June 2022 |  Linda Armstrong |  ✓  Medically reviewed by: Gary Falcetano, PA-C, AE-C; Fabio Iachetti, MD; Rebecca Rosenberger, MMSc, PA-C; Eva Södergren, PhD, MSc

Gluten is a family of proteins that acts as a sort of glue that holds food together. (The term is actually the Latin word for glue. Not surprising, huh?) Gluten can be found in rye, barley, triticale (a hybrid of wheat and rye), and wheat (including wheatberries, durum, emmer, semolina, spelt, farina, farro, graham, Kamut Khorasan wheat, and einkorn).¹

These seemingly sweet little proteins have gotten a bad rap, as everyone from Billy Bob Thornton to Miley Cyrus have claimed to have removed gluten from their diets at one time or another. Naturally, then, if you have digestive issues or mysterious symptoms, you might be wondering if gluten is causing your troubles as well.

So to provide you with some reliable info—as opposed to celebrity chatter—we put together the following primer. It’ll help you understand some of the more common gluten-related disorders and what steps you might take to seek a diagnosis.

Gluten-Related Ailments

There are five major gluten-related disorders: celiac disease, dermatitis herpetiformis, gluten ataxia, wheat allergy (which can be triggered by both gluten proteins and other proteins in wheat), and non-celiac gluten sensitivity.² (You probably haven’t heard of some of these, but each one is totally a thing. We promise.) Symptoms of these conditions overlap, so their diagnosis can be pretty difficult. ² That said, here’s a brief rundown of each of them.

Foods that Contain Gluten

While gluten can be found in all of the foods listed in the first section, some sources identify the “Big Three” gluten sources as wheat, rye, and barley. Here’s a brief list of some foods that contain these three sources of gluten:¹

• Wheat: breads, baked goods, soups, pasta, cereals, sauces, salad dressings, roux
• Barley: malt (e.g., malted barley flour, malted milk/milkshakes, malt flavoring, malt vinegar), food coloring, soups, beer, Brewer’s yeast
• Rye: bread (e.g., pumpernickel), beer, cereals

Keep in mind, this list is by no means exhaustive. Plus, in contrast to the other gluten-related disorders where you need to avoid all sources of gluten, a wheat allergic patient may be able to tolerate other grains such as barley and rye, as his or her allergy is not necessarily connected to gluten. Therefore, testing is important, and your healthcare provider can assist in providing additional nutritional guidance.

Diagnosing Gluten-Related Disorders

There are various ways to diagnose these disorders. For example, two types of blood tests can help diagnose celiac disease: 1) a serology test looks for antibodies in the blood that can indicate an autoimmune disease triggered by gluten, and 2) genetic testing for human leukocyte antigens can help rule out celiac disease.⁷

For wheat allergy, various tests and diagnostic tools may be used (e.g., skin-prick test, blood test, food diary, elimination diet, food-challenge test).⁸ Consult your healthcare provider to determine the type of tools and tests that are right for you.

Gluten-Free Diet

A gluten-free diet is essential for managing signs and symptoms of celiac disease and other gluten-related disorders. However, removing gluten from your diet likely changes your overall intake of fiber, vitamins, and other nutrients. Thus, it’s important to understand how this elimination can affect your overall nutritional needs. ⁹ (And just because your favorite singer or actor might go gluten free doesn’t mean it’s the right nutritional move for you.)

Also, keep in mind that those with a wheat allergy may not react to gluten and may in fact be sensitized to other proteins found in wheat. For these individuals, a gluten-free diet may be unnecessary.

For all these reasons, it’s important to consult your healthcare provider to make appropriate dietary choices.

Clearly, then, gluten-related issues aren’t just limited to celiac disease. These sticky proteins are linked to five key disorders. Still, it’s important to talk to your healthcare provider and successfully diagnose what’s causing your symptoms, rather than making assumptions and following the gluten-free trend. After all, you don’t want to break (with) bread or go against the grain if you don’t have to.