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Did you know, if you’re already eating gluten free but have yet to be diagnosed with Celiac Disease or Gluten Intolerance, you will likely have to partake in the Gluten Challenge to receive either of these.

That means you’ll need to eat gluten, potentially a lot of it. You need to eat gluten for Celiac Disease testing to be accurate, looking for damage to your intestines.

What is the Gluten Challenge and How Does it Affect You?

A gluten challenge is a period of time when gluten containing foods are added back into a person’s diet to assist in the diagnosis of Celiac Disease. Antibodies take time to build into the blood stream before they can be detected through blood analysis.

In some instances, medical professionals may opt out of doing the gluten challenge and move immediately to an endoscopic biopsy. This is dependent on each individual and potential of worsening health. 

Is There an Alternative to the Gluten Challenge?

Dreams don’t always come true, sadly. Currently, there is no alternative to the gluten challenge if a definitive diagnosis of gluten intolerance or Celiac Disease is hoped for. Many medical professionals urge people to be tested before going gluten free for this reason. There is no alternative, yet. 


If definitive or official diagnosis isn’t needed, gene testing has been known to help indicate if someone has Celiac Disease. 

Gene testing is NOT going to tell you if you have Celiac, considering the number of people who carry the Celiac gene without the disease itself. This just lets you know if it is a possibility. 

Many forgoe getting an official diagnosis after already maintaining a gluten free diet. Individuals who experience horrible symptoms from accidental gluten ingestion commonly choose forgoing the gluten challenge. 

Benefits & Risks of Participating in Gluten Challenge

It is highly recommended that anyone considering going gluten free to get tested for Celiac Disease before changing their diet. Always speak with your Physician before making any big switches in foods.

We understand though many people go gluten-free without testing because they’ve heard it might make them feel better. Others make the switch because they believe it might be a healthier way to eat, in turn feeling better too.

Without test results for celiac disease, those people don’t know whether they’re at risk for complications of celiac, including osteoporosis and malnutrition.

There’s another reason often cited by people undergoing a gluten challenge: leverage to urge family members to also get tested for celiac disease. Current medical guidelines call for testing of all close relatives once someone in the family is diagnosed with celiac.

What to Expect Doing the Gluten Challenge

The short explanation of what to expect doing the gluten challenge, consume gluten, a lot of it.

How much gluten do you need to eat, and for how long?

Currently, there is no set medical guidelines for the gluten challenge. Little research has been done on the subject indicating improved odds of achieving accurate test results. Speak with your medical professional for individual requirements of gluten intake.

An analysis of the few medical studies that have been performed on this issue indicates that between 70% and 100% of children will develop positive celiac blood test results within three months while eating gluten. In adults, between 50% and 100% will show positive test results within three months.

Many medical professionals recommend a six to eight week gluten challenge. During the challenge you’ll consume two slices of gluten-filled bread each day.

Again, there is no real research showing that’s enough, either.

Keep in regular communication with your Physician when doing the gluten challenge. Any and all complications need to be documented and discussed at appointments. We liked to call this our Gluten Challenge Diary.

Frequently Asked Questions

How long do you need to eat gluten to be tested for celiac disease?

To diagnose pediatric patients with suspected CD on a gluten-free diet, a moderate-to-high dose gluten challenge for up to 3 months should be sufficient to induce changes in mucosal histology and antibodies in the majority of patients.

However, it was observed that in adults on a gluten-free diet, histological and serological relapse rates to gluten may be slower and prolonged challenge may be considered if no relapse is observed.

How much gluten should you eat a day?

A study conducted at the University of Maryland’s Center for Celiac Research found that people who consumed 50 mg of gluten per day developed villous atrophy after just 90 days. By contrast, those who consume either 10 mg or no gluten had no significant changes to their intestinal lining.

Based on research findings, you could reasonably assume that the daily intake of 10 milligrams of gluten would likely be enough to avoid illness. And, in most cases, it does.

Is a gluten challenge worth it?

It really depends on each individual. For some, yes it is absolutely worth it. For others, no. It could be very risky and potentially dangerous for your long term health. 

How fast does gluten affect Celiac Disease?

Symptoms related to Celiac Disease/gluten intolerance will commonly begin within minutes of consuming gluten.

For some, they can experience symptoms up to two hours after consumption. The symptoms can range from mild to life-threatening. Severe difficulty breathing, known as anaphylaxis, can even sometimes occur.

Celiac Disease: A Hidden Epidemic by Jonathan Todd Ross and Peter H. R. Green and Rory Jones

From Dr. Peter H. R. Green, internationally renowned expert on celiac disease and director of the Celiac Disease Center at Columbia University, and medical writer Rory Jones, this is the definitive book on celiac disease, one of the most underdiagnosed autoimmune diseases in the U.S. 

Do you suffer from gastrointestinal complaints, fatigue, headaches, joint pain, anemia, and/or itchy skin conditions? Have you consulted numerous doctors, and been prescribed drugs and diets that have only temporarily alleviated some symptoms? If so, you may have celiac disease, a hereditary autoimmune condition that affects nearly one in every hundred people–97 percent of whom remain undiagnosed and untreated.

This revised and updated edition contains the most current information on celiac disease, gluten intolerance, and gluten sensitivity. It examines the disease’s many manifestations and includes an entire section devoted to coping with the psychological aspects of living with a chronic illness and following a gluten-free diet. It also includes a guide to ingredients and safe grains, a selection of gluten-free manufacturers, and a list of national and international support groups.