While the reported symptoms may be attributable to factors other than gluten, such as FODMAPs, fructose or lactose intolerance, or the “nocebo” effect, a recent double-blind study found that patients with challenged with vital wheat gluten exhibited an elevated interleukin-2 response in 97% of participants, which correlated with the severity of nausea and vomiting, in contrast to a sham low-FODMAP challenge (20). Here, IL2 is linked to lactose intolerance.