The information contained in this section has been procured  from  HealthyEating.SFgate.com,  CentrespringMD.com,  VeryWellFit.com,  BMCMedicine,  Journals.LWW.com, BeyondCeliac.com, and my own personal experience. It is all for educational purposes and not intended to be taken as medical adviceConsult your physician before making changes to your diet

What to Expect When Going Gluten Free

As you have finally made the decision to start a gluten free diet for medical or personal reasons,  you find yourself wondering what to expect or do next.  It can be frustrating and intimidating. 

Your body will undergo through a process that will leave you wondering if that is normal or worth it.  Yes it is. However, you most be aware that it will be quite an adjustment, physically, emotionally, and financially.  And yes it will be difficult at times for weeks or even months. 

 

The two most important things to know and remember are that (1) is a normal part of the process of adjusting to a gluten free diet and (2) you can make it through without breaking the bank in doing so.

So let's  discuss what to expect when going gluten free: the good, the bad, and the ugly.

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What to Expect when Going Gluten Free
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Mental Side Effects

Starting a gluten free diet  will promote changes in your body that will affect your brain... just like any other diet.  Just be aware  that at first,  you might experience some changes in your behavior, that could get to you unless you are aware that this is part of the process.  If gluten was a big part of your every day life, your brain is going to miss it.  Just remember:  it gets better as time passes. 

 

Just as your body adjusts to the new diet, your brain also needs to adjust to the changes. You could experience the following:

  • Mood swings

  • Irritability

  • Brain Fog

  • Confusion

 

Here a couple of things you can do to get you through this:

 

  • Exercise. Be active and get those endorphins naturally flowing. That always helps improve your mental well-being.

  • Educate yourself about the gluten free lifestyle. The more you know the more you will understand what to expect and how to deal with the changes without getting overwhelmed by them.

  • Learn about cross-contact:  Cross-contact is when a gluten-free food or food product is exposed to a gluten-containing ingredient or food – making it unsafe for people with celiac disease to eat. There are many obvious (and not-so-obvious) sources of cross-contact at home and in restaurants and other foodservice locations. There is even a risk of cross-contact before ingredients make it to the kitchen, such as during the growing, processing, and manufacturing processes.  While it may seem like a challenge to remember and be proactive about all of the possible sources of cross-contact at first,  your improved health will make the effort worth it. Read on to better understand some of these sources and what you can do to prevent cross-contact for more information about cross-contact click here.

  • Eat the right things.  Very important you supply your brain with the right foods it needs throughout this adjustment period. But what are the right things you need? Fresh fruits and vegetables, lean meats, plenty of fluids, multivitamins, probiotics to aid your digestion, etc.  All these things are discussed in more detail below. During these first few days, try to fill your plate with plenty of gluten-free foods you enjoy to avoid feeling overwhelmed.

  • Understand that each person will experience side effects differently. There is not a set time period to adjust to these changes. It could be days, weeks or even months...and that's normal.

Source: Healthy Eating

Source: BeyondCeliac.org

 

Physical Side Effects

The first few days on a gluten-free diet, you might experience a number of physical side effects. Some of this side effects could be debilitating and downright annoying, yet it's normal.  Your body is detoxing from the gluten,  adjusting to the new diet... and it will  sometimes fight back.

 

Here are some of the things you might experience :

  • Headaches

  • Bloating

  • Constipation

  • Diarrhea

  • Skin outbreaks

  • Nausea

  • Fatigue

  • Hair loss

  • Joint pain

  • Muscle aches

Here are some things you can do to help with these side effects: 

 

  • Understand that each person will experience side effects differently. There is not a set time period to adjust to these changes. It could be days, weeks or even months...and that's normal.

  • Eat fresh fruits and vegetables. Eating fresh fruits and vegetables will help supply your body with fiber that will aid digestion and help settle your GI system.

  • Consume lean meats.  Avoid red meats for a while. Let your gut adjust to the new diet.  

  • Be aware of diets that might increase your risk of disease.  Aside from being diagnosed with celiac disease, gluten allergy or  intolerance, or having been diagnosed with an autoimmune disorder that requires a strict dietary restriction, one reason many people are going gluten-free is because they're following the "Paleo Diet "or another "Low-carb Diet"... which advocates going grain-free (and therefore gluten-free).  This caveman style of eating also encourages eating more meat. Research shows that following a low-carb diet and increasing your protein intake can put you at risk for heart disease, diabetes, and other diseases.  Moreover, a 2018 study from Circulation showed that higher intake of animal protein has been associated with increased cardiovascular risk.  But by balancing your diet with more plant-based protein, gluten-free whole grains, and plenty of veggies and fruits, you can reduce your risk for disease.

  • Drink plenty of water.  Doing this will help to avoid constipation.

  • Find a good probiotic and multivitamins to prevent a nutritional deficiency.  Your body will need some help in getting nutrients that due to the change in diet and beginner's confusion you might not be getting anymore or not in the recommended daily amounts as you normally would. When you eliminate wheat, barley, and rye from your meals, you're not just getting rid of gluten, you're lowering your intake of a wide range of other nutrients that tend to come in those foods, including iron, fiber, folic acid, zinc, vitamin D, and more.

  • Prevent Folate Deficiency.   This is very important and will be discussed in length below. 

  • Learn about cross-contact:  Cross-contact is when a gluten-free food or food product is exposed to a gluten-containing ingredient or food – making it unsafe for people with celiac disease to eat. There are many obvious (and not-so-obvious) sources of cross-contact at home and in restaurants and other foodservice locations. There is even a risk of cross-contact before ingredients make it to the kitchen, such as during the growing, processing, and manufacturing processes.  While it may seem like a challenge to remember and be proactive about all of the possible sources of cross-contact at first,  your improved health will make the effort worth it. Read on to better understand some of these sources and what you can do to prevent cross-contact for more information about cross-contact click here.

  • Do not re-introduce gluten into your diet.  If you reintroduce gluten back into your diet,  you will never be able to overcome the beginning stages of adjustment.  When you were eating gluten every day, you may not have had reactions to individual instances of accidental gluten ingestion.  However, once you remove it from your diet, you may find your body is more sensitive to trace amounts of gluten found in cross-contact in your food.  You could also find that you're more sensitive to that single bite of glutenous cake that you just couldn't resist.  Sensitivity to trace gluten and cross-contact is a common side effect of the gluten-free diet,  and the level and severity of sensitivity can vary from person to person. A reaction to gluten in your food may come quickly within an hour or less in some cases, or may not appear until the next day or even later. Your digestive symptoms may come in the form of the following:

    • Constipation

    • Diarrhea

    • Gas

    • Reflux

    • Vomiting

    • You may also experience other symptoms, including:

    • Brain fog

    • Bouts of depression

    • Fatigue

    • Joint pain

    • Abdominal pain

Source: Healthy Eating

Source: Prevention.com

Source: VeryWellFit.com

 

Folate Deficiency

 

While this change is health-promoting for so many people, there’s one thing you need to be mindful when you cut out processed breads and other enriched flours from your life: Folate Deficiency.  

 

Folate is a naturally occurring B-vitamin found in many foods.  Due to its importance for our own health and for the health of developing fetuses in pregnant women, many foods have been fortified with folic acid (a synthetic version of folate).  These include bread, cereal, flour, cornmeal, pasta, rice, and other grain products. However, just because you choose not to eat foods from those categories doesn’t mean you have to decrease your intake of folate. The hope is that you are replacing those foods with healthy, whole fruits and vegetables. If that’s the case, you should be in the clear! 

 

Some examples of folate-rich foods are:

  • Dark leafy greens like spinach and kale

  • Cruciferous vegetables like broccoli, cauliflower and Brussels sprouts

  • Other green vegetables like asparagus and okra

  • Legumes like beans and lentils

  • Colorful fruits like papaya, oranges and strawberries

  • Avocado 

  • Nuts and seeds

 

If you include at least a couple servings per day from the foods listed above, your folate intake will be just fine.  Many people also choose to take a folate supplement.

 

This can come in the form of:

  • A multivitamin for kids

  • A B-complex vitamin for adults

  • Or folate alone

f you do chose to supplement,  Dr. Jamilet Alegria , M.D.  recommends  that you consider taking the active form of folate (5-methyltetrahydrofolate) as some people are unable to process and effectively use the inactive folic acid.

Taking on a gluten-free diet can be a great step towards better health for you or your child.  Don’t let concerns over folate deficiency stop you from enjoying the benefits of this new lifestyle!

Source: CentreSpringMD

 

Body Weight Fluctuation

At first, at  gluten free diet could seems as a balancing act.  During my early days of adjusting to the lifestyle,  my own experience was marked with a sudden weight lost of almost 20 pounds in two months.  Once I understood what my body needed and how to provide or eliminate certain  things from my diet, my weight became healthy and stable.  However every person reacts to the weight fluctuation differently.

 

If you have celiac disease and experienced malabsorption of nutrients that led to weight loss and/or other health issues,  a 2019 review published in BMC Medicine found that a gluten-free diet can lead to weight gain,  since many gluten-free foods tend to be higher in vegetable fats, sugars, and carbs

But not all people with celiac disease are underweight prior to their medical diagnosis.  A 2010 study published in Journal of Clinical Gastroenterology observed the effects of a gluten-free diet on 61% of newly diagnosed celiacs who were considered normal weight, 17% percent who were underweight, 15% percent who were overweight, and 7% who were obese.

The researchers noted that a gluten-free diet helped to regulate body weight to normal levels in the subjects who were either underweight or overweight.

Therefore, your weight could normalize as a side effect of the gluten-free diet.  Many people also mistakenly believe a gluten-free diet will automatically lead to weight loss.  If you indulge in too many gluten-free snack foods (which tend to be high in calories and low in nutrition,  just like their conventional counterparts),  you could find yourself packing on a few extra pounds.

Some of the things recommended to help with weigh fluctuation are:

  • Consult your physician. Nobody will know you medical history better than you and your physician. Not every single dietary plan works for everyone... specially if you are struggling with multiple autoimmune disorders or medical conditions as well as starting your gluten free journey.  Always and foremost ask for advice to a professional primary care physician.  Bloggers like myself can provide you  with educational tools to help you through this adjustment process but are not supposed to give medical advice. That's your physician's job.

  • Exercise. Be active and get those endorphins naturally flowing. That always helps improve your mental well-being and your overall health.

  • Educate yourself about the gluten free lifestyle. The more you know the more you will understand what to expect and how to deal with the changes without getting overwhelmed by them.

  • Eat the right things.  Very important you supply your body with the right foods it needs throughout this adjustment period. But what are the right things you need? Fresh fruits and vegetables, lean meats, plenty of fluids, multivitamins, probiotics to aid your digestion, etc. 

  • Research products.  Read labels and ingredients. You need to familiarize yourself with the products that actually will work best for you on your gluten free journey.  Keep in mind that gluten free processed foods are still processed foods and will contain the fats, carbs, sugars,  preservatives and additives like regular processed foods.

Source: VeryWellFit.com

Source: BMCMedicine

Source: Journals.lww.com

 

Be Aware of Hidden Gluten in Medications

Gluten can be used in the excipients of medication.  Excipients are the binders that hold medicine together. It is important that people with celiac disease work with their doctor or pharmacist to make sure their medications are gluten-free.

 

The manufacturer should also be able to help you determine if the medication you will be taking is gluten-free or if it is not safe for people with celiac disease.

Source: BeyondCeliac.org

The Problem with Gluten in Medication

  • There are currently no requirements for labeling gluten or common allergens found in drug ingredients

  • There are no specific precautions for individuals with celiac disease in labeling

  • Potential sources of gluten in medications are not well-recognized by healthcare professionals

  • Generic drugs may use different binders than name brand drugs

Source: BeyondCeliac.org

Starches Found in Medications

The following inactive ingredients are considered “red flags,” as they may be sourced from wheat, barley or rye.  If you see a red flag ingredient, it means that more information is needed to find out if the drug’s ingredients contain gluten. Some ingredients are more obvious than others.

  • Wheat

  • Modified starch (if source is not specified)

  • Pregelatinized starch (if source is not specified)

  • Pregelatinized modified starch (if source is not specified)

  • Dextrates (if source is not specified)

  • Dextrin (if source is not specified; the source is usually corn or potato which is acceptable)

  • Dextrimaltose (when barley malt is used)

  • Caramel coloring (when barley malt is used)

Source: BeyondCeliac.org

 

How to Get Answers

Getting answers about gluten in your medication can be challenging. Your best sources of information are your physician, pharmacist and the drug manufacturer.

 

There are some lists available online, however, it is extremely important that you double check any claims found on the internet with those mentioned above to be sure that your medication is truly gluten-free.

For help getting started, you can access a free drug list at GlutenFreeDrugs.com.

Source: BeyondCeliac.org

 

 

Shopping Gluten Free and  Relieving Financial Stress

Going gluten free at first is going to feel like is hitting your wallet hard.  That's because (a) we tend to panic and go on a shopping spree and buy whatever gluten free item we see at the store, trying to substitute what we can't have anymore with gluten free alternatives; (b) in our confusion we  buy expensive items that are truly not worth the money,  are bad for your health,  and are overall just horrible products;  or (c) we don't realize that gluten-free products, such as breads, pretzels, pasta, cookies, pastries,  and crackers cost 139 percent more, on average, than their wheat-based counterpart of the same product. 

I think the greatest and  most important thing I have found since beginning this journey a decade ago is that the majority of the edible products geared to the gluten free community are either overpriced, unhealthy,  or have terrible taste or texture.  Not all of them but a great number of things.   And the truth is that some corporations are  just trying to cash out on the gluten-free bandwagon  while others are truly trying to provide the gluten free community with good healthy and delicious products... at a price, of course.

Going gluten free doesn't have to be a financial burden if you do your research first.  Yes, there are some things you will need to buy that are necessary for your everyday life,  which may be a little more expensive from what you normally budget and pay for. But these are things that if you are celiac, have a wheat allergy,  or are gluten sensitive,  you will need to get the gluten free version no matter what.  Why?  Because the original  products do contain hidden gluten.  Shocking, no? 

 

Some of these products are:

  •  Oral Products and  Oral Care  (tooth paste, mouthwash,  oral cleansers, dental strips, and lip balms, breath sprays).  Scroll below to Cosmetics, Medications & Toys for more information.

  • Cosmetics & Hygiene Products (lipsticks, lip gloss, foundations, facial moisturizers, mascara, powders, makeup removers, soaps, shampoos,  conditioners,  and some lotions).  Scroll below to Cosmetics, Medications & Toys for more information.

  • Condiments & Spices. Gluten is used for flavor, thickening agent or as an additive to prevent "caking' in powders and spices. Scroll below to  "Where Gluten Is Found" , Hidden Gluten" and Is it Gluten Free Or Not?" for more information.

There are a couple of things you can do to avoid the pit fall of expending a lot of money when going gluten free:

 

  • Research things before buying them. Take your time at the store and read the labels. Not everything labeled gluten-free is good for you.

  • Use helpful apps to identify products and ingredients.  Using these apps could be a lifesaver when unsure about a product and may help you save money by choosing the right products.

  • Plan ahead what you need before going shopping.  Don't go hungry to the store and just start shopping with your stomach.  You will spend a lot of money that way. Trust me...I know.  I've have done it before!

  • Learn how to make things yourself.  By learning how to cook things you will realize there is a plethora of ingredients, dishes, and foods from all over the world that are actually naturally gluten free, healthy, delicious, and above all: it won't break the bank.

  • Do meal prepping to save time and money.  If you don't have much time to cook a fresh meal every day,  just do some meal prepping, refrigerate or freeze, and then consume  when you need it.  Doing this will help you plan for meals and budget your money better.

  • Avoid certain gluten free products until you know more about them. Breads, flours, pasta, pastries, baking mixes, spices, beverages,  pizzas, etc. They tend to be very expensive and most of them are horrible when it comes to taste and textures.  Give yourself sometime  to research and ask others living a gluten free lifestyle for suggestions regarding products.

  • Go to places that offer gluten free foods in their everyday menu. Guess what? There are many restaurants that already serve food and dishes that are naturally gluten free.  All you have to do is research a little,  ask questions, and ensure that the facilities do practice safety protocols in order to avoid cross-contact.  Some good examples of these restaurants are:

    • Southeast Asian: rice noodles, fish sauce, and coconut-based foods are naturally gluten-free.

    • Indian: rice, chickpeas (also called “gram flour”), and curries are naturally gluten-free.

    • Japanese and Korean: rice, seafood, and meat are naturally gluten-free, but be aware that most sauces will contain soy sauce (wheat). Ask for tamari if available. Avoid Udon or ramen noodles, which are made with wheat.

    • South American: rice, beans, corn, and tapioca-based products are plentiful. This is a very easy cuisine to navigate gluten-free.

    • African and Middle Eastern: teff, millet, lentils, and cassava (tapioca) are commonly used starches and naturally gluten-free.

    • Spanish, Latin, and Caribbean: rice, beans, corn, seafood, grilled and baked meat based dishes, salads and vegetables, etc. 

    • Mediterranean: most Mediterranean cuisines have a lot of dishes that are naturally gluten free (Greek, Italian, Spanish, Israeli, Egyptian, Lebanese, Croatian, Moroccan, Turkish, etc).

    • European Countries:  Some European cuisines can be challenging to navigate gluten-free, but many European countries include allergen labeling on packaged foods and in restaurants, making it easier to identify products that contain gluten.

  • Use resources available to you (apps, support groups, international organizations, social media groups, magazines and publications, and blogs &  websites like this one with free recipes and information for everyone to use).

 Source: Celiac.org

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