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  • Jefferson Adams
    Jefferson Adams

    Celiac Disease in the Military—Don't Ask Don't Tell?

    Reviewed and edited by a celiac disease expert.

    Caption: Photo: CC--Tomi Knuutila

    Celiac.com 03/04/2016 - For anyone who hasn't seen it, the website Glutendude.com has an article titled "Why Doesn't the Military Accept Those With Celiac Disease?"

    The article highlights the story of a smart, capable, American who was motivated to serve in the military, but who was medically disqualified by military policy, and all had failed in all attempts to secure an admission waiver. The man was further frustrated by the fact that he had very minimal symptoms, and felt that he had the ability to serve effectively.

    The article also highlights the military's uneven treatment of personnel with celiac disease.

    Medical fitness for the military is governed mainly by the Department of Defense Medical Examination Review Board (DoDMERB), which schedules, evaluates, and certifies all applicants as "medically qualified," or as "medically does not meet the medical accession standards" for the US Service Academies, ROTC Scholarship Programs, Direct Commission Programs, and the Uniformed Services University of the Health Sciences.

    Basically, current military policy is to reject potential recruits with known celiac disease, provide some accommodation for some troops already in the service, and to provide medical discharges other troops, as needed.

    The military doesn't reject you if they don't know you have celiac disease, and wouldn't likely test you for celiac disease unless you pressed the issue.

    But if there's no official diagnosis, or no debilitating symptoms, and the recruit says nothing, then celiac disease is not a barrier to military service. And, once in the military, if the disease is kept under wraps, then it's likely it will never come up, and thus pose no problem.

    Going back to GlutenDude's article, here's part of a quote from the soldier who was rejected due to celiac disease:

    "Two years ago I was diagnosed with celiac disease, and the military does not accept people with this disease. I was medically disqualified by DODMERB, and all waiver attempts have been denied. Years of hard work, a 3.9 GPA, a 32 MCAT, and a desire to spend my entire career in the service have been for naught. The most frustrating aspect of this situation is that I have almost no physical symptoms, am not on medications, and the few symptoms I have are completely controlled by diet. Yet even though my disease would not affect my ability to serve, my dreams have come to a screeching halt."

    The man also points out that: "Militaries in other countries accept celiac patients like Israel. Even in our military there are celiac patients that are accommodated for, albeit ones that have already been accepted and are diagnosed after being in for some time. The fact that one percent of the population, nearly 3 million people, have no chance to give their service to their country is a disgrace."

    What do you think? Is the current military policy of rejecting people with celiac disease only if it becomes known a bit like Don't Ask Don't Tell? Are potentially good recruits being turned away unnecessarily? Are existing soldiers being asked to cover up a treatable medical condition for fear of being discharged?

    Should people with celiac disease or gluten-intolerance be able to serve in the military?


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    Does anyone know how to get in touch with the military personnel with celiac? I'd be happy to get connected send gluten-free care packages. Seems like whenever I see info about sending gifts to military (usually around the holidays) they are general lists that can be distributed to anyone.

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    I think that the military should accept people that are gluten free/ celiac. There are many non-combat roles where you don't need to be on the front line that are just as important. For example, just because someone is in the Air Force dosen't mean that they are a pilot. It is stupid that some political figures (the ones who WANT to expand the military) are denying 3 million people access. It just dosen't make sense. I don't know what the new president's position is on this is, but a I hope he and his defense secretary can change something.

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    I'm in the navy and I have celiac and I even I don't believe people with it should join even if its they have very minor side affects. people like me who got lucky and got to a good command where I can cook for myself is rare and its really hard to watch what you eat in another country.

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    It's ridiculous some people think the military should accommodate people with this disease. The military doesn't accommodate, that's why they screen people before accepting them. It doesn't matter that there are 3 million people in the United States with this disease, that's 3 million people who will almost certainly never be allowed to join the military. The military isn't a civilian employer who has to accommodate you. The military requires you to be able to perform certain jobs at all times, and if have a disease that could prevent that, it would be negligent of them to accept you. Controlling this disease by diet is not an option when you are deployed, there is no guarantee you will have a say in the food you are given. You would be putting yourself and other soldiers in danger if you became ill because you couldn't control your symptoms. As for those who say not all soldiers need to deploy, why would the military accept anyone who could not deploy? A 3.9 GPA and a 32 MCAT are great but there are other people who are just as qualified, and don't need special accommodations. As someone who's been medically cleared and is going into the Air Force, I find it completely ridiculous that anyone could think they could join the military and not have to deploy because of a medical condition. Deploying is a huge part of being in the military, especially during war time. In my opinion it's a bit arrogant to think some people should be excused from deploying, while there are those who are literally risking their lives. I have no problem deploying, because I want to serve my country in any way I can, but also because it would be incredibly ignorant of me to think that I can join the military and not ever face the possibility of deploying. If I had the same job as another officer, the same rank, the same age, everything exactly the same, and I was deployed and they weren't, even though it wouldn't be intentional it would still be giving them preferential treatment. But besides that, if I was deployed and someone in my unit had a disease that made it so that, they couldn't 100% perform their job 100% of the time, it would put my life in danger. I feel bad for the guy, but his feelings and his wants do not compare to the need to keep the military safe and efficient.

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    As someone who has personally dealt with celiac for over 17 years, and as a military spouse of 27 years I feel confident that people with celiac sprue should NOT be in the military at this time. Even with symptoms under control, if a soldier were deployed they have no guarantee over the control of their food sources. In the middle of the desert, a war, a foxhole, or 3rd world country there are no guarantees that a soldier could secure gluten free meals. Not only does that put the soldier at risk, it puts the soldiers around them at risk who need to be able to move quickly and respond rapidly to anything that comes their way. Imagine your squadron gets attacked and the soldier next to you is suffering from a gluten reaction.

     

    There are those who may say that you simply don't deploy soldiers with celiac. The problem with that mentality is you are now increasing the responsibility for the soldiers who can eat anything, anywhere, anytime, and who don't have restrictive medical conditions. It would be unfair to have a medical condition that would allow a soldier to stay home with their family while others are constantly deployed. The military already faces a multitude of other limiting medical conditions (diagnosed after entering the service) that are now putting the military in a position where the the same people must deploy over and over again. It poses an unfair situation to those soldiers who have no limitations. If the medical conditions are severe enough, soldiers are medically boarded and can be discharged due to medical reasons.

     

    While some celiacs may not experience symptoms on a daily basis (and that's great), when celiacs are not in control of what they eat it's a concern for their well-being. Our military has shrunk considerably over the last few decades. It is estimated that approximately 1 percent of the population now serve in the US military. They must be deployable without restrictions. Some deployments last for a year and even longer.

     

    Before Celiacs take this as a personal slam, consider the long list of other medical conditions that keep people out of the service. usmilitary.about.com/od/joiningthemilitary/a/intmedstandards.htm

     

    Perhaps at some point in the future, once the pill treatment for gluten exposure is perfected, it would be possible. Until then, I commend anyone who wants to serve our country (and for those who already serve) . I am grateful for their desire to defend and protect. I appreciate your frustration and also your patriotism.

    You could literally say that about any allergies whatsoever, there's absolutely no guarantees a nut, milk, latex, silicone, whatever the heck else hasn't touched your food. And some celiacs don't show hardly any symptoms; I was just diagnosed, and likely have had it for many, many years. I have no problems if I don't purposefully eat gluten, cross-contamination is not an issue for me. Contrast this with any other allergy, where immediate symptoms are shown and potentially fatal.

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    As someone who has personally dealt with celiac for over 17 years, and as a military spouse of 27 years I feel confident that people with celiac sprue should NOT be in the military at this time. Even with symptoms under control, if a soldier were deployed they have no guarantee over the control of their food sources. In the middle of the desert, a war, a foxhole, or 3rd world country there are no guarantees that a soldier could secure gluten free meals. Not only does that put the soldier at risk, it puts the soldiers around them at risk who need to be able to move quickly and respond rapidly to anything that comes their way. Imagine your squadron gets attacked and the soldier next to you is suffering from a gluten reaction.

     

    There are those who may say that you simply don't deploy soldiers with celiac. The problem with that mentality is you are now increasing the responsibility for the soldiers who can eat anything, anywhere, anytime, and who don't have restrictive medical conditions. It would be unfair to have a medical condition that would allow a soldier to stay home with their family while others are constantly deployed. The military already faces a multitude of other limiting medical conditions (diagnosed after entering the service) that are now putting the military in a position where the the same people must deploy over and over again. It poses an unfair situation to those soldiers who have no limitations. If the medical conditions are severe enough, soldiers are medically boarded and can be discharged due to medical reasons.

     

    While some celiacs may not experience symptoms on a daily basis (and that's great), when celiacs are not in control of what they eat it's a concern for their well-being. Our military has shrunk considerably over the last few decades. It is estimated that approximately 1 percent of the population now serve in the US military. They must be deployable without restrictions. Some deployments last for a year and even longer.

     

    Before Celiacs take this as a personal slam, consider the long list of other medical conditions that keep people out of the service. usmilitary.about.com/od/joiningthemilitary/a/intmedstandards.htm

     

    Perhaps at some point in the future, once the pill treatment for gluten exposure is perfected, it would be possible. Until then, I commend anyone who wants to serve our country (and for those who already serve) . I am grateful for their desire to defend and protect. I appreciate your frustration and also your patriotism.

    As a military spouse with celiac who has a medical degree and wants to also join, it's disheartening. Granted I understand any ground troops dealing with securing gluten free food and maintaining a balanced diet would be difficult, but as someone who would be stationed on base especially in the Navy that is a physical therapist, it's hard to see why I am disqualified. In my situation I would go home at night and be able to pack food during the day.

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    I am disturbed by the apparent reluctance of the military to consider candidates with celiac disease on a case by case basis. While it is true that some with the disease may pose a risk to others if their diet is not controlled, this is not true for all. There is a broad spectrum of symptoms among those diagnosed, and many like my son showed no symptoms. Until a few months ago, my 10 year old son lived on white bread sandwiches and macaroni and cheese and yet never missed a day of elementary school from Kindergarten through 4th grade. He was NEVER sick! We simply discovered his celiac diagnosis because his growth rate is slow. I don't think his experience is unique, and for situations like his I believe a waiver should remain a possibility. Even if he adds gluten back in his diet as an adult, he will NOT be a risk to others. My son loves the Blue Angels and has aspirations for the Naval Academy. He is also wicked smart, and and it would be a waste for the military to not recognize the gray area that may exist in this disqualification diagnosis and consider each candidates symptoms and medical history.

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    I am a Soldier with over 22 years of Military service. I was recently diagnosed with celiac after spending a week in the ICU on a military installation because my kidneys were shutting down. After a couple days in the ICU the Army doctors diagnosed me. I am allowed to continue to serve and there was no consideration to remove me from service. Luckily due to my rank and military specialty I am able to accommodate my diet most of the time. In situations when I am required to eat in dinning facilities I do find it difficult to find a gluten free meal. I do not expect the Army to accommodate my condition as I am one of the few in the military. I have deployed to several contingency operations prior to my diagnosis and due to not having resources on ground our diets were limited to mostly Meals Ready to Eat (MRE). They are no gluten-free MRE options yet but they do have vegetarian options available. I think that after more awareness of Celiac is brought to the attention of the Military there will be more gluten-free options at dining facilities and MREs. I still would not recommend enlistment to the Military if you have Celiac. There are members of our Military who disclosed they were Celiac but it was not "caught" when they Enlisted. I still recommend serving as a civilian if you have Celiac and wanted to serve the Military.

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    This article only dealt with celiacs in combat...so you recommend banning all celiacs from the military completely? This would be totally unnecessary. Many celiacs have served this country in the military, including in combat. Celiac.com supports the right for celiacs to serve in the military in all positions.

    In the military, *everyone* is expected to be combat ready, because you never know when they will be in combat, or needed for combat. I learned that the first day of boot camp, and it makes a lot of sense. My disease did not get severe until years after I had been discharged from the US Navy, and I didn´t know I had it. It But, I fully agree that the military should not accept diagnosed Celiacs unless the military has an extreme need. In that case, sure, and in that case, they would, just as they would waive other conditions that detract from optimal combat capacity. The military does not exist to provide training or jobs or to make people feel good. It exists to provide the nation the ability to defend itself. That may, without warning, include killing people, destroying things, and putting the people in the military at grave risk. Also unlike a job, it is against the law to quit - which should tell you how different this is than any normal employment.

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    On 3/16/2016 at 5:47 AM, Guest admin said:

    This article only dealt with celiacs in combat...so you recommend banning all celiacs from the military completely? This would be totally unnecessary. Many celiacs have served this country in the military, including in combat. Celiac.com supports the right for celiacs to serve in the military in all positions.

    The military rejects ANYONE with celiacs regardless of whether you have a “grunt” classified job. As someone who is currently active duty and recently diagnosed I can assure you the military is NOT a safe or healthy environment for celiacs. Most military assignments ( to be considered fit to be in the navy you are supposed to be fit for sea duty) will require you to eat at the galley. Especially when you first join and are forced to live in the barracks. Not only is the galley you’re required to eat at FULL of mostly gluten items, non gluten items are contaminated. I stand duty every 4 days (duty is where you stay overnight on the ship and don’t leave until end of working day the next day) I have to pack so much food, there’s gluten all over the place so even your own food can become contaminated with you being careful. Not to mention people make fun of you and leave gluten containing products with notes on them. If I get exposed (which happens often) I’m exhausted and in the bathroom literally all day for the next three days. THis is NOT compatible with military life. The navy doctor (after being diagnosed by a civilian GI) was like “well you can eat a little”, “you’re going to go crazy trying to see if there’s gluten in every little thing just don’t eat bread” they are ignorant and apathetic. Then he told me to bring my own food for a 9montj deployment.... um no bud I can’t have that much food in my rack. Plus boot camp requires you to eat the gluten food also for 8 weeks (longer in other branches) even if you COULD be assigned to somewhere not on a ship or deployed (mostly the point of my branch) I am very sick, shriveling away and miserable. Do not wish this on anyone else please. I know all y’all are just trying to be nice but people will get sick. 

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    Guest Matthew S. Robinson

    Posted

    I am composing a piece for a national publication about how to send gluten-free items to soldiers
    Who can I ask about policy (has it changed) and the # of gluten-free soldiers?
    Thanks
     

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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