Why You Shouldn't Take Advil PM If You're Following A Gluten-Free Diet

Though only an estimated 5-6% of Americans have medical conditions that prevent them from consuming gluten, roughly 25% of Americans choose to go gluten-free, according to Nebraska Today. The experts at Cleveland Clinic explain that gluten is a protein that is present in a variety of foods, particularly wheat, barley, and various other grains. As you can imagine, gluten is therefore present in many common food and beverage products such as pasta, cereal, and beer.

If you are gluten-intolerant, you may experience feeling bloated or nauseated after consuming gluten. A sense of fatigue can also be a symptom. Though anyone can either be born with or develop gluten intolerance, also known as non-celiac gluten sensitivity (NCGS), the condition tends to be more present in women. The causes for gluten intolerance are still a mystery, though some research has suggested that, rather than gluten, people are actually sensitive to a particular carbohydrate in a wide variety of foods. At the same time, other research indicates that gluten may impact the lining of the digestive tract in certain people, leading to inflammation.

In addition to being present in food and drinks, gluten can also be found in some vitamins and medications. One medication that includes a wheat derivative is the over-the-counter sleep aid and pain relief drug Advil PM, meaning it is not gluten-free — so if you're on a gluten-free diet, you should avoid taking it or speak with your doctor before you do.

Gluten intolerance vs celiac disease: What's the difference?

While many use gluten intolerance, or NCGS, and celiac disease interchangeably, these are different conditions. The American Academy of Allergy, Asthma & Immunology (AAAAI) explains that NCGS describes those who seem to have a symptomatic response to gluten, but whose blood and tissues exhibit no signs of celiac disease.

On the other hand, celiac disease is a chronic autoimmune disease within the small intestine. Experts estimate that celiac disease affects between 1% and 4% of the world's population. For those with celiac disease, ingesting even a minute amount of gluten can lead to dangerous health consequences within and without the small intestine, including chronic diarrhea, food absorption issues, weight loss, anemia, chronic fatigue, and cancer, among others. For this reason, people with celiac need to take special care to avoid consuming gluten, such as that found in medications like Advil PM. If someone with celiac disease does not seek treatment, they are also at greater risk of developing other serious health issues, such as Addison's disease and thyroid and liver disorders. Diagnosis of celiac disease usually requires a blood test and possibly a biopsy and endoscopy, per AAAAI.

However, confirming NCGS can be more challenging, as there is no singular testing method. Even so, doctors will typically diagnose NCGS by conducting tests that rule out celiac disease or a wheat allergy. A doctor will conduct blood tests, skin prick tests, and food challenges. If tests come back negative for celiac disease and a wheat allergy, but the patient is experiencing symptoms when consuming gluten, there is a good chance the cause is gluten sensitivity, per Beyond Celiac.

Gluten-free diet dos and don'ts

Whether you're engaging in a gluten-free diet for medical or other reasons, it's important to keep in mind that by avoiding foods containing gluten you're also excluding foods that the body counts on for certain nutrients. For instance, the Mayo Clinic points out that foods such as whole-grain bread that are not permitted on the gluten-free diet often either naturally contain or are enriched with iron, calcium, and fiber among other important nutrients. Consequently, you should work with a doctor or nutritionist to find alternative, healthy, gluten-free foods that provide the same vitamins and minerals.

And if you get aches and pains while trying to stay gluten-free, you may want to dig more deeply into the ingredients of any prescription or over-the-counter medications you are taking. It's important to note that drug manufacturers aren't currently required to flag gluten or other potential allergens on their product labels, though some choose to list inactive ingredients voluntarily. On drug labels, some ingredients to watch out for include wheat starch, modified starch, dextrates, and more (per Beyond Celiac). Though the majority of oral medications don't contain gluten, some do — and others, like certain non-steroidal anti-inflammatory drugs (NSAIDs), may worsen celiac symptoms for other reasons (per Pharmacy Times). For the most reliable information on whether a medication is gluten-free, contact the drug manufacturer or consult your pharmacist.