I watched a reel today of a pharmacist talking about the rise in Celiac Disease and “gluten sensitivity,” blaming the increase on our heavier reliance on processed foods.

I saw another post about a wave of people questioning their celiac diagnosis, embarking on a gluten challenge, having the diagnosis overturned—and then living happily ever after.

I see people touting that the “gold standard” in celiac diagnosis is a blood test and colonoscopy—and that anything less is invalid.

What troubles me is that each of these statements contains a kernel of truth.

The Rise in Celiac Disease

The rise in celiac disease—at least in the U.S.—is largely the admission that celiac does exist here. Before the early 2000s, celiac was thought to be extremely rare or even non-existent in the U.S. Around this time, accurate blood tests for celiac began to become available, and the gluten-free fad was born.

See also: Why the Increase in Celiac Disease is Real.

Questionable Diagnoses

Many people have questionable celiac diagnoses—and I see it all the time. They go to the doctor, the doctor runs one test, pronounces them “celiac,” and that’s it. Or the blood test and biopsy don’t confirm each other, and doctors simply give the diagnosis without further digging.

The problem is: if it isn’t truly celiac, what else is causing the issue? That’s the hard part—and the part we pay doctors to work through. It’s a lot easier to hand out a half-hearted diagnosis of celiac disease than to do the real work of finding the root cause of the illness. Finding the root cause is what we should be fighting for.

“It’s a lot easier to hand out a half-hearted diagnosis of celiac disease than to do the real work of finding the root cause.”

Alternative Medicine Isn’t Always the Answer

PS — And don’t hand me the mumbo-jumbo about holistic or naturopathic doctors either. They’ve got their own racket. They’ll pitch supplements that will “solve all your problems,” drain your money and your soul, and still not really solve the issue. I’ve walked that road, and seen the results.

What the Science Says About Diagnosis

The half-hearted or half-researched celiac diagnosis is one that hurts my heart to see every day. People become convinced they have celiac disease, and they’ll take any confirmatory test—no matter the accuracy or whether celiac is truly the root cause.

There are currently two recognized diagnostic pathways for celiac disease, according to the latest guidelines from the American College of Gastroenterology.

• Triple Positive: A level of tissue-transglutaminase IgA (TTG IgA) at ≥ 10× the upper limit of normal (for example, if normal is 40 then the result is 400 or higher), plus positive endomysial antibodies (EMA) plus positive genetic screening (HLA-DQ2/DQ8).
• Traditional: A full diagnostic panel (serology) with multiple antibodies, then an upper endoscopy with duodenal biopsies showing at least Marsh 3 damage (blunted villi, increased intraepithelial lymphocytes, crypt hyperplasia).

Where the Traditional Diagnosis Often Goes Wrong

If the only positive result in the panel is deamidated gliadin peptide IgG (DGP IgG), the probability that celiac disease is the cause may be very low.

Simply seeing “blunted villi” on biopsy is not enough for a celiac diagnosis. Other things can cause villous blunting—certain medications like Methotrexate or Olmesartan (Benicar), and chronic infections such as giardia.

Learn more about the Celiac Biopsy Process and what your Celiac Blood Tests Really Mean.

Get Educated, Stay Skeptical

What I’m trying to say: please educate yourself, and tell your friends about what is truth and what is fiction in the celiac world. Be careful what you read and listen to on social media. Make sure you’re getting good information. Finally: learn as much as you can about celiac disease—including the latest research news and clinical guidelines.

For trusted resources, visit:

• Celiac Disease Foundation
• NIH Celiac Disease Overview
• FatCeliac.net — Real Talk, Research, and Lived Experience

Stay smart. Stay skeptical. And keep fighting for the truth about your health.