Ever get questioned why you are gluten free? I get asked a lot, often accompanied by a look that suggest I am being health obsessive. For instance, when I won't eat a salad that is served with "only a few croutons" crowning the lettuce.

People have no idea how I would love to eat that crouton! Unfortunately for me, it’s a medical necessity to avoid gluten as I was diagnosed celiac several years ago. And I’ve been sleuthing out gluten ever since. What I put in my mouth and what I put on my skin makes all the difference to my health.

There's no shortage of gluten free (GF) labeled foods; they are the fastest growing segment of the food industry. Some see GF as just another health fad, like going vegan or eating low carb. True, a few Hollywood celebrities add to the media buzz by admitting that going gluten free makes them shed a few pounds and feel so much better. But should you be gluten free if you are not celiac? And if you are celiac, how do you find real GF products?

Let's explain gluten. It's a protein found in wheat and other grains. Some people are sensitive to gluten but for others like me who are diagnosed celiac, gluten is off limits. Even eating the amount on the head of a pin could cause celiac GI symptoms of pain, bloating, constipation or diarrhea. Worse, the lining of the GI tract gets inflamed and damaged, affecting your ability to make and absorb multiple nutrients. Low levels of some nutrients such as B vitamins affect energy and mood. Deficiency of magnesium and vitamin K may lead to early bone loss or osteoporosis. Other nutrients affect thyroid function and hormone levels. What some people consider "no big deal" to avoiding gluten is a "big deal" due to the negative health impact that consuming gluten holds for a celiac.

Who decides if a product is gluten free? Only recently did the FDA determine GF standards for labels claiming GF after August 2014. Their criteria states a label can be GF if it contains ingredients considered gluten free like yogurt and eggs, is made without gluten ingredients or if it tests less than 20 parts per million (ppm) in the finished product. The government also did a study and found most celiacs, especially in the first year when the GI tract is healing, cannot tolerate more than 1 ppm.

There are several problems with having a zero ppm gluten standard. One is that some manufacturers state they can only test to 20 ppm. However, a lab in Wisconsin which TyH has used to test some of its products, calibrates to zero, proving it can be done. The second problem is products can be manufactured in a facility that processes gluten containing grains, exposing the product to cross contamination. Technically, the product does not have gluten ingredients, making it "legal" to be labeled GF, no matter what it tests as. Cross-contamination is also possible in bakeries and restaurants that offer GF fare. Gluten hides in spices (flour is added to reduce "stickiness"), foods with "natural flavorings", soy sauce, French fries (even though potatoes are GF), cosmetics and even prescription drugs and supplements. Whether you go gluten free as a lifestyle option or because your health depends on it, "just a little" gluten makes a huge difference because your body deals with it on such a microscopic level, too.

When I was diagnosed celiac several years ago, I helped start the first celiac support group with a fellow celiac and naturopathic doctor who had celiac for more than 20 years. I represented the “newbie”, learning how to deal with a new diagnosis and all the health ramifications that went with it; the doctor represented the veteran who’d “been there, done that”. Although today it seems like gluten is well known, sadly thousands of people who have celiac go undiagnosed, exposing them to diseases like Hashimoto's thyroiditis, neurologic disorders, diabetes and even cancer of the digestive tract.

Since I take supplements, I scrutinized those ingredients, too. Are they tested GF? Are they made in a dedicated GF facility? A simple way to check is by reading the manufacturing statement on the label which starts "Manufactured without...", and is followed by a list of ingredients the product does not contain. Look for the word "gluten" within that statement. But I did not stop with only what I eat. Because skin is your largest organ, I also opted for gluten free skin care as well and found DERMA E, a natural skin care line which is also free of GMOs and parabens. Read about my favorite product here.

Since supplements are so beneficial in covering for nutritional deficiencies, I think it important that celiacs in particular supplement. Here's why. Probiotics replenish the GI tract and optimize mineral metabolism. Fiber is so difficult to get your daily 24-35 grams from nuts, seeds and veggies when you give up whole grains. A multi-vitamin-mineral complex helps lay the foundation as the odds are against you getting all you need from food alone. Gluten digesting enzymes help break down any gluten you accidentally ingest and for other proteins (like beans) that your GI system may mistake as gluten. CoQ10 supplies antioxidant and energy needs as every cell in your body requires CoQ10 for life. D3 is a pro-vitamin and bone support agent for calcium. B-12 is typically low since celiac affects the small intestines where you naturally make B-12. Especially important and often found low in celiac, take magnesium glycinate to help D3 and calcium bone building, too. Your energy production requires magnesium.

While it may seem daunting to supplement, look first to your diet and keep a diary for a week or so if needed. Some with celiac do not tolerate dairy so if you’re one of them, supplementing may be the only way to get your 500 mg or so a day. With a little investigating of your own, you can figure out your supplement needs and add those accordingly. I've named a few just to give you an idea of what might be missing for you.

In case it bears mentioning, eating as close to nature is your best bet, organically grown and harvested fruits, veggies non-farmed fish and hormone free meat if you consume it. Read labels carefully. I have also enclosed links below for more information on diet, testing and helpful organizations.

It’s not always fun being stuck with a disease you don't want. But do what you can to be as healthy as you can despite the hand your dealt. It's a challenge for sure!

You can read more in the TyH Online Health Library because what you don't know can hurt you. Here's some healthful reads for you!

• Celiac: Beyond Diet
• Celiac: Should You be Gluten Free?
• Food Allergy Testing, A (Doctor's) Conversation
• Supplements: Shopping for Supplements

©TyH Publications (M. Squires). For informational purposes only.