacturer/kitchen staff.


       Most distilled alcoholic beverages and vinegars are gluten-free. These distilled products do not contain any harmful gluten peptides even if they are made from gluten-containing grains. Research indicates that the gluten peptide is too large to carry over in the distillation process, leaving the resulting liquid gluten-free. However, some types of alcoholic beverages do contain an unsafe amount of gluten for people with celiac disease, and include those with added color or flavoring such as dessert wines, and those made from barley malt, such as bottled wine coolers. For these, consumers should check the label, and if in doubt, contact the company. Beers, ales, lagers, malt beverages and malt vinegars that are made from gluten-containing grains are not distilled and therefore are not gluten-free. There are several brands of gluten-free beers available in the United States and abroad.


Other Items That Must Be Verified By Reading The Label Or Checking With The Manufacturer



        Gluten intolerance is different from celiac disease because there is no autoimmune process. However, people with gluten intolerance can have all the same symptoms as celiac, including bloating, nausea, vomiting, diarrhea, skin rashes, constipation, brain fog, and more. The only treatment for gluten intolerance and celiac disease is a gluten-free diet.



       If you’ve already looked up anything on the subject of foods that trigger IBS (Irritable Bowel Syndrome) attacks, then you know the foods that most people tell you to avoid – greasy foods, alcohol, caffeine, spicy foods, and you’ve probably heard about high FODMAP foods too. If not, no worries. We’ll cover them all here.

       But if you’re like most people, avoiding those things hasn’t stopped your IBS attacks.  It may have helped some, but it probably wasn’t the answer that you really wanted. And there is a very good reason for that.

       Once your digestive system is compromised and you have IBS, it becomes clear that there are certain foods that are usually more difficult to digest than others. These are the foods that are more likely to trigger an IBS attack. These are greasy foods, alcohol, caffeine, spicy foods, heavy proteins, raw foods, and high fodmap foods.

       So if you cut them out, you might feel a little better. But those foods weren’t the things that caused your IBS in the first place. They are only irritating an already irritated digestive tract. And avoiding them may help, but it won’t solve your IBS.

       But why are those foods so problematic? Let’s examine raw foods like salads and nuts, first. These foods require a lot of energy to break down. You have to chew them really well, and even then they require a lot more work to digest than processed food. That’s good when you want to eat healthy. It’s bad when you have a compromised digestive system.

        The same is true for greasy foods, and for big proteins like read meat. They require more work to digest and absorb too. Not a big deal if your digestion is good, but wreaks havoc if you have IBS.

       Processed foods and soft foods like soups and smoothies are super easy to digest. All of that processing and/or cooking has basically already broken down those foods for you. All you have to do is chew them and they fall apart and then you can swallow them. That is very easy on your digestive system.

       And alcohol, caffeine, and spicy foods are always hard on your digestive tract. But when your digestion is working well, it can deal with those. When it’s not working well, it can’t.


What To Eat During An IBS Flare Up?

       There are two ways of looking at this. One is to try to minimize the flare up by doing what is statistically helpful, meaning that some people feel better when they do it. You can do that. We will discuss it and how to do it. And you will probably feel better. But it will only be temporary, and it won’t cure your problem.

       The other way to figure out what foods to eat during an IBS attack is to find out exactly what is causing your IBS in the first place and then stop having flare-ups altogether. The latter option may sound impossible. It’s not, and we’ll talk about both options.

       We’ll start with things to eat or not eat that can help with an IBS flare up.




The Low FODMAP Diet for an IBS Flare Up

       The latest fad diet for IBS (and there have been many before it and will be many after it, that’s why I call it a fad) is the low FODMAP diet. Just because it’s a fad doesn’t mean that you shouldn’t try it. But know that it only helps a small percentage of people.

       FODMAP is an acronym for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, which are short-chain carbohydrates.  This is a really fancy way of saying that there are different types of carbohydrate molecules in foods, some of which you may have a problem digesting. Some foods have more of these molecules than others.


The foods that you need to avoid during a low FODMAP diet include the following:

§  Wheat (that includes pasta)

§  Milk

§  Yogurt

§  Soft cheeses

§  Soy milk

§  Coconut milk

§  Apples

§  Pears

§  Garlic

§  Onions

§  Mushrooms

§  Beans

§  Anything with high fructose corn syrup in it


The foods that you CAN eat, that are low in FODMAPs, include the following:

·      Beef

·      Chicken

·      Pork

·      Turkey

·      Fish

·      Egg

·      Tofu

·      Corn

·      Oats

·      Rice

·      Potato

·      Quinoa

·      Sourdough bread

·      Bananas (unripe)

·      Oranges

·      Grapes

·      Lettuce

·      Carrots

·      Broccoli

·      Cucumber

·      Spinach

·      Tomato

·      Lactose free ice cream

·      Wine

·      Beer

·      Spirits

·      Coffee

·      Sucrose sweetened things

       These lists aren’t conclusive, but they are a really good start and hit most of the highlights of the low FODMAP diet.


The Best Diet For An IBS Flare-Up

       In our experience the best way to approach any discussion of foods that trigger an IBS attack is not about focusing on whether or not they are high or low FODMAP foods, it’s to divide them into foods that are commonly the cause of digestive problems and foods that are more difficult to digest when you have an IBS flare up.

       The goal is to give your digestive system a mini vacation, so that it can relax and heal. You don’t want to challenge it with anything that will cause it to work hard.

       You can go easy on your digestive track by keeping any food intake very simple and soft. You want everything you eat to either be well cooked and/or already broken down. For example, all of your food should be in the form of a smoothie or a soup.  No digestive work required.


Don’t eat any of the following:

·      Raw foods (like salads)

·      Fruits with skins (like apples)

·      Nuts

·      Fatty/greasy foods

·      Steak

·      Whole grains

·      Brown rice


Also don’t eat:

·      Sugar

·      Caffeine

·      Spicy food

·      Alcohol

All of these things will irritate an already irritated digestive tract.


And finally, don’t eat:

·      Dairy

·      Gluten

These are two of the most common causes of digestive problems.


Foods To Help An IBS Flare Up

       Up to this point we’ve been primarily discussing foods to avoid that can trigger an IBS flare up, not foods to eat. So here we’ll switch gears and focus on foods to eat during an IBS attack.

       What you CAN eat is virtually everything else not in our list above, as long as it is well cooked, cut into small pieces, or even better, made into a soup or a smoothie to make it super easy to digest.

        You want to eat foods that are basically already broken down, so that your digestive system can go on that well deserved vacation that it needs in order to recover from the stress it’s been under.


DO eat:

·      Gluten-free Smoothies (But not sweet ones. Go easy on the fruit too.)

·      Soups  (GF)

·      Cooked vegetables (almost to the point of being overcooked)

·      Mashed potatoes (no dairy)

·      White rice

·      Fish (grilled or baked and cut into nice small pieces)

·      Chicken (baked and cut into nice small pieces)

      And chew everything (that isn’t a soup or smoothie) really well!  You’ve heard the old adage to “chew your food.”  This is why! It will reduce the amount of work that the rest of your digestive system has to do.

       Do those things for a couple of days or so and there is a good chance that you’ll start to feel better soon after an IBS attack.


Preventing IBS Attacks From Ever Happening Again

       The ideal goal is to prevent IBS attacks from occurring, so that you don’t have to suffer through them and worry about the super restrictive diets we just went over. That is certainly our goal for all of our patients at the IBS Treatment Center.

       They first key to accomplishing this is to see an IBS specialist. Most people confuse this person with a gastroenterologist, but they are two very different specialties. An IBS specialist only treats IBS.  They are very rare, but they do exist. Gastroenterologists do a whole lot of other things, but they don’t go very deep into IBS.

       Up till now everything that we’ve talked about is very generic and broad stroke. It may help you, but it’s probably not going to cure your problem.  An IBS specialist can help you figure out exactly what is weakening your digestive system and what is triggering your IBS attacks. And they can fine tune all of the above dietary advice into a much more specific and dialed in treatment plan.

         That’s the difference between reading about IBS online and getting treatments customized to your body. There are some things that can’t be solved by reading about them online or watching videos. This is unfortunately one of them. But I hope that what I’ve covered here helps you feel at least somewhat better sooner rather than later.



Can you tell what foods trigger your IBS?

Dr. Stephen Wangen is the award winning author of two books on solving digestive disorders, and a nationally recognized speaker on IBS. He has been on ABC, NBC, and Fox as well as public radio. He was recently named one of Seattle’s Top Doctors by Seattle Magazine.

Seattle IBS TREATMENT CENTER, 6100 219th St. SW, Suite 480;

   Mountainlake Terrace, WA 98043;  206/264-1111






Living with Celiac Disease: A Guide to a Gluten-Free Lifestyle

Divya Singh; July 14, 2023

       Celiac disease is an autoimmune disease that attacks your small intestine, and as a result, the body is unable to absorb nutrients properly.  When someone with celiac disease consumes gluten, their gut becomes inflamed. The small intestine is gradually harmed by repeated exposure, which can cause issues with food's ability to absorb minerals and nutrients.

      Around 1 in 100 people globally have this disease, and many more do not even realize they do. There could be 2.5 million undiscovered cases of celiac disease in the US.

Common Symptoms of Celiac Disease

       This autoimmune disease affects the digestive system. Here’s a list of common symptoms which may vary from person to person in severity:


Unusual Symptoms of Celiac Disease

       Even though they might not be as well-known as the typical gastrointestinal ones, the symptoms of this autoimmune disease may still be present, therefore it is important to be aware of them.

1) Dermatological issues: 

Dermatitis Herpetiformis

        A skin disorder known as dermatitis herpetiformis causes itchy, blistering rashes. It is a particular symptom of this autoimmune disease that frequently affects the scalp, buttocks, elbows, and knees.

Alopecia areata

       Some people may also experience this condition, alopecia areata, which is marked by sudden hair loss in patches. 


2) Bone and joint problems

Osteoporosis or osteopenia

Celiac disease can obstruct calcium and vitamin D absorption, resulting in fragile and brittle bones.


Joint inflammation and pain

       Some people with this autoimmune disease may develop joint pain, swollen joints, or symptoms resembling arthritis.


3) Iron deficiency anemia

       Malabsorption of nutrients, including iron, can result from this autoimmune disease. Anemia due to iron shortage can cause shortness of breath, weakness, pale skin, and exhaustion.

Is Celiac Disease Genetic?

       Yes, there is a large hereditary component to celiac disease. It is an autoimmune condition that is brought on by consuming gluten, but it also requires a particular genetic propensity. The presence of specific human leukocyte antigen (HLA) genes, particularly the HLA-DQ2 and HLA-DQ8 genes, is the main genetic component linked to this disease.

      The HLA-DQ2 or HLA-DQ8 gene is present in around 95% of people with this autoimmune disease, whereas the other 5% may have other, less frequent HLA gene variations. Keep in mind that not everyone who possesses these genetic markers will experience the disease. These genes raise the risk of the illness occurring, but they do not ensure that it will.


Foods To Avoid with Celiac Disease

       When you consume gluten-containing foods while suffering from this autoimmune disease, your body reacts in an abnormal way. Your small intestine starts to experience discomfort as a result of your immune system, which battles sickness. Your small intestine's lining is attacked, including the microscopic bumps (villi).

       Gluten free diet is recommended to manage the symptoms.  Gluten-containing foods must be strictly avoided by people with this autoimmune disease since even trace amounts of gluten can cause symptoms and harm the small intestine. A few common foods and ingredients to stay away from are listed below:

Wheat and wheat products: Bread, cakes, cookies, semolina, durum wheat, etc.

Barley: Barley flour, barley malt, malted drinks, etc.

Rye: Rye flour, rye bread, and other rye products

       It is crucial to carefully study ingredient labels and check packaged products for "gluten-free" certifications.  In order to avoid cross-contamination, it is important to make sure that gluten-free foods are not prepared or cooked with gluten-containing items.

       Understanding which foods to avoid and how to live a successful gluten-free lifestyle can be greatly aided by speaking with a qualified dietitian who specializes in celiac and gluten-free diets.



By Kyle Umipig; July 31, 2023


       Meal preparation for those with gluten sensitivities has become essential to leading a healthy and full life in a society where dietary restrictions are becoming increasingly common. 

       People with celiac disease or gluten sensitivity may experience negative responses to the protein gluten, which is present in wheat, barley and rye. 

       This thorough beginner’s guide aims to reveal gluten-free meal planning by giving you the information and resources you need to make delicious and healthy meals. 

       This guide covers everything, including how to deal with eating out and handle social situations as well as the basics of gluten-free foods. 

       You can experience better digestion, more energy and general well-being by adopting gluten-free meal planning. 

       Prepare to go off on a life-changing journey of culinary discovery and self-care and full life in a society where dietary restrictions are becoming increasingly common. 



       Embarking on a gluten-free meal planning journey can seem daunting at first, but with the right approach, it becomes a rewarding and fulfilling experience. 

      Here are essential steps to help you get started:                                                                                             

Assess your dietary needs and goals

       Consider your specific dietary needs and goals before starting a gluten-free food plan. Consider any particular dietary restrictions, health issues and lifestyle considerations that may affect your meal planning decisions.  For instance, your approach to meal planning will be more strict if you have celiac disease, gluten sensitivity or any other medical condition connected to gluten.



       It might be extremely helpful to get advice from a healthcare practitioner or a qualified dietitian who specializes in gluten-free diets, especially if you have specific conditions or medical problems.  It may be

helpful to write down what you generally have for breakfast, lunch, and dinners before you have the consultation with the dietitian.

       They may offer professional guidance, respond to any worries or inquiries you might have and assist you in developing a well-rounded food plan that satisfies your nutritional needs.

       In order to maintain a balanced diet, a healthcare provider or dietician can assist you in detecting any nutrient deficits that may result from eliminating gluten and will offer adequate substitutes. 

       Additionally, they can offer advice on serving quantities, suggested dietary categories and any required supplements. 

       You may approach your gluten-free meal planning journey with assurance and clarity if you consult with a professional.

Create a gluten-free pantry

       A key component of effective meal planning is creating a gluten-free pantry. 

       Eliminate any gluten-containing items from your pantry and replace them with gluten-free options. 

       Cooking delicious and varied gluten-free meals will be easier if your pantry is stocked with gluten-free essentials.

       Grain alternatives to wheat-based grains, such as quinoa, rice, millet and cornmeal, are some pantry staples for people following a gluten-free diet. 

       Almond, coconut and tapioca flours, all of which do not have gluten, can be used in baking and cooking. 

       To fulfill your pasta needs, try gluten-free pasta made from rice, quinoa or lentils. Gluten-free lasagna noodles are available.

        Stock up on gluten-free sauces, condiments and spices as well to make your meals taste even better.


What are the essential ingredients for gluten-free cooking?

       When it comes to gluten-free cooking, it’s important to have a well-stocked pantry with essential ingredients that can serve as alternatives to gluten-containing foods. 

       Here are some key ingredients to include in your gluten-free cooking arsenal:


Gluten-free grains and flours

       Bread, classic sweets and noodles are among familiar foods that use flour or grain. It’s frequently used in soups and sauces as a thickening agent.

       Though generally not an issue, these two kinds of flour should not be consumed by anyone who has celiac disease, non-celiac gluten sensitivity, or who must avoid gluten for other reasons. 

       You can try the following gluten-free flour and grain alternatives:


       It may be used as a side dish, in salads, or as a base for stir-fries and risottos. Rice is a versatile gluten-free grain. Different flavors and textures may be found in varieties of rice such white rice, brown rice, basmati rice and wild rice.


       A grain that cooks quickly, quinoa, is packed with nutrients, and tastes great in salads, grain bowls and pilafs. It is a good source of complete protein and gives food a pleasing texture.


       It is possible to use corn in a variety of ways, such as cornmeal, cornstarch and corn flour. Corn flour and cornstarch may be used as thickeners in sauces and mixes, while cornmeal is excellent for baking cornbread.  (Corn gluten is gluten free.  Jyr)


       A grain without gluten, millet has a delicate, nutty taste. You may cook it and serve it as a side dish, include it in soups or use it in baked products.


       Despite its name, buckwheat is not related to wheat and is naturally gluten free. While buckwheat groats may be cooked and used as a substitute for grains, buckwheat flour can be used to make pancakes, crepes and other baked items.


Gluten-Free Alternative Binders And Thickeners

        These gluten-free thickeners will come to the rescue when a soup is too thin or a sauce is a little too runny. Here are some alternatives to gluten-free binder and thickeners you can try:

 Xanthan gum

       A common gluten-free substance used as a binder and thickening in baking is xanthan gum. It enhances the texture and suppleness of baked goods made without gluten.

 Psyllium husk

       A soluble fiber that can serve as a binder in gluten-free baking is psyllium husk. It helps to simulate the structure of gluten and is very helpful in bread and dough recipes.

 Chia seeds

       When chia seeds are combined with water, they form a gel-like consistency that may be used as an egg replacement in baking. They provide moisture and aid in mixing ingredients.


Gluten-Free Condiments, sauces and Seasonings

       Condiments are among the most helpful ingredients for those who prefer to spice up their meals. You may use them for flavoring a sandwich, to dip chips or carrot sticks in or as a marinade for beef, chicken or fish. 

       However, when you follow a gluten-free diet, you can feel as though your selections are restricted to only a few products, such as ketchup, mustard and mayonnaise, which you can be certain are free of gluten.

       You might try the following alternatives to add flavor to your meals:

 Tamari or gluten-free soy sauce

        As a tasty substitute for normal soy sauce, which frequently includes gluten, tamari or gluten-free soy sauce can be used. Stir-fries, marinades and sauces all benefit from their depth and umami.

 Gluten-free pasta sauce

           To guarantee they are devoid of any hidden gluten components, look for pasta sauces labeled gluten-free.  Or read labels carefully for any possible gluten.

 Herbs, spices and seasoning blends

        Naturally gluten-free, herbs, spices and seasoning mixes give your food depth and taste. Basil, oregano, cumin, paprika and onion or garlic powder are a few examples. 

        It is crucial to carefully examine every spice blend to ensure that no additional ingredients containing gluten have been added.



Gluten-Free Baking Beyond the Basics: Elevating Your Culinary Creations for Celiac-Friendly Delights

Advanced Techniques, Recipes, And Ingredient Substitutions To Empower Celiac Individuals To Create Exceptional Gluten-Free Baked Goods. 09/23/2023; by Scott Adams


       For those with celiac disease, gluten-free baking isn't just about culinary preference; it's a vital aspect of maintaining their health and preventing the symptoms and damage associated with gluten consumption. In recognition of the unique challenges faced by individuals with celiac disease, this article is dedicated to advancing the art of gluten-free baking. While many are familiar with the basics of gluten-free substitutions and recipes, we aim to take your culinary creations to the next level. Our purpose is to empower those affected by celiac disease, as well as anyone interested in gluten-free baking, with advanced techniques, innovative recipes, and creative ingredient substitutions. We want to inspire you to go beyond the ordinary and create exceptional gluten-free baked goods that rival their gluten-containing counterparts in flavor, texture, and presentation.

       We will explore the world of gluten-free baking, uncovering the secrets to mastering flour blends, harnessing the potential of innovative gluten-free ingredients, employing advanced baking techniques, elevating flavor profiles, customizing and adapting recipes, and showcasing the artistic presentation of your gluten-free creations. Whether you're a seasoned gluten-free baker or just beginning your journey into this culinary realm, there's something here for everyone. Together, let's embark on a delicious and satisfying adventure into the realm of gluten-free baking beyond the basics.


Mastering Gluten-Free Flour Blends

      Gluten-free flour blends are the cornerstone of successful gluten-free baking. These blends serve as the foundation of your recipes, mimicking the structure and texture that gluten provides in traditional baking. Now we will delve into the significance of gluten-free flour blends and offer guidance on how to master them.                                                       

The Importance of Gluten-Free Flour Blends

       For individuals with celiac disease or gluten sensitivity, removing wheat flour from their diet is a necessity. However, wheat flour contains gluten, a protein that contributes to the elasticity and structure of baked goods. To replicate this essential texture, gluten-free flours must be combined in precise ratios to create a blend that closely mimics the properties of wheat flour. The right blend can make the difference between a crumbly, dry product and a moist, tender one.                     

Creating Your Own Gluten-Free Flour Blend

       While pre-packaged gluten-free flour blends are readily available, creating your own blend allows for greater control over taste and texture. Here's a basic guide to crafting your custom flour blend:

o   Choose a Base Flour: Start with a primary flour, such as rice flour, sorghum flour, or brown rice flour. This will make up the majority of your blend.

o   Add Starch: Incorporate a starch like tapioca starch, potato starch, or cornstarch to improve the texture and tenderness of your baked goods. Starches help bind ingredients together and create a lighter crumb.

o   Enhance Nutritional Value: To boost nutrition and flavor, consider adding nut flours like almond, coconut, or hazelnut. These flours contribute a delightful nuttiness and moisture to your creations.

o   Experiment with Ancient Grains: Explore ancient grains like quinoa flour, amaranth flour, or teff flour. These nutritious options add depth and unique flavor profiles to your blend.

o   Xanthan Gum or Guar Gum: Include a small amount of xanthan gum or guar gum (typically 1/2 to 1 teaspoon per cup of flour blend) to improve elasticity and binding. These gums mimic gluten's role in providing structure.

o   Test and Adjust: Blend your chosen flours in the desired ratios, and test your blend in various recipes. Adjust the proportions to achieve the desired texture and taste for your specific recipes.                                                                                                                                                          

Commercially Available Gluten-Free Flour Blends

       If you prefer convenience or are new to gluten-free baking, several excellent commercially available gluten-free flour blends are worth considering. Some popular options include:

o   gfJules Gluten Free All Purpose Flour: Certified Gluten-Free (GFCO), Certified Kosher (OU) & Certified Free From the Big 9 Food Allergens (CFF): wheat, milk, eggs, peanuts, tree nuts, soy, fish, crustaceans, sesame.

o   Bob's Red Mill 1-to-1 Baking Flour: This blend is designed for easy substitution in traditional recipes, making it an excellent choice for beginners.

o   Cup4Cup Multipurpose Flour: Developed by renowned chef Thomas Keller, this blend is praised for its performance and taste, closely mirroring wheat flour in various recipes.

o   King Arthur Gluten-Free Flour: Known for its consistent results, King Arthur's blend is a versatile choice for both sweet and savory dishes.

o   Pamela's Products Artisan Blend: This mix incorporates a variety of flours and starches to produce a reliable and well-balanced flour blend.

       Each of these blends has its unique characteristics and works well in specific applications. Experimenting with different commercial blends can help you find the one that suits your baking needs best.

       In the journey of mastering gluten-free flour blends, patience and experimentation are key. By understanding the importance of these blends, crafting your own, and exploring commercially available options, you'll be well on your way to creating exceptional gluten-free baked goods with the perfect texture and flavor.




Innovative Gluten-Free Ingredients

       In the world of gluten-free baking, innovation often leads to delightful surprises. Beyond the conventional gluten-free flours like rice and sorghum, there exists a treasure trove of lesser-known ingredients with unique properties that can transform your gluten-free baked goods into culinary masterpieces. It's time to explore some of these innovative gluten-free ingredients, understand their distinct qualities, and share recipes that demonstrate their potential.


Almond Flour: Nutty Excellence

o   Unique Properties: Almond flour, made from finely ground almonds, boasts a rich, nutty flavor and a moist, tender texture. It's high in healthy fats and protein, making it a nutritional powerhouse.

o   Enhancing Baked Goods: Almond flour adds a delightful nuttiness and moisture to your creations. Use it as a partial replacement for traditional flour in recipes for cookies, cakes, and muffins. It's particularly well-suited for gluten-free pastry crusts, providing a buttery, crumbly texture.

o   Recipe Inspiration: Try making almond flour-based chocolate chip cookies for a nutty twist on a classic favorite. The almond flour's texture and flavor elevate these cookies to a whole new level.


Coconut Flour: The Versatile Grain-Free Choice

o   Unique Properties: Coconut flour is a gluten-free, grain-free option made from the dried, defatted coconut meat. It's exceptionally absorbent, requiring more liquid in recipes, and imparts a subtle coconut flavor.

o   Enhancing Baked Goods: Due to its high absorbency, coconut flour is excellent for recipes that require moisture, such as banana bread, brownies, and pancakes. It also provides a pleasant coconut aroma and flavor.

o   Recipe Inspiration: Create gluten-free coconut flour pancakes that are light, fluffy, and infused with a tropical twist. Top them with fresh fruit and a drizzle of pure maple syrup for a delightful breakfast treat.


Tapioca Starch: The Textural Marvel

o   Unique Properties: Tapioca starch, also known as tapioca flour, is a gluten-free starch derived from the cassava root. It has an incredible ability to create a chewy, elastic texture in baked goods.

o   Enhancing Baked Goods: Tapioca starch is a valuable addition to gluten-free flour blends, enhancing the texture of bread, pizza crust, and tortillas. It imparts a satisfying chewiness, which can be elusive in gluten-free recipes.

o   Recipe Inspiration: Try crafting gluten-free Brazilian cheese bread (Pão de Queijo) with tapioca starch. These savory cheese puffs have a chewy, cheesy interior and a crisp crust—an irresistible combination.


Teff Flour: The Ancient Grain Secret

o   Unique Properties: Teff flour is a nutrient-dense, gluten-free flour made from teff, an ancient grain. It has a mild, earthy flavor and a fine texture.

o   Enhancing Baked Goods: Teff flour is versatile, adding a unique depth of flavor to your gluten-free baked goods. It works well in recipes for pancakes, muffins, and injera (a spongy Ethiopian flatbread).

o   Recipe Inspiration: Explore the world of East African cuisine by making gluten-free teff injera. This sourdough flatbread is a perfect accompaniment to stews and curries, providing a tangy and hearty base.


      These innovative gluten-free ingredients open up a world of possibilities for elevating your baked goods. By understanding their unique properties and experimenting with recipes, you can create exceptional gluten-free treats that not only cater to dietary restrictions but also satisfy your culinary cravings. The key is to embrace these ingredients as creative allies in your gluten-free baking journey.

Advanced Baking Techniques

        Elevating your gluten-free baking game goes beyond just using alternative flours. Advanced baking techniques can make a substantial difference in the texture, flavor, and overall quality of your gluten-free baked goods. Now we'll explore three advanced techniques: sourdough starters, long fermentation, and managing hydration levels. We'll delve into how these methods can enhance your gluten-free creations and provide step-by-step instructions and tips for their effective use.


1. Sourdough Starters: Capturing Natural Fermentation

       Why Sourdough for Gluten-Free BakingSourdough starters harness the power of natural fermentation to improve both flavor and texture. In gluten-free baking, where the absence of gluten can lead to denseness, sourdough can create a lighter, airier crumb. The beneficial microbes in sourdough help break down starches, making it easier for the body to digest.


Getting Started with a Gluten-Free Sourdough Starter:

o   Mix 1/2 cup of gluten-free flour (e.g., brown rice flour or a blend) and 1/2 cup of lukewarm water.

o   Cover the mixture loosely and let it sit at room temperature for 24 hours.

o   Discard half of the mixture and feed it with another 1/2 cup of flour and 1/2 cup of water. Repeat this daily until it's active (usually 5-7 days).

Using Sourdough in Recipes:

o   Replace a portion of the liquid and flour in your recipe with an equivalent amount of active sourdough starter.

o   Adjust hydration levels as needed to maintain the desired dough consistency.


2. Long Fermentation: Developing Flavor and Structure

The Benefits of Long Fermentation: Long fermentation allows the dough to develop complex flavors and improve its structure. In gluten-free baking, this extended rest period enhances the texture, making it less crumbly.

Steps for Long Fermentation:

o   Mix your gluten-free dough as usual.

o   Cover the dough and let it rest in the refrigerator for an extended period (12-24 hours or more).

o   Remove the dough from the refrigerator and allow it to come to room temperature before baking.

Tips for Success:

o   Longer fermentation periods may require adjustments to the hydration level. The dough should remain workable.

o   Experiment with different recipes, such as bread, pizza dough, or even muffins, to experience the benefits of long fermentation.

3. Managing Hydration Levels: Achieving the Right Consistency

Why Hydration Matters: Hydration levels in gluten-free dough significantly impact the final product. Different flours absorb liquid differently, so understanding and managing hydration is crucial for achieving the desired texture.

General Guidelines:

o   Start with a standard recipe and note the hydration level (water-to-flour ratio).

o   Adjust hydration gradually by adding more liquid or flour until the dough reaches the desired consistency.                                                                                                           

Tips for Hydration Adjustment:

o   For bread-like textures, aim for a higher hydration level.

o   For cookies and cakes, a lower hydration level may be preferable.

       Mastering these advanced baking techniques can transform your gluten-free baked goods into culinary delights. Sourdough starters infuse flavor and lightness, long fermentation enhances structure and complexity, and managing hydration ensures the perfect dough consistency. Experiment, observe, and adapt these techniques to your favorite recipes to create exceptional gluten-free treats that will leave everyone craving more.


       Elevating the flavor of gluten-free baked goods is a delightful journey that can transform your creations from good to exceptional. In this section, we'll share valuable tips and tricks for enhancing the taste of your gluten-free treats. We'll explore the art of using spices, extracts, and natural sweeteners to create delicious, flavorful baked goods. Additionally, we'll provide recipes that demonstrate these flavor-enhancing techniques.


1. Tips and Tricks for Flavor Enhancement

o   Toasting Nuts and Flours: Toasting ingredients like almond flour, coconut, or nuts before incorporating them into your recipes adds a rich, nutty depth to your baked goods.

o   Citrus Zest: Grated citrus zest (lemon, orange, or lime) can infuse a burst of bright, fresh flavor into your baked goods. It pairs beautifully with a variety of recipes, from muffins to cakes.

o   Infused Liquids: Experiment with infusing liquids like milk or cream with spices (e.g., cinnamon sticks or cardamom pods) before adding them to your recipes. This subtle infusion can enhance the overall taste.


2. The Power of Spices and Extracts

o   Cinnamon and Nutmeg: These warm, aromatic spices can bring a comforting, homey feel to your baked goods. They're perfect for everything from cookies to bread.

o   Vanilla Extract: High-quality vanilla extract adds a sweet, floral note that complements a wide range of flavors. It's a must-have for cakes, cookies, and even pancakes.

o   Almond Extract: Almond extract lends a delightful nuttiness to your creations. It's particularly suited for enhancing the flavor of almond-based desserts.


3. Natural Sweeteners and Flavor Infusions

o   Honey and Maple Syrup: These natural sweeteners not only provide sweetness but also contribute unique flavors. They're great for drizzling over muffins or incorporating into glazes.

o   Fresh Herbs: Surprisingly, fresh herbs like rosemary, basil, or lavender can be used to infuse unique and delightful flavors into your baked goods. Try adding them to shortbread cookies or scones.

o   Fruit Reductions: Simmering fruits like berries or peaches with a touch of sugar can create a flavorful reduction to swirl into muffins or use as a topping for cakes.


Customizing and Adapting Recipes

       Adapting traditional recipes to make them gluten-free can be a rewarding and creative endeavor. In this section, we'll provide guidance on how to successfully transform your favorite recipes into gluten-free versions. We'll discuss the importance of accurate ingredient measurements and adjusting ratios to maintain the desired texture and flavor. Plus, we'll share examples of successfully adapted recipes to inspire your culinary experiments. 


1. Adapting Traditional Recipes to Be Gluten-Free

o   Select the Right Flour: Begin by selecting an appropriate gluten-free flour or blend based on your recipe's requirements. For instance, rice flour or a 1-to-1 gluten-free flour blend can often replace all-purpose wheat flour in recipes like cakes and cookies.

o   Leavening Agents: Gluten-free flours may require adjustments in leavening agents like baking powder or yeast. Experimentation may be necessary to achieve the desired rise and texture.

o   Binders: Gluten is a natural binder, so in its absence, you may need to add binders like xanthan gum or guar gum to maintain the structure of your baked goods.                                            

2. The Importance of Accurate Measurements and Ratios

o   Weigh Your Ingredients: Measuring ingredients by weight, rather than volume, can provide more accurate results in gluten-free baking. Invest in a kitchen scale to ensure precision.

o   Balance Hydration Levels: Gluten-free flours often absorb moisture differently, so adjusting the liquid content is crucial. Too much or too little liquid can affect the texture and consistency of your baked goods.

o   Experiment Gradually: Adaptation is often an iterative process. Make small changes, record your adjustments, and be patient. Over time, you'll develop a feel for how to adjust recipes effectively.                                                                                                                                   

3. Successfully Adapted Recipes

o   Gluten-Free Chocolate Cake: Adapt a classic chocolate cake recipe by replacing wheat flour with a gluten-free blend. Adjust the leavening agents and moisture levels as needed. The result is a moist, decadent cake with the same rich flavor.

o   Gluten-Free Pizza: Transform your favorite pizza recipe by using gluten-free pizza crust mix or creating your own gluten-free pizza dough. Don't forget to adjust the baking time and temperature for the crust.

o   Gluten-Free Pancakes: Make fluffy, gluten-free pancakes by swapping wheat flour with a combination of gluten-free flours. Ensure the batter has the right consistency, and you'll have light, airy pancakes for breakfast.

o   Gluten-Free Chocolate Chip Cookies: Adapt the classic chocolate chip cookie recipe by using a gluten-free flour blend and adding xanthan gum or guar gum to maintain the chewy texture. The end result? Delicious gluten-free cookies that rival their traditional counterparts.

       Customizing and adapting recipes to be gluten-free allows you to enjoy your favorite dishes without compromising on taste and quality. By following these guidelines, paying attention to measurements, and experimenting thoughtfully, you can successfully create gluten-free versions of your beloved recipes that are just as satisfying and delicious.

Showcasing Artistic Presentation

        The art of gluten-free baking goes beyond taste; it extends to presentation and aesthetics. In this section, we'll explore the importance of presentation in gluten-free baking and offer decorating and plating tips to help you create visually appealing gluten-free desserts. We'll also share inspiring photos of beautifully presented gluten-free baked goods to spark your creativity.


1. The Importance of Presentation in Gluten-Free Baking

o   First Impressions: Presentation is the first thing that catches the eye when serving gluten-free baked goods. A beautifully presented dessert not only looks enticing but also communicates care and attention to detail.

o   Enhancing the Experience: Aesthetically pleasing desserts elevate the overall dining experience. They can make your gluten-free treats feel special and indulgent.

o   Appetite Stimulation: Well-presented dishes can stimulate the appetite and make your gluten-free baked goods even more appealing to family and guests.


2. Decorating and Plating Tips for Gluten-Free Desserts

o   Use Vibrant Ingredients: Incorporate colorful, fresh fruits like berries, citrus segments, or edible flowers to add a pop of color and freshness to your desserts.

o   Textures and Layers: Play with different textures by adding crunchy elements like chopped nuts or crumbled meringue alongside creamy components like whipped cream or ganache.

o   Sauces and Drizzles: Decorative sauces or drizzles can add elegance and complexity to your dessert plates. Consider chocolate ganache, berry coulis, or caramel.

o   Edible Garnishes: Elevate your presentation with edible garnishes like mint leaves, grated chocolate, or finely shredded coconut.

o   Plate with Precision: Pay attention to the arrangement of elements on the plate. Balance colors, shapes, and heights for an appealing composition.                                                                

3. Beautifully Presented Gluten-Free Baked Goods

      Remember that the key to showcasing artistic presentation in gluten-free baking is creativity and attention to detail. Experiment with different plating techniques and decorations to make your gluten-free desserts not only delectable but also visually stunning, ensuring a memorable dining experience for all.                                                                                                                                            


       In the world of gluten-free baking, the journey is not only about necessity but also about creativity and culinary innovation. Throughout this article, we've embarked on a flavorful exploration of gluten-free baking beyond the basics, uncovering techniques, ingredients, and presentation tips that can empower individuals with celiac disease and gluten sensitivities to create exceptional treats. Let's recap the key takeaways and celebrate the joys of gluten-free baking.


Key Takeaways:

o   Mastering Flour Blends: Gluten-free flour blends are the foundation of successful gluten-free baking. Create your own or explore commercial options to achieve the right texture and structure for your recipes.

o   Innovative Ingredients: Embrace unique gluten-free ingredients like almond flour, coconut flour, tapioca starch, and more to enhance the flavor and moisture of your baked goods.

o   Advanced Baking Techniques: Experiment with sourdough starters, long fermentation, and hydration levels to improve the texture and taste of your gluten-free creations.

o   Elevating Flavor Profiles: Enhance the taste of your gluten-free treats with spices, extracts, natural sweeteners, and creative flavor infusions.

o   Customizing and Adapting Recipes: Adapt traditional recipes thoughtfully, focusing on selecting the right flour, precise measurements, and achieving the perfect balance in ratios.

o   Artistic Presentation: Pay attention to presentation and aesthetics, using colorful ingredients, textures, garnishes, and plating techniques to create visually appealing gluten-free desserts.


Embrace the Gluten-Free Culinary Journey

       We encourage every celiac and gluten-sensitive baker to embrace the gluten-free culinary journey with enthusiasm and creativity. Don't be afraid to experiment, adapt, and innovate in your kitchen. Gluten-free baking can be an art form in itself, offering endless possibilities for delicious and safe treats.

       Remember that gluten-free baking is not just a necessity; it's an opportunity to explore new flavors, textures, and techniques. Whether you're baking for yourself or sharing your creations with friends and family, take pride in the fact that you're not only enjoying safe gluten-free treats but also delighting in the joys of culinary creativity.

       So, go ahead and embark on your next gluten-free baking adventure. Create, savor, and share your exceptional gluten-free delights with the world. After all, in the realm of gluten-free baking, the possibilities are as limitless as your imagination, and the results are truly scrumptious.


What are the meal planning strategies for a gluten-free lifestyle?

       The key to effectively adjusting to a gluten-free lifestyle is meal preparation. You can keep organized, save time, and always have wholesome, delectable gluten-free meals on hand. Here are some practical tactics to include in your routine for planning gluten-free meals:


1. Meal-prep weekly for convenience

        The secret to successful healthy eating is preparation. Fortunately, choosing nutritious foods won’t need much thought if you plan and prepare your meals in advance.  The following are some weekly routines you can do for convenient prepping:

 Plan your meal

       Choose the meals you want to make during the coming week to start. Consider your snacks, lunch and dinner.  Assess your tastes, any unique dietary restrictions and the ingredients you have on hand.

 Create a shopping list

       Make a thorough shopping list of all the gluten-free foods you’ll need based on your meal plan.  By doing this, you can ensure you have everything you need to make your meals.

 Prep ingredients in advance

       Prepare items in advance by washing, cutting and cooking grains or marinating meats.  This frees up time during the week and facilitates speedy dinner preparation.


2. Batch cook and freeze meals

       If you are on a tight schedule and always on the go, it can be hard for you to prepare your gluten-free meals every day. That is why, it is advised that you batch-cook your meals and freeze them so you can easily grab it whenever you are ready to go.

       Here are some tips to keep in mind:

 Choose freezer-friendly recipe

       Look for gluten-free recipes for baked goods, soups, stews, casseroles and other dishes that can be frozen. These may be prepared in greater amounts and frozen for later use.

 Label and date freezer meals

       When freezing meals, carefully provide the dish’s name and the date it was made on the containers. This makes it easier for you to keep track of what is in your freezer and guarantees that you will use the items promptly.

 Thaw and reheat with care

       When it’s time to eat your frozen meals, defrost them in the microwave or let them thaw overnight in the refrigerator. To preserve food safety, fully reheat the meal before eating.


3. Use leftovers effectively

       By now, we’re all aware that preparing gluten-free meals is much more time consuming and hard than normal foods. That is why it is advisable sometimes to reuse your leftovers and enjoy them for the next day.   Here are some ways to effectively do this:

 Plan leftover-friendly meals

       Prepare more food than you would consume at one meal so that you have leftovers the next day.  Consider using the leftover chicken from roasted chicken, for instance, in a salad or wrap the following day for lunch.

 Repurpose leftovers creatively

       Get creative with repurposing leftovers into new meals. For instance, use leftover grilled steak to top a salad or transform cooked vegetables into a flavorful stir-fry.

 Store leftovers properly

       To keep leftovers fresh and avoid cross-contamination, store them in the refrigerator in airtight containers. For simple reference, mark them with the date.



       Planning your gluten-free meals is essential to leading a healthy and full life.  You may easily eat tasty and nutritious gluten-free meals by being aware of gluten-free goods, practicing efficient meal planning skills, and using smart cooking techniques. 

       We can simplify our gluten-free meal planning process by adding these techniques into your routine, whether it’s weekly meal preparation, bulk cooking or making the most of leftovers. 

       Enjoy a gluten-free diet’s variety of tastes while appreciating the advantages of well-organized and mindful meal preparation. 

       Start preparing gluten-free meals to open up a world of culinary opportunities.


What are the basic rules of a gluten-free diet?

       Eliminating all sources of gluten from your meals and snacks is one of the fundamental principles of a gluten-free diet. This means staying away from all types of wheat, barley, rye, and their derivatives. When preparing and eating meals, it’s crucial to carefully read food labels, select naturally gluten-free items, and be aware of cross-contamination.


Is oatmeal gluten-free?

       Oatmeal itself is gluten-free. However, cross-contamination (very likely in regular oats) can occur during processing, harvesting, storage, and transportation where oats may come into contact with gluten-containing grains. Avoid regular oats; only eat gluten-free oats.


How do you manage a gluten-free diet?

       Keeping a gluten-free diet under control entails choosing naturally gluten-free goods, carefully reading food labels, and removing any sources of gluten from your meals and snacks. Planning and preparing meals ahead of time is crucial. You should also stock your pantry with gluten-free options and be cautious of possible cross-contamination whether eating out or cooking at home.







Last Updated September 12, 2023. Published FEBRUARY 27, 2019


This article discusses what you should do when you accidentally eat gluten despite following a strict gluten-free diet due to celiac disease or gluten intolerance. I’ll also share home remedies that may help you recover quickly after gluten exposure. This post contains affiliate links and is not a substitute for medical advice or care.

       The thing I fear most happened to me: I ate a piece of gluten.  My friend thought she bought gluten-free cookies from Trader Joe’s, but she was confused by the packaging and instead served me regular cookies made with wheat flour!   I only ate a small bite of the cookie before we realized the mistake. And my friend was extremely apologetic. I tried to minimize the situation by telling her it was okay, but all the while, I was secretly panicking.

       Would I get sick? Would I have diarrhea and bloating for days? Would my geographic tongue flare up? Would I get annoying acne?  I didn’t know what to expect because it’s always hard to pinpoint exactly how I would react to gluten exposure.  In the past, whenever I felt sick after eating, I’d blame gluten. But the truth is, I had never knowingly eaten gluten. I only suspected I had.  But in this caseI knew with absolute certainty that I had eaten a piece of gluten. I was terrified.

What Happened After I Ate Gluten

       Surprisingly, I didn’t get sick or bloated after eating the gluten cookie. I was fine.   How could this be?  I ate gluten! I should be sick as a dog, spending hours on the toilet, right?   While I got off lucky in this situation, most of the time, I’m not so fortunate.

       Most people who accidentally eat gluten, a sticky protein found in wheat, rye, barley, and sometimes oats, feel sick. They may race to the bathroom to violently purge the ill-gotten protein.  Despite your or my best efforts, gluten happens.    When I suspect I’ve been accidentally glutened, it takes about 60-90 minutes for me to bloat up like a balloon. I become incredibly gassy. Eventually, I’ll race for the bathroom to purge the offending protein.  Others might experience headaches, skin breakouts (acnerashes), fatigue, or a combination of these devastating symptoms.  And sometimes, we have no symptoms at all, leaving us scratching our heads, wondering why gluten sometimes creates chaos in our bodies and sometimes doesn’t.  The reaction varies from person to person and likely depends on how much gluten someone accidentally ate. 

       I feel better once I purge gluten from my system and take time for self-care.  However, how “easily” you process gluten depends on the strength of your digestive system and how much gluten you have consumed.

       The good news is that if you’ve been on the gluten-free diet for a while, your body has had time to heal, and your intestinal lining is likely stronger and more resilient than it was when you first started a gluten-free diet. 

       It’s important never to consume gluten when on a gluten-free diet, regardless if you have celiac disease or gluten intolerance.

       Continuously cheating on your gluten-free diet will harm your body, but one exposure to gluten probably won’t, especially if you’ve put in the hard work to heal your body and gut.

       The remedies detailed below are for one-time accidental gluten exposure only and should not be used as an excuse to eat gluten nor as a remedy for careless eating.  Also, implement these strategies as soon as you realize you’ve been glutened--don’t delay! The more quickly you get in front of it, the faster you will likely recover.

Remedy #1: Hydrate Like Crazy

       Drink a lot of water after an accidental glutening to flush your digestive system and help eliminate whatever you ate or drank more quickly.

       I recommend adding a squeeze of lemon to your water, too. Lemon is alkalizing, helping you more quickly restore your body’s natural pH balance.  (Also, you may want to add some cranberry juice to the plain water to augment the taste.)

        Another herb to consider adding to water is ginger. Ginger has natural anti-inflammatory properties known to aid in digestion.

        Warm tea with lemon and ginger may help to settle your stomach and calm the inflammatory fire inside you.

       Drinking plenty of water is also essential if you experience diarrhea after consuming gluten. Water will replenish the lost liquid and ensure you don’t become dehydrated.

       You can also drink unsweetened coconut water as a natural remedy to replenish lost electrolytes.  Coconut water contains sodium, potassium, calcium, magnesium, and phosphorus. It’s a better alternative to electrolyte drinks like Gatorade, which is loaded with sugar and artificial dyes.


9/18/2023 - Vomiting and nausea are considered common symptoms related to gluten ingestion in treated celiac disease. However, the overall rates and associated factors of these symptoms after chronic gluten exposure, and acute re-exposure during gluten challenge, remain poorly understood.


Remedy #2:  Consider Taking Digestive Enzymes

        Your body already produces a plethora of digestive enzymes naturally. These enzymes help break down and improve the absorption of food.  Today, you can purchase gluten digestive enzyme supplements to inflate the number of digestive enzymes in your body and aid in the breakdown of food. This can be particularly helpful in people with digestive diseases like celiac disease.

       While I don’t recommend digestive enzymes for long-term use, as you don’t want your digestive system to become dependent on them, they can be helpful as an insurance policy that comes to your aid in times of need.  For example, when you’ve been accidentally glutened, a digestive enzyme may help to relieve some of the GI symptoms you will likely experience.

       However, a digestive enzyme is much more helpful before a meal. A good time to pop a digestive enzyme is before eating at a restaurant or a friend’s house, just in case you get glutened despite your best efforts.

       There are many digestive enzymes on the market, but I have personal experience with the following enzymes:

·       GlutenEase contains dipeptidyl peptidase (DPP-IV), a form of “protease,” an enzyme that assists in the breakdown of gluten and gliadin proteins.

·       Wheat Rescue has received Dr. Tom O’Bryan’s stamp of approval. It also contains enzymes that assist in the breakdown of glutenin and gliadin proteins, along with probiotic spores that aid in creating good gut health.                                                                                                            

       Digestive enzymes should not be used as permission to eat gluten; they should only be used when an accidental exposure could happen.


Gluten Detect; 09/25/2023 –

Recent studies demonstrate that accidental gluten ingestion happens at least once a month and most often on weekends. Put your GFD to the test with Gluten Detect, the at-home test for self-monitoring recent gluten ingestion to avoid repeated exposure. Gluten Detect is trusted by experts to monitor gluten exposure in dozens of clinical trials all over the world.


Remedy #3: Take OTC (Over-the-Counter) Medications

       If you’re experiencing diarrhea after accidentally eating gluten, you might find relief by taking Pepto-Bismol, Kaopectate, or Imodium A-D.

Remedy #4: Take Activated Charcoal

       I haven’t taken activated charcoal, but when I asked my gluten-free community what they take after accidental exposure to gluten, it was clear that many gluten-free people already know about and take activated charcoal.

       Activated charcoal is sometimes used to treat poisonings or drug overdoses because toxins bind to charcoal, which helps the body get rid of unwanted substances.

       It’s also commonly used as a digestive aid due to its absorption qualities in the digestive tract. It can provide some intestinal comfort by absorbing gas and neutralizing diarrhea.

       One community member told me that activated charcoal helps relieve bloating and lessens the duration of her symptoms.

       However, no studies validate the use of activated charcoal in helping people recover after accidentally eating gluten. Consult your doctor before taking it.

Remedy #5: Get Plenty of Rest

        While you might be kicking yourself for accidentally eating gluten after all the hard work you’ve put into your gluten-free diet, go easy on yourself  We all make mistakes; even veteran gluten-free eaters like me have made a mistake or two (or 50!).

       Stay close to home when you’ve been glutened so you’re close to your bed and toilet, and give your body time to rest.

       Stressing about something out of your control will only make you feel worse, and stress may compound your symptoms.

       My mom always says, “This, too, shall pass.” Tomorrow is a new day to get it right.

Remedy #6: Rest Your Digestive System

       Give your digestive system time to rest and recover from gluten exposure. Focus on eating easy-to-digest foods like bone brothsrice, bananas, gluten-free crackers, and tea (with lemon and ginger). These foods will help settle your roaring stomach.

       Avoid eating a big meal until you feel better.  Also, avoid rich and hard-to-digest foods, such as meats and dairy. Similar to gluten, dairy contains a hard-to-digest protein called casein. Focus on easy-to-digest foods as much as possible.

Remedy #7: Take Probiotics

         Did you know that 80 percent of the immune system is in the digestive tract and gut? That means a healthy gut is more likely to bounce back quickly after accidentally eating gluten.

       I recommend taking a high dose of probiotics daily (at least 40 billion CFUs) to maintain good gut health continuously, as you never know when gluten might [accidentally] happen.  I think my well-nurtured gut was what helped me bounce back quickly when I accidentally ate that Trader Joe’s cookie.

       If you’ve been glutened, I recommend doubling on probiotics for a few days to boost your gut health during this crisis.

Remedy #8: Don’t Let It Happen Again

       While no one is perfect, there are measures you can take to prevent accidental gluten exposure. I like to say, “When I know better, I do better.” Use this as your mantra, too.


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