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  • About Me

    Jefferson Adams is a freelance writer living in San Francisco. He has covered Health News for Examiner.com, and provided health and medical content for Sharecare.com. His work has appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden's Ferry Review, Huffington Post, the Mississippi Review, and Slate, among others.

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    Jefferson Adams
    Celiac.com 02/02/2012 - A team of researchers recently conducted a prospective controlled study on a gluten-free diet and autoimmune thyroiditis in patients with celiac disease.
    The research team included S. Metso, H. Hyytiä-Ilmonen, K. Kaukinen, H. Huhtala, P. Jaatinen, J. Salmi, J. Taurio, and P. Collin. They are affiliated with the Department of Internal Medicine at Tampere University Hospital in Tampere, Finland.
    Prior to the study, there had been contradictory data regarding the ways in which early diagnosis and a gluten-free diet might slow the progression of associated autoimmune diseases in celiac disease.
    The research team investigated the course of autoimmune thyroid diseases in newly diagnosed celiac disease patients, both before and after gluten-free dietary treatment.
    For their study, the team examined twenty-seven adults with newly diagnosed celiac disease, both at the time of diagnosis and after one year on gluten-free diet.
    They also recorded and examined previously diagnosed and subclinical autoimmune thyroid diseases. The team used ultrasound to measure thyroid gland volume and echo-genicity. They also measured autoantibodies against celiac disease and thyroiditis, and conducted thyroid function tests.
    As a control group, they enrolled twenty-seven non-celiac subjects, all of whom followed a normal, gluten-containing diet.
    The data showed that, upon diagnosis, ten of 27 celiac disease patients had either manifest (n = 7) or subclinical (n = 3) thyroid diseases. Only three of 27 control subjects (10/27 vs. 3/27, p = 0.055) had thyroid disease.
    After treatment with a gluten-free diet, thyroid volume continued to decrease significantly in the patients with celiac disease compared with the control subjects, indicating the progression of thyroid gland atrophy regardless of the gluten-free diet.
    Overall, celiac patients faced a higher risk of thyroid autoimmune disorders than non-celiac control subjects. Moreover, a gluten-free diet did not seem to stop or reverse the progression of autoimmune disease after one year.
    Source:

    Scand J Gastroenterol. 2012 Jan;47(1):43-8. Epub 2011 Nov 30.

    Jefferson Adams
    Celiac.com 05/07/2012 - People with celiac disease face a higher risk of developing primary hyperparathyroidism (PHPT) in the early years after their celiac disease is diagnosed, according to a new report from Sweden. The report appears in the The Journal of Clinical Endocrinology & Metabolism.
    A team of researchers recently set out to examine the risk of primary hyperparathyroidism (PHPT) in people with celiac disease. The researchers included Dr. Jonas F. Ludvigsson, Olle Kämpe, Benjamin Lebwohl, Peter H. R. Green, Shonni J. Silverberg and Anders Ekbom. They are affiliated with the Department of Pediatrics (J.F.L.) at Örebro University Hospital in Örebro, Sweden, the Clinical Epidemiology Unit (J.F.L., A.E.) of the Department of Medicine at Karolinska Institutet in Stockholm, Sweden; the Department of Medical Sciences (O.K.) at Uppsala University and University Hospital in Uppsala, Sweden; and Celiac Disease Center (B.L., P.H.R.G.), and Division of Endocrinology, Department of Medicine (S.J.S.) at Columbia University College of Physicians and Surgeons in New York city, USA.
    At least one other study has suggested an association between celiac disease and primary hyperparathyroidism.
    For their study, Dr. Jonas F. Ludvigsson from Orebro University Hospital and colleagues examined the risk of PHPT among 17,121 patients with biopsy-verified celiac disease. They found that patients with celiac disease faced a 1.91-fold increased risk of PHPT compared to 85,166 matched controls.
    Ignoring the first year, due to a risk of ascertainment bias, the team found that the risk level for PHPT increased 3.29-fold through 60 months, and disappeared after that period.
    The decrease in risk level over time may be due to the beneficial effect of the gluten-free diet, the team noted. For every per 100,000 person-years at risk, the absolute risk level from one to five years of follow-up was 61 cases in patient, compared with just 22 cases in controls. The overall risk level was even greater, by 2.53 times, when the outcome was restricted to PHPT with an adenoma diagnosis in the National Cancer Registry.
    A review of the data show that the increased risk of PHPT persisted after restricting the analysis to 1987 or later, which post-date changes in ICD coding. The risk for PHPT was slightly higher for women diagnosed with celiac disease after menopause than for women diagnosed earlier in life.
    Their study does not "provide any insight into the nature of the association between celiac disease and PHPT," the authors admit. They are unsure whether the association  is causal or whether celiac disease and PHPT might be tied another unidentified condition.
    Because most patients with untreated celiac disease have vitamin D and calcium deficiencies, the team expected to find a "constellation of celiac disease and elevated parathyroid hormone levels," but that they did not expect to see a connection between celiac disease with hypercalcemia and PHPT.
    The team calls for future studies to focus on thoroughly investigating the connection, so that researchers can understand all possible aspects of the link between these two conditions.
    Source:
    J Clin Endocrinol Metab 2012

    Jefferson Adams
    Celiac.com 01/05/2017 - Patients who have both pancreatic disease and celiac disease can experience adverse endocrine and exocrine changes. When this happens, severe clinical changes with marked nutritional alteration may result. For some patients, a gluten-free diet can help improve endocrine and exocrine pancreatic function.
    Also, numerous studies show that people with celiac disease have higher rates of type 1 diabetes mellitus. In part, this relationship was possibly due to shared human leukocyte antigen alleles, DR3, and by linkage disequilibrium, DQ2. Besides this hypothesized common "immune-mediated" etiopathogenesis, some celiacs with pancreatic disease likely have developed secondary diabetic changes from severe exocrine pancreatic failure, driven in part by celiac-induced protein malnutrition.
    Some researchers estimate that more than one in five celiac patients have defective pancreatic function, possibly due to impaired release of peptides, because of mucosal endocrine cell loss.
    Researcher Hugh J. Freeman recently set out to evaluate the prevalence of type 1 diabetes in celiac disease. He is a gastroenterologist affiliated with the Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
    Prospective studies using an initial screening IgA tissue transglutaminase antibody assay (tTG) were done at the university center, while a total of 125 male and 108 female children and adolescents with type 1 diabetes mellitus were evaluated from an established pediatric diabetes clinic. Of these, 15 male and 11 female patients had elevated tTG titers, of whom 19 were also positive for endomysial antibodies. Among these cases, 1 was already known to have celiac disease. Small intestinal biopsies were done in the other 18 children positive for both antibodies.
    In all, histopathological changes consistent with celiac disease were detected, ranging from increased numbers of intraepithelial lymphocytes to severe crypt hyperplastic villous atrophy (i.e., so-called Marsh 3 lesion). Studies also suggested that serial tTG titers in insulin-dependent diabetic children might play a useful clinical role in monitoring compliance to a gluten-free diet, possibly of value since close monitoring of compliance of children to a gluten-free diet may be exceedingly difficult.
    In this study, over 40% of diabetic children were asymptomatic, and yet, prospective serological screening facilitated selection for small intestinal biopsy evaluation. Overall, 7.7% of this entire pediatric patient population had biopsy features common in celiac disease. A subsequent European study found 8.6% of diabetic children and adolescents to have tTG positivity; many had no symptoms, or only non-specific or mild gastrointestinal symptoms.
    Prior studies have shown increased serum amylase levels in about 25% of patients, indicating possible low-grade pancreatic inflammation. Later studies examined exocrine pancreatic function in celiac disease by measuring fecal elastase-1 concentrations along with magnetic resonance imaging (MRI) showed pancreatic insufficiency in 4 of 90 celiacs, or 4.4% (1 mild, 3 severe), while MRI was normal in all 4 of these celiac patients.
    In contrast, a study from India shows exocrine pancreatic insufficiency in 10 of 36 young adults under 30 years of age, based on fecal elastase determinations. Of these, over 80% showed reversal of elevated fecal elastase values on a gluten-free diet.
    Most had moderate to severely abnormal small bowel biopsies (i.e., Marsh 2-3C) and only 1 had recurrent bouts of acute pancreatitis. Structural changes based on imaging studies were rarely encountered.
    Although his own study, like a number of others, has documented the relationship between pancreatic exocrine function and celiac disease, Dr. Freeman calls for further longer-term study to determine if these observations can be verified by other centers.
    Source:
    Ann Gastroenterol. 2016 Jul-Sep; 29(3): 241–242. Published online 2016 May 20. doi: 10.20524/aog.2016.0048 PMCID: PMC4923808

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    Jefferson Adams
    Celiac.com 06/20/2018 - Currently, the only way to manage celiac disease is to eliminate gluten from the diet. That could be set to change as clinical trials begin in Australia for a new vaccine that aims to switch off the immune response to gluten. 
    The trials are set to begin at Australia’s University of the Sunshine Coast Clinical Trials Centre. The vaccine is designed to allow people with celiac disease to consume gluten with no adverse effects. A successful vaccine could be the beginning of the end for the gluten-free diet as the only currently viable treatment for celiac disease. That could be a massive breakthrough for people with celiac disease.
    USC’s Clinical Trials Centre Director Lucas Litewka said trial participants would receive an injection of the vaccine twice a week for seven weeks. The trials will be conducted alongside gastroenterologist Dr. James Daveson, who called the vaccine “a very exciting potential new therapy that has been undergoing clinical trials for several years now.”
    Dr. Daveson said the investigational vaccine might potentially restore gluten tolerance to people with celiac disease.The trial is open to adults between the ages of 18 and 70 who have clinically diagnosed celiac disease, and have followed a strict gluten-free diet for at least 12 months. Anyone interested in participating can go to www.joinourtrials.com.
    Read more at the website for Australia’s University of the Sunshine Coast Clinical Trials Centre.

    Source:
    FoodProcessing.com.au

    Jefferson Adams
    Celiac.com 06/19/2018 - Could baking soda help reduce the inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease? Scientists at the Medical College of Georgia at Augusta University say that a daily dose of baking soda may in fact help reduce inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease.
    Those scientists recently gathered some of the first evidence to show that cheap, over-the-counter antacids can prompt the spleen to promote an anti-inflammatory environment that could be helpful in combating inflammatory disease.
    A type of cell called mesothelial cells line our body cavities, like the digestive tract. They have little fingers, called microvilli, that sense the environment, and warn the organs they cover that there is an invader and an immune response is needed.
    The team’s data shows that when rats or healthy people drink a solution of baking soda, the stomach makes more acid, which causes mesothelial cells on the outside of the spleen to tell the spleen to go easy on the immune response.  "It's most likely a hamburger not a bacterial infection," is basically the message, says Dr. Paul O'Connor, renal physiologist in the MCG Department of Physiology at Augusta University and the study's corresponding author.
    That message, which is transmitted with help from a chemical messenger called acetylcholine, seems to encourage the gut to shift against inflammation, say the scientists.
    In patients who drank water with baking soda for two weeks, immune cells called macrophages, shifted from primarily those that promote inflammation, called M1, to those that reduce it, called M2. "The shift from inflammatory to an anti-inflammatory profile is happening everywhere," O'Connor says. "We saw it in the kidneys, we saw it in the spleen, now we see it in the peripheral blood."
    O'Connor hopes drinking baking soda can one day produce similar results for people with autoimmune disease. "You are not really turning anything off or on, you are just pushing it toward one side by giving an anti-inflammatory stimulus," he says, in this case, away from harmful inflammation. "It's potentially a really safe way to treat inflammatory disease."
    The research was funded by the National Institutes of Health.
    Read more at: Sciencedaily.com

    Jefferson Adams
    Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown.  To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. 
    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
    For their review, the team searched Medline, PubMed, and EMBASE for the keywords ‘celiac disease,’ ‘celiac,’ ‘tissue transglutaminase antibody,’ ‘anti-endomysium antibody,’ ‘endomysial antibody,’ and ‘prevalence’ for studies published from January 1991 through March 2016. 
    The team cross-referenced each article with the words ‘Asia,’ ‘Europe,’ ‘Africa,’ ‘South America,’ ‘North America,’ and ‘Australia.’ They defined celiac diagnosis based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. The team used 96 articles of 3,843 articles in their final analysis.
    Overall global prevalence of celiac disease was 1.4% in 275,818 individuals, based on positive blood tests for anti-tissue transglutaminase and/or anti-endomysial antibodies. The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% in 138,792 individuals. That means that numerous people with celiac disease potentially remain undiagnosed.
    Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults.
    This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. 
    This review demonstrates a need for more comprehensive population-based studies of celiac disease in numerous countries.  The 1.4% rate indicates that there are 91.2 million people worldwide with celiac disease, and 3.9 million are in the U.S.A.
    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.

    Jefferson Adams
    Celiac.com 06/16/2018 - Summer is the time for chips and salsa. This fresh salsa recipe relies on cabbage, yes, cabbage, as a secret ingredient. The cabbage brings a delicious flavor and helps the salsa hold together nicely for scooping with your favorite chips. The result is a fresh, tasty salsa that goes great with guacamole.
    Ingredients:
    3 cups ripe fresh tomatoes, diced 1 cup shredded green cabbage ½ cup diced yellow onion ¼ cup chopped fresh cilantro 1 jalapeno, seeded 1 Serrano pepper, seeded 2 tablespoons lemon juice 2 tablespoons red wine vinegar 2 garlic cloves, minced salt to taste black pepper, to taste Directions:
    Purée all ingredients together in a blender.
    Cover and refrigerate for at least 1 hour. 
    Adjust seasoning with salt and pepper, as desired. 
    Serve is a bowl with tortilla chips and guacamole.