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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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    UNTREATED CELIAC DISEASE OFTEN COMES WITH PSYCHOLOGICAL BURDEN


    Jefferson Adams

    Celiac.com 10/28/2015 - Image: CC--noshiA team of researchers recently set out to review the medical literature for psychological morbidity associated with celiac disease.


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    The team included F. Zingone, G.L. Swift, T.R. Card, D.S. Sanders, J.F. Ludvigsson, and J.C. Bai. They are variously associated with the University of Salerno, Department of Medicine and Surgery in Salerno, Italy, the Department of Gastroenterology at University Hospital Llandough in Cardiff, Wales, UK, the Division of Epidemiology and Public Health at The University of Nottingham in Nottingham City Hospital, Nottingham, UK, the Department of Gastroenterology, Royal Hallamshire Hospital & the University of Sheffield, UK, the Department of Pediatrics at Örebro University Hospital in Örebro, Sweden, the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet in Stockholm, Sweden, the Department of Medicine, "C. Bonorino Udaondo" Gastroenterology Hospital, Universidad del Salvador in Buenos Aires, Argentina.

    For their study, the team searched PubMed for all papers on psychological aspects of celiac disease, specifically quality of life, anxiety, depression and fatigue, published between 1900 and June, 2014.

    Their results showed that anxiety, depression and fatigue are common complaints in patients with untreated celiac disease and contribute significantly to lower quality of life. While aspects of these conditions may improve within a few months after starting a gluten-free diet, some patients continue to suffer from significant psychological morbidity.

    These psychological symptoms may have an impact on the quality of life and the dietary adherence for people with celiac disease.

    The team encourages health care professionals to keep in mind any associated psychological burdens when treating patients with celiac disease.

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    Image Caption: Image: CC--noshi
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    Guest Angie Lyman

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    I've been working with a lot of doctors and we have found that inflammation in the digestive system causes poor absorption of vitamins, which causes depression and anxiety. I got my neurotransmitter levels tested and found they where really out of balance. Now I take vitamin supplements and get Cocktails to increase vitamin levels. And Yay! It totally works!!!!

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    I have suffered from clinical anxiety, panic attacks and depression since I was 20. Took effexor for over 12 years for it. Those psychological conditions as well as IBS, anemia, irregularity and foggy brain have cleared up entirely since discovering I had gluten enteropathy 5 years ago. I'm now 67. Which basically means I suffered with a lack of self esteem due to those conditions all my life. Even though my sister nearly died of celiac in 1948 as a six-month old, not one doctor, EVER, thought to see if gluten might be at the bottom of everything for me also. I sometimes painfully think on how different my life might have been had some doctor thought to check into this for me!

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    Dr. Vikki Petersen D.C, C.C.N
    This article originally appeared in the Spring 2009 edition of Journal of Gluten Sensitivity.
    Celiac.com 03/02/2009 - Patients with depression are told they have a chemical imbalance.  If someone else in their family is also depressed, the “gene card” is played.  “Your depression is genetic”, they are told.
    I have been in practice for over 20 years and I find the above data to be false.  Consistently we find patients who are suffering from depression and anxiety to be gluten sensitive. How could a food cause depression?  Let’s take a look.
    After the digestive tract, the most commonly affected system to be affected by gluten is the nervous system. It is thought that depression can be caused by gluten in one of two ways.  
    The first area addresses the inflammatory changes gluten can cause. A gluten sensitive individual’s immune system responds to the protein gliadin.  Unfortunately, that protein is similar in structure to other proteins present in the body, including those of the brain and nerve cells. A cross reactivity can occur whereby the immune system “confuses” proteins in the body for the protein gliadin.  This is called cellular mimicry and the result is the body attacking it’s own tissues with inflammation resulting. When inflammation happens in the brain and nervous system, a variety of symptoms can occur, including depression. Research shows us that patients with symptoms involving the nervous system suffer from digestive problems only 13% of the time.  This is significant because mainstream medicine equates gluten sensitivity almost exclusively with digestive complaints.
    In a study examining blood flow to the brain, 15 patients with untreated celiac disease were compared to 15 patients treated with a gluten-free diet for a year.  The findings were amazing. In the untreated group, 73% had abnormalities in brain circulation by testing while only 7% in the treated group showed any abnormalities. The patients with the brain circulation problems were frequently suffering from anxiety and depression as well.
    In addition to circulation problems, other research looks at the association between gluten sensitivity and its interference with protein absorption.  Specifically the amino acid tryptophan can be deficient. Tryptophan is a protein in the brain responsible for a feeling of well-being and relaxation. A deficiency can be correlated to feelings of depression and anxiety.
    Our society is too willing to accept a “chemical imbalance” as an explanation for their symptoms and instead of getting to the root cause of the condition, simply swallow a pill – a pill that in the case of anti-depressants has very dangerous and sometimes lethal side effects.
    The frequency with which we are able to successfully taper patients off their anti-depressants is considered “unbelievable” to many mainstream doctors, yet we do it regularly.  How is that possible?  We actually diagnose the root cause of the depression.  Frequently the culprit is gluten, and in such cases a gluten-free diet is the main path to recovery.


    Jefferson Adams
    Celiac.com 07/13/2010 - More and more, researchers are showing connections between inflammatory diseases, like celiac disease, and complex disorders, such as anxiety and depression. There's also a good amount of anecdotal evidence to suggest that people with celiac disease have higher rates of anxiety and depression than the general population.
    A study of the German population is the first to show that female adults following a gluten-free diet for celiac disease show higher levels of anxiety than do members of the general population.
    The researchers are recommending that female celiacs on a gluten-free diet be screened for anxiety. The researchers included W. Häuser, K. H. Janke, B. Klump, M. Gregor, and A. Hinz of the Department of Internal Medicine I of the Klinikum Saarbrücken, Winterberg in Saarbrücken, Germany.
    The team set out to examine levels of depression and anxiety between adults with celiac disease following a gluten-free diet (GFD), and in control subjects drawn from the general population.
    For their study, the team used the Hospital Anxiety and Depression Scale to measure levels of anxiety, depression, and likely anxiety or depressive disorder, in 441 adult patients with celiac disease recruited by the German Celiac Society. They then conducted the same assessments on 235 comparable patients with inflammatory bowel disease (IBD), either in remission or with slight disease activity. They did the same for the cross-sample control group of 441 adults from the general population.
    The team used regression analysis to test possible demographic and disease-related predictors of anxiety and depression in celiac disease. Demographic predictors included age, sex, social class, and family status. Disease-related predictors included latency to diagnosis, duration of GFD, compliance with GFD, thyroid disease.
    The team found that female gender (P = 0.01) was the main predictor (R(2) = 0.07) of anxiety levels in patients with celiac disease. Female patients had a higher risk for a probable anxiety disorder (OR = 3.6, 95% CI: 1.3-9.4, P = 0.01)  Patients who lived alone (OR = 0.5, 95% CI: 0.2-0.9, P = 0.05) enjoyed a lower risk of anxiety disorder. None of the demographic and medical variables for which the team screened predicted either depression levels or risk for a probable depressive disorders.
    Patients with celiac disease showed anxiety levels of 6.6 +/- 3.4, and those with IBD, anxiety levels of 6.9 +/- 3.7, both higher than the general population's level of 4.6 +/- 3.3 - (both P < 0.001). Depression levels were similar for people with celiac disease (4.2 +/- 3.4), IBD (4.6 +/- 3.4) and the general population (4.2 +/- 3.8) (P = 0.3). Rates of likely anxiety disorders in people with celiac disease were 16.8%, and 14.0% for IBD, both higher than the rates of 5.7% in the general population (P < 0.001). All three groups showed similar rates of probable depressive disorder (P = 0.1).
    Their results provide strong indications that adult women with celiac disease on a gluten-free diet suffer higher rates of anxiety than persons of the general population. They encourage clinicians to provide anxiety screens for adult women with celiac disease on a gluten-free diet.
    Source:

    World J Gastroenterol. 2010 Jun 14;16(22):2780-7. PMID 20533598

    Jefferson Adams
    Celiac.com 10/03/2011 - A number of studies show that people with celiac disease have higher risk of depression and death from external causes, but there are no conclusive studies on death from suicide.
    A research team set out to more deeply examine the risk of suicide in people with celiac disease. The team included J. F. Ludvigsson, C. Sellgren, B. Runeson, N. Långström, and P. Lichtenstein. They are affiliated with the Department of Paediatrics at Örebro University Hospital in Sweden.
    The team examined suicide risk in individuals with celiac disease where the small intestinal biopsy showed no villous atrophy.
    For their study, the team collected biopsy data from all 28 clinical pathology departments in Sweden for 29,083 individuals diagnosed during 1969-2007 with celiac disease with Marsh 3 villous atrophy, with inflammation without villous atrophy (Marsh 1-2; n=13,263), or with positive celiac disease serology, but normal mucosa (Marsh 0, n=3719).
    The team used Cox regression to calculated hazard ratios for suicide as recorded in the Swedish Cause of Death Register.
    The team found that people with celiac disease have a higher risk for suicide compared to general population control subjects (HR=1.55; 95%CI=1.15-2.10; based on 54 completed suicides).
    The results showed that suicide was more common among those who suffered from inflammation (HR=1.96; 95%CI=1.39-2.77), but the team found no such increase in people who showed positive celiac disease serology, but normal mucosa. (HR=1.06; 95%CI=0.37-3.02).
    Overall, the team found a slightly higher risk of suicide in patients with celiac disease than in the general population. The increased risk is one that merits attention from doctors, when treating patients with celiac disease.
    Source:

    Dig Liver Dis. 2011 Aug;43(8):616-22.

    Jefferson Adams
    Celiac.com 01/09/2012 - Women with celiac disease face a higher risk for depression than the general population, even once they have adopted a gluten-free diet, according to U.S. researchers.
    A team of researchers recently used a Web-mediated survey to assess a range of physical, behavioral and emotional experiences in 177 U.S. adult women, who reported a physician-provided diagnosis of celiac disease.
    The team was led by Josh Smyth, professor of biobehavioral health and medicine at Pennsylvania State University, and included members from  Syracuse University and Drexel University.
    The survey gathered information about how closely people follow a gluten-free diet and assessed various symptoms of celiac disease from physical symptoms to the respondents' experience and management of stressful situations, along with charting symptoms of clinical depression and frequency of thoughts and behaviors associated with eating and body image.
    Perhaps unsurprisingly, many women with celiac disease suffer from disordered eating, given that the management of celiac disease requires careful attention to diet and food, Smyth said.
    "What we don't know is what leads to what and under what circumstances," Smyth said. "It's likely that the disease, stress, weight, shape and eating issues, and depression are interconnected."
    The findings are forthcoming in the journal of Chronic Illness.
    Source:

    http://www.upi.com/Health_News/2011/12/28/Celiac-ups-depression-risk-for-women/UPI-75401325131984/#ixzz1iQynze9k.

  • Recent Articles

    Jefferson Adams
    Celiac.com 04/23/2018 - A team of researchers recently set out to learn whether celiac disease patients commonly suffer cognitive impairment at the time they are diagnosed, and to compare their cognitive performance with non-celiac subjects with similar chronic symptoms and to a group of healthy control subjects.
    The research team included G Longarini, P Richly, MP Temprano, AF Costa, H Vázquez, ML Moreno, S Niveloni, P López, E Smecuol, R Mazure, A González, E Mauriño, and JC Bai. They are variously associated with the Small Bowel Section, Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital; Neurocience Cognitive and Traslational Institute (INECO), Favaloro Fundation, CONICET, Buenos Aires; the Brain Health Center (CESAL), Quilmes, Argentina; the Research Council, MSAL, CABA; and with the Research Institute, School of Medicine, Universidad del Salvador.
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    Source:
    J Clin Gastroenterol. 2018 Mar 1. doi: 10.1097/MCG.0000000000001018.

    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
    Due to personal health reasons and restrictions, I find that I need to retire. My husband and I can no longer travel the country speaking at conferences and to support groups (which we dearly loved to do) nor can I commit to writing more books, articles, or menus. Consequently, I will no longer be contributing articles to the Journal of Gluten Sensitivity. 
    My following books will still be available at Amazon.com:
    Gluten-free Cooking for Dummies Student's Vegetarian Cookbook for Dummies Wheat-free Gluten-free Dessert Cookbook Wheat-free Gluten-free Reduced Calorie Cookbook Wheat-free Gluten-free Cookbook for Kids and Busy Adults (revised version) My first book was published in 1996. My journey since then has been incredible. I have met so many in the celiac community and I feel blessed to be able to call you friends. Many of you have told me that I helped to change your life – let me assure you that your kind words, your phone calls, your thoughtful notes, and your feedback throughout the years have had a vital impact on my life, too. Thank you for all of your support through these years.

    Jefferson Adams
    Celiac.com 04/20/2018 - A digital media company and a label data company are teaming up to help major manufacturers target, reach and convert their desired shoppers based on dietary needs, such as gluten-free diet. The deal could bring synergy in emerging markets such as the gluten-free and allergen-free markets, which represent major growth sectors in the global food industry. 
    Under the deal, personalized digital media company Catalina will be joining forces with Label Insight. Catalina uses consumer purchases data to target shoppers on a personal base, while Label Insight works with major companies like Kellogg, Betty Crocker, and Pepsi to provide insight on food label data to government, retailers, manufacturers and app developers.
    "Brands with very specific product benefits, gluten-free for example, require precise targeting to efficiently reach and convert their desired shoppers,” says Todd Morris, President of Catalina's Go-to-Market organization, adding that “Catalina offers the only purchase-based targeting solution with this capability.” 
    Label Insight’s clients include food and beverage giants such as Unilever, Ben & Jerry's, Lipton and Hellman’s. Label Insight technology has helped the Food and Drug Administration (FDA) build the sector’s very first scientifically accurate database of food ingredients, health attributes and claims.
    Morris says the joint partnership will allow Catalina to “enhance our dataset and further increase our ability to target shoppers who are currently buying - or have shown intent to buy - in these emerging categories,” including gluten-free, allergen-free, and other free-from foods.
    The deal will likely make for easier, more precise targeting of goods to consumers, and thus provide benefits for manufacturers and retailers looking to better serve their retail food customers, especially in specialty areas like gluten-free and allergen-free foods.
    Source:
    fdfworld.com

    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.
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    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