Sometimes you crave the very foods that are making you ill. These foods can mess with your mind, as well as your body. Of all potential food felons, there’s nothing quite like gluten. This protein can trigger a broad range of symptoms and conditions, from gastrointestinal pain to schizophrenia. Most commonly, it can cause depression, headache, anxiety, insomnia, fatigue and a “foggy” brain.
As a nutrition consultant throughout the 1990s and 2000s, I regularly saw many of these symptoms in my clients. And I lost count of the times that they disappeared after gluten was removed from the diet. It normally took less than a week to conclude that gluten sensitivity was the problem.
Here’s how you can test yourself for gluten sensitivity in just seven days. But first, some context.
The Difference Between Sensitivity And Disease
Gluten is the name of a group of proteins found within certain grains, namely wheat, rye and barley. Gluten sensitivity is not the same as celiac disease, or wheat allergy, which until recently were the only gluten-related conditions recognised by the medical community.
Perhaps that’s why so many people choose to look elsewhere for help. Simon, a 29 year-old managing director, came to see me with various health problems, the main ones being lack of energy, depression, poor concentration and anxiety. He also had a history of gastroenteritis, and regularly experienced bloating and indigestion.
This looked to me like a classic case of gluten sensitivity, especially when I saw his food questionnaire. In response to the question “What food or drinks would you find hard to give up?” he wrote: “pasta and sandwiches”.
The good thing about paying for advice is that you are more likely to take it. I had no trouble persuading Simon to do the exclusion/challenge test, described below. I saw Simon three weeks later, and sure enough he had tested positive for gluten sensitivity.
He was astonished by the changes he saw in himself, within just a few days. His anxiety and depression had vanished, and his concentration and energy levels were “much better.” He said he felt really good off gluten, but “groggy” when he ate it again as part of the challenge.
Simon already knew he didn’t have celiac disease or a wheat allergy, because he’d tested negative to both conditions. Celiac disease is a debilitating autoimmune disease caused by damage to the small intestine by gluten. It results in malabsorption and symptoms that can affect the whole body. Wheat allergy is an allergic reaction to wheat gluten, and can take many forms, from swelling of the mouth to hives, headaches and diarrhea.
Until very recently, gluten intolerance (or sensitivity) was considered the preserve of the “worried well”, an attention-seeking trend outside the peripheral vision of medics. After all, bread is a staple food, and wheat is a natural plant food that grows in fields, not factories.
The only diagnosis you were ever going to get was a self-diagnosis; the only treatment available was the one you self-administered, as best you could. But now the concept of gluten sensitivity is gaining traction within the scientific community, with the emergence of irrefutable evidence. It has even been given a medical term: non-celiac gluten sensitivity (NCGS).
A Paradigm Shift In Science
The “classical” presentation of NCGS is, indeed, a combination of gastro-intestinal symptoms including abdominal pain, bloating, bowel habit abnormalities (either diarrhea or constipation), and systemic manifestations including disorders of the neuropsychiatric area such as “foggy mind”, depression, headache, fatigue, and leg or arm numbness.” — Gluten Psychosis: Confirmation of a New Clinical Entity
In 2018, researchers published a disturbing case history in the journal Nutrients. They told the story of a 14-year-old girl who in 2012 developed psychosis, after recovering from a fever. Her symptoms included headache, irritability, crying episodes, apathy and trouble concentrating. Her teachers confirmed that her school performance had deteriorated.
The child was referred to a local neuropsychiatric outpatient clinic, and treated with the psychoactive drug benzodiazepine. It had no effect, and her mental health deteriorated with the onset of complex hallucinations. At the same time, she developed gut problems: bloating and severe constipation.
After months of tests, misdiagnoses, scans, a lumbar puncture and several hospitalizations for psychotic episodes, her symptoms not only remained a mystery, they got worse. By September 2013, she was experiencing severe abdominal pain together with depression, “distorted” and paranoid thinking, and suicidal thoughts.
Two months later, a nutritionist was consulted — not for the child’s psychiatric symptoms, but for her gastrointestinal problems. A gluten-free diet was prescribed, and within a week both intestinal and psychiatric symptoms “dramatically improved”.
An exclusion/challenge test confirmed that she was gluten intolerant. This test is considered the “gold standard” method of determining food sensitivities, as blood tests are notoriously unreliable. Her mother reported that, after remaining on a gluten-free diet, her daughter had returned to being a “normal girl”.
The gold standard test is straightforward and reliable. If you have a combination of gastrointestinal and neuropsychological symptoms, it is well worth a punt. You won’t be missing out on anything: gluten grains have low nutritional value, and offer nothing that can’t be obtained from better sources.
There are a number of variations on the exclusion/challenge theme, but I’ve always found this particular system to work well. Others recommend an exclusion period of 2–4 weeks, but from experience I know that after a week, people are prone to slipping up and accidentally ingesting something containing gluten. Plus, I’ve always found a week to be perfectly adequate in terms of results.
Here’s how you can run your own gold standard test, in five steps.
Step 1: Prepare
You are preparing to exclude gluten from your diet for a period of 7 days. Have a kitchen clear out. This test only works if you scrupulously avoid any and every food that contains gluten. If it slips into your diet, you’ll have to start again.
Here is where you’ll find gluten:
- Wheat, and wheat species: spelt, kamut and durum flour.
- Wheat derivitives: semolina, couscous, bulgar
- Rye and rye products
- Rye and barley products
- Products made from wheat, including bread, cakes, biscuits, savory snacks, croissants.
Bear in mind that processed foods — anything in a can, plastic box, jar or tube may contain gluten. Check labels — or better still, cook all your meals from scratch and avoid processed foods. It’s only a week!
As a rule, I am not a big fan of cereal grains in any form. They have low nutritional value and can play havoc with blood sugar. But I understand that for many people, giving up all starchy foods, all at once, is way too ambitious. In any case, for the time being you just want to know if gluten is your nemesis.
So feel free to include, in your diet:
- Buckwheat (despite its name)
*Oats are not gluten grains, but can become contaminated if grown near wheat or other gluten crops. Therefore seek out oat products that state on the packaging that they are gluten-free.
Step 2: Exclude
Avoid all gluten foods strictly for seven days. Don’t forget, you can still eat plenty of protein foods — meat, eggs, fish, dairy, nuts and beans, as well as fruits and vegetables.
Step 3: Track
I’ve always found it helps to keep a symptom diary. Write a list of all your common symptoms, and cross them off as they vanish over the course of the week. You may start noticing changes straight away.
Step 4: Challenge
On day 8, you get to eat a portion of your favorite gluten fix. You might choose a sandwich, or a small bowl of pasta. Whatever you miss most. It could be your last! But only have one dish.
Tip: it’s a good idea to do this challenge on a day when you are at home. If you do have gluten sensitivity, you might experience all your old symptoms at once, so be prepared and only have one portion.
Step 5: Observe
Watch what happens. If you are gluten sensitive, your symptoms will return and you will know about it. Obviously, if you get a reaction, you should continue to exclude gluten from your diet.
As you might guess, this test is useful for identifying any food intolerance, aside from gluten, so you can repeat it with any food that falls under suspicion. These foods may include eggs, chicken, dairy, nuts, and soya beans.
If you do find you’re gluten sensitive, at least now you know. But why?
From Meat To Wheat, From Grain To Brain
Wheat, rye, barley…. These are all natural grains, not fake industrial foods. So how can they wreak such havoc on mind and body?
The answer is that all cereal grains are relatively new components of the human diet. Until around 10,000 years ago, there was no agriculture, and therefore no cultivation of grains. In Britain, we were hunter-gatherers until about 7,000–8,000 years ago. Cereals grew wild, and any consumption was opportunistic rather than habitual. Farming eventually spread across the globe and cereals became the main staple food.
After three million years of evolution based on a diet of meat, fish, nuts, fruits and vegetables, with the odd variation, the human genome has simply not had time to adapt to this whole new menu. Wheat has been bred well beyond its wild origins to maximize the gluten content. Gluten makes bread more doughy and elastic, so high-gluten wheat offers significant benefits to food manufacturers, even if it comes at a cost for the rest of us.
The effect of gluten is so powerful that the term gluten-psychosis has been coined, as described in the paper Gluten Psychosis: Confirmation of a New Clinical Entity. One theory is that NCGS is caused by intestinal permeability, or “leaky gut” which allows gluten proteins to leak into the blood, then cross the blood-brain barrier and enter the brain.
This is a highly plausible theory — I wrote about leaky gut in a previous article, and about how damage to the gut lining can allow all manner of food particles and undesirable elements to cross into the blood. Once there, they can travel to every part of the body. We know that about a third of patients with celiac disease suffer from depression and other psychiatric syndromes. Depression is not the only possible outcome.
“An overlap between the irritable bowel syndrome (IBS) and NCGS has been detected, requiring even more stringent diagnostic criteria. Several studies suggested a relationship between NCGS and neuropsychiatric disorders, particularly autism and schizophrenia.” — Gluten Psychosis: Confirmation of a New Clinical Entity
Who knows how many people are affected by NCGS without knowing it. It is estimated that the prevalence of NCGS among people with irritable bowel syndrome is about 28%. Women seem to be affected more than men.
Why You Should Run Your Own Test This Week
The researchers who described the case history of the 14-year-old child concluded their paper by saying:
“Until a few years ago, the spectrum of gluten-related disorders included only CD (celiac disease) and wheat allergy, therefore our patient would be turned back home as a “psychotic patient” and receive lifelong treatment with anti-psychotic drugs.” — Gluten Psychosis: Confirmation of a New Clinical Entity
It really is quite unnerving, and desperately sad, to think of all the gluten-sensitive people for whom anti-psychotic drugs have indeed been their only, lasting treatment. Even today, there must be countless people needlessly being turned back home, facing a lifelong future of anti-psychotics.
Don’t be one of them.