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      Frequently Asked Questions About Celiac Disease   04/24/2018

      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 is Celiac Disease and the Gluten-Free Diet? 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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    STUDY SHOWS HIGH PREVALENCE OF CELIAC DISEASE IN PATIENTS WITH TYPE 1 DIABETES


    Jefferson Adams

    Celiac.com 06/08/2007 - This study shows that celiac disease is as common among British Columbians with Type 1 diabetes as it is in Europeans with Type 1 Diabetes.


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    The research team was made up of doctors P.M. Gillett, H.R. Gillett, D.M. Israel, D.L. Metzger, L. Stewart, J-P. Chanoine, H.J. Freeman.

    The team looked at 233 children with Type1 diabetes. In a blind study, the children were screened for celiac disease using immunoglublin A endomysium antibody (EmA), and the Immunoglublin A tissue transglutaminase. Children with positive results were offered small bowel biopsies. For those confirmed with celiac disease, doctors recommended a gluten-free diet.

    British Columbians with Type 1 Diabetes Get Celiac Disease at Rates Comparable to their European Counterparts

    Nineteen children tested positive for EmA and showed elevated tTG levels. Of the 18 patients who agreed to biopsies, one was normal, three showed normal morphology with elevated Intraepithelial lymphocyte counts, and 14 biopsies showed morphological changes consistent with celiac disease.

    9 of the 19 children who tested positive for EmA were asymptomatic. Seven patients showed only mildly elevated tTG levels. Of this second group, five refused biopsy and two showed normal biopsies.

    In addition to the four known cases, the doctors uncovered at least 14 new cases of celiac disease. The total rate of biopsy confirmed celiac disease was 18 out of 233, or 7.7%. The doctors concluded that these results confirm that celiac disease is prevalent in pediatric type 1 diabetes.

    The doctors say the study reinforces the importance of celiac screening for children with type 1 diabetes, and also the advisability of keeping an eye on tTg serology as part of determining the effects of and compliance to a gluten-free diet.

    Participating Facilities
    1. Division of Pediatric Gastroenterology at British Columbias Childrens Hospital Vancouver, British Columbia.
    2. Division of Endocrinology, British Columbias Childrens Hospital, Vancouver, British Columbia.
    3. Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia

    Journal of Pediatric Gastroenterology & Nutrition: Volume 29(4)October 1999p 495.

    About the Author: Jefferson Adams is a freelance health writer who lives in San Francisco and is a frequent author of articles for Celiac.com.



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    I'm a researcher (prevalence of celiac disease among type 1 diabetes in Sudan)

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    Diabetes Care 2004;27:1294-1298.
    Celiac.com 11/29/2004 - In an effort to determine the prevalence of biopsy-confirmed celiac disease in Italian children and adolescents with type 1 diabetes, and to determine whether age at onset of diabetes is independently associated with the diagnosis of celiac disease, Dr. Franco Cerutti and colleagues at the Universita di Torino, Italy looked at 4,322 children and adolescents (4-11 years old) who had type 1 diabetes. Yearly celiac disease screening was performed on them by using IgA/IgG anti-gliadin and IgA anti-endomysium antibodies, and those with positive antibody results were given a biopsy for confirmation. Out of 4,322 children screened 292 or 6.8% had celiac disease. In 89% of cases diabetes was diagnosed before celiac disease. Using logistic regression analyses the researchers determined that those diagnosed with diabetes at a younger age, those who are female, and those with a thyroid disorder are independently associated with the risk of having both diabetes and celiac disease.
    The researchers conclude: "We have provided evidence that 1) the prevalence of biopsy-confirmed celiac disease in children and adolescents with type 1 diabetes is high (6.8%); 2) the risk of having both diseases is threefold higher in children diagnosed with type 1 diabetes at age 9 years; and 3) girls have a higher risk of having both diseases than boys."

    Jefferson Adams
    Celiac.com 09/24/2009 - Could a reduced level of antibodies against infectious agents indicate a protective role for such infections in T1DM development in susceptible individuals? Recent research points in that direction. Type 1 diabetes mellitus (T1DM) is an autoimmune disease with intricate and poorly understood associations between genetic and environmental factors.
    A joint Israeli-Colombian research team recently set out to examine the connections between anti-infectious antibodies and autoimmune-associated autoantibodies in patients with Type I diabetes mellitus and their close family members. Among other things, their findings confirmed a strong association between celiac disease and Type 1 diabetes mellitus.
    The research team was made up of Ilan Krause, Juan Manuel Anaya, Abigail Fraser, Ori Barzilai, Maya Ram, Verónica Abad, Alvaro Arango, Jorge García, and Yehuda Shoenfeld. The team compared levels of antibodies to numerous infectious agents and of autoimmune-associated antibodies between Colombian T1DM patients, their close family members and healthy control subjects.
    T1DM patients showed substantially reduced levels of antibodies against several infectious agents, including: cytomegalovirus (P= 0.001); Epstein-Barr virus (P= 0.02); Helicobacter pylori (P= 0.01); and Toxoplasma (P= 0.001).
    T1DM patients showed markedly elevated levels of IgG-anti-gliadin antibodies (P= 0.001) and IgG-antitissue transglutaminase antibodies (P= 0.03), and a marginal connection with anti-centromere antibodies (P= 0.06).
    T1DM patients also showed a reduced level of antibodies against infectious agents that may be associated with their younger ages, but could also indicate a protective role for such infections in T1DM development in susceptible individuals.
    The results reinforce the connection between T1DM and celiac disease, though the
    possible connection with the anti-centromere antibody requires a deeper examination.
    Studies like this are important to help build a record of all of the points of contact between these associated conditions so we can begin to understand the intricate web that ties these conditions together, and inch toward the deeper causes that lie at the heart of the mystery of celiac disease, diabetes, and so many other auto-immune/inflammatory disorders.
    Source:
    Annals of the New York Academy of Sciences - Volume 1173 Issue Contemporary Challenges in Autoimmunity, Pages 633 - 639


    Jefferson Adams
    Celiac.com 09/19/2012 - Researchers have documented rising rates of celiac disease in patients with type 1 diabetes (T1D). A research team recently tried to assess the effect of celiac disease on growth and glycemic control in patients with T1D, and to determine the effects of a gluten-free diet on these parameters.
    The research team included I. Taler, M. Phillip, Y. Lebenthal, L. de Vries, R. Shamir, and S. Shalitin. They are affiliated with the Department of Pediatrics B, Schneider Children's Medical Center of Israel in Petach Tikva, Israel.
    To do so, they conducted a longitudinal retrospective case-control study, in which they reviewed the medical data on 68 patients with T1D and duodenal-biopsy-confirmed celiac disease. They looked at weight, height, hemoglobin A1c (HbA1c), frequency of diabetic ketoacidosis (DKA), and severe hypoglycemic events before and after diagnosis and treatment of celiac disease.
    They then compared their findings with 131 patients with T1D alone, who were all matched for age, gender, and duration of diabetes.
    In all, 5.5% patients with T1D who attended the center during the study period were diagnosed with celiac disease, while 26% of the patients with celiac disease were symptomatic.
    The data showed no significant differences in glycemic control or frequency of severe hypoglycemia or DKA events between the study group and control subjects.
    Body mass index-standard deviation score (SDS), height-SDS, and HbA1c values were insignificantly higher in the control group than in the study group, and similar in celiac disease patients with good or fair/poor adherence to a gluten-free diet during follow-up.
    Patients with T1D and celiac disease and following a gluten-free diet have growth and metabolic control similar to those with T1D with no celiac disease.
    To determine whether a gluten-free diet is appropriate for asymptomatic celiac patients or only symptomatic patients must be assessed against possible short- and long-term consequences of no intervention, and the decision should be based on more evidence from larger randomized studies.
    Source:
    Pediatr Diabetes. 2012 May 7. doi: 10.1111/j.1399-5448.2012.00878.x.

    Jefferson Adams
    Celiac.com 07/11/2013 - A team of researchers wanted to better understand screening practices for celiac disease in patients with type 1 diabetes across North America. One question they sought to answer was whether diabetes centers screen for celiac disease in type 1 diabetes more frequently than other facilities.
    The research team included S.M. Simpson, E.J. Ciaccio, S. Case, N. Jaffe, S. Mahadov, B. Lebwohl, P.H. Green. All except Case are affiliated with the Celiac Disease Center at Columbia University, New York, USA. Shelley Case runs her own nutrition consulting business in Regina, Saskatchewan.
    For their study, the team conducted a survey with 27 questions on screening practices for celiac disease in patients with type 1 diabetes. The questions were compiled by experts in celiac disease and diabetes.
    The team sent surveys by email to diabetes educators and dietitians throughout the United States and Canada between December 2010 and May 2011.
    They received 514 responses from 484 endocrine clinics, diabetes clinics, private practices, community nutrition centers, and inpatient centers.
    Thirty-five percent of these locations screened for celiac disease, with endocrine clinics reporting screening at the highest rate of eighty percent.
    Not surprisingly, the most common test celiac disease test was tissue transglutaminase, while the most frequently recommended treatment of confirmed celiac disease was a gluten-free diet. However, only 365 respondents (71%) recommended biopsy in patients with positive blood results.
    More than half of those responding (55.3%) reported that patient symptoms improved once they adopted a gluten-free diet.
    Staff at endocrine clinics were most likely to suggest celiac disease testing for patients with type 1 diabetes.
    Due to low screening frequency as well as inconsistency in management of positive celiac disease blood tests, the research team is calling for increased education regarding celiac disease in patients with type 1 diabetes, along with the adoption of uniform protocols.

    Source:
    Diabetes Educ. 2013 May 14. 

  • Recent Articles

    Jefferson Adams
    Celiac.com 04/26/2018 - Emily Dickson is one of Canada’s top athletes. As a world-class competitor in the biathlon, the event that combines cross-country skiing with shooting marksmanship, Emily Dickson was familiar with a demanding routine of training and competition. After discovering she had celiac disease, Dickson is using her diagnosis and gluten-free diet a fuel to help her get her mojo back.
    Just a few years ago, Dickson dominated her peers nationally and won a gold medal at Canada Games for both pursuit and team relay. She also won silver in the sprint and bronze in the individual race. But just as she was set to reach her peak, Dickson found herself in an agonizing battle. She was suffering a mysterious loss of strength and endurance, which itself caused huge anxiety for Dickson. As a result of these physical and mental pressures, Dickson slipped from her perch as one of Canada's most promising young biathletes.
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    Dickson’s own positive test proved to be both a revelation and a catalyst for her own goals as an athlete. Armed with there new diagnosis, a gluten-free diet, and a body that is steadily healing, Dickson is looking to reap the benefits of improved strength, recovery and endurance to ramp up her training and competition results.
    Keep your eyes open for the 20-year-old native of Burns Lake, British Columbia. Next season, she will be competing internationally, making a big jump to the senior ranks, and hopefully a regular next on the IBU Cup tour.
    Read more at princegeorgecitizen.com

    Jefferson Adams
    Celiac.com 04/25/2018 - A team of Yale University researchers discovered that bacteria in the small intestine can travel to other organs and trigger an autoimmune response. In this case, they looked at Enterococcus gallinarum, which can travel beyond the gut to the spleen, lymph nodes, and liver. The research could be helpful for treating type 1 diabetes, lupus, and celiac disease.
    In autoimmune diseases, such as type 1 diabetes, lupus, and celiac disease, the body’s immune system mistakenly attacks healthy cells and tissues. Autoimmune disease affects nearly 24 million people in the United States. 
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    This study indicates that gut bacteria may be the key to treating chronic autoimmune conditions such as systemic lupus and autoimmune liver disease. Numerous autoimmune conditions have been linked to gut bacteria.
    Read the full study in Science.

    Tammy Rhodes
    Celiac.com 04/24/2018 - Did you know in 2017 alone, the United States had OVER TENS OF THOUSANDS of people evacuate their homes due to natural disasters such as fires, floods, hurricanes, tornadoes and tsunamis? Most evacuation sites are not equipped to feed your family the safe gluten free foods that are required to stay healthy.  Are you prepared in case of an emergency? Do you have your Gluten Free Emergency Food Bag ready to grab and go?  
    I have already lived through two natural disasters. Neither of which I ever want to experience again, but they taught me a very valuable lesson, which is why I created a Gluten Free Emergency Food Bag (see link below). Here’s my story. If you’ve ever lived in or visited the Los Angeles area, you’re probably familiar with the Santa Ana winds and how bitter sweet they are. Sweet for cleaning the air and leaving the skies a brilliant crystal blue, and bitter for the power outages and potential brush fires that might ensue.  It was one of those bitter nights where the Santa Ana winds were howling, and we had subsequently lost our power. We had to drive over an hour just to find a restaurant so we could eat dinner. I remember vividly seeing the glow of a brush fire on the upper hillside of the San Gabriel Mountains, a good distance from our neighborhood. I really didn’t think much of it, given that it seemed so far from where we lived, and I was hungry! After we ate, we headed back home to a very dark house and called it a night. 
    That’s where the story takes a dangerous turn….about 3:15am. I awoke to the TV blaring loudly, along with the lights shining brightly. Our power was back on! I proceeded to walk throughout the house turning everything off at exactly the same time our neighbor, who was told to evacuate our street, saw me through our window, assuming I knew that our hillside was ablaze with flames. Flames that were shooting 50 feet into the air. I went back to bed and fell fast asleep. The fire department was assured we had left because our house was dark and quiet again. Two hours had passed.  I suddenly awoke to screams coming from a family member yelling, “fire, fire, fire”! Flames were shooting straight up into the sky, just blocks from our house. We lived on a private drive with only one way in and one way out.  The entrance to our street was full of smoke and the fire fighters were doing their best to save our neighbors homes. We literally had enough time to grab our dogs, pile into the car, and speed to safety. As we were coming down our street, fire trucks passed us with sirens blaring, and I wondered if I would ever see my house and our possessions ever again. Where do we go? Who do we turn to? Are shelters a safe option? 
    When our daughter was almost three years old, we left the West Coast and relocated to Northern Illinois. A place where severe weather is a common occurrence. Since the age of two, I noticed that my daughter appeared gaunt, had an incredibly distended belly, along with gas, stomach pain, low weight, slow growth, unusual looking stool, and a dislike for pizza, hotdog buns, crackers, Toast, etc. The phone call from our doctor overwhelmed me.  She was diagnosed with Celiac Disease. I broke down into tears sobbing. What am I going to feed my child? Gluten is everywhere.
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    Then, my second brush with a natural disaster happened, without any notice, leaving us once again scrambling to find a safe place to shelter. It was a warm and muggy summer morning, and my husband was away on a business trip leaving my young daughter and me to enjoy our summer day. Our Severe Weather Alert Radio was going off, again, as I continued getting our daughter ready for gymnastics.  Having gotten used to the (what seemed to be daily) “Severe Thunderstorm warning,” I didn’t pay much attention to it. I continued downstairs with my daughter and our dog, when I caught a glimpse out the window of an incredibly black looking cloud. By the time I got downstairs, I saw the cover to our grill literally shoot straight up into the air. Because we didn’t have a fenced in yard, I quickly ran outside and chased the cover, when subsequently, I saw my neighbor’s lawn furniture blow pass me. I quickly realized I made a big mistake going outside. As I ran back inside, I heard debris hitting the front of our home.  Our dog was the first one to the basement door! As we sat huddled in the dark corner of our basement, I was once again thinking where are we going to go if our house is destroyed. I was not prepared, and I should have been. I should have learned my lesson the first time. Once the storm passed, we quickly realized we were without power and most of our trees were destroyed. We were lucky that our house had minimal damage, but that wasn’t true for most of the area surrounding us.  We were without power for five days. We lost most of our food - our gluten free food.
    That is when I knew we had to be prepared. No more winging it. We couldn’t take a chance like that ever again. We were “lucky” one too many times. We were very fortunate that we did not lose our home to the Los Angeles wildfire, and only had minimal damage from the severe storm which hit our home in Illinois.
      
    In 2017 alone, FEMA (Federal Emergency Management Agency) had 137 natural disasters declared within the United States. According to FEMA, around 50% of the United States population isn’t prepared for a natural disaster. These disasters can happen anywhere, anytime and some without notice. It’s hard enough being a parent, let alone being a parent of a gluten free family member. Now, add a natural disaster on top of that. Are you prepared?
    You can find my Gluten Free Emergency Food Bags and other useful products at www.allergynavigator.com.  

    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.
    The team enrolled fifty adults with symptoms and indications of celiac disease in a prospective cohort without regard to the final diagnosis.  At baseline, all individuals underwent cognitive functional and psychological evaluation. The team then compared celiac disease patients with subjects without celiac disease, and with healthy controls matched by sex, age, and education.
    Celiac disease patients had similar cognitive performance and anxiety, but no significant differences in depression scores compared with disease controls.
    A total of thirty-three subjects were diagnosed with celiac disease. Compared with the 26 healthy control subjects, the 17 celiac disease subjects, and the 17 disease control subjects, who mostly had irritable bowel syndrome, showed impaired cognitive performance (P=0.02 and P=0.04, respectively), functional impairment (P<0.01), and higher depression (P<0.01). 
    From their data, the team noted that any abnormal cognitive functions they saw in adults with newly diagnosed celiac disease did not seem not to be a result of the disease itself. 
    Their results indicate that cognitive dysfunction in celiac patients could be related to long-term symptoms from chronic disease, in general.
    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.