Celiac Disease Beyond the Gut: Stress, Inflammation & HPA Axis Dysregulation

What is the difference between celiac disease and gluten sensitivity or intolerance, and why do we have to care about that distinction? Let's just kind of lay it out.

What's the difference?

Yeah.

So celiac disease is an autoimmune disease.

We can test for it.

There are specific endoscopy procedures and lab work that can be done to diagnose somebody with celiac disease, because somebody with celiac disease has an autoimmune reaction, which we can test for the antibodies.

And so if you are somebody with celiac disease, eating even a small amount of gluten causes an autoimmune response, which causes damage to the small intestine.

Um, and the small intestine is where we absorb so many nutrients.

And so having damage to the small intestine causes nutrient deficiencies, which then cause a lot of downstream issues.

Mm.

So definitely a big deal, um, and really important for somebody with celiac to follow a strict gluten-free lifelong diet.

Whereas somebody with gluten intolerance, that can be more system- symptomatic of something more underlying, right? So it's something that might be resolved with treating the gut properly and addressing their health.

In some cases, the symptoms might look the same for somebody-

Mm

... with celiac and someone gluten intolerance, but the mechanism and the severity of health risks and damage are significantly different.

different.That's really important to point out.

It's like the long-term sequelae.

I actually had this come up because I got a workup.

It's been a long time since my biopsy, and I had a workup at a new hospital.

Yeah.

And they were like, "You don't have any nutritional deficiencies.

This is pretty amazing.

Let's...

You know, maybe you don't actually have celiac.

Let's do another-"