Symptoms of Non-Celiac Gluten Sensitivity (NCGS)

If you’re reading this, you’ve probably heard of gluten sensitivity. It is often lumped together with celiac disease, although they are two separate issues. Non-celiac gluten sensitivity (NCGS) is usually a “diagnosis of exclusion”, meaning someone has symptoms after ingesting gluten, but they have been thoroughly tested and do not have celiac disease or a wheat allergy.

It is estimated that at least 6% of the population has NCGS, far more than the estimated 1% of the population with celiac disease (1).

As a refresher, celiac disease is an autoimmune disease triggered by the ingestion of gluten, where the body’s immune system begins to attack itself. Wheat allergy is a true allergy and can result in anaphylaxis… but it’s not autoimmune.

Symptoms of non-celiac gluten sensitivity are likely caused by an innate immune response—the initial, broad-spectrum attack of our immune system.

Some researchers think it could be related to autoimmunity (2). Unfortunately, it really hasn’t been studied enough to know for certain. As opposed to celiac disease, there isn’t a strict set of criteria for diagnosing non-celiac gluten sensitivity (3) and no clear diagnostic markers. The autoimmune possibility comes in as studies have found that some NCGS folks create antibodies after eating gluten (4,5). They may also have a degree of intestinal tissue damage, although not to the extent seen in celiac disease (6). Elimination and reintroduction of gluten is the best way to determine whether NCGS is present. And the common solution to both celiac and NCGS? A life-long gluten-free diet (3).

Symptoms of Non-Celiac Gluten Sensitivity are numerous, reaching beyond the gut to the entire body.

Gut problems are usually the most obvious signs of NCGS. Gluten ingestion can cause gut issues like bloating, diarrhea, abdominal pain, constipation, and diarrhea (2).

The symptoms listed below are also caused by non-celiac gluten sensitivity—and some of them are surprising! These sneaky extra-intestinal symptoms can often evade a proper diagnosis of NCGS since they don’t fit into the hallmark signs of bloating or abdominal pain.

They include:

Depression (7,9)
Neurological symptoms such as brain fog, headaches, balance issues, and feelings of tingling/numbness (7,9).
Aphthous stomatitis (aka canker sores) (7)
Fatigue (7,9)
Eczema & rash (7)
Joint pain (7)
Anemia (7)
Small intestinal permeability (aka leaky gut) (6,10,11,12)

If you have symptoms of non-celiac gluten sensitivity, trying a gluten elimination and then reintroduction may be helpful for you. You can learn more about that here.

The great news is that if you are one of the 6% of the population with NCGS, removing all gluten should significantly reduce your symptoms—you might even feel like an entirely new person!

For me, it was a night & day difference.

I remember feeling like a “little old lady” in my 20s. Chronic fatigue, chronic debilitating pain, and this super weird symptom where my hands just wouldn’t work for the first hour or two in the morning. I was constantly in danger of dropping whatever I was holding, because I had some kind of neuropathy in my hands (which made my morning coffee experience extra exciting).

But it was super confusing trying to figure out HOW to go 100% gluten-free, which is why I created Easy Peasy Gluten Freezy.

NCGS may be more common in women than men (5) and associated with other diseases (5).

In a study of 436 NCGS patients, 47% also had IBS, 35% had another food intolerance (usually dairy), and 22% had allergies (especially to dust!) (5). Having a first-degree relative with celiac disease was also pretty common. This study also found that 14% of these NCGS folks also had an autoimmune disease—autoimmune thyroiditis, psoriasis, and Graves’ disease were the most common diagnoses (5).

Symptoms of Non-Celiac Gluten Sensitivity can overlap with Irritable Bowel Syndrome (IBS).

IBS is a prevalent gut problem, affecting up to 35% of people worldwide (13). IBS symptoms of bloating, abdominal pain, and constipation/diarrhea are also symptoms of NCGS. So how do you know if you have IBS or NCGS? For starters, look beyond the gut. The body-wide symptoms of NCGS listed above are not usually present in IBS (6). And while those with IBS typically benefit from a gluten-free diet, they may be sensitive to other foods as well. Finally, they do not have the presence of antibodies or intestinal damage that is present in some NCGS cases (6).