Guide on Gluten-Related Disorders

Celiac disease is only one of several gluten-related disorders. A recent paradigm shift has occurred within the healthcare field with the recognition that non-celiac gluten sensitivity is at least six-fold

Celiac disease is only one of several gluten-related disorders. A recent paradigm shift has occurred within the healthcare field with the recognition that non-celiac gluten sensitivity is at least six-fold, and (so far) as high as 20-fold more frequent than celiac disease — and there are even more gluten-related disorders where those came from.

How do we differentiate the world of gluten-related disorders? This is a critical discussion. Would you treat an IgE reaction the same as an IgA reaction? There are similarities in protocols, but each carries a different emphasis.

There is a spectrum of gluten-related disorders. Now, what does that mean? It means there are at least four different conditions that fall under the category of a “gluten-related disorder.”

Here we cover the four most recognized categories of gluten-related disorders.

Allergy (IgE)

The first one—the oldest of these in terms of being identified in medical literature—is an allergy, more specifically a wheat allergy. That’s an IgE reaction. And those tests came out in the 1950s. The skin prick test is still used today. It can be diagnosed by skin pricking or by a blood test.

Any other immunoglobulin response cannot be called an allergy because the first immune response that was identified was coined as an allergy — an IgE response.

To get your language right so that you are referring to the proper conditions when you’re talking with your peers, do not refer to a gluten-related disorder as an allergy unless there is an IgE response present. Refer to it simply as a gluten-related disorder.
Common symptoms of a wheat allergy include:
In the following serious but rare circumstances listed below, seek emergency treatment immediately:

Celiac disease

Celiac disease is the most well-known gluten-related disorder. In fact, many people don’t even realize there are other gluten-related problems other than celiac disease. It’s an autoimmune condition that results in tissue damage in the small intestine. Celiac disease is unique and separate in its own way.

The standard test for celiac disease looks at transglutaminase antibodies [IgA]. There are nine different transglutaminases. We look at transglutaminase 2, which is on the microvilli in the intestines. It also covers the organs, liver, kidneys, heart, and spleen.

This test is considered the diagnostic marker for celiac disease, but there’s a problem with the test. It shows transglutaminase ninety-seven percent sensitive to identify celiac disease.

The problem is that the researchers use celiac patients in these studies, and to qualify as a celiac patient, you have total villous atrophy. In order to get diagnosed, a patient would have had an endoscopy where a doctor could see that the microvilli were worn down completely. So, if you have total villous atrophy, the transglutaminase blood test will be accurate 9.5 to 9.9 out of 10 times.

But, if you have partial villous atrophy, the test may come back negative — that’s a problem. You won’t see it in that blood test because it’s only sensitive at total villous atrophy.

I would personally like to change how the medical community views and tests for celiac disease. Rather than wait until you have reached the final stage, I propose we look at it as a spectrum so people can identify the problem early on and follow a gluten-free protocol.

We already have the ability to do this. In the US, we have an excellent tool to distinguish between celiac, non-celiac gluten sensitivity, non-gluten wheat sensitivity and autoimmune processes triggered by gluten: the Vibrant Wellness Wheat Zoomer test. At this time, it is available everywhere in the US except New York.

In both the US and internationally, we have the Cyrex Array Panels.

Unless you notice an immediate reaction upon eating a food, it can be difficult to make the association between the food and symptoms that can appear later. Many people with celiac experience problems outside of their gut, making it even less likely to make a food association.
Some Common Symptoms of Celiac Disease:

Non-Celiac Gluten Sensitivity

Unlike an allergy, non-celiac gluten sensitivity is a non-IgE immune response*. And that would be IgM, IgG, or IgA. Remember, there are different branches of the armed forces. Your immune system is like the armed forces. It’s there to protect you. You have an Army, an Air Force, Marines, Coast Guard. IgA, IgG, IgE, IgM. So this category is non-IgE immune response. There is a tremendous amount of discussion in the literature about this category. This includes the world of non-celiac gluten sensitivity .

Most of its symptoms occur outside of the intestines and gastrointestinal tract. People with gluten sensitivity develop symptoms after eating gluten, but the immune reaction is different than the one that occurs in celiac disease. Non-celiac gluten sensitivity is more common than celiac disease.

In one study, researchers from Italian medical centers that specialize in the diagnosis and treatment of gluten-related disorders identified nearly 500 patients with suspected non-celiac gluten sensitivity. They used patients’ reported symptoms, lab tests, intestinal biopsy results (if performed), and other factors to identify those who were sensitive to gluten.

The most common symptoms reported in people with gluten sensitivity included:

Gluten-sensitive people in the study also experienced constipation, rashes, weight loss, anemia, depression, mouth sores, and more. More women than men suffered from gluten sensitivity, by a ratio of more than 5 to 1. The average age of the patients was 38. Nearly half of the patients had irritable bowel syndrome (IBS) while 35% reported food intolerance. Almost 1 in 5 patients had a relative with celiac disease. Researchers reported that 14% of gluten-sensitive people in the study had an autoimmune disease, most commonly autoimmune thyroiditis.

Non-immune Malabsorption Syndrome

Your body is opportunistic, seeking to draw in and utilize as many nutrients as it can. When you ingest foods, the expectation is that your body can and will use whatever properties that food provides, and discard as waste that which it cannot. But if you have a malabsorption syndrome, foods go through you without reaping much benefit.

There are different tests that may indicate a problem, such as high fat content in the stools. The tests chosen greatly depend upon symptoms, medical history, and the suspected reason behind your malabsorption syndrome.

Common Symptoms of Malabsorption Syndrome

Addressing Gluten-Related Disorders

Avoid gluten.

The #1 rule for addressing gluten-related disorders is to avoid gluten. This includes inhaling it, eating it, putting it on your skin or hair. Wherever your body finds it, it will attack if you have a problem with gluten (or wheat).

Hidden Gluten is EVERYWHERE

It isn’t just in your food, so learn what to look for and where your most likely accidental exposures may happen. To address cross-contamination preventatively in high-risk situations like eating out, take E3 Advanced Plus or WheatRescue. Both of these products act to breakdown gluten proteins within 90 minutes (prior to entry into the small intestine where the autoimmune response occurs).

Know when to seek emergency treatment.

If you have an allergy to wheat or gluten, carry an EpiPen in case of an extreme reaction like anaphylaxis. This can be a dangerous and life threatening situation if left untreated. Some signs include constriction of air pathways making it difficult to breathe, a weak and rapid heartbeat, fainting, dizziness, hives, and nausea. This requires an immediate trip to the emergency room — even after you have injected yourself with epinephrine and begun showing improvement. You can have a second reaction called biphasic anaphylaxis.

Supplement as needed

With the necessary absence of gluten in your diet, your microbiome changes and you can lose prebiotics that feed the probiotics in your gut that protect you. Other nutritional changes occur due to your change in diet. If you don’t address these changes, you could inadvertently end up causing an inflammatory cascade of events while attempting to address your gluten-related disorder. See a nutritionist who can guide you in adjusting your diet to not just exclude gluten, but to include foods that will make up for the nutritional losses.

Test periodically.

People who have been living gluten-free assume they no longer need to get tested. They tested to discover the problem, and now they are on a gluten-free diet. What’s the point? Without periodic testing, you don’t know if the protocol you are using is actually working. If you think you are gluten-free and antibodies are firing away, you may not feel it until an autoimmune disease rears its ugly head. You want to make adjustments before feeling symptoms.Tests give you insight into what’s really going on, so that you can make whatever improvements and modifications in what you are currently doing in order to be more successful.

Who wants to go through all the trouble of being on a gluten-free diet only to realize that one of their daily exposures keeps them in the same predicament as before? Test. Fix. Retest.

You Can’t Eat a Little Gluten.

When you have a gluten-related disorder, you can’t eat a little gluten every now and then. Maintaining a gluten-free diet can feel restrictive and require a commitment to your health, but your health is at risk when you eat gluten. So avoid it.

If you go to someone’s house to eat, bring a dish you can eat. Slowly educate friends and family about what you can and can’t eat — and WHY! It isn’t a fad. It’s a health condition.

Rather than dwelling in what once was, becoming increasingly isolated, or giving in on special occasions, find ways to create opportunities to be included that allow you to eat.

With time and dedication, you will get some basics down and begin to expand out into exploring new foods and finding ways that work easily within your lifestyle. Give yourself time to get used to this new way of life, and remind yourself why you are doing it in the first place. Find treats that are gluten-free that allow you to not feel denied and keep you on a path to wellness.

To find a wealth of information about gluten-related disorders, add The Gluten Summit to your health library. The Gluten Summit gathers 29 of the world’s experts for a one-to-one conversation with me about celiac disease, food sensitivities, autoimmunity, nutrition and more. Find your motivation through patient education. 

Educational Center

Gluten Related Disorders
Your Need To Know Guide
Learn More
Gluten Summit
Hidden Sources of Gluten
Autoimmunity & Gluten: What's The Formula?
Gluten Intolerance Testing
Learn More
Gluten-free Food Service and Restaurant Guide
Learn More
Wheat and Other Grains
Learn More
ALl Blogs
Learn More
Scroll to Top

Get the latest articles, podcasts, special offers, and more...

By submitting this form, you’re agreeing to receive messages from Your email address will NEVER be shared or sold. You’re always free to easily unsubscribe at any time.

Coriolus Versicolor

Coriolus Versicolor, a remarkable mushroom, is esteemed for its potential to contribute to overall wellness. Known for its immune-supporting properties, Coriolus Versicolor may help strengthen the body’s natural defenses. This extraordinary mushroom has also been associated with promoting healthy energy levels, supporting digestion, and fostering vitality.

Fo Ti

Fo Ti, a revered Chinese herb also known as He Shou Wu, is valued for its potential to support overall wellness. Traditionally used for promoting vitality and longevity, Fo Ti may contribute to maintaining healthy energy levels, cognitive function, and immune system performance. This remarkable herb has also been associated with supporting liver and kidney health, as well as fostering a sense of overall balance


Agave, a versatile desert plant native to the Americas, is recognized for its potential to support overall wellness. Rich in natural fibers and low-glycemic sweeteners, Agave may contribute to maintaining healthy blood sugar levels, digestive health, and providing a natural alternative to refined sugars.

Maral Root

Maral Root, a potent adaptogenic herb native to Siberia, is celebrated for its potential to contribute to overall well-being. Known for helping the body manage stress and maintain balance, Maral Root may also promote healthy energy levels, endurance, and cognitive function. This exceptional herb has been associated with supporting the immune system, fostering vitality, and enhancing physical performance.

  • Antioxidant and DNA Repair Stimulating Effect of Extracts from Transformed and Normal Roots of Rhaponticum carthamoides against Induced Oxidative Stress and DNA Damage in CHO Cells:


NotoGinseng, a distinct variety of Panax ginseng native to the Changbai Mountains, is esteemed for its potential to contribute to overall well-being. Renowned for its adaptogenic properties, Noto Ginseng may help the body manage stress and maintain balance. This exceptional herb has been linked to supporting cognitive function, promoting healthy energy levels, and boosting immune system performance.


Baicalin, a potent bioflavonoid derived from the Scutellaria baicalensis plant, is appreciated for its potential to promote overall wellness. With its antioxidant and anti-inflammatory properties, Baicalin may help protect cells from oxidative stress and maintain a balanced response to inflammation. This remarkable compound has been associated with supporting liver health, promoting cardiovascular function, and fostering a sense of vitality.

Purple Lapacho

Purple Lapacho, a unique and potent herb, is valued for its potential to support overall well-being. Known for its immune-boosting properties, Purple Lapacho may help fortify the body’s natural defenses. This remarkable herb has also been associated with promoting healthy energy levels, supporting digestion, and fostering vitality.

Holy Basil

Holy Basil has been found to protect organs and tissues against chemical stress from industrial pollutants and heavy metals, and physical stress from prolonged physical exertion. It has also been shown to counter metabolic stress through normalization of blood glucose, blood pressure and lipid levels.


Ashwagandha, a revered adaptogenic herb, is acclaimed for its potential to support overall well-being. Known for helping the body manage stress and maintain balance, Ashwagandha may also contribute to healthy energy levels and mental clarity. This remarkable herb has been associated with promoting relaxation, supporting the immune system, and fostering vitality.


Guarana, a powerful plant, is celebrated for its potential to support overall wellness. Rich in natural caffeine, Guarana may help promote mental alertness, focus, and healthy energy levels. This remarkable plant has also been associated with supporting endurance and enhancing physical performance.


Catuaba, a potent herb, is appreciated for its potential to contribute to overall well-being. Known for its adaptogenic qualities, Catuaba may help the body cope with stress and maintain balance. This remarkable herb has also been associated with promoting mental alertness, healthy energy levels, and fostering a sense of vitality.

Reishi Mushroom

Reishi Mushroom, a highly-regarded fungus, is esteemed for its potential to enhance overall wellness. With adaptogenic properties, Reishi Mushroom may help the body manage stress and maintain balance. This extraordinary mushroom has also been linked to promoting immune system support, healthy energy levels, and fostering a sense of calm and relaxation.

Astragalus Root

Astragalus Root, a powerful herb, is respected for its potential to contribute to overall well-being. Renowned for its immune-supporting properties, Astragalus Root may help fortify the body’s natural defenses. Additionally, this remarkable root has been associated with promoting healthy energy levels, heart health, and supporting the body’s ability to adapt to stress.

Asian Licorice Root

Asian Licorice Root, a versatile herb, is valued for its potential to support overall wellness. Known for its adaptogenic properties, it may help the body cope with stress and maintain balance. This remarkable root has also been linked to promoting healthy digestion, respiratory function, and supporting the immune system.

American Ginseng

American Ginseng, a revered herb, is prized for its potential to contribute to overall well-being. With adaptogenic properties, it may assist the body in managing stress and maintaining harmony. American Ginseng has also been associated with promoting mental alertness, healthy energy levels, and supporting the immune system.

Rhodiola Rosea

Rhodiola Rosea, a robust herb, is admired for its potential to support overall wellness. As an adaptogen, Rhodiola Rosea may help the body cope with stress and maintain balance. This remarkable herb has been linked to promoting mental clarity, healthy energy levels, and increased endurance.

Peruvian Maca

Peruvian Maca, a nutrient-packed root, is celebrated for its potential to enhance overall well-being. Known for its adaptogenic qualities, Maca may help the body manage stress and maintain balance. This powerful root has also been associated with promoting healthy energy levels, endurance, and supporting hormonal balance.

Schisandra Fruit

Schisandra Fruit, a unique berry, is renowned for its potential to contribute to overall wellness. Boasting adaptogenic properties, it may help the body adapt to stress and maintain equilibrium. Schisandra Fruit has also been linked to promoting healthy energy levels, mental clarity, and supporting the body’s natural defense


Acai, a nutrient-dense berry, is recognized for its potential to enhance overall well-being. Rich in antioxidants, Acai may help support the body’s defenses against environmental stressors, while promoting healthy energy levels and vitality.

Himalayan Goji

Himalayan Goji, a nutrient-rich fruit, is valued for its potential contribution to overall wellness. This superfood is believed to support the immune system, promote healthy energy levels, and aid in maintaining balance within the body. With its antioxidant properties, Himalayan Goji may help protect cells from environmental stressors.

Gotu Kola

The main group of components in gotu kola is the triterpenes including asiaticoside, madecassoside, asiatic acid, and madecassic acid, which have antioxidant and anti-inflammatory properties that are shown to positively influence brain plasticity which means a much sharper you.

  • Exhibits significant wound healing ability, Improves microcirculatory parameters, Sedative and anxiolytic properties, Antidepressant, Re-vitalize the brain and nervous system, increase attention span and concentration and combat aging:

Water Hyssop

Best known as a neural tonic and memory enhancer this powerful herb increases cerebral blood flow and neurotransmitter modulation.

Green Tea Extract

Healthy energy producer and one of the more researched and promising supplements. It upregulates fat metabolism at rest and during exercise. In recent years the consumption of Green Tea Extract has shown to help prevent lifestyle diseases like cardiovascular disease because of it’s preventative effects on chronic inflammation.

  • Helps with weight loss by increasing a protein hormone which is involved in regulating glucose levels as well
    as fatty acid breakdown:
  • Decrease cholesterol absorption and plasma levels, has strong free radical-scavenging
    activity inhibiting LDL oxidation, reduce the adhesion molecule expression, has antitrombotic activities by inhibiting platelet aggregation: 

Mikania Guaco

“Guaco” is Sun Horse Energy founder Dan Moriarty’s favorite herb, and the reason why he’s still alive. Traditionally, it’s a well-known herb for snake bites, scorpion stings and other venomous creatures. Guaco acts as a non-steroidal bronchodilator, meaning it opens up the airways without steroids. As a result of guaco opening up the airways, the alveoli (tiny air sacs in the lungs) are better able to accept oxygen transfer and get rid of carbon dioxide. In Brazil, Guaco syrup is one of the most popular herbal medicines used to treat the symptoms of asthmatic bronchitis, cough and hoarseness.

Osha Root

A traditional Native American herb, Osha is also known as “Bear Root”. Native Americans noticed that when bears emerged from hibernation, the first thing they did after being in a state of torpor for 4 months was not feast on salmon or drink water, but rather, dig up osha and eat it. Why? It decongests and wakes up the lungs. Native Americans who used Osha were able to run further, and treat their colds and congestion. Modern research studies suggest Osha may support the immune system by offering protective effects against oxidative damage.

I want to thank you for your existence. I want you to know that functional medicine has changed my life, well the life of my autistic son. So much so that I plan on taking the Functional Medicine Health Coach Certificate and work with my new friend who is now a Functional Medicine Doctor from the Institute of Functional Medicine and spread the word on GI testing and how finding the underlying issues will help eliminate autistic traits. 

I hope to be able to meet you one day so I can share this great news with others. Changing my son’s diet has changed him. Food is medicine!! By the way, I’m cooking my rutabaga. I’m Italian and never grew up with these. With love.

Rita Mastrangelo

I found you on YouTube a couple of weeks ago and I’m hooked. I listen to you a couple of hours every morning. I am being tested for celiac disease and have been gluten-free for a couple of weeks. Thank you for all of your insight.

April Renee

Just wanted to tell you that you’re amazing! You are helping so many people all over the world! Including me! Thank you so very much, Dr. Tom O’Bryan!

Patricia Puddle

Good morning Dr. Tom, Would just like to say thank you! This time last year I was going through a hell of a time with my gut. Terrible indigestion on a regular basis, feeling as if I had eaten a boulder and the tiredness was doing my heed (scottish for head) in! With two young girls being tired is not an option!

I went to the doctors on a number of occasions and they decided to prescribe omeprazole to mask the problem, sorry help my problem. I decided taking these drugs was not an option for me! So I started googling the life out of it!! Low and behold you started popping up!! Oh and Gluten intolerance! 

Your advice has been second to none! You have in my case really simplified what gluten does to my body and now that I have cut it out (which as it appears in lots of foods, some I can’t understand) I have found that my symptoms very quickly reduced and now I’m a year down the line they have gone for the vast majority of the time!! For that I’m truly grateful. I now follow you on YouTube and Instagram, which continues to educate me and the importance of gut health. I look forward to your future advice. Yours faithfully,

Gary Christie

Black Ant Extract

A Chinese medicine tonic, Black Ant is used to support energy levels. (In traditional Chinese medicine, Black Ant is given to increase vital Qi.) Research studies demonstrate that Black Ant supports the function of the thymus gland, which plays a crucial role in the immune system, producing and activating lymphocytes.

Siberian Ginseng

This well known adaptogen has been proven to reduce cardiovascular stress, lower and stabilize blood sugar to healthy levels, and encourages a more efficient lipid metabolism.

Pine Bark Extract

Many studies have shown that pine bark possesses anti-aging properties. It’s very similar in nature to the well-known antioxidant and anti-inflammatory compound, resveratrol, which is abundant in red wine and grapes. Pine bark has a proven beneficial effect on lipids, the cardiovascular and immune systems.

Lion's Mane

A very yummy and medicinal mushroom is a well established candidate for brain and nerve health because it triggers neurite outgrowth and regenerates damaged nerves. Lions Mane has been extensively studied for its neuro-health properties.


This is an enzyme/protein that speeds up biochemical reactions and helps to prevent and dissolve the formations of blood clots (thrombi); addresses the problem of blood hyperviscosity, thereby preventing thick and sticky blood, which is not conducive to overall cardiovascular health.


Referred to as the women’s ultimate power herb, by some herbal enthusiasts. Used in India for at least 3,000 years, Shatavari, is structurally similar to estrogen produced within the body. Some researchers have concluded shatavari can be a highly effective alternative to synthetic hormone replacement therapy for peri- and menopausal women.

Chaste Tree Berry

Improve female libido, mitigate PMS, reproductive health

Horny Goat Weed

Increase para-sympathetic nervous activity, mitigate osteoporosis, improve libido, enhance smooth muscle tissue function

  • Treatment for erectile problems and nerve injuries in human patients:
  • Prevents thickening or hardening of the arteries through multiple mechanisms, including attenuating DNA damage, correcting endothelial dysfunction, inhibiting the proliferation and migration of smooth muscle cells, repressing macrophage-derived foam cell formation and inflammatory responses, as well as preventing platelet activation:

Bulgarian Tribulus

Enhance athletic performance, improve circulation, improve sexual performance, more efficient rates of protein synthesis


Cordyceps, a genus of mushroom, gained lots of attention after Chinese long-distance runners performed impressively at international competitions in the 1990s and early 2000s. Along with high-altitude training, supplementing with cordyceps was part of their intense training program. A research study concludes that cordyceps improves tolerance to high-intensity exercise after supplementation with it because the fungus is thought to increase blood flow, enhance oxygen utilization; it also acts as an antioxidant. It also has powerful anti-tumor properties, the ability to regulate the endocrine system, enhance your immune function, and protect the kidneys, lung, liver, and other organs.

  • Immunomodulatory, antitumor, anti-inflammatory, and antioxidant activities, promotion of endurance capacity, and learning-memory improvement, can be used to treat conditions such as hyposexuality, night sweats, hyperglycemia, hyperlipidemia, asthenia, arrhythmias, and other heart, respiratory, renal and liver diseases:
  • Various pharmacological actions, including nephroprotective, hepatoprotective, anti-inflammatory, antioxidative, and antiapoptotic effects:

Ginkgo Biloba

In recent decades, an extract of the leaves of the tree Ginkgo biloba L. has been used to improve memory in disorders like Dementia disorders that affect memory and intellectual functioning, and are caused primarily by Alzheimer’s disease and vascular disorders.

  • Potent antioxidant properties and ability to enhance peripheral and cerebral circulation, ginkgo’s primary application lies in the treatment of cerebrovascular dysfunctions and peripheral vascular disorders:
  • Experimental results showed extracts of G.Biloba to upregulate protein expressions of BDNF:
  • The effects of Ginkgo biloba extract on cognitive functions in aged female rats;
  • The role of oxidative stress and brain-derived neurotrophic factor:


Jiaogulan, a versatile herb, is celebrated for its potential to support overall well-being. Known for its adaptogenic properties, Jiaogulan may help the body cope with stress and maintain balance. This remarkable herb has also been associated with promoting healthy energy levels, boosting endurance, and fostering a sense of calm and relaxation.