Gluten Free Works Symptom Guide

Could m y health problem s be related to celiac disease?

This is a common question people ask in the face of a bewildering array of possible symptoms.
We have developed a Symptom Guide below to help you identify possible symptoms and health
problems that you can present to your doctor.
Here is the list of over 300 Signs, Symptoms, Associated Disorders and Complications directly or
indirectly resulting from celiac disease.
We were the first to present this information in our comprehensive book, "Recognizing Celiac
Disease." (by Cleo J. Libonati, RN, BSN). This list is now being used by celiac disease centers,
national celiac organizations and health organizations worldwide.
BLOOD SYSTEM PROBLEMS -- Abnormal levels of blood components and quality of blood cells
and plasma, detected by blood studies ordered by a doctor.

Anemia, Folic acid

Anemia, Iron

Anemia, Vitamin B12

Anti-Endomysium Antibodies (EMA)

Anti-Gliadin Antibodies (AGA)

Anti-Tissue Transglutaminase Antibodies

(tTG)

Associated Autoimmune Antibodies

Bone Alkaline Phosphatase Enzyme,

Elevated

Calcium, Low

Cholesterol, Low (below 156)

Coagulation Factors, Low

Copper, Low

Hemochromatosis

Glucose, Low or elevated

Homocysteine, Elevated

Hyperprolactinemia (elevated prolactin

hormone)

Hypoprothrombinemia

Idiopathic Thrombocytopenic Purpura

Liver Enzymes, Elevated

Macroamylasemia

Macrocytosis

Macrolipasemia

Magnesium, Low

Neutropenia

Phosphorus, Low

Plasma Proteins, Low

Potassium, Low

Prolonged Prothrombin Time

Transient Erythroblastopenia

Zinc, Low

BODY COMPOSITION PROBLEMS -- Disorders of the body as a whole.

Anorexia (Poor appetite)

Obesity

Appetite, Increased

Weight Gain, Unexplained

Cachexia (Wasting of the body)

Weight Loss, Unexplained

Loss of Vitality

CARDIOVASCULAR SYSTEM PROBLEMS -- Disorders of the heart and blood vessels.

Angina Pectoris

Easy Bruising (Ecchymosis)

Aortic Vasculitis

Hypertension

Atherosclerosis

Idiopathic Dilated Cardiomyopathy

Cardiomegaly

Nosebleeds, Unexplained

Coronary Artery Disease

DIGESTIVE SYSTEM PROBLEMS - The following symptoms in this section may be present
alone or in any combination in celiac disease. They result from inflammation, damage, and
interference with normal function caused by gluten exposure in the digestive tract itself and/or
nutritional deficiencies. As you see, problems can develop not only in the small intestine where
inflammation can be intense, but also in other areas such as mucosal tissues of the mouth,
esophagus, stomach and colon.

Abdominal Distention (Bloating)

Diarrhea, acute (Also called celiac crisis)

Abdominal Pain

Diarrhea, chronic

Adenocarcinoma of the Small Intestine

Duodenal Erosions in the Second Part of

Duodenum (Small ulcers)

Aphthous Ulcers (Canker sores in

mouth)

Autoimmune Cholangitis

Beta Casein Enteropathy (Cow's dairy

intolerance similar to celiac disease)

Bleeding, Unexplained

Cancer of the Esophagus

Cancer of the Pharynx

Candida Infections

Carbohydrate Malabsorption

Cheilosis (Red lips, cracking/ oozing at

corners of mouth)

Dysphagia (Difficulty swallowing)

Edema of Small Intestinal Lining

Esophageal Small Cell Cancer

Esophageal Motor
Abnormalities (Poor muscle
activity/coordination)

Gas

Gastric Ulcer (Stomach ulcers)

Gastric Ulcerations

Gastritis, Collagenous

Gastritis, Lymphocytic
Gastro-Esophageal Reflux Disease (GERD)

Colitis, Collagenous

Colitis, Lymphocytic

Colitis, Ulcerative

Gastro-Intestinal Occult Bleeding (Blood in

stool that is not visible to naked eye)

Colonic Volvulus (Loop of intestine

twists causing strangulation of intestine)

Constipation

Constipation Alternating with Diarrhea

Crohn's Disease

Defective Tooth Enamel (Yellow, white

spots, missing enamel)
Delayed Gastric Emptying (Early fullness
after eating)

Gluten Sensitive Enteritis

Gums bleeding/ swollen (Purplish in adults/

red in children)

Heartburn

H. Pylori Bacter (Infection of the stomach)

Impaired Gall Bladder Motility

Irritable Bowel Syndrome

Jejunitis, chronic

DIGESTIVE SYSTEM PROBLEMS - cont

Lactose Intolerance (Gas, bloating,
loose stools from milk)

Laryngospasm

Leaky Gut Syndrome

Lymphoma

Malabsorption of Nutrients

Maltose Intolerance (Gas, bloating,

loose stools from maltose, a simple
carbohydrate)

Nausea

Oral Mucosal Lesions (Mouth lesions)

Plummer-Vinson Syndrome

Post-cricoid Cancer

Primary Sclerosing Cholangitis (Scarring of

bile ducts in liver)
Small Bowel Intussusception (One loop
of intestine slips into another)

Small Intestinal Bacterial Overgrowth

Steatorrhea (Pale, smelly, floating stool hard

to flush or sticks to toilet)
Sucrose Intolerance (Gas, bloating, mucous
in stool from sugar)

Tongue (Beefy, red, smooth, burning)

Tongue (Fiery red, smooth, swollen, sore)

Tongue (Magenta, swollen)

Tongue (Pale, smooth, burning)

Vomiting

Primary Biliary Cirrhosis (Bile backs up

in liver)
GLANDULAR SYSTEM PROBLEMS - Disorders of the glands.
Addison's Disease (Adrenal gland
failure)

Autoimmune Hepatitis

Autoimmune Thyroiditis
(Hypothyroidism)

Diabetes Mellitus Type I

Diabetic Instability

Gastro-Intestinal Complications of
Type 1 Diabetes

Grave's Disease (Hyperthyroidism)

Hepatic Granulomatous Disease

Idiopathic Hypoparathyroidism

Non-Alcoholic Fatty Liver Disease

Pancreatic Insufficiency

Parathyroid Carcinoma

Primary Hyperparathyroidism

Secondary Hypoparathyroidis

IMMUNE SYSTEM PROBLEMS - Disorders of antibody production.

Allergic Rhinitis

Antiphospholipid Syndrome

Asthma

Autoimmune Disorders in Celiac Disease

Autoimmune Disorders in Dermatitis

Herpetiformis

Autoimmune Polyglandular Syndromes

Common Variable Immunodeficiency

Food Allergies, IgE and non-IgE

Immune Responses

IgA Deficiency

Sarcoidosis

Sjgrens Syndrome

Systemic Lupus Erythematosus

Urticaria, chronic (Hives)

INTEGUMENTARY SYSTEM PROBLEMS - Disorders of skin, hair, and nails.

Melanoma

Alopecia Areata (Patches of hair loss)

Alopecia, Diffuse (Balding)

Cutaneous Vasculitis

Nails, Dry and brittle that chip, peel,

crack or break easily

Cutis Laxa

Dermatitis Herpetiformis

Dermatomyositis

Nail with Rounded and Curved Down

Ends, Dark, Dry

Eczema

Nails with White Spots

Edema (Swelling)

Nails with Splinter Hemorrhages

Eythema Elevatum Diutinum

Pityriasis Rubra Pilaris

Erythema Nodosum

Prurigo Nodularis (Hyde's Prurigo)

Psoriasis

Scleroderma

Seborrhea

Thin hair

Vitiligo

Follicular Hyperkeratosis (Dry rough

skin/ plugged hair follicles on body)

Ichthyosis, Acquired

Itchy Skin Rash

Hangnail

Koilonychia (Thin nails that flatten, ends

progressively turning up instead of down)

Nails with Horizontal and Vertical

Ridges/Fragile

LYMPATIC SYSTEM PROBLEMS - Disorders of the lymphocytes (white blood cells), lymph
nodes and spleen.

B-cell non-Hodgkin's Lymphoma

Cryptic Intestinal T-cell Lymphoma

(Refractory Sprue)
Enteropathy Associated T-cell
Lymphoma (EATL)

Extraintestinal Lymphomas

Intraepithelial Lymphocytosis in Small

Bowel Samples

Lymphadenopathy

Mesenteric Lymph Node Cavitation

Hyposplenism (Atrophy of spleen)

MUSCULAR SYSTEM PROBLEMS -Disorders of muscle structure and function.

Hypokalemic Rhabdomyolysis (Acute, severe potassium deficiency)

Muscle Pain and Tenderness

Muscle Spasm and Cramps

Muscle Wasting

Muscle Weakness

Osteomalacic Myopathy

Polymyositis

Tetany

NERVOUS SYSTEM PROBLEMS - Disorders of nerves, brain and spinal cord structure and
function.

Anxiety

Headache

Apathy

Inability to Concentrate

Ataxia, Gait Disturbance

Insomnia

Ataxia, Gluten

Irritability

Ataxia, Progressive Myoclonic

Migraine

Brain Atrophy

Multiple Sclerosis

Nervous System Disorders

Peripheral Neuropathy

Progressive Multifocal Leukoencephalopathy

Schizophrenic Spectrum Disorders

Tremors

Vasculitis of the Central Nervous System

Cerebral Perfusion Abnormalities

(Poor blood flow)

Chonic Fatigue Syndrome

Chorea

Cortical Calcifying Angiomatosis

Dementia

Depression

Epilepsy

Fatigue/ Lassitude

PULMONARY SYSTEM PROBLEMS- Disorders of lung tissue and broncheal tree structure and
function.

Bronchiectasis

Increased Susceptibility to Tuberculosis

Bronchial Pneumonia

Lung Cavities or Abcess

Idiopathic Pulmonary Hemosiderosis

Non-Response to Tuberculosis Treatment

Increased Pulmonary Permeability

Pneumococcal Septicemia

SENSORY SYSTEM PROBLEMS -Disorders of sense organ structure and function.

Bitot's Spots (Foamy patches on whites
of eye)

Blepharitis

Bloodshot Eyes

Blurred Vision

Cataracts

Keratoconjunctivitis Sicca

Keratomalacia

Nightblindness

Ocular Myopathy

Smell, Loss of

Taste, Loss of

Uveitis, Bilateral

Xerophthalmia

SKELETAL SYSTEM PROBLEMS - Disorders of bone, joints and teeth.

Bone Fracture

Osteitis Fibrosa

Osteoporosis

Bone Pain

Osteomalacia

Psoriatic Arthritis

Enteropathic Arthritis

Osteonecrosis

Recurrent Monoarthritis

URINARY SYSTEM PROBLEMS - Disorders of kidneys and urinaty tract structure and function.

Hypocalciuria

Kidney Stones

IgA Nephropathy

Urinary Tract Infection

REPRODUCTIVE SYSTEM PROBLEMS IN FEMALES - Disorders of organ structure and

function.
Amenorrhea (Absence of menstrual
period)

Dysmenorrhea (Painful menstrual

periods)

Early Menopause

Dyspareunia (Painful intercourse)

Infertility

Vaginitis

Late Menarche (Late start of menstrual

periods)

Premenstrual Syndrome

REPRODUCTIVE SYSTEM PROBLEMS IN MALES - Disorders of organ structure and function.

Hypogonadism

Infertility

Impotence

Sperm Abnormalities

REPRODUCTION: PREGNANCY, LABOR & DELIVERY AND PUERPERIUM PROBLEMS Disorders of childbearing.
Severe Iron Deficiency Anemia in
Pregnancy

Short Duration of Breast Feeding

Miscarriage

Complications During Pregnancy, Labor

and Delivery

Complications After Childbirth

ZYGOTE DEVELOPMENT PROBLEMS - Disorders of chromosomes.

Down Syndrome

Turner's Syndrome

FETUS DEVELOPMENT PROBLEMS - Disorders of that occur before birth of the child.

Congenital Anomalies

Cystic Fibrosis

Intrauterine Growth Retardation

Spina Bifida

CHILD DEVELOPMENT PROBLEMS - Disorders of children that occur after birth.

Autism and Learning Disorders

Attention Deficit Hyperactive Disorder

(ADHD)

Cancer Predisposition in Children

Chronic Bullous Dermatosis

Delayed Puberty in Boys

Delayed Puberty in Girls

Dermatitis Herpetiformis

Developmental Delay

Hypotonia

Juvenile Diabetes Type 1

Juvenile Idiopathic Arthritis

Abnormal Blood Studies

Penicilllin V Impaired Absorption

Refractory Anemia (Unresponsive to iron

therapy)

Fecal Occult Blood (Blood found in stool

that is not visible to the naked eye)
Glycogenic Acanthosis

Juvenile Autoimmune Thyroid Disease

Latent Anemia in Enzymopathies of

Small Intestine (Lack of enzymes produced
by villi)

Failure to Thrive and Growth

Retardation

Osteopenia

Rickets

Short Stature

Stroke in Childhood

Here are some other ways to look at problems:

BEHAVIOR PROBLEMS

Aloofness

Lack of Desire to Get Things Done

Hyperactivity

Lack of Feeling

Restlessness

Timid Behavior

Violent Behavior

Irritability (Common in children with

celiac disease)

Impatience

NEUROLOGICAL ISSUES

Anxiety

Difficulty Making Friendships

Sense of Worthlessness

Apathy

Easy Frustration and Anger

Overly Self-critical

Bipolar disorder

Nervousness

Hysteria

Depression

Panic Attacks

Hypochondria

THINKING PROBLEMS

Confused/ Faulty Thinking

Faulty Learning

Poor Memory

Confabulation

Hallucination

Reduced Learning

Delusions

Inattentiveness

Slow Thinking

Dementia

Loss of Memory

Scattered Thinking

Disorientation

Loss of Immediate Memory

Living Without Pantry

Substitution Solutions

Milk Replace 1 cup milk with one of the

following:
1
1
1
1
1

cup soy milk (plain or vanilla)

cup rice milk + 1 egg yolk
cup fruit juice
cup water + 1 egg yolk
cup coconut milk

Buttermilk Replace 1 cup buttermilk with

one of the following:
1



1
7/8
7/8
7/8

cup soy milk + 1 tablespoon

lemon juice or 1 tablespoon white
vinegar (Let stand until slightly
thickened.)
cup coconut milk
cup rice milk
cup fruit juice
cup water

Yogurt Replace 1 cup yogurt with one of

the following:
1 cup soy yogurt
1 cup soy sour cream
1 cup unsweetened applesauce
1 cup fruit puree

Butter Replace 8 tablespoons (1 stick)

butter with one of the following:
8 tablespoons (1 stick) Fleischmanns
unsalted margarine
8 tablespoons Earth Balance (Non-
Dairy) Buttery Spread
8 tablespoons Spectrum Organic
Shortening
8 tablespoons vegetable or
olive oil
For reduced fat:
6 tablespoons unsweetened apple-
sauce +2 tablespoons fat of
choice

Eggs Replacing more than two eggs

will change the integrity of a recipe. For
recipes that call for a lot of eggs, like a
quiche, use pureed silken tofu. Because
egg substitutions add moisture, you may
have to increase baking times slightly.
Replace 1 large egg with one of the
following:
3 tablespoons unsweetened
applesauce (or other fruit puree)
+ 1 teaspoon baking powder
1 tablespoon flax meal + 3 table-
spoons hot water. (Let stand,

GLUTEN-FREE FLOUR SUBSTITUTIONS

To make a flour blend, thoroughly combine all ingredients. Store in a covered container
in the refrigerator until used. You can double or triple these recipes to make as much
flour mix as you need.

All-Purpose Flour Blend

Use this blend for all your gluten-free
baking.
cup rice flour
cup tapioca starch
cup cornstarch or potato starch

High-Fiber Blend
This high-fiber blend works for breads,
pancakes, snack bars and cookies that
contain chocolate, warm spices, raisins or
other fruits. It is not suited to delicately
flavored recipes, such as sugar cookies,
crepes, cream puffs, birthday cakes or
cupcakes.
1 cup brown rice flour or sorghum
flour
cup teff flour (preferably light)
cup millet flour or Montina flour
2/3 cup tapioca starch
1/3 cup cornstarch or potato starch

igh-Protein Flour Blend

H
This nutritious blend works best in baked
goods that require elasticity, such as wraps
and pie crusts.
1 1/4

1

1
1

cups bean flour (your choice),

chickpea flour or soy flour
cup arrowroot starch, cornstarch
or potato starch
cup tapioca flour
cup white rice flour

Self-Rising Flour Blend

Use this blend for muffins, scones, cakes,
cupcakes or any recipe that uses baking
powder for leavening.

1
1

2
4

cups white sorghum flour

cups white rice flour
cup tapioca starch
teaspoons xanthan or guar gum
teaspoons baking powder
teaspoon salt

General Guidelines to Using Gum

Gum (xanthan or guar) is the key to successful gluten-free baking. It provides the binding needed to give the baked product proper elasticity, keeping it from crumbling.
l Add teaspoon xanthan or guar gum per cup of flour blend to make cakes, cookies,

bars, muffins and other quick breads.

l Add 1 teaspoon per cup of flour blend to make yeast bread, pizza dough or other

baked items that call for yeast.

Note: If you purchase a commercial flour blend, read the ingredient list carefully. Some blends
contain salt and xanthan or guar gum. If so, there is no need to add more.

stirring occasionally, about 10

minutes or until thick. Use with-
out straining.)
Egg Replacer, according to
package directions
4 tablespoons pureed silken tofu +
1 teaspoon baking powder
Note: To replace one egg white, dissolve 1
tablespoon plain agar powder into 1 tablespoon water. Beat, chill for 15 minutes and
beat again.

Nuts Replace tree nuts or peanuts with

an equal amount of the following:

Toasted coconut
Sunflower seeds
Toasted sesame seeds (use only 2 to 3
tablespoons)
Crushed cornflakes
Crushed crispy rice cereal
Crushed potato chips
Perkys Nutty Rice cereal
Pumpkin seeds

Unsafe Gluten-Free Food List

(Unsafe Ingredients)
Abyssinian Hard (Wheat
triticum durum)
Alcohol (Spirits - Specific
Types)
Amp-Isostearoyl Hydrolyzed
Wheat Protein
Barley Grass (can contain
seeds)
Barley Hordeum vulgare
Barley Malt
Beer
Bleached Flour
Blue Cheese (made with
bread)
Bran
Bread Flour
Brewers Yeast
Brown Flour
Bulgur (Bulgar Wheat/Nuts)
Bulgur Wheat
Cereal Binding
Chilton
Club Wheat (Triticum
aestivum subspecies
compactum)
Common Wheat (Triticum
aestivum)
Couscous
Dextrimaltose
Disodium Wheatgermamido
Peg-2 Sulfosuccinate
Durum wheat (Triticum
durum)
Edible Starch
Einkorn (Triticum
monococcum)
Emmer (Triticum dicoccon)
Farina
Farina Graham
Filler
Flour (normally this is
wheat)
Fu (dried wheat gluten)
Germ
Graham Flour
Granary Flour
Groats (barley, wheat)

Hard Wheat
Hydrolyzed Wheat Gluten
Hydrolyzed Wheat Protein
Hydrolyzed Wheat Protein
Pg-Propyl Silanetriol
Hydrolyzed Wheat Starch
Hydroxypropyltrimonium
Hydrolyzed Wheat Protein
Kamut (Pasta wheat)
Malt
Malt Extract
Malt Syrup
Malt Flavoring
Malt Vinegar
Macha Wheat (Triticum
aestivum)
Matzo Semolina
Mir
Oriental Wheat (Triticum
turanicum)
Pasta
Pearl Barley
Persian Wheat (Triticum
carthlicum)
Poulard Wheat (Triticum
turgidum)
Polish Wheat (Triticum
polonicum)
Rice Malt (if barley or
Koji are used)
Rye
Seitan
Semolina
Semolina Triticum
Shot Wheat (Triticum
aestivum)
Small Spelt
Spirits (Specific Types)
Spelt (Triticum spelta)
Sprouted Wheat or Barley
Stearyldimoniumhydroxypropy
l Hydrolyzed Wheat Protein
Strong Flour
Suet in Packets
Tabbouleh
Teriyaki Sauce
Textured Vegetable Protein
- TVP
Timopheevi Wheat (Triticum

timopheevii)
Triticale X triticosecale
Triticum Vulgare (Wheat)
Flour Lipids
Triticum Vulgare (Wheat)
Germ Extract
Triticum Vulgare (Wheat)
Germ Oil
Udon (wheat noodles)
Unbleached Flour
Vavilovi Wheat (Triticum
aestivum)
Vegetable Starch
Wheat, Abyssinian Hard
triticum durum
Wheat amino acids
Wheat Bran Extract
Wheat, Bulgur
Wheat Durum Triticum
Wheat Germ Extract
Wheat Germ Glycerides
Wheat Germ Oil
Wheat
Germamidopropyldimonium
Hydroxypropyl Hydrolyzed
Wheat Protein
Wheat Grass (can contain
seeds)
Wheat Nuts
Wheat Protein
Wheat Triticum aestivum
Wheat Triticum Monococcum
Wheat (Triticum Vulgare)
Bran Extract
Whole-Meal Flour
Wild Einkorn (Triticum
boeotictim)

Wild Emmer (Triticum

dicoccoides)

The following items may or

may not contain gluten
depending on where and how
they are made, and it is
sometimes necessary to
check with the manufacturer
to find out:
Artificial Color4
Caramel Color1, 3
Coloring4
Dextrins1,7
Flavoring6
Food Starch1, 4
Glucose Syrup4
Gravy Cubes4
Ground Spices4
Maltodextrin1, 8
Maltose4
Miso4
Modified Food Starch1, 4
Monosodium Glutimate (MSG)1,
4

Mustard Powder 4
Natural Flavoring6
Shoyu (soy sauce)4
Smoke Flavoring4
Soba Noodles4
Soy Sauce4
Starch1, 4
Stock Cubes4
Vitamins4
Wheat Starch5

1) If this ingredient is made in North America it is

likely to be gluten-free.
3) The problem with caramel color is it may or may not
contain gluten depending on how it is manufactured. In
the USA caramel color must conform with the FDA
standard of identity from 21CFR CH.1. This statute
says: the color additive caramel is the dark-brown
liquid or solid material resulting from the carefully
controlled heat treatment of the following food-grade
carbohydrates: Dextrose (corn sugar), invert sugar,
lactose (milk sugar), malt syrup (usually from barley
malt), molasses (from cane), starch hydrolysates and

fractions thereof (can include wheat), sucrose (cane

or beet). Also, acids, alkalis and salts are listed as
additives which may be employed to assist the
caramelization process.
4) Can utilize a gluten-containing grain or by-product
in the manufacturing process, or as an ingredient.
5) Most celiac organizations in the USA and Canada do
not believe that wheat starch is safe for celiacs. In
Europe, however, Codex Alimentarius Quality wheat
starch is considered acceptable in the celiac diet by
most doctors and celiac organizations. This is a
higher quality of wheat starch than is generally
available in the USA or Canada.
6) According to 21 C.F.R. S 101,22(a)(3): [t]he terns
natural flavor or natural flavoring means the
essential oil, oleoresin, essence or extractive,
protein hydrolysate, distillate, or any product of
roasting, heating or enzymolysis, which contains the
flavoring constituents derived from a spice, fruit or
fruit juice, vegetable or vegetable juice, edible
yeast, herb, bark, bud, root, leaf or similar plant
material, meat, seafood, poultry, eggs, dairy
products, or fermentation products thereof. Whose
significant function in food is flavoring rather than
nutritional.
7) Dextrin is an incompletely hydrolyzed starch. It is
prepared by dry heating corn, waxy maize, waxy milo,
potato, arrowroot, WHEAT, rice, tapioca, or sago
starches, or by dry heating the starches after: (1)
Treatment with safe and suitable alkalis, acids, or pH
control agents and (2) drying the acid or alkali
treated starch. (1) Therefore, unless you know the
source, you must avoid dextrin.
May 1997 Sprue-Nik News.
(1) Federal Register (4-1-96 Edition) 21CFR Ch.1,
Section 184.12277.
(2) Federal Register (4-1-96) 21 CFR. Ch.1, Section
184.1444

8) Maltodextrin is prepared as a white powder or

concentrated solution by partial hydrolysis of corn
starch or potato starch with safe and suitable acids
and enzymes. (1) Maltodextrin, when listed on food
sold in the USA, must be (per FDA regulation) made
from corn or potato. This rule does NOT apply to
vitamin or mineral supplements and medications. (2)
Donald Kasarda Ph.D., a research chemist specializing
on grain proteins, of the United States Department of
Agriculture, found that all maltodextrins in the USA

are made from corn starch, using enzymes that are NOT
derived from wheat, rye, barley, or oats. On that
basis he believes that celiacs need not be too
concerned about maltodextrins, though he cautions that
there is no guarantee that a manufacturer wont change
their process to use wheat starch or a gluten-based
enzyme in the future. (3) - May 1997 Sprue-Nik News
1. Federal Register (4-1-96) 21 CFR. Ch.1, Section
184.1444
2.Additives Alert, an information sheet from the
Greater Philadelphia Celiac Support Group, updated
early in 1997. This specific information comes from
Nancy Patin Falini, the dietitian advisor for the
group and a speaker at a national celiac conferences
in the past few years.
3. From the CELLIAC Listserv archives, on the
Internet, Donald D. Kasarda, posted November 6, 1996.

**Thank you to Judy Mayer for this handout

Safe Gluten-Free Food

List (Safe
Acacia Gum
Acesulfame K
Acesulfame
Potassium
Acetanisole
Acetophenone
Acorn Quercus
Adipic Acid
Adzuki Bean
Acacia Gum
Agar
Agave
Albumen
Alcohol (Spirits Specific Types)
Alfalfa
Algae
Algin
Alginic Acid
Alginate
Alkalized Cocoa
Allicin
Almond Nut
Alpha-amylase
Alpha-lactalbumin
Aluminum
Amaranth
Ambergris
Ammonium Hydroxide
Ammonium Phosphate
Ammonium Sulphate
Amylose
Amylopectin
Annatto
Annatto Color
Apple Cider Vinegar
Arabic Gum
Arrowroot
Artichokes
Artificial Butter
Flavor
Artificial
Flavoring
Ascorbic Acid
Aspartame (can
cause IBS symptoms)
Aspartic Acid
Aspic
Astragalus Gummifer
Autolyzed Yeast
Extract
Avena Sativia
(Oats3)
Avena Sativia
Extract (from Oats3)
Avidin
Azodicarbonamide
Baking Soda
Balsamic Vinegar
Beeswax

Ingredients)
Beans
Bean, Adzuki
Bean, Hyacinth
Bean, Lentil
Bean, Mung
Bean Romano
(Chickpea)
Bean Tepary
Benzoic acid
Besan (Chickpea)
Beta Glucan (from
Oats3)
Betaine
Beta Carotene
BHA
BHT
Bicarbonate of Soda
Biotin
Blue Cheese
Brown Sugar
Buckwheat
Butter (check
additives)
Butylated
Hydroxyanisole
Butyl Compounds
Calcium Acetate
Calcium Carbonate
Calcium Caseinate
Calcium Chloride
Calcium Disodium
Calcium Hydroxide
Calcium Lactate
Calcium
Pantothenate
Calcium Phosphate
Calcium Propionate
Calcium Silicate
Calcium Sorbate
Calcium Stearoyl
Lactylate
Calcium Stearate
Calcium Sulfate
Calrose
Camphor
Cane Sugar
Cane Vinegar
Canola (Rapeseed)
Canola Oil
(Rapeseed Oil)
Caprylic Acid
Carageenan Chondrus
Crispus
Carbonated Water
Carboxymethyl
Cellulose
Carmine
Carnauba Wax
Carob Bean
Carob Bean Gum
Carob Flour

Carrageenan
Casein
Cassava Manihot
Esculenta
Castor Oil
Catalase
Cellulose1
Cellulose Ether
Cellulose Gum
Cetyl Alcohol
Cetyl Stearyl
Alcohol
Champagne Vinegar
Channa (Chickpea)
Chana Flour
(Chickpea Flour)
Cheeses - (most,
but check
ingredients)
Chestnuts
Chickpea
Chlorella
Chocolate Liquor
Choline Chloride
Chromium Citrate
Chymosin
Citric Acid
Citrus Red No. 2
Cochineal
Cocoa
Cocoa Butter
Coconut
Coconut Vinegar
Collagen
Colloidal Silicon
Dioxide
Confectioner's
Glaze
Copernicia Cerifera
Copper Sulphate
Corn
Corn Gluten
Corn Masa Flour
Corn Meal
Corn Flour
Corn Starch
Corn Sugar
Corn Sugar Vinegar
Corn Syrup
Corn Syrup Solids
Corn Swetener
Corn Vinegar
Corn Zein
Cortisone
Cotton Seed
Cotton Seed Oil
Cowitch
Cowpea
Cream of Tartar
Crospovidone
Curds

Cyanocobalamin
Cysteine, L
Dal (Lentils)
D-Alpha-tocopherol
Dasheen Flour
(Taro)
Dates
D-Calcium
Pantothenate
Delactosed Whey
Demineralized Whey
Desamidocollagen
Dextran
Dextrose
Dioctyl Sodium
Dioctyl Sodium
Solfosuccinate
Dipotassium
Phosphate
Disodium Guanylate
Disodium Inosinate
Disodium Phosphate
Distilled Alcohols
Distilled Vinegar
Distilled White
Vinegar
Dutch Processed
Cocoa
EDTA
(Ethylenediaminetet
raacetic Acid)
Eggs
Egg Yolks
Elastin
Ester Gum
Ethyl Alcohol
Ethylenediaminetetr
aacetic Acid
Ethyl Maltol
Ethyl Vanillin
Expeller Pressed
Canola Oil
FD&C Blue No. 1 Dye
FD&C Blue No. 1
Lake
FD&C Blue No. 2 Dye
FD&C Blue No. 2
Lake
FD&C Green No. 3
Dye
FD&C Green No. 3
Lake
FD&C Red No. 3 Dye
FD&C Red No. 40 Dye
FD&C Red No. 40
Lake
FD&C Yellow No. 5

Dye
FD&C Yellow No. 6
Dye
FD&C Yellow No. 6
Lake
Ferric
Orthophosphate
Ferrous Gluconate
Ferrous Fumerate
Ferrous Lactate
Ferrous Sulfate
Fish (fresh)
Flaked Rice
Flax
Folacin
Folate
Folic Acid-Folacin
Formaldehyde
Fructose
Fruit (including
dried)
Fruit Vinegar
Fumaric Acid
Galactose
Garbanzo Beans
Gelatin
Glucoamylase
Gluconolactone
Glucose
Glucose Syrup
Glutamate (free)
Glutamic Acid
Glutamine (amino
acid)
Glutinous Rice
Glutinous Rice
Flour
Glycerin
Glycerol Monooleate
Glycol Monosterate
Glycol
Glycolic acid
Gram flour (chick
peas)
Grape Skin Extract
Grits, Corn
Guar Gum
Gum Acacia
Gum Arabic
Gum Base
Gum Tragacanth
Hemp
Hemp Seeds
Herbs
Herb Vinegar
Hexanedioic Acid
High Fructose Corn

Syrup
Hominy
Honey
Hops
Horseradish (Pure)
Hyacinth Bean
Hydrogen Peroxide
Hydrolyzed
Caseinate
Hydrolyzed Meat
Protein
Hydrolyzed Soy
Protein
Hydroxypropyl
Cellulose
Hydroxypropyl
Methylcellulose
Hypromellose
Illepe
Iodine
Inulin
Invert Sugar
Iron Ammonium
Citrate
Isinglass
Isolated Soy
Protein
Isomalt
Job's Tears
Jowar (Sorghum)
Karaya Gum
Kasha (roasted
buckwheat)
Keratin
K-Carmine Color
K-Gelatin
Koshihikari (rice)
Kudzu
Kudzu Root Starch
Lactalbumin
Phosphate
Lactase
Lactic Acid
Lactitol
Lactose
Lactulose
Lanolin
Lard
L-cysteine
Lecithin
Lemon Grass
Lentils
Licorice
Licorice Extract
Lipase
L-leucine
L-lysine

L-methionine
Locust Bean Gum
L-tryptophan
Magnesium Carbonate
Magnesium Hydroxide
Magnesium Oxide
Maize
Maize Waxy
Malic Acid
Maltitol
Maltodextrin
Maltol
Manganese Sulfate
Manioc
Masa
Masa Flour
Masa Harina
Meat (fresh)
Medium Chain
Triglycerides
Menhaden Oil
Methyl Cellulose2
Microcrystalline
Cellulose
Micro-particulated
Egg White Protein
Milk
Milk Protein
Isolate
Millet
Milo (Sorghum)
Mineral Oil
Mineral Salts
Molybdenum Amino
Acid Chelate
Monocalcium
Phosphate
Monopotassium
Phosphate
Monosaccharides
Monosodium
Glutamate (MSG)
Monostearates
MSG
Mung Bean
Musk
Mustard Flour
Myristic Acid
Natural Smoke
Flavor
Niacin-Niacinamide
Neotame
Niacin
Niacinamide
Nitrates
Nitrous Oxide
Non-fat Milk

Nuts (except wheat,

rye & barley)
Nut, Acron
Nut, Almond
Oats3
Oils and Fats
Oleic Acid
Oleoresin
Olestra
Oleyl Alcohol/Oil
Orange B
Oryzanol
Palmitic Acid
Pantothenic Acid
Papain
Paprika
Paraffin
Patially
Hydrogenated
Cottonseed Oil
Patially
Hydrogenated
Soybean Oil
Peas
Pea - Chick
Pea - Cow
Pea Flour
Pea Starch
Peanuts
Peanut Flour
Pectin
Pectinase
Peppermint Oil
Peppers
Pepsin
Peru Balsam
Petrolatum
PGPR (Polyglycerol
Polyricinoleate)
Phenylalanine
Phosphoric Acid
Phosphoric Glycol
Pigeon Peas
Polenta
Polydextrose
Polyethylene Glycol
Polyglycerol
Polyglycerol
Polyricinoleate
(PGPR)
Polysorbates
Polysorbate 60
Polysorbate 80
Potassium Benzoate
Potassium Caseinate
Potassium Citrate
Potassium Iodide

Potassium Lactate
Potassium
Matabisulphite
Potassium Sorbate
Potatoes
Potato Flour
Potato Starch
Povidone
Prinus
Pristane
Propolis
Propylene Glycol
Propylene Glycol
Monosterate
Propyl Gallate
Protease
Psyllium
Pyridoxine
Hydrochloride
Quinoa
Ragi
Raisin Vinegar
Rape
Recaldent
Reduced Iron
Rennet
Rennet Casein
Resinous Glaze
Reticulin
Riboflavin
Rice
Rice (Enriched)
Rice Flour
Rice Starch
Rice Syrup
Rice Vinegar
Ricinoleic Acid
Romano Bean
(chickpea)
Rosematta
Rosin
Royal Jelly
Saccharin
Saffron
Sago
Sago Palm
Sago Flour
Sago Starch
Saifun (bean
threads)
Salt
Seaweed
Seeds (except
wheat, rye &
barley)
Seed - Sesame
Seed - Sunflower

Shea
Sherry Vinegar
Silicon Dioxide
Soba (be sure its
100% buckwheat)
Sodium Acid
Pyrophosphate
Sodium Acetate
Sodium Alginate
Sodium Ascorbate
Sodium Benzoate
Sodium Caseinate
Sodium Citrate
Sodium Erythrobate
Sodium
Hexametaphosphate
Sodium Lactate
Sodium Lauryl
Sulfate
Sodium
Metabisulphite
Sodium Nitrate
Sodium Phosphate
Sodium
Polyphosphate
Sodium Silaco
Aluminate
Sodium Stearoyl
Lactylate
Sodium Sulphite
Sodium Stannate
Sodium
Tripolyphosphate
Sorbic Acid
Sorbitan
Monostearate
Sorbitol-Mannitol
(can cause IBS
symptoms)
Sorghum
Sorghum Flour
Soy
Soybean
Soy Lecithin
Soy Protein
Soy Protein Isolate
Spices (pure)
Spirits (Specific
Types)
Spirit Vinegar
Stearates
Stearamide
Stearamine
Stearic Acid
Stearyl Lactate
Stevia
Subflower Seed

Succotash (corn and

beans)
Sucralose
Sucrose
Sulfosuccinate
Sulfites
Sulfur Dioxide
Sweet Chestnut
Flour
Tagatose
Tallow
Tapioca
Tapioca Flour
Tapioca Starch
Tara Gum
Taro
Tarro
Tarrow Root
Tartaric Acid
Tartrazine
TBHQ is Tetra or
Tributylhydroquinon
e
Tea
Tea-Tree Oil
Teff
Teff Flour
Tepary Bean
Textured Vegetable
Protein
Thiamin
Hydrochloride
Thiamine
Mononitrate
Thiamine
Hydrochloride
Titanium Dioxide
Tofu (Soy Curd)
Tolu Balsam
Torula Yeast
Tragacanth
Tragacanth Gum
Triacetin
Tricalcium
Phosphate
Tri-Calcium
Phosphate
Trypsin
Turmeric (Kurkuma)
TVP
Tyrosine
Urad/Urid Beans
Urad/Urid Dal
(peas) Vegetables
Urad/Urid flour
Urd
Vinegar (All except

Malt)
Vanilla Extract
Vanilla Flavoring
Vanillin
Vinegars (Specific
Types)
Vitamin A (retinol)
Vitamin A Palmitate
Vitamin B1
Vitamin B-12
Vitamin B2
Vitamin B6
Vitamin D
Vitamin E Acetate
Waxy Maize
Whey
Whey Protein
Concentrate
Whey Protein
Isolate
White Vinegar
Wines
Wine Vinegars (&
Balsamic)
Wild Rice
Xanthan Gum
Xylitol
Yam Flour
Yeast
Yogurt (plain,
unflavored)
Zinc Oxide
Zinc Sulfate

1) Cellulose
is a
carbohydrate
polymer of Dglucose. It
is the
structural
material of
plants, such
as wood in
trees. It
contains no
gluten
protein.
2) Methyl
cellulose is
a chemically
modified form
of cellulose
that makes a
good
substitute

for gluten in
rice-based
breads, etc.
3) Recent
research
indicates
that oats may
be safe for
people on
gluten-free
diets,
although many
people may
also have an
additional,
unrelated
intolerance
to them.
Cross
contamination
with wheat is
also a factor
that you need
to consider
before
choosing to
include oats
in your diet.

Are Distilled Vinegars

Made from Wheat Safe?
White vinegar or
just plain vinegar
are typically
distilled, and, if
so, are glutenfree. Distilled
vinegar can be
distilled from
wheat, corn,
potatoes, beets,
wood, apples and
many other things.
Most in the USA are
not made from
wheat, but are
instead made from
corn, potatoes or
wood, which are all
safe (Heinz white
vinegar is
distilled from

corn). Distilled
vinegars that are
made from wheat are
probably glutenfree because of the
distillation
process described
in Frederik Willem
Janssens article on
this site.
Distilled vinegar
made from wood are
gluten-free. Woodbased vinegar is
often the vinegar
used in processed
foods.
Flavored vinegars
are made with
white, distilled
vinegar, and
flavorings are then
added. Some of
these may also not
be gluten-free (the
cheapest vinegars
are used since the
flavors are masked
by the herbs and
flavoring).
Malted vinegars are
usually not glutenfree.
Red and white wine
and balsamic
vinegars are
gluten-free.

**Thanks to Judy
Mayer for this
handout

Gluten Free Flours

Almond flour (blanched)

Low in carbohydrates, good source of protein,

fiber and
vitamin E. Lends a moist texture
and rich buttery flavor to cakes, cookies muffins
etc. Great for breading. For more information on
recipes visit http://www.elanaspantry.com/

Arrowroot

Arrowroot is high in fiber and easily digestible.

It is very useful for thickening recipes. It is
tasteless, and the fine powder becomes clear when
it is cooked, which makes it good for making gels
or thickening clear sauces. Arrowroot flour can
be substituted for cornstarch if you are allergic
to corn.

Bean flours:

White bean most commonly used in GF baking in

combination
with other bean flours. Excellent mild flour to
use with
breads, cookies, muffins etc. May impart a beany
flavor.

Chickpea, white bean,

fava bean, garfava

Buckwheat flour

A grain or fruit related to rhubarb and sorrel.

Unroasted it is called kasha. Buckwheat is ground
into flour light or dark, the darker being more
nutritious. Adds moisture.

Coconut flour

More protein than wheat flour and ten times more

fiber. It has fewer absorbable carbohydrates.
Absorbs more liquid than other flours. For more
information on this very healthy flour:
http://www.livingwithout.com/issues/4_7/cooking_w
ith_coconut_flour-1955-1.html

Corn flour

Milled from corn. Can be blended with cornmeal to

make cornbread or muffins. Excellent for pancakes
or waffles.

Cornstarch

A fine, white powder milled from corn. Its used

to thicken recipes and sauces. It has a bland
taste, and therefore is used with other
ingredients that will give flavor to the recipe.
Corn starch can also be mixed with other flours
to make batters for coating foods.

Gluten Free Flours

Garbava flour

A flour made form garbanzo (chickpeas) and fava

beans. High in protein.

Guar gum

Made from the guar bean. It is a free-flowing,

pale, off-white colored coarse to fine ground
powder. In baked goods it increases dough yield,
gives elasticity and improves texture and shelf
life.

Millet seed
Millet flour

A tiny grain that can be cooked like rice.

Millet flour has a buttery, slightly sweet taste.
Works well to dust fried foods with.
Can be interchanged with sorghum.

Potato flour

Made from dehydrated potatoes. A white, velvety

flour,
sweetly pungent. (do not confuse with potato
starch)

Potato starch

Potato starch is the starch of the potato. Used

as a
thickener or gelling agent.

Quinoa seed
rice.
Quinoa flour

A small seed that can be cooked like white

Flour is high in protein and adds moisture to
baked goods. Quinoa has a nutty taste.

Rice flours:

Ground from the whole grain. Sweet in flavor.

Rice
Brown, white, rice bran,
Brown rice flour made form whole grain;
white from
Rice flakes
de-branned rice. Provides lightness to recipes.
Does not impart
any flavors.
Sorghum flour

Acceptable for breads, cakes, crackers and

cookies. High protein and good taste

Soy flour

High protein and fat content. Used with

combination of other flours. Has a nutty taste.

Tapioca flour

A tropical plant that comes from the cassava

root. Made into tapioca flour. Adds chewy
texture. High in protein.

White Sandwich Bread

(from the Delphi Celiac Forum)
Makes one loaf
2 cups brown rice flour
2/3 cup cornstarch
2/3 cup dry milk powder
1 tablespoon xanthan gum
1 tablespoon sugar
1 teaspoon salt
1 cups warm water
2 tablespoons oil
2 large eggs
1 packet active dry yeast
Combine wet ingredients and dry ingredients in separate bowls. Pour wet ingredients
into the Zo bread pan. Cover evenly with dry ingredients. Make a little divot in the flour
mixture in which to pour yeast packet.
Use this guide for the machine:
Preheat: 10 minutes
Knead: 18 minutes
Rise 1: Off
Rise 2: Off
Rise 3: 1 hour
Bake: 70 minutes
Warm: Off

White Bread (from Bette Hagmans More from the Gluten-Free Gourmet)
2 cups white rice flour
cup potato starch flour
cup tapioca flour
2 tsp xanthan gum
2/3 cup dry milk powder
1 tsp salt
1 tsp egg replacer (dry powder) (This is an optional ingredient but I always use it plus
the eggs. I think it has to do with the protein missing when gluten is eliminated.)
3 tbsp sugar, divided
2/3 cup lukewarm water
1 tbsp dry yeast granules
4 tbsp. butter or margarine, melted
1 additional cup warm water
1 tsp distilled white vinegar
3 eggs at room temperature

Combine flours, xanthan gum, milk powder, salt, egg replacer, and all but 2 tsp. of sugar
in bowl of mixer. Use strongest beater.
Dissolve remaining sugar in 2/3 cup lukewarm water and mix in the yeast.
Combine melted butter with 1 cup warm water and add vinegar.
Turn mixer on low. Blend dry ingredients and slowly add butter/water mix. Add eggs one
at a time. The mixture should feel slightly warm.
Pour yeast mixture into the bowl and beat at highest speed for 2 min. Place mixing bowl
in warm spot (I put it in the microwave), covered with plastic wrap and a towel. Let the
dough rise for approx. 1 hr or until doubled in size.
Return dough to mixer and beat on high speed for 3 min. The dough texture should be
more like cookie dough than typical bread dough. Spoon dough into large greased bread
pan or three 2 x 5 inch pans. Fill 2/3 full.
Let dough rise again for 45-60 min, or until just above top of pan. Preheat oven to 400F.
Bake for 1 hr. (per directionsit usually takes mine about 45 min, so check). After about
10 min, cover with foil. Dont forget the foil step or you will have an overflowing mess! I
forgot this step once. I also put the pan on a baking sheet just in case.
Bread will have a slightly hollow sound when tapped.

Pizza Crust

2 Tbsp. dry yeast

1 tsp sugar
1 cup milk
1 1/3 cup white rice flour
1 cup tapioca flour
4 tsp xanthan gum
1 tsp salt
2 tsp Italian seasoning
2 tsp olive oil
2 tsp cider vinegar

Preheat oven to 425 degrees.

Dissolve yeast and sugar in warm milk for five minutes. In food processor or mixer,
blend all crust ingredients, including yeast mixture. Mix until a ball forms.
Place mixture on greased pizza pan and form thicker edges to hold toppings in. Sprinkle
with rice flour or corn meal if dough is too sticky.
Bake for 10 minutes before adding toppings. Add toppings and bake for another 20-25
minutes or until top is nicely browned.

****Chebe pizza crust mix also is very goodyou need to use 2 packages for a regular
size pizza.

Pumpkin Pie
from Living Without
I use double the recipe for the crust and halve the pie filling amount, but this is how the original recipe was
written.
The gluten-free flour mixture used is this (makes about 4 1/2 cups):
2 1/4 cups finely ground brown rice flour
1/4 cup potato starch
2/3 cup tapioca starch
3/4 cup sweet rice flour
1/3 cup cornstarch
2 tsp xanthan or guar gum (I use xanthan)

Crust:
1 3/4 cup gluten-free flour mixture ( I use just a bit less when calculating the recipe, as it gets too crumbly
to stay together )
1/2 tsp salt
1 tbsp sugar
9 tbsp cold unsalted butter, cut into pieces
1 jumbo egg plus one egg yolk, lightly beaten
1 1/2 tbsp sour cream
Combine flour, salt, and sugar. Using a pastry blender or fork, work butter into small pieces the size of peas
and distribute throughout flour mixture. Knead very lightly with your hands until dough sticks together.
Make a well in mixture and add eggs and sour cream. Mix thoroughly. Gather half the dough into a ball and
shape into a disk. Cover with plastic wrap and refrigerate for 30 min. Repeat with other half. Roll the
dough between 2 pieces of plastic wrap or wax paper to place in pie pan; take off the top wrap and flip
upside down into pan. Shape crust. Repeat with other disk. Bake for 20 min. at 400 degrees or until edges
are golden brown.
Filling:
1 29-oz can of pumpkin
4 eggs, lightly beaten
2 tbsp gluten-free flour mixture
1 tsp salt
1 tsp ground cinnamon
1/4 tsp ground cloves
1/2 tsp allspice
1 tsp ginger
2 cups sugar
1 tsp vanilla extract ( I use the vanilla powder from the GF Trading Co., which calls for less; it's great stuff
to add to coffee and other sweets!)
2 1/2 cups evaporated milk
Preheat oven to 325 degrees. Blend pumpkin and eggs together in large bowl. Mix flour, salt, and spices in
another bowl. Slowly add spice mixture to pumpkin blend. Add sugar and vanilla, mixing well. Add
evaporated milk in a slow stream, mixing thoroughly. Pour filling into two cooked pie crusts and bake for
one hour or until knife comes out of center clean.