Glutened?

With the holiday season creeping up, I thought it was about time that I finally compile this very important FAQ post on what to do if you’ve been glutened while on the AIP. 

If you’re here because you’ve been contemplating just how bad it would be to cheat on the AIP this holiday season or for a special event (completely different than someone dealing with celiac disease or non-celiac gluten sensitivity), stick around until the end of the post where I’ll touch on that too. But first, let’s talk about what happens when the gluten was UNintentional.

While I’m hopeful you’re making good decisions and choosing food wisely for your healing journey, I know all too well that sometimes, as careful as we are, it happens – we get glutened!

It’s especially challenging if we’re eating at a restaurant, or even at friends’ and families’ homes. Cross-contamination happens, ingredients get overlooked, or someone thinks they know what is gluten free and … well, they don’t. 

It happens.

The BEST advice I can give is:

DON’T PANIC!

I know … easier said than done! But stressing about the situation isn’t going to undo what happened, and piling a whole lot of anxiety on top of an already unhappy digestive system isn’t going to make you feel any better.

Try to remain calm and focus on taking care of yourself.

FACT:  Feeling emotionally stressed can compound the physical reactions you might have when gluten gets into your system. According to the Mayo Clinic, stress can affect your body in many ways, including causing symptoms such as stomach pain that overlap and amplify possible physical symptoms of gluten consumption.
– Source: Gluten.org

Hidden Names for Gluten: What to Watch For

One of the easiest ways unintentional gluten exposure happens is through tricky ingredient labels. Manufacturers rarely list “gluten” plainly on a package. Instead, it hides behind technical terms, derivatives, and cross-contaminated ingredients.

Important Note on AIP vs. Gluten-Free:

The list below is specifically designed to help you spot gluten and gluten-containing ingredients. Keep in mind that just because an ingredient isn’t on this list doesn’t mean it’s automatically AIP-compliant. Many gluten-free grains, starches, and nightshade-based additives are still eliminated during the strict AIP phase. Use this guide strictly as a filter to detect hidden gluten.

To help you spot these hidden culprits, here’s a breakdown of ingredients to watch out for:

1. Standard Grains & Primary Sources

Barley (including barley malt, barley flour, and barley extract), Rye, Wheat (and all varieties like spelt, kamut, farro, durum, einkorn, and emmer), Triticale (a cross between wheat and rye)

2. Wheat Derivatives & Technical Names

Atta (whole wheat flour common in South Asian cooking), Bulgur, Couscous, Farina, and Semolina, Fu (dried wheat gluten used in Asian cuisine), Graham flour & Maida, Matzo / Matzo meal, Seitan (pure wheat gluten used as a meat substitute), Udon (wheat-based noodles), Wheat berries, wheat germ, and wheat starch (unless explicitly certified gluten-free)

3. Hidden Additives & Processing Agents

Brewer’s yeast (a beer-brewing byproduct containing barley; note that standard baker’s yeast for baking is typically gluten-free), Hydrolyzed wheat protein, Malt (malt syrup, malt extract, malt flavorings, and malt vinegar), Modified food starch (if source grain isn’t listed, assume wheat outside strict GF labeling zones), Smoke flavoring (frequently uses barley malt as a carrier), Textured vegetable protein (TVP) (often wheat-derived unless specified as soy or pea)

4. Ingredients Requiring Double-Checking

Oats / Oat flour (naturally gluten-free, but highly prone to severe cross-contamination during harvesting and processing unless labeled Certified Gluten-Free), Soy sauce / Teriyaki sauce (traditionally brewed with wheat unless labeled tamari or gluten-free), Yeast extract / Autolyzed yeast extract (frequently made from spent brewer’s yeast, so verify the source or look for a gluten-free label)

How do you know if you’ve been “Glutened?” 

Unfortunately, there isn’t one universal “I’ve been glutened” reaction.

Some people know almost immediately that something is wrong. Others don’t notice anything until later. And some people have mostly digestive symptoms while others may experience headaches, fatigue, joint pain, brain fog or skin problems.

Some common reactions to gluten exposure include:

• Constipation
• Diarrhea
• Vomiting
• Nausea
• Abdominal pain
• Numbness
• Bloating
• Gas
• Headaches / Migraines
• Brain fog
• Mood swings
• Anxiety
• Depression
• Joint pain
• Fatigue
• Insomnia
• Skin issues / Rashes / Mouth Ulcers

You may experience several of these symptoms, or only one or two. You may also have symptoms that aren’t on this list at all.

Over time, you’ll probably get to know your own particular “glutened” symptoms. I think that’s actually pretty useful information to have especially if you aren’t sure what has caused a flare of symptoms.

One important thing to remember … symptoms don’t necessarily tell you what’s happening inside your gut. Someone with celiac disease, for example, may have an immune reaction to gluten without having a dramatic set of symptoms. It’s highly individual.

Before You Get Glutened: Be Prepared

Preparation is always key!

As someone living with food sensitivities and/or allergies, having a plan in place before you need it can make a bad situation a little easier to deal with.

I recommend talking to your healthcare professional BEFORE you’re in a situation where you’ve been glutened. That way you know what protocol is right for YOU, particularly if you have celiac disease or another condition that requires specific medical care.

I also think it’s worth having a few simple things on hand that you know you tolerate and that may help you manage some of the symptoms if an exposure happens.

1. Hydration & Electrolytes
   This isn’t particularly exciting advice, but it’s probably one of the first things I’d focus on.
   If you’re dealing with diarrhea or vomiting, you’re losing fluids, and replacing those fluids is important. Water is fine, and an electrolyte drink can be useful if you’re losing a lot of fluid. 
   If you’re nauseated … tiny sips are easier to manage.
2. Digestive Enzymes
   You may have seen digestive enzymes recommended for accidental gluten exposure, particularly in natural health and wellness and AIP circles. I see this suggestion come up quite often, and some people say they really do feel better when they take them.
   There is, however, an important distinction between something that makes a person feel better and something that has been shown to break down enough gluten to prevent a reaction.
   The Celiac Disease Foundation does not consider commercially available digestive enzyme products a reliable way to digest gluten, and Autoimmune Wellness mentions the same issue in their Gluten Exposure: A Healing Guide.
   So while this is something you may hear recommended, I wouldn’t rely on digestive enzymes as protection against gluten. And they definitely aren’t a green light to intentionally eat gluten.
3. Herbal Tea
   This is one of those simple things that can be worth having around.
   Peppermint, chamomile and ginger tea may help with particular symptoms such as nausea, gas or digestive discomfort. They aren’t going to remove gluten from your system, but if a warm cup of tea makes your stomach feel a little less angry, I’m all for it. Sometimes simple is good.
4. Keep Your Diet Simple
   If you’re feeling nauseated, you don’t have to force yourself to eat, but when you’re ready, keep it simple! Stick with foods you already know you tolerate well. Chicken soup (without too much fat), broth, and well-cooked vegetables. Consider avoiding dairy and sugar, even if you are no longer in the AIP elimination phase.
5. Activated Charcoal
   You’ll find differing opinions on this one. Activated charcoal is sometimes recommended by natural practitioners, and I’ve personally used it for stomach upset and found some relief. 
   The Celiac Disease Foundation, however, does not recommend activated charcoal for gluten exposure, and there are some good reasons for caution, as it can interfere with absorption of medications and supplements and cause constipation. Talk to your healthcare professional to decide what’s right for you.
6. Rest
   Getting glutened can leave you feeling like you were hit by a truck. Prioritize as much rest as possible. Give yourself permission to have a quiet day or two.

What To Do After You’ve Been Glutened

Once the accidental exposure has happened, there isn’t a magic way to get the gluten back out. Thankfully though, you’ve prepared for such an unfortunate event if you followed the advice above.

The best thing you can do is: stop the exposure, take care of yourself and give your body some time to deal with the aftermath.

Focus on fluids, rest and foods you know you tolerate. Use simple things that may help with the particular symptoms you’re experiencing, rather than feeling like you need to throw every supplement in your cupboard at the problem.

And don’t forget that you don’t necessarily need to do anything.

Sometimes you just need to wait it out.

Autoimmune Wellness has a great article on this topic, Gluten Exposure: A Healing Guide, which goes into much more detail about dealing with the aftermath of an exposure.

How Long Will It Take to Feel Better?

That’s the million dollar question everyone wants the answer to!

Unfortunately, there isn’t a magic number of hours or days. It’s highly individual and depends on a number of factors.

How long you’ll feel lousy after gluten exposure can vary quite a bit from one person to another. Current research into accidental gluten exposure in people with celiac disease also shows considerable variation in people’s symptoms and how long those symptoms affect their day-to-day lives.

So if someone else tells you they felt completely fine the next morning while you’re still curled up on the couch a couple of days later, don’t assume you’re doing something wrong.

Your reaction may simply be different.

And there’s another distinction that’s important here. Feeling better isn’t necessarily the same thing as your gut being completely healed. For someone with celiac disease, gluten triggers an immune response that can damage the small intestine, and intestinal healing takes place over time with a strict gluten-free diet.

In other words, don’t judge what’s happening inside your gut solely by how you feel on the outside.

If your symptoms are severe, continue to worsen, aren’t improving, or you’re unable to keep fluids down, it’s time to check in with your healthcare provider.

Do I Need to Start the AIP Over?

The short answer … No!

If you’ve been following the AIP and accidentally consumed gluten, you do not need to go back to Day One and start the entire elimination phase over again.

Take a breath, get back to your usual AIP elimination diet and keep going.

Maybe there’s something you can learn from the experience. Ask more questions at a restaurant. Double-check a label. Bring your own food to a family gathering. (See my posts: Dining Out on the AIP and Surviving Social Life on the AIP for more tips and tricks)

But don’t beat yourself up over an accident. One exposure does not erase all the work you’ve done.

What About Cheating on the AIP?

That’s a different question.

Accidentally eating gluten and deliberately choosing to eat gluten for a special occasion aren’t the same thing (I do get this question frequently, so I’ve written about that too.)

If you’re considering intentionally stepping outside the parameters of the AIP diet for a holiday celebration, birthday, vacation or other event, check out my FAQ: Can I Cheat on the AIP? for my thoughts on that.

For now, if you’ve been accidentally glutened, take a breath, take care of yourself and get back to the AIP … slow and steady.