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Gluten is sneaky! Even in the aisles of health food stores, item after item is often loaded with gluten. And for those with an autoimmune disease such as Hashimoto’s or hypothyroidism -- whether in the earlier stages of the disease or highly symptomatic at a later stage -- steering clear of gluten is a good strategy. Ahead, the rundown on gluten, which products to watch out for, and how to eat gluten-free while shopping and eating out.
When you hear the term gluten, you may think of bread or crackers. But there are many ways gluten can sneak into common food items. Gluten is the name for the proteins -- also known as food starches -- that are found in wheat, rye, and barley. Gluten acts as a glue that helps foods maintain their shape. In our bodies, we have an enzyme called protease that helps to break down and process proteins. However, it cannot completely break down gluten. This is why some people experience uncomfortable digestive symptoms after eating something that contains gluten. These symptoms can include:
- Abdominal pain
- Bloating or persistent gas
- Brain fog or trouble concentrating
- Diarrhea or constipation
- Headache
- Joint pain and swelling
- Nausea and vomiting
- Skin rash
We humans have been digesting gluten for centuries, and usually without any uncomfortable side effects or concerns. However over the years as food becomes more processed and the prevalence of cross-contamination happens more frequently, the rise of gluten allergies, sensitivities, and intolerances continues to rise.
Celiac disease: Celiac disease is an autoimmune response to gluten that occurs in 1% of the United States population. Celiac disease can cause damage to the small intestine and more severe symptoms when ingesting gluten-containing ingredients. Those with celiac disease tend to have a slightly higher risk of osteoporosis and anemia, and because of the malabsorption of both calcium and iron, there's also an increased risk of infertility and nerve disorders. Diagnosing celiac disease is done by an antibody test and genetic testing that looks for 2 specific antigens (HLA-DQ2 and HLA-DQ8). In some cases, diagnosis is done by endoscopy, where a doctor guides a tiny camera down the throat to the small intestine, and takes a small tissue sample to analyze for any damage to the villi that line the intestine.
Gluten Allergy: A gluten allergy, also known as a wheat allergy, is when someone has an allergy to one or more of the proteins found in wheat. Symptoms can range from mild to severe, depending on the degree of the allergy in the individual person. This allergy is diagnosed with a positive immunoglobulin IgE blood test.
Gluten Sensitivity or Intolerance: An intolerance to gluten bears similar symptoms to celiac disease, however it doesn't typically feature elevated levels of antibodies or intestinal damage. If you don't have celiac disease or a diagnosed wheat allergy but still experience persistent negative symptoms when consuming gluten, it is likely that you are gluten-sensitive or gluten intolerant.
If you need to ’avoid consuming gluten, it can be challenging to maintain a low-gluten or gluten- free lifestyle. The easiest items to limit or remove the intake of are going to be bread-like items such as bread, pasta, and pastries.
You should also be mindful that you are likely to find gluten in many common pantry items and otherwise healthy foods, including:
- Salad dressings: some salad dressings contain malt vinegar, soy sauce or flour to act as a binding agent
- Soups, especially stocks: sometimes use roux, a mixture of fat and flour, to help thicken the soup
- Sauces: such as soy, teriyaki, and barbecue sauce are traditionally made using fermented wheat and soy
- Sausage and jerky: many types of sausages contain gluten as a filler
- Meat substitutes: many of the most popular meat alternative brands contain seitan, which is made of wheat gluten
- Deli meats: may contain an added ingredient that could contain gluten as a thickener, such as wheat-derived dextrin
- Gummy candy: candies, including licorice, contain a wheat flour as the main ingredient to bind the rest of the ingredients together
- Coffee alternatives: some coffee alternatives such as dandelion root might contain roasted barley
- Beer: beer is typically made from a combination of malted barley and hops
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Now, don’t let the list above scare you from going grocery shopping! The best way to avoid bringing home gluten-containing food is to read the label. Always read the ingredients list thoroughly, to see if you catch any mention of a gluten-containing ingredient. It’s also helpful to know the grain-based gluten-free products, so you are aware of the best alternatives. These include quinoa, amaranth, rice, buckwheat, sorghum, and gluten-free oats. Even so, check the ingredient list to triple check you’re in the clear.
If your lifestyle includes eating out at restaurants, you can still enjoy dining out while avoiding gluten. The first thing to do is scan the menu, so you have an idea of what is offered and where you can make modifications. If you have celiac disease, it’s suggested to avoid eating at places where there might be cross-contamination of gluten items. You can always call the restaurant or establishment ahead of arrival to ask about their gluten safety procedures. If all checks out, let your waitress or the person preparing your food know that you are avoiding gluten so they can make note to the kitchen and also help steer you to the best and safest menu choices. If you are planning to order anything that contains oil or a sauce, either opt out or ask what kind of oil they’re using to prepare the item. Don’t shy away from asking questions! You’re also helping the restaurant staff be more vigilant to take the presence of gluten more seriously for future customers.
If you find that you have consumed gluten and it is not life-threatening, drink plenty of water, sip herbal teas such as peppermint or ginger to soothe an upset stomach, and avoid eating anything too spicy or fatty, so your digestive system doesn’t have to work overtime.
We understand that taking on a new eating and nutrition lifestyle can be overwhelming, but we’re here to help. If you feel that you need additional support and guidance to better understand how to go about creating a gluten-free lifestyle, Paloma Health is here to set you up for lifelong success. Reach out to us to schedule your appointment and we’ll also connect you to a thyroid-savvy nutritionist who can work with you on a thyroid-healthy diet that limits or eliminates gluten.
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