Part of the controversy surrounding gluten sensitivity stems from the fact that it is difficult to disentangle any benefits someone may experience by adopting a gluten-free diet from the placebo effect - the power of a patient’s expectation that a treatment will lead to a cure.
A study published in February is the latest in a number of experiments with a “double blind” design, to sidestep the placebo effect. The Italian researchers tested 61 non-coeliac patients who believed they had gluten sensitivity, dividing them into groups that either received a daily dose of gluten or a rice starch placebo for a week, before swapping to the other treatment. Neither the patients nor the researchers knew until after the experiment who had been given the placebo first, and who the gluten first.
Many of the patients suffered symptoms including intestinal problems, foggy mind and depression while they were taking gluten, suggesting it really was the source of their problems.
The lack of physical biomarkers for gluten sensitivity also means that it is hard to know how many people are affected. Fasano’s best guess, which he has arrived at by looking at patient records, is 6% - a much higher number than coeliac disease’s 1%.
Gluten is a huge problem for many people and as the article points out it could be responsible for other problems that people are not even aware of. There is no cure but the easiet way to find out is to remove gluten from your diet completely and see if things get better.