<<Disclaimer: Verify this information before applying it to your situation.>> My opinion based on seeing a large number of patients with celiac disease both in Ireland and in the USA, is that there is a remendous variablity in sensitivity to gluten in patients. I am frequently asked what is the most gluten a patient can tolerate and get away with it. How often can they deliberately cheat on the diet and get away it? How do they know if they have overdone it? Therre are no absolutely good answers to these questions. This is a short and generalised summary of my answers If eating it makes you sick avoid it.( dont assume its gluten that makes you sick ; it could be lactose intolerance) If you know it has gluten ( like wheat bread, bagels etc) avoid it. Follow up with your doctor with some objective test such as a biopsy and or blood tests ( antibodies to gliadin or similar tests). If these show there is still a problem, you must ask yourself if you gluten free enough? There are people who are exquisitily sensitive to minute quantities of gluten but they make up the minority of people with CD. What is minute? for some it is vinegar, others malt flavoring, others think of minute as a small slice of bread( wheat that is) What I mean by minute is less than the codex alimentarius agreed amount. People are unique, in their make up, hence their reactions to things are different both in type and severity. Those with a professional interest in any topic have to make some general assumptions based on aggregate data, Individuals must make their own minds up as to what is best for them, obviously and hopefully gaining some benefit from the experiences of others that gone before and from observers like Don Kasorda and myself. Discussing celiac disease can evoke some emotive issues, and responses, that in the e-mail world are not qualified by tonal inflections in the voice or gestures or mannerisms of the face to face conversations. Netiquette is a whole new skill that is strange to most of us, and we are all learning. Get well Stay well and be happy This opinion is not medical advice Nor is it the opinion of the US Government, the State of Iowa, the University of Iowa, Joe Murray MD University of Iowa