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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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    SCREENING CHILDREN OF SHORT STATURE FOR CELIAC DISEASE


    Kathleen La Point

    This article appeared in the Winter 2008 edition of Celiac.com's Scott-Free Newsletter.


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    Celiac.com 12/20/2007 - Celiac disease is under-diagnosed because many celiac disease patients do not show classic gastrointestinal symptoms. Highly sensitive and specific serological tests have led to the diagnosis of celiac disease in patients for whom short stature may be the only obvious symptom. Researchers from Brazil and Italy have previously reported that celiac disease accounts for 1-5% of short stature in children.

    Prevalence of celiac disease varies widely according to geographic location. Although epidemiological studies are lacking in India, celiac disease reporting has increased exponentially due to targeted screening and better serological tests. To better understand the relationship between short stature and celiac disease, researchers from the Endocrine Clinic of the Postgraduate Institute of Medical Education and Research in Chandigarh studied children referred for a work-up of short stature from January 2005 to December 2006.

    Researchers enrolled 176 patients, half male and half female, who fit the criteria for short stature: height ≥ 2.5 standard deviations below the mean for chronological age, growth rate below the fifth percentile for chronological age, and height ≥ 2 standard deviations below mean for chronological age when corrected for mid-parental height. Most patients were 10-15 years old (mean age of 14.5).

    Researchers took detailed histories and carried out clinical evaluations and screening tests. If they could find no endocrine cause for short stature or if diarrhea had been present for more than 3 months, researchers estimated IgA anti-tissue transglutaminase antibodies (anti-tTG) and performed an endoscopic biopsy.

    Celiac disease was found in 27 (15.3%) of the patients, making it the single most common cause of short stature. 25 children had pituitary disorder (14%), 24 had hypothyroidism (14%), and constitutional delay of growth and puberty or  familial short stature accounted for 18 (11%). Other less common causes of short stature were metabolic bone disease, Turner syndrome, adrenal disorders, diabetes mellitus, and nutritional deficiency. All celiac disease patients were positive for tTG antibodies and had a duodenal biopsy suggestive of celiac disease. All celiac disease patients were symptomatic; the most common symptoms after growth retardation were anemia (88%), weight loss (80%), diarrhea (69%), and delayed puberty (54%).

    The average time to diagnosis for these patients was 5.5 years (95% cI: = 2.5 to 8.5 years). The celiac disease patients were treated with a gluten-free diet, calcium (500 mg/day), vitamin D (300,000 U cholecalciferol once every 3 months), and iron and multivitamin supplementation including folic acid and vitamin B12. During the 6-9 month follow-up period, growth rate velocity increased significantly from  2.9 cm/year (95%  cI = 2.41 to 3.39 cm/year) to 8.9 cm/year (95% cI = 6.7 to 11.1 cm/year).

    Celiac disease can lead to short stature by causing autoimmune hypothydroidism, resistance to growth hormones, and malabsorption of protein, calcium and vitamin D. Additionally, celiac disease can lead to hypogonadism which inhibits the pubertal growth spurt. Researchers recommend that all short children be screened for celiac disease.

    Resources
    Bhadada, S. Bhansali, A., Kochhar, R., Shankar, A., Menon, A., Sinha, S., Dutta, PP., and Nain, C. Does every short stature child need screening for celiac disease? Gastroenterology [OnlineEarly Articles]. doi:10.1111/j.1440-1746.2007.05261.x


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    Guest Sandra Haste

    Posted

    I was born in 12/1948 in Detroit Michigan. I was taken to the doctor when I was about 2 or so because I had quit growing. After another 18 months I was diagnosed with celiac. I was also diagnosed with hypothyroid at age of 6. I was under physician care at Henry Ford Hospital (I was adopted at age 8 and the medical permanency of the celiac was not given to new family). Thus I went 55 years before finding out I never got rid of celiac. I had many, many health issues until few years ago.

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    I am so excited to see this article because it supports what I was trying to tell my pediatrician regarding my sons short stature. My son is on a gluten-free diet for a year and we are not seeing enough progress therefor I consulted with a nutritional consultant who is a medical practitioner and she had recommended Vitamin D and B12 testing to check for absorption on top of all the other testing now I am waiting for results.

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    Guest Ragini Sreenivas

    Posted

    Ever since I was young I always seemed to suffer from stomach disorders. About 6 years ago it got worse and I underwent X-rays and sonography. The latter showed hyperplasia of lymph nodes and my doctor suspected autoimmune disease or food allergy. He asked me to avoid wheat and its products and then the diarrhea stopped. I am short and my weight is below normal.

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    very good. My daughter is 5 years old and has been gluten free diet for six months and she is improving.

    I would like to have anything new on the issue--thanks.

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    Guest guadalupe

    Posted

    Routine testing for celiac in children with growth problems should be encouraged. It is done in Spain by the national health service and this is how my daughter was diagnosed. She had always been average height but at 11 she didn't keep up with average growth spurts. A battery of standard blood tests was done (among them the one for celiac) and she was diagnosed. She had no other visible symptom except very indefinite pains here and there that doctors had taken no notice of but the biopsy results showed a very damaged intestine. So if the routine test had not been done, who knows when and in what conditions we would have found out! I am very grateful to our system for this.

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    Thank you so much. We are getting our son tested for this. I have changed his diet and he is doing much better.

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    All articles that help with celiac are EXCELLENT! Let's not forget the third of adults that are obese at diagnoses. When I was an infant I had nausea all the time, and was one of the biggest tallest kids growing up, and I had rashes that they said I would outgrow. I was disgnosed via a biopsy at age 38, I now believe that I had it all my life. Too many signs to list here. Thank you for your website! I would bet a million dollars my son's doctor has never been on this site, even with the articles I give him.

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    I learned of Celiac when a good friend told me she had it at our 25-year high school reunion. She had symptoms in high school and took 20+ years to get the correct diagnosis.

     

    Short stature was the primary reason that I took my 10-year old son for testing. He had no other symptoms, except slight anemia at his last checkup just a couple of months earlier. He tested positive for Celiac. As we got his blood work down to negative with the gluten-free diet, his growth improved somewhat, but he was still below 2.5 standard in height at age 13 (Mom and Dad slightly above average height). After not seeing catch-up growth after 3 years on the gluten-free diet, he has started growth hormones. We are seeing positive response and a steep change in growth rate.

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    Only three days ago, a friend was talking about the short stature of his grandson who happens to have respiratory problems as well. He didn't mention his dietary intakes and I wasn't aware of the damages gluten-loaded diet can do. I'll pass this article to my friend and wait for any outcomes and will inform you of developments. Thanks

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    Guest Katherine Ulrich

    Posted

    I have several grand children and great grand children whom I suspect have this from me, but can't get them to be interested. I have tried and about given up.

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    Guest Ariel

    Posted

    This makes me feel a lot better. I am 20 years old and only made it to 5' which was a source of teasing since 6th grade but I was never tested for anything because I was half Hispanic so it was assumed that was why I was so short. I was diagnosed about 5 months ago and this is the first I have heard about short stature being connected with the disease. Thank you so much for this!

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    Guest louise foucek

    Posted

    My daughter has been on a gluten free diet for almost 3 years and has grown approximately 6 inches from total growth arrest. She is now 15. There is a need for mandatory testing!

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    Guest M Rockwell

    Posted

    I have just added this page to my Favorites. I have a 3-year-old who is in the category of failure to thrive. He tested positive for his endocrine screening and we will be asking his doctor to look into celiac disease and test for that. We are worried, but are hopeful. Thanks for this information! It has helped a great deal in understanding a little bit more about celiac disease as it relates to children.

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    I am 4'10 and the average height for other females in my family is 5'4.5" this is mom, aunts and a sister. All run between 5"3 and 5'6". My brother is a full foot taller than I am and we have the same parents. I have had bowel issues as long as I can remember and host of symptoms that seem autoimmune for about 7-0 years but bad for about 7. I was finally diagnosed with Fibro and IBS when they couldn't find anything else. NOT ONE of the four Dr's I saw ever thought of gluten. Then on vacation I landed in the ER after indulging in lots of yummy carbs I normally wouldn't eat much. The DR there acted like I was stupid I hadn't found it my research but it never came up in symptom checker or anything. Lactose did but the diet made very little difference. My Dr., who is actual fab, felt awful but I was already going gluten free by my follow up so while it seem s obvious I have gluten issue I may never know if I am celiac. PS I feel awesome, poop great and have very little pain or swelling anymore, and no headaches!

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    Clinical Endocrinology, March 2005, vol. 62, no. 3, pp. 372-375(4)
    Celiac.com 04/29/2005 – In an effort to determine the occurrence of growth hormone deficiency (GFD) in children with celiac disease, Italian researchers evaluated 1,066 children who were diagnosed with short stature. All patients were screened for celiac disease using anti-endomysial antibodies (EMA), and those with positive results were given a follow-up biopsy. The researchers found that 210 or 19.7% of the children had GHD, and of these12 also had positive EMA and biopsy and were diagnosed with celiac disease. After one year on a gluten-free diet 9 of these 12 children showed marked growth improvement, while the remaining 3 showed no catch-up growth. Additional tests found an isolated GHD in one of the children, and multiple GHDs in the other 2 children. Growth hormone therapy was initiated in addition to a gluten-free diet in these 3 children, which led to an increase in their growth rate.
    The researchers conclude that growth hormone should be evaluated in those with celiac disease whose growth does not improve on a gluten-free diet, and growth hormone therapy should be started in these individuals while on a gluten-free diet.

    Jefferson Adams
    Celiac.com 09/13/2008 - Men who are diagnosed with celiac disease in adulthood tend to be shorter than those diagnosed and treated in childhood.
    A team of Israeli researchers led by Dr. Batia Weiss and colleagues recently set out to compare the adult height of people with celiac disease who were diagnosed and treated as children, against the height of those diagnosed as adults. The researchers analyzed the height of 290 patients—83 men and 207 women. Patients were grouped according to age at diagnosis. The 113 patients of group 1 were diagnosed before age 18 years, while the 177 patients of group 2 were diagnosed after age 18 years.
    The average adult height was 178.4 cm for men of group 1, and 176.3 cm for men of group 2, (p = 0.22). The height Z scores for men were 0.22 for group 1 and -0.08 for group 2 (p = 0.022). Researchers noted a significant inverse relationship between the age of the men at celiac disease diagnosis and their final adult height.
    For women, average adult height was 163.0 cm for group 1 and 162.6 cm for group 2, (p = 0.68). Height Z scores were -0.05 for the women of group 1 and -0.11 for the women of group 2 (p = 0.68). Researchers noted no significant relationship between age at diagnosis and final height in women.
    The exact reasons for these gender-related height differences remain unknown. They may have to do with variations in timing and duration of growth in puberty, the increased nutritional demands of adolescent men, or gender-related hormonal differences.
    Regardless of the exact reasons for these results, this study is just the latest of many to drive home the importance of early detection and treatment of celiac disease for everyone.
    American Journal of Gastroenterology 2008; 103:1770-1774.


    Jefferson Adams
    Celiac.com 12/16/2009 - Research has suggested potential autoimmune involvement of the pituitary gland in patients with celiac disease, but such activity has only been shown in only a few patients on gluten-free diet.
    A team of researchers recently set out to assess the prevalence and clinical meaning of anti-pituitary antibodies (APA) in children and adolescents with the newly diagnosed celiac disease. The research team was made up of M. Delvecchio, A. De Bellis, R. Francavilla, V. Rutigliano, B. Predieri, F. Indrio, D. De Venuto, A. A. Sinisi, A. Bizzarro, A. Bellastella, L. Iughetti, and L. Cavallo.
    They are affiliated with the Unità Operativa Complessa di Pediatria, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
    The team set out to assess the prevalence and clinical meaning of anti-pituitary antibodies (APA) in children and adolescents with the newly diagnosed celiac disease.
    For their cross-sectional study, the team recruited atonal of 119 patients with celiac disease from the inpatient clinic of University Hospital.
    Test subjects ranged from 0.9 to 15.8 years in age. Clinicians recorded their height, weight, and body mass index (BMI), and assayed their insulin-like growth factor-1 (IGF-1) and APA.
    Researchers determined APA in 98 sex- and age-matched control subjects. They found APA in 50 of those subjects (42.0%), 15 of whom showed high titer (30%), 35 showed low titer (70%), and 2 control subjects showed low titer (2%) (P<0.001).
    More patients with negative than with low titer (P=0.02) or high titer APA (P=0.03) showed higher IGF-1. High-titer APA patients showed more reduced height than did negative ones (P<0.01). Researchers positively correlated height with IGF-1 (P<0.01) and negatively with chronological age (P=0.001). They positively correlated IGF-1 with BMI (P<0.001). For height prediction the regression analysis showed the rank order 1 for chronological age and 2 for IGF-1.
    This results of this study demonstrate a substantial prevalence of positive APA in newly diagnosed celiac disease patients. High APA titers are associated with reduced height impairment, likely mediated by a reduction of IGF-1, thus indicating that autoimmune pituitary process may induce a linear-growth impairment.
    Source:
    Am J Gastroenterol advance online publication, 10 November 2009; doi:10.1038/ajg.2009.642.


    Jefferson Adams
    Celiac.com 08/21/2013 - It is becoming much more common for people with celiac disease to receive a diagnosis late in life, the implications of which are largely unknown. Although short stature is a common trait of childhood celiac disease, there has been no clear data on the height of adult celiac disease patients. 
    A team of researchers recently set out to determine if men with celiac disease are shorter than their peers in the general population.
    The research team included R. Sonti, B. Lebwohl, S.K. Lewis, H. Abu Daya, H. Klavan, K. Aguilar, and P.H. Green. They are affiliated with the Department of Medicine, Celiac Disease Center, Columbia University Medical Center, New York, New York, USA.
    Their cross-sectional study assessed the final height of men and women diagnosed with celiac disease in adulthood.
    The team looked at 585 adults at the Celiac Disease Center at Columbia University, comparing their height against that of a control population (NHANES). The study included only patients who were over 18 years of age at diagnosis, and with available baseline height and weight data.
    The team also looked for differences in demographic and physical features, mode of presentation, and concomitant illnesses in shorter versus taller celiac patients.
    The 162 men with celiac disease diagnosed in adulthood were shorter than men in the general population. Overall, the men with celiac disease were 169.3±10.5 cm compared to 177.3±7.0 cm (P
    Interestingly, this was not the case with women. The 423 women with celiac disease averaged 166.3±9.4 cm compared with 163.2±6.7 cm for the general population.
    There were no significant differences in age at diagnosis, BMI, concomitant autoimmune illnesses (hypothyroidism, type I diabetes, dermatitis herpetiformis), or mode of presentation in shorter versus taller celiac disease patients of either sex.
    Hemoglobin was associated with short stature in men with celiac disease (short: 13.9 g/dl, tall: 14.6 g/dl; P=0.01), but not in women with celiac disease (short: 12.9 g/dl, tall: 13.0 g/dl, P=0.41).
    Short stature is a a common and well documented feature of childhood celiac disease. Many celiac children who suffer low BMD experience 'catch-up growth' once they adopt a gluten-free diet.
    However, men with celiac disease who reach their final height before diagnosis are shorter relative to the general population. This is not true for adult women with celiac disease.
    Source:
     Eur J Gastroenterol Hepatol. 2013 Jun 5.

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    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.
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    Jefferson Adams
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    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