In recent years, gluten – a protein naturally found in rye, wheat, barley – has become a topic of great interest to many inside and outside of the medical field. Reducing or eliminating one’s gluten intake has long been regarded as a beneficial remedy for individuals that struggle to metabolize it. However, the “gluten-free diet” has recently seen a surge in popularity among individuals who do not suffer from these conditions as advocates of diet culture have claimed it can reduce headaches, joint pain, inflammation, fatigue, and promote weight loss. While there is research that can attest to the benefits aforementioned in patients who avoid gluten out of necessity, whether or not this is true of the remainder of the population remains a contentious issue. In order to determine whether a gluten-free diet is right for you, there are a number of considerations to take into account – many of which are best left at the discretion of your physician. 

One reason you could consider a gluten-free diet is if you believe you might be suffering from a gluten-related disorder. This broad category includes multiple conditions characterized by an adverse reaction to gluten including celiac disease (CD) and gluten sensitivities. Celiac disease is an autoimmune disease in which gluten triggers a cascade of gluten-specific antibodies in the small intestine which damages the absorptive endothelial lining, and causes diarrhea, fatigue, gas and bloating, nausea, and constipation. Non-digestive symptoms of celiac disease may also include anemia, osteoporosis, mouth ulcers, and numbness in the extremities. Many of these symptoms overlap with those of patients suffering from gluten intolerance – the key difference between these conditions being that the former is testable with a known cause, while the latter is not directly linked to any specific biomarkers and may vary in severity from person to person. Approximately 1% of the US population suffers from celiac disease, while an estimated 6% suffer from gluten sensitivity. 

If you experience one or more of the symptoms aforementioned some time after consuming gluten, it is best to consult your physician. The Mayo Clinic recommends doing so if you experience discomfort lasting longer than 2 weeks – though you should not stop eating gluten beforehand as this may affect the results of a test for celiac disease. While there is not a definitive test for gluten sensitivity, your doctor can conduct “rule-out” tests in order to determine whether this might be the case via process of elimination. In the event of either diagnosis, abstaining from gluten would undeniably be the wisest course of action, as sustained harm from ingestion in the case of celiac disease in particular may result in damage to your nervous system, bones, and potentially cancer. 

Should you consider a gluten-free diet in the absence of any gluten-related disorders? It is advisable that you consult a physician before doing so and keep a close eye on your health as you proceed. Although the drawbacks of celiac disease undoubtedly outweigh those of this diet, that does not make it a universally healthy option. Recent research into the intestinal microbiota–the collective populations of bacterial organisms that live in our intestine and aid in metabolizing certain nutrients and protecting against pathogens – has shown that eliminating gluten-containing foods from one’s diet produces mixed results. One study examining the microbiota of 21 adults who ate a gluten-free diet (GFD) for four weeks found reductions in a family of bacteria commonly linked to inflammation but also an increase in several families previously linked to adverse conditions and few signs elsewhere that the inflammatory response was mitigated. Another study – of 10 subjects who followed a GFD for four weeks–actually noted an uptick in many bacterial families generally associated with adverse effects in humans and a decrease in families considered beneficial, as well as biomarkers indicating that the immune response responsible for inflammation in CD patients might be hampered, but so might the system’s response to actual threats.

Critically, researchers and clinicians note that the effects of environmental disturbances upon the microbiota vary tremendously from person to person. The makeup of one’s intestinal bacteria is different from anyone else’s, and it is difficult to study due to limited technological capacities and small sample sizes. Since the microbiota is believed to be among the most important factors in the body’s reactions to gluten, any sweeping generalizations about health benefits of abandoning gluten for everyone should be taken with a grain of salt. 

With all of this in mind, it remains incredibly important that you consult with your physician on the appropriateness of a gluten-free diet before adopting it. Should you decide to do so, experts recommend keeping an eye on the nutritive value of the non-gluten foods that you are consuming, as replacing glutinous food with red meat, sweets, starches, and processed gluten-free snacks may lead to greater cholesterol, saturated fat, sugar, and salt consumption - all of which carry adverse effects of their own. In short, while a gluten-free diet certainly has the potential to be a healthy lifestyle choice if your situation calls for it and you manage it properly, the best available evidence shows that it should not serve as a panacea for everyone, regardless of health status.