About Non-Celiac Gluten Sensitivity (NCGS)
by Roxie Johnson
There are some individuals who:
- don't have celiac disease by the current testing standards
- don't have a wheat allergy
- do respond well to the gluten-free diet
This condition in the past was called "gluten intolerance" or "gluten sensitivity". The precise definition of non-celiac gluten sensitivity (NCGS) is currently being debated among experts. One possible description is "a state of heightened immunological responsiveness to ingested gluten in genetically susceptible people".
Although this problem is not fully understood at this time, the following are the current thoughts on NCGS:
- The symptoms are sometimes identical to a person with celiac disease.
- The response to the gluten-free diet can be identical to those with celiac disease.
- It is not an auto-immune disease like celiac disease, and therefore may not cause the serious complications so often found in celiac disease. Undiagnosed celiac disease can cause significant organ damage, which is not thought to be true with those with NCGS. There is also not the concern of associated auto-immune diseases.*
- An individual with NCGS may do fine on a low-gluten diet. This is definitely not the case for someone with celiac disease, who must eliminate all gluten from their diet.
- There is no specific test as yet to determine if a person has NCGS besides noting the response to the gluten-free diet.
- A person suspecting a gluten sensitivity should not eliminate gluten from their diet until tested for celiac disease (first step is a simple blood test). The implications from celiac disease are serious and far-reaching, so it is important to eliminate that diagnosis.
NFCA website: The National Foundation for Celiac Awareness website has a very informative 4-part discussion of "Non-Celiac Gluten Sensitivity". 1/13
Parade Magazine article: In September, 2012, Parade Magazine had an article "Going Gluten-Free: Hype or Help?" It gives an accurate description of both celiac disease and NCGS, with quotes from Dr. Alessio Fasano.
NCGS Testing: An excellent article in the Wall Street Journal titled "New Guide to Who Really Shouldn't Eat Gluten" discusses currents thoughts by medical experts on gluten sensitivity testing. Notably, Dr. Fasano states "If anyone claims they have a test that is specifically for gluten sensitivity" (such as stool or saliva tests) "there is no such thing, though I'm not ruling it out in the future." The article discusses the growing evidence, however, that gluten sensitivity is a valid condition suffered by many. 2/9/12
ACDA article: Article describing celiac disease, wheat allergy, and gluten intolerance, as well as a discussion titled "Why is it important to know if you have celiac disease, versus wheat allergy or gluten intolerance?" on the Amercan Celiac Disease Alliance (ACDA) website.
Article on recent research at the Maryland School of Medicine Researchers Identify Key Pathogenic Difference Between Celiac Disease & Gluten Sensitivity.
An article in the Huffington Post gives a good summary on celiac disease and gluten senstivity. Celiac Disease and Gluten Sensitivity: An Interview with Medical Experts. 10/12
Osteoporosis: An article "GI Disorder and Osteoporosis" appeared in the San Diego Union Tribune on March 2013. It states that those with diagnosed celiac disease are at higher risk for osteoporosis due to malabsorption, but the risk for those with only gluten intolerance is greatly reduced.
The Wall Street Journal.com did an article "Clues to Gluten Sensitivity" in March 2011. It discusses a study that shows "gluten can set off a distinct reaction in the intestines and the immune system, even in people who don't have celiac disease".
*In the June 2010 publication of Gluten Free Living, Peter Green, MD states: "Recent studies are showing that gluten sensitivity may be much more common than previously thought. It may, in fact, be a separate disease entity that involves different organs and different mechansims than celiac disease. While there is no doubt that the condition exists, the lack of definite criteria for a diagnosis has resuted in a skeptical attitude on the part of many doctors."
A YouTube video titled "Celiac Disease or Gluten Intolerance" by Cynthia Kupper, National Director of the Gluten Intolerance Group.
An interview with Dr. Alessio Fasano, a leading celiac researcher at the University of Maryland.
A free downloadable publication from the Gluten Intolerance Group (GIG) called "Gluten Sensitivity".
An article titled Gluten then and now in Natural News.com discusses the history of celiac disease, gluten sensitivity and gluten in our products. 2011
Community lectures given at the Warren Center for Celiac Disease Research in 2008 and 2010 on YouTube give information about the difference between CD and gluten intolerance.
A study summarized by Tricia Thompson "The Celiac Dietician" discusses how those who had mild enteropathy but didn't qualify as celiacs still improved on the gluten-free diet.
The results of a collaborative study between four laboratories in Italy and the U.S. over a 4-year period is summarized in an article "Clinical study distinguishes between gluten-sensitivity and celiac disease." (2011)
The National Foundation for Celiac Awareness (NFCA) provides a lot of information about Non-celiac Gluten Sensitivity on their website..