Living with Celiac while Living Overseas

Back in November 2020, I was with my sister, brother-in-law, and roommate in Berat, Albania on the day after Thanksgiving when I got back my endoscopy results and learned I have celiac disease. I had been feeling horrible for months and I was afraid it was something like cancer, so when the doctor told me it was Celiac, I breathed a sigh of relief. I had no idea how serious Celiac disease is or what this journey would entail. I had been living in the Balkans nearly 3 years and knew that was where I wanted to be. At the same time, I imagined that adjusting my lifestyle to be 100% gluten-free was going to be a significant challenge though not impossible.

Here I am 6 months later saying that it hasn’t been impossible. Difficult, yes. Isolating, sometimes. Time-consuming, definitely. But I’m experiencing God’s grace here. I’ve learned how to make so many tasty, nutritious meals. So many friends have loved me in a new way – by preparing gluten-free foods or choosing to go to restaurants based on my comfort level. I’ve had to ask for help and be a burden, in ways that I never would have wanted, but in ways that have humbled and changed me for the better.

There are, in fact, several things I love about being gluten-free while living in the Balkans. In this article, I want to share the bright side and, in the process, hopefully provide a resource for others who are living or traveling in the Balkans with Celiac Disease. Friend, you are not facing this and you can do this. Here’s what I’ve learned these past months.

What I Love:

1- Fresh produce! They say that the best way to eat gluten-free is by consuming products that are naturally gluten-free like fruit, vegetables, meat, and nuts. In the Balkans, produce is so reasonably priced! The other day I picked up a container of strawberries, 3 avocados, a bunch of bananas, 1/2 kilo of carrots, a bag of arugula, garlic, 2 lemons, 2 zucchini, and fresh parsley for just $12. I love making smoothies, salads, and stir-fry dishes. Reasonably-priced produce is such a blessing to me since most other aspects of eating gluten-free are more expensive.

2- Going for coffee. The most common way that Albanians relax and hang out is by going for coffee (or tea or juice) rather than for meals. Part of the reason for this is that going for coffee is so cheap (just $1 or less) and that coffee bars won’t ever kick you out for staying too long to socialize. This is THE BEST in my opinion, because I can still enjoy spending regular time with friends without even having to mention my diet restrictions.

3- Italian and German brands. Because the Balkan countries are smaller, a lot of products are imported from Germany and Italy. Both Germany and Italy have a higher awareness of Celiac disease and clearly label their gluten-free products. While in Albania, I’ve had a lot of luck finding GF products at Conad, Spar, and Rossman, as well as Bio-Ju and Baronesha in the Bllok neighborhood of Tirana. In Macedonia, gluten-free products have been more scattered across different grocery store chains, with DM (Deutsch Markt) being the most reliable store for essentials and snacks. I love the brand Schär for alternative bread products and BioCosmos for peanut and almond butters. I was so grateful when I was diagnosed that at least I can still eat peanut butter!

4- Hospitality culture. The Balkans consist of hospitality cultures, which means that treating visitors and guests with the utmost care and respect is a high value. For example, I recently had a conference at Llogara Resort in Southern Albania and was amazed by how accommodating they were during my week-long stay. I texted them ahead-of-time, explaining celiac disease, and they said they offered to buy gluten-free pasta and bread for me. When I arrived, I talked with the head chef, a sweet woman named Shega, who graciously took on the challenge of preparing food for me. She followed my specific instructions about keeping my food separate and checked in on me during the week to make sure I was feeling well. I have also experienced this same gracious hospitality from friends who invited me to an Iftar meal and made it gluten-free for me, as well as other friends who have stocked gluten-free snack shelves in their kitchens with food just for me.

5- Some awareness. Though there are no exclusively gluten-free restaurants that I know of in North Macedonia or Albania, it seems to me that there is growing awareness in the restaurant industry. In Skopje, both Forza and Markt Kitchen have several menu items that are gluten-free. I ordered a salad at Veneto in City Mall, asking them to be careful, and didn’t have any problems. In Tirana, I’ve had delicious meals at Tony’s (GF pizza), Era (salmon salad), A La Sante (vegetable risotto), the Stephen Center (brunch foods), and Green and Protein (salads). I’m excited to discover many more restaurants in both Skopje and Tirana over the following years, and I’ll be sure to keep you updated about my discoveries.

In addition to this joys, I wanted to share a few specific roadblocks I've run into when trying to live gluten-free in the Balkans.

What is Hard:

1- Traditional foods. Bread is a big deal in the Balkans, and especially in Albania. Most people, if they want to ask you if you’ve had lunch already, will say, “A ke ngrene buke?” which literally means, “Have you eaten bread?” Before I was diagnosed with Celiac, I used to love cooking authentic Albanian dishes with my friends in their homes. One of my favorites to prepare was byrek, a flaky pastry crust filled with cheese and spinach or other vegetables. This was so tasty and baking it was a special way to embrace the culture in my new home. It’s hard that I have to miss out on many of these traditional foods now, since cross-contamination is a real issue.

2- Traveling. As I’ve mentioned before, if you’re in bigger cities, there are restaurants with gluten-free options. Unfortunately, it gets a bit more dicey in smaller cities and towns. I’m still figuring out how to make this work for the future, as I love exploring other beautiful places around the Balkans with friends.

3- Packaged nuts. I struggled a lot during my first month being gluten-free because, without realizing it, I ate packaged nuts that contain gluten. Since then, the only brands of nuts and trail mixes that I’ve come to trust are the ones sold at DM and Rossman. I also buy nuts from local produce stands since they are often picked and sold directly, without being processed in a factory first.

4- Medicines. I’m pretty sensitive to any gluten contact, so even taking a Tylenol with starch (often gluten) in it will make me sick. I’ve asked around at several pharmacies but have not been able to find basic medicines like Tylenol or Claritin that are gluten-free. My mom mailed them to me from the U.S. and I plan to stock up on them every time I go back.

5- No gluten-free nutritionists. So far, I haven’t heard of any dieticians or nutritionists in the area who are knowledgeable specifically about Celiac Disease. They may be out there, but for now, I’m benefitting from resources that another friend with Celiac disease in Chicago has shared with me.

So there you have it! The difficult but not impossible art of living gluten-free in the Balkans.

With joy,

Annie