Gluten Sensitivity May Not Involve the Gut

David Perlmutter, MD.

Recently, Australian researchers published a report in the journal Gastroenterologythat purported to argue against the clinical entity known as non-celiac gluten sensitivity. In their research, the claim was made that because there were no biomarkers for gluten sensitivity correlated with introduction of gluten into the diet and no clear cut correlation of gluten exposure to gastrointestinal symptoms in their small study, the existence of gluten sensitivity as a clinical entity should be doubted.

The researchers evaluated the clinical parameter of “gastrointestinal distress,” in a mere 37 subjects. What’s troubling about this report is that it completely misses the point. As I have stated on multiple occasions, gluten sensitivity is frequently anextra-intestinal disease that may have no impact on the gut whatsoever.

As Dr. Marios Hadjivassiliou pointed out 12 years ago in his landmark publication,Gluten sensitivity as a neurological illness, gluten sensitivity may relate to a number of neurological conditions in the absence of gastrointestinal involvement. As this same author has stated more recently in a report appearing in Practical Neurology: 

Neurological manifestations of gluten sensitivity are a scientific fact, not a theological issue. Whilst the debate continues, we owe it to our patients to screen them effectively for gluten sensitivity with the simple widely available antigliadin antibody test so that we do not in the meantime deprive them of a harmless but potentially effective treatment in the form of a gluten-free diet.

As a practicing physician who has witnessed first hand the life changing effects of a gluten-free diet in individuals who have suffered from any number of physical ailments for literally decades, media attention to this study serves only to compromise the health of those who need this information the most.

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