Why would getting a formal diagnosis matter if you’re already on a gluten-free diet? First of all, it’s a genetic disease, so you’ll know to test your family. More significantly, though, many people on so-called gluten-free diets are not actually on truly gluten-free diets. Even twenty parts per million can be toxic to someone with celiac. Sometimes, even foods labeled “gluten-free” may not be safe for celiac sufferers.