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I would worry about purchasing gluten free pizza from a regular pizza shop due to cross contamination. I'm not sure how they can keep it separate especially if they are making their own crusts. But other than that if you're comfortable with how the food is prepared it should be okay.

Expanding on this- Flour stays in the air for around a day or two, and lands on surfaces, including prep areas, tools, and in toppings. Most pizza places with gluten free options use the same toppings as regular pizza. So that hand that just touched wheat dough is grabbing toppings that are used for the GF crust. Some may have separate toppings, and that's a little better, but you still have the flour issue. And then you've got to factor in human error. Grabbing the wrong crust but still marking the box GF (! Ask me how I know this one!). Not switching gloves. Sitting the gf pizza crust down on the gluten surface. Using toppings that aren't set aside for GF pizzas. My hard rule is that I won't eat at a place that has much flour in the air. And that if flour is in the air, gf stuff is prepped in another area. That limits a lot of pizza places and places that make their own pasta fresh- regular bakeries with a few GF offerings as well. My kid and I both have some food allergies, and we completely cut gluten at home because of me. We've had to learn to be flexible, and to redirect things into positives, especially when making changes to things like bakery day (which was hard because we used to live in a mix use building above an award winning bakery 😭). But through a lot of positive rerouting, we developed our own new traditions. The key thing is not to emphasize what the child "can't have anymore". Like "we can't do pizza night because of your celiac disease" would hit a kid hard and direct their focus to what they can't have. Keep the focus on trying something new, and answer honestly while directing forward if they ask why. (Idk their age. So tweak this more age appropriately as needed) "Pizza from this place is causing problems for your tummy. So we're going to try something new and fun that won't cause anyone's tummy any problems! I have all these toppings and I need you to be the chef. You decide what goes where and then put all the toppings on!".... Sorry this got so long. It hits close to home. PS- also recommend packing celiac safe snacks if your kiddo is going to a friend's- maybe enough to share. And also packing an equivalent safe treat for things like birthday parties. You got this! :)

I don’t eat anything from places that make pizza. Not even a bowl of olives is safe. Pizza definitely not. Make it at home. It’s fun, and you get to choose your favourite topping.

I've worked in a pizza restaurant for 5 years. I can confirm that all of this is true. I generally tell people who ask that I can't even sell them a gluten free salad since the flour is *everywhere*.

This is an excellent response.

I get sick everytime if it’s not the one place that has a dedicated space for it.

Oh, I'm so sorry. I use a 32 oz Elvira jug that I fill twice a day with an electrolyte mixer. It keeps it cool enough. I don't wash it everyday as I don't have the strength to wash things either. It's usually about once a week. I'm sure that's not the best but it's the best I can do.

If you feel the restaurants are safe and taking precautions, do what works for you and your family!

It’s so nice to see a sensible answer here. Most of us celiacs or celiac care givers eat out regularly at places we feel are safe with no issues.

That was unnecessary. So, you think people who are more cautious are NOT sensible? When the leading research suggests that even restaurants that claim they are celiac friendly and have seperate workspaces, etc are still cross contaminating the food they serve to an unsafe degree 1/3 of the time? And that’s just the places that would be considered the MOST safe? And that number goes up to 50% when it’s gluten free pizza?

Yes it was necessary. This sub promotes an excessive amount of fear for most newly diagnosed celiacs. I understand some folks have a harder time than others but there is entirely too much fear mongering here.

It’s not fear mongering, it’s laying out the truth. I think a lot of people really don’t want to have to take those extra precautions and inconvenience themselves to that degree so instead shame the people who are advocating for medically recommended precautions. The fact that YOU take it a step farther and shame those people says quite a bit about your subconscious motivations here. Now, for the purposes of this comment I called out this behavior as I see it, but generally it’s those of you who are always saying everyone else is being too finicky that take it to name calling and shaming, while the “be cautious” crowd are only stating facts and experiences. There is no reason to feel the need to call it out unless you have a reason to feel defensive. If you don’t feel like doing the extra work (hopefully for yourself and not for a child who can’t make the decision for themselves) then fine, but don’t advocate for others to take risks with their children’s health.

It becomes fear mongering when people try and argue that X is not safe period when the person asking has no reason to show they are having a negative effect from it. If a person has no reactions and if they are getting follow up testing that shows normal numbers again there is no reason they should make their lives harder. If someone has reactions still or has increased numbers that are not going down then sure they should take more precautions. But not everyone needs to work at the same risk aversion level and it’s causing harm to imply that everyone should.

100% agree and it’s the exact advice I received from my gastroenterologist and primary care doctor.

“No reason to show they are having a negative reaction from it” does not mean no negative reaction is happening. And again, it’s fine to make the decision for yourself to take risks with your own health if the cost/benefit analysis makes sense to you. But if someone wants to prioritize their health, both immediate or long term, or even more so the health of their child, then they need to know the scientific FACT behind eating out…that’s it’s a huge gamble that you are going to lose roughly half of the time unless you are EXTREMELY cautious. Those are the FACTS. And as someone who has developed multiple autoimmune diseases and lost their fertility due to the long term damage celiac disease did over my lifetime being left untreated, i advocate for caution in these cases because of those consequences. When a newly diagnosed person is in here, they should be given the actual facts as to what can and will damage their intestinal lining, symptoms or not. Because a newly diagnosed person is scared and stressed and would love to hang on to the idea that it’s fine to eat out regularly. Ans again, it’s fine to have all of the information and to make that decision for yourself, but let’s not lie to them and tell them that it’s safe when it’s not. It’s been proven not to be. *edit to say that numbers don’t show the entire picture either, as I have been tested after a confirmed glutening that totally wrecked me and my numbers were barely elevated.

… read the rest of the point I made. If they have normal blood work that means their body is NOT reacting and thus NOT causing damage.

Read the rest of mine. That’s not always the case or even mostly the case. There is a reason that the gluten challenge involves eating gluten every day for weeks. It is VERY likely not to catch mild levels of contamination. Now, again, I pass no judgement on anyone who wants to use those parameters on themselves because it’s their life, but you need to stop passing your apathy off as facts. Newly diagnosed patients and parents of newly diagnosed patients should make those decisions understanding all of the risks FULLY. Not a watered down version designed to make you and them feel more comfortable.

If you’re not having immune response then how can you possibly be having immune system caused damage?

I personally wouldn’t trust anywhere unless they are dedicated which leaves you with 3 options. Having worked in restaurants - CC is just too big of a risk that they don’t take seriously even if they tell you otherwise. Especially pizza places. If they also do regular gluten pizzas it’s an automatic no.

If I had options that were safe and cost effective I would probably order a lot more, but I just haven’t discovered a lot of good places in my city (despite it being somewhere that I would expect to have a lot more options). Then again maybe I just haven’t taken the time to really search out places.

Please ALWAYS tells them your child is celiac and must be gluten free, cross contamination is the main way I get glutened. Even with telling them you run the risk. Make friends with the staff, they will always wash an extra dish for you.

I eat out quite a bit, but I never do delivery. I need to be able to talk face to face to the person making my food for me.

Yes. I have my trusted restaurants and eat from them. There are two places in my town owned by a couple whose daughter has celiac, another with a dedicated kitchen because his niece has it, and a couple of others with strict protocols.

I don’t, but I might if there were spots near me that I trusted enough to not order in person. I do takeout once a week or so though, similar idea. There’s a fast casual mexican spot and a fast casual Japanese spot near me that I feel safe eating at. A side note: Pizza spots are at the top of my “not gonna risk it” list, though, because of the flour flying around everywhere. But our personal comfort levels are all different. I dunno how sensitive or symptomatic he is but just be extra cautious with places whose main focus is wheat flour.

Ordering pizza from places that have non-GF pizza is a no for me, just too much flour flying around. So when my family orders pizza, I bake myself a frozen GF pizza. There are some good ones.

I don’t eat out less, I just only go to places I know will take care of me.

Whether this is a good idea depends very much on the restaurants. Since kids aren't always great at communicating about symptoms be sure to get regular follow-up such as repeat serology and other non-specific blood markers (eg. CBC, C reactive protein). This is the sort of protocol that any person with celiac should be doing but I think it's especially important if one eats out a lot. If your son's results are good and he feels fine then whatever you're doing is probably fine. I'd be cautious on the pizza though - it's really tough to make a safe GF pizza unless there's a separate kitchen due to the flour aspect + CC of toppings.

As a celiac who has worked in a pizza place… no pizza place is safe to eat from… if u need to prove it to him get a blood test they are relatively cheap considering that you eat out twice a week.

Keep in mind that you have to eat full on gluteny meals for 6 weeks to test positive on a blood test. So many people have completely normal bloodwork even if they are regularly getting cross contaminated.

In this case no… you would actually just eat out a bunch in a week or 2 and then get a test to see if eating out is causing any issues at all

Ttg-IgA and other celiac labs are not sensitive enough to show if you are reacting to cross contamination.

Huh? Wdym? to my knowledge the ttgia will show if your body has reacted for the past month and give you an amount of ttgia that corresponds to how much you’ve reacted, as long as it’s more than 20ppm

Yes, but it takes eating straight up gluteny meals to register. The recommendation before trying to get a positive result is to eat two servings of gluten a day for 6 weeks. That's because it's known to not register smaller amounts of gluten than that. It cannot be used to test if you're getting cross contaminated, only if you're eating regular gluteny foods.

Depends on where you're located and how the restaurants are in terms of handling cross contamination. Personally, I only order from dedicated gluten-free restaurants and bakeries since the risk of cross contamination is massive in non-dedicated places. That said, some regulated countries like Italy will be fairly safe.

My kid wasn’t properly on the growth chart for 12 years so we avoided eating out regularly.

Yes, my husband is Celiac and gets food from restaurants (takeout/delivery) two or three times a week. There is a limited range of places that he can get gluten-free meals from but it's enough of a variety for him.

I was once very glutened to the lvl I thought I had regular pizza instead of a GF one but I think it was just some serious CC... Even though the restaurant had it labelled GF and all that. I was seeing a guy back then who mostly ate GF due to other issues, we both had the same pizza base and he had none of what I had even though he says he feels he is sensitive, nope - me a WHOLE another lvl. And that was NOT FUN ;(

You’re going to get a lot of conflicting opinions. At the end of the day the only thing that should matter is your son’s health. If you can monitor him and be sure he isn’t getting glutened and his health isn’t being compromised, go for it. Many celiacs aren’t comfortable with eating out (with good reason) others feel comfortable while taking precautions (like me). Neither are right or wrong. Do what works for you and your family as long as your child is healthy.

I stopped going out to non-gf restaurants after my doctor said my levels are not going down after 2 years knowing.

Eating out is fine.  Eating at pizza parlors are not fine. I promise your kid is getting CC from that place every single time. I worked in one just before my diagnosis. Flour on the clothes. The aprons. Hair. Every single surface. Walls. Floors. Wire racks. Cutting boards. Pizza slicer. Boxes.  It's just not safe, not matter what they promise. Same as getting gluten free baked goods from a classic, non-gf bakery. Just not safe. Flour is everywhere. 

I personally order out twice a week, but from the same places. One is a pizza place (I order the salad, and they have strict cc protocols), and the other is a sushi place. I have ordered at each 30+ times and been fine. I think if you are able to do it without issues then I say go for it. Everyone has their own comfort level with the amount of risk they are willing to take. This board tends to skew a little more towards the risk averse, which is fine but there are plenty of people with celiac who order out a decent amount and are successful at doing so.

Best thing to do is confirm the restaurants online with other celiacs in the area with your local areas Reddit page ex: r/newyorkcity

It's very unsafe unless these restaurants are dedicated gluten free, which is very rare. He's probably getting cross contaminated most of the time...

I eat own quite often, at least once a week (Buffalo Wild Wings every Tuesday) + several trusted restaurants when my mom doesn’t feel like cooking. If your local pizza place(s) are aware of celiac that’s great. If you haven’t already I’d ask them how their gf pizza is prepared, if it’s separate, etc. Still, make sure you stress the importance of gluten free/being prepared separately every time! This goes for any takeout and in person restaurant. Big tip is for pizza is ask them not to cut it, have your own dedicated pizza cutter at home. Based on experience, even if things are prepared separately someone might cut it with a gluten contaminated cutter without even thinking. Make sure to monitor your son’s reactions all the while. Someone else said this but making friends with staff at places you frequent will do wonders! I happen to be friends with a local pizza shop owner prior to my diagnosis and he hooks me up with safe pizza.

It's Russian roulette. Some nights you'll be fine and others you'll be glued to the toilet seat.

Is your child still experiencing any symptoms? Honestly don’t crowdsource your child’s long term health, look at the research. Pizza labeled gluten free in restaurants has been found to contain an unsafe amount of gluten 50% of the time. About 30% of food labeled gluten free in restaurants is also not actually safe. I worked in restaurants and can tell you, most are not going to be able to guarantee a safe environment to make gluten free food…though plenty will claim they can out of ignorance and lack of caring. Eliminating eating at any establishment that works with flour regularly is a good precaution to take..it gets everywhere no matter what you try to do to mitigate it. I see a lot of people saying “do what works for your family”. And yes….but no? My long term health has absolutely been negatively affected in a way that significantly impacts my life due to my family not treating celiac disease as a child. It’s not worth it imo.

Yes. Granted I’m relatively asymptomatic but I don’t limit how much I eat out based on celiac. I just aim for GF friendly places and order GF items

There are 2 parts to your question. 1. Is it OK to order takeaway twice a week? Yes, if that works for you and forms a part of a balanced diet it's perfectly fine. 2. Is it OK to order takeaway as a coeliac? If you trust these to know what they're doing, go for it. If in doubt, don't.

I eat out at least twice a week. Fairly recently diagnosed and have a few other things going on as well which means I'm still exhausted a lot of the time, so ordering food is a god send. I pick my places beforehand, let the places know, and they're generally pretty good. My ttG has gone from 680 to 90 in 4 months so I guess I'm doing ok. Got a way to go, but once it gets down further, if eating out is keeping that level up, I might have to reconsider my choices.

I order gluten-free pizza once in awhile and have never had a problem.

I'd keep a close eye on his symptoms. There's nothing wrong with ordering out twice a week as long as they're careful, and I've found even restaurants that have gluten free options and seem to be aware mess up ALL the time. I also check the 'find me gf' app to see other reviews and safety info.

I ordered a gluten-free pizza from pizza hut once, luckily I knew what their gluten free pizzas look like because immediately I knew something was wrong. I looked at the receipt and they had sent a small pizza instead of a gluten-free one. I called the customer service and explained how serious this could have been and they gave me a credit for two free pizzas which was nice. Just be very careful.

How long has your son been diagnosed? Is he able to distinguish any reaction that he has from gluten ingestion? Are you able to have his antibody levels tested regularly? His physical reactions and antibody levels are going to be the true indicators of whether he's adequately adhering to a GF diet.

I got diagnosed in December. Had a ttc-iga level of 97. I went strict gluten free at home but we still go out once or twice a week to restaurants that I feel safe going to. I got another celiac panel last week. I have been GF for 3.5 months and my level was at a 6. My doctor told me to expect a level around 20-30 since it had only been a few months. So with this knowledge, I still feel safe eating out on occasion. I would just keep regular booodwork appointments and adjust if his levels aren’t improving. Too many people see celiac as an end all when it comes to eating out, but I do feel like it is possible to safely navigate eating out, it just requires more research and effort to find good places.

Seems expensive but I don’t see an issue otherwise.