'Gluten Free' written in flour.

Celiac Disease

Gluten Free is not Always a Choice

We have all heard the girl in front of us on line asking if there are any “gluten free” options available, followed by the 17 year old kid behind the counter looking at them like they are speaking a different language because they have no idea what “gluten” is. This leads to a lengthy conversation with the cook or manager and everyone behind them in line rolling their eyes in annoyance. The people in line think the request is a part of a crazy diet to lose weight that they pick and choose when to follow. They think that gluten is like ice cream, she says she doesn't eat it, but she probably has a big pint of Ben and Jerry's hidden in her freezer that she takes a bite of when no one is looking. But what the people in this line don't know is that the person ordering suffers from a serious medical condition in which they can't eat gluten: Celiac Disease.

Celiac Disease is an autoimmune disorder that can affect men and women of all ages and injures the small intestine. When these individuals eat gluten, their bodies attack cells of the small intestine, causing inflammation that leads to a number of symptoms. This means the only true way to treat Celiac is by avoiding any foods that contain gluten. Simple enough, right? Well, not really. Finding gluten free options can be harder than it appears and many of those suffering from Celiac Disease don't even know they have it. Over three quarters of those with Celiac go undiagnosed. They spend most of their lives suffering digestive issues, chronic fatigue and other autoimmune diseases with no real relief. So let's break it down, go over all the facts, and save someone we know and love, maybe even yourself, a lifetime of discomfort.

What is Autoimmunity and How Does Gluten Cause it?

Our body’s immune system has an army of soldiers ready to fight to keep you healthy at all times. Whether it is a tiny speck of dirt that infects a paper cut on your finger or the virus causing the flu that keeps us in bed for a week, the immune system produces antibodies to fight against any foreign invader. However, when someone has an autoimmune disorder the immune system mistakes the body’s own cells for an invader and attacks them.

For those with Celiac Disease this happens in the small intestine when they eat gluten. The immune system sees gluten as a harmful substance and goes to attack it. However, something goes wrong and the antibodies that were released attack the villi of the small intestine instead. Villi are small finger like projections that line the entire length of the small intestine and help the body to absorb nutrients from the food we eat. If Celiac is not diagnosed and the person continues to eat gluten, these villi become inflamed and inhibit the absorption of nutrients as well as cause a myriad of digestive issues and discomfort.

If that was not enough, if a person who has an autoimmune diseases is not diagnosed and treated by the time they are 20 years old they are over 30% more likely to develop a secondary condition. These secondary conditions include other autoimmune disease such as Hashimoto’s Thyroiditis or non autoimmune conditions such as anemia, chronic fatigue syndrome, and infertility.

What Are the Symptoms of Celiac Disease?

As we already talked about Celiac Disease damages the small intestine, but how does that manifest in symptoms? Although the damage is being done in the gastrointestinal (GI) tract, it is important to remember that the symptoms of Celiac can affect the entire body. Equally as important, symptoms can be different in children than in adults. Listed are the symptoms most commonly seen in children and adults with Celiac Disease:


  • Chronic diarrhea
  • Abdominal bloating and pain
  • Behavioral issues
  • ADHD
  • Failure to thrive
  • Constipation
  • Vomiting
  • Weight loss
  • Dermatits


  • Anemia
  • Anxiety
  • Menstrual irregularites
  • Migraines
  • Fatigue
  • Joint pain
  • Brittle bones
  • Mouth sores
  • Skin rash

Also remember that untreated Celiac Disease can lead to secondary conditions. If you are suffering from any autoimmune disease or other disorder you have trouble managing consider being tested for Celiac or adhering to a strict gluten free diet to relieve uncontrolled symptoms.

What is Gluten and Where is it in My Food?

Ok, so we know what gluten does to a person with Celiac, but what is it? Gluten is a sticky protein that helps food hold its shape. It is found in cereal grains such as wheat, barley and rye. It helps breads rise and give them their soft yet enjoyable texture. A person with Celiac adheres to a strict gluten free diet and therefore cannot eat traditional flour based foods such as pastas, baked goods, fried foods, flour based sauces and breads. However, with our food supply becoming increasingly more processed the Celiac patient must be even more careful. Because of its “sticky” quality, gluten is used in many packaged foods to improve texture and shelf life. Great for food science, but bad for the consumer, especially our gluten free friends. Gluten can be found in many of the following non-bread products:

This all may seem a little overwhelming. But the good news is that Celiac Disease is easy to treat by just avoiding gluten in the diet. And with awareness of Celiac Disease increasing, many companies and restaurants are producing and offering gluten free options of our favorite foods from pizza to salad dressing.

So the next time you hear someone asking for gluten free options, don’t roll your eyes at them. They could have Celiac Disease, a serious autoimmune disorder. And maybe take a minute to think about any signs and symptoms you may have. Remember 1 in 100 people suffer from Celiac Disease, and you or a loved one could be one of the 83% that goes undiagnosed.

The information in this article is for general educational purposes only, and should not be construed or interpreted as medical advice. Always seek the advice of your physician or other qualified healthcare provider regarding any medical condition or treatment, and before undertaking a new heathcare regimen. Never disregard professional medical advice or delay in seeking it because of something you have read in this article or any linked materials.

Anna Mahoney is a Licensed Acupuncturist with a Bachelor's Degree in Nutrition from Rutgers University. In her practice, she focuses on bringing her patients back to health through Chinese Medicine, nutritional counseling, and overall wellness care. In her personal life, she is a passionate cook, musician, yogi, and athlete. Anna lives in New Jersey, with her husband, John, and their dog, Betty. Anna blogs at The Green Banana.