How Gluten Intolerance May Be Linked To Genetics

What do bloating, diarrhea, nausea, brain fog, fatigue, depression and anemia all have in common? According to Beyond Celiac, they make up the list of the most common symptoms for gluten intolerance. Symptoms so vast and undesirable leave little mystery as to why one-third of Americans are kicking gluten to the curb (according to NYU Langone Health). While it seems like a no-brainer to eliminate dietary culprits that prevent us from feeling our best, some doctors stress that grains containing gluten may provide important dietary nutrients and complete elimination of gluten could be costly to one's health. So who should be concerned and what constitutes necessary elimination? Genetics may provide important clues to a small percentage of the population who carry a pathogenic intolerance to gluten and higher risk of developing the disease. Therefore, some medical professionals recommend that those considering nixing gluten altogether should first get the proper diagnostic testing, in order to avoid needlessly restricting their diet.

Beyond Celiac suggest about 1 in 133 Americans has celiac disease, though prevalence may be higher than diagnosis rate. Additionally, the Celiac Disease Foundation claims there's a steady rise of celiac disease, with a 7.5% increase per year. While celiac susceptibility carries genetic risk, the disease is not inherited, according to Genetic and Rare Diseases Information Center. This means that in order to develop celiac disease, one must carry two genetic markers and certain environmental factors must have then influenced those genes. The genetic markers associated with celiac disease are HLA-DQA1 and HLA-DQB1. It's estimated that HLA-DQ2 is the most common gene association, found in roughly 95% of people with celiac disease, while the less common HLA-DQ8 gene is found in about 5% of cases (via Beyond Celiac). While family history of celiac disease doesn't guarantee you'll develop it, knowing your family history can provide important clues as to your risk in order to manage symptoms and long-term health risks. By avoiding gluten, those with celiac disease can prevent repeated immune response triggers and damage to the lining of the small intestine. It's this intestinal damage that prevents absorption of critical nutrients and induces unpleasant side effects that could lead to health complications down the road, according to Mayo Clinic. Currently, no cure exists for celiac disease, but for many, symptoms are managed by adhering to a strict gluten-free diet.

Non-celiac gluten sensitivity, or gluten intolerance, may be to blame for undesirable symptoms even if one isn't susceptible to celiac disease. However, some doctors suggest these intolerances be treated slightly differently from celiac disease, insist that variations of tolerance levels exist, and caution against a 100% gluten-free diet for those who dont have celiac disease (according to NYU Langone Health). But how does one determine a sensitivity if they test negative for the celiac genetic markers? According to Beyond Celiac, there's currently no accurate way to test for non-celiac gluten sensitivity or gluten intolerance. Therefore, if there's a genetic component to non-celiac gluten sensitivity, it's yet to be discovered. Those in the scientific community caution consumers about tests claiming to detect non-celiac gluten sensitivities via stool, saliva, or blood, as they've not been scientifically validated. As such, some doctors may recommend an elimination diet, which typically involves a period of eliminating 100% of gluten from the diet, followed by a reintroduction and monitoring for symptoms during reintroduction.