Gluten: How to tell if it’s a problem and what to do next

Do you feel bloated, tired, or brain-fogged after bread or pasta? Gluten can be the culprit, but not always. Some people have celiac disease, an autoimmune condition. Others have non-celiac gluten sensitivity or a wheat allergy. Each needs a different approach — and the right steps matter.

Testing and diagnosis

If you suspect celiac disease, don’t cut gluten out before testing. Blood tests like anti-tTG IgA (plus total IgA) are the first step. If blood tests are unclear, a gastroenterologist may recommend an intestinal biopsy. For wheat allergy, skin or blood tests can help. Non-celiac gluten sensitivity has no reliable lab test — doctors usually use a ruled-out approach: test for celiac and allergy first, then try a monitored gluten-free trial.

Quick tip: being already gluten-free can make tests false negative. If testing matters to you, eat gluten until your doctor says otherwise.

Practical tips: shopping, cooking, and eating out

Reading labels is your best defense. Look for obvious words: wheat, barley, rye, malt, brewer’s yeast, spelt, kamut, and triticale. Words like "hydrolyzed wheat protein" or "modified wheat starch" also mean gluten. Certified "gluten-free" claims are regulated in many places and usually mean less than 20 ppm — a useful shortcut.

Oats are tricky. Pure oats don’t have gluten, but cross-contamination with barley can happen. Pick oats labeled "gluten-free" if you react to gluten.

At home, avoid cross-contamination: use separate toasters, label jars, and keep condiments covered. At restaurants, ask how foods are prepared and whether fryers and cutting boards are shared. When in doubt, choose naturally gluten-free dishes (grilled meats, plain rice, steamed veggies) and ask for sauces on the side.

Switching your pantry doesn’t mean giving up nutrients. Gluten-free junk food exists, so aim for whole foods: rice, quinoa, buckwheat, millet, potatoes, beans, nuts, seeds, fruits, and vegetables. These give fiber and micronutrients. If you remove wheat products, check iron and B12 intake — some people need fortified foods or supplements.

Need a short grocery list? Stock rice, quinoa, gluten-free oats, chickpea or almond flour, canned beans, frozen vegetables, plain yogurt, eggs, and a few certified gluten-free snack options for emergencies.

If symptoms are severe, get medical help. If you’re already diagnosed, follow-up with your care team helps catch nutrient gaps and bone health issues. Want easy recipes or a printable shopping list? Search our site for practical gluten-free guides and meal ideas that make this change less stressful.