You are always a
girl, usually in her twenties, but sometimes younger, and you say you’re going
to stop eating gluten. You say you’ve been feeling a bit ill, a bit bloated, a
bit sick, a bit tired-all-the-time, and – why not – you think this gluten-free
diet thing’s worth a go. Someone called Miley Cyrus said something about it,
after all.
I see a lot of
your tweets. This is because I check out the gluten, glutenfree and coeliac hashtags on
Twitter during idle moments, just to see what is happening in GF and CD world, to find
something worth RTing to my followers, that kind of thing. And when I see one I
usually I think, ‘Best ignore it – I’d be interfering’. But occasionally what I
read is a bit more alarming than the norm, so I think, ‘I’ll drop her a quick
tweet, just to tell her to carry on eating gluten and to see her doctor’. And so
I do and I’m ignored. Who can blame you? Random bald git telling you to do the
opposite of what you want to do – I’d ignore me too.
But what needs
to be said can’t be said in 140 characters. It can only be said in about 5,000.
So here they are.
Continue to eat
gluten. If you stop eating gluten one of three things will happen, and none of
them are good things.
1. You feel better
Why isn’t this
good? Because feeling better means you’ll probably decide that, yes, gluten is
making you feel ill, therefore that gluten is bad, and that you may have
coeliac disease and so you are going to avoid it. Welcome to the many problems associated
with all this:
a/ Your decision
that gluten has been making you feel ill is not reliable. I’ve explained why
eliminating gluten and feeling better does not mean gluten is making you ill
here and
here, but in a nutshell, your improvement could be psychological, or
it could be due to another constitutent of all the food you’ve cut out (eg
yeast, wheat starch), or to some nice nutrient you’re now consuming in the food
you’ve introduced to compensate for all the foods you’re no longer eating. It
does not mean your body hates gluten. Even if that somebody called
Miley Cyrus said it’s crappp.
b/ If you decide
your body does hate gluten it will reinforce your determination to avoid it,
perhaps needlessly, perhaps forever. A gluten-free diet requires specialist
advice and support from a trained dietitian in order to be nutritionally
complete. You won’t have received this because you’ve gone it alone, and you
are now vulnerable to deficiencies in things like B vitamins and zinc, which
can impact your health long-term in many colourful ways.
c/ But let’s say
you are right: you do react to gluten and you are a coeliac. Avoiding gluten
would, then, be the right thing. But because you’ve not had proper dietetic
advice, you may not be avoiding gluten as strictly as you need to be. How hard,
you might wonder, can it be? Very hard, actually, as countless people with (properly
diagnosed) coeliac disease will tell you.
Yes, you are
quite clever, and you will avoid bread and Weetabix and swap your standard
pasta for corn pasta. However, you’re not as clever as you think, and you will
perhaps drink some cheap cola, or eat a sausage, or a chocolate bar, or
any other potential surprising source of gluten, and these small traces will
continue to damage your gut. The worst thing about this is that because you
have reduced your gluten intake, you may no longer feel the symptoms (you feel
better, remember), so you may get no warning of what’s going on inside you.
Congratulations: you’re now increasing your risk of osteoporosis in later life,
and quite possibly intestinal cancer.
d/ At some point
you’ll hear that people with coeliac disease can get food on prescription and
you think how handy that would be. You eventually go to your doctor and ask for
a test. She tells you that you need to eat gluten regularly for six weeks
before you can be tested, because the blood tests only work when you are eating
gluten – a key reason why the charity
Coeliac UK implores undiagnosed people
like you to continue to eat gluten until you are diagnosed by doctors who know more
about gluten than somebody called Miley Cyrus. You either refuse to go back on
gluten – which leaves you stuck with some of the issues above – or you do go
back on gluten. If you do have underlying coeliac disease, going back on gluten
may well make you feel very ill, because your body was just getting used to
having a bit of a break, and it is now going to rebel fairly violently at having
this substance which it hates back in its system. You have six weeks of this
before you can get tested. Good luck with that.
2. You feel the same
If you feel the
same you will then decide your problems aren’t related to gluten. But this
isn’t necessarily true either. Because coeliacs take a while to get better, so if
you do have undiagnosed coeliac disease you may not feel the benefit of your
gluten-free diet straight away. Still, because you don’t know this, you might
go back to eating gluten, opening yourself up to long-term health risks mentioned
already. You may also tinker with your diet experimentally in other ways –
which again could leave you lacking in nutrition. This is because you’ve now abandoned
soya, or nuts, or dairy, or lactose, or another food which somebody called
Miley Cyrus or somebody called something else mentioned on Twitter, and now
your diet is severely restricted and difficult. All you are doing is delaying
the proper investigation you may need and causing yourself a lot of distress.
3. You feel worse
You feel worse
and you may not be eating properly and now you’re confused and you feel
depressed and you have not achieved anything. Except make yourself feel worse.
Do not give up
gluten.
Do not fork out
for an unproven high street allergy test of suspect science. Do not consult a
homeopath, a kinesiologist, a reiki person, a clairvoyant, or your mother’s cousin’s
neighbour who once tried an echinacea and arrowroot brew and never had the
trots again.
Do go to your
doctor. Please!
Labels: gluten, self diagnosis