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More About Dr. Kenneth Fine
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Anybody been to any seminars or meetings with Dr. Fine lately? Anything new? Is there any explanation at all for why he still hasn't published his findings or why no medical celiac experts will endorse him? Anybody have the real story?

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That would be interesting to hear yes. I heard he had another seminar this last fall. Sorry I don't have an answer to your questions myself.

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I personally have given up hope that he'll publish. He's been saying it for a few years now and still hasn't.

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I was tested by him (Enterolab), came back positive for gluten, dairy, and soy sensitivity. I believe he knows his stuff because since eliminating those things I have felt so much better. I know I still don't feel 100%, and there could still be more sensitivities that I don't know about, but I feel much better than I did and I feel like crap when I accidentally get cross-contaminated with any of those things. My mother in law was also tested through them (as well as biopsy previously by her GI doc) and came back positive for all of the things he tests for and feels much better since eliminating those things. She has called Enterolab many times with questions about the new diet and they are extremely kind and helpful. All I have are positive things to say about Dr. Fine.

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If Dr. Fine's #1 priority is helping people become well...and if he truelly has developed a test that is valid....why hasnt he published?? He's made alot of claims but until he publishes there is nothing to validate any of it.

In my opinion if he is unable to publish (for whatever reason) he should not be claiming that he is "about to publish" for several years now. He leads people to believe he has a test that is superior to others....and yet he cant back it up with evidence to support this??

Many people have leaky gut nowadays....having reactions to foods can be a symptom of that. It makes sense that most people with symptoms will feel much better removing the most allergenic foods from their diet. My doctors put ALL of their chronically ill patients on restricted diets which eliminate problematic foods such as gluten and casein. They dont need to use an expensive unproven test to know that most people will benefit from removing these foods....and especially when leaky gut is an issue.

I think Dr. Fine is capitalizing on the fact that many people suffer from leaky gut and food sensitivities....which are not necessarily caused by gluten. Its an expensive food intolerance test.....but in my opinion its not much more than that.

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I've also given up hope that he'll ever publish. It seems that he wants to completely avoid the peer review. Also, you have to figure that he runs a pretty lucrative business. At almost $400 a pop for the "complete" test, he's raking it in from people desperate for answers. If he publishes, and ends up being shot down by his peers in the medical community, he risks losing the credibility that he has gained in the "alternative testing" community. And that wouldn't be good for business.

I'm not knocking Dr. Fine, because he has definitely helped a lot of people. But there has to be something wrong with his process and research to make him avoid publishing. But I would definitely like to see it happen eventually.

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If he publishes, and ends up being shot down by his peers in the medical community, he risks losing the credibility that he has gained in the "alternative testing" community. And that wouldn't be good for business.

Exactly.

Personally, I dont feel that his test will stand up to peer review....and I'm sure he is well aware of that. In the meantime he's making plenty of money without having to put himself out there....so its working quite well for him.

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The former leader of our support group, a Naturopath, knows Dr. Fine personally. Dr. Fine has eaten dinner at his house. I asked him if he had ever spoken to Dr. Fine about why he has not published his results for peer review, he said yes. Well why not, was my next question? The answer to the question was....wait for it......"He just doesn't."

That does not inspire a great deal of confidence for me. Not that my opinion means anything, since I have never used Enterolab. But if people are making lifestyle and diet changes based on these test results, they are owed the courtesy of having had the methods and findings validated. That's good customer service.

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He's published other stuff, so it isn't like he doesn't know how to do it.

https://www.enterolab.com/StaticPages/Frame_Cirrculum.htm

PUBLICATIONS:

JOURNAL ARTICLES

1. Zarabi CM, Huntrakoon M, Fine KD. Disseminated rhabdomyosarcoma of the urinary bladder in an adult. Southern Med J 1987;80:526-529.

2. Fine KD. Arthritis in the elderly, is it degenerative or rheumatoid? Baylor University Medical Center Proc 1988;1:25-34.

3. Hammer HF, Fine KD, Santa Ana CA, Porter JL, Schiller LR, Fordtran JS. Carbohydrate malabsorption. Its measurement and its contribution to diarrhea. J Clin Invest 1990;86:1936-1944.

4. Fine KD. Benzodiazepine withdrawal. Baylor University Medical Center Proc 1991;4:27-30.

5. Fine KD, Santa Ana CA, Fordtran JS. Diagnosis of magnesium-induced diarrhea. N Engl J Med 1991;324:1012-1017.

6. Fine KD, Santa Ana CA, Porter JL, Fordtran JS. Intestinal absorption of magnesium from food and supplements. J Clin Invest 1991;88:396-402.

7. Fine KD, Fordtran JS. The effect of diarrhea on fecal fat excretion. Gastroenterology 1992;102:1936-1939.

8. Fine KD, Santa Ana CA, Porter JL, Fordtran JS. Effect of D-glucose on intestinal permeability and its passive absorption in the human small intestine in vivo. Gastroenterology 1993;105:1117-1125.

9. Fine KD, Santa Ana CA, Porter JL, Fordtran JS. Mechanism by which glucose stimulates the passive absorption of small solutes by the human jejunum in vivo. Gastroenterology 1994;107:389-395.

10. Emmett M, Hootkins RE, Fine KD, Santa Ana CA, Porter JS, Fordtran JS. Effect of three laxatives and a cation exchange resin on fecal sodium and potassium excretion. Gastroenterology 1995;108:752-760.

11. Fine KD, Solano M, Polter DE, Tillery GW. Malignant histiocytosis in a patient with hepatic dysfunction and peliosis hepatis. Am J Gastroenterol 1995;90:485-488.

12. Fine KD, Santa Ana CA, Porter JL, Fordtran JS. Effect of changing intestinal flow rate on a measurement of intestinal permeability. Gastroenterology 1995;108:983-989.

13. Wenzl HH, Fine KD, Schiller LR, Fordtran JS. Determinants of decreased fecal consistency in diarrhea. Gastroenterology 1995;108:1729-1738.

14. Fine KD. The prevalence of occult gastrointestinal bleeding in celiac sprue. N Engl J Med 1996;334:1163-1167.

15. Wenzl HH, Fine KD, Santa Ana CA, Porter JL, Fordtran JS. Effect of fludrocortisone and spironolactone on sodium and potassium losses in secretory diarrhea. Dig Dis Sci 1997;42:119-128.

16. Fine KD, Byrd TD, Stone MJ. Successful treatment of chronic severe neutropenia with weekly granulocyte-colony stimulating factor. Br J Haematol 1997; 97:175-178.

17. Fine KD, Meyer RL, Lee EL. The prevalence and causes of chronic diarrhea in treated celiac sprue. Gastroenterology 1997; 112:1830-1837.

18. Fine KD, Lee EL. Efficacy of open-label bismuth subsalicylate for the treatment of microscopic colitis. Gastroenterology. 1998; 114:29-36.

19. Fine KD, Sarles HE, Cryer, B. Investigation of diarrhea caused by mesalamine in a patient with chronic non-granulomatous enterocolitis. N Engl J Med. 1998;338:923-925.

20. Fine KD, Ogunji F, George J, Niehaus MD, Guerrant RL. Utility of a rapid fecal latex agglutination test detecting the neutrophil protein, lactoferrin, for diagnosing inflammatory causes of chronic diarrhea. Am J Gastroenterol 1998;93:1300-1305.

21. Gruy-Kapral C, Emmett M, Santa Ana CA, Porter JL, Fordtran JS, Fine KD. Evaluation of cathartic-resin therapy for management of hyperkalemia. J Am Soc Nephrol 1998;9:1924-1930.

22. Fine KD, Meyer R, Lee EL. Colonic histopathology in untreated celiac sprue and refractory sprue: Is it lymphocytic colitis or colonic lymphocytosis? Human Pathology 1998;29:1433-1440.

23. Fine KD, Ogunji F, Florio R, Porter J, Santa Ana C. Investigation and diagnosis of diarrhea caused by sodium phosphate. Dig Dis Sci 1998;43:2708-2714.

24. Fine KD, Schiller LR. AGA technical review on the evaluation and management of chronic diarrhea. Gastroenterology 1999;116:1464-1486.

25. Fine KD, Stone MJ. Alpha-heavy chain disease, mediterranean lymphoma, and immunoproliferative small intestinal disease:a review of clinicopathologic features, pathogenesis, and differential diagnosis. Am J Gastroenterol 1999;94:1139-1152.

26. Fine KD, Nelson AC, Mossburg A, Ellington RT. Comparison of the color of fecal blood with the anatomical location of gastrointestinal bleeding lesions: potential misdiagnosis using only flexible sigmoidoscopy for bright red blood per rectum. Am J Gastroenterol. 1999;94:3202-3210.

27. Fine KD, Seidel RH, Do K. The prevalence, anatomic distribution, and diagnosis of colonic causes of chronic diarrhea. Gastrointest Endosc. 2000;51:318-326.

28. Fine KD, Ogunji F. A New Method of Quantitative Fecal Fat Microscopy and its Correlation with Chemically Measured Fecal Fat Output. Am J Clin Pathol. 2000;113:528-534.

29. Fine K, Lafon G, Ogunji F, Do K, Schulte K, Osowski L, McCormack J, Guerra R. High Prevalence of Celiac Sprue-Like HLA-DQ Genes and Enteropathy in Patients with the Microscopic Colitis Syndrome. Am J Gastroenterol 2000;95:1974-1982.

30. Fine KD, Ogunji F, Saloum YA, Beharry S, Crippin JS, Weinstein JS. Celiac Sprue: Another Autoimmune Syndrome Associated with Hepatitis C. Am J Gastroenterol 2001;96:138-145.

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I personally have no respect for Dr. Fine whatsoever. I feel he is lining his pockets at the expense of those he swears he is helping. People who are sick and seeking answers. I feel he has violated the oath he took as a doctor to first do no harm. He does do harm when people put their faith in unproven tests and delay seeking proper medical treatments. His tests do not diagnose celiac. What if what you have is colon cancer and you waste 6 months to a year trying a gluten-free diet? You could die!

neesee

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Okay, I know nothing about Dr. Fine, and I have never bothered with Enterolab.

But my question would be, is there any possibility that he has gotten blacklisted by his peers for going "against the grain" (sorry, didn't mean it as a pun) by looking for food intolerances as cause/cure rather than testing/handing out pharmaceutical products?

The reason I ask this is that I know that this is standard practice in medical research.

Dr. Andrew Wakefield was totally blasted and blacklisted when he stated NOT that vaccines caused autism (he's never said that) but that the MMR should be given as 3 separate shots and that he suspected a link between vaccines and autism based on his findings in tests on autistic kids with celiac symptoms.

Dr. Peter Duesberg (Nobel-prize-winning, no less) was blasted and blacklisted for showing that AZT could cause ALL known symptoms of AIDS.

And my husband (a PhD chemist) knows researchers who were legally gagged when their findings were not what their pharmaceutical company employer wanted to hear--and the products stayed on the market.

We assume that the peer review process is fair and unbiased, etc. But is it? Hey, if it were, half of the medicines/vaccines/ chemical products out there would never have been approved in the first place.

Now, what's been pointed out about Dr. Fine above might very well be true--I haven't looked into it. But let's not jump on the bandwagon if we don't REALLY know what's going on.

I get mad at Mercola from mercola.com because he peddles all kinds of nutraceuticals that may or may not be helpful, I don't know. But he spends so much time blasting the pharmaceutical companies for the kind of propaganda/mass brainwashing they do--and then he uses exactly the same marketing tactics they do to sell his own stuff. I can certainly understand everyone being ticked off if Fine is doing the same thing.

I would just like to know the whole story before I judge.

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Fiddle-faddle, I think it's good that you haven't bothered with enterolab because he can't tell you anything that you don't already know. Gluten makes you sick! You don't need to pay 400 bucks for him to tell you that. He can't tell you if you have celiac,colitis, crohn's, cancer or anything for that matter! All he can tell you is that gluten disagrees with you, but you knew that or you wouldn't be looking at his website. A person's best bet is to go to a real medical doctor and get checked out to see why they feel so bad. If everything comes up negative,then by all means try going gluten-free. You don't need him to tell you that.

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Fiddle faddle, I totally agree. And many of us have tried alternative healings and testings which have not been "validated." No one forces anyone to use Enterolab. If we respect others doing alternatives but not Dr. Fine, we are not being consistent IMHO.

Neesee, that is fine if you have a clearcut reaction and clearcut improvement. I don't, and not everyone else does either. After months and months my doctors and I are certain I have a severe case of celiac.

My new GP (takes only gluten sensitive patients) said that she heard him speak in a conference and he was very well respected in the field. Then he put the test available on the internet, and around the same time there was some kind of picture or video of him where he was dressed casually with a beard or something on a hike???. Sorry can't remember the details. Anyway, the two things suddenly branded him as a maverick, out of the mainstream, etc.

Maybe he has decided that peers who treat him that way are not important to convince.

My GP says she has no problem with his testing, but she warns patients that it won't be respected elsewhere (like if they go to a GI).

The thing is, many of us have lost respect for mainstream medicine's closed minds too.

I prefer to give him the benefit of the doubt, and am much appreciative of his testing being available. I would have not found out I was celiac without it.

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[quote name='mftnchn' date='Nov 7 2008, 08:09 PM' post='482625'

I would have not found out I was celiac without it.

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[quote name='mftnchn' date='Nov 7 2008, 08:09 PM' post='482625'

I would have not found out I was celiac without it.

I don't know what you base your diagnosis on because Dr Fine himself says he cannot diagnose celiac with his test. He tests for gluten intolerance, but not celiac. Just having the genes alone also does not diagnose celiac.

neesee

Just posing an honest question...........

If you have the genes, and you have the symptoms, wouldn't it be reasonable to assume that you actually have Celiac Disease?

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Just posing an honest question...........

If you have the genes, and you have the symptoms, wouldn't it be reasonable to assume that you actually have Celiac Disease?

Honestly? I suppose you could assume that. But that isn't necessarily your wisest option. A lot of diseases have very similar symptoms to celiac. A person's best bet is to seek out a medical doctor and get checked out properly. It could just save your life.

I thought I had a pretty bad glutening this past summer. Guess what? It was diverticulitis. Bad too!! I had my sigmoid colon and part of my descending colon removed. It was twisted, full of bleeding ulcers and infected diverticuli.

neesee

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For what it's worth... Enterolab doesn't do its own genetic analysis. They send the swabs to Bonfils. I know you can't diagnose anything on genetics alone, but I find it extremely useful to know my genes. It gave me the opportunity to look up peer-reviewed scholarship on conditions that have been linked to DQ8 and DQ7... now I have a better idea of what to watch for in myself and in my kids.

Like any piece of information, you need the big picture. Even if a doctor diagnosed me with celiac, I would still do my own research and try to figure out what it means for my own personal health. And frankly... I couldn't get a celiac diagnosis (even though I have the gene... and I was having a lot of abdominal symptoms that resolved once I took gluten out of my diet) because an allergist told me to try an elimination diet without offering a blood test first. <_<

I had a huge improvement within 48 hours after going off gluten! If I had continued to have a lot of pain, gas, bloating, etc... I definitely would have gone to another doctor for help.

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Just posing an honest question...........

If you have the genes, and you have the symptoms, wouldn't it be reasonable to assume that you actually have Celiac Disease?

My opinion - no. But, the presence of the genes and symptoms warrant further investigation.

30-40% of Americans have one or both genes.

1 in 133 Americans (less than 1%) have Celiac.

1 in 56 symptomatic patients has Celiac.

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Neesee, I am well aware of the limitations of Enterolab testing and do not speak of it as "gold standard" diagnosis to anyone. I say I have a clinical diagnosis of celiac. I have non-classic symptoms.

In my case, I did Enterolab testing on a whim, I was looking for an answer to chronic constipation. My results were starkly positive. Malabsorption over 1300, high levels on the gluten tests. I have two DQ2 genes which carries the highest possible risk for celiac. Had I been in the USA or a country where I could have gotten a blood test and reliable biopsy I would have done that next.

However, I was overseas for 10 months. Phone consults with two of my doctors. Both did NOT want me to wait that long to go gluten-free.

Since then the malabsorption has been confirmed by other testing, which showed it to be profound even after 9 months gluten-free. I have long term thyroid issues and other autoimmune conditions.

I have had a dietary response to gluten-free however, it isn't by itself clear cut due to other issues like lyme disease. After going gluten-free I had as many negative as positive changes, and started wide swings of being better then worse. Also I recently discovered that I cannot digest carbs, likely due to villa damage that has not been able to heal while I was still eating carbs. My response to the SCD diet has been huge and I have greatly stabilized since starting this in July.

My new GP looked over all of the testing and evidence and she said it was the most distinctively positive she had ever seen. None of my doctors want me to challenge with gluten to get further diagnosis. She ordered a bone scan (which was fine) and a routine colonoscopy, but saw no need to do an endoscopy or biopsy at this point. After a recent gluten exposure with a hidden source, I would agree that doing a gluten challenge for further diagnosis is not an option.

My point is that Enterolab testing can be a valid piece of the puzzle as we search out answers when used wisely and thoughtfully. There is no need in my opinion to bash someone/something that is helpful.

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Honestly? I suppose you could assume that. But that isn't necessarily your wisest option. A lot of diseases have very similar symptoms to celiac. A person's best bet is to seek out a medical doctor and get checked out properly. It could just save your life.

I thought I had a pretty bad glutening this past summer. Guess what? It was diverticulitis. Bad too!! I had my sigmoid colon and part of my descending colon removed. It was twisted, full of bleeding ulcers and infected diverticuli.

neesee

I suppose what I should have said was:

If you have gone through traditional medicine channels and undergone a bunch of inconclusive tests, and then opt for Enterolab, and find out that you have the genes and have the symptoms, wouldn't it be reasonable to assume that you have Celiac Disease?

(Wow, that was a run-on sentence!)

I guess my point is this: if you've gone through a battery of testing and found no answers (negative blood tests, negative biopsy, 'normal' everything), but Enterolab tells you that you have the genes and are sensitive to gluten, it would make sense (to me) to go on the gluten free diet. I guess I don't really care what it's called, as long as I know how to treat it.

FWIW, I haven't used Enterolab, but I am curious about the gene testing, so I might go that route at some point.

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Neesee, I am well aware of the limitations of Enterolab testing and do not speak of it as "gold standard" diagnosis to anyone. I say I have a clinical diagnosis of celiac. I have non-classic symptoms.

In my case, I did Enterolab testing on a whim, I was looking for an answer to chronic constipation. My results were starkly positive. Malabsorption over 1300, high levels on the gluten tests. I have two DQ2 genes which carries the highest possible risk for celiac. Had I been in the USA or a country where I could have gotten a blood test and reliable biopsy I would have done that next.

However, I was overseas for 10 months. Phone consults with two of my doctors. Both did NOT want me to wait that long to go gluten-free.

Since then the malabsorption has been confirmed by other testing, which showed it to be profound even after 9 months gluten-free. I have long term thyroid issues and other autoimmune conditions.

I have had a dietary response to gluten-free however, it isn't by itself clear cut due to other issues like lyme disease. After going gluten-free I had as many negative as positive changes, and started wide swings of being better then worse. Also I recently discovered that I cannot digest carbs, likely due to villa damage that has not been able to heal while I was still eating carbs. My response to the SCD diet has been huge and I have greatly stabilized since starting this in July.

My new GP looked over all of the testing and evidence and she said it was the most distinctively positive she had ever seen. None of my doctors want me to challenge with gluten to get further diagnosis. She ordered a bone scan (which was fine) and a routine colonoscopy, but saw no need to do an endoscopy or biopsy at this point. After a recent gluten exposure with a hidden source, I would agree that doing a gluten challenge for further diagnosis is not an option.

My point is that Enterolab testing can be a valid piece of the puzzle as we search out answers when used wisely and thoughtfully. There is no need in my opinion to bash someone/something that is helpful.

If you have never had an endoscopy, how do you know you have villi damage? It would have been cheaper just to give the gluten-free diet a try in you situation. Don't they have drs. overseas?

Well if you are feeling better I don't suppose it matters whether you have the gold standard diagnosis or not. I just wouldn't have spent the money on enterolab,but that's just me.

neesee

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I suppose what I should have said was:

If you have gone through traditional medicine channels and undergone a bunch of inconclusive tests, and then opt for Enterolab, and find out that you have the genes and have the symptoms, wouldn't it be reasonable to assume that you have Celiac Disease?

(Wow, that was a run-on sentence!)

I guess my point is this: if you've gone through a battery of testing and found no answers (negative blood tests, negative biopsy, 'normal' everything), but Enterolab tells you that you have the genes and are sensitive to gluten, it would make sense (to me) to go on the gluten free diet. I guess I don't really care what it's called, as long as I know how to treat it.

FWIW, I haven't used Enterolab, but I am curious about the gene testing, so I might go that route at some point.

If you've gone through all the tests and you know it isn't something more serious, why bother with enterolab. just go gluten-free. I think the gene aspect is very interesting too. but I'm a fussbudget and would prefer to be tested by a lab that tests for both the alpha and beta alleles. After all, it isn't impossible to have celiac with just the alpha allele alone. Rare, but not impossible.

neesee

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I did have an endoscopy such as was offered here, prior to doing Enterolab. No biopsy. No one here even knows what celiac is, I have found. It isn't common in Asia--although there is more of it then previously thought so over time it might be "discovered." I live in an area where there is a high consumption of wheat.

I (and my doctors) have been the educated assumption I have villi damage due to the evidence of it in the malabsorption and lack of ability to make the enzymes the villi produce. The little evidence I have from the endoscopy (a tiny pix of the duodenum), looks like the duodenum shows clear evidence pointing to celiac which may have been picked up had I been in the USA with a sharp GI.

It was a year following my Enterolab tests before I began stating that I have celiac disease. In my case, I wouldn't have known to even try gluten-free had it not been for Enterolab.

Neesee, it is not my intention to single you out here. You are entitled to your opinion, no one pushes you to do Enterolab. I have reacted to the negative bashing in general on this thread. I support a thoughtful approach that is as scientifically based as possible for each person's diagnosis and treatment, and that respects that each patient is unique and in unique circumstances.

When I post on threads about Enterolab, I try to make the caveat when appropriate that there are limitations to the testing in terms of diagnosis. That, I think, is appropriate.

We need to remember that there are limitations to the gold standard diagnosis as well. It misses many celiacs, there can be inaccuracies in the process due to human failure, and there is more than one cause of villi damage. Therefore it is appropriate to make caveats about that form of diagnosis as well.

I think I have said what I want to say here, and don't have the time to keep following this thread. I wish you all well.

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mftnchn, I am not bashing you in any way. I will however bash Dr. Fine if I feel so inclined. I think he's a charlaton. He is making his money off the pain and misfortune of others. He needs to publish his findings to have any credibility.

neesee

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neesee, your approach to Dr. Fine sounds as though you have an ax to grind, which doesn't make you sound unbiased and fair. What if he can't publish because of corruption in the industry? Knowing what I do, that's my first assumption.

And I'd like to remind you that the"gold standard" of diagnosis by endoscopy is deeply flawed, as it only diagnoses late-stage celiac; under current medical practice, if your villi aren't visibly damaged (or if the doctor just happens to hit an undamaged patch), you are told not only that you don't have celiac but that gluten is not a problem.

It seems to me that Enterolab does a huge service to those who either have celiac or gluten intolerance but have negative biopsies.

Also, the figure of 1/133 having celiac is incorrect. The 2006 University of Chicago stated that 1/133 have already been diagnosed with celiac--after an average of 11 years of seeking a diagnosis. That implies that far more people actually have it--they just have not yet been diagnosed. And both the U of C study and several publications (including Against the Grain and Celiac Disease: a Hidden Epidemic say that the 1/133 figure is just the tip of the iceberg.

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