Recently I’ve had some conversations with my teenage exchange student about the idea of getting a little bit of gluten here and there and the impact it may have on a celiac’s body. While some people may get sick from the slightest cross contamination, others may not. So my question – if you’re a non-reacting celiac, can you nickel and dime yourself into being glutenized with a reaction?

Gluten-by the numbers

An article from Medscape reported on research that analyzed several studies and the issue of “how much is too much gluten for a celiac.” It looked at total amount of gluten ingested in a day as opposed to the amount of gluten in individual food products. “Consumption of gluten at levels of 200 mg a day or more was definitely associated with the development of intestinal abnormalities,” the article reported. It also said in most cases the damage was evident within several weeks, but one other trial said it could happen as early as one week.  The Medscape article also noted studies involving lower levels of gluten being ingested weren’t very consistent. Some studies showed as little as 10 mg of gluten-per-day caused villi damage.

The article concluded that 200 PPM guideline is too high of a gluten-content for celiacs and 20 PPM is a more reasonable level. “The current body of research suggests that this level of gluten intake [20 PPM] would not promote mucosal abnormalities among the majority of patients with celiac disease,” the report said and it also recommended further research on the subject.

So How Much gluten can cause a reaction?

The University of Chicago’s Celiac Disease Center put it this way, “As little as 1/8 of a teaspoon of flour is enough to set off this abnormal response (trigger celiac disease to become active).” Basically allowing symptoms to rear their ugly head again. put another spin on it: “The smallest amount of gluten which has been shown by a biopsy to cause damage to a celiac is 0.1 gram per day (Catassi et al.). This is approximately the amount of gluten contained in 1/48th of a slice of bread!”

So I haven’t found any major scientific research on whether you can nickel and dime your way to gut damage by gluten, but with the research noted above, celiacs should proceed with caution when it comes to the potential for cross contamination with knives, butter, crumbs, straws, counter tops, etc.  Cross-contamination or just careless handling of food either by you or someone else may not seem hazardous the first time, but each time you have an extra crumb of gluten, you may be doing damage to your gut.  If you don’t have immediate symptoms, it could eventually be enough to give to bring them on.

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