“Many people assume that cutting out gluten will ease arthritis symptoms, but the connection is not as straightforward as it may seem,” explains registered dietitian Cristina Montoya in a recent Arthritis Talks webinar. “There are different types of gluten-related sensitivities, and not all of them are linked to inflammation in arthritis.”
Before eliminating gluten from your diet, it’s important to understand what gluten is, the various gluten-related disorders, and whether scientific evidence truly supports its role in arthritis.
What is gluten?
Gluten is a protein found in grains such as wheat, barley and rye. Most people can digest it without any issues, but for some, it can trigger an autoimmune response or lead to discomfort.
Gluten, wheat and other digestive sensitivities
There are a variety of gluten-related disorders, differing in their severity of reactions upon gluten consumption.
Celiac disease: An autoimmune disorder where consumption of gluten damages the small intestine, leading to malabsorption of nutrients and symptoms like digestive issues, headaches and abdominal pain.
Diagnostic methods available: Blood tests, small intestinal biopsy (Gold standard).
Wheat allergy: An allergic reaction to wheat proteins (not just gluten) that can include swelling, itching, hives, nasal congestion, indigestion, headaches, and, in severe cases, difficulty breathing or anaphylaxis.
Diagnostic methods available: Skin prick tests, blood tests, elimination diets, and food challenge tests
Non-Celiac Gluten/ Wheat Sensitivity (NCGS): Causes digestive symptoms like gas, bloating, abdominal pain, constipation and diarrhea and other symptoms like dizziness and fatigue. Unlike celiac disease, NCGS doesn’t damage one’s intestines.
Diagnostic methods available: Food challenge tests and elimination diets
Fructan intolerance: Digestive discomfort upon consuming fermentable carbohydrates (
FODMAPS), sugars that the small intestine cannot completely digest. Many foods with or without gluten contain fructan, including wheat, barley, rye watermelon, onions, and black beans.
Diagnostic methods available: Elimination diets and food challenge tests
Is there a connection between gluten-related diseases and inflammation?
“People living with arthritis may experience reduced inflammation after switching to a gluten-free diet, though this might not be a direct result of gluten itself,” says Cristina. “The shift to a gluten free diet often leads one to eat fewer processed foods and more antioxidant and anti-inflammatory options, which may help reduce inflammation.”
Celiac disease is an autoimmune disease like many forms of arthritis, and we know that autoimmune diseases frequently overlap – this means, people living with autoimmune forms of arthritis, may be at a higher risk of developing celiac disease.
According to the Celiac Disease Foundation, celiac disease is commonly associated with other autoimmune diseases, including thyroid disease and Type 1 diabetes. In some cases, like Sjögren's disease, the increased risk of celiac disease can be as high as 15 per cent. One study found that the overall burden of autoimmune diseases in people with celiac disease was 15%—significantly higher than the general population's prevalence of 3–5%.
Nutritional risks of following a gluten-free diet
Gluten-containing foods provide essential nutrients, including protein, fiber, and key vitamins. Eliminating gluten without proper planning can lead to nutritional deficiencies, so consulting a healthcare provider or a registered dietitian before making dietary changes is crucial.
While autoimmune diseases often overlap, research on gluten’s specific role in arthritis-related inflammation remains limited. In some cases, digestive discomfort linked to gluten may actually stem from fructan intolerance.
Instead of eliminating gluten entirely, focusing on an overall anti-inflammatory lifestyle—including regular exercise and a nutrient-dense diet—may be a more effective way to manage arthritis symptoms.
Try our arthritis-friendly recipes
Eating a balanced and nutrient-dense diet is key to managing arthritis symptoms. Whether you’re exploring gluten-free options or looking for nourishing anti-inflammatory meals, be sure to try these delicious arthritis-friendly and gluten-free recipes:
Spicy shrimp stir-fry: This delicious dish is rich with protein, selenium, and vitamin D – nutrients that support your immune health. Shrimp is also an excellent source of zinc, an essential mineral for those living with inflammatory arthritis.
Chipotle burrito bowl: This hearty bowl delivers plant-based protein, complex carbohydrates, and antioxidants to fuel your body and support overall well-being.
Date and carrot muffins: These naturally sweet muffins are packed with fiber-rich flax seeds, a great source of thiamin to help convert carbohydrates into energy. A wholesome, energizing treat for any time of day!
Disclaimer: Before making any dietary changes, including going gluten-free, consult a registered dietitian or healthcare provider to ensure your nutritional needs are met.