Celiac Disease: What’s Really Happening in the Body — and Why Early Detection Matters
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Celiac disease is not a food intolerance.
It is not a lifestyle choice.
Celiac disease is often misunderstood as a simple “gut issue.” In reality it is a systemic autoimmune condition triggered by gluten — one that can affect digestion, nutrient absorption, hormones, the nervous system, and long-term immune health. It affects approximately 1 in 100 people worldwide, yet shockingly, only 30% receive a proper diagnosis and care.
But celiac disease is not the only way gluten can impact the body. Many individuals experience non-celiac gluten sensitivity, a form of immune reactivity that doesn’t show up on standard celiac tests yet still creates inflammation and immune stress.
From a functional and prevention-focused perspective, both celiac disease and gluten sensitivity exist on a continuum of immune response to gluten exposure. Early recognition of this spectrum can prevent serious downstream health consequences, including additional autoimmune disease and long-term inflammatory burden.
I was diagnosed with Celiac Disease in 2017. I was devastated — and honestly, felt unsupported. I was simply told to “eat gluten-free” without guidance, education, or long-term strategy.
After my own research, I realized this diagnosis didn’t have to define or limit my life. With the right approach, you can live fully and thrive.
What Is Celiac Disease?
Celiac disease is an autoimmune condition in which the immune system reacts to gluten, a protein found in wheat, barley, and rye.
When someone with celiac disease consumes gluten, the immune system attacks not only the gluten protein — but also the lining of the small intestine. Over time, this leads to:
Damage to intestinal villi
Impaired nutrient absorption
Chronic inflammation
Widespread immune activation
Because the immune response is systemic, symptoms often extend far beyond digestion. Celiac is also a hereditary condition, meaning it can run in families and be passed down to your children.
Gluten Sensitivity: Early Immune Reactivity
Not everyone who reacts to gluten meets the diagnostic criteria for celiac disease. Non-celiac gluten sensitivity (NCGS) describes individuals who develop immune responses or inflammation from gluten without showing the intestinal damage or biomarkers associated with celiac disease. Symptoms can include:
Gastrointestinal discomfort
Fatigue
Brain fog
Joint pain
Mood changes
Research suggests that individuals with gluten sensitivity may experience immune activation and inflammation even when traditional celiac biomarkers are absent.
From a functional standpoint, both celiac disease and gluten sensitivity represent immune responses to gluten, differing in degree rather than kind. Sensitivity may precede more severe autoimmune expression if gluten exposure continues over time, particularly in genetically susceptible individuals or those with existing immune stress.
Why Gluten Exposure Today Is Different
According to Dr. Tom O'Bryan, wheat activates immune pathways in all individuals through mechanisms such as increased intestinal permeability — even when symptoms are not immediately apparent.
His research highlights that proteins in modern wheat, particularly gluten, can trigger an immune response that disrupts the gut barrier (“leaky gut”) in everyone who consumes it, regardless of geography or diagnosis. While some individuals may not experience obvious or immediate symptoms, repeated exposure can contribute to cumulative gut barrier damage and chronic immune activation over time.
From this perspective, gluten’s impact is not defined solely by short-term symptoms, but by its long-term effects on immune regulation, inflammation, and disease risk — making awareness and early intervention critical, even before overt illness develops.
Modern Wheat Agriculture & Glyphosate
Wheat produced in the U.S. is often sprayed with glyphosate (the active ingredient in Roundup) as a pre-harvest dessicant. Glyphosate is associated with gut microbiome disruption, increased intestinal permeability, and inflammatory stress — compounding gluten’s effects on the immune system.
U.S. Wheat vs. European Wheat
Many individuals report symptomatic differences when consuming wheat in Europe. Contributing factors may include:
Lower glyphosate use
Different wheat varieties
Different agricultural and processing standards
While this does not make gluten safe for those with celiac disease or sensitivity, it highlights how modern agricultural practices can influence immune responses. Dr. Tom emphasizes that whether you're in the U.S. or Europe, no one is immune to gluten's harmful effects.
Symptoms: A Broad and Misleading Spectrum
Both celiac disease and gluten sensitivity can manifest with digestive and non-digestive symptoms:
Common signs include:
✔ Bloating, gas, diarrhea
✔ Fatigue, brain fog
✔ Mood changes (anxiety, depression)
✔ Joint pain
✔ Skin issues
✔ Nutrient deficiencies (iron, B vitamins)
✔ Hormonal imbalance
Because symptoms can be subtle or systemic, many individuals go undiagnosed for years.
For a more comprehensive list, refer to sources such as webmd, mayoclinic or my favorite is celiac.org.
Long-Term Risks of Untreated Celiac Disease
Untreated celiac disease or gluten sensitivity can lead to severe complications as ongoing immune activation can contribute to:
Development of additional autoimmune conditions
Chronic inflammation
Nutrient deficiencies
Bone density loss
Neurological complications
Certain gastrointestinal cancers
Studies show that long-term untreated celiac disease increases risk for conditions such as lymphoma and other malignancies, and may increase autoimmune phenomena.
From a functional prevention standpoint, recognizing gluten sensitivity as an active immune trigger — not just something that “causes symptoms” — is key for reducing long-term risk.
Why Proper Testing Matters
Celiac and gluten sensitivity testing must be performed while gluten is still being consumed. Most guidelines recommend a gluten challenge of 2–8 weeks, depending on the amount of gluten consumed and the test being performed.
Removing gluten before testing can result in false-negative blood work and delayed diagnosis. Standard testing may include:
Celiac-specific antibodies (such as tTG-IgA)
Total IgA
In some cases, intestinal biopsy
If celiac disease is suspected, testing should be completed before eliminating gluten.
Gluten Testing and Misconceptions
Celiac testing requires gluten exposure. Removing gluten too soon can produce false-negative results.
Gluten sensitivity has no standard lab test, but may be suggested by immune markers, symptom patterns, or improvement following elimination.
Functional practitioners often use a combination of clinical history, food response patterns, and supportive labs to guide personalized care.
The Only Proven Treatment
Currently, the only proven treatment for celiac disease — and the most consistently effective strategy for gluten sensitivity — is strict gluten elimination.
This means complete avoidance — not reduction — of gluten exposure, including cross-contamination. Opting for non-GMO and organic foods is recommended, as some studies suggest a link between glyphosate (a chemical found in herbicides) and gluten sensitivity. Additionally, eliminating dairy might provide relief for those who continue to experience symptoms, as its proteins can mimic gluten in the body.
For those with celiac disease, even small amounts of gluten can perpetuate immune activation, regardless of whether symptoms are immediately noticeable.
But here’s where the conversation often stops too early.
Celiac disease represents the most severe and visible end of the gluten–immune spectrum — not necessarily the beginning of it.
And that’s where the broader conversation about gluten, intestinal permeability, and immune dysfunction begins.
Dr. Tom advocates eliminating wheat altogether as a preventive measure, even for those without a formal gluten diagnosis. The damage wheat can cause to the gut barrier may lead to a wide range of health issues, including skin conditions, autoimmune disorders, and neurological problems.
Navigating the Grocery Aisles:
Living a gluten-free life involves label reading. A “gluten-free” label doesn’t always guarantee safety, and the same applies to “wheat-free”. Always check allergen listings and scrutinize ingredient lists for hidden sources of gluten. Common culprits include wheat, barley, rye, malt, brewer’s yeast and oats. For a truly safe gluten-free experience, stick to whole foods like fruits, vegetables and unprocessed meats.
Hidden ingredients can be found in:
Wheat (found in: breads, baked goods, soups, pasta, cereals, sauces, salad dressings, roux)
Barley (food coloring, soups, beer, brewer’s yeast)
Rye (found in rye bread, rye beer, cereals)
Malt (found in malted barley flour, malted milk and milkshakes, malt extract, malt syrup, malt flavoring, malt vinegar)
Brewer’s Yeast
Oats & Cross-Contamination (unless they specifically are labeled Gluten-free, they may be contaminated and cause you issues. Oats have a protein called avenin that is similar to gluten so if you select a GF (gluten-free) oats you may be sensitive to avenin). If you purchase, only get gluten-free organic oats to help eliminate further toxins of pesticides.
Other grains (Triticale)
Helpful Apps while Shopping or Eating Out:
Findme Gluten Free (Note this doesn’t include all restaurants, I typically start here and then look at menus in the area if a restaurant isn’t listed.)
Practical Takeaways
Who should remove gluten?
✔ Individuals with diagnosed celiac disease
✔ Individuals with immune-mediated gluten sensitivity
✔ Individuals with autoimmune disease, chronic inflammation, or unresolved symptoms
Complete elimination of gluten — not just “reduction” — is recommended to prevent immune stimulation and promote long-term immune resilience.
Advanced FAQ
Q: If I don’t have celiac, do I need to be gluten-free?
A: If you have immune reactivity to gluten — whether diagnosed as sensitivity or suggested by symptoms — ongoing exposure can perpetuate immune activation. Eliminating gluten is a preventive strategy to protect long-term immune balance.
Q: Is European wheat safer?
A: For those with celiac disease or diagnosed sensitivity, gluten is still harmful regardless of source. Differences in agricultural practice may influence symptom severity for some, but do not eliminate immune activation.
Q: What’s the difference between gluten sensitivity and celiac?
A: Celiac is autoimmune with specific biomarkers and intestinal damage. Gluten sensitivity involves immune reactivity without those specific markers but still creates inflammation.
👉 In Part 2, we’ll explore why many functional and autoimmune-focused clinicians believe gluten plays a role far beyond diagnosed celiac disease — and what that means for long-term health.