It’s not your imagination. Symptoms caused by gluten intolerance can come and go, depending on whether you've consumed gluten. Besides that, you may have a hard time recognizing the symptoms because they are sometimes generic and may seem like normal daily fatigue. And it’s not just confusing for you. Healthcare providers didn't have a clear definition of gluten intolerance until 2012, according to the University of Florida IFAS Extension.
You consume gluten any time you eat bread, baked goods, breakfast cereals or any other product that contains wheat, rye or barley, because it's a natural protein in all three grains. Even though it’s present in all products made from these grains, it has an especially important role in baked goods that depend on yeast for leavening. Gluten makes dough rise by trapping the gas bubbles produced by yeast.
Gluten intolerance is often used to mean celiac disease, but they’re not the same medical condition. Celiac disease is an inherited condition in which the autoimmune system creates antibodies to gluten. When people with celiac disease eat gluten-containing foods, antibodies attack and damage the small intestine, which causes inflammation and interferes with the body’s ability to absorb nutrients. Over time, the inflammation can spread throughout the body, causing other health problems and symptoms. When you have a gluten sensitivity, or non-celiac gluten intolerance, the immune system overreacts to the gluten and causes symptoms, but antibodies are not created and the small intestine is not usually damaged.
Symptoms can wax and wane because they only appear when you have gluten in your system. If you follow a strict gluten-free diet, you will stay symptom-free. Introduce gluten into your system and symptoms appear, but they can develop within hours, or not until days, after you eat gluten, according to the National Foundation for Celiac Awareness. Symptoms may also seem random because you may not associate them with the consumption of gluten. Symptoms such as abdominal pain and diarrhea are easy to connect to food, but gluten intolerance sometimes causes generic symptoms such as fatigue, headache, sore joints, a foggy brain and numb arms and legs.
Removing all sources of gluten from your diet is the only way to prevent symptoms. Eating just a small amount can cause symptoms and, in the case of celiac disease, will damage the small intestine, according to the National Digestive Diseases and Information Clearinghouse. Foods containing wheat must state that on the label, but you’ll need to check the ingredient list if the gluten comes from rye and barley. Don't hesitate to ask whether foods contain gluten when you eat out or buy prepared foods. Be aware that gluten lurks in foods you might not suspect, such as lunch meats, sauces and soups. And gluten is sometimes used as a binder in medications and vitamin supplements.
- National Foundation for Celiac Awareness: Should You Be Gluten-Free? Celiac Disease and Non-Celiac Gluten Sensitivity
- BMC Medicine: Divergence of Gut Permeability and Mucosal Immune Gene Expression in Two Gluten-Associated Conditions: Celiac Disease and Gluten Sensitivity
- National Foundation for Celiac Awareness: What Is Non-Celiac Gluten Sensitivity?
- National Digestive Diseases and Information Clearinghouse: Celiac Disease - How Is Celiac Disease Treated?
- National Digestive Diseases Information Clearinghouse: Celiac Disease - The Gluten-Free Diet: Some Examples
- The University of Maine: Understanding Wheat Quality -- What Bakers and Millers Need, and What Farmers Can Do
Sandi Busch received a Bachelor of Arts in psychology, then pursued training in nursing and nutrition. She taught families to plan and prepare special diets, worked as a therapeutic support specialist, and now writes about her favorite topics – nutrition, food, families and parenting – for hospitals and trade magazines.