
Have you ever wondered what’s the difference between gluten sensitivity vs gluten intolerance?
The terms are used interchangeably even by functional practitioners which would make you think that a sensitivity and an intolerance are the same thing. The problem is that they aren’t. Each term speaks to very different mechanisms at play in your body.
Now I admit that until about a month of so, I was also under the impression that gluten sensitivity and gluten intolerance were the same exact thing. Just about every website you’ll read (especially the big sites intended for the layperson like you) will interchange them. Doctors will also do the same thing even if they’ve been schooled in functional medicine.
I don’t know if it’s that thought leaders in health and wellness got lazy or honestly didn’t know the difference, but either way it’s time to start being accurate with how you (and I) talk about how gluten affects you. It’s important to be accurate with how you talk about your health or a condition you have.
Using the wrong terms to describe something ultimately undermines the trust of those who know better. It’s like when people claim they are allergic to gluten because they are gluten insensitive (yes, I did just write the word “insensitive” on purpose).
First of all, you can’t be allergic to gluten (though you can be allergic to wheat).
And second, there’s no such thing as gluten insensitivity.
I’m not trying to poke fun here, but to point out that it becomes hard for others to take us seriously when we use terminology incorrectly.
So let’s take a moment to get in the know so that we can all start using the correct terms from here on out, okay?
Gluten Sensitivity vs Gluten Intolerance
To kick off this discussion, let’s drop the focus on gluten for a moment and just focus on the terms intolerance and sensitivity. According to the “Laboratory Evaluations for Integrative and Functional Medicine” textbook, a food sensitivity involves “various classes of food-specific immunoglobulin molecules that can form food immune complexes.” This differs from a food intolerance where an immunological reaction is not triggered.
To be clear — a food sensitivity involves the activation of specific parts of your immune system, but a food intolerance does not.
In order for you to truly understand that there are difference mechanisms here, I want to explain these two concepts a bit further without this conversation devolving into one that’s highly biochemical in nature and beyond the comprehension of many who lack a background in biochemistry and atopic (or allergic) conditions.
What’s a Food Sensitivity?
Let’s start with the concept of food sensitivity.
If you’ve heard of antibodies (they’re like soldiers of your immune system who attack anything that’s not you like bacteria, viruses, proteins, etc.), then perhaps you’ve heard of IgG antibodies. They are a type of antibody that will attach itself to undigested food proteins that sneak into your body due to leaky gut (also known as gut permeability).
These food proteins do not belong inside your body in their current state. They should have been digested properly and then absorbed by your GI tract, but that’s not what happened. The union of these food proteins with the IgG antibodies triggers an immune response cascade associated with proteins naturally produced in your body called complements.
These complements in turn trigger inflammation and all the other symptoms you experience associated with a food sensitivity which can be delayed for hours up to days after eating something to which you are sensitive.
What’s a Food Intolerance?
Now, the easiest way to explain an intolerance is by understanding lactose intolerance.
Many of us are familiar with someone who eats dairy and then has to run to the bathroom because they are lactose intolerant. To get around this, they’ll buy lactose-free dairy products. The reason that someone with a lactose intolerance has gastrointestinal issues is because they lack a specific enzyme called lactase which makes the digestion of lactose (a sugar found in dairy) difficult. So that we are very clear — lactose intolerance exists because the body doesn’t produce enough of the lactase enzyme to breakdown lactose.
Other types of common food intolerances include sucrose/maltose; histamine; tyramine; salicylate (found in aspirin); tartrazine; certain food preservatives such as “Benzoates, butylhydroxyanisol (BHA), butylhydroxytoluene (BHT), sulfites;” MSG; and food dyes.
Can you see the difference now between the two terms? They refer to very different mechanisms. Food sensitivities trigger an immune system response whereas food intolerances have to do with your body lacking specific enzymes necessary to break down a particular food substance.
Is Celiac Disease a Gluten Intolerance?
That said, I understand why there is so much confusion. WebMD argues that Celiac Disease is an autoimmune “food intolerance” because the body lacks the proper enzymes to break down gluten which then puts it in the same category as lactose intolerance.
Umm… Celiac Disease is an autoimmune disease, not a food intolerance.
An autoimmune disease involves your own antibodies that confuse your own tissue with that of an enemy or intruder. It thinks that, in the case of Celiac Disease, that the lining of the small intestine is the bad guy.
And to make matters worse, while it states that the field of food sensitivities is understudied, WebMD says that these types of reactions are not immune reactions even though they are.
But as many of us who’ve failed to get help through conventional medicine know, conventional understanding of this topic tends to be limited unless a doctor personally takes an interest to learn about it.
Why There’s No Such Thing As A Gluten Allergy
Since I mentioned a “gluten allergy” in my example above, I thought I should quickly explain this further because way, WAY too many people say they have an allergy to gluten. There are even websites that use the term “gluten allergy” on purpose because they know that people like you and I will search that term on the internet. Upon greater inspection, you’ll find that the only actual “allergy” mentioned is one to wheat.
Because of the rise in awareness of gluten sensitivity, there are people who will say that they have an allergy to gluten which is, from my research, incorrect.
One can have an allergy to wheat, but not to gluten specifically.
This has been reported numerous times in the media about people with gluten sensitivity or Celiac Disease (the autoimmune disease triggered by the ingestion of anything with gluten) who say that they have a gluten allergy. Allergists confirm that there is currently no validity that a gluten allergy exists.
You either have an allergy to wheat, gluten sensitivity or Celiac Disease… those are the three options.
Sure, there can be overlap (meaning you could be allergic to wheat and have Celiac Disease).
Actual allergies and sensitivities (and even intolerances) are different. VERY different specifically in the mechanisms of how they occur as a reaction to something (in this case, specifically a food particle).
You do not have the potential to go into a state of anaphylaxis if you have a sensitivity or an intolerance.
Typically IgE antibodies are involved which play a role along with mast cells and the release of histamine during an allergic reaction. If you need more information on food allergies, I’d highly recommend checking out the organization FARE.
Moving Forward…
Let’s be clear and correct with our words because it matters.
The media, your suspicious friends and family, and even chefs annoyed at the many faddish gluten free restaurant goers are listening.
And… most importantly, they are judging you every time you sit down at their table.
They have a scorecard by which they unfairly act as judge, jury and executioner.
The result?
A meal pretty much guaranteed to make you sick because they figure you won’t notice.
Now that you know the difference, please… stop saying you’re gluten intolerant or have a gluten allergy.
I certainly have and apologize for the past few years of using these terms interchangeably. I also call on practitioners to use these terms correctly because patients and the public take your lead.
And now you too, dear reader, can speak more accurately of what’s going on with you and gluten.
Jennifer,
Thanks for putting this out there. I can also I was doing this even I knew there was a difference. I will take on being clear as well. When I speak to people and educate them.
Connie
Gluten and Food Allergy Specialist
Good morning, Jennifer. I enjoy your emails. I send love and light to your mom and you as her surgery approaches.
I asked my endocrinologist for a celiac test. Result was negative. I have Hashimoto’s Thyroiditis and have adopted a gluten free diet as much as I can. There have been times that I have, out of frustration, jumped into a pool of gluten. And of course, within 30 minutes I present with major bloating, gas and just pure blah…it’s frustrating when my husband suggests that I order a “thin crust” pizza so I won’t get as much “wheat”!! Oh bother!! So these are my thoughts.
I’ve clearly missed the point. What do you say? Gluten, wheat and dairy make my child horribly sick… we say insensitive. What should we say at a restaurant?
Rachel, you should say that you’re gluten sensitive and that you will become very sick if you consume food that’s come in contact with gluten. That said, don’t just walk into any restaurant and expect them to be able to accommodate you. Always do your research first about restaurants that are willing and able to serve those with gluten issues, call them and be clear about your issues and ask if it’s safe for you, and then should you decide to go, make sure that they are aware of your food restrictions. What I am telling you here is just a tiny snippet of how I teach clients to eat out. I offer a short 30 minute audio course on how to do it that you can find over at https://www.jenniferfugo.com/services/.
Wonderful article. I hope lots of my FB friends read it – so useful and educating! Thanks so much.
‘Most importantly, they are judging you’ – that’s not the most important thing! I read that and was like ‘REALLY?’ 😮
The most important thing is that, when you say you’re gluten intolerant or you have a gluten allergy and next thing you’re ordering a beer or eating a certain cookie, people get confused to what food contains gluten. It’s not easy for people to understand that. I get questions like ‘does a potato have gluten?’ and people offer me bread and beer…
To be fair, I’m ‘just’ a sensitive one. In the Netherlands we use the word allergy as ‘I might die because of it’ and the word intolerance as ‘my body will get really angry with me when I eat this’. If I eat a certain amount of gluten, I can’t poop and my belly will bloat, which gives me the constant feeling of needing to pee… and I can only relieve all gas after midnight (or maybe it’s because I need to lay down 2h before I can go, which means I’d have to go to bed at 9pm and still ignore my urge to pee while waiting…).
When I go to a restaurant, I order whatever I think is most gluten free. I do in fact use soya sauce when I eat sushi and I know that people with wheat allergy of gluten sensitivity (both, according to this article) couldn’t. That’s why I pretty much never tell people I eat gluten free – unless it’s lunch or breakfast or when I’m at someone’s home and I have the time to explain what it means to me and only me 😉
BTW; I found this site via Pinterest. Really like it :3
I get what you are saying but I worry about using the term gluten sensitive. Many who choose to eat what they call “gluten light” use the term sensitive and many now equate that with being able to eat just a bit of gluten and be ok. I cannot do that. Just a tiny bit of cross contamination will give me a 3 day migraine along with gi issues and that doesn’t even take into account the damage being done to my thyroid. I need to ensure that restaurant staff understand that and unfortunately I think that the term sensitive doesn’t get me that any longer. I think that the mindset of restaurant staff needs to be changed before I could feel comfortable using the correct terminology myself.
I don’t know anyone who eats “gluten light” and have never heard that term until you used it just now. Some people choose to avoid gluten because they think it’s bad for them. Maybe it is, maybe it isn’t. I don’t have a crystal ball to say whether someone will need to strictly avoid it or not without looking at their individual case. I’m presenting the information based on what the reaction is called from a scientific perspective. We as a community would do better to work with the science that proves what is going on with us than cherry-picking terms that we think sound more serious than others. I do not believe that gluten intolerance sounds serious… especially since people who don’t believe that gluten is that big of a deal don’t think that gluten intolerance is a thing. So if you have a health reaction, you can say to the server, manager, and chef “I cannot eat gluten for medical reasons which would cause me to get incredibly ill in your establishment and I’m sure you don’t want that, right?”
There are clearer ways to share the seriousness of your gluten issues than using terms that aren’t scientifically grounded and ultimately make people who are already skeptical feel justified that it’s not real.
So to be clear, because I want to understand exactly what you were saying, it’s impossible to have an allergy or IgE response to gluten? I am aware gluten is a component of wheat, like lactose is a component of milk. I believe people can have an allergy to anything. I have always thought of an allergy as an immune system response, whether it be IgE or IgG mediated. How do you refer to seasonal allergies, as seasonal sensitivities? I guess it can be a bit confusing as it depends on how you want to view the issue. Unfortunately I do have multiple IgE and IgG allergies and sensitivities, validated through blood testing.
Hi Sarah, it’s easy to get confused because of how they’ve been talked about. Doctors use the terms interchangeably because it’s too complicated to explain the difference, but I do think it’s hurt our community and eroded our own message… the more we use terms that are wrong, the greater the opportunity for disbelievers to write more and more articles on how we peddle falsehoods and fake claims about gluten.
I’ve never heard the term “seasonal sensitivities”… if you’re allergic to pollen, you’re having an IgE response. IgG is a completely different mechanism involving a different part of the immune system. All I’m hoping to do here is to bring about more awareness that’s backed by science so that as we all talk about what happens to us with our health, we can do so from an educated perspective and give critics less fodder to say “see, they’re making stuff up!”
I understand what you’re saying, but I am just now reading an article from Dr. Alan Christianson where he takes a different opinion and says the following:
When it comes to using the term sensitivity or intolerance, I always like to go with the term intolerance. It’s used by more people and, to me, sensitivity sounds like the patient is being taken less seriously. This is a real problem, so we should take it seriously. (- See more at: http://drchristianson.com/the-ultimate-guide-to-food-intolerances/)
And I have the same feeling as him, that a sensitivity sounds less serious, so at restaurants they won’t be as strict. That is the opposite side of the coin…..
I agree with you about a “sensitivity” not being taken as seriously at a restaurant, but that’s not what I’m talking about here. It’s important to be able to speak from an educated perspective about what’s going on with one’s health and insisting that you have one thing when really it’s another can be a way for people to easily discredit you and our community.
Gluten is autoimmune..may start from low sunlight heritage/low sunlight/low Vit D. Gluten may hurt the gut lining so less nutrients absorb…then cells are not made right to work right to burn oxygen/food/make ATP. Gluten may hurt glands like thyroid/liver/pancreas/sex glands/adrenals/pituitary etc…hurt brain/body/all cells. To me it is all the same….tests may not work to diagnose Celiac, but gluten may still hurt. They don’t need to give it special names. Gluten may hurt worse with age and a person may collapse if they don’t change their diet. They may suffer and die early. Certified gluten free/food with a label/nuts not sold in a shell/meat basting/lotions/air make up etc may have hidden gluten. LDN may help block hidden gluten. Gluten enzymes may help in emergencies, but did not help totally which would still destroy intestines. Gluten is wheat/barley/rye…oats/corn/rice. Gluten issues are not a fad. Most people may need to figure out their own Celiac since tests may not work to diagnose it. People may heal fast if they change to gluten free. Glutlen may cause hair loss/depression/low thyroid/fibromyalgia/cancer/Diabetes/ADD/failure to thrive/skin issues/gut issues/addictions/alcoholism/bipolar etc. Celiac is America’ downfall. Fix the Celiac and 10 health issues may disappear fast. I had 1000X more energy and felt 20 years younger after two weeks of no gluten.
Jennifer, just found you web site and very interesting.
I had a blood test for food sensitive. it came back showing mild sensitive to
gluten and moderate to candida. So my nutritionist had me stop cold turkey on both and it’s been 2 weeks and I
am having a lot of withdrawal symptoms. I feel bloated which I have never had stomach problem also pain ,joint pain in my toes and fingers, my anxiety have been worse. I was also had hair sample and found my mercury level was high. that’s because I was always eating tuna every day for years. So I stopped that. I think I stopped to many things at once and my body doesn’t know what is happening. Can you please tell me if this is normal; and will pass.
Thanks
Hi Marie, I’m assuming when you said that you cut out the foods to which you were sensitive to, you cut out all gluten containing grains as well as processed flours and sugar. You can’t cut candida from your diet since it is a fungal infection, though you can certainly avoid foods that feed it or may have more fungus in it like kombucha.
It isn’t uncommon to have “withdrawal” symptoms, however everyone’s experience is different. Sometimes it takes months to pass, however you may want to approach your nutritionist about what’s going on. They need to be made aware and help you get through this. It’s possible that your protocol is too drastic for what your system can handle right now. I really can’t say because I do not have access to your case.
I have clients check in with me weekly and we work closely on protocols that they can sustain. That’s why I’d make a point if I were you to immediately contact your nutritionist to get support.