| I was diagnosed with celiac disease eight years ago — an autoimmune disorder where the body attacks its own gut lining if you eat gluten. Changing my diet was more than a health adjustment, it was also a financial one, and the price I’ve been paying to eat gluten-free has been adding up ever since. Britons with celiac pay up to 35% more for a weekly food shop, according to a 2024 study by Coeliac UK, a charity that helps people living with the disease. Nearly 9 of 10 respondents had difficulty obtaining gluten-free foods, and gluten-free bread was 4.5 times more expensive than a typical loaf. None of this surprised me. The only statistic I found really shocking was that 27% of Britons with celiac eat food with a “may contain” label to cut costs. This means that while a product is itself gluten-free, it is manufactured in an environment where it could come into contact with gluten. This is a risk I’d never take, so it’s pretty scary that some of my fellow celiacs feel financially forced to. I’m often asked what happens if I eat gluten. Unfortunately, there’s no simple answer. It’s a multi-system disorder, so the symptoms are different for everyone. The most common are stomach pain and fatigue, but joint pain, a blistering rash called dermatitis herpetiformis, or a disrupted menstrual cycle can occur too. With celiac disease, gluten triggers the immune system to attack villi, “thousands of tiny, finger-like projections” that line the small intestine, says David Sanders, a professor of gastreoenterology at the University of Sheffield in England. “It looks like someone has taken a razor and run it along the inside of the bowel.” Prolonged exposure to gluten can make it difficult to process nutrients from food, resulting in vitamin deficiencies, anemia and thin bones which can lead to osteoporosis, he says. If it keeps happening, there’s a risk of infertility and small bowel cancer. There’s also a greater chance of developing related disorders, or making existing ones worse. The genetics underlying celiac are linked with Type 1 diabetes, arthritis and thyroid disease, studies compiled by Celiac Disease Foundation show. This hit home for me when accidental gluten exposure landed me in the hospital with rheumatic fever, unable to move my fingers. It was a real wake-up call, and I ended up making my diet anti-inflammatory as well as gluten-free. Research into drug treatments to manage the body’s immune response is under way at Royal Hallamshire Hospital in Sheffield, where Sanders also consults. For now, he says, strict adherence to a gluten-free diet is the only treatment available. My own experience has also been shaped by an allergy to oats, which further restricts my choices and drives up the grocery bill. The Keto Hana granola I purchase at Holland & Barrett costs £6.75 ($9.25) for 300 grams, compared with £3.79 for a 380-gram package of Deliciously Ella Nutty Granola, which contains oats. Going out poses a separate challenge. I once went to a Michelin-starred restaurant in Berlin, where my date insisted that a place this good must have something I could eat. Alas, the kitchen couldn’t guarantee no cross-contamination, and I was memorably served a single boiled egg in its shell, presented in a bed of salt. I’d like to say this is a story to dine out on, but I haven’t actually dined out since. — Freya Jones | 
