Alison, a 60-year-old grandmother, had been a successful ceramic artist for many years. But in the last year she had given up her professional life… in fact, she had curtailed most activities, including regular visits with her three grandchildren. She was sleeping poorly and most days she was too exhausted to work or go out. She also had chronic diarrhea and felt uncomfortably cold, even though she lived in sunny southern California. Alison’s doctor ordered a bunch of tests and, when the results came in, told her she had several fairly serious ailments. In addition to the low platelet count she already knew was a problem, her blood pressure was elevated and her blood tests showed markers characteristic of lupus, an autoimmune disease that causes high levels of inflammation.

Based on the test results her doctor immediately advised Alison to have a platelet transfusion, after which he said she should plan to have a splenectomy — surgical removal of the spleen, the small blood-filtering organ that, when it becomes overactive, destroys platelets. Alison was horrified by both suggestions, even after a second doctor echoed the advice. Hoping to prove all this unnecessary, she set out to explore all possible options before agreeing to undergo procedures she saw as being drastic and uncomfortable, at the very least. She called naturopathic physician, Mark Stengler, ND.


In reviewing Alison’s health and medical history, Dr. Stengler was interested to learn that several years earlier a nutritionist had advised her to see whether giving up wheat and other forms of gluten helped her feel better. In fact, doing so improved her health dramatically — clearing up both her diarrhea and fatigue and even halting her platelet disorder. Alison proudly shared this news with her doctor at a check-up nine months later, but he dismissed all of it as nonsense, though he did agree to test her blood for celiac disease, an intolerance to gluten. Much to Alison’s surprise, her test results were negative. Assuming the cause was something else entirely, her doctor said it was fine to go back to eating the pasta and bread she loved and missed. So, she went back to her old ways of eating, and the pain and other symptoms returned. She began to feel ill again within months, but it was several years before she went to Dr. Stengler.

Despite the earlier negative results for celiac disease, Dr. Stengler suspected Alison did in fact have serious gluten sensitivity, at the very least — and when he tested her, she saw that he was right. He explained the earlier negative test finding as being due to the gluten-free diet she was on, which makes people with celiac test negative. Ironically, it was because Alison had returned to eating wheat that the test results for gluten intolerance were now accurate.

Celiac disease and to a lesser degree gluten sensitivity cause the body to attack its own tissues, reacting to the gluten as a foreign substance. As such, it damages the lining of the digestive tract and impairs nutrient absorption, which, in turn, causes fatigue, diarrhea and the other chronic problems. Dr. Stengler prescribed a completely gluten-free diet for Alison — no wheat, rye, barley or oats. It turns out that Alison had the most extreme form of celiac — meaning she has absolutely no tolerance for gluten and must eliminate even trace amounts which show up in such seemingly disparate products as sauces, medicines, vitamins, salad dressing, soups and rice… even herbal teas and adhesives on stamps and envelopes. In a matter of months after Alison gave up gluten-based foods, her symptoms had disappeared, including even the lupus blood markers.


Dr. Stengler explains that it is important to distinguish between gluten sensitivity and celiac disease. Gluten sensitivity does not show up on blood tests for celiac, but it can still produce many symptoms including fatigue, digestive upset, depression, skin rashes and more. While only about 1% of Americans have celiac disease (genetic tests confirm whether or not you carry the gene), gluten sensitivity is much more common — some people are gluten sensitive, and virtually all of us have difficulty digesting gluten, Dr. Stengler told me. It is not unusual for people to develop gluten sensitivity and even celiac disease later in life, as apparently was the case for Alison. It’s unclear why this happens, said Dr. Stengler, noting that new research suggests it could be triggered by complications of a Candida albicans fungus. As people age, Dr. Stengler says it is not uncommon to have an overgrowth in the gastrointestinal tract caused by antibiotic use or decreasing stomach acid, which allows Candida to thrive.

Though many doctors won’t diagnose it unless a patient has specific symptoms, including weight loss and a particular type of smelly, grey, oily stool, Dr. Stengler said he often sees patients for whom fatigue is the primary symptom of both gluten sensitivity and celiac disease. Consequently he advises testing for anyone who suffers from fatigue, digestive troubles, autoimmune symptoms and other unexplained health problems. Stool testing is the most sensitive testing for both problems, especially early on, before the damage to the cells and intestinal villi becomes profound enough to render the blood test positive.

If it turns out you have either gluten sensitivity or celiac disease, a gluten-free diet will bring the happy rewards of a return to health and an active life. As for that pasta and bread? While not exactly the same, there’s an increasing array of recipes and products available for those who are gluten sensitive or have celiac disease. Many can be found at your local supermarket or Whole Foods Market or online.