This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc. Subscribe to FREE Celiac.com email alerts What are the major symptoms of celiac disease? Celiac Disease SymptomsWhat testing is available for celiac disease? - list blood tests, endo with biopsy, genetic test and enterolab (not diagnostic) Celiac Disease ScreeningInterpretation of Celiac Disease Blood Test ResultsCan I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful?The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-FreeIs celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic TestingIs there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and DisordersIs there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients)Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients)Gluten-Free Alcoholic BeveragesDistilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free?Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free DietFree recipes: Gluten-Free RecipesWhere can I buy gluten-free stuff? Support this site by shopping at The Celiac.com Store.For Additional Information: Subscribe to: Journal of Gluten Sensitivity
Have your doctor do tests for ferritin and serum copper to see if you are deficient in either of these trace minerals. Deficiency of the former can result in hair loss and deficiency of the latter can result in worsened glucose tolerance. When high fiber, gluten-free diets are very high in phytates, they can interfere with absorption of iron, copper, and other trace minerals.
One of the most powerful things you can do to reverse constipation and keep your bowels moving is exercise, and walking continuously for up to 30 minutes a day (if you are up to this) will help a great deal if you are not yet doing this. As for fiber, the best type of fiber is the natural fiber that is found in whole foods--vegetables and nuts. Although almost all vegetables can be beneficial, nondigestable carbohydrates called fructooligosaccharides (found in significant amounts in foods such as onions, garlic, asparagus, and artichoke) may be especially helpful because they promote and stimulate the growth of probiotic "bifidofacteria" in the gastrointestinal tract. These probiotic bacteria help to minimize inflammation caused by other bacteria that are normally found and grow in the gastrointestinal tract.
The research paper below from UCLA was one of the publications I referred to earlier. If you have an open mind, I would be interested in hearing from you whether or not you think this study was well done:
Opposing effects of n-6 and n-3 polyunsaturated fatty acids on pancreatic cancer growth.
This is my hypothesis: The protective molecules in the olive oil protect against the omega-6's in the olive oil; the vegetables have nothing that needs protecting against. The omega 3's in eggs from grass fed chickens protect against omega 6's in these same eggs on a one to one basis. The omega 3's in the eggs from grain fed chickens are markedly outnumbered by the omega 6's in these same eggs (15 to 1 according to the USDA study you brought to my attention). The protective molecules in the olive oil do not protect against additional omega 6's in the eggs from grain fed chickens.
Regarding further formal study I have done, I would prefer for personal reasons not to go into that at the present time. But I can assure you that my education and training beyond my undergraduate degree are quite solid. On the other hand, if the citation of additional formal study might influence you to more seriously consider what I am proposing, I would strongly urge you to get the following book: "Anti-Cancer: A New Way of Life" by David Servan-Schreiber, M.D., PhD. The physician who wrote this book developed a relatively aggressive type of brain cancer (glioblastoma multiforme) during his psychiatric residency, and went through surgery and chemotherapy only to have his tumor come back a few years later. Faced with a poor prognosis, he then decided to use all the latest knowledge in nutritional research to devise a diet that could slow the growth of his tumor. And he successfully went on for the next 10 years, living an active and productive life. Quite remarkable in my book. Reading his book was the first time I was exposed to the latest experimental research on omega-6 fatty acids. And the interesting thing is that I have seen individuals with cancer or autoimmune diseases benefit from his recommendations. On the other hand, I will be the first to admit that there is much that I still have to learn. That being said, I suspect that with your scientific background, you know as well as I do that observation is frequently the first step in the process of making new discoveries.
My undergraduate degree is in biology. As for protective molecules and physical proximity, I am basically referring to molecules and chemical reactions that most readily occur in a liquified medium. Solid food (such as vegetables cooked in olive oil) needs to be digested, broken down, and liqufied in the stomach before it absorbed. In my mind's eye, I visualize egg fats (omega 6's and omega 3's) being digested and coming in contact with (likely inflammed or previously damaged) mucusal epithelium or submucosa temporally close together. Because of the temporal closeness, chemical reactions (inflammatory and anti-inflammatory) can be affected by the relative concentrations of the omega 6 and omega 3 fatty acids (ie: a 15 to 1 ratio fosters the reactions promoted by the omega 6's). For olives, the omega 6's and the protective molecules (phenols like hydroxytyrosol and oleuropein, as well as other molecules that have antioxidant activity) are also temporally digested at the same time because they are present in the same whole food. For vegetables cooked in olive oil, the olive oil gets absorbed into and onto the vegetables, and the two are digested together. For high omega 6 eggs and vegetables cooked in olive oil, the two foods (which together are effectively not one whole food) are not digested and absorbed simultaneously (ie: the omega 6's from the eggs and the protective molecules from the olive oil saturated vegetables) hit the mucosa and submucosa at different times and in different locations). In addition, I would like to point out that because digested food is a mixture of solubilized molecules and undigestable fiber, I seriously doubt that all of the molecules in this mixture are evenly dispersed as one would expect if all constituents (including fiber) were solubilized and broken down into small molecules (ie: like sodium chloride in water).
I just expanded my post above with more detail, hopefully helping you to understand better what I think is going on here. As far as the different numbers, 20-30 to 1 vs. 15 to 1, different studies can come up with different results. The Greek egg study was about 1 to 1, and there is a big difference between 15 to 1 and 1 to 1. Omega 3's do have protective effects against omega 6's, so eggs with a 1 to 1 ratio are effectively much more balanced. Eggs with 15 to 1 ratios, on the other hand, are way out of balance. Please let me know what you think.
The egg data you cite for the omega-6 to omega-3 ratio of 15 to 1 comes from the USDA and is based on grain fed chickens here in the United States. The ratio of 1 to 1 which I cited comes from grass fed chickens in Greece and was published in the New England Journal of Medicine about 24 years ago:
n-3 fatty acids in eggs from range-fed Greek chickens.
You have some excellent questions. The fact of the matter is that olive oil is different than egg fat because it contains anti-inflammatory phenols like “hydroxytyrosol” and antibacterial phenols like “oleuropein”, as well as antioxidants which protect against damage from free radicals. Egg fats do not contain any of these protective molecules. I should add that these phenols and antioxidants are thought to play a major role in the widely touted beneficial aspects of the “Mediterranean Diet”. Now just to draw an analogy illustrating the importance of consuming protective molecules with inflammatory molecules, think of what happens when you drop a lit match on a pile of dry wood, and compare that to what happens when you simultaneously pour water with a lit match. I believe the same thing is happening in the gastrointestinal tract with these different sources of fat, both of which contain significant amounts of omega-6 fatty acids. I suspect the problem with your "simultaneous" consumption of olive oil and high omega 6 eggs in the same meal is that the physical distance between protective molecules in the olive oil and inflammatory omega 6's in the eggs is way too great on a molecular level to protect the gastrointestinal tract: the olive oil adherent to the vegetables and the egg particles are not liquid and do not mix instantaneously, something that would be required to prevent damage from being done to the gastrointestinal surface cells. Also, I should add that the inflammatory effects of omega 6's in the eggs and olive oil are additive--omega 6's in the olive oil do not swamp out omega 6's in the eggs. Finally, one has to consider the effect of relative concentrations of protective molecules versus inflammatory omega 6's: there are sufficient amounts of protective molecules in the olive oil to counteract inflammatory omega 6's in the olive oil, but not enough to also counteract omega 6's in the eggs. It is like having a football team with 11 players trying to neutralize a football team with 16 players--the 11 player team will generally be outplayed...
To illustrate what omega-6 fatty acids can do when they are administered in the lab without sufficient quantities of protective molecules, just take a look at the following recent publication from UCLA:
Opposing effects of n-6 and n-3 polyunsaturated fatty acids on pancreatic cancer growth.
There are indeed scientific explanations for a number of the food intolerances you have--explanations based on a number of publications in recent research publications:
eggs: In the United States, hens are fed grains, and the hens covert these grains into fat composed primarily of omega-6 fatty acids. On the other hand, hens in a number of European countries are grass fed, and grass is converted into a balance of omega-3 and omega-6 fatty acids. The difference between the two types of fatty acids is that omega-3 fatty acids are anti-inflammatory, and omega-6 fatty acids are pro-inflammatory. With regard to eggs from grass fed chickens, the omega 6 to omega 3 ratio is about 1 to 1. With regard to grain fed chickens, the omega 6 to omega 3 ratio is about 20-30 to 1. The conclusion in my mind is obvious. And earlier today, I actually read a post on this web site from a person with celiac disease who someone learned that grain fed eggs were causing her problems.
dairy: In the United State, cows are fed grains, similarly to chickens. The end result is similar to that found with eggs.
pears: An inflamed gastrointestinal tract can be a haven for growth of certain bacteria that are pro-inflammatory, and certain fruits and/or fruit juices can promote bacterial growth and add to this inflammation. Some research has found this to be the case with apple juice; and in my mind, it is not too far of a jump to think that this might also be the case in some people with pears or pear juice--especially if you consume alot of this (or any other fruit for that matter). In my opinion, one of the better types of fruits for a person with an inflamed gastrointestinal tracts is berries, which are rich in the naturally found sugar alcohol "xylitol", which inhibits growth of inflammatory bacteria. Interestingly, xylitol also decreases dental decay because of its antibacterial effects.
An excellent book about nutrition which goes into a lot more detail than what I have indicated above is "Anti-Cancer: A New Way of Life" by David Servan-Schreiber, M.D., PhD. Just Google the word "anti-cancer" and it will be right at the top of the list of web sites listed.
Wow. This is quite stunning. I have suspected for quite a while that something like this was possible in people with celiac disease, but you are the first individual I am aware of who has expressed these clear cut side effects from eggs. Eggs from grain fed chickens are very high in inflammatory omega 6 fatty acids, with an omega 6 to omega 3 fatty acid ratio of about 20-30 to 1. Eggs from 100% grass fed chickens are low in inflammatory omega 6 fatty acids, with an omega 6 to omega 3 fatty acid ratio of about 1 to 1. The first time I learned about this was reading the book "Anticancer: A New Way of Life" by David Servan-Schreiber, M.D., PhD.
The key here is to optimize the function of your immune system. And although you think you eat healthy, the fact is that most Americans do not because they are not sufficiently knowledgeable about nutrition and how the foods they eat can help or hinder. An excellent book that I highly recommend was written by a physician who developed brain cancer (glioblastoma multiforme), went through surgery and chemotherapy, had his brain cancer recur, and subsequently kept the cancer in check for the next 10 years by applying the latest discoveries in nutritional research to guide his diet. For this type of cancer, this was quite extraordinary. Unfortunately, he recently passed away from the cancer. His name was David Servan-Schreiber, M.D, PhD, and the title of the book was Anticancer--A New Way of Life. (The book can easily be found using Google and entering the word "anticancer"; it will be right at the top of the list of web pages selected.) In the book, he makes some of the following recommendations: Eat whole foods and keep away from foods containing added sugars. Avoid grain fed cattle, chickens, and eggs as these are very high in omega-6 fatty acids which promote growth of cancer cells and promote inflammation, the latter of which is not good for people with autoimmune diseases in my opinion. In the US, you will not be able to find 100% grass fed chickens or their eggs, and you will have to look around hard to find cows that are 100% grass fed. Just to give you an illustration of what grain feeding does to chickens, studies have shown that eggs from grass fed chickens have an omega 6 to omega 3 fatty acid ratio of about 1 to 1, whereas eggs from grain fed chickens (even if it is organic) is about 20-30 to 1. The conclusion is obvious. As for "farm raised" fish which are also raised on grains (like tilapia), the problem is the same: high in omega 6 fatty acids. On the other hand, wild caught fish do not have this problem. As for an ideal diet, most carbohydrate should be complex carbohydrate--not simple sugars that are found in fruits. I, myself, am a type 1 diabetic for almost 40 years, only on insulin and no other medications, and have absolutely no complications from my diabetes because I diligently control my blood sugars through optimal diet and daily exercise. I also follow many of the recommendations in Servan-Schreiber's book. I agree with you that healing the gut is key. Is your diet high is simple sugars or fruits? Do you know what your fasting blood sugar is?
Upper GI and lower GI normal--that's good. The fact that you have positive p anca, ana, and "sicca" suggests to me that some time of autoimmune phenomenon may be involved here. Are there any autoimmune diseases in any of your relatives? Whatever the case, take heart because even if it is some type of autoimmune phenomenon, it is my firm belief that it can be significantly improved through exercise and optimal diet--diet that is rich in healthful substances and which minimizes inflammatory substances. Without optimal diet and exercise, the immune system will not function in the healthiest fashion. So have you been diagnosed with any diseases for which you are presently on any medications? Are you overweight? Do you know what your fasting blood sugar is? By the way, when you say that your biopsy "looks like celiac but the biopsy will come back negative too", was the biopsy done after you had been eating a gluten-free diet for a long period of time?
Perhaps one of the most common causes of elevated cholesterol is glucose intolerance. Have you ever been diagnosed with diabetes? Even an elevated fasting blood sugar without overt diabetes can be associated with increased cholesterol--so have you had a recent fasting blood sugar done. If you do have glucose intolerance, this is most easily approached by daily exercise (minimum 30 minutes of continuous walking daily) and eliminating foods containing added sugar or sugar alcohols. Also, diets excessively rich in fruits can worsen glucose tolerance. A diet in which carbohydrates are carbohydrates from whole foods (gluten free grains and other foods rich in complex carbohydrates) and vegetables is best. As for fruit, berries in moderation are an excellent as they contain a number vitamins and other substances that promote health and have anti-cancer activity. The reason that watching your carbs helps you is that most of your elevated cholesterol is due to excess cholesterol that your body synthesizes, not too much cholesterol in your foods. Improve your glucose tolerance and you have a good chance of lowering your cholesterol. If you want to read about someone with elevated cholesterol and a history of familial heart disease who improved his health through diet and exercise, look up Nathan Pritikin. If you want to read about a well known person who strongly advocated exercise and avoidance of sweets and added sugars, look up Jack Lalanne.
If you look up the drug Terbinafine, you will see that one of the possible side effects is liver injury--so if your liver enzymes are elevated before you even start taking the drug, that might put you at greater risk for liver injury. Don't worry, however, about having taken the drug for such a short period of time. As for your elevated "liver enzymes", they might really reflect what is going on with you celiac condition and your gastrointestinal tract rather than what is going on with your liver since these tests can sometimes be elevated with diseases not involving the liver. Depending on what your liver enzyme test results were, your doctor may want to do some further testing to determine why they are elevated.
1. Do you have a diagnosis of celiac disease, or do you have a diagnosis of some other gastrointestinal disease?
2. Since you are unexpectedly losing weight now, has your doctor recently determined your fasting blood sugar to make sure that everything is OK with your blood sugar? Blood sugar problems can result in gastrointestinal as well as other health problems.
3. I have seen at least one publication suggesting that apple juice can worsen inflammatory bowel disease by promoting proliferation of inflammatory bacteria in the GI tract. I suspect consumption of large quantities of fruits might also worsen bowel disease in some individuals, especially those prone to glucose intolerance. If you do want to include fruit, berries are probably one of the best types because they contain naturally formed xylitol, a sugar alcohol that inhibits growth of inflammatory bacteria. But even excessive quantities of blueberries might be too much for you. I know that when I switched from apple juice to blueberry juice, I saw a significant improvement in my blood sugar control and GI tract function.