GlutenFreeSmartStore.com
Healthy Store
The gluten-free diet consists of strictly eliminating from the diet all products that contain or are cooked with wheat, rye, barley and oats, or any of their varieties and hybrids (spelt, spelt, kamut, triticale…), and derived products, avoiding inadvertent contaminations and all types of dietary transgressions. Gluten is not indispensable for human beings. It is a mixture of proteins of low nutritional and biological value, deficient in essential amino acids, so from a nutritional point of view its exclusion from the diet does not represent any problem. The gluten-free diet is a safe diet, which does not cause any negative side effects, and is normally balanced. Only celiacs and people sensitive to non-coeliac gluten experience symptoms and various health disorders if they do not maintain the gluten-free diet strictly and for life.
The gluten-free diet should be based primarily on natural gluten-free products, which have a more balanced composition of micro and macronutrients, such as meat, fish, eggs, milk and dairy products, legumes, nuts, fruits, vegetables, potatoes, rice, corn and pseudocereals. If specific coeliac preparations are consumed commercially, the best choice is those enriched or fortified with vitamins and minerals. A healthy alternative to these commercial products is the production of pseudocereal flours (certified without gluten contamination), such as quinoa, amaranth, buckwheat and other minor cereals, which have a high nutritional and biological value, superior to those of gluten-containing cereals. The different varieties of pure oats (without gluten contamination of other cereals) have different degrees of toxicity.
Bestselling Products
essence | Lash Princess False Lash Effect Mascara | Gluten & Cruelty Free
- If you receive this mascara UNWRAPPED, it did not come from essence cosmetics.
- NO FALSIES NEEDED! Lash Princess False Lash Mascara defines and separates lashes while achieving a bold look.
- DRAMATIC VOLUME: the conic shape fiber brush delivers dramatic volume and sculpted length WITHOUT clumps or globs.
- CLAIMS: Cruelty Free. Free from gluten, silicones, parabens, oil, fragrance, alcohol, & microplastic particles. Made in Luxembourg.
- CRUELTY FREE: essence cosmetics is certified and acknowledged by PETA as a cruelty-free brand. We do not test any of our products on animals.
Garden of Life, Dr. Formulated Women's Probiotics Once Daily, 16 Strains, 50 Billion, 30 Capsules
- THE GUT STUFF: Once Daily Women’s is formulated for her unique needs with 50 Billion CFU of 16 diverse probiotics for optimal digestive and immune support; We’ve also added our whole food prebiotic fiber blend to help promote the growth of good bacteria
- HIT REPHRESH: Girls just want to have pHun; Our doctor formulated daily probiotic has clinically studied strains, L. reuteri and L. fermentum, to help maintain a healthy balance of good bacteria and pH levels for vaginal health and overall women’s health
- BACKED BY SCIENCE: As a 4x Award Winning #1 Probiotic Brand, our probiotic is made with a great deal of research to ensure you are receiving the highest-quality and most diverse strains in a shelf-stable bottle to ensure they arrive alive and stay alive
- CONVENIENCE IN MIND: Keep your standards and strains high in a once-daily, easy-to-swallow vegetarian capsule; If you prefer probiotic drinks, our capsules can also be opened & contents mixed into water or your favorite beverages (not too hot or acidic)
- EXPERTLY FORMULATED: Our once daily probiotic supplement for women is proudly Dr. Formulated by David Perlmutter, MD for women’s health and Third-Party Certified Non-GMO, Gluten-Free and Carbon Neutral; Made in the USA with no dairy, soy, or gluten
LMNT Zero-Sugar Electrolytes - Variety Pack - Hydration Powder Packets | No Artificial Ingredients | Keto & Paleo Friendly | 12 Sticks
- THE BEST ELECTROLYTE DRINK MIX EVER: LMNT is a tasty electrolyte drink mix with everything you need and nothing you don't. LMNT is perfect for anyone interested in a keto, low-carb or intermittent fasting lifestyle, and a gluten-free diet. Our electrolyte supplement fights against the low-carb fatigue and keto fog to keep energy levels high
- WINTER HYDRATION NEEDS: Hydration is critical during the colder months; due to drier air, cold-induced diuresis, or a simple lack of water, it's important to stay salty year round. When spending time at or below freezing temps, be mindful that you likely need to intake more electrolytes even when you're not necessarily feeling thirsty
- INGREDIENTS THAT WORK FOR YOU: At LMNT, we like to cut through the BS. We are committed to no sugar, no gluten, no fillers, and no artificial ingredients. Our products are carefully formulated with the perfect ratio of sodium, potassium, and magnesium
- DEVELOPED BY ROBB WOLF AND KETOGAINS. Traditional electrolyte drinks don't meet the standards of our active life, so we created LMNT with zero sugar, fillers, or artificial ingredients. Born from a need, backed by science, and built for you
- HOW TO USE: Mix one packet with 16 ounces of water (or more, depending on preference). May not be suitable for those following a low-sodium diet or those directed by a physician to follow a low-sodium diet
TheraBreath Fresh Breath Mouthwash, Icy Mint Flavor, Alcohol-Free, 16 Fl Oz (Pack of 2)
- FIGHTS BAD BREATH: TheraBreath Fresh Breath Mouthwash fights bad breath for 24 hours when used every 12 hours after brushing and flossing
- DENTIST FORMULATED: Dr. Katz created the TheraBreath formulas in 1993 to help his own daughter with her bad breath
- ADA ACCEPTED: Our alcohol-free, non-burning formula is powered by oxygen, and is ADA accepted to help reduce bad breath
- RESTORE CONFIDENCE: TheraBreath believes you should define success any way you please. We exist to motivate you to go get it!
- IT'S A BETTER MOUTHWASH: Try the #1 fastest growing mouthwash brand in the USA (data on file)
NatureWise Vitamin D3 5000iu (125 mcg) 1 Year Supply for Healthy Muscle Function, and Immune Support, Non-GMO, Gluten Free in Cold-Pressed Olive Oil, Packaging Vary ( Mini Softgel), 360 Count
- An essential Vitamin: Vitamin D is an essential nutrient for healthy bones, teeth, muscle function, and immune system support. The mayo Clinic estimates that 25%-50% of the general population may be Vitamin D deficient.
- Sunshine In a Bottle: The Vitamin D Council recommends daily vitamin D supplementation for most adults to achieve and maintain optimal levels, regardless of weather or season.* NatureWise Vitamin D3 is all natural, non-GMO, and gluten free with no artificial additives, fillers or binders.
- Pure & natural: These Vitamin D3 immune support and bone health supplements are gluten-free and non-GMO. Third party tested for purity and potency. Packaging may vary due to high demand, same great product and ingredients.
- Uncompromising Quality: All NatureWise supplements are Manufactured in USA-based facilities that comply to the strictest cGMP standards and undergo rigorous testing by third party labs to ensure the highest quality and purity.
- Directions: It's normal for softgels to stick together and clump during warm weather conditions. This does NOT affect the quality or efficacy of the product. To release the clumps, give your bottle a good shake or knock it against the counter.
CELSIUS Assorted Flavors Official Variety Pack, Functional Essential Energy Drinks, 12 Fl Oz (Pack of 12)
- Functional, Essential Energy with 200mg Caffeine to help you LIVE FIT
- Made with Premium, Proven Ingredients and 7 Essential Vitamins
- No Sugar, No Sodium
- No High Fructose Corn Syrup, No Aspartame, No Artificial Colors
- Gluten-Free, Kosher, Non-GMO, & Certified Vegan
- Variety Pack Assorted Flavors May Vary
COLOR WOW Dream Coat Supernatural Spray, 6.7 Fl Oz – Keep Your Hair Frizz-Free and Shiny No Matter the Weather with Award-Winning Anti-Frizz Spray
- Advanced anti-frizz formula leaves hair super glossy, glassy, ultra smooth
- Groundbreaking humidity-blocking technology stops moisture from wrecking your style
- Economical. Results last through 3-4 shampoos
- Ultra-light spray feels like nothing is on the hair
- Anti-frizz treatment waterproofs your hair to stop frizz, even in the worst humidity
Premier Protein Shake 30g Protein 1g Sugar 24 Vitamins Minerals Nutrients to Support Immune Health For keto diet , Chocolate, 11.5 Fl Oz (Pack of 12), Liquid,Powder, Bottle
- Chocolately goodness: Smooth and creamy, rich chocolate flavored shake; Winner of American Masters of Taste Gold Medal for SUPERIOR TASTING ready-to-drink protein beverages.
- 30g of protein to help curb your hunger as a mid-day snack or for post workout recovery; includes all essential amino acids
- 24 Vitamins and Minerals: Support a healthy immune system as part of a healthy diet and lifestyle (Antioxidants Vitamins C and E plus Zinc), 50 percent daily value of calcium and 30 percent daily value of Vitamin D to help maintain healthy bones
- Guilt free indulgence: 1g Sugar, 5g Carbs, 160 Calories and Low Fat; Gluten Free, Keto and Bariatric Friendly, Kosher
- Try all eleven (11) delicious smooth and creamy flavors: Chocolate, Vanilla, Caramel, Cookies & Cream, Cafe Latte, Strawberries & Cream, Peaches & Cream, Bananas & Cream, Cinnamon Roll, Chocolate Peanut Butter and Cake Batter Delight
- Contains: Milk and Soy
Better Body Co. Provitalize | Probiotics for Women, Menopause, 68.2 Billion CFU, Digestive Health - Relief for Bloating, Hot Flashes, Joint Support, Night Sweats - Gut Health & Metabolism - 60 Caps
- FEEL YOUR CHERISHED CLOTHES FIT BEAUTIFULLY ONCE MORE: No more hiding under baggy, shapeless clothes. This is what makes Provitalize one of the best & most popular probiotics for women over 40.
- BENEFITS: With just 2 capsules a day, Provitalize supports healthy digestion & a calm tummy. Natural antioxidant & phytoestrogenic herbs supports hormonal balance, joint health and managing hot flashes/night sweats.
- INGREDIENTS: Premium Probiotic blend (L.Gasseri, B.Breve, B.Lactis) 68.2 billion CFUs per serving, Turmeric Curcumin standardized to 95% curcuminoids, 100% organic Moringa Oleifera leaf extract, pure Curry Leaf extract, Bioperine black pepper extract, Sunflower Lecithin Booster, DRCaps
- DIETARY FEATURES: This menopause supplement bundle is 100% natural, soy-free, gluten-free & GMO-Free. Hormone & estrogen free.
- RETURN POLICY: Our products are meant to be consumed within 30 days after opening thus we are not accepting returns to ensure that only the highest quality products go to our customers. If you have any concerns, send us a message by reporting a problem with your order, select 'Other issue' as the reason, and select 'Contact seller'. **Better Body Co is not affiliated, associated, or in any way officially connected with BetterBody Foods**
Airheads Candy Bars, Variety Bulk Box, Chewy Full Size Fruit Taffy, Gifts, Holiday, Parties, Concessions, Pantry, Non Melting, Party, 60 Individually Wrapped Full Size Bars
- CONTAINS: Unwrap the fun and play delicious with this 60-count, six-flavor bulk variety pack of Airheads individually wrapped full-sized candy bars
- Product Note: Exposure to heat or sunlight may lead to melting/damage of product. Hence customers are expected to be available during the product delivery
- INTRO: Get crafty with your treats at playtime. Airheads are the chewy non-melting candy sure to satisfy any sweet tooth
- FLAVOR: Your taste buds can’t get enough of these flavors: Cherry, Watermelon, Blue Raspberry, White Mystery, Grape, and Orange
- OCCASION: Stash a few in lunch boxes, dress up a wedding candy bar, do some crafts with the family, or stock up for concession stands
- ALLERGY: These candies are peanut and tree nut free, gluten free, and kosher. A great treat for the classroom
Nature’s Way Sambucus Elderberry Immune Gummies, Daily Immune Support for Kids and Adults*, with Vitamin C, Vitamin D3, Zinc, Gluten Free, Vegetarian, 60 Gummies (Packaging May Vary)
- Nature's Way Sambucus Elderberry Gummies support immune health with high potency vitamins C & D, and an excellent source of zinc. Gummies also contain highly concentrated (64x) black elderberry extract made from 3,200 mg of elderberries per serving.
- Elderberries have naturally-occurring anthocyanins, which provide antioxidant support.* Antioxidants help neutralize free radicals.* Elderberries have been used for centuries for traditional immune support you can enjoy all year long.*
- Adults and children 4 years of age and older chew 2 gummies daily. Great tasting gummies for the whole family!
- Gummies are made with pectin, not gelatin, and sweetened with organic tapioca and cane sugar. Gluten-free with no yeast-derived ingredients, wheat, dairy, eggs, peanut, or artificial colors.
- At Nature’s Way, we believe nature is the ultimate problem solver. For over 50 years, we have looked to the natural world for inspiration. Our quality vitamins and supplements are formulated to help you find your way to wellness.
Orgain Organic Vegan Protein Powder, Creamy Chocolate Fudge - 21g Plant Based Protein, Gluten Free, Dairy Free, Lactose Free, Soy Free, No Sugar Added, Kosher, For Smoothies & Shakes - 2.03lb
- New look and label, same great product! Includes 1 (2.03 Lb) Orgain Organic Plant Based Protein Powder, Creamy Chocolate Fudge
- 21 grams of organic plant based protein (pea, brown rice, chia seeds), 2 grams of organic dietary fiber, low net carbs, 0 grams of added sugar, 150 calories per serving
- USDA organic, vegan, gluten free, dairy free, lactose free, low net carbs, no added sugar, soy free, kosher, Non GMO, carrageenan free, and no artificial ingredients
- Mix with water, milk, or your favorite protein shake recipe for a quick breakfast or snack drink. Use when baking to give your cakes, muffins, brownies, or cookies a protein and energy boost
- Ideal for healthy, on the go nutrition for men, women, and kids. These are great for meal replacement, smoothie boosters, muscle recovery, and pre or post workouts
Orgain Organic Vegan Protein Powder, Vanilla Bean - 21g Plant Based Protein, Gluten Free, Dairy Free, Lactose Free, Soy Free, No Sugar Added, Kosher, For Smoothies & Shakes - 2.03lb
- Includes 1 (2.03 pound) Orgain organic plant based vanilla bean protein powder
- 21 grams of organic plant based protein (pea, brown rice, chia seeds), 2 grams of organic dietary fiber, low net carbs, 0 grams of added sugar, 150 calories per serving
- USDA organic, vegan, gluten free, dairy free, lactose free, low net carbs, no added sugar, soy free, kosher, non GMO, carrageenan free, and no artificial ingredients
- Mix with water, milk, or your favorite protein shake recipe for a quick breakfast or snack drink. Use when baking to give your cakes, muffins, brownies, or cookies a protein and energy boost
- Ideal for healthy, on the go nutrition for men, women, and kids. These are great for meal replacement, smoothie boosters, muscle recovery, and pre or post workouts
BioEmblem Triple Magnesium Complex | 300mg of Magnesium Glycinate, Malate, & Citrate for Muscles, Nerves, & Energy | High Absorption | Vegan, Non-GMO | 90 Capsules
- Maximum Absorption & Potent Magnesium Supplement: BioEmblem Triple Magnesium Complex features 300mg of three types of pure magnesium (Glycinate, Malate, Citrate). Each is chelate or highly absorbable for maximum bioavailability. Our formula is easy on the stomach and "non-buffered," meaning this blend isn't diluted with less expensive and less absorbable magnesium oxide.*
- Supports Healthy Nerves: Magnesium, especially in mag glycinate form, is an essential nutrient that supports healthy muscle and nerve function. This can help with muscles & legs at night, brain health, and mood.*
- Promotes Heart Health And Energy Production: As a cofactor in hundreds of enzyme reactions, magnesium, especially magnesium malate, supports nutrient intake for cellular energy production. Magnesium supplements also help to support overall cardiovascular health.*
- Bone Density & Muscle Exercise: Studies have shown that magnesium helps regulate vitamins and nutrients like calcium and zinc to support healthy bones and strong bone density. Magnesium can also help support muscles after exercising.*
- 3rd Party Tested & BioEmblem Quality: BioEmblem Triple Magnesium Complex is made in the USA at a NSF-registered cGMP facility and is 3rd party tested for purity and accuracy. Every magnesium pill is vegan, non-GMO, gluten-free and contains no fillers, artificial ingredients, preservatives, or stearates.
Life Extension Neuro-mag Magnesium L-threonate, Magnesium L-threonate, Brain Health, Memory & Attention, Gluten Free, Vegetarian, Non-GMO, 90 Vegetarian Capsules
- Memory, focus & cognitive boost - Magnesium is essential for overall brain performance, but not all magnesium supplements are easy to absorb. But magnesium L-threonate is! This highly absorbable form of bioavailable magnesium can cross the blood-brain barrier, supporting brain cell communication and signaling pathways associated with learning, memory and focus.
- Maintain ideal magnesium levels - Magnesium does wonders for your brain, but unfortunately, most of us don’t get enough magnesium from our diets. That’s why supplementing with high-absorption magnesium is a great complement to your brain-friendly lifestyle choices!
- Keep your brain at its best - Your daily activities demand focus and adequate attention span. Still, over time, the little details can slip your mind and you find yourself looking for sunglasses on your head. Our magnesium L-threonate cognitive supplement helps maintain the crucial connections between your brain cells so your memory stays razor-sharp.
- Ingredients matter - Sourced using only the finest raw ingredients with the purity and potency your body deserves. The majority of our products are non-GMO, gluten-free and manufactured in the USA—and a Certificate of Analysis is available for every product we produce.
- Live your healthiest life - For over 40 years, we’ve been developing advanced, effective formulas made with the highest standards and based on the latest scientific findings. We believe the answers to a healthier, richer life are within reach, and that rigorous scientific research is the path to get us there. That’s why so many of our nutritional formulas are designed using specific ingredients and amounts based on scientific studies.
- For customers who may be sensitive to Magnesium products, we recommend taking a reduced dose of (1) capsule daily and slowly increasing the dosage to the recommended Serving Size of (3) capsules as needed. Customers with underlying digestive issues may also experience a negative reaction to the item.
Nature's Bounty Magnesium, Bone and Muscle Health, Whole Body Support, Tablets, 500 Mg, 200 Ct
- SUPPORTS BONE AND MUSCLE HEALTH (1): Magnesium plays an essential role in supporting bone health and maintaining bone mineralization. (1)
- 500 MG OF MAGNESIUM: Each tablet of Nature’s Bounty Magnesium contains 500 mg of Magnesium, which is 119% of the daily recommended value for this important mineral
- VITAL MINERAL SUPPLEMENT: Magnesium is involved in muscle contractions, nerve impulses, energy metabolism, and protein formation (1)
- NO ARTIFICIAL FLAVORS OR SWEETENERS: Nature’s Bounty Magnesium is free of artificial flavors and sweeteners, and is gluten free for your dietary needs
- UNSURPASSED QUALITY AND VALUE: Using the latest breakthroughs in nutritional science and the finest ingredients, Nature’s Bounty provides supplements of unsurpassed quality and value
AZO Cranberry Urinary Tract Health Supplement, 1 Serving = 1 Glass of Cranberry Juice, Sugar Free Cranberry Pills, Non-GMO 100 Softgels
- AZO CRANBERRY PILLS URINARY TRACT HEALTH SUPPLEMENT – Taking these softgels can help maintain a healthy urinary tract for men & women
- NATURALLY SOURCED INGREDIENTS – These cranberry softgels are made with Pacran, a super-concentrated whole fruit cranberry blend which helps flush the urinary tract
- SUGAR FREE & GLUTEN FREE – Each serving is equal to the benefits of one glass of cranberry juice; many cranberry juice cocktails have over 42 grams of sugar & 165 calories per 12 ounce serving while AZO cranberry softgels are sugar & gluten free
- HOW TO TAKE - Take two softgels daily with water; 100 softgels per bottle (50 day supply)
- CONVENIENT, EASY TO SWALLOW SOFTGELS - Try AZO Cranberry Softgels as a convenient way to maintain your healthy urinary tract without extra sugar or calories found in cranberry juice
Colgate Optic White Advanced Teeth Whitening Toothpaste, 2% Hydrogen Peroxide Toothpaste, Sparkling White, 3.2 Oz, 3 Pack
- Three 3.2 oz. tubes of Colgate Optic White Advanced Whitening Toothpaste
- Get a bold, confident smile with this hydrogen peroxide toothpaste that contains Colgate’s patented 2% hydrogen peroxide formula
- Enamel-safe for daily use and fights stains
- Optic White Advanced deeply whitens up to four shades* and helps whiten teeth both inside and out (*when brushing twice daily for 6 weeks)
- Sparkling White mint toothpaste is a white paste with a cool, herbal minty wintergreen flavor
Mott's Fruit Flavored Snacks, Assorted Fruit, Pouches, 0.8 oz, 40 ct
- FRUIT FLAVORED SNACKS: Gummy treats the whole family can enjoy; Made with real fruit and veggie juice and individually wrapped for on-the-go convenience
- FUN KIDS SNACK: These individually wrapped snack bags are the perfect treat to include in a packed school lunch box
- GLUTEN FREE: Tasty gummy treats made without gluten, gelatin, or artificial flavors; Contains real fruit and vitamin C for snacks you can feel great about
- ON-THE-GO SNACK: These bulk Fruit Flavored Snacks are the perfect addition to your pantry and a snack every member of the family will love
- CONTAINS: 0.8 oz, 40 ct
Nature Made Vitamin D3 1000 IU (25 mcg), Dietary Supplement for Bone, Teeth, Muscle and Immune Health Support, 300 Day Supply,300 Count (Pack of 1)
- Immune, muscle, teeth and bone health support supplement: contains one 300 count bottle of Nature Made Vitamin D3 1000 IU (25 mcg) Softgels for a 300-day supply
- Nature Made Vitamin D 1000 IU softgels support bone health, teeth health, muscle health, and provide immune support
- These Vitamin D 1000IU softgels help improve calcium absorption and contain 25mcg of Vitamin D 3, the body’s preferred form of Vitamin D
- Adults, take one Vitamin D3 softgel daily with water and a meal
- Sourced from high-quality ingredients, this Nature Made Vitamin D3 supplement is gluten free and has no color added and no artificial flavors
- United States Pharmacopeia (USP) Verified, Number 1 Pharmacist Recommended Vitamin & Supplement Brand*
As of 2018, Except in Brazil, it is not mandatory in any country in the world to label products as “Gluten-Free” or to declare the presence of traces of gluten, so simply reading the list of ingredients does not allow one to know if a product is safe. Other unsuspected sources of gluten can be medicines, supplements and food supplements, as well as adhesive bandages, plasters, feed and food for farm animals and pets, all kinds of cosmetic and personal care products, shampoos for dogs, modeling paste for children (such as Play-Doh), among others. These products may be the cause of inadvertent gluten contamination, as they may reach the mouth directly, or indirectly through the remains left on the hands when handled.
The gluten-free diet is a healthy diet because it is very varied and requires more attention to the composition and preparation of food, increasing the consumption of all types of vegetables and fruits, as well as natural foods, not frozen or processed, thus reducing the consumption of additives and sodium. However, some patients focus only on the elimination of gluten from the diet and downplay the importance of proper diet planning. An unbalanced selection of foods and an incorrect choice of alternative commercial gluten-free products specific to coeliacs (those traditionally made with wheat flour, such as breads, biscuits, etc.), can lead to certain nutritional deficiencies. In general, these alternative products are not usually fortified compared to their gluten equivalents, so there may be a lower intake of iron and B vitamins; they also contain higher amounts of lipids and carbohydrates, although since 2017 there is a trend of nutritional improvement with increased levels of fiber and decreased sugar content. These products are especially overconsumed by children, which also leads to a decrease in the consumption of other, healthier foods. These nutritional imbalances can be prevented with proper dietary education. In addition, certain complications of celiac disease, which sometimes do not subside despite a gluten-free diet, can lead to overweight or obesity.
The gluten-free diet is the only currently available treatment for celiac disease, which must be followed strictly and for life, without transgressions, in order to achieve a sustained and effective improvement, avoiding and/or significantly diminishing the appearance of numerous diseases and associated complications both digestive and extradigestive, since celiac disease can damage virtually any organ or tissue. Although there is a “permanent intolerance” to gluten, it is not a simple food intolerance, much less an allergy. It is a chronic, multi-organ autoimmune process that, if left untreated, can lead to very serious health complications, including various types of cancer (both of the digestive tract, with a 60% increased risk, and of other organs), neurological and psychiatric disorders (known as “neurogluten”), other autoimmune diseases, cardiovascular diseases, and osteoporosis, among others. The mean for complete bowel recovery usually ranges from two to five years. In addition, the gluten-free diet has been shown to be an effective treatment for all other gluten-related disorders, including non-coeliac gluten sensitivity, gluten ataxia, dermatitis herpetiformis, and wheat allergy. The mean for complete bowel recovery is usually two to five years.
In people with gluten-related neurological disorders, the regeneration of the nervous system once the diet is initiated is slow and sometimes incomplete, mainly when the diagnosis is delayed, but prevents the progression of neurological damage. Minimal amounts of gluten, including those present in most products labeled “Gluten-Free,” may be sufficient to keep the immune system response responsible for the neuronal lesion activated in a portion of patients.
Other diseases in which improvement of both gastrointestinal and systemic symptoms with the gluten-free diet has been documented in at least part of the patients include irritable bowel syndrome, type 1 diabetes mellitus, thyroiditis, systemic lupus erythematosus, rheumatoid arthritis, psoriasis, multiple sclerosis, Tourette syndrome and HIV enteropathy, among others. There is no experimental evidence that the gluten-free diet is a healthier option for the general population.
Adherence to the diet in coeliacs is much worse than what was traditionally considered by scientists and specialists. Current studies show that approximately 80% of coeliacs continue to have intestinal injury, despite continued treatment with the gluten-free diet. The main cause of this lack of recovery is the inadvertent intake of gluten, mainly due to cross-contamination. A 2018 meta-analysis concludes that most celiacs, especially adults but also children, continue to ingest gluten regularly, involuntarily, despite being on a gluten-free diet. People with poor basic education and low understanding of how to follow a gluten-free diet often believe that they are strictly following the diet, but are making frequent mistakes. A common problem is the patient’s lack of awareness of avoiding gluten contamination in food preparation and other common sources of gluten, such as oatmeal, communion wafers, malted beverages, medications, processed foods, restaurant meals, and social events. Eating out poses a great risk since despite offering a “gluten-free” menu, many establishments (restaurants, school canteens, etc.) do not strictly follow the rules to avoid cross-contamination. If gluten suppression is not complete and maintained for life, intestinal mucosal damage, immune activation, and the risk of developing very serious health complications persist. The strict gluten-free diet appears to have a protective role against the development of cancers in celiacs and is the only option to prevent certain rare, highly aggressive cancers. However, delay in the diagnosis of celiac disease increases the likelihood of developing malignancy. The protective effect is most effective when the gluten-free diet is initiated at an early age, especially during the first year of life.
None of the methods used to date (2018) to evaluate strict adherence to the gluten-free diet is objective or reliable: patient questionnaires, symptom assessment, determination of celiac-specific antibodies, and findings in duodenal biopsies. Neither the absence of digestive symptoms nor the negativity of antibodies guarantee recovery of intestinal mucosa, which is complicated by biopsies. This is due to the fact that lesions of the intestine usually consist of minimal changes, without atrophy of the villi, which are difficult to identify. A new method based on the detection of gluten in samples of urine or feces for professional use has been available since 2017 and, since January 2018, in a version for domestic use, which has demonstrated its effectiveness in scientific studies to control compliance with the diet and detect trace contamination.
Spanish gluten free store: GlutenFreeSmartStore.com/es/
