Shades of Gray


Shades of Gray: Celiac Disease, Gluten Sensitivity and Everything In-Between
By Dr. Amber Golshani

No. We aren’t going to talk about that book. We are going to talk about the shades of gray that lie between overt celiac disease and wheat allergy, and the newer diagnosis of “gluten sensitivity.” The first two terms, despite being well-defined, are under-recognized, and the latter is still virtually invisible to the conventional medical world.

Celiac disease is an autoimmune condition in which there is increased intestinal permeability. What this means is that when a susceptible person eats a gluten-containing food (anything with wheat, barley or rye), an inflammatory condition is triggered in the intestinal lining. Eventually the lining begins to lose its ability to absorb nutrients. This is obviously a bad thing!

Along with the classic symptoms of abdominal pain, bloating, diarrhea and weight loss, there are often diseases related to malnutrition like thyroid disorders, infertility and osteoporosis/penia. Celiac disease is diagnosed first by a blood test, then by intestinal biopsy. The diagnosis is confirmed by a patient’s improvement on a gluten-free diet.

A wheat allergy is just like other common food allergies, such as shellfish, peanuts and strawberries. Symptoms usually occur soon after eating the offending food and include itching and swelling of the mouth, tongue, gums and throat (which can be life threatening), rashes, hives, vomiting, abdominal pain, and diarrhea. You may notice that these symptoms are similar to celiac disease symptoms. A blood test or skin-prick test can diagnose a wheat allergy, thereby differentiating it from celiac disease.

But what if your blood tests are negative for celiac disease and a wheat allergy and you continue to have symptoms that get better when you go on a gluten-free diet? The answer is gluten-sensitivity.

Though Naturopathic Doctors have recognized gluten as a potential problem for decades, the conventional medical community is just beginning to catch on. Last year, the 11th International Celiac Disease Symposium officially defined the term gluten-sensitivity for people who feel better on a gluten-free diet but whose laboratory results do not fit them into the other two categories.

Gluten sensitivity is estimated to be six times more prevalent than celiac disease, affecting about one in 132 individuals. Symptoms include those that occur in the gastrointestinal system (such as abdominal pain and diarrhea) and elsewhere in the body (including eczema or rash, headaches, foggy mind, fatigue, depression, anemia, numbness in legs, arms and fingers, and joint pain.)

Given the increase in diagnosis of celiac disease, wheat allergy and gluten-sensitivity, if you are suffering from any of the above symptoms, there is a good chance you will benefit from going gluten-free.

I recommend to my patients that they abstain from all foods that are made from wheat, rye, barley and oats (which do not contain gluten themselves, but are often contaminated in processing) for at least 30 days. Most people, if they have been 100% compliant, will notice a remarkable improvement in their health and stick with the gluten-free lifestyle.

It is a simple intervention, not expensive to undertake, requires no surgeries or pharmaceutical drugs and has no harmful side effects. If you are suffering, why not give it a try? I’d love to hear how it went.


Amber Golshani, N.D., received her Bachelor of Science degree in Chemistry from Southampton College of Long Island University. In her final year of college while studying abroad in Australia, she met a Naturopath who changed her health, her life, and her career path. Intrigued with the healing power of nature, Dr. Golshani went on to receive her Doctorate of Naturopathic Medicine with honors from Southwest College of Naturopathic Medicine in Tempe, AZ, a four year, accredited, postgraduate medical school. She has now returned to her home state of Maryland to bring Naturopathic Medicine to the Eastern Shore of Maryland.



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