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Hello, I just wanted to see if anyone else had similar symptoms during recovery. After dealing with severe abdominal pain for a couple of months, an endoscopy/biopsy confirmed I had Celiac. For the first few weeks going gluten free, I was generally feeling better. While I still had symptoms, they weren’t usually severe and my appetite was returning. I was finally able to sleep through the night and wasn’t bedridden the majority of the time. Fast forward to yesterday (6 weeks post-diagnosis) and I’ve been sick as a dog. I’m almost back to where I was pre-diagnosis: waves of nausea, heartburn, joint pain (especially in hips), restlessness, fatigue, loss of appetite, brain fog, and water just goes through me so I’m urinating frequently. I’m confused because I’ve been so careful about not eating out, cross contamination, and sticking to the gluten-free diet. I feel miserable! I haven’t been able to get out of bed most of the day. Anyone else get these debilitating episodes?? The only thing I can think of is eating Aussie Bites within the past couple of days. They’re labeled as gluten-free but they have oats and millet, so maybe I’m sensitive to that. And I just read that they were likely stored in a facility containing wheat 🙄. I also was having lactose almost daily until I cut it out a couple days ago after reading that it can irritate the intestines. So I’m wondering first how others have been able to recover from severe flare ups. But also is it normal to just have crazy, seemingly random flare ups throughout your recovery like this? I’m feeling really stressed and demotivated because this illness takes up so much of my time and mental space. I’m a graduate student and this has really interfered with my productivity. If it helps, my TTG was high at diagnosis (above 250) and there was a lot of villi damage. I was also tested for diabetes and got the full panel (CBC, kidney, etc.) at time of diagnosis and all came back negative. Glucose was fine. Had abdominal CT scan, which was also normal, and I’m waiting to hear back on follow up TTG + vitamin lab work results.

I never really had much heartburn before my diagnosis of Celiac and consequent dietary changes. But since then, I have discovered Udis, Van's, Canyon Bakehouse, and many other gluten-free brands. About a year ago I began eating 2 waffles every day, 7 days a week with my breakfast. The waffles I was eating were Nature's Path and Van's, both which use very high amounts of sodium acid pyrophosphate. The waffles are mostly air and carbs. Within a few weeks I began to develop recurrent, very painful heartburn that would popup constantly. My tolerance for acidic foods declined--whereas previously it would take much more acidic foods to cause heartburn, now any amount, no matter how small, would cause heartburn. And it kept getting worse with each month to the point that I began to worry about my health. I developed GERD that wouldn't go away for 24 hours after eating an offending food. The offending foods list kept growing bigger and bigger to the point that almost anything would cause heartburn and some degree of GERD. So I eliminated almost all foods containing sodium acid pyrophosphate and the heartburn and GERD stopped. I can eat tomato-based foods again with either no discomfort or 5% of the discomfort I used to experience, and I can eat foods on the offending food list again with no heartburn at all. Despite searching the internet for hours for an answer to what was causing my heartburn and GERD, I found nothing definitive and had to figure it out on my own. Did you know there is absolutely nothing at all anywhere on the internet connecting sodium acid pyrophosphate with hearburn? To my knowledge this will be the first ever post on the topic on the entire internet. Either that, or both Google and DuckDuckGo are suppressing the information. Also, did you know that sodium acid pyrophosphate is an ingredient found in almost all aluminum-free baking powder? That's what I get for trying to eliminate aluminum! I am making the switch to single-action aluminum-free baking powder soon--single-action doesn't have this ingredient, but it's less convenient to use unfortunately. I'm interested to hear if it causes anyone else heartburn as well. I'm glad to be heartburn-free and comfortable for the first time in a year.

Open Letter to the many GI sufferers etc Part 1’ Like IBS, UC and other GI diseases like Infant Heartburn (GERD) that grows into (in time) to IBS, UC, Chron’s and NCGS as a teenager or Celiac disease in time as an adult— Look Beyond these symptom’s to the parent disease –- Pellagra. *** a couple of notes to begin with. You can see I meant this to be one post -- but as usual it got too long to read at one seating. 2) because I might be having a medical procedure soon (I am posting part 1) in case I don't get to part 2 until latter. ****This is only my experience (and my research) that has lead me to my conclusions. They are NOT endorsed by celiac.com nor should this blog post be considered and endorsement of these ideas by celiac.com. Thank you in advance for letting me share my opinions and conclusions. (God being my help) may this posterboy blog post benefit those who take the time to read them/it. What follows is something that has been on my heart to share for a while. It is my story only. . . yours may be different but I have found if it helps you . . . it will help others too! And as they say "Without Further Ado" Here are my thoughts about my original celiac diagnosis and what/why I think was also low in stomach acid but a proper diagnosis was not made because not enough/proper test's were done to rule it out as an official "differential diagnosis". If it is happening to me. . . it is happening to others! Below begins the body of blog post of "An Open Letter Part 1 to Fellow GI Sufferers" Because as I am fond of saying “To Educate is to (Truly) Free” God being my help 2 Timothy 2: 7 as always“Consider what I say; and the Lord give thee understanding in all things” this included and all the knowledge I have absorbed in 10 years of researching this topic for myself (God being my help) how I discovered this forgotten medical fact after 4 years of research (see below) and have been helping people for over 6 years (those who will listen) and who better to learn from than someone who has done it himself and not only for himself but 100’s of his friend too! See this celiac.com article where much of this information is summarized in something called a white paper about the “When Myth becomes Medical Fact People suffer unnecessarily; The Case of Mistaken Identity: How Pellagra now thought to be rare became known as Celiac Disease — A White Paper linked at the end of the article. Referenced here if you have not had a chance to read the article since it was featured on celiac.com https://www.celiac.com/articles/24658/1/A-Differential-Diagnosis-How-Pellagra-Can-be-Confused-with-Celiac-Disease/Page1.html “A white paper is an authoritative report or guide that informs readers concisely about a complex issue and presents the issuing body’s philosophy on the matter. It is meant to help readers understand a (complex) issue, solve a problem, or make a decision.” By reading this blog post I hope to convenience you that your experience can be the same as mine. A differential diagnosis is one of the best standard of medicine rarely practiced today and how specialists decide between competing diseases like UC or Chron’s or IBS or Celiac Disease and if I am right Co-Morbid Pellagra now forgotten for 75+ years since the “War on Pellagra” is now over according to medical professionals’ but sadly the battle rages on for at least for the 60 Million American’s alone who get (Infant) Heartburn once a month not counting the heartburn that grows up to be IBS, UC, Chron’s or Celiac disease. See link below from Creighton University that mention’s this medical fact. Pellagra is not a disease of TODAY. Celiac is the disease of Choice today! But in 58% of those diagnosed with Celiac TODAY 58% are Co-Morbid with Pellagra as I was and most ALL my friends because they ALL get better when they take the Niacinamide. I now it works. I have seen it work for too many people. And I believe it can/could work for you too! See end of this blog posts and my doctor does too. He now uses this method in his practice with great success! And it can work for you too! (I believe) Lord willing if you do as I suggest and take Niacinamide 2or 3/day for 6 months (see below). I now describe myself as the Celiac and Pellgara Posterboy as a “Former Celiac Sufferer” who blogs about digestive disorders that Co-Morbid Pellagra causes often presenting as other GI diseases like IBS, UC, Chons, NCGS and GERD” Note **** This IS NOT medical advice only my personal experience of how through deep research (and the Grace of God) after 4 years of study I found what the doctors have always known but overlook in treating the many symptoms of Celiac Disease. The true cause as recorded in medical textbooks the world over the cause of 90+ percent of Digestive disorders (I believe) is because of one Vitamin Deficiency/Dependency. This blog post and (Posterboy blog) is about that ONE nutrient/vitamin/mineral that is lacking and the causative agent for most Digestive Disorder(s) presenting as the Iceberg Disease(s) of Gluten Insensitivity aka Celiac Disease in its most advanced stage (with enough time). And I hope at least ONE other Celiac besides me will believe also and be helped from this post. As proven/researched by Prousky almost 17 years ago that low Niacin levels lead too low stomach acid. It is time this information was known by a wider audience – the Celiac audience. http://www.yourhealthbase.com/database/niacin-treats-digestive-problems.htm see also by posterboy blog about this topic. It is a devastating delay. 2 Timothy 2:7 “Consider what I say; and the Lord give thee understanding in all things” this included. When Celiac Disease points it head (rears it head) out of the water 20+ symptoms (known as associated diseases) have already presented themselves in various malady’s. When only 3 (the 3 Ds) symptoms where need 75 years ago to diagnose the condition once considered cured but is rampant in today’s society because we are more STRESSED than ever. Digestive disorders, dermatitis syndromes, and dementia disorders – known then as Pellagra 75+ years ago but now is known mostly as various GI diseases depending on how long or low you are in Pellagra Preventive Factor as it was called in the day. Here is the best research article I have ever read on the topic. https://www.hindawi.com/journals/cggr/2012/302875/ They called it “Lessons from Pellagra” but the problem is we haven’t learned them. What does this look like in human beings? If one is critically low in Niacin the 3 D’s of Pellagra (Dementias, Dermatitis’s, and Digestive Issues) show up. (see hindawi link about for the exhaustive complete diagnostic picture of all the ways Pellagra might present itself. It is very exhaustive and informative) We will not count the 4th D of death if you are reading this blog. Explained here well http://blogs.creighton.edu/heaney/2013/11/18/pellagra-and-the-four-ds/ To quote Dr. Heaney a Past Professor of Medicine at Creighton University “2014 marks the 100th anniversary of the war on Pellagra, a war that lasted nearly 25 of those years before victory could finally be declared. You have not heard of the war on Pellagra? The celebration is not on your calendar? You’re not alone.” I have been in remission now for 5+ years after suffering 30+ years. Remission is possible! From Pellagra! Epigenetics has been discovered as the cause for Pellagra being diagnosed as Non-Celiac Gluten Sensitivity (NCGS) or Celiac disease when Heartburn/Gerd then IBS etc. and NCGS in time grows up to become your Celiac Diagnosis. Learn how Lifestyle (STRESS) is a risk factor for Celiac Disease. see this article entitled ‘Lifestyle is a Risk Factor for Celiac Disease”. https://www.sciencedaily.com/releases/2015/11/151102100302.htm Quoting an article that appears on Celiac.com https://www.celiac.com/articles/24166/1/Could-Changing-Gut-Bacteria-Prevent-Celiac-Disease/Page1.html “According to Dr. Decker Butzner, a Calgary-based pediatric gastroenterologist, there are another triggering factor which we’ve never understood…[t]here is an environmental trigger.“ i,e. STRESS Have you been stressed of late? Stress is said to kill you well it also maims you. NCGS is that maiming of people who have eaten wheat without resetting their stress clock. Find out how you can reset your stress clock (my words). Also see this very well article on pregnancy. https://www.verywell.com/can-pregnancy-trigger-celiac-disease-562302 where they say quoting First Comes Baby, Then Comes Symptoms "Most women are diagnosed with celiac disease after at least one pregnancy — in fact, a comprehensive Italian study published in 2010 on the reproductive effects of celiac found that 85.7% of women received their celiac diagnosis following their first pregnancy." WE also know stress is a trigger for Celiac disease. https://www.celiac.com/articles/23506/1/Stress-Common-Before-Celiac-Diagnosis/Page1.html Join his friends who no longer suffer from heartburn, gas, constipation, diarrhea, IBS , UC, Chron’s and Ulcer’s etc. of NCGS/GERD. You too can be in remission in as little as six months if you follow this ground breaking discovery hidden in medical text books now brought to light about how to manage digestive stress from Pellagra. When he (God being his help) rediscovered Pellagra as a disease of TODAY now often Diagnosed as Celiac disease instead of one conquered 75+ years ago as the doctors teach. A brief history: over 4+ years ago after being able to eat gluten again after being Gluten Free for 4 years and suffering 30+ years before I received a diagnosis as Celiac disease I begun to realize I had low stomach acid instead. So now I speak about it freely and blog about it regularly with only modest success and why I participate on celiac.com to Educate those still suffering unnecessarily to help explain how Pellagra is often confused for many GI issues up to and including Celiac Disease in time – usually 10 years or more. *** This is not medical advice and should not be considered such. Results may vary. Always consult your doctor before making any changes to your diet or your prescribed medical regimen. After 4 years of research and 5+ years of GI symptom remission I am convinced more than ever that 90+ percent of the most common GERD/Gluten issues are related to sub-clinical presentation of Pellagra unrecognized in a clinical setting. So much so that I tell those who will listen. As I am fond of saying Learn from my mistakes. Honey is like knowledge sticky and sweet when good news comes. “This posterboy blog is just that storehouse of knowledge learned from life experiences. The blog’s author has been stung so you don’t have to be. No man is so dumb as the man who won’t learn from other people’s mistakes. Take as much honey (knowledge) as you can from my mistakes so bad health will not sting your quality of life. Feel free to ladle and dollop your life with the sweet stickiness of the truth found here. For honey like truth stick to you once in contact and you can’t just wash it away.” This posterboy blog is about my struggle to reach people yet only about 10 percent believe and are helped when they read these things though 95+ percent are helped when they treat their Pellagra symptoms with Niacinamide taking it 3 times/daily for 4 to 6 months. Education (this blog) is about raising the conversion rate so people don’t have to suffer any longer. I will go on telling those who will listen. How can they hear if no one tells’ them? Romans 10:14 (I speak as a man) Tell others about this blog post if you decide to try Niacinamide for yourself and see If it helps you. It will help others/them too most likely! At least it helps most of my friends that will/have believe/believed and tried it for themselves. Take the Niacinamide and get/be better in 6 months (begin BURPING) (w/o bloating I might add) for the first time in years IF EVER from Pellagra undiagnosed. No one seems to believe (or at least not many) becoming deficient in (a) vitamin or vitamin(s)/minerals will/can make us sick. What a novel concept. You would not think I would need to write a blog post to tell people that! Maybe it is not true in your case. But you won’t know if you don’t try it. All I know it has been true in my life! and Hundreds’ and hundreds’ of my friends. Thanks bee to God who helped me to see these things. 2 Corinthians (KJV) 1:3,4 3) “Blessed be God, even the Father of our Lord Jesus Christ, the Father of mercies, and the God of all comfort; 4) who comforteth us in all our tribulation, that we may be able to comfort them which are in any trouble, by the comfort wherewith we ourselves are comforted of God.” Tell someone (share) is all I ask tell others is all I ask –when you are BURPING for the first time in years or (EVER) – tell a friend about this blog post “is all I ask” but don’t let the chain break with you. There a lot of fellow sufferers’ who still need help. I always say the number one mistake people make with Niacinamide is not taking it long enough (3 to 6 months 3/day in divided doses) but now I am going to amend that. The number one mistake people make with GI problems is the mistake of not taking the Vitamin in the first place. The 2nd biggest mistake is they don’t take it long enough! If you want to try and educate your doctor/friends and think he/she/they will listen tell them how Niacinamide helped you or some fellow who says it helped him but I was too scared to try it. Maybe they will listen to your better than they will/do me. *** This is not medical advice and should not be considered such. Results may vary. Always consult your doctor before making any changes to your medical regimen. But mine has taken Niacinamide and his digestive/GI problems are in remission. And his difficult to help/treat patients who don’t respond to “popular” medicine’s like Linzess etc. are better for IBS-C. And have stopped the medicine because their symptoms are in remission. He has even given Niacinamide to his sister to help her Chrons symptoms’ though research bears this out people don’t (Heck doctors don’t even) well understand the connection. See this article entitled “Pellagra as the presenting manifestation of Crohn's disease.” https://www.ncbi.nlm.nih.gov/pubmed/7060914 (***Note: this is an update. I saw my doctor recently and he admitted as such. But I could see it in his eyes (and hear it in his voice) because it did not fit his paradigm (world view of Vitamins/medicine) he spoke only of her Chron’s being in remission. It never occurs too him that her co-morbid Pellagra is better and it (Pellagra) could be being misdiagnosed as Chron’s instead (and won’t/wouldn’t) even if I brought him the research.) But Vitamin(s)/Minerals especially Niacinamide and Magnesium don’t get the attention they deserve because Vitamins’ don’t have a USP today in this genetic age we now live in. They (drugs) are popular because they have drug companies who have the money to advertise them. I do not. I do not have a Unique Selling Position (USP). Nor do Vitamins these days! And I say too you too. Put your Pellagra symptoms into remission too! (Your Celiac diagnosis can remain your primary disease diagnosis) as the doctor's wonder why your (Pellagra misdiagnosed) symptom's are in remission. No body profits if you get better in 6 months or a year and you no longer need the Vitamin! We don’t’ get sick from being low in “a Medicine” to quote the frustrated pharmacist but a Vitamin. I usually end up giving Niacinamide away and often they (friends) give it back instead much like a Johnny Appleseed character. Such is the fear of Vitamins these days. See also the posterboy blog post on celiac.com why this is so. . . entitled it is time for a Vitamin Reformation; Why all the hate for Vitamin’s these days. 2 Timothy 2:7 “Consider what I say; and the Lord give thee understanding in all things” this included. I am just trying to help those who still haven’t heard yet Pellagra is being diagnosed as Celiac disease today and your Pellagra undiagnosed/mistakeningly diagnosed as Celiac can be in remission from a Vitamin deficiency. If we follow most normal paths’ for adoption it will take another 20 years (a generation) for the medical community to accept Pellagra as the proper diagnosis. ****Note: I am only reporting what medical journals have concluded. It is just not well understood today one disease is being diagnosed as the other because it can take a generation for this knowledge to filter down to the clinical level. How do we know this??? Or can we? The International Journal of Celiac disease notes this association/connection. http://pubs.sciepub.com/ijcd/3/1/6/ Not only did/does the Journal of Celiac cite common symptom’s 58 percent of the time in Celiac and Pellagra but they also cite that Pellagra has been described in a Celiac Disease diagnosis. Now if the symptoms’ are similar it is easy to confuse one disease for the other and if not well understood they might be considered “exceptional” or, i.e., not well understood and discounted as the cause. I would argue that it should be the other way around if the majority (58 Percent) of the time Pellagra symptoms are described in a Celiac diagnosis it stands to reason that medical science is identifying the wrong disease. The math doesn’t add up. 58% is the Majority (primary/parent) disease and as such should be treated first. Pellagra has 3 faces that often confuse doctors today but 75 years ago they were able to diagnose this disease with only 3 symptoms the D’s of Pellagra. Dementia’s, Digestive Disorder and Dermatitis issues. Are You starting to see a pattern here? If it starts with a D then Pellagra a Niacinamide deficiency is involved. Quoting the Celiac Posterboy “These D’s a Celiac patient encounters are not the sign of several different diseases but one parent disease Pellagra with many children.” I could go on and on and on . .. but there is no need for that. I need to stop for now. Either you will believe and be helped or go on suffering needlessly if indeed Pellagra is the parent disease and GERD, IBS, UC, Chrons, NCGS and Celiac disease it‘s unruly children. 2 Corinthians (KJV) 1:3,4 3) “Blessed be God, even the Father of our Lord Jesus Christ, the Father of mercies, and the God of all comfort; 4) who comforteth us in all our tribulation, that we may be able to comfort them which are in any trouble, by the comfort wherewith we ourselves are comforted of God.” ****Again this is not medical advice but it is too easy, simple and cheap not to try and see if it works for you . . . I have found it works for others. Remember Occams’ Razor. . . The Simple answer is a Vitamin. But convincing people of that fact has not been simple or easy. I can’t convince you either way. You will have to decide for yourself . . . I only know it help’s those (of my friends) who have tried it for themselves. Praise bee to God and I want other’s still suffering from Pellagra disease if the research is to be believed being diagnosed as Celiac disease to be the next to be helped Praise bee to God! But I know now you will have to discover it for yourself. I stand as your witness. I tried! Posterboy by the Grace of God, 2 Timothy 2:7 As always, “Consider what I say; and the Lord give thee understanding in all things” this included. **** I will update this blog post in a month to 6 weeks with Part 2 about how you can test these things for yourself (if I am not recovering (God forbid) from a medical procedure) depending on how and if my CT scan shows any blockage that might require a stent to be implanted like my brother had to have done. . . Otherwise I wish you all who read this posterboy blog post God speed! And good GI health soon! Praise bee to God if you are encouraged enough from this post to try the Niacinamide 3/day for 6 months for yourself.

Hi there! I am looking for insight from anyone that may have insight on what is going on in my body. I have had 6 years of fuzzy head and GI issues (bloating, constipation, nausea, pain, discomfort). I cut out gluten 3 years ago. Then did a IgG mediated food allergy test with a holistic doctor and did a food elimination diet based on those results. So I now avoid dairy and gluten and tomato. I notice i have flare ups when I consume corn so I am trying to be more strict about it lately but I get a week long of nausea/heartburn/acid reflux when i do eat it. I also started following a low fodmap diet a few months ago due to still not feeling great and when I follow all of these things (gluten free, dairy free, corn free, low fodmap) I feel the best I ever have, although it is very hard to sustain. Also, i still have random spouts of horrible heart burn and nausea occasionally and cannot pinpoint it. I also am on a PPI for this. I have had a hydrogen breath test in 2015 and it was negative. I also have had multiple EGD's and Colonoscopies that have been unrevealing besides a stomach ulcer which is now healed and some esophagus irritation most recently. I am now scared of eating so many foods because I have had so many days of not feeling right. I have considered getting more strict on the corn restriction or maybe considering nightshade free because I am not sure what to do/if Fodmap is really helping since it isnt all the time and I am stressed about what I can even eat anymore. Any suggestions or thoughts are appreciated! Thanks in advanced, Sara

Is it NCGS or Low stomach acid misdiagnosed Low Stomach Acid and Celiac Disease Dear Gluten Intolerant please consider Low Stomach Acid as a possible Differential Diagnosis as a possible way to achieve remission of your GI symptom's. “Consider what I say; and the Lord give thee understanding in all things” 2 Timothy 2: 7 Low stomach acid has now been linked to a probable cause of damage to the Small Intestine before and/or occurring with a Non-Celiac Gluten Sensitivity (NCGS) or Celiac diagnosis. See this research as reported on celiac.com that discusses the increased risk of/for someone to develop celiac disease after taking PPI’s. https://www.celiac.com/articles/23432/1/Do-Proton-Pump-Inhibitors-Increase-Risk-of-Celiac-Disease/Page1.html Note how the article starts quoting “Rates of celiac disease and the use of drugs to inhibit the secretion of stomach acid have both increased in recent decades. A research team recently set out to explore the association between anti-secretory medication exposure and subsequent development of celiac disease.” If these medicine are lowering stomach acid what cause effect relationship does/ could this have on Celaic/NCGS diagnosis is what he is postulating. He goes on to say without being very technical (read the whole article for yourself) that “The data clearly show that patients who use anti-secretory medications are at much greater risk for developing celiac disease following the use of these medicines. The fact that this connection persisted even after the team excluded prescriptions for anti-secretory medicines in the year preceding the celiac disease diagnosis suggests a causal relationship”. If even after a year OFF these medicines your chances of developing Celiac Disease (celiac disease) not to mention even NCGS which is much more prominent surely the researcher is correct in postulating that there is a cause and effect relationship between low stomach acid and NCGS and/or Celiac disease. Surely there is something we can learn here. I now postulate some homework for the reader of this blog post. Do some research for yourself and see if achlorhydia or hypochlorhydia symptoms don’t at least resemble in some manner all of the GI symptoms you have been having. (I note some of the many symptom’s low stomach acid can present with below as referenced from Dr. Myatt’s online article “What’s Burning You” for easy reference (It might not be what you think (my words)) It is important to note here that “some” symptoms does not mean all but many or several. It is called a differential diagnosis. It is an important diagnostic tool in medicine. Think of the tv show “House” where they spend the whole hour/over a week times going through the ‘differential diagnosis’ in short any one symptom can/have many different causes. The trick is how to quickly eliminate possible outcomes as symptoms (many) go up. All is usually never meet because that would make the disease in full outbreak and obvious even to the layman a condition described as “frank” or “classic” Scurvy or Rickets as an example. Sadly too often after 8 to 10+ years of testing after all the differential diagnosis’s are ruled out you are said by process of elimination to have Celiac Disease if you are lucky or maybe NCGS and not some other acronym GI disease as I like to refer to them as a group. GERD,IBS,UC, Chrons etc because if they turned down that street … . you are/could be in/at a dead end for they stop looking at the trigger (gluten) as the cause of your gastric upset/digestive disorder(s). So in summary if 3 or 4 or 5 or 6 of these symptoms overlap “many of’ these symptoms could be Low Stomach Acid related. IF that is the cause/case for you then there is hope! For remission! From Dr. Myatts’ Online article what’s burning you? From Dr. Myatts’ Online article what’s burning you? http://healthbeatnews.com/whats-burning-you/ Diseases Associated with Low Gastric Function Low stomach acid is associated with the following conditions: * Acne rosacea * Addison’s disease * Allergic reactions * Candidiasis (chronic) * Cardiac arrhythmias * Celiac disease * Childhood asthma * Chronic autoimmune hepatitis * Chronic cough * Dermatitis herpeteformis * Diabetes (type I) * Eczema * Gallbladder disease * GERD * Graves disease (hyperthyroid) * Iron deficiency anemia * Laryngitis (chronic) * Lupus erythromatosis * Macular degeneration * Multiple sclerosis * Muscle Cramps * Myasthenia gravis * Mycobacterium avium complex (MAC) * Osteoporosis * Pernicious anemia * Polymyalgia rheumatica * Reynaud’s syndrome * Rheumatoid arthritis * Scleroderma * Sjogren’s syndrome * Stomach cancer * Ulcerative colitis * Vitiligo When low in stomach acid we become low in essential nutrients Quoting from Dr. Myatts “what’s burning you” online article “Our bodies need 60 or so essential nutrients. “Essential” means that the body MUST have this nutrient or death will eventually ensue, and the nutrient must be obtained from diet because the body cannot manufacture it. Many of these essential nutrients require stomach acid for their assimilation. When stomach acid production declines, nutrient deficiencies begin. Calcium, for example, requires vigorous stomach acid in order to be assimilated. Interestingly, the rate of hip replacement surgery is much higher in people who routinely use antacids and acid-blocking drugs. We know that people who have “acid stomach” were already having trouble assimilating calcium from food and nutritional supplements due to lack of normal stomach acid production. When these symptoms are “band-aided” with drugs which decrease stomach acid even more, calcium assimilation can come to a near-halt. The result? Weak bones, hip fractures and joint complaints resulting in major surgery. Jonathan Wright, M.D., well-known and respected holistic physician, states that “Although research in this area is entirely inadequate, its been my linical observation that calcium, magnesium, iron, zinc, copper, chromium, selenium, manganese, vanadium, molybdenum, cobalt, and many other micro-trace elements are not nearly as well-absorbed in those with poor stomach acid as they are in those whose acid levels are normal. When we test plasma amino acid levels for those with poor stomach function, we frequently find lower than usual levels of one or more of the eight essential amino acids: isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. Often there are functional insufficiencies of folic acid and/or vitamin B12.” Remember, these are essential nutrients. Deficiencies of any single one of them can cause serious health problems over time. Weak bones, diminish immune function, failing memory, loss of eyesight and many other “diseases of aging” are often the result of decreased stomach function.” It is me again reader. So low stomach acid is the triggering agent (often) for low nutrients. Make too much sense! Now don’t take Vitamin’s for this condition where low Vitamins/Minerals are known to be low in patients who have this condition because . . . . (if you do you won’t need to keep coming back to the doctor) I can almost hear the doctor say now. Of course he/she doesn’t say that . . . just that the “average person” doesn’t need to take Vitamins. Well I hate to break it too you . . . . but if you are having GI problems and reading this blog post on celac.com then you are not the “average” person. You my friend or a sufferer or a friend of a sufferer still looking for answers. If that is you then consider taking either powdered stomach acid – Betaine HCL or taking Niacinamide to help you reset your stress clock. A Canadian researcher wrote about this connection 15+ years ago but still most doctors’ don’t understand this connection between about how “Niacin treats digestive Problems” Here is the full link so you can research it more yourself. http://orthomolecular.org/library/jom/2001/articles/2001-v16n04-p225.shtml And you might not after a first reading. I didn’t believe it myself for over a year . . . but every time I thought about it – it (Low Stomach Acid) made/makes the most sense to me. **** Note: research this yourself. Here is a link about how to take Betaine HCL (powdered stomach) for maximum effectiveness. http://20somethingallergies.com/how-much-hcl-do-i-take-learn-to-test-for-your-correct-dose/ Don’t take my blog post as medical advice. It is only what I did . . . it might not work for you but I think it is worth a try especially if you are not now taking an acid reducer. (see notes below about why this might) be more difficult if you are already taking an acid reducer . . . because the rebound wall (see chris kresser link) keeps us locked in . . . sometimes for years. Since I was not taking acid reducers at the time I took Betaine HCL my stomach problems improved and I am sharing this now in the hopes it might help yours too! Now back to (really) LOW stomach acid being diagnosed as HIGH stomach acid these days. How can we know if it truly high or low? You’ve heard the phrase timing is everything well it is here too! Timeline is important in any diagnosis. IF your stomach acid was HIGH as you often hear (everywhere) you hear take a Proton Pump Inhibitor aka acid reducer’s for heartburn/GERD (medical name for heartburn) then eating food (carbs, greasy things) wouldn’t bother you. The acid would cut it up but if it is already low/weak then even a little acid can burn your esophagus which is not coated like the stomach to protect you from high acid. BUT if it is low to start with then food will WEAKEN our/your acid so that you lose the food fight your in and things (carbs/fats) become to ferment, rancidify and cause heart burn. Leading in time to Non-Celiac disease first and with enough injury (and time) to Marsh lesions qualifying you for diagnosis as a Celiac candidate / patient. See above link between/about PPI’s in the year preceding a Celiac diagnosis. If you (can) be that patient and weight the xx number of years for all this damage to occur, there is a better way it is called digestion! A virtuous cycle can replace the vicious cycle you are now in – it is caused digestion. Digest your food with healthy stomach acid and your body will thank you for it with the God given burp. A healthy child burps (at 6 months of age normally) and a healthy adult should too and you will again after taken Niacinamide 3/day for 6 months or this is not the right diagnosis. *********Note this is not medical advice only my experience with Niacinamide and my many years researching this topic as a fellow sufferer. Let me make these disclaimer(s). If you are a) experiencing heartburn that causing vomiting (with unintended weight loss) you may have a special case of heartburn that feels like heartburn (on steroids) that is really Bile Reflux and taking Stomach is not something you should do without medical advice and supervision. See this NYtimes article that discusses the many complications often seen with Bile Reflux patients and why it is treated as Heartburn often and why Bile Reflux is especially hard to recover from. http://www.nytimes.com/2009/06/30/health/30brod.html you are already taking an acid reducer then the chance you will get better (off of acid reducers completely) is only 50/50 on your first try but going low CARB can help your transition. Otherwise most people will get better when taking BetaineHCL for gastric support and Niacinamide to help them/you reset your digestive processes. See this online article about how Jo Lynne Shane got off Nexium for good. http://www.jolynneshane.com/how-i-got-off-nexium-for-good.html and her Epilogue http://www.jolynneshane.com/epilogue.html You will see she still struggles some but is much better when she let her natural digestive juices do their job. I call it the “Natural Order of Things”. See this article about the digestion process being a North South Affair from the bodywisdom website http://bodywisdomnutrition.com/digestion-a-north-to-south-process/ Taking it (Niacinamide) (or any B-Vitamin) should be taken 2 to 3/day (too keep up serum levels) for 3 to 4 months (the time you can store B-Vitamins) in the liver mostly. Once you have a distinctive BURP that displaces the bloating and sense of “I am going to explode” if I eat another bite (though you haven’t eaten half your meal) then normal digestion is occurring again. If you stool did not sink before this process (of taking Niacinamide begun) and burping became your “new normal” then it (your stool) will begin to sink too! Burping without bloating is the “Natural Order” of good digestion. Don’t stop this process of taking B-Vitamins as Niacimaide or Slo-Niacin 2/day for at least 4 months then you should see most of your GI symptom’s go into remission. (I did not say "cure" but remission from your cross contamination's (flares/symptom's etc.) might be possible. Because our defenses are now strong enough to cut up proteins before they reach our small intestine (where most of the damage is done). Think of a castle with a moat around it (stomach acid is designed to protect us) when it is low (the moat doesn’t protect us) and when the moat is dry the castle becomes a ruin!!! So do proteins (lactose (casein), gluten, soy, seafood etc.) to our small intestines (they become ruined) when our stomach acid (moat) is low or worse dry! I repeat again Timeline is important in any diagnosis. All heartburn is not equal. IF your stomach acid is truly high then it WILL occur between meals when there is no food to tamp down the fire (occurring in your stomach) not your esophagus. The excess pressure from fermented carbs push open the trap door allowing the low acid you have to burn the lining of your uncoated esophagus. See also this online article by Chris Kresser to study this more about why/how this could be a case of medical misdiagnosis in more detail https://chriskresser.com/what-everybody-ought-to-know-but-doesnt-about-heartburn-gerd/ This is part of a 3 part series that I think you will find very informative. This (low stomach acid) is a vicious cycle. STRONG stomach acid makes it a virtuous circle/cycle. Now food benefits you because low acid not only causes heartburn it limits your body’s absorptive ability by limiting its ability to cut up your food into digestible peptides and amino acids which are no longer harmful to your Small Intestine but helpful to your overall health because nutrients can now be absorbed because the food particles are now small enough to not cause harm to your villi. I hope this is helpful and it helps you the way it helped me. Maybe it will help you in a similar manner. I write this only as a guidepost on your way. May you find your way back to digestive peace! The “Natural Order” of things! Praise bee to God! It is not a long way if you know the way . . . . from someone who has found his way back God being his help! There are more things I could say . . . but this post is getting kind of long but you get the gest. I noticed someone else on the celiac.com noticed the same improvement when they treated their low stomach acid and thought it was time a blog post talked about it. It is so much easier to consume all this information in one setting instead of hunting and peeking through several thread posts. Search for the posterboy on celiac.com and you will find it is my focus (how low stomach acid is misdiagnosed) and how Niacinamide helped me to restore its “Natural Order” in the digestive process because it helped me! Here is the link to the Prousky’s abstract. 15+ years is a long time for people to continue to suffer but if the research it right then Niacinamide might help you too! http://www.yourhealthbase.com/database/niacin-treats-digestive-problems.htm Let’s hope it is not another 15 years before doctor’s and people realize low stomach acid can explain many of the same symptom’s an IBS, NCGS or even a Celiac patient might experience given a long enough time for these conditions to develop from too low a stomach acid to protect our Small Intestine. See link at start of this blog post posted here again for convenience. https://www.celiac.com/articles/23432/1/Do-Proton-Pump-Inhibitors-Increase-Risk-of-Celiac-Disease/Page1.html And it is worth noting about the time Celiac disease started (began to be more prevalent) / to increase in the population Acid reducer’s became more and more popular. *** Some plot the increase in time to Roundup usage but I am not buying it. PPI’s increase seam more plausible to me based on the relatively new research (less than 5 years old) is pretty current by research standards and the near linear response to increased first H2 stomach acid reducer’s then PPI’s in the population at large. *****Note: after I finished writing this blog post new research that in my mind confirms this connection was reported on celiac.com today that notes the link between gastric pH and impaired nutrient absorption. This very topic as I was getting ready to publish my post about low stomach acid possibly being diagnosed as Celiac disease on my posterboy blog mentions how a Celiac patient’s absorption can be impaired by gastric pH. https://www.celiac.com/articles/24738/1/Can-Celiac-Disease-Impair-Drug-Therapy-in-Patients/Page1.html Where they (researchers) say/ask discussing Celiac Disease and whether it (celiac disease) can impair drug therapy in patients. Note the opening paragraph discussing this topic quoting “Celiac disease is associated with numerous chronic conditions, such as anemia and malabsorption of some critical vitamins. Changes in the gastrointestinal tract, rates of gastric emptying, and gastric pH are responsible for impaired vitamin and mineral absorption." i.e., low gastric pH can effect absorption. It stands to make reasonable sense to me they are related conditions and one is being diagnosed for the other often or at least one is being confused as the other and treating one (raising your stomach pH) might treat the other since many of the symptoms’ are the same. *** this/these opinion(s) are my own and do not reflect an endorsement by celiac.com of these ideas, comments, thoughts or opinions. I hope this helps! You the way it did me! Good luck on your continued journey, Remember **** This is not medical advice and should not be considered such. Results may vary. Always consult your doctor before making any changes to your regimen. 2 Timothy 2:7 Consider what I say; and the Lord give thee understanding in all things. Posterboy by the Grace of God,

Why and How Pellagra is (often) Confused with Celiac Disease and/or Digestive Problems ; The Science of Pellagra a Hidden Epidemic in the 21st Century presenting/revealing as Celiac Disease. When I was gluten intolerant following a Gluten Free diet religiously and newly diagnosed as a Celiac I began studying to see if there was a “cure” for this disease. About 3 years into my study of Celiac disease I begin to match up/cross reference symptoms of Low Stomach acid – Hypochlorhydria. It seemed obvious my symptoms were the same. See the link by Dr. Dana Myatt “What’s Burning You” that explains why this is so. https://www.drmyattswellnessclub.com/WhatsBurningYou.htm It was on that day the seed was planted that if I could begin to digest my food again then gluten would be cut up into harmless peptides. It would take another year before I had the courage of my conviction to actually try gluten again knowing the five alarm bathroom visit I would set off if I was wrong … but the research was clear the doctor’s had the wrong disease. I had become/was low in Stomach Acid. This post/thread on Celiac.com talks about the effects of leaky gut when your stomach acid is not strong enough to digest proteins – it is known as hydrolysis – to cleave by water and it explains why a healthy baby burps at 6 months of age and a healthy adult should too. https://www.celiac.com/forums/topic/117026-leaky-gut-intestinal-barrier-impairment-help/#comment-969684 (I didn’t know this at the time) but Celiac.com reported on this finding that Proton Pump Inhibitors can contribute to a Celiac Diagnosis. See this link https://www.celiac.com/articles/23432/1/Do-Proton-Pump-Inhibitors-Increase-Risk-of-Celiac-Disease/Page1.html Where the researchers concluded “Patients prescribed both proton pump inhibitors and histamine-2 receptor antagonists had an even higher risk for celiac disease .. . The data clearly show that patients who use anti-secretory medications are at much greater risk for developing celiac disease following the use of these medicines. The fact that this connection persisted even after the team excluded prescriptions for anti-secretory medicines in the year preceding the Celiac disease diagnosis suggests a causal relationship.” So this confirmed my hunch and over 3+ years of research. So with faith in myself and God that He had led me to this wisdom (2 Timothy 2:7) I began my journey back to peace with Gluten and health I had not known in over three decades. And after a year of being able to put my cross contamination issues in remission (no accident poisoning’s when dining out) – defeating my mortal enemy gluten I began to write about my opus /journey back to peace with gluten. “I Know World Peace is Easier”. Someone who I was explaining this too (or trying to explain this to) asked me but “why does this happen” and I didn’t have an answer for them. So that set me off again. If I could figure out by God’s Grace why this was happening then imagine all the suffering that could be avoided by people? Well after much study and the Grace of God – I did. STRESS! What happens when we are stressed – we burn energy and a lot of it? Fight or Flight right? All this fighting takes energy and lots of it to survive the body takes our energy reserves from other parts’ of the body when it does this too much or too often over a 3 to 4 month period our body becomes STRESSED out. This is the same amount of time our body can store B Vitamins usually in the Liver. Is there anything we can do to help with this STRESS we are experiencing or is it hopeless. No it/we are not helpless or hopeless if we will supplement (or feed our cravings) of the missing ingredient/nutrient then we can meet our need and remission from too much stress is obtained. Hence the Niacinamide Challenge I have mentioned elsewhere in this blog. Prousky talks about this in his seminal work “Is Vitamin B3 Dependency a Causal Factor in the Development of Hypochlorhydria and Achlorydia” linked here http://orthomolecular.org/library/jom/2001/articles/2001-v16n04-p225.shtml where he theorizes (note this is research 15+years old) and still we don’t know/understand this connection or it is not widely talked about enough that Niacinamide supplementation can help digestive problems and that quoting prousky “The primary somatic complaints of individuals with vitamin B3 dependency are be gastrointestinal disturbances with hypochlorhydria presenting as one of the early clinical signs of the vitamin dependency. The only way to confirm a clinical suspicion of a vitamin B3 dependency is to provide optimal doses of the vitamin, and see if the clinical problems improve or resolve.” Or be tested for Pellagra. Which the Doctor’ are not looking for today. Like the doctor’s did not look for Celiac disease 15 or 20 years ago neither is Pellagra looked for today because they don’t know to look for it anymore. See this blog post by Dr. Heaney of Creighton University that talks about why this is so today. http://blogs.creighton.edu/heaney/2013/11/18/pellagra-and-the-four-ds/ where he (Dr. Heaney) says correctly that “In the United States, at least, pellagra is a disease of the past – fortunately – and it is doubtful today that most health professionals would recognize it if a case happened to come to their attention.” And that is unfortunate for GI patients of all stripes and kinds (IBS, Heartburn aka GERD, Non-Celiac Gluten Sensitivity etc.) because doctor’s today don’t know to look for Pellagra anymore as a GI disease. How do we know this? We can’t for sure unless we are willing to take the missing nutrient according to Prousky “a vitamin B3 deficiency occurs when the intake of the vitamin is below a known minimal amount that guards against pellagra. A vitamin B3 dependency occurs when there is an increased metabolic need for the vitamin requiring treatment with megadose amounts”. Or have our doctor’s test us for a Niacin deficiency. A deficiency is why we enrich/fortify are bread with Niacin our milk with Vitamin D and our salt with Iodine. A dependency is when are bodies don’t function properly due to high stress levels requiring high or increased metabolic need as quoted by Prousky above. What does this look like in human beings? If one is critically low in Niacin the 3 D’s of Pellagra (Dementias, Dermatitis’s, and Digestive Issues) show up. As cited in the International Journal of Celia Disease http://pubs.sciepub.com/ijcd/3/1/5/ from the article “Two Exceptional Complications Revealing Celiac Pellagra and Ischemic Cardiomyopathy … “pellagra is essentially affecting tissues with a high rate of cell turnover, such as the digestive tract and the skin, and tissues with high energy needs, such as the brain”. Now if the symptoms’ are similar it is easy to confuse one disease for the other and if not well understood they might be considered “exceptional” or, i.e., not well understood. How do we know this? The same Journal of Celiac in another issue entitled Celiac Disease Intestinal Heart and Skin Interconnections http://pubs.sciepub.com/ijcd/3/1/6/ when listing common aspects of both diseases’ says and I quote “The two diseases can be connected in two aspects. 58% of pellagra patients were shown to have malabsorption and many had intestinal pathology on biopsies [36, 37]. Alternatively, Pellagra was described in celiac disease.” Not only did/does the Journal of Celiac cite common symptom’s 58 percent of the time in Celiac and Pellagra but they also cite that Pellagra has been described in a Celiac Disease diagnosis. I would argue that it should be the other way around if the majority (58 Percent) of the time Pellagra symptoms are described in a Celiac diagnosis it stands to reason that medical science is identifying the wrong disease. Quoting the Celiac Posterboy “Pathology presumably would qualify the Pellagra patient as a Celiac Patient if the Pellgarin was first diagnosed as a Celiac first as often is the case TODAY!” I ask if you have the wrong disease would you get better Or Is Non-Celiac Gluten Sensitivity and/or Celiac Disease really Pellagra in disguise in the 21st Century? Suffering by another name hurts just as much???? Does it not? Pellagra being confused for Celiac disease in the Majority of those being diagnosed as Celiacs’ today -- hurt’s as much Does it not . .. and probably worse because then/now you have ruled out a valid differential diagnosis. Why is this? Or how is this possible? The International Journal of Celiac Disease muses on this point too? when discussing the “exceptional” (not well understood) reason why Pellagra shows up in a Celiac Diagnosis. They say “Little progress has been made in our knowledge of pellagra … since Goldberger discovered that nicotinamide was a preventive factor in 1926” of Pellagra. Continuing the citation “Proof of this is that there have been no changes’ in treatment or diagnostic criteria in the last 90 years” for Pellagra. As the International Journal of Celiac Disease summarizes this case of “Exceptional Complications Revealing Celiac Disease and Pellagra “illustrates … rare (I would say common) complication revealing celiac disease”. Because it is not YET well understood that 58 percent of Celiac patients are Co-Morbid with Pellagra. Common enough I believe to declare Pellagra as the Parent disease and the subsequent Celiac patient the child meaning every one (95 plus percent probably) of those diagnosed with Celiac disease has symptoms derived from Pellagra though it is not now commonly understood in the medical community. If we follow most normal paths’ for adoption it will take another 15 or 20 years (a generation) for the medical community to accept Pellagra as the proper diagnosis. Don’t suffer in the meantime! If the International Journal of Celiac Disease is right and Pellagra is Co-Morbid revealing as Celiac disease the majority of the time? Then take the “Niacinamide Challenge” for yourself and see if you don’t begin burping in 6 months or less depending on how many times a day you take it and potentially put your IBS/GERD/NCGS and possibly ??? dare I say it Celiac in remission along with your Co-Morbid Pellagra symptoms aka (the 3 D’s) 75+ years ago if one is being diagnosed as the other. It will take one more test to make a valid determination or else we can’t know for sure which disease we really have since they are eerily similar in their clinical presentations. The Mdguidelines website outlines why this is so see their link http://www.mdguidelines.com/pellagra Where they (Mdguidlines) say quoting “The diagnosis of pellagra is straightforward when the classic rash is present but may be (more/my word) elusive if there are only gastrointestinal and/or neurological manifestations.” The LTO website gives an good overview of the B-Complex test than be performed to confirm if Pellagra is presenting as Celiac disease. See this link https://labtestsonline.org/understanding/analytes/b-vitamins/tab/test As I have said before in this blog. A healthy child burps at 6 months of age and you can too in six months by taking the Niacinamide putting your Co-Morbid Pellagra (digestive) symptom’s into remission if indeed we can believe the International Journal of Celiac Disease and your Celiac Disease is presenting as Pellagra the majority of the time. See this article feature on Celiac.com that explains in more details why this is so. https://www.celiac.com/articles/24658/1/A-Differential-Diagnosis-How-Pellagra-Can-be-Confused-with-Celiac-Disease/Page1.html Keep in mind the more times a day you take it (Niacinamide) the quicker the desired effect. You will begin burping and your stool will sink if does not already. See my other blog post where I say I was a Pellagra patient diagnosed as a Celiac patient to learn more about how to take Niacinamide properly and what signs too look for when it is working and the natural order of things has been restored and you are now digesting your food again. Remember **** This is not medical advice and should not be considered such. Results may vary. Always consult your doctor before making any changes to your regimen. This will not work if are already taking a PPI (proton pump inhibitor) like Prilosec, Nexium or one of their generics or other acid reducers for hearburn/GERD but if you are only taking antacid’s like Rolaids or Tums then burping will occur where it is most likely not occurring now. You will need to take stomach acid to get you over rebound wall that comes on when you stop taking your acid reducers. See prousky link about how to do this or check with Dr. Google where there are websites that explain how to do this. But new research by Washington University strongly suggest that you need to work with your doctor to get off you PPI’s and do it as quickly as possible where they say the “ Popular heartburn drugs (PPIs are) linked to gradual yet 'silent' kidney damage Most patients don't experience acute kidney problems beforehand” https://www.sciencedaily.com/releases/2017/02/170222082252.htm This is only the latest bad news for Proton Pump Inhibitors. So if you are taking them for gastric support they may be doing more harm than good in the long run. But I prefer to talk about Vitamins because they are safer to take and are at the root cause for most diseases and yes Pellagra being diagnosed as Celiac’s today. What have you got to loose there is better than a 50/50 chance your doctor will find Pellagra is the correct disease or at least you will eliminate the contributing concomitant Pellagra symptom’s greatly controlling your Pellagra flare up’s (the 3 D’s – dementia(s), digestive issue(s) dermatitis issue(s)) being confused/revealing as your Celiac disease by mistake. If you have never heard of Pellagra you are not alone. Many doctors have not either and that is why they don’t find it. You only find what you are looking for! Perhaps with this education/awareness you now have the doctor’s/patients will be more aware now that the presenting symptoms of Celiac disease and Pellagra are eerily familiar and one disease is being confused for the other. Or at least they were in my case. As I am fond of saying “To Educate is to Truly Free”. YOU don’t have to have all 3 D’s to have Pellagra any one of the D’s like C and D is enough to confirm Pellagra in the absence of Dermatitis issues etc. See md guideline quote above. Quoted again here for easy reference Where they (Mdguidlines) say quoting “The diagnosis of pellagra is straightforward when the classic rash is present but may be (more/my word) elusive if there are only gastrointestinal and/or neurological manifestations.” I couldn’t agree more. Your path to the knowledge of a Celiac diagnosis as we know is a long one for most people. It doesn’t have to be a long path back if you know the way. Knowledge of Pellagra is fairly poor (elusive) today the way Celiac disease was 15 or 20 years but the path to a valid/correct diagnosis of Pellagra doesn’t have to be a long one if you will have your doctor test you for It (Pellagra) to see if your Pellagra is like the 58% of Celiac’s according to the Journal of Celiac Disease is masking/presenting as Celiac disease today. Let’s take the mask of Celiac disease off and reveal the true diagnosis if you will and get tested for a Niacin deficiency proving that Pellagra is contributing to your poor patient experience i.e. super sensitivity etc. The gluten free works website covers this topic well. A niacin deficiency in Celiac’s. https://glutenfreeworks.com/blog/2010/06/23/niacin-vitamin-b3-deficiency-in-celiac-disease/ Where they quote old research (again this is not new information) but the awareness is low that a “niacin deficiency itself sensitizes the intestinal mucosa of rats to gluten in wheat, barley, rye, oats and corn and induces susceptibility to gluten toxicity by means of cellular dysfunction.3” This research is 30+ years old. How much longer will we suffer in ignorance of this fact? They say and I couldn’t agree more! “Human research needs to investigate this effect of niacin deficiency in human celiac disease” or at least it is high time that Celiac’s are also tested to see if co-morbid Pellagra is contributing to their Celiac Diagnosis. And Prousky did 15+ years ago (did human research on Niacin and digestive issues) but people still suffer today because it still not well known (understood) today that Pellagra a Niacin deficiency treats digestive problems. This blog post is about awareness of this fact that medical doctor’s today are not looking for Pellagra in Celiac’s and therefore people continue to suffer because of it. Good luck to those who are still on our journey who come across this blog post and find it helpful. I hope it helps you on your journey to find at least one was able to find (their way back)/help himself /herself/themselves of their GI problems by taking a Vitamin for a rarely diagnosed disease today -- Pellagra but is eerily similar to the way Celiac disease presents/is diagnosed today. If you still have questions after reading this blog post about my journey of how I learned Pellagra is being diagnosed as Celiac Disease today then visit the website in my profile to read more about why doctors are ignorant of this fact today but there is only so much you can put in one blog post. But I hope this is enough to pique your curiosity. Or search for the posterboy on celiac.com to read all my posts or comment threads about why Pellagra is being diagnosed as Celiac Disease today. Knitty Kitty also comments a lot about how Niacin helped her DH symptoms. It is my hope it will help you too to know that there is an alternative diagnosis. It is said ignorance is bliss. Well in this case it is dangerous. If you had cancer wouldn’t you want to know . . . of course you would! If you have Pellagra the ignorance of this fact can kill as surely as Cancer. The 4th D of Pellagra is death. So please have yourself tested to see if Pellagra is contributing to your Celiac disease symptom’s is my advice to you and maybe just maybe you too like me will have a good/favorable response and your cross contamination issues will go into remission. Praise bee to God! To those who will hear and listen! I am just trying to help those who are still suffering. I am that boy walking along the shore throwing starfish back or trying too! The Starfish Story Original Story by: Loren Eisley “One day a man was walking along the beach when he noticed a boy picking something up and gently throwing it into the ocean (world wide web) … Son, the man said, don’t you realize there are miles and miles of beach and hundreds of starfish? You can’t make a difference! After listening politely, the boy bent down, picked up another starfish, and threw it back into the surf. Then, smiling at the man, he said I made a difference for that one.” . . . I hope that one is you reader -- fellow sufferer from a former Pellagra sufferer diagnosed as Celiac disease. 2 Corinthians (KJV) 1:3,4 3) “Blessed be God, even the Father of our Lord Jesus Christ, the Father of mercies, and the God of all comfort; 4) who comforteth us in all our tribulation, that we may be able to comfort them which are in any trouble (starfish), by the comfort wherewith we ourselves are comforted of God.” 2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things” this included. posterboy by the Grace of God,

Prologue I never know what to call a post. What Else Could it Be; Co-Morbidity in Celiac disease and what else could be causing your Celiac like symptoms or I had Celiac Disease and developed Pellagra. This is my story yours may be similar. I have tried to write as much as I could of this beforehand to summarize some of my experience and research since I was first serology confirmed a Celiac and why I think Pellagra explains if not all the complications a Celiac develops at least many of them seem common in undiagnosed Pellagra but I find formatting and links can be a challenge. This is not meant to be an answer to all your questions but a beginning, posterboy by God’s Grace. See post that follows “I had Celiac disease and developed Pellagra”. Good luck on your journey. 2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things”. I had Celiac Disease and developed Pellagra I try and educate about how Pellagra can be confused for Celiac disease and/or GI problems like IBS, GERD, Ulcer’s, UC etc. after having received a Celiac diagnosis and my symptom’s improved greatly after taking Niacinamide (the non-flushing form of Niacin). And almost without fail people do not see the connection. They say but I have … . fill in the blank. They don’t see the connection. But if I say it this way maybe it will help you “I am a Celiac who developed Pellagra” or fill in the blank … . heartburn, IBS, UC, Chron’s etc. I named this post this because another board/forum member said as much in a thread post on this forum and it struck with me. She had the digestive problems of a Celiac but also the dermatitis issues of DH and her itching got better after taking Niacin. What we fail to understand often with any diagnosis there is continuum of disease/symptoms. Since this happens gradually you develop heartburn first then you have IBS, and Constipation and diarrhea then maybe an ulcer etc we don’t often see the connection. But all along it was the same disease in a more pronounced condition. If we catch it early enough say at IBS then the ulcer or UC might not develop. When we think spectrum of disease it helps us to understand these diseases’ can be and are more related that we often understand. They are all bound by STRESS. Do not all these conditions worsen when you are stressed does not the heartburn turn into IBS i.e. your constipation and diarrhea flare up? Yet we think of them as separate diseases Right? No there is a continuum of disease bound by STRESS and TIME. The longer the stress the more your symptom’s Right! You just haven’t stopped to think about the relationship. Relationship and time is important to a proper diagnosis. So how are these related? Our mucus membranes are always in a constant state of repair either of repairing or rebuilding what is broken or maintaining our bodies defenses. This takes energy and lots of it and one is not able to make enough energy to repair the lining of our stomach without enough Niacin and Pellagra develops. I am not even saying I have been cured of Celiac disease. I say my GI symptoms are in remission which leads me to Pellagra as a cause and effect relationship of stress and our environment — Epigenetics. I am saying I was/am a Celiac who developed Pellagra. The International Journal of Celiac disease notes that both Pellagra and Celiac disease does often occur in the same person. How do we know this? The Journal of Celiac in an issue entitled Celiac Disease Intestinal Heart and Skin Interconnections http://pubs.sciepub.com/ijcd/3/1/6/ when listing common aspects of both diseases’ says and I quote “The two diseases can be connected in two aspects. 58% of pellagra patients were shown to have malabsorption and many had intestinal pathology on biopsies [36, 37]. Alternatively, Pellagra was described in celiac disease.” Which also explains why a Genetic disease can increase in two or three generations because our stress changes our genes. There is a trigger. Stress — it is not your day to day stress. We can handle all that kind of stuff but TRAUMA lasting 3 or 4 more months at a time. Think when Celiac disease was first studied as a Disease? It was during and directly after WWII and I dare say a stressful time to say the least. Not to mention all the energy needed day to day to just survive. Europe almost starved after the war. So much so he U.S. government had to step in and help deliver/air drop humanitarian aid to Europe. It was called the Marshall Plan named after the man who devised the relief plan and it is credited with keeping Europe alive after WWII and averting another possible world war because of the infighting that would have developed from a starving Europe. 3 to 4 months is approx. the exact time we can store B Vitamins. Anything that triggers the fight or flight high energy response (TRAUMA) that depletes our bodies reserve’s. Stress is coincidently what Niacin helps us control. It (Niacin) helps control our stress response’s in the body without which cellular disfunction happens (are membranes brake down). Like the alternating constipation and diarrhea you have had for years if you have developed Celiac disease. Things like a Car Accident, difficult divorce, injury to our kids, extended care giving, surgery etc. can and often does trigger GI problem’s. And yes the stress of pregnancy. And it (STRESS) is common with with/before a pregnant lady gives birth triggering heartburn. A good example is pregnant women in their 3rd trimester often develop heartburn that’s goes away when the child is born. Those who are predisposed continue to have heartburn and GI problems because their body couldn’t meet their need. Half of pregnant women develop heartburn during pregnancy that goes away in all but about 1/3 of those who get heartburn when the child is born. Think of Heartburn as infant Celiac disease if it helps you to think in these terms. The older/longer the heartburn persists or the more GI symptom’s (heartburn/GERD/IBS, Constipation, diarrhea, ulcer etc) reoccur the more serious the conditions and diagnosis becomes. The genetic component is that 1/3 are predispose to high Niacin consumption when stressed. It is those1/3 of us who had Pellagra and Celiac disease developed is who I am trying to help. But it should be noted up and until your Celiac diagnosis things like the Ulcer, UC, IBS etc can/could be helped also if Pellagra is the Parent diseases and all these other diseases are its children. Co-Morbidity is the term. A B-Vitamin deficiency can be inherited but does not have to be permanent. It is a reversible condition. See this new research that ties eczema in babies to low Niacinamide in the mother during pregnancy. Nicotinamide is usually the way Europeans spell Niacinamide. Both names refer to the same amide form of Niacin. https://www.sciencedaily.com/releases/2016/09/160923092924.htm The very definition of a Vitamin (especially in the case of B vitamins) a vital (life giving) nutrient/substance needed in a minimum amount without which we become sick. Your continuum of diseases are completely reversible if your symptom’s look like Pellagra (digestive, dermatitis and dementia’s) in nature and your respond (BURP in 3 to 4 months) to Niacinamide you might have Pellagra and the doctors have not figured it out in a clinical setting (they are sub-clinical) yet or at least you (may) have Pellagra and Celiac Diseases Co-Morbid. If one is critically low in Niacin the 3 D’s of Pellagra (Dementias, Dermatitis’s, and Digestive Issues) show up. Really there are 4 D’s more on that latter but we are trying to catch Pellagra before it gets that far. The International Journal of Celiac Disease notes this co-morbidity when they note in 58% of Celiac -- Pellagra ALSO occurs. See this link http://pubs.sciepub.com/ijcd/3/1/6/ Quoting their paragraph 3 on the Co-Morbidity of Celiac and Pellagra together 3. Pellagra and Celiac Disease “The two diseases can be connected in two aspects. 58% of pellagra patients were shown to have malabsorption and many had intestinal pathology on biopsies [36, 37]. Alternatively, Pellagra was described in celiac disease [38]. The skin manifestations in pellagra might have some additional etiologies, since multiple nutrient deficiencies are at the origin of the cutaneous manifestations in celiac disease. The following nutritional deficiencies inducing skin rashes, were describe in celiac disease: Zinc, Iron, Vitamin A, E, B12, niacin, folate, selenium and essential fatty acids [39, 40]. “ 58% of the time (that is a majority folks) Celiac’s go on to develop Pellagra too! Or is it really the other way around? Have you had Pellagra all along and now you have developed Celiac from it (Pellagra) undiagnosed. The later may be more true than you know. Ask your friends if they have ever heard of Pellagra. I dare say it a low percentage that knows Pellagra a once rampant disease especially in the rural south can cause many of the GI problems you are now experiencing as a Celiac disease patient or even the Non-Celiac Gluten Sensitivity (NCGS) patients that have not yet received a Celiac diagnosis. And it maybe a lower percentage today that know what Pellagra (or even that they could have it) is than have heard of Celiac disease or think they have Celiac disease instead. Think beri beri, rickets, scurvy etc all complex diseases completely forgotten about today that were/are completely reversible conditions. As Dr. Heaney points out about Pellagra today! That as Creighton’s University Dr. Heaney says “In the United States, at least, Pellagra is a disease of the past – fortunately – and it is doubtful today that most health professionals would recognize it if a case happened to come to their attention.” See Dr. Heaney’s Professor of Medicine post here at this link http://blogs.creighton.edu/heaney/2013/11/18/pellagra-and-the-four-ds/ The knowledge of Pellagra (if you have ever heard of it) is in that same state of forgotten diseases now thought relegated to the history books. If you have Pellagra co-morbid then you just have to take a Vitamin to get rid of this morbidity. This is a summary of my 10 year journey. I researched these things for 3 to 4 year (2 Tim 2:7) before I had the courage in my conviction to test this Pellagra theory. But I think most people would rather hear from some who has suffered like them and has been able to help themselves. This is not theory anymore for me. It is my story. In case this is the only post you read I will repeat here for knowledge sakes ****** the number one mistake people make when taking Niacinamide is they don’t take it often or long enough. It should be taken UNTIL you are burping. Most people will burp when taking Niacinamide in 3 to 4 months or less taking it 3/daily — ie with each meal. What do I mean by burping? This confuses some people sometimes. I don’t mean the little burp you get with drink some carbonated beverage or burp a little in the first 20 minutes after eating but also are bloated. But your new normal BURPING the natural order of things burping – The burp will come later after the meal the longer you take the vitamin. Burping will occur the more frequently the less you eat. Soon water will cause you to burp -- Burping without the bloat and distension (pain from gas) that comes later. When your stool begin sinking your body is digesting the carbs and proteins that were causing you the backwash (heartburn/GERD/IBS) before when you only burped a little or occasionally or when you drank something carbonated. Now BURPING will occur two hours after you ate something. Long after you have finished your meal you will burp if you have taken the Niacinamide 3/day for 3 to 4 months at a minimum. Dr. Prousky proved this 15 years ago this past November that Niacinamide treats digestive problems. http://www.yourhealthbase.com/database/a124b.htm Yet 15 years later people still are bemused when you mention Pellagra let alone that Pellagra could be contributing to your Co-Morbid Celiac disease. I for one will tell those will listen. I am a Celiac who developed Pellagra. Learn from my mistakes so you don’t have to repeat them and get your doctor to test you for a Niacin deficiency. Pellagra once rampant early in the 20th Century is now known TODAY as Celiac disease in the 21st Century (I believe) or at least in a good majority of cases could be. To paraphrase William Shakespeare “Disease by another name hurts just as much” and maybe more because if you get the right disease you can get better! You know have the power to help yourself forum reader (because knowledge is power) the question is what will you do about it? This blog post is a store house of 10 years of research learned from life experiences. The blog’s author has been stung so you don’t have to be. Learn from my mistakes. No man is so dumb as the man who won’t learn from other people’s mistakes. Take as much honey (knowledge) as you can from my mistakes so bad health will not sting your quality of life. Is it any wonder God’s promised land was described as a land flowing with milk and honey? Where knowledge flows there is health of mind and body. Feel free to ladle and dollop your life with the sweet stickiness of the truth (knowledge) found/ gained today. For honey like truth stick to you once in contact and you can’t just wash it away. Don’t let them the doctor’ almost kill you before you are willing to take a Vitamin to see if it is really the Co-Morbid Pellagra as the International Journal of Celiac Disease notes that could be causing your Celiac symptom’s in the MAJORITY of Celiac patients if the International Journal of Celiac disease is correct. Quoting again from the IJCD “The two diseases can be connected in two aspects. 58% of pellagra patients were shown to have malabsorption and many had intestinal pathology on biopsies [36, 37]. Alternatively, Pellagra was described in celiac disease [38].” See this link provided again for easy reference http://pubs.sciepub.com/ijcd/3/1/6/ Stop the madness! Admit the MAJORITY of Celiac Patients today are Co-Morbid with Pellagra and if you treat the co-morbid disease you can get better from that morbidity. The Celiac Posterboy might say “(Unfortunately) for most patients it (Pellagra) is not recognized as Disease TODAY! By their admission (a professor of medicine/health professionals/doctors) Pellagra is OMITTED as a disease in most doctor’s differential diagnosis TODAY!” If you have (a) Celiac disease diagnosis then you have been stung with/by this ignorance. That as Creighton’s Dr. Heaney says “In the United States, at least, Pellagra is a disease of the past – fortunately – and it is doubtful today that most health professionals would recognize it if a case happened to come to their attention.” See Dr. Heaney’s Professor of Medicine discussion about why Pellagra is not diagnosed today here at this link http://blogs.creighton.edu/heaney/2013/11/18/pellagra-and-the-four-ds/ This blog post is about the ignorance (of) Pellagra cost’s you when the doctor’s diagnose you with Celiac Disease/NCGS when 58% of their patients is/are Co-Morbid with Pellagra and they get the wrong “key” diagnosis. **** This is not medical advice and should not be considered such. Results may vary. Always consult your doctor before making any changes to your medical regimen. But I have found and my friends have found if you take it (Niacinamide) like an antibiotic (UNTIL BURPING) and your stool SINK then 95% of your GI stress will be in remission. You could still have other things that are bothering you but it won’t be Pellagra. If you take fiber and still have GI trouble then eliminating supplemental dietary fiber for 30 days (like you did to see if gluten was your’ problem) might help you figure out whether the fiber is helping or hurting your GI problems. People do have bad reactions to fiber sometimes that can be confused for IBS problems and unless you try eliminating it for 30 days you won’t know for sure if it is causing or contributing to the remaining GI problems you might still be having after taking Niacin until burping if any. As I am fond of saying “To Educate is to truly Free”. But do not do as I did! Learn from my mistakes. DO NOT take Niacin or Niacinamide or any form of Niacin UNTIL you have your doctor’s test you for it (Pellagra). If you notice the IJCD link these were clinical observations only. Quoting the IJCD again “It is the first description of celiac disease . . . .and Pellagra in the same person, however, only associative linkscan be established, but not cause and effect relationships. Unfortunately, the patient was not diagnosed biochemically as pellagra and died before gluten free diet was initiated.” You probably know this by now if you are a Celiac or even a NCGS patient the diagnosis rate for Celiac disease can be a horrible and if you have Pellagra it is even worse because the doctor’s like Celiac disease 15 or 20 years ago are not even looking for it today. One more test needs to be done to differentiate Pellagra from Celiac and it is not being done today as Dr. Heaney correctly noted. Doctor’s don’t know to look for it (Pellagra) much less in a Celiac patient. See this link to the Merck Manual a commonly used traditional desk reference for Physician’s when they need to look up a diagnosis. http://www.merckmanuals.com/professional/nutritional-disorders/vitamin-deficiency,-dependency,-and-toxicity/niacin Quoting from the Merck Manual “If available, laboratory testing can help confirm the diagnosis, particularly when the diagnosis is otherwise unclear. Urinary excretion of N1-methylnicotinamide (NMN) is decreased; < 0.8 mg/day (< 5.8 mcmol/day) suggests a niacin deficiency.” No, doctors don’t know everything they have to look things up from time to time too. And when they do look up Pellagra when you ask them to test you for it the way some people on this board went to their doctor’s to have them test for Celiac disease instead of accepting as Gemini on this board said and say you had IBS instead “I Be Stumped” they learned/were taught by their patient’s that Celiac is not as rare as once thought. And neither is Pellagra. Quoting the Celiac Posterboy “Pathology presumably would qualify the Pellagra patient as a Celiac Patient if the Pellgarin was first diagnosed as a Celiac first as often is the case TODAY!” Why is this? The pellagra disease blog explains why this is https://pellagradisease.wordpress.com/ Quoting Niki Frost “Since pellagra is (thought to be my words) such a rare disease today, few people recognize it based on their symptoms alone (any of the three D’s: dementia, dermatitis, and diarrhea). Pellagra patients are consequently (constantly being my words) referred to specialists in fields that are ultimately unrelated to the underlying nutritional deficiency and metabolic nature of the disease.” So the cycle repeats. Since these specialists don’t consider you in a subgroup that is prone to be diagnosed with Pellagra then Celiac/NCGS disease is diagnosed if you are lucky and not some other GI problem like chrons, IBS, UC etc because in these cases the GI specialists is not even looking for Gluten as a possible trigger. This is not to even mention the other D’s of Pellagra today being diagnosed as various degrees’ of Dermatitis like ezcema, psorsias, Dermatitis Herpetiformis (DH) etc which are related to skin presentations of Pellagra. Pellagra when it was first named means rough/sour skin in Italian and people forget that today. Or the dementia’s of Pellagra like depression (40 percent of Celiac’s are depressed) or the “brain fog” a Celiac develops after being “glutened” I could go on and on but you get the idea. But unless you are tested for it your doctor’ won’t know to look for it in their next Celiac patient because they do not know to look for it in GI patients today remember the war on Pellagra ended 75+years ago so they don’t look for (see) Pellagra anymore in a clinical setting unless you are in a subgroup like being an alcoholic etc . The same way they didn’t or might not of known to test their IBS patients for a Celiac diagnosis 10 or 15 years ago. I am not saying this will help you the way it seemed to help me. But I am saying have your doctor verify these things for you before doing these things because if you are a Celiac that has developed Pellagra also then it needs to be documented. If you want to read more about my story search for the posterboy on this board to read my other forum threads or visit the website in my profile. I have specifically left out dosage amounts because the frequency you take a B-Vitamin is more important than the amount you take of it. Because B-Vitamins are water soluble 2 or 3 hours later if one is deficient in that Vitamin then the body can absorb more of it. So taking higher doses don’t necessary help you any more than lower doses. They (higher doses 500mg) can be easier to find especially if you are taking it (Niacin) for cholesterol management but it doesn’t help you any quicker than smaller amounts more frequently and higher Niacin causing flushing (which can be mitigated to some degree by taking Niacin with food) where the Niacinamide form doesn’t. In fact taking smaller amounts frequently 3/day with meals will help approximately 40 percent faster than one larger 500mg capsule/tablet only once daily. And why if given a specific amount and you retain it (is low in the urine) is a sign you are low in Niacin. I do prefer the Niacinamide form because it is a naturally flush free form. The Merck Manual notes this quoting “Nicotinamide is usually used to treat niacin deficiency, because nicotinamide, unlike nicotinic acid (the most common form of niacin ), does not cause flushing, itching, burning, or tingling sensations. Nicotinamide is given in doses in doses of 250 to 500 mg po daily.” But a Slo-Niacin can work just as well. The Townsend Letter makes note of this in their Feb/Mar 2003 edition. http://www.townsendletter.com/FebMar_2003/inositol0203.htm This will be a cycle. You will take it until burping 2 hours after you finish your meal and your stool sinks where before it floated and even water now causes burping without bloating or gas or distension. It might be 3 or 4 months for some people or it might be even 6 months or longer for some people. But it is a cycle. Usually people feel better when they begin burping for the first time in years and their stool now sinks when before it always floated. I do not now take Niacinamide and haven’t for several years since my symptoms’ are in remission. I stopped taking it when I had rebound acid reflux. By that I mean I begin to have acid reflux symptoms when I had no food in my stomach that when away when I ate something. Timeline is important in any diagnosis. All heartburn is not equal. IF your stomach acid was HIGH as you often hear then eating food (carbs, greasy things or your other triggers) wouldn’t bother you because it would only weaken it. BUT if it is low to start with then food will WEAKEN our/your acid so that you lose the food fight you are in and things (carbs/fats) become to ferment, rancidify and cause heart burn. The excess pressure from fermented carbs push open the trap door allowing the low acid you have burn the lining of your esophagus. TRUE heartburn from too HIGH acid happens between meals when there is no food in your stomach to tamp it down and will occur if you take Niacinamide too long and how I knew I needed to stop taking Niacinamide. When low in stomach acid for too long in time this can lead to Non-Celiac disease first and with enough injury to Marsh lesions qualifying you for diagnosis as a Celiac candidate/patient. How do we know this? Low stomach acid has now been linked to a probable cause of damage to the Small Intestine before and/or occurring with a Non-Celiac Gluten Sensitivity (NCGS) or Celiac diagnosis. Celiac.com reports these findings https://www.celiac.com/articles/23432/1/Do-Proton-Pump-Inhibitors-Increase-Risk-of-Celiac-Disease/Page1.html Note how the researcher’s starts the article “Rates of celiac disease and the use of drugs to inhibit the secretion of stomach acid have both increased in recent decades. A research team recently set out to explore the association between anti-secretory medication exposure and subsequent development of celiac disease.” If these medicine are lowering stomach acid what cause effect relationship does/ could this have on Celaic/NCGS diagnosis is what they are postulating. They go on to say without being very technical (read the whole article for yourself) that “The data clearly show that patients who use anti-secretory medications are at much greater risk for developing celiac disease following the use of these medicines.” . . .. Summarizing their findings “The fact that this connection persisted even after the team excluded prescriptions for anti-secretory medicines in the year preceding the celiac disease diagnosis suggests a causal relationship”. Now the term causal is not used lightly. To prove causal is much harder than casual (occurring with) like the 58% of Celiac who are also casually observed as having Pellagra. Gluten Free works summarizes a casual association of a Niacin deficiency very well at this link https://glutenfreeworks.com/blog/2010/06/23/niacin-vitamin-b3-deficiency-in-celiac-disease/ They only note a casual association only noting similar symptoms occur in Pellagrin’s too. Quoting “ Inadequate levels of niacin slows metabolism and impairs functioning of the brain and nervous system, digestion, skin, DNA repair and other key cell processes, and steroid and sex hormone production. Severe deficiency of niacin causes the disease pellagra.2 “ I can not prove that Niacin helped me because I did not know to test for it or have the doctor test me for it but you can teach your doctor to look for i it in you if you are an IBS, NCGS, or Celiac patient by sharing the information in the Merck Manual with him/her. To prove causal you will have to have your doctor test you for a Niacin deficiency verifying the International Journal of Celiac disease casual observation that the majority of Celiac are co-morbid with Pellagra establishing if not a causal link that it at least contributes to your concomitant GI conditions in at least the 50 percent of Celiacs’ who are low in Niacin and don’t know it. Taking the Niacinamide as the Merck Manual notes in their key points for doctors can confirm the diagnosis. Quoting “Use nicotinamide/Niacinamide to treat the deficiency; a favorable response can confirm the diagnosis.” If you want to research more about Pellagra and how it can present as so many different diseases and its clinical presentation(s). I say presentation(s) because if it begins with a “D” i.e., dementia, dermatitis or Digestive Disorders(s) (I added the S to Digestive Disorder because I think it speaks to the spectrum of diseases) that Pellagra can and is often confused for in modern medicine. And could be added to dementia(s) and dermatitis (s) see above about depression and Celiac and Pellagra meaning rough/sour skin in Italian and the Hindai link below to do more research on Pellagra if this blog post is not enough to answer all of your questions. Read this great Hindawi article linked below for a great synopsis of Pellagra https://www.hindawi.com/journals/cggr/2012/302875/ where they pose the question what role does Pellagra play in contemporary disease (today) In one of their breakout paragraphs talking about Pellagra today! They discuss how Pellagra is still prevalent today in contemporary disease pathways entitled “Is Subclinical Pellagra Relevant to Contemporary Disease?” And they list a dozen plus ways it is and I whole-heartily agree and I hope you do too after reading this post. And doing some of the research listed therein. It bears repeating though I said it earlier **** Note: This is not medical advice and should not be considered such. Results may vary. Always consult your doctor before making any changes to your medical regimen. Good luck on your journey and I hope it helps you the way it seemed to help me. Posterboy by God’s Grace! 2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things” this included. Blessed are those who will hear and take a Vitamin for their health or at least have their doctor check their Vitamin levels so they can get better from that morbidity if indeed as the International Journal of Celiac disease notes – Celiac’s are co-morbid with Pellagra in the Majority of celiac patients and the doctor’s don’t know yet to test for it but by having your doctor test your urine for low levels of Niacin it indicates you are retaining Niacin to maintain and repair your membranes the doctor can treat you for this morbidity a sign of undiagnosed Pellagra today.