Elimination Diet: Gluten
Gluten is a protein found in wheat, rye, and barley. For those with sensitivity to gluten, ingestion of gluten may give rise to a wide range of systemic, behavioral and gastroinstestinal (GI) symptoms such as headaches, muscle cramps, bone and joint pain, rashes, fatigue, depression and brain fog as well as abdominal cramps, diarrhea, bloating and nausea.
A gluten-free diet may be necessary to either establish or confirm the diagnosis of gluten sensitiity/hypersensitivity or to treat the condition and reverse the symptoms associated with ingesting gluten.
A catch-all term for conditions which result in symptoms due to ingestion of a food or nutrient, regardless of the mechanism by which the symptoms occur.
Symptoms resulting from the inability to digest/metabolize a food or nutrient – symptoms that are usually limited to the gastrointestinal (GI) tract.
An immune/allergic response to a food or nutrient that causes gastrointestinal (GI) symptoms and/or systemic symptoms.
Wellness/Anti-Inflammatory Diets (coming soon):
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Elimination Diet – Gluten
For those with gluten sensitivity, ingestion of gluten, a protein found in wheat, rye, and barley. may give rise to a wide range of systemic, behavioral and GI symptoms. Eliminating gluten from the diet is both diagnostic and therapeutic.
Gluten Elimination Diet: Celiac Disaease (CeD)
In order to verify the diagnosis of gluten hypersensitivity (Celiac disease) when blood testing and/or intestinal biopsy identify high risk for this condition, a trial diet eliminating gluten is warranted to both confirm the diagnosis and treat the condition. While an improvement in symptoms should be evident in weeks to months, it may take up to a year for the full benefits to be evident.
Gluten Elimination Diet: Non-celiac gluten sensitivity (NCGS)
In order to verify the diagnosis of gluten sensitivity (non-celiac gluten sensitivity) when blood testing and/or intestinal biopsy identify low risk for Celiac disease (CeD0, a trial diet eliminating gluten is warranted to both confirm the diagnosis of NCGS and treat the condition. Improvement in symptoms should be evident in 3-4 weeks after completely eliminating gluten in the diet. Upon resolution of symptoms, reintroduction of gluten into the diet followed by return of symptoms is the final determination establishing the diagnosis.
While it is difficult to maintain a gluten-free diet (GFD), careful attention to the process can be successful and rewarding. The following is a list of foods described as safe, to be ingested with caution only and those known to contain gluten and not be safe. This list is of course not all-inclusive. Care with reading food ingredients labels is mandatory and there are a number of resources available on the internet to help.
Grains, flours, breads and starches
Grains & Flours
Amaranth, Arrowroot, Bean Flour (Lentil, Romano, Garbanzo, etc.), Buckwheat, Carob Flour, Chickpea Flour, Corn Flour, Corn Meal, Cornstarch, Job’s Tears Kasha (Roasted -Buckwheat), Kudzu Root Starch, Maize, Maize Waxy, Masa Flour, Millet, Montina Flour (Indian Rice Grass), Nut Flour (Almond, Chestnut etc.), Pea Flour (Chickpea, Besan, Cowpea etc.), Potato Flour, Potato Starch, Quinoa, Ragi, Rape, Rice Flour (White, Brown, Sweet, Bran), Sago Flour, Sorghum, Soy Flour, Tapioca, Flour, Tarrow Root, Teff Flour, Yam Flour
“Safe” flours in bulk bins in stores.
Groats can be from either safe or unsafe grains.
Soba Flour is usually buckwheat but may contain wheat as an ingredient
Barley (Malt, Pearl, Grass etc.), Bleached Flour, Bran, Bread Flour, Brown Flour, Farina Graham, Fu (dried wheat gluten), Gluten Flour, Graham Flour, Granary Flour, Groats (Barley, Wheat), Harina, Malt, Matzo Semolina, Oats, Rye, Semolina, Spelt, Wheat (Semolina, Sprouted, Durum, Starch, Bulgar, Kamut, Grass, etc.), Whole-Meal Flour Wheat Germ
Breads and mixes using only allowed flours, (100% corn, rice, soy etc).
Gluten-free breads and mixes made in a non-dedicated facility.
All breads and bread products made with flours and grains not allowed.
Hot and cold cereals made from the allowed grains, Cream of Rice, Cream of Buckwheat, Grits Corn, Hominy Grits
Commercial cereals made in a non-dedicated facility
Hot and cold cereals containing a grain not allowed. Cereals made with malt or malt extract.
Pastas, Potatoes & Other starches
Pastas made from allowed grains, Rice including white brown and wild, Corn tacos and corn tortillas, Potatoes, Saifun (bean threads), rice noodles
Commercial rice and pasta mixes, French Fries, Fried restaurant foods (gluten contaminated grease), Polenta
All pastas made from grains not allowed, Couscous, Tabbouleh, Soba Noodles
ckers & Snack foods
Corn Tortillas (plain), Potato Chips (plain), Popcorn (plain), Nuts (plain), Crackers made with grains are allowed.
Flavored tortillas and chips, Flavored rice cakes, Rice Crackers, Roasted Nuts, Rice Cakes, Microwave popcorn
All containing grains not allowed, Pretzels, Flour Tortillas
Milk dry, evaporated and condensed milk, Cream, Yogurt (plain), Aged Cheeses
Whipping Cream, Flavored Yogurts, Milkshakes, Flavored milk, Ice-cream, Frozen Yogurt, Soy and Rice milks, Cottage Cheese, American Cheese, Cheese Spreads, Cream Cheese, Low Fat and Fat Free Cheese, Ricotta Cheese, Imitation Cheeses, Sour cream, Veined Cheese (Blue, Gorgonzola).
Dairy products containing ingredients not allowed, Malted Milk, Chocolate milk with malt.
Meat & Other Proteins
Fresh 100% meat, beef, pork, and poultry, Eggs, Tuna Fish canned in oil or water, Tofu-Soya Curd, Nuts (plain), Legumes (beans, peas and lentils)
Soybean and other meat substitutes, Sausages, Meat Imitations, Seafood Imitations, Egg Substitutes, Tuna canned in broth or brine, Meats and fish containing HVP or HPP, Deli Meats, Peanut Butter, Products that contain broth.
Processed meat products containing ingredients not allowed, Seitan
Fruits, Vegetables and Soups
Fruits & Fruit Products
Fresh Fruit, Pure Fruit Juices
Thickened or prepared fruits and pie fillings, Dried fruit mixes, Jelly and Jam
Fresh, frozen and canned plain vegetables without additives, Legumes, Peas Beans and Lentils.
Tomato paste, sauce, and puree, Vegetables in sauces or contain additives, Baked Beans
Battered dipped vegetables
Commercially prepared gluten-free soups and stocks.
Commercially prepared soups and stocks, Beware “home made” statements. Bouillon cubes and Powder.
Any soup containing ingredients not allowed.
Nuts and Seeds
Nuts & Seeds
Nuts (plain), Seeds (plain), Soybeans, Coconut
Dry roasted nuts, Flavored or sweetened nuts, Nuts in bins, Flavored or sweetened coconut
Butter, Oils (vegetable, canola, olive etc), Shortening, Crisco
Margarine, Low fat butter spreads, Salad Dressing, Mayonnaise
Packaged Suet Wheat Germ Oil
Gluten-free cakes, cookies and baking mixes, Pure Cocoa, Gluten-free ice cream
Ice Cream, Frozen Yogurt, Sherbet, Pudding/Custard, mixes, Candy, Frozen Desserts, Icing, Ices, Meringues
Cakes, cookies and other baked goods made with unsafe grains, Ice Cream Cones, Licorice
Tea (black, green and white), Coffee (plain), Pure Fruit Juices, Cider
Soy & rice beverages, Instant tea and coffee, Flavored tea and coffee, Hot Cocoa, Hot Chocolate, Soda, Sports Drinks, Nutritional Supplements
Malted Beverages, Ground coffee with added grains
Hard Cider, Wine, Sake, Sherry, Champagne, Tequila, Cognac, Brandy, Rum, Kaluha, Gluten-free Beer
Alcohol distilled from grains, Vodka, Whiskey, Bourbon
Beer, Ale, and Lager
Salt, Pepper (black, white and red), Pure Herbs, Pure Spices, Pure Flavoring Extracts, Wheat Free Soy Sauce, Cream of Tartar, Pickles, Honey
Ground Spices, Seasoning and Spice mixes, Gravy Cubes and Mixes, Bouillon Cubes and Powder, Ketchup, Mustard, Mustard Powder, Worcestershire Sauce, Salad Dressings, Soy Sauce, Teriyaki Sauce, Relish
Most Soy Sauces contain wheat
Seaweed (algin, algae, alginate), Alfalfa, Aspic
Yeast, Yeast Flakes, Bicarbonate of Soda, Baking Soda, Baking Powder, Powdered Sugar, Molasses, Rice Paper, Confectioner Sugar
Communion Wafers, Brewer’s Yeast
Lotions, Creams, Cosmetics, Lip Gloss, Lip Balm, Sunscreen, Toothpaste, Mouthwash, Products used in Dental Offices, Medications: Prescription and over the counter (many contain gluten), Laxatives, Vitamins, Stamps, Envelopes, and Gummed Labels, Play Doh, Paper Mache
- Celiac Disease – National Institute of Diabetic, Digestive and Kidney Diseases (NIDDK)
- What should I avoid eating if I have celiac disease? – NIDDK
Gluten: Celiac Disease
- Update on Celiac Disease – New Standards and New Tests – Algorithm
- ACG CLINICAL GUIDELINE – DIAGNOSIS AND MANAGEMENT OF CELIAC DISEASE – 2013
- Benefits of a gluten-free diet for asymptomatic patients with serologic markers of celiac disease. – PubMed – NCBI
- Coeliac disease -2008-Leeds
- Diagnosis and management of adult coeliac disease – guidelines from the British Society of Gastroenterology
Gluten: FM and Celiac Disease
- Clinical impact of a gluten-free diet on health-related quality of life in seven fibromyalgia syndrome patients with associated celiac disease
Gluten: Non-Celiac Gluten Sensitivity (NCGS)
- Nonceliac gluten sensitivity. – PubMed – NCBI
- Non-celiac gluten sensitivity – Time for sifting the grain – 2015
- Non-celiac gluten hypersensitivity. – PubMed – NCBI
- The Overlap between Irritable Bowel Syndrome and Non-Celiac Gluten Sensitivity – A Clinical Dilemma – 2015
- Non-celiac Gluten Sensitivity. Is it in the Gluten or the Grain? – 2013
- Fibromyalgia and non-celiac gluten sensitivity – a description with remission of fibromyalgia – 2014
- The Effects of a Gluten-free Diet Versus a Hypocaloric Diet Among Patients With Fibromyalgia Experiencing Gluten Sensitivity-like Symptoms: A Pilot… – PubMed – NCBI
- Gluten-free diet in the management of patients with irritable bowel syndrome, fibromyalgia and lymphocytic enteritis – 2014
- Non-coeliac-gluten-sensitivity – A-new-disease-with-gluten-intolerance-2015
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