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      Frequently Asked Questions About Celiac Disease   04/07/2018

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes
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    CELIAC DISEASE AND PARAPROTEINEMIA (SERUM MONOCLONAL PROTEINS)


    Hallie Davis

    Celiac.com 02/28/2008 - A study published in the Leukemia Research Journal (Volume 30, issue 12, Pages 1585-1586 - December 2006) looked at samples of serum from multiple myeloma patients. In 35% of the samples the myeloma monoclonal proteins had antigliadin activity, and migrated just like celiac anti-gliadin antibodies when subjected to electrophoresis. Monoclonal gammopathy (MGUS) is a precursor stage to multiple myeloma, with the same or very similar sort of monoclonal proteins as in multiple myeloma, and converts to it at the rate of about 1.5% per year. Therefore if one lives for 20 years after diagnosis with MGUS, one has a 30% chance of ending up with deadly, so far incurable, multiple myeloma, which is a cancer of the bone marrow and blood. For those diagnosed with MGUS it seems like a time bomb ticking, and each time one goes for the monitoring blood tests, there is some degree of anxiety. It was postulated by the researchers that multiple myeloma may actually be an end result of untreated celiac disease. This is why there has been a large reaction about this on the various MGUS web forums.Thirty-five percent is very high! At least one of our ChooseHope.com MGUS forum members was recently tested and found to have Celiac Disease and there are numerous other persons on the various MGUS forums alleging that they have this combination of conditions.


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    In another publication from the database at PubMed.gov (Gut. 1976 Sep;17(9):735-9.), a study that showed that when a patient with MGUS and Celiac Disease was put on a gluten-free diet the monoclonal proteins entirely disappeared by the end of 3 years! Hence you can imagine what big news this is to all the MGUS patients, on the various online MGUS forums. Here is the suggestion that Celiacs might avoid becoming MGUS patients, that MGUS patients might perhaps avoid progression to multiple myeloma, and that multiple myeloma patients might have halted or slower progression of their disease, simply by being on a gluten-free diet! This is indeed big news!

    The ramifications of this are that everyone with Celiac Disease really should undergo testing for MGUS/Myeloma which can be associated with various autoimmune diseases, increased rate of osteoporosis,  and neuropathy, or no symptoms at all! Likewise all MGUS patients should be tested for celiac disease, which again can be associated with various autoimmune diseases, increased rate of osteoporosis,  and neuropathy, or no symptoms at all! Do you see the similarities?

    I am currently working on a letter to Blue Cross Blue Shield,  informing them of the results of these studies and suggesting that their policy of reimbursing for celiac DNA testing of first degree relatives of known celiacs should be expanded to also include all persons having serum monoclonal proteins. This would include not just MGUS and multiple myeloma, but also Waldenstrom's macroglobulinemia.

    I would also like to call for intensified research on the link between celiac disease and paraproteinemia.


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    Guest Tommie Thomas

    Posted

    Found this interesting as an iridiology picture indicates that I am not digesting protein and that cells are surrounded by something and protein at least is not getting into cells. I also have a blob of something on one eye which seems to be causing changing readings from 20/25 - 20/60. Can this have to do with celiac disease which I have?

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    Guest Tamara W

    Posted

    Hello.

    I receive the email updates. I found a lot of information in this article I did not understand, but with a bit of studying have made sense of it. Thank you for including it on your site.

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    Guest Ellen S

    Posted

    Very interesting article. My mother has MGUS and recently I have begun to suspect she (and I) have gluten sensitivity based on other symptoms. This article adds more support to my efforts to get her to stay on a gluten-free diet.

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    Guest Beverly

    Posted

    This theory definitely sounds logical to me. I am a newly diagnosed Celiac who suspects there are many more celiacs in my large family. Specifically, I have an aunt who died of Multiple Myeloma and cousins with IBS. There is so much more to be learned about Celiac and autoimmune diseases.

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    Guest Annie Barnes

    Posted

    I am a dermatitis herpetiformis and coeliac disease patient and I have had raised levels of gamma kappa paraproteins for some years now. I have a blood test about every 6 months and thankfully, nothing untoward has occurred. I have been on a strict gluten-free diet for the last 8 years but these paraproteins don't disappear. The doctors just tell me they are non-specific.

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    Wonderful, but scary news. It is nice to see some research going on about celiac and cancer.

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    Guest Jody S

    Posted

    This is a very interesting article. I often search for genetic links, or th 'why I have celiac'. My father died of Leukemia at age 38. I was diagnosed with celiac at age 30, with osteoporosis at age 36. Now at 51 my osteoporosis is reversed, I'm healthy and enjoying life and FOOD. But I will be checked for MGUS.

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    Guest quinnafrina

    Posted

    Interesting article. I was diagnosed with celiac disease about 2 1/2 years ago, and with MGUS (IgG kappa) shortly after that. At that time, my endocrinologist (I'm osteoporotic) attributed the MGUS to the celiac. As to the disappearance of the paraprotein, my paraprotein levels have remained stable over the 2 1/2 years.

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    Guest Darlene K

    Posted

    Very interesting. My father was diagnosed with MGUS approx 10 years ago and I was finally diagnosed with celiac disease 6/07 after having symptoms since childhood. Ironically, both of my parents were tested for celiac after my confirmed diagnosis and both their tissue antibodies came back negative. Definitely warrants some investigation.

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    Guest Donna Stewart

    Posted

    I am a 55 year old woman who was diagnosed with MGUS by Dr. Durie at Cedar's Sinai Medical Center in 1995. My IGg numbers have been pretty constant since. When I went for my first colonoscopy screening last month I happened to mention to the doctor that I occasionally had bouts of IBS. He tested me for celiac disease but the results were neg. He did mention that because my IGa was low it might cause a false reading. Since I did not want to have any invasive procedures done I decided to try a gluten free diet. There has been a noticeable absence of intestinal pain. I was already anticipating my upcoming MGUS lab work in May, thinking there may be some correlation when I read this article. I would like to get in touch with the author of this article to update you further and compare notes. Thank you so much for validating my suspicions.

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    Guest Sherri

    Posted

    The info is interesting. However, I would temper the advice that every celiac get the MGUS testing. If there is nothing that medicine knows to do, why get the testing? It will only provide another medical record and 'diagnosis' used against the person when he or she seeks health insurance. Stay on a gluten-free diet and undertake other health-oriented nutritional therapy. I frankly don't believe that the diagnostic system used in conventional medicine is helpful in our quest to understand whole body dynamics.

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    Guest Hallie

    Posted

    I want to let all of you MGUS (and other) patients know not to quit your celiac testing prematurely. My celiac specialist, who is probably the nation's, if not the world's foremost celiac researcher, told me that even if the blood antigliadin IgG and IgA, EMA, and TTG tests are all negative or equivocal, one should proceed to have the celiac DNA tests. And he further stated that even if those are negative, they only usually test for DQ8 and DQ2, so if these are negative, one can STILL have celiac. He says they are finding out that many genes are involved, not just those two. So then if celiac is still suspected, one should proceed to having intestinal biopsies done.

     

    As a case in point, one of our ChooseHope.com MGUS patients found in the past that all of her blood tests for celiac were negative. However recently she resumed testing with Enterlab, and they found that both her fecal antigliadin test, and her DNA test were positive!

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    Guest Hallie

    Posted

    Sheri,

    While it is true there is no known cure so far for multiple myeloma, there ARE various treatments that can give significant remissions, prolong life, and help retain quality of life longer. By testing celiac patients for MGUS and multiple myeloma those who turn out to have MGUS can be monitored and receive prompt treatment if their condition converts to multiple myeloma. Those who have multiple myeloma can be entered into treatment if their stage warrants it. There are many clinical trials currently in progress on multiple myeloma, and one of these just may turn out to be the actual cure we are looking for! It's just too early to know yet for many of these trials. And even remission is welcome to those who have it. As they say, 'Where there is life, there is hope!' So much research is ongoing that we have minor breakthroughs about this cancer all the time, and a major breakthrough is surely not far away. I have a relative with multiple myeloma who has lived about 13 years with various treatments. Without treatment he would have been dead long ago. Instead, however, he comes every year to our family reunions!

     

    There is another paraproteinemia called POEMS syndrome. It has been found that high dose chemotherapy followed by stem cell transplant, has been followed by extremely long remissions, perhaps some cures. Only a few persons have relapsed. This may turn out to have been a cure for many of these patients. It is just too early to know yet!

     

    I hope I have illustrated that it does not pay to take a fatalistic approach to the possibility of MGUS/multiple myeloma and other paraproteinemias.

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    Guest joe Pagliarini

    Posted

    This article sounds like that last 4 years of my life. My mom is celiac and although none of the tests showed celiac my wife insisted I follow this diet since after therapy for my bone marrow para proteins I could not get control of my digestive system. I have never gone of the diet and recently after 3 years on the diet religiously my proteins have disappeared entirely.

     

    Wow I can not wait to share with my oncologist and primary care physician.

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    Guest William West jr.

    Posted

    I have had celiac disease+dh for 53 years, and it has turned my is sides into a mass of hurt.

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    This was very interesting and informative.....I'm staying Gluten free for life! I have MGUS and want to keep it in check.

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    Guest Lois Wannamaker

    Posted

    I am really glad I found this article. Recently I went to have regular check for my MGUS and they told me I need to be more vigilant with my gluten free diet, I've been gluten intolerant since 1980. Also they found the MGUS is causing neuropathy and that is why my carpal tunnel surgery was not successful and came back - bad proteins stick to nerve endings. Now it is in my legs and feet and have to use a cane. I had never been very careful with my gluten free diet but now I will be more vigilant.

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    Guest Paula W

    Posted

    This IS interesting, I have had a VERY bloated stomach for several years and I am a baker, eats HEAPS of wheat.

    Was diagnosed for MGUS, 1 year ago now am having monthly tests as my M is 29.1.

    About to order curcumin once I figure out best quality and price.

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    I am relieved to see these remarks and the article. I have MGUS, but the doctors I had here on Long Island don't seem to have the first clue! I put myself on the diet to reverse the MGUS in July 2010, after researching and finding a commonality the excess M protein in the red blood cell that the oncologist explained to me was MGUS and in celiac, and also discovered that other conditions I have had for over 30 years also started to subside (nerve damage, osteoporosis, skin sensitivities, arthritis, and extensive digestive problems) within 2 weeks of starting the gluten-free diet. My PCP said I should stick with it in view of those improvements. I did agree to an endoscopic procedure a month later, which was negative, but caused an injury to the site where the biopsy was taken in my upper GI region. He also neglected to tell me about a hiatal hernia he supposedly detected in 2008 when treating me for ischemic cholitis, but never told me I had it, or to treat for it. My MGUS numbers were in Normal range after 10 months on the gluten-free diet. I plan to continue, but because I don't have a specific positive diagnosis for celiac, I do for MGUS, the GI who performed the test later in the year told me to see a shrink when I was hospitalized late 2010 and then again in March 2011, for an intestinal blockage, resulting in surgery to remove a 9 inch adhesion in the appendix region. If the doctors aren't aware or willing to learn I will treat myself. I don't trust the doctors in my region. Thank you for this information.

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    Guest Ramona

    Posted

    I was diagnosed with MGUS last year. I went gluten-free and the MGUS disappeared. I no longer need blood test monitoring.

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    Guest LenaP

    Posted

    This is a very interesting article. I often search for genetic links, or th 'why I have celiac'. My father died of Leukemia at age 38. I was diagnosed with celiac at age 30, with osteoporosis at age 36. Now at 51 my osteoporosis is reversed, I'm healthy and enjoying life and FOOD. But I will be checked for MGUS.

    How did you reverse the osteoporosis?

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    Guest Laurie

    Posted

    I am gluten intolerant, have celiac disease which developed in multiple myeloma. I went into immediate remission after about 5 months of Velcade. I feel great! I also followed Dr. Huldah's protocol, with respect to the de-malonating diet, and the addition of specific amino acids. That along with the green hull of Black Walnut Hull drops and cloves to kill all parasites. I saw improvement in my counts around the second month of chemo. I continued with Alkalife, to keep my system alkaline, and added fresh papaya with the black seeds included, and aloe directly from the gel in the leaf to my daily diet. These have properties that kill the multiple myeloma cells. I was told to go gluten free, but didn't adhere strictly. Even when the m count was undetectable, sometimes after eating a gluten product, I'd continue to have a burning back paint. At the same time as the MM diagnosis, I was diagnosed with acid reflux disease, and have been on protonics for 9 months, since this first occurred. As I a m in complete remission, I am certain that by continuing to be strictly gluten free, and adhering to the above protocol that the mm will not return to take my life prematurely. I'm 59 and I believe that I can live another 20 years cancer free. The only other things that I used were Uma da Gato, which I boiled from the bark and took a small swig of daily. The morning power drink I make is with organic arugulla, spinach, flax seeds, shitake mushrooms, turmeric, green onion, almonds, aloe vera, and garbanzos. I also do everything that my oncologist tells me to do.

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    Guest danielle

    Posted

    Hi, my father was diagnosed with multiple myeloma last year and since than I have researched about this disease. I found it interesting that there might be a connection between it and celiac. I have gerd and gastritis a lot though no obvious risk factors for this. I took huge amounts of stomach medications for it the past three years and nothing was working really well. Then I remembered that my sister was sensitive to wheat, and that the stomach problems ran on my fathers side of the family. I decided to go gluten free, even though I was tested for celiac in an endoscopy 2 years earlier and it came back negative. After being one week gluten free I was able to quit my stomach med (Nexium). After one month being off of Nexium and gluten I had a blood work done and my hypothyroidism was gone and also my platelet count that used to be low for the last 2 years was normal. ( I haven't been diagnosed with any condition about this though, was always unspecified thrombocythopenia of unknown cause) . A week later I reintroduced wheat/gluten in the form of two slices of white bread. I literally was sick half an hour later with diarrhea and horrible bloating, and had to get back on my Nexium the following day with severe gastritis! Kind of clear, huh? I immediately quit the gluten again and was able to quit the Nexium 2 weeks later. Since then I'm gluten free and feeling wonderful. I wonder if my dad is gluten intolerant and doesn't even know....

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    Guest cristiana

    Posted

    My doctor thought at first I might have MM, as I had raised immunoglobulins (41, I gather the normal reading is meant to be under 35, or perhaps some labs say 38). When it was sent to electrophoresis though the readings were diffuse, indicating inflammation. When my celiac disease was diagnosed a few months later it was discovered that my readings of this protein was down to normal levels - 31.

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    Dr. Ron Hoggan, Ed.D.

    The following piece was written by Ronald Hoggan who is a teacher at Queen Elizabeth High School in Calgary, Alberta, Canada.
    There is much evidence linking untreated celiac disease with malignancy. I have recently been notified of publication of a report I have written on that connection, which is promised for the September, 1997 issue of Medical Hypotheses (1). In that report, I combine a review of the literature with an outline of a possible biochemical pathway whereby psychoactive peptides derived from the pepsin digests of wheat, rye and barley may down-regulate the activation of natural killer cells, the bodys first line of defense against malignancy. This is not a postulation that glutinous grains are carcinogenic. Humankind has been exposed to carcinogens throughout its ~ two million year evolution. But it is only in recent centuries that malignancy has increased exponentially, and has struck so many children and adolescents. This is clearly a counter-evolutionary trend when youngsters are afflicted, because the incidence should be decreasing over time, as these youngsters genes are being pruned from the gene pool. There is some evidence that has come to light since my aforementioned report, which will be of interest to celiacs and members of their families.
    M. Stanislas Tanchou, a truly visionary physician, and campaigned with Napoleon Bonaparte, presented a paper to the Paris Science Society in 1843, which was a complex statistical examination of malignancy, offering evidence of increased malignancy with increased civilization (2). One of the prime indicators of a civilizing trend was a diet that included cereal grains. The greater the consumption of these foods, the greater the incidence of malignancy (3).
    Dr. Chris Reading, an orthomolecular psychiatrist, in Australia, has documented the treatment of five cancer patients for depression (4). His testing for food allergies, and subsequent treatment of depression with dietary exclusion of cereal grains resulted in total remission of the cancers (which were also given conventional treatments) in all five patients he reports treating. One of these patients did die, but that was from the cancer treatment.
    There are also two reports in the Journal of Clinical Gastroenterology (5) Lancet (6) that I cite in my Medical Hypotheses article. These reveal a total remission of malignancy in each patient. One report then recants the original diagnosis, and identifies the correct diagnosis as lymphadenopathy. In the other report, which spurs a heated debate, the original diagnosis is supported by a resected section of malignant bowel, and there can be no doubt as to the correct diagnosis.
    Further, in a 1977 report, in Nutrition and Cancer (8), from Stanford University, all the children suffering from radiation and chemotherapy damage to the small bowel recovered fully from their chronic enteritis, and suffered no relapse of either the bowel obstruction or the disease. The treatment they were given was a gluten-free, dairy-free, low fat, low residue diet.
    In an obscure Czech journal, a report has recently indicated that one or more of the gliadins, a sub-set of proteins in gluten, may also interfere with natural killer cell activation in peripheral blood (9). They tested the levels of natural killer cell activation in normal, and in treated celiacs, and found no significant difference. BUT, after 30 minutes exposure of the celiacs blood to gliadin, there was a reduced activation of natural killer cells.
    For the last hundred years, billions of dollars have been spent identifying carcinogens. Most of what we encounter in our environment appears to have some measure of carcinogenic potential. Unfortunately, we have failed to reconcile that Humanity has been exposed to most of these carcinogens throughout its evolution. Conventional wisdom has pointed to the increasing levels of chemical pollution and environmental damage. And I do not doubt that these factors are contributing to the current epidemic of malignancy. What I do doubt is that segment of the population, variously reported at 20% to 30%, which has the HLA factors which predispose to celiac disease and many other autoimmune diseases, can mount an adequate immune response, with natural killer cells, against malignancy.
    References: Hoggan R, Considering Wheat, Rye, and Barley Proteins as Aids to Carcinogens in press Medical Hypotheses, 1997. Tanchou S, Statistics of Cancer London Lancet 1843; Aug 5, 593. Audette R, personal communication. Reading C, Meillon R, Your Family Tree Connection, Keats; New Canaan, Conn.: 1988. Wink A, et. al. Disappearance of Mesenteric Lymphadenopathy with Gluten-Free Deit in Celiac Sprue, J. Clin. Gastroenterol, 1993; 16(4): 317-319. Wright DH, et. al. Celiac disease and Lymphoma, Lancet 1991; 337:1373. Wright DH, et. al. letter Lancet 1991; 338: 318-319. Donaldson SS, Effect of Nutrition as Related to Radiation and Chemotherapy, Nutrition and Cancer, Winick ed. 1977; Wiley & Sons, NewYork, 137153. Castany M, Nguyen H, Pospisil M, Fric P, Tlaskalova-Hogenova H, Natural Killer Cell Activity in Celiac Disease: Effect of in Vitro Treatment on Effector Lymphocytes and/or Target Lymphoblastoid, Myeloid and Epithelial Cell Lines with Gliadin, Folia Microbial, 1995 (Praha) 40; 6: 615-620.

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    Eur J Gastroenterol Hepatol 2006;18:187-194.
    Celiac.com 04/10/2006 - According to findings by Dutch researchers, celiac disease increases the risk of non-Hodgkin lymphoma—but to a lower level than once believed. Past celiac disease studies have indicated that there is a 30 to 40-fold increased risk of enteropathy-associated T-cell lymphoma, however, Dr. M. Luisa Mearin and colleagues in The Netherlands investigated the frequency of celiac disease in two large European populations—one was a control group and the other was a group of non-Hodgkin lymphoma patients—and found that 1.2% of the non-Hodgkin lymphoma patients had celiac disease compared to 0.5% of the controls. After adjusting for age and sex differences between the two groups they found that celiac disease patients had a 2.6-fold increase risk of getting non-Hodgkin lymphoma, and this increased risk was only associated with patients who had been diagnosed prior to the study, and not in those with “silent” celiac disease which was found during the study. The odds of T-cell type small bowel lymphoma in celiac disease patients was estimated to be 28 times higher than for other localizations.
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    Jefferson Adams
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    The data showed that from 1975-1984, patients with celiac disease faced a 13.2-fold greater risk of non-Hodgkin's lymphoma; from 1985-1994, that level fell to a 7.90-fold increased risk, and from 1995-2004 that risk fell again to 3.84-fold increased risk. Siblings of those affected with celiac disease also faced a 2.03-fold greater risk of non-Hodgkin's lymphoma.
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    Celiac.com 04/15/2013 - Enteropathy-associated T cell lymphoma (EATL) is a gut cancer that often ends in death. Currently, doctors have very little idea what factors might help patients survive.
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    Jefferson Adams
    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    First, the team used liquid chromatography-tandem mass spectrometry (LC/MS) to analyze amino acid levels in fasting plasma samples from 141 children with celiac disease and 129 non-celiac disease controls. They then crafted a general linear model using age and experimental effects as covariates to compare amino acid levels between children with celiac disease and non-celiac control subjects.
    Compared with the control group, seven out of twenty-three children with celiac disease showed elevated levels of the the following amino acids: tryptophan; taurine; glutamic acid; proline; ornithine; alanine; and methionine.
    The significance of the individual amino acids do not survive multiple correction, however, multivariate analyses of the amino acid profile showed significantly altered amino acid levels in children with celiac disease overall and after correction for age, sex and experimental effects.
    This study shows that amino acids can influence inflammation and may play a role in the development of celiac disease.
    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764

    Jefferson Adams
    Celiac.com 04/18/2018 - To the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service animals.
    If you’ve flown anywhere lately, you may have seen them. People flying with their designated “emotional support” animals. We’re not talking genuine service animals, like seeing eye dogs, or hearing ear dogs, or even the Belgian Malinois that alerts its owner when there is gluten in food that may trigger her celiac disease.
    Now, to be honest, some of those animals in question do perform a genuine service for those who need emotional support dogs, like veterans with PTSD.
    However, many of these animals are not service animals at all. Many of these animals perform no actual service to their owners, and are nothing more than thinly disguised pets. Many lack proper training, and some have caused serious problems for the airlines and for other passengers.
    Now the major airlines are taking note and introducing stringent requirements for service animals.
    Delta was the first to strike. As reported by the New York Times on January 19: “Effective March 1, Delta, the second largest US airline by passenger traffic, said it will require passengers seeking to fly with pets to present additional documents outlining the passenger’s need for the animal and proof of its training and vaccinations, 48 hours prior to the flight.… This comes in response to what the carrier said was a 150 percent increase in service and support animals — pets, often dogs, that accompany people with disabilities — carried onboard since 2015.… Delta said that it flies some 700 service animals a day. Among them, customers have attempted to fly with comfort turkeys, gliding possums, snakes, spiders, and other unusual pets.”
    Fresh from an unsavory incident with an “emotional support” peacock incident, United Airlines has followed Delta’s lead and set stricter rules for emotional support animals. United’s rules also took effect March 1, 2018.
    So, to the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service and emotional support animals.
    Source:
    cnbc.com

    admin
    WHAT IS CELIAC DISEASE?
    Celiac disease is an autoimmune condition that affects around 1% of the population. People with celiac disease suffer an autoimmune reaction when they consume wheat, rye or barley. The immune reaction is triggered by certain proteins in the wheat, rye, or barley, and, left untreated, causes damage to the small, finger-like structures, called villi, that line the gut. The damage occurs as shortening and villous flattening in the lamina propria and crypt regions of the intestines. The damage to these villi then leads to numerous other issues that commonly plague people with untreated celiac disease, including poor nutritional uptake, fatigue, and myriad other problems.
    Celiac disease mostly affects people of Northern European descent, but recent studies show that it also affects large numbers of people in Italy, China, Iran, India, and numerous other places thought to have few or no cases.
    Celiac disease is most often uncovered because people experience symptoms that lead them to get tests for antibodies to gluten. If these tests are positive, then the people usually get biopsy confirmation of their celiac disease. Once they adopt a gluten-free diet, they usually see gut healing, and major improvements in their symptoms. 
    CLASSIC CELIAC DISEASE SYMPTOMS
    Symptoms of celiac disease can range from the classic features, such as diarrhea, upset stomach, bloating, gas, weight loss, and malnutrition, among others.
    LESS OBVIOUS SYMPTOMS
    Celiac disease can often less obvious symptoms, such fatigue, vitamin and nutrient deficiencies, anemia, to name a few. Often, these symptoms are regarded as less obvious because they are not gastrointestinal in nature. You got that right, it is not uncommon for people with celiac disease to have few or no gastrointestinal symptoms. That makes spotting and connecting these seemingly unrelated and unclear celiac symptoms so important.
    NO SYMPTOMS
    Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors. 

    CELIAC DISEASE VS. GLUTEN INTOLERANCE
    Gluten intolerance is a generic term for people who have some sort of sensitivity to gluten. These people may or may not have celiac disease. Researchers generally agree that there is a condition called non-celiac gluten sensitivity. That term has largely replaced the term gluten-intolerance. What’s the difference between celiac disease and non-celiac gluten-sensitivity? 
    CELIAC DISEASE VS. NON-CELIAC GLUTEN SENSITIVITY (NCGS)
    Gluten triggers symptoms and immune reactions in people with celiac disease. Gluten can also trigger symptoms in some people with NCGS, but the similarities largely end there.

    There are four main differences between celiac disease and non-celiac gluten sensitivity:
    No Hereditary Link in NCGS
    Researchers know for certain that genetic heredity plays a major role in celiac disease. If a first-degree relative has celiac disease, then you have a statistically higher risk of carrying genetic markers DQ2 and/or DQ8, and of developing celiac disease yourself. NCGS is not known to be hereditary. Some research has shown certain genetic associations, such as some NCGS patients, but there is no proof that NCGS is hereditary. No Connection with Celiac-related Disorders
    Unlike celiac disease, NCGS is so far not associated with malabsorption, nutritional deficiencies, or a higher risk of autoimmune disorders or intestinal malignancies. No Immunological or Serological Markers
    People with celiac disease nearly always test positive for antibodies to gluten proteins. Researchers have, as yet, identified no such antobodies or serologic markers for NCGS. That means that, unlike with celiac disease, there are no telltale screening tests that can point to NCGS. Absence of Celiac Disease or Wheat Allergy
    Doctors diagnose NCGS only by excluding both celiac disease, an IgE-mediated allergy to wheat, and by the noting ongoing adverse symptoms associated with gluten consumption. WHAT ABOUT IRRITABLE BOWEL SYNDROME (IBS) AND IRRITABLE BOWEL DISEASE (IBD)?
    IBS and IBD are usually diagnosed in part by ruling out celiac disease. Many patients with irritable bowel syndrome are sensitive to gluten. Many experience celiac disease-like symptoms in reaction to wheat. However, patients with IBS generally show no gut damage, and do not test positive for antibodies to gliadin and other proteins as do people with celiac disease. Some IBS patients also suffer from NCGS.

    To add more confusion, many cases of IBS are, in fact, celiac disease in disguise.

    That said, people with IBS generally react to more than just wheat. People with NCGS generally react to wheat and not to other things, but that’s not always the case. Doctors generally try to rule out celiac disease before making a diagnosis of IBS or NCGS. 
    Crohn’s Disease and celiac disease share many common symptoms, though causes are different.  In Crohn’s disease, the immune system can cause disruption anywhere along the gastrointestinal tract, and a diagnosis of Crohn’s disease typically requires more diagnostic testing than does a celiac diagnosis.  
    Crohn’s treatment consists of changes to diet and possible surgery.  Up to 10% of Crohn's patients can have both of conditions, which suggests a genetic connection, and researchers continue to examine that connection.
    Is There a Connection Between Celiac Disease, Non-Celiac Gluten Sensitivity and Irritable Bowel Syndrome? Large Number of Irritable Bowel Syndrome Patients Sensitive To Gluten Some IBD Patients also Suffer from Non-Celiac Gluten Sensitivity Many Cases of IBS and Fibromyalgia Actually Celiac Disease in Disguise CELIAC DISEASE DIAGNOSIS
    Diagnosis of celiac disease can be difficult. 

    Perhaps because celiac disease presents clinically in such a variety of ways, proper diagnosis often takes years. A positive serological test for antibodies against tissue transglutaminase is considered a very strong diagnostic indicator, and a duodenal biopsy revealing villous atrophy is still considered by many to be the diagnostic gold standard. 
    But this idea is being questioned; some think the biopsy is unnecessary in the face of clear serological tests and obvious symptoms. Also, researchers are developing accurate and reliable ways to test for celiac disease even when patients are already avoiding wheat. In the past, patients needed to be consuming wheat to get an accurate test result. 
    Celiac disease can have numerous vague, or confusing symptoms that can make diagnosis difficult.  Celiac disease is commonly misdiagnosed by doctors. Read a Personal Story About Celiac Disease Diagnosis from the Founder of Celiac.com Currently, testing and biopsy still form the cornerstone of celiac diagnosis.
    TESTING
    There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.
    Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis. Also, it is now possible to test people for celiac disease without making them concume wheat products.

    BIOPSY
    Until recently, biopsy confirmation of a positive gluten antibody test was the gold standard for celiac diagnosis. It still is, but things are changing fairly quickly. Children can now be accurately diagnosed for celiac disease without biopsy. Diagnosis based on level of TGA-IgA 10-fold or more the ULN, a positive result from the EMA tests in a second blood sample, and the presence of at least 1 symptom could avoid risks and costs of endoscopy for more than half the children with celiac disease worldwide.

    WHY A GLUTEN-FREE DIET?
    Currently the only effective, medically approved treatment for celiac disease is a strict gluten-free diet. Following a gluten-free diet relieves symptoms, promotes gut healing, and prevents nearly all celiac-related complications. 
    A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods. Still, with effort, most people with celiac disease manage to make the transition. The vast majority of celiac disease patients who follow a gluten-free diet see symptom relief and experience gut healing within two years.
    For these reasons, a gluten-free diet remains the only effective, medically proven treatment for celiac disease.
    WHAT ABOUT ENZYMES, VACCINES, ETC.?
    There is currently no enzyme or vaccine that can replace a gluten-free diet for people with celiac disease.
    There are enzyme supplements currently available, such as AN-PEP, Latiglutetenase, GluteGuard, and KumaMax, which may help to mitigate accidental gluten ingestion by celiacs. KumaMax, has been shown to survive the stomach, and to break down gluten in the small intestine. Latiglutenase, formerly known as ALV003, is an enzyme therapy designed to be taken with meals. GluteGuard has been shown to significantly protect celiac patients from the serious symptoms they would normally experience after gluten ingestion. There are other enzymes, including those based on papaya enzymes.

    Additionally, there are many celiac disease drugs, enzymes, and therapies in various stages of development by pharmaceutical companies, including at least one vaccine that has received financial backing. At some point in the not too distant future there will likely be new treatments available for those who seek an alternative to a lifelong gluten-free diet. 

    For now though, there are no products on the market that can take the place of a gluten-free diet. Any enzyme or other treatment for celiac disease is intended to be used in conjunction with a gluten-free diet, not as a replacement.

    ASSOCIATED DISEASES
    The most common disorders associated with celiac disease are thyroid disease and Type 1 Diabetes, however, celiac disease is associated with many other conditions, including but not limited to the following autoimmune conditions:
    Type 1 Diabetes Mellitus: 2.4-16.4% Multiple Sclerosis (MS): 11% Hashimoto’s thyroiditis: 4-6% Autoimmune hepatitis: 6-15% Addison disease: 6% Arthritis: 1.5-7.5% Sjögren’s syndrome: 2-15% Idiopathic dilated cardiomyopathy: 5.7% IgA Nephropathy (Berger’s Disease): 3.6% Other celiac co-morditities include:
    Crohn’s Disease; Inflammatory Bowel Disease Chronic Pancreatitis Down Syndrome Irritable Bowel Syndrome (IBS) Lupus Multiple Sclerosis Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Psoriasis Rheumatoid Arthritis Scleroderma Turner Syndrome Ulcerative Colitis; Inflammatory Bowel Disease Williams Syndrome Cancers:
    Non-Hodgkin lymphoma (intestinal and extra-intestinal, T- and B-cell types) Small intestinal adenocarcinoma Esophageal carcinoma Papillary thyroid cancer Melanoma CELIAC DISEASE REFERENCES:
    Celiac Disease Center, Columbia University
    Gluten Intolerance Group
    National Institutes of Health
    U.S. National Library of Medicine
    Mayo Clinic
    University of Chicago Celiac Disease Center

    Jefferson Adams
    Celiac.com 04/17/2018 - Could the holy grail of gluten-free food lie in special strains of wheat that lack “bad glutens” that trigger the celiac disease, but include the “good glutens” that make bread and other products chewy, spongey and delicious? Such products would include all of the good things about wheat, but none of the bad things that might trigger celiac disease.
    A team of researchers in Spain is creating strains of wheat that lack the “bad glutens” that trigger the autoimmune disorder celiac disease. The team, based at the Institute for Sustainable Agriculture in Cordoba, Spain, is making use of the new and highly effective CRISPR gene editing to eliminate the majority of the gliadins in wheat.
    Gliadins are the gluten proteins that trigger the majority of symptoms for people with celiac disease.
    As part of their efforts, the team has conducted a small study on 20 people with “gluten sensitivity.” That study showed that test subjects can tolerate bread made with this special wheat, says team member Francisco Barro. However, the team has yet to publish the results.
    Clearly, more comprehensive testing would be needed to determine if such a product is safely tolerated by people with celiac disease. Still, with these efforts, along with efforts to develop vaccines, enzymes, and other treatments making steady progress, we are living in exciting times for people with celiac disease.
    It is entirely conceivable that in the not-so-distant future we will see safe, viable treatments for celiac disease that do not require a strict gluten-free diet.
    Read more at Digitaltrends.com , and at Newscientist.com

    Jefferson Adams
    Celiac.com 04/16/2018 - A team of researchers recently set out to investigate whether alterations in the developing intestinal microbiota and immune markers precede celiac disease onset in infants with family risk for the disease.
    The research team included Marta Olivares, Alan W. Walker, Amalia Capilla, Alfonso Benítez-Páez, Francesc Palau, Julian Parkhill, Gemma Castillejo, and Yolanda Sanz. They are variously affiliated with the Microbial Ecology, Nutrition and Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), C/Catedrático Agustín Escardin, Paterna, Valencia, Spain; the Gut Health Group, The Rowett Institute, University of Aberdeen, Aberdeen, UK; the Genetics and Molecular Medicine Unit, Institute of Biomedicine of Valencia, National Research Council (IBV-CSIC), Valencia, Spain; the Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire UK; the Hospital Universitari de Sant Joan de Reus, IISPV, URV, Tarragona, Spain; the Center for regenerative medicine, Boston university school of medicine, Boston, USA; and the Institut de Recerca Sant Joan de Déu and CIBERER, Hospital Sant Joan de Déu, Barcelona, Spain
    The team conducted a nested case-control study out as part of a larger prospective cohort study, which included healthy full-term newborns (> 200) with at least one first relative with biopsy-verified celiac disease. The present study includes 10 cases of celiac disease, along with 10 best-matched controls who did not develop the disease after 5-year follow-up.
    The team profiled fecal microbiota, as assessed by high-throughput 16S rRNA gene amplicon sequencing, along with immune parameters, at 4 and 6 months of age and related to celiac disease onset. The microbiota of infants who remained healthy showed an increase in bacterial diversity over time, especially by increases in microbiota from the Firmicutes families, those who with no increase in bacterial diversity developed celiac disease.
    Infants who subsequently developed celiac disease showed a significant reduction in sIgA levels over time, while those who remained healthy showed increases in TNF-α correlated to Bifidobacterium spp.
    Healthy children in the control group showed a greater relative abundance of Bifidobacterium longum, while children who developed celiac disease showed increased levels of Bifidobacterium breve and Enterococcus spp.
    The data from this study suggest that early changes in gut microbiota in infants with celiac disease risk could influence immune development, and thus increase risk levels for celiac disease. The team is calling for larger studies to confirm their hypothesis.
    Source:
    Microbiome. 2018; 6: 36. Published online 2018 Feb 20. doi: 10.1186/s40168-018-0415-6