International Journal of Celiac Disease
ISSN (Print): 2334-3427 ISSN (Online): 2334-3486 Website: Editor-in-chief: Samasca Gabriel
Open Access
Journal Browser
International Journal of Celiac Disease. 2018, 6(3), 71-73
DOI: 10.12691/ijcd-6-3-7
Open AccessArticle

Adverse Effects of Gluten-free Diets

Hugh James Freeman1,

1Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC, Canada

Pub. Date: January 04, 2019

Cite this paper:
Hugh James Freeman. Adverse Effects of Gluten-free Diets. International Journal of Celiac Disease. 2018; 6(3):71-73. doi: 10.12691/ijcd-6-3-7


In celiac disease, treatment with a gluten-free diet is highly effective for management of clinical features, particularly resolution of diarrhea and weight loss. In children, normalization of growth results. In adult celiacs with iron deficiency anemia, complete normalization of iron levels and resolution of anemia may occur with a gluten-free diet alone. In addition, the small intestinal mucosa responds to restriction of dietary gluten and, eventually, in the vast majority, complete histological recovery occurs. Although effective in celiac disease, the gluten-free diet has been increasingly used in clinical conditions unrelated to celiac disease. Unfortunately, gluten-free diets may have significant negative effects with evidence for development of nutrient deficiencies, an increased risk for obesity particularly in children, and measurable evidence for the accumulation of several heavy metals in blood and urine. Although longer term studies are still needed, caution must be advised in the use of gluten-free diets for non-celiac disorders including those based solely on patient-reported gluten sensitivity

celiac disease negative effects of gluten-free diets heavy metals fiber gluten sensitivity

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Freeman HJ. Celiac disease. In Reference Module in Biomedical Sciences. Elsevier. 6-Dec-2017.
[2]  Freeman HJ. Role of biopsy in diagnosis and treatment of adult celiac disease. Gastroenterol Hepatol Bed to Bench 2018; 11: 191-196.
[3]  Freeman HJ. Detection of adult celiac disease with duodenal screening biopsies over a 30-yr-period. Can J Gastroenterol 2013; 27: 403-408.
[4]  Freeman HJ. The Neolithic revolution and subsequent emergence of the celiac affection. Int J Celiac Dis 2013; 1: 19-22.
[5]  Niland B, Cash BD. Health benefits and adverse effects of a gluten-free diet in non-celiac disease patients. Gastroenterol Hepatol (NY) 2018; 14: 82-91.
[6]  Biesiekierski JR, Peters SL, Newnham ED, Rosella O, Muir JG, Gibson PR. No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Gastroenterology 2013; 145: 320-328.
[7]  Molina-Infante J, Carroccio A. Suspected non-celiac gluten sensitivity confirmed in few patients after gluten challenge in double-blind, placebo-controlled trials. Clin Gastroenterol Hepatol 2017; 15: 339-348.
[8]  Koning F. Adverse effects of wheat gluten. Ann Nutr Metab 2015; 67 Suppl 2: 8-14.
[9]  Thompson T, Dennis M, Higgins LA, Lee AR, Sharrett MK. Gluten-free diet survey: are Americans with celiac disease consuming recommended amounts of fibre, iron, calcium and grain foods? J Hum Nutr Diet 2005; 18: 163-169.
[10]  Thompson T. Folate, iron and dietary fibre contents of the gluten-free diet. J Am Diet Assoc 2000; 100: 1389-1396.
[11]  Thompson T. Thiamin, riboflavin, and niacin contents of the gluten-free diet: is there cause for concern? J Am Diet Assoc 1999; 99: 858-862.
[12]  Mariani P, Viti MG, Montuori M, La Vecchia A, Cipoletta E, Calvani L, Bonamico M. The gluten-free diet: a nutritional risk factor for adolescents with celiac disease? J Pediatr Gastroenterol Nutr 1998; 27: 519-523.
[13]  Rea F, Polito C, Marotta A, Di Toro A, Iovene A, Collini R, Rea L, Sessa G. Restoration of body composition in celiac children after one year of gluten-free diet. J Pediatr Gastroenterol Nutr 1996; 23: 408-412.
[14]  Levran N, Wilschanski M, Livovsky J, Shachar E, Moskovitz M, Assaf-Jabrin L, Shteyer E. Obesogenci habits among children and their families in response to initiation of gluten-free diet. Eur J Pediatr 2018; 177: 859-866.
[15]  Raehsler SL, Choung RS, Marietta EV, Murray JA. Accumulation of heavy metals in people on a gluten-free diet. Clin Gastroenterol Hepatol 2018; 16: 244-251.
[16]  Patel NK, Lacy BE. Another reason to avoid the gluten-free fad? Clin Gastroenterol Hepatol 2018; 16: 184-185.
[17]  Zarkadas M, Cranney A, Case S, Molloy M, Switzer C, Graham ID, Butzner JD, Rashid M, Warren RE, Burrows V. The impact of a gluten-free diet on adults with celiac disease: results of a national survey J Hum Nutr Diet 2006: 19: 41-49.
[18]  Pulido O, Zarkadas M, Dubois S, MacIsaac K, Cantin I, La Vieille S, Godefroy S, Rashid M. Cllinical features and symptom recovery on a gluten-free diet in Canadian adults with celiac disease. Can J Gastroenterol 2013; 27: 449-453.
[19]  Freeman HJ. Mucosal recovery and mucosal healing in biopsy-defined adult celiac disease. Int J Celiac Dis 2017; 5: 14-18.
[20]  Freeman HJ. Iron deficiency anemia in celiac disease. World J Gastroenterol 2015; 21: 9233-9238.