It’s common for individuals to go on a gluten-free diet on their own without being medically diagnosed with celiac disease or gluten intolerance, because of the remarkable disappearance of symptoms on the gluten-free diet. However, it’s natural to want to be tested for celiac disease so that you know for sure one way or the other. But in order for blood tests and an intestinal biopsy to be as accurate as possible, gluten must be consumed for a period of time prior to and during testing. Dr. Peter Green, in his book Celiac Disease, A Hidden Epidemic, discusses the gluten challenge, stating that it typically requires the individual to consume the equivalent of at least four slices of bread a day for one to four months prior to testing. This time frame should be long enough for the indicators of celiac disease (i.e. damage to the small intestinal wall) to become present and render a blood test or biopsy conclusive.
The gluten challenge can be an uncomfortable scenario to contemplate, as well as undergo, for anyone who has concluded for themselves that gluten is the culprit behind their physical malaise. But the gluten-challenge is a necessary evil if you are after a conclusive diagnosis for celiac disease. For some individuals, taking on the gluten challenge may illicit such uncomfortable physical symptoms that a doctor will not recommended it. Or, if someone has been on the gluten-free diet for several years and symptoms no longer exist, taking on the gluten-challenge may be a moot point, you already know you feel better without gluten, so why subject yourself to the test?
While the prospect of knowing for certain whether or not you have celiac disease may encourage you to take on the gluten challenge, the mere thought of the resulting sickness may be enough to make you content in your uncertainty. Just knowing that the gluten-free diet improved your well-being in dramatic ways may be all you need to know, even though the mystery will still linger. It’s a hard decision, but one that should be given serious consideration, particularly if you are trying to determine possible associations to the disease in your family.