 Symptoms of gluten sensitivity include irritable bowel type symptoms, such as bloating, abdominal pain, changes in bowel habits, as well as systemic manifestations such as brain fog, headache, fatigue, depression, joint muscle aches, numbness in the extremities, a skin rash, or anemia. If those who suspect they might be gluten sensitive should not go on a gluten-free diet, what should they do? The first thing is a formal evaluation for celiac disease, which currently involves blood tests and small intestinal biopsy. If that's positive, then one goes on a gluten-free diet. But if it's negative, we should try eating a healthier diet. More fruits and vegetables, more whole grains, and beans while avoiding processed junk. See, in the past, a gluten-free diet had many benefits of the traditional American diet, because it required increasing food and vegetable intake. So no wonder people felt better eating gluten-free, no more deep-fried Twinkies, couldn't eat in fast-food restaurants. Now, though, there's just as much gluten-free junk out there. I call it the vegan donut phenomenon. A few decades ago, vegans were forced to eat healthy, eat actual vegetables. But now they can eat their cheesy puffs while waiting for their candy-coated chocolate marshmallows to deep fry in vegan bacon grease. If a healthy diet doesn't help, then I might add another step here, and that is to try to rule out other causes of chronic intestinal distress. When researchers study P-wogs, that's what they're called in the literature, people who avoid wheat and or gluten, in a study of 84 P-wogs, about a third didn't appear to have gluten sensitivity at all, but instead in overgrowth of bacteria in their small intestine, or where fructose or lactose intolerant are at a neuromuscular disorder like gastroparesis or pelvic floor dysfunction. When those are all ruled out as well, then I'd suggest people suffering from chronic suspicious symptoms try a gluten-free diet. And if symptoms improve, stick with it, though maybe re-challenging with gluten periodically. Unlike celiac disease, a gluten-free diet has begun not to prevent serious complications from an autoimmune reaction, but just to resolve gluten sensitivity symptoms to try to improve patients' quality of life. However, a gluten-free diet itself can reduce quality of life, so it's a matter of trying to continually strike the balance. For example, gluten-free foods can be expensive, averaging about triple the cost, and so most people would benefit more from buying an extra bunch of kale or blueberries instead. No current data suggests that the general population should maintain a gluten-free lifestyle, but for those with a celiac disease, wheat allergy, or sensitivity diagnosis, gluten-free diets can be a lifesaver.