The gluten-free craze has taken health-conscious and diet-conscious people on a wild ride over the past few years. While anybody’s had the open invite to jump on the no-gluten bandwagon through it all, only those with something known as celiac disease are the people who really need to avoid gluten, a composite of storage proteins found in things like wheat, barley, rye and more.

Celiac is a disease in which eating gluten causes inflammation that can damage everything from the lining of your small intestines to preventing the absorption of some nutrients in the body. Some people have no symptoms at all while others experience diarrhea, fatigue, osteoporosis, and just like arthritis, joint pain. 

Alessio Fasano, MD, who directs the Center for Celiac Research at Massachusetts General Hospital in Boston says “In some people, the immune system sees gluten as the enemy and will unleash weapons to attack it, causing inflammation in the intestines as well as in other organs and tissues."

One mystery within the gluten-free conundrum of misinformation and hype is gluten’s connection to arthritis. Many have wondered if one causes the other, or vice versa. Both celiac disease and common forms of arthritis are autoimmune diseases and in both cases, immune systems don’t function properly, attacking healthy cells and causing inflammation as if there were viruses, bacteria, and other pathogens to heal when there actually isn’t. Because of this, the confusion about celiac and arthritis begins. Arthritis is actually a series of joint pain or joint pain diseases in which inflammation is the culprit and symptom, whereas, inflammation is a natural response of the body attempting to heal an injury, and autoimmune diseases like celiac and arthritis are both triggers of inflammation. Certain foods can actually trigger and worsen inflammation, and with celiac, gluten is the culprit. Celiac disease is actually often misdiagnosed as arthritis because some of the symptoms are similar.

So while there are commonalities between the two diseases, there’s still no definitive proof that gluten, celiac, and arthritis are always connected. It is common, however, for doctors to recommend arthritis patients consider a gluten-free diet. Certain foods are known to cause inflammation, like sugar, certain oils, refined carbohydrates, and processed meats. This alone is enough for arthritis patients to consider a gluten-free diet, but it’s not a definitive cure-all. If you do have an autoimmune disorder, talking to your doctor about the possibility of having celiac is certainly necessary, as celiac increases the chances of developing other autoimmune disorders like Crohn's, Addison’s disease, and of course, arthritis. But unless you’ve been diagnosed with celiac specifically, going gluten-free isn’t mandatory.

There are definitely many foods connected to causing the inflammation that worsens arthritis symptoms. But the truth is, researchers actually don’t have any definitive answers about gluten and arthritis specifically. So, is gluten ever to blame for arthritis flare-ups? The final quick and short point in a very long and complex answer to that is simply, “maybe.”