Don't worry, the real flow chart isn't this complicated.

There are lots of reasons to like the Wall Street Journal, but one of the biggest has to be columnist Melinda Beck.

In September of 2010, Beck published an article called, “Giving up Gluten to Lose Weight? Not so Fast” (and we wrote about it, of course).

Now, she’s followed up with, “New Guide to Who Really Shouldn’t Eat Gluten,” an overview of  a newly-proposed classification system for all people who are better-off without gluten.

Thanks, Melinda Beck! It’s nice to see the gluten-free world get coverage in such a mainstream publication, year in and year out.

So what’s this article about?

Not too long ago (non-celiac) gluten sensitivity was thought to be made-up or psychosomatic. Recently it’s been more broadly accepted as a very legitimate medical concern — but there’s more work to be done. Fifteen international experts have issued a proposal that, “defines a spectrum of illnesses based on the kind of immune defenses people mount to gluten, from wheat allergies to autoimmune responses, such as celiac disease,” according to Beck’s article.

The proposal also acknowledges other autoimmune responses, like dermatitis herpetiformis and gluten ataxia, and non-autoimmune responses that would include gluten sensitivity.’s Celiac Disease Guide Jane Anderson explains that the team of experts, “proposes using an algorithm that first rules out celiac disease and wheat allergy, and then diagnoses gluten sensitivity based on the person’s response to a gluten challenge.”

If you’d like to read a provisional PDf of the source material, check out BMC Medicine online; there will be a full version up as soon as it’s ready. It’s worth perusing, especially for the charts at the end: figure 4 is a flow chart to help doctors figure out which questions and tests are important for different stages of diagnosis.

One of the biggest pieces that Beck pulls from this — and something we harp on here sometimes — is that in order to get a proper diagnosis, a patient must be consuming gluten. A “normal” diet is required for effective tests. This is unlikely to change anytime in the near future — so if you’re thinking of going gluten-free, get yourself to a (well-read) doctor first!

If you have non-celiac reasons to avoid gluten, what was your diagnosis like?