Gluten Cross-Reactivity: How your body can still think you’re eating gluten even after giving it up.

October 4, 2012 in Categories: , , by

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NOTE:  An updated version of this post can be found here.

For those 20% of us with celiac disease or gluten-intolerance/sensitivity (whether diagnosed or not), it is critical to understand the concept of gluten cross-reactivity.  Essentially, when your body creates antibodies against gluten, those same antibodies also recognize proteins in other foods.  When you eat those foods, even though they don’t contain gluten, your body reacts as though they do.  You can do a fantastic job of remaining completely gluten-free but still suffer all of the symptoms of gluten consumption—because your body still thinks you are eating gluten.  This is a very important piece of information that I was missing until recently.

Proteins are made of long chains of amino acids (small proteins may only be 50 amino acids long whereas large proteins may be 2000 amino acids long) and it is the specific sequence of these amino acids that determines what kind of protein is formed.  These amino acid chains are folded, kinked and buckled in extremely complex ways, which gives a protein its ‘structure’.  This folding/structure is integral to the function of the protein.

An antibody is a Y shaped protein produced by immune cells in your body.  Each tip of the Y contains the region of the antibody (called the paratope) that can bind to a specific sequence of amino acids (called the epitope) that are a part of the protein that the antibody recognizes/binds to (called the antigen).  The classic analogy is that the antibody is like a lock and a 15-20 amino acid section of a protein/antigen is the key. There are 5 classes (or isotypes) of antibodies, each with distinctive functions in the body.  The IgE class of antibodies are responsible for allergic reactions; for example, when someone goes into anaphylaxis after eating shellfish. The two classes IgG and IgA are critical for protecting us from invading pathogens but are also responsible for food sensitivities/intolerances.  Both IgA and IgG antibodies are secreted by immune cells into the circulation, lymph, various fluids of the body (like saliva!) and tissues themselves.  And both IgG and IgA antibodies are found in high concentrations in the tissues and fluids surrounding the gut (this is part of why the gut is considered our primary defense against infection).

The formation of antibodies against an antigen (whether this is an invading pathogen or a food) is an extremely complex process.  When antibodies are being formed against a protein, the antibodies recognize specific (and short) sequences of amino acids in that protein.  Depending on how the antigenic protein is folded, certain amino acid sequences in that protein are more likely to be the target of new antibody formation than others, simply because of the location of that sequence in the structure of the protein.  Certain sequences of amino acids are more antigenic than others as well (i.e., more likely to stimulate antibody formation).  This is also part of why certain foods have a higher potential to cause allergies and sensitivities.

Understanding that antibodies recognize short sequences of amino acids and not an entire protein is key to understanding the concept of cross-reactivity (and molecular mimicry, but that’s a topic for another post).  It also is the reason why many different antibodies can be formed against one protein (this redundancy is important for protecting us from pathogens).  Many different antibodies can also be formed against one pathogen or, more relevant to this discussion, one specific food.

So what happens in cross-reactivity?  In this case the amino acid sequence that an antibody recognizes is also present in another protein from another food (in the case of molecular mimicry, that sequence is also present is a protein in the human body).  There are only 20 different amino acids, so while there are millions of possible ways to link various amount of each amino acid together to form a protein, there are certain amino acid sequences that do tend to repeat in biology.

The take home message:  depending on exactly what antibody or antibodies your body forms against gluten, it/they may or may not cross-react with other foods.  So, not only are you sensitive to gluten, but your body now recognizes non-gluten containing foods as one and the same.  Who needs to worry about this?  Any of the estimated 20% of people who are gluten sensitive/intolerant or have celiac disease, i.e., have formed antibodies against gluten.

Cyrex Labs offers a simple blood test that tests for cross-reactivity to the most common culprits (Chris Kresser vouches for the high quality tests done by this company, which is good enough for me!).  Here is the full list (some of these are obviously not paleo, but you might consider them cheat foods, which is why I mention them):

  • Rye
  • Barley
  • Spelt
  • Polish Wheat
  • Oats
  • Buckwheat
  • Sorghum
  • Millet
  • Amaranth
  • Quinoa
  • Corn
  • Rice
  • Potato
  • Hemp
  • Teff
  • Soy
  • Milk (Alpha-Casein, Beta-Casein, Casomorphin, Butyrophilin, Whey Protein)
  • Chocolate
  • Yeast
  • Coffee
  • Sesame
  • Tapioca (a.k.a. cassava or yucca)
  • Egg

Just like trace amounts of gluten can cause a reaction in at least those with celiac disease (the threshold for a reaction has not been tested in non-celiac gluten sensitivity), even a small amount of these foods can perpetuate inflammation and immune responses.  This is important when you think of the small amounts of soy used in so many foods and even the trace milk proteins that can be found in ghee.

If you have autoimmune disease (which has a very high correlation with gluten-sensitivity), celiac disease, gluten-sensitivity, or are simply not seeing the improvements you were hoping for by following a standard paleo diet, one or all of these foods may be the culprit.  You have the choice of either cutting these foods out of your diet and seeing if you improve or get tested to see if your body produces antibodies against these foods.  For me, it’s a no brainer (because it just all makes so much sense now!): I have to stop eating chocolate (sniff), fermented foods like sauerkraut and kombucha (because of the yeast content), eggs, and tapioca.  I am very happy to report dramatic improvement in my lichen planus lesions in just four days! (and as much as I miss chocolate and kombucha, it’s worth it!)

A great overview of proteins and antibodies (and source of protein folding image):

A fairly technical review of food IgG-mediated food sensitivities:

Cyrex Labs Array 4:

Image of antibody binding taken from


Wow, this is exactly what I needed to read today! I have recently begun experiencing the same joint pain that gluten elimination initially cured, and I wondered if there was *something else* that might be the culprit. I think I’ll do an elimination and then slowly add them back and see if I can pinpoint the culprit. Thanks so much for the great info!

OK, so I have a follow-on science question for you. I was diagnosed celiac via blood test in 2001. I’ve been gluten-free ever since, no cheating, but I’m sure I’ve had contamination over the years now and again. In the last year or so, I’ve had symptoms similar to what I had before I went gluten-free. Even on a primal diet (with dairy) since Feb. and a paleo diet (took out dairy) since May. So I went to the doctor, and along with several other tests, did a celiac blood panel, which came up negative. Doesn’t the blood panel measure antibodies, and if I came up negative, does that rule out cross-reactivity as being a problem? I just got a diagnosis of microscopic colitis, but it seems that little is known about it…they *think* it’s autoimmune, but that has not been conclusively proven, for example. So I’m wondering if the negative blood panel has any relevance as far as dietary changes that may help my symptoms.

The blood test is not actually sensitive enough to detect reactions to small amounts of gluten or gluten cross-reactive foods, even though these can still have a dramatic effect in terms of symptoms (a biopsy would be a more sensitive test). I think it is worthwhile getting some food sensitivity testing done and/or attempting an elimination diet (such as the autoimmune protocol, but there are other options too) to try and isolate problematic foods.

Wow! You’re so inspiring. Sad that we have to be such “health investigators”. As if just going plain ol’ Paleo wasn’t hard enough, now this. How seriously you take your health is utterly remarkable 🙂 I’d have to be pretty sick to give up the things you’ve given up. Way to go!

I previously gave up coffee and haven’t been brave enough to try it again (and now that I know more, probably won’t try it for at let several more months). If you click the link in the post where coffee is in the list it will take you to a whole post I wrote about the pros and cons of coffee.

Wow. This is dedication. I have noticed, however, that sneaking in a few french fries or mashed potatoes will give me heartburn a few hours later. Same thing with a bag of gluten-free corn chips. Chronic heartburn was the first thing I found relief from after 3 days of going gluten free. For my son, I think I need to re-examine milk.

No booch or kraut, I might tear up a little. I’ll admit, kombucha has been my crutch through this process… In the last ten days I’ve had a significant uptick in my symptoms (self-diagnosed scalp psoriasis). Are there other probiotic foods that you would recommend in their place?

PS I really appreciate you sharing all your knowledge and research!!

Do you think that this means that in spite of paleo our gut linings don’t completely heal (I mean if they are still letting proteins through)? And is it even a possibility that they will ever heal so that you can again enjoy a diverse diet, obviously sans the non paleo stuff that caused the problem int he first place. It’s just that the idea of restricting, restricting and then restricting some more without any hope of eating an egg again in the future just seems bleak to me.

Yes, your gut should be able to heal enough to reintroduce at least some foods. I have an autoimmune disease though, so the chances of me successfully reintroducing much are pretty low. 🙁

Hi Paleo Mom!

I don’t think all ferments have yeast. I know Kombucha and Kefir do since they have a SCOBY but yoghurt and sauerkraut (and other fermented vegetables) should be okay because the fermentation is being done by bacteria only. I’m no scientist but I have done a ton of reading on fermentation lately.

As usual, your best posts give me happy aha’s and then some sadness. I just mastered coconut milk kefir and water kefir. Been loving both but it seems there are more things that need to be eliminated, at least for awhile. I’ve been thinking of doing a GAPS intro like diet now that the Fall is here (well, as soon as Fall gets to SF, it was 90º the other day) where I scroll it back to very simple foods (like broth/soup) for a few weeks and then slowly bring back in new foods every 3-4 days.

In some ways I think having obvious signs like your lichen planus lesions is a blessing. They give you fabulous feedback. I certainly don’t wish for more AI issues but I do sometimes wish I could read my body better.

Glad you found another clue in your quest for health.

My understanding is that fermented vegetables do contain some yeast, although not as much as kefir or kombucha. Definitely sauerkraut will be top on my list to try and reintroduce, but I’m planning on staying strict with this for some months first.

Ah, ok. Thanks for the clarification. I think I’m heading toward trying the autoimmune protocol, but I’m not ready to give up eggs and coffee just yet. 🙁 Soon, though, unless my GI doc has some other strategy to try other than automatically starting me on meds.

Here’s a question from a very unscientific fellow AI follower: my doc has me on something called IgG 2000 to help with gut healing while I adhere to a super restrictive diet. It’s made by xymmogen. The only ingredient is non-dairy serum derived immunoglobulin concentrate. Could this be a cross reactor?

I just looked up IgG 2000. It’s basically a cocktail of chemicals and proteins that your immune system would normally produce to fight infection or as part of a food sensitivity. It sounds like the goal of this cocktail is to stimulate the immune system, but my thought is that you want to do the exact opposite. Although the claim that this cocktail helps to restore healthy gut flora does make some sense. This type of supplement really isn’t my field and I don’t know what your health history is so I don’t really want to make a specific recommendation as to whether or not this is a useful supplement to take. However, to directly answer your question, no I don’t believe this supplement would be a gluten cross-reactor unless there are any corn or soy ingredients in any filler.

Thanks for this post! I found out through experimenting over the past 2 years that my 7yo reacts to several other foods on top of those he tested positive for on his IgG blood test (eggs, dairy, gluten/wheat and soy). All of which are on the list of cross-reactors above. I feel a little less crazy now that I understand the science behind it and can explain WHY 7yo can’t have these things (despite the negative test on those things) to all of those people who give me a raised eyebrow.

I reacted to a number of these foods prior to finding out about the Cyrex lab test (potato, hemp, soy, milk, sesame, coffee). Unfortunately the test is unavailable in Canada or was when I last checked. I suspect tapioca too. I need to get back to sleuthing.

I am in Canada too… there has got to be some Canadian equivalent, hasn’t there? I would drive to the US, but you can’t just order the tests, you need a practitioner. 🙁

I did the cyrex panel… boy was that an eye opener! I am cross reactive to 8 and sensitive to another 11!!! Yeast was on my 8 as well as coffee, and all the dairy/milk proteins. After following the AIP strict for 3 months I was able to add eggs and almonds (hooray!)… haven’t had much success with other introductions 🙁 Your posts are awesome. Thank you for providing such easy to understand articles!

I’m right there with you. Cross-reactive to 9 (and I mean WAY over the ranges) and sensitive to 4. The hardest part for me is trying to make sure that egg, corn and rice never enter my mouth in any form. I’m going blind reading labels, but I guess it’s time to take all of this seriously and start the AIP. Wish me luck!

I wrote this earlier on another email chain. I’m still struggling with tummy issues. Thanks!!

“Sorry, but I’m a little “chemically challenged”. If my Cyrex IgG / IgA test shows that I’m not cross-reactive to rye, barley, spelt, Polish wheat, or oats (but I am cross-reactive to all gluten-free products), does that mean that I am not gluten-intolerant or gluten-sensitive? I’m still avoiding gluten at this time, but a little clarification would be greatly appreciated.”

Not necessarily. If you are gluten sensitive, that doesn’t automatically mean that the antibodies your body creates will react will all of the foods on the Cyrex panel. You can be gluten intolerant and the antibodies your body creates don’t cross react with any other foods, or cross react with some foods on the panel or all of the foods on the panel. Also, when you test positive to the cross-reactive foods, that can mean that you have gluten antibodies that cross react with those foods OR that you are sensitive to those foods independently (as far as I understand it, the test doesn’t explicitly determine the difference). Have you had a gluten-sensitivity test done? It’s probably also important to mention that you can have issues with gluten that are not through antibody production (like gluten opening the tight junctions between gut epithelial cells and letting other things leak through). Sorry, if this answer is a little complicated. Does this help or just muddy the waters more?

I am glad I discovered your web site. Other than the weight, I’ve struggled with some of the same issues you have. Migraine, eczema, IBS (which is usually when I have a migraine, which is often) and now arthritis. I have had some food allergy testing, both the skin and blood tests (IgE??). I wonder if the test that you mention by Cyrex labs is different than what I had. Should I get the name of what I had from my allergist and look at the Cyrex web site to determine if they are the same? I’m encouraged by what you say although I’m not excited about having to eliminate MORE foods. But I would do anything to get rid of the migraines and other health problems. Anything!!

Lucy, the test mentioned in this article has only been available for 2-3 years and is only performed by Cyrex Laboratories. Any other test you’ve had done is not the same. IgE is not enough to determine a food sensitivity to these foods.

I agree that it’s not fun to eliminate more foods, but why suffer through eliminating only a few foods without seeing any results in terms of improved health and healing? Hope this helps, and maybe by this time you’ve already had the Cyrex test done.

My son is seeing improved behavior from his ADHD after doing the Cyrex Array 4 panel and eliminating the foods that showed up on that test. We also did Array 2, which determined he has bacteria leaking from his gut. We now have him on four different supplements (cod liver oil, Candi-Bactin AR, Vitamin D, and Perma-Clear) to help heal his gut faster.

We never would have learned about gluten sensitivity, nor about Cyrex and the helpful tests they perform, were it not for a program called Brain Balance. If anyone out there has a child with a neurological disorder such as ADD/ADHD, autism, aspergers, tourettes, etc, I highly recommend looking into finding a Brain Balance center near you, or at least reading a copy of the book “Disconnected Kids,” written Dr. Robert Melillo. He’s the founder of this program. My son is about half way through their 3 month program and doing better already. Most, if not all, of the kids with these disorders are sensitive to gluten!

OK, first…THANK YOU from the bottom of my heart! I LOVE you, your blog and receiving your emails every day. You help make the AIP diet much easier to ‘digest’ (pun intended) and much easier to understand. I guess I will have to give up my kombucha and water kefir. :o( But I will change it up to ACV and water. I actually kinda like that!)

As Amanda said, we can’t get Cyrex tests done in Canada. But I’ve made an apt with my ND to get food sensitivity tests done. Hopefully, that will give me a better idea of what AIP foods to avoid.

What is ACV?
And do you think there are any dairy, gluten, soy, egg free probiotic supplements that are helpful? I have been having kombucha and fermented veggies for the probiotics. Do you think probiotics are important?

ACV is apple cider vinegar.

Yes, I think probiotics are important. I typically feel that food sources are always best of any nutrient, but it can be hard to get varied probiotics from food when also trying to avoid yeast. I have just ordered a clean soil-based probiotic to try and will report back once I have an opinion! 🙂

Thank you!

I’m hooked on your blog and podcasts right now. It’s so good to communicate with other people who are healing AI issues through diet. I’ve wanted to give up. I’ve been at this for many years. Knowing these tidbits gives me more actions to take that may make a difference.

I’ve been using GOL probiotics for years. They contain homeostatic soil organisms. I find I have more issues when I’m not taking them. I take less than I should because they are pricey. So, I’m really bummed that I’ll be cutting out probiotic foods and drinks. Now I’m reading the label and wondering about the rice maltodextrin and the small amount of dairy used in culturing. Please let us know if you have a particular probiotic that you recommend.

I’m still researching, but I think you’re taking a good one (especially if you can say that you feel better when you’re taking them). But, I’m shopping around for one for myself and once I have one chosen, I will definitely write a post about it.

Jarrow produces a very potent blend of probiotics- I think it’s called EFX or something like that. It comes in a box with sheets of capsules; kept refrigerated in the store and at home.

Is the reverse of the above list also true – that for every food in the above list, gluten would be a cross-reactive food? For instance, should someone allergic to dairy also avoid gluten (assuming they aren’t already avoiding it for Paleo reasons)? Do you have any recommendations on where to find cross-reactive foods for other food allergies?

Yes, it is totally possible to develop an allergy to dairy and have it cross-react with gluten, although it’s not necessarily true (just as it’s not necessarily true that someone who is allergic to gluten will cross-react with dairy). I haven’t seen cross-reactive food lists for other food allergies (this is fairly new stuff). The best course of action would be to have a food sensitivity test done (IgG and IgA).

Sorry, but I’m a little “chemically challenged”. If my Cyrex IgG / IgA test shows that I’m not cross-reactive to rye, barley, spelt, Polish wheat, or oats (but I am cross-reactive to all gluten-free products), does that mean that I am not gluten-intolerant or gluten-sensitive? I’m still avoiding gluten at this time, but a little clarification would be greatly appreciated.

Thanks for such a great webpage. You’ve helped me better understand all-things-paleo a lot better. I shared your site with my doctor and he in turn shared it with his medical colleagues. He loves it!

Hi! I just came across your website today and absolutely love it. I am a big fan of chris kresser and someone mentioned your link on his comment area. I have a bachelor/masters degree in nutrition and love reading all of your information.
I started having GI issues a few years ago and recently went paleo a little over a year ago. Once I read the first chapter of Robb Wolf’s book I was hooked. IT ALL MADE SENSE!

I do have a few questions, since going paleo (didnt do AI protocol) I have recently had some crazy issues.
Deficient in Pantothenic acid and biotin; very low progesterone and DHEA; totally crazy rash now on wk 9.
Have an OBGYN who is paleo based and she basically said I still have GI issues. Preventing absorption of vitamins. Pantothenic acid is needed for proper progesterone production. Those correlate with each other then cause high cortisol explaining my complete lack of energy. I also had previously had a miscarriage (first time to be pregnant) she said the lack of progesterone caused my miscarriage and I should refrain from trying for a little while.
I understand that bizarre rashes can be accompanied by deficiencies in B5 and biotin specifically. These two need each other to work properly anyways. Also, my own GI system should be making biotin itself (dont eat raw egg whites). They suggested that I follow FODMAPs and supplement with B5 till I was healed inside. This just does not seem to be a real solution to me.
Four doctors have not been able to figure out my rash and when I mention nutrition related majority look at me like I am crazy. Also, an endoscopy showed no inflammation what so ever. Stool test were negative. Basic allergy panel was all negative. Thyroid is normal (or so they say sister/mom both thyroid issues). Definitely gluten sensitive, corn, beans, potatoes…and dairy intolerant (although have not had any GI reaction to grassfed butter).
I am now on week 9 and my rash is only visible on my hands and forearms. Itch on/off daily on my chest, neck, arms, and hands. Very little dermatographism shows up now on my torso or arms.

Basically I was thinking of seeing a functional doctor to look into this some more. Do not know if that is even necessary since they would probably put me on an AI lifestyle.
Sorry for the rambling, I could include more detailed information but will refrain from doing so.
I just figure that even though I feel tremendously better since going Paleo (I am strict) that there is still something that I am eating, probably more of, that is causing problems.

Thank you for having some very helpful step by step information on AI protocol. Do you have any advice for me? What are the best probiotics to take instead of Kombucha (which I started drinking regularly before rash)?
Any advice on the specific vitamin deficiencies? when should i stop supplementing them?
Again, apologize for the lengthy post. I am trying to put the puzzle together and just need some extra help.

meant to include that I had a fructose sensitive test done and it was negative. Why I was confused if I should still do FODMAPs.

My initial thought is autoimmune, likely the early stages of something (which is good because that’s the easiest to reverse) and maybe aggravated by something you’re eating more of (tomatoes or eggs?) and potentially aggravated by something you’re eating less of (iodine?). I definitely think a month on the autoimmune protocol would be worth a try (keep on with your supplements basically until the rash is going away and your energy is returning).

A functional medicine specialist isn’t a bad idea. They can do a more detailed thyroid function test and more detailed micronutrient deficiencies to target supplements. But, yes, you will probably end up on a more restricted diet no matter what.

I have just ordered two probiotic supplements. The first is a soil based probiotic (you have to read the labels carefully because they can contain some wonky ingredients). You only take it once per week, but it is important for adding diversity to your gut microflora that can be lost with acidophilus/bifidus supplementation. The second is a fairly diverse acidophilus/bifidus (yeast-free), which I’m hoping to use to make coconut milk yogurt (instead of kefir). If you want the brands, let me know and I can get you the links. I haven’t tried them yet, but everything I’ve red emphasizes the importance of probiotics and now that I am avoiding yeast, most fermented foods are out.

Other thoughts. Digestive symptoms are not the only symptoms you can get with a food sensitivity. Headaches, acne, mood changes, low energy all can be signs too. I would definitely try cutting out the butter if you decide to try a strict month on the autoimmune protocol. Also, an L-glutamine supplement may help speed gut healing. And bone broth and coconut oil are your best friends.

If you tested negative for fructose malabsorption, I’m not sure why they are saying no FODMAPs. I can see still staying away from starchy vegetables, but the low starch FODMAPs should be fine.

I used to get a crazy itchy rash just where I got sun exposure that was do to food allergies (processed foods, it turned out, and chocolate). I would just get it on my hands, arms and neck and only if I ate that food and then got sun exposure that day or the next day. That took a long time to figure out. If you’re in the early stages of an autoimmune disorder, no one can relly diagnose you until it gets bad enough that your symptoms are more obvious.

Good luck and keep me posted.

Thank you so very much Sarah!
I wont lie, this is all taking a bit of a toll on my mental state right now. I am only 28 yo and never thought I would ever have problems to this degree. Do know that it could all be a lot worse. Family does not understand that I want my problem solved and not symptoms (hormone pills for progesterone). Will definitely stick to the AI protocol. Started this Monday and have been keeping a detailed food diary. About to make my first batch of bone broth. I do definitely think tomatoes and eggs might be culprits. Avoiding butter for now too. Have not eaten chocolate in 2 months 🙁

Do not feel so crazy that I dont have to have GI symptoms to still have sensitivities. My acne has been clearing up this past month but still low energy and yes, mood changes (My poor husband).

I started supplementing with Pure encapsulations nutrient 950 (kresser recommends) with vit. k about 7 months ago. It helped my menstrual cycles to be more regular but still didnt solve all my problems. Wondering if these are still okay to take (does say that they contain soy). I know he recommended them for those with sensitive GI’s.

Would love to get the link to the probiotics if you could send those to me.
Thank you again for the fast reply and very helpful information! I greatly appreciate it. Will keep you up to date as time goes on.


Britt, I had a crazy itchy rash for 10 months, mostly on my chest and ribs. I kept eliminating suspicious foods (stevia, corn, etc) and it would improve somewhat each time. It finally came roaring back and I finally clued in that the main culprit was avocado. I still get some minor itching with things like zucchini, some FODMAPs, flax/olive/coconut oil, so it’s obviously a food-related or digestive/gut thing. All I can say is definitely test the different foods you’re on by eliminating one at a time and see what happens. It’s worth it if it gives you relief. Crossing my fingers for you 🙂

Hi Sarah,

I wanted to give you an update on my health (Britt with the crazy rash, vit absorption issues, miscarriage). I was not having any relief from the AI protocol and was losing too much weight. I made an appointment with a functional medicine doctor in Austin, TX. Dr. Amy Myers with Austin Ultra Health.
During the month prior to my appointment, we found leaky plumbing in our house and noticed some mold in the sheet rock. I started to suspect that my illness was due to mold and not so many food issues.
This morning I had my second appointment with Dr. Myers to review all of my test. I was double the upper limit for mold exposure and it has taken a beating on my GI and immune system. I am extremely gluten sensitive (in cross reactive foods and even minute exposures); that was nice to have a test to show that so now people cannot think that I am making things up.
Although, all of the six thyroid test are showing up normal she still suspects that I have a thyroid issue. I have multiple symptoms and she wants to address them later in case they disappear when I am removed/detoxed from the mold.
She also found a mutation with my MTHFR C667T (can be related to multiple miscarriages).
My hormones levels are pretty good minus my DHEA (little low) and testosterone is low. Explains the fatigue and low libido 🙁 for a 28 yo. Another sign of thyroid issues. I also track my resting body tempt every morning. Learned this through NFP, tracks my hormones and allows me to see if my low body tempts are improving (thryoid). I run as low as 96.4 in the mornings and I live in the south.

Hopefully this helps many others out there who have unexplained problems that are not relieved through diet alone. I believe eating right (anti-inflammatory) has helped me function everyday. Our diet is extremely important in supporting our bodies through challenging times.

Now, I am leaving my house to detox. Getting support with digestive enzymes and many other natural supplements that will be easy on my liver.

Thanks again Sarah, for all your information you allow so many of us to read. Getting that list of gluten cross reactive foods has made a difference in my GI health.


Wow! Thank you so much for sharing! The C667T variant of MTHFR reduces your body’s ability to recycle methyl groups so you can end up with build-ups of homocysteine, which can then be toxic. There are a variety of supplements that you can take to support the methyl cycle in your body. Sounds like you have a great functional medicine practitioner, so I’m sure they are already on it!

Hello Britt, I too have dermographism. Were you diagnosed with this? I am trying to find other people who have or who had dermographism to see if the itchy rash went way or got better? I’ve had dermographism for 7 years now. I would love any info from you. Thanks!

Sarah, I’m also interested in the probiotics since I can’t do fermented foods now.

Britt, I have celiac, and I also get the weirdest rashes and hives, but after following all the recommendations on this site, it seems like everything is clearing up. Have you heard of Dermatitis herpetiformis? It’s also called celiac rash, and that’s one of the rashes I get, but I don’t think I had any exposure to gluten the last flare up I had. Maybe it was one of the gluten cross-reactive foods, which I have now eliminated, thanks to the info on this site.

I am sorry about your miscarriage. I had three, and recently found out that frequent unexplained miscarriages are a symptom of celiac. Also excessive bruising and bleeding, both of which were life-long problems which have completely gone away now that I know I have celiac. I have known about my celiac for three years.

Another thing to consider: when you are having leaky gut issues, you have nutrient malabsorption, as you know. I have been getting a b-12 shot once a month for about 6 months now, and my energy is much better.

Good luck!

The lactobacillus based probiotic that I’m trying is this one: which has 6 strains and is very clean.

I am also trying a soil-based probiotic: which has 29 different strains and has been tested in clinical trials for some digestive disorders. If you were going to try just one of these, I’d go with this one.

Wow.. I had 3 miscarriages a long while ago and now reading this post just brought such tears to my eyes.. I didn’t know about any of this stuff back then… They were totally unexplained to me. I was just told.. it happens… I too am sorry for your loss Britt.
I originally came on this to ask a question about tomatoes.. I know on the AIP you can’t have tomatoes, but I just realized I made a yummy meat sauce last night for dinner with organic ground beef and canned organic tomatoes . Is it a no-no??? Also what about canned pure pumpkin and mushrooms?
I am trying very hard to follow the AIP to get my RA back in control… In the middle of quite a flair! I am trying to figure out why I am having a flair. It started worse after doing whole30.. I am thinking maybe b/c I increased eggs, tomatoes, coffee.. even was having a fair amount of eggplant b/c it was in season (and so tasty).
Thank you so much for all this information!
Oh also, Who do you recommend take those probiotics? Wondering if it might help? My Chiro just recommended to start taking L-glutamine. Havent gotten it yet do to Sandy! (I like in N.J.)
I really appreciate your information! I was really starting to feel WAY too sorry for myself. This helps so much!!! It’s hard when you feel like you’re doing so much to heal and you’re still not.

If you’re in the middle of a flare, I would definitely stay away from tomatoes, even canned, even organic. Pumpkin is totally fine though, and mushrooms are generally okay (there is some evidence that some mushrooms may influence thyroid hormones, but they should be okay for most people).

I’m working on a post all about probiotics. The idea is that your gut normally has 500-1000 different species of bacteria and yet growing in it. To get back to that diversity, it’s important to introduce as many different strains as possible. The soil based probiotics are the hardest to get fom foods. As for lactobacillus type, they are easier to get, and I just recommend for thse who want to go the supplement route to get a supplement with as many different strains as possible. It’s also a good idea to change brands every time you buy a new bottle since different companies have different proprietary strains (even the acidophilus from one company may be slightly different than the acidophilus from a different company, and that’s a good thing!). An do agree that l-glutamin is a very good supplement to take!

Inflammation WAS a huge issue for me.
Eliminating ALL grains and dairy for 3 months helped a lot.
I’m told that astaxanthin is the most powerful anti-inflammatory.
Thanks so much for your awesome blog- I wish I’d had that info a decade ago. You are doing a HUGE service!

I have auto-immune disorders. I was tested to see if I was IgA deficient… I am, so any blood test for food allergies will return a false negative. But, the doctors tell me that having a very low IgA doesn’t affect my health. However, as a child I was constantly ill with bronchitis, pneumonia, nasal infections, ear infections, and tummy upsets that made everyone think I was having a flu. As I grew older, the illnesses grew to be less frequent, but I am still ill frequently. A biopsy of my stomach says I am not celiac, but eating gluten free helps with my health issues. I find all of this extremely confusing because doctors still act like my illnesses are just in my head, even though my body suffers.

Autoimmune disease can be very difficult to diagnose. 45% of people who have severe autoimmune disease are labelled as hypochondriacs in the early stages of their disease, so you are not alone. It is fortunate that you are learning about how food affects you this early in the game. I know it can be confusing and overwhelming, but you are not alone, and learning about nutrition is definitely a huge step forward!

Re: Cross-reactive foods? But, there is no validation for these Cyrex lab tests, correct? I have tried finding peer-reviewed articles on their validity and medical application, but I cannot find any. I have searched and I had others with access to scientific journals help me look, too.

If you have any links to them– I would be very, very grateful.

I am wondering about this because the question comes up often on celiac,com and I cannot honestly say to other celiacs that paying for these tests is a good idea, since there is no evidence. I usually say, take out the food you think is bothering you and see what happens. I myself have gone paleo recently to try and reduce inflammation and painful joints,

Here is the discussion of it in an interview I read.

“Chris Kresser: OK. So in your opinion, Dr. Fasano, what’s the best commercially available way to test for intestinal permeability? A lot of my listeners are interested and concerned about this. We have the lactulose/mannitol test, but I’m also wondering if you’re aware of Dr. Aristo Vojdani’s work in Cyrex Laboratories and what your opinion is on that test, which screens for antibodies to gluten and zonulin and actinomycin and lipopolysaccharide.

Dr. Alessio Fasano: That’s right. So you know, unfortunately none of these tests are validated.
Who has interest in testing permeability is finding the conundrum of how to do this. ”

I read this here:

Yes, the test is based on internal data, although apparently there will be scientific papers published based on the Cyrex data. There have been no third party research papers to support this list as the most common gluten cross-reactors. I have listened to the interview you quoted and the answer that Dr. Fasano gave was really specific to testing for intestinal permeability which this test does not do. This test is a food sensitivity test, plain and simple, and the list of foods tested are only those foods that Cyrex labs claims (based on internal data) are the foods most likely to cross-react with gluten. This means that if your body forms antibodies against gluten, those antibodies are likely to also recognize some other foods (Cyrex claims these foods). You could just as easily get a food sensitivity test done that includes these foods from any other company and get the same information. I definitely agree with your suggestion of simply cutting out potential culprit foods for a few weeks and then reintroducing them one by one, which is much cheaper than ordering a test (although some people prefer to just get tested). The point of this article is to suggest some possible culprits to try and eliminate for those with diagnosed gluten sensitivity, since having multiple sensitivities can be very difficult to figure out when you eliminate only one at a time.

“There have been no third party research papers to support this list as the most common gluten cross-reactors.”

That’s what I thought.

Yes, I see what you mean about Dr. Fasano’s comment , yet I am raising it because Cyrex labs offers “gut permeability tests” and if those are not validated, how can anyone be sure these so-called “cross-reactive to gluten” food tests are valid either?

No published studies. Can you see my concern?

And yes, figuring out other food intolerances one may have after a celiac diagnosis is difficult, People are told “go gluten free and you’ll be all right”. That is often untrue and sometimes a dairy or soy intolerance is at play, people require follow up care for multiple vitamin deficiencies and they may take years to heal.

Thanks for your thoughts! I appreciate it..

Cyrex labs isn’t actually sure. They are using milk chocolate as the antibody “bait”. So it could be the milk or the cocoa. For some people it may be one or the other or even both.

Good question. If you are actually cross-reacting with coffee, I think it would irritate even from the bottom end. Try a few weeks with no coffee and tehn try a little (your choice on whether you want to drink or or do an enema) and see how you feel.

Thank God for this article! I thought I was going to have to give up Paleo! I never heard of the Al protocol and the problem with these foods if you’ve had autoimmune issues. I thought I was doomed to have allergies for the rest of my life. THANK YOU!

Hi, thanks for writing this article. I have celiac and have an adverse reaction to some of the foods on this list. I also seem to have a celiac type reaction to chia seeds, hemp seeds and pumpkin seeds. Other nuts and seeds are ok though. I also don’t have a problem with tapioca and rice so eat those occasionally.

I’m confused. I took out every food on the list and I’m still getting reactions from cinnamon and some herbs that were deemed safe on FODSMAP. Should I omit herbs and spices completely and fruit?

I stopped taking all medications and supplements except dessicated adrenal, vitamin D, krill oil, B-12 & i-cool D. None have weird ingredients or fillers except i-cool and I refuse to give that up! I had a hysterectomy in May and my hot flashes are severe. I’m going to try abstaining from beef for a while. It’s the only thing I’ve eaten pretty much every day since starting paleo. I did take an intolerance test. I heard it could be a scam but it did list beef as one of my intolerances. I guess I need to take a sensitivity test to be sure. Can’t afford it right now but the minute I can I will do it. I’m down to meat, seafood, vegetables (allowed on FODSMAP) and 1-2 pieces of fruit a day (allowed on FODSMAP). No spices except salt and still having trouble. Plus I haven’t lost a single pound and it’s been over 20 days since I started. I’m totally screwed up though (hashimoto’s, sjogren’s, celiac and endometriosis) so I’m assuming it will take me quite a while to heal. Thanks for the reply! I’m stumped.

It can take some time. Trying to get some organ meats in your diet can help with mineral deficiencies (if you don’t have the money to get tested now). Are you making bone broth? Also doing some kind of meditation (just sit somewhere quiet and focus on your breathing for 5-10 minutes) can help with the gut-brain axis stuff. Some digestive support might help too? Also, losing weight can be a hard thing to accomplish while the body is trying to heal.

just started with the organ meat this week and bone broth last week but I haven’t been consistent with the bone broth which I will do right now! Yes, need to schedule meditation time. Every time I get stressed a hot flash comes on so I know I still have some stress management I need to take care of. Thanks again for your advice and encouragement. It means the world to have that support. You will be remembered in my giving 🙂

Many of the detoxification supplements that a functional medicine practitioner would prescribe are minerals that are easiest to get from organ meats. I eat organs pretty much every day now (mostly liver, kidney and heart). And I notice a huge difference when I get lazy on the bone broth too. I hope it helps!

every day? I thought it was only supposed to be twice a week! GOOD TO KNOW! organ meat has taken some getting used to. I hide it in my ground meat but I will eat it everyday if that’s what it takes.

Hi Sarah,
I just got results of some tests done. Have some questions you might be able to answer (better than my doctor I’m guessing:), but still plan to ask her).
I had antibodies out of the normal range for gluten thru a salivary gliadan IgA test. I’ve been avoiding gluten for several years. Does this mean I’m still getting exposed or could cross reactives be raising my antibodies; or can that be this way without exposure? Do I need to bother with further testing for possible celiac – I wouldn’t ingest gluten for testing purposes so its probably a mute point.
I also had food sensitivity testing done. I was normal for several cross reactives but it wasn’t a cyrex test. Could they still be causing cross reactions, despite no sensitivity?

And i showed no sensitivity to almonds or eggs- should I still cut them out or a trial on AI paleo?

Thanks for any insight into this, MaryCay

It could be trace gluten exposure (I’ve heard of people so sensitive to gluten that they have trouble with waxed fruits) or it could be something you’re cross-reacting with. There’s really no way to know for sure. Just because the antibodies you make cross with some of the cross-reactors, that doesn’t mean that all of the cross-reactors are a problem (so if you tested okay for almonds and eggs, you should be fine). If you tested negative for anything, then that’s very unlikely to be the problem either, especially since your gluten antibodies are measurable (it is possible to be sensitive to something but not make enough antibodies to meet the test threshold, but that’s probably not the case here). Actually, anything that you tested positive for on your food sensitivity test could be the culprit even if it’s not on the list above.

I don’t think there’s much point to testing for celiac. You may or may not have it, but it doesn’t take away from the fact that you are gluten intolerant and will never be able to eat gluten again. As for doing a trial AIP, do you have alot of symptoms of autoimmune disease? fatigue? aches? rashes? if so, then I think it’s a good idea. If you’re just trying to get a hold on gluten sensitivity, I don’t think it’s necessary. You could just focus on very clean paleo with lots of anti-inflammatory foods like fish, broth, coconut oil… I will say that the foods that are restricted on the AIP can all be problematic in ways that are not food sensitivities (eggs have lysozyme, nightshades have saponins, nuts and seeds have phytic acid). And it is possible that one of these foods is a trigger food for you even though you aren’t producing antibodies against it. Nightshades in particular can be very problematic for people because they can rev up the immune system. So, another way to go is very clean paleo without nightshades.

I hope this helps!

It is helpful, thank you. I do have an autoimmune disease- spondylitis arthritis (early ankylosing spondylitis). I’m struggling with cutting out eggs and nuts because I can’t have starchy vegetables either and I just don’t feel well eating only meat and greens -low energy, constipation. I tested high sensitive for tomatoes but been staying away from nightshades. There were some other veggies I tested sensitive for that I do eat regularly so hoping I will notice a difference cutting them. I’m just running out of foods to eat:( luckily no sensitivity to coconut showed up:). enough of my pity party, thanks so much – your blog and research have been a tremendous help!

FYI wooden spoons, wood cutting boards and wood counter tops can contain trace amounts of gluten. Sometimes this is overlooked when removing certain foods. Some people are sensitive to this.

Maybe. It would be very individual. It’s a fairly short starch and considered highly digestible, so it’s definitely worth trying. Potentially better tolerated than something like taro or sweet potato.

When you get the name brand, could you email it to me? I have been suffering from Hashimoto’s and scalp psoriasis for three years. Unfortunately, I have had to search the internet to find information. Oklahoma does not seem to have functional medicine doctors. Also, thank you very much for all of this great information. I have been struggling and now that I know about the coffee and all the grains, I hope to see some progress.

OOPS! I am a little new at this. I wanted to know about the soil based probiotics you mentioned. Do you have a brand name on this product?

Do you had any further information on kombucha and kefir? I say this only because your 21-Day Detox meals seem to include kefir yogurt and kombucha. I have been on the AIP protocol for three months with no improvement, but I have been drinking kombucha. I wonder if you added in kombucha and kefir again because of new medical/scientific findings about these foods?

Thanks as always for *all* the information you provide.

I have always said that kombucha and kefir are great sources of probiotics, but they do have yeast cultures (beneficial ones) and some people will have food sensitivities to them (or to something else like gluten that cross-reacts). I have successfully reintroduced sauerkraut and am playing with some kombucha to see if I have a reaction. I’m fairly certain that it’s okay, but I’m going slow. The yogurt I’m making these days is a yeast-free yogurt culture though, not kefir.

Why do you think you are ok with sauerkraut now (what happened to change things) and possibly kombucha? And, can I ask what is your yeast-free yogurt culture? I was using Body Ecology to make coconut milk kefit (not cow’s milk) but I am concerned with the yeast in the product… Thank you!

I took out yeast foods at the same time as I took out some other problem foods. The other foods have definitely been problematic when I’ve tried to reintroduce them (most recent disappointment is my sensitivity to whole coconut, although I okay with coconut oil and milk). I prefer to take out everything that I think might be a problem and the reintroduce one at a time because I think it’s easier to see what’s working and what isn’t that way.

I’m using my probiotic supplement as a yogurt starter: kirkman biogold.

Is it possible to eat/make fermented foods without yeast (like from probiotic pills that do not contain yeast in them?).

Depends on the probiotic. Kombucha and kefir inherently contain yeast. Yu can make yeast-free yogurt. Fermented vegetables typically contain a little yeast, whether you add lactobacillus to the or not.

Could you clarify whether these cross-reactors have the same damaging effect on the body as gluten does? My daughter is definitely cross-reacting and is on a very limited diet. I was under the assumption that if she still ate some of the foods that were giving her “gluten symptoms” she was only have symptoms and not the actual same effect that gluten has on her body. Am I understanding correctly that her body is also being damaged by these other foods? Thank you sooo much for your site. We have been on a quest for years now to create a “normal” life for our daughter with Celiac. I am forever researching and have a library of books and cookbooks. We have been paleo for some time now, but she is recently reacting to almond flour which has become a staple in our house…sigh. I’m going to try your tapioca bread recipe and see if she does ok this morning. Definitely going to get the Cyrex test done!

In some ways yes and in some ways no. These proteins are not (likely) interacting with the intestinal brush border and directly increasing intestinal permeability the way gluten does. However, while you (or in this case you daughter) has a leaky gut (with Celiac that may be years), they are still getting across the intestinal barrier. That’s where they do their damage in the sense that they activate the immune system which is already primed to attack gluten. Because the antibodies are the same to gluten and these cross-reactors, when they are present, it stimulates the immune system and increases inflammation, which can have a whole host of effects including propelling autoimmune disease.

I have Celiac and still struggle with some inflammation and trying to eliminate as many of these ingredients as I can. I make your paleo bread in my bread machine twice a week and now I’m wondering if I need to cut out tapioca? Can I make the bread without that ingredient or double the arrowroot?

If a person has avoided gluten and all cross reactors for a year or more and all of the gluten antibodies have died off, will they be able to reintroduce the cross reactors (of course, one at a time, looking for sensitivities and without any gluten) without creating more gluten antibodies? So, if my question isn’t clear, I’ll rephrase: Do the cross-reactors, by themselves, create the gluten antibodies, even in the absence of gluten, or do they tend to just “join the party” when gluten-caused antibodies are wandering around? Thank you, in advance, for clearing this up for me.

I took a look at the panels done by Cyrex, and they look like great tests to do. But their webpage states you have to go through a healthcare professional as they don’t market direct-to-consumer. I don’t even know where/how to start looking. Any tips?

This is an excellent write-up, and really helps to explain various ailments I’ve had over the past 8 years or more (leaky gut, gluten intolerance, gallbladder attacks). Thank you so much for sharing!

The question I have is – are you aware of whether it’s possible for the body to dissolve a (large) gallstone? I have omitted chocolate, eggs and coffee (those were the remaining culprits for me after going paleo) – I’m sure it will take time for my body to heal. But I’m wondering if my gallstone will ever go away. I went through a process with a naturopath over a year ago to do so, but in hindsight, I was still eating too many “triggers” (this was way before my paleo transition), which I presume thwarted my body’s ability to heal. At least I avoided the need for gallbladder surgery (or rather, refused it and worked with a naturopath to gain back the 15 pounds I lost and be able to eat again without pain).

My understanding is that it is possible, although I’m not familiar enough with the details to know how long it might take. I would definitely recommend digestive enzymes and ox bile supplements to help with digestion while you heal.

Thanks for the supplements rec!!! I discovered your site only 2 days ago, and am reading as fervently as possible (with two little guys at home) to learn the terminology so that I might truly develop a scientific understanding of my situation for myself (my PhD is in fuel science, nothing bio related, so I have a lot of work to do). I’m really curious as to why I am feeling the way I do. I hadn’t had any symptoms of “gallbladder” upset for over a year. I had cut out dairy, grains and eggs for several weeks to several months before going Paleo (I had blood tests that showed I am allergic to eggs, mustard seed, and dairy). Two weeks into being truly Paleo, I added eggs back in (feeing a bit cocky that I was perhaps “healed” of all food allergies or something haha). After a particularly high dose of cocoa (avocado pudding), I had a HORRIBLE gallbladder attack. I found your site the morning after, and am now cleaning up my paleo diet to be AI-friendly.

I’m feeling drained, swollen hands, bloated tummy, cranky, sappy, hungry, not sleeping well. It’s such a let down after feeling immensely WONDERFUL just a few weeks into the Paleo diet (I was sleeping well despite nursing an infant throughout the night, and waking without an alarm and NOT craving sugar; even though I’m nursing a four-month old and a two-year old I was eating three meals per day without really needing snacks most days – it was awesome)!.

I’m wondering: how bad is my “AI” situation? And, why such a freaking crash all of a sudden? And will I always be allergic to eggs? I am an emotional wreck some moments and it’s terribly unnerving – that’s the worst part of all! One “big” question is, once someone really does heal their gut, and the adrenals become rebalanced and inflammation is truly gone, is it possible to eat non-AI paleo again? Or will it always be a case of watching for food sensitivities or only having known sensitivities in small quantities rarely? (I’m sure this is highly individualistic).

I’m now eating homemade bone broth with each meal, avocado daily, and wild-caught sustainably-fished salmon every other day. All of my meats are high quality (grass-finished, pastured, etc. – I’m lucky to have an awesome local farmer). I’ve ordered high quality grass-fed gelatin to add to foods. Is there anything else I can do to promote healing in addition to those things plus the supplements you suggested? Fermented foods (fermented without yeast)?

P.S. I pre-ordered your book – September can’t arrive soon enough!!!

Organ meats and make sure you’re eating lots of veggies. Some food sensitivities will go away with a healed gut (maybe even most or all), but some may still be lifelong (especially true for food allergies). I think that with autoimmune issues, even healing the gut completely probably won’t let us tolerate the occasional exposure to grains very well and nightshades seem to be particularly problematic. But, I think nuts and seeds and the occasional egg are likely to be reintroduced in moderation for most people.

Paleo Mom,

Just wanted to let you know that the issue of Cross-Reactvity has been refined a bit.

Dr. Vojdani published a new paper in January 2013 that really clarifies exactly what foods cross react and which don’t:
Food and Nutrition Sciences, 2013, 4, 20-32 doi:10.4236/fns.2013.41005 Published Online January 2013 (

I’ve published a few videos on the topic that you might find interesting:

As the paper notes, milk (all forms) is the #1 cross reactor, followed by yeast (brewer’s and baker’s), corn, oats (only the cultivars containing avenin), millet and rice.

NON cross reactors include: potato, quinoa, hemp, teff, soy and egg.

And regarding coffee & cross reaction..the problem is INSTANT coffee not regular brewed coffee. instant coffee either contains, or is contaminated with gluten.

Hope this is helpful for everyone

I am shocked to learn this. Long list. It would have been shorter to list the few remaining foods that are safe. I can’t think of any besides meat, fruit, veg and nuts which are too expensive to live on. But interesting how those four items are typical of early human diet, with emphasis on meat.

Hi. I have recentlybeen tested for food intolerances. Would gluten cross reactors come up in this test? I have also been tested for celiac diesease which was negative. Your help is appreciated. Sara.

Wow. I was diagnosed as being hypothyroid at 16 and after dealing with endocrinologists who don’t know much for 30 years, I finally made headway by eliminating gluten and soy. I just found out about six weeks ago that it is Hashimoto’s (TPO <13,000 but no AB) so I guess I need to eliminate the coffee (BUMMER! I've been doing Bulletproof), eggs, dairy, chocolate and quinoa too to see if that helps. However, I know my 'new' endocrinologist won't test any more antibodies 'because it won't tell us anything' so I won't know if I'm in remission or not. Finding a doctor is the hardest part, as I feel so much better without the gluten and soy, how do I know if I can still feel even better? Now to check out the lab link…

@ Mary Lou Paquin: If you go to, there’s a place to enter your zip code to find a Gluten Certified Practitioner near you. He/she will be an alternative-type doctor, therefore it’s quite possible they will not accept any form of insurance – depending on your insurance company/plan, if you have one. However, the Cyrex Labs testing spoken of in this article will not be covered under insurance anyway. They only accept payment directly from the patient. Cyrex Array 4 (the test that checks for all these foods) is about $225-280. (We paid $225, I think.) Array 2, which tests to see what is leaking through your gut, was roughly the same price, if I remember correctly. You do have to find a doctor who will order the blood tests and can follow up to tell you what they mean. This is really the only way to get some help for your issues, in my opinion. As you said,your endocrinologist will not order additional tests. He/she is not likely to even be familiar with the Cyrex tests, let alone believe they will help.

Hope this helps.

I’m so glad to have a good scientific explanation for this! The only thing I know I can have on that list is eggs, with yeast, hemp, coffee, and sesame not being a big enough deal for me to test yet. Between my gluten intolerance, my IBS, fibro, and whatever else, I’ve had to cut out everything else on the list, plus nightshades, oranges, coconut, sweet potatoes, all grain and grainlike seeds and berries, sugar, winter squash, and probably some things I’m forgetting, plus limiting nuts and beans. A friend actually showed me the Paleo Autoimmune diet, and it’s an approximation of how I eat. What I’m curious about is your opinion on people healing an being able to add some of these things back into their diet eventually.

Hi, I’d like to know about the symptoms. When I eat gluten accidentally I know by going to the the wc. Plus I might get a migrane. Are these the same symptoms I should feel when eating cross reactive foods? I have vitiligo and still don’t see changes. I’ve been on the diet since february, but making mistakes every 3 weeks or so.

Symptoms would typically be similar to what happens when you eat gluten, but not necessarily. They could include any kind of gastrointestinal symptom, any kind of skin change or symptom, headaches, fatigues, trouble sleeping, anxiety, or mood changes.

Help! I had my gall bladder removed back in February(laproscopic), the stone was so large they had to open the removal incision larger than normal to remove. I guess I may have been having symptom/trouble from my diet before but never noticed anything major. Now I do. I think I have a problem with gluten. I am not aware of when I eat gluten because I have never had to be. With my current diet, almost everyday I have feel nauseous, have sharp pains in my stomach, gas in my stomach, and 75% of the time loosey goosey. I have no idea how to start to change my diet as I have eating the same way for 30yrs. What do I do??? Thanks.

Well, definitely removing gluten is important (check out for lists of which foods contain gluten). I also recommend digestive enzyme supplements with your meals, especially ox bile.

Hi PaleoMom, great blog, and I look forward to reading the book. So far the GAPS and SCD books have been very helpful, but I’m excited to see someone taking a broader look at autoimmunity issues and how diet can help manage/mitigate symptoms.

My question on this post is, what is your take on the possibility of other non-listed foods presenting a cross-reactivity issue, due to yeast content. For example, fruits, Vitamin C and also, although they’re listed, coffee and chocolate.

Many fruits contain natural yeast/mold spores on their skins, some of which can be washed off, but perhaps not entirely. The biggest examples I’ve come up with are grapes, possibly bananas and cantaloupe.

Also, it is my understanding that most commercially produced Vitamin C is created using a yeast fermentation process. For a while I was researching celiac, IBS and Crohn’s. For Crohn’s patients, saccharomyces cerevisiae (bakers yeast), is an issue, and my research on that yeast led to a lot of information about products that may contain it, including Vitamin C, as well as many commercial probiotics.

I think yeast could also be a tie-in for coffee and chocolate sensitivity, due to the fact that these two products are processed in ways which encourage fermentation (coffee bean pods are literally placed in heaps and encouraged to get hot), and while the pods are washed and processed, possibly they contain trace amounts of yeast antigens in the end product. I wonder if when sensitivity testing is done, it is possible that folks do *not* react to the native protein in the product, i.e. cocoa or coffee proteins, but they *do* react in the real world to tag-along yeast proteins. I tested negative for cocoa, but positive for yeast in IGG tests, and have always noticed flare-ups of symptoms after chocolate consumption, even non-dairy chocolate chips, darn it! Because of cyclical cravings, parsing out the science on this one has always been on my radar, to see if it would be possible to consume somehow without triggering reactions. Likely not, although I’d love if someone could come up with a yeast-free way of producing coffee and chocolate to give it a try 🙂


It’s certainly possible. Most of the natural yeasts are typically a different strain, but still saccharomyces genus. I would think that this would probably affect a very small percentage of people with gluten sensitivity (yeast is one of the weaker cross-reactors and then you would have to have antibodies that recognize several species of yeast).

Hi Kelly,

Another issue wrt cacao, chocolate and coffee is MOLD! The majority of products contain mold! Lindt chocolate does not. You might try that and see if it works for you. The very dark versions probably don’t have dairy. You can get mold-free coffee and cacao from

Curious to know if vinegars, ie balsamic, red wine…, are problematic and should be avoided on the AI protocol? Also, maybe more importantly, I have an issue with not producing adequate HCl. I am currently taking HCl with pepsin supplements and a digestive enzyme prior to meals. I have read conflicting information about these supplements, where some experts say they are necessary for a period of time, and others say they should be avoided. What are your thoughts in taking these in conjunction with the AI Protocol?

The only vinegar that should be avoided is malt vinegar due to gluten. I think that HCl supplements and/or other digestive support supplements can be very helpful for those on the auotimmune protocol. I always recommend checking with your doctor before taking HCl supplements because they are contraindicated in a variety of conditions (like eosinophilic esophagitis, history of ulcers, blood clotting disorders, etc.) in which case, digestive enzymes is a great alternative.

Is the soy in multivitamins (e.g. Pure Encapsulations Nutrient 950 w/ vit K2) a concern?

I do my best to stay away since it is a gluten cross reactive food that I am still trying to find out if I am sensitive to.
Just curious if it is not a problem when extracted from soy to make vit E in vitamins? I have not found any valid data for either side.

The only good quality multivitamin that I can find that is soy free, etc. with Vit K2 and Folate. Is Dr. Ron’s Ultra Pure: Doc’s Best the next generation. It is a bit expensive.

It depends a little on exactly what is being used (soy oil, soy lecithin, tocopherols from soy, etc.) and how sensitive you are. I’m very sensitive, so I work hard to avoid it, but most people are okay, especially with these very isolated compounds (the soy oil is high omega-6 so that’s probably the worst of the bunch in terms of frequency of reactions).

Thanks for the quick reply!
It is tocopherols from soy. Appreciate the clarification. My body works much better on a multi. I have border line thyroid issues and it keeps me in check.

I’ve been looking for this post for days as I read it recently and couldn’t find it again. I am wondering if you’ve rewritten and expanded it though B/C the post I read was much longer and went into more detail about the acutal cross-reactivity process of specific non-gluten containing foods.

Regarding the testing for the cross-reactivity: What kind of practitioner would order these cryex tests and how to find one?

Thanks in advance

I believe this is the post you are looking for: Sarah recommends both and as excellent directories for finding qualified health professionals in your area (and many of which can work with patients long distance). — Tamar, Sarah’s assistant

Julie, another source to help you locate a Certified Gluten Practitioner is This is the website of Dr. Tom O’Bryan, who is probably one of the most knowledgeable doctors regarding gluten related disorders you will ever run across. He even did a week-long webinar—called the Gluten Summit—in which he featured interviews with 28 of the world’s leading specialists on the subject. On his site, click the tab that says Certified Gluten Practitioners and you can enter your zip code to find one near you. These doctors should be very familiar with the Cyrex tests and utilize them in their practice.

Great blog. Is it ok to introduce in diet eggs, brown rice or groats after 2 month period of time on AIP? If it doesn’t call any sympthoms that means it’s ok to eat?

I just left some questions about edible foods on the post about the elimination diet. And now I am reading that you say no to sauerkraut? So all the eczema website say to eat this to restore good gut bacteria. I also started drinking apple cider vinegar?

So I’m thinking I should just eliminate everything? And start with the basics (your list that is)? This seems so hard to do without an idea of what to make…at least a guideline of ideas. So like I said earlier, if you know any please pass that along.

I feel that I should just start a juice fast…lol!

Thanks so much!

Sarah recommends starting with the autoimmune protocol ( and then only making additional restrictions if the AIP does not seem to be working after 30-90 days. Not everyone is sensitive to gluten cross-reactive foods. You can find a more recent version of this post with an updated list here: — Christina, Sarah’s assistant

I’m pretty confused and find this a bit overwhelming in the UK we have stricter laws around food so I eat glutenfree oats with no problem at all would you advice cutting them out still? but our dr’s do not see leaky gut as a real thing so they will not do tests against it. I have bile reflux disease for no reason I do not eat gluten dairy or eggs so I was wondering what is there to eat for breakfast!?

Gluten-free oats, along with other grains and pseudograins, are not considered Paleo. Sarah recommends treating breakfast just like lunch or dinner. Soup, leftovers, and sausage patties are great breakfasts. – Christina, Sarah’s assistant

I am investigating GAPS and auto immune protocol at the moment. I am pretty sure I have a fairly rampant case of SIBO and am being treated by my homeopath for Hypo thyroid. I am gluten, sugar, soy and grain free and am about to implement Auto immune protocol restrictions as of next weekly food shop.
I have a persistent case of Lichen Planus that my homeopath is having trouble getting rid of. It took years to diagnose and I was told by the skin specialist that there is a small risk of it turning cancerous if not treated (she wants me on steroids).
Do you know if any one of your cross reactions causes yours to flare up or is it personal to each individual?
I eat my homemade sauerkraut, kimchi, milk kefir (which I will switch to coconut kefir after reading today), kombucha. I have dehydrated water kefir granules that I will rehydrate and I make spelt sour dough for the kids.
What do you eat/drink to keep your fermented foods up now that you can’t have kombucha or lactofermented vegies? Oh, I hope I don’t react. I have been off yeast for years due to its link with candida in me so it most probably is a culprit.
I am in Australia so will need to see if I can get a Cyrex test.
Once my gut is healed, can I expect cross reactions to disappear or will they be a never more food like gluten? How strong is the link between these proteins and gluten in the long term in a healthy person? I can do no coffee, would prefer to be able to eat my homemade chocolate but my fermented foods……No!

I appreciate the information, as I have been following the AIP diet for over a month and still having flares (though much less frequently). I will be honest and say that I am battling depression over my limited food choices. Just when I start to find foods that I enjoy- they seem to end up later on the do not eat list. I’m not sure if others feel as I do, but I had to throw it out there. I hope I can regain some of my energy to maintain this lifestyle for my health. Today is one of those days where I want to throw in the towel. It would greatly help too if more AIP recipes would not include these items. Thank you.

It’s pretty common that more and more things end up on the reactivity list, unfortunately. I feel like my body’s just so used to reacting to food that it keeps reacting, even when it’s nothing bad. The “danger” signal is stuck in the ON position. :p

I’m trying the EFT for autoimmune disorders; hope that’ll help. As well as shifting my mind and self-talk, and a lot of spiritual practice. I know from prior experience that a big part (if not all) of the illness and the healing lies in the realm of my interactions with food, and LIFE.

I’m also taking something a naturopath recommended: DPP4 (Specifically, the one I found was GlutenEase by Enzymedica — free of GMOs and other problematic fillers. It helps prevent cross-reactivity, which I suspect is at least part of the “decreasing diet” issue.

It is distressing. But I try to keep in mind that this is a healing journey, and it won’t always be like this. <3

Hi! I have recently been informed I have an autoimmune disease affecting my cellular tissues relating to nerves. I get inflammation- primarily in the sclera of my eyes (probably other places but none that I see or feel). I have taken the Cyrex labs tests Array 4 and 5 and have been advised to buy your book (should be in the mail). My question is on the test Array 4 if showed that oats and rice do not have any cross reactive tendencies for me. But I also read in your post to avoid these items on the paleo autoimmune protocol. I just wanted to check and see- do I still avoid these or since they tested that they do not produce the antigens can I include them in my diet? I am fairly new to this, I feel like I am looking at a mountain of diet issues. Thanks for your time!

Hello! I have Sjogren’s Syndrome and am Hypothyroid, I also had my gallbladder removed about 13 years ago. My husband and I started Crossfit about a year ago, and that is when I was introduced to the Paleo diet! What a lifesaver! I have learned more about my Autoimmune disorder, and how to manage it in the past year, than I have since my diagnosis over 10 years ago! IMAGINE!!! On top of all of this, I recently discovered that I have a Gluten Sensitivity. I am not sure if it is Celiac Disease or just a sensitivity, but I can tell you that the Keratosis Pilaris on my arms has all but completely gone away! I have that since I was a CHILD! My brain fog (which I always attributed to the thyroid condition) has also cleared up.
My question is, sometimes I react (usually a gut reaction, but can also be a skin reaction) to items that I have eaten, when I know I haven’t had any gluten. How do I determine what is making me react?

Thank you! Still a Paleo (and definitely Gluten free) Newbie!


Hello Leah,
I also have hypothyroid and have just found out I have Sjogren’s (and other AI issues). Feeling a bit lost with diet recommendations (am on low FODMAP for GI symptoms and no dairy/gluten) but still get tummy ache. My question is whether the diet has helped your Sjogren symptoms? I am desperate for something to reduce them. Thanks for your reply.

Hi, I suffer from rosacea and I have been noticing my lymph nodes under armpit swell on and off. I am thinking about this diet but should I also avoid apple cider vinegar?? Thanks!

Hi Sarah,

First of all, thank you for all the invaluable information you made available on line.

I have Hashimoto’s and after getting to know your website, I have done the whole 30 first, reintroduced AIP ingredients, and have been strictly paleo ever since. All in all, 20 months.

I have enjoyed great health benefits, though not a complete reversal – I have been diagnosed with Hashimoto’s 8 years ago- and have sort of plateaued, so I am considering a food intolerance testing (Pinner test, dried blood sample testing for IgG) but I am not sure the foods I have been avoiding for the last 20 months can be diagnosed ( gluten, dairy, etc) The testing company says it will still work, but my online research suggests maybe not after 3 – 6 months.

I would appreciate if you give me your opinion, since the cost of the test is not negligible, and I don’t want to have it unless it will help me, not further confuse me.

Finally, I am in Turkey, where Paleo is almost unknown, and many of the Paleo resources (testing, food ingredients, supplements, etc.) are unavailable.

Thank you in advance.


Hello Paleomom,

Congratulations on your site and also for being the only one that I have found that makes the Gluten/Gallbladder link.

I was diagosed with cholesterolosis about 8mths ago due to pain and cold sharp electric like pains on the right side and nausea and so had an ultrasound and was told I have gallbladder disease, man I felt so anxious and sad as I didnt know what this was but the word disease stood out in my mind and was scared to be honest.

I founf out that I have polyps on the inner wall of the GB and that they are less than 1 cm and so they take a wait and see approach were I regularly go and have an ultasound, if they get to more than 1cm then the chances of malignancy are higher 40 to 80% in some study and therefore the GB has to come out, and so Ive been looking online on what therapy or herb or food etc there is to get rid of the polyps maybe a drug even, I dont want to have an operation if I can avoid getting my gallbladder removed.
Come to think of it I’ve had ‘allergies’ for the past 2 yrs at least but they came on suddenly, I started sneezing and eyes red and thought it was dust and so tried avoiding dust, it took me such a long time to realise french bread made my dust allergy worse, I thought I had a really good diet, extreme even, i did coffee enemas about 2 per day on avergae for 8 years and ate as much organic foods that I could and of course ate wheat bread, pasta etc.

I’m not sure if the many years of coffee enemas may have contributed to gallbladder disease and/or gluten difficulties, seeing as the many enemas may have worn out or damaged my small intestine, the reason I did the coffee enemas was because I have been taking prescipition meds for 20yrs (Prilosec for GERD and Paxil for depression) and so I wanted to help ‘cleanse’ my liver – I also have Gilberts syndrome which basically means that my liver phase 2 detox is sluggish and so my liver function tests most times show high bilirubin level and so I thought ok I can help the process along, right? Well I was wondering whether me speeding this process up , created cholessterol to back up or too much bile to accumulate there, I dont know but maybe by doing the enemas I somehow created the cholesterol polyps situation.

I stopped doing the coffee enemas and pain has redued by 95% I only get twinges twice a week possibly but the polyps are still there, I am totally Gluten free, not on paleo seeing as I dont want to eat any meat to avoid cholesterol, just a little chicken or turkey or fish occasionally. If I drink milk or yoghurt I get loads of mucus and phlegm and I’m a person who drank milk ALL my life and LOVED milk so much, but now I can’t an don’t.
Can any of you guys give me any advice or tips on getting rid of these polyps? Thanks for any advice Paleomum that you can give me or your viewers, thankyou so much.

Thanks for finally talking about >Gluten Cross-Reactivity:
How your body can still think you’re eating gluten even after giving it up.
– The Paleo Mom <Liked it!


I have enjoyed the cross reactivity discussion with gluten but as a scientist, nuclear, I wonder if it works the other way. Say cross reactivity with soy or milk, for instance.

I have Hashimotos and have been on AIP for about six months now and doing pretty well. I was excited to learn about cassava flour and make tortillas often and I love my Kombucha. I still have issues with too much hair coming out, occasional leg cramps and creaky joints. In this article you mention Celiac but does this apply to Hashimoto as well?

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