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    Kim Hopkins
    Celiac.com 06/24/2009 - If you are like the majority of people diagnosed with celiac disease, it probably took you many years of experiencing debilitating symptoms, talking to multiple doctors who gave you varied theories and diagnoses, thinking that you would never feel better…before you finally got it figured out.  Whether you had a positive experience with your health care professionals or not, hearing the diagnosis can lead to feeling lost and unsure of what to do next.  It can be quite overwhelming.  After all, food plays an important part in our culture – it’s how we share special moments together, celebrate, and nurture one another.  A big sense of loss can overcome someone when they hear that they can no longer eat wheat, barley, rye, and contaminated oats.  Some people say they go through the roller coaster of emotions similar to the grieving process.
    Can you make the necessary lifestyle adjustments to feel better and regain your health?  Absolutely!  Everyone’s pace is different and you need to give yourself time.  Is there a way that may help you to adjust a bit more quickly and with less frustration?  Yes:  consider hiring a personal coach that specializes in food challenges.
    What Is A Personal Coach?
    Coaching is a powerful, ongoing relationship which focuses on clients making important changes in their lives.  Coaching uses a process of inquiry and personal discovery to build a client’s level of awareness and responsibility, and provides the client with structure, support, and feedback.  The coaching process helps clients to both define and achieve personal and professional goals faster and with more ease than would be possible otherwise.   In coaching, the focus is on designing the future, not getting over the past.
    The field of coaching is booming and there are many coaching niche areas.  Business coaching for executives and teams has become quite popular.  Coaching children and teens to help them excel with academics is on the rise, as is parenting coaching.  Many small business owners higher coaches to help them increase revenue.
    Coaching usually occurs in the context of a long-term relationship, where the client’s goals, dreams, and vision drive the action.  The belief is that there are multiple paths to reach a goal, and that the client knows the way (though they might not realize it at the time).  The coach assists the client to become a “change master.”  To this end, coaching and adjustment to dietary changes go hand-in-hand.
    A Personal Coach Specializing In Dietary Restrictions Can Help You To:

    Learn the gluten-free lifestyle - Where to buy gluten-free food, product reviews, how to prepare gluten-free recipes, where to eat out, how to become a skilled label reader, understanding the safe & unsafe ingredient lists, decrease cross-contamination risk, how to set up your kitchen, where to find out if your cosmetics, hair care products, and medications are safe. Develop a support network - Website resources, how to get the most out of your primary care doctor, engaging a specialist such as a dietician or nutritionist. Vary your diet, taking into consideration essential nutrients. Adjust for the financial impact- Learn to live gluten-free on a budget. Brush up on your advocacy and education skills – Practice explaining celiac to friends, relatives, and coworkers, advocate to you/your child’s school, learn how to eat out safely, manage your anxiety. Monitor any ongoing symptoms and known associate health risks - Iron deficiency anemia, osteoporosis, fertility problems, leaky gut syndrome, candida, food sensitivities, other auto-immune disorders. Keep up on the latest research and what it may mean for you – there are many exciting studies happening that may have an impact on how you take care of yourself. Assist with other goals to help your life feel more balanced.
    How Does Coaching Work?
    Generally, most coaches have a structure that includes three to four sessions each month, with quick check-ins by phone and email in between.  Coaching sessions can be either one-on-one, in small groups, or a combination of both.  They can be in-person, via phone, or a combination of both throughout the month, which allows for financial and logistical flexibility.  In-person sessions can include shopping, practice with advocating, and cooking.A coach will encourage clients to set goals that they truly want, ask them to do more than they have done on their own, help them focus in order to produce results more quickly, and provide the tools, information, support, and structure to help them accomplish more.   It’s like having a personal trainer to assist you with making adjustments to improve your life.
    Who Should Consider Hiring A Coach?

    If you are feeling unsure as to how to adjust your lifestyle around your food challenges. If you are feeling limited by food allergies/intolerance/sensitivities. If you are not sure where to go for information or are overwhelmed by all the information you are finding. If you are restricting yourself from enjoying going out to restaurants, parties, etc. If you are having difficulty sticking to the gluten-free diet. It’s important to find someone that you “click” with.  Most coachesoffer a free initial session to help get to know them, and to answerany questions you might have about the coaching process.

    Kim Hopkins
    Plan your meals:  It sounds simple, but it’s one that is often ignored.  Sit down before you do your weekly grocery run.  Know what you are going to make for each meal including snacks.  Find out what’s on sale before you make your weekly meal plan.  Stick to the list when you shop! Develop a file of dependable, go to gluten-free recipes.  My people report that, when they are short on time, that’s when they are likely to make extravagant purchases.  Take the thinking and guess work out of meal planning by looking through your file.  You can even write down the estimated cost of the meal. Eat foods that are naturally gluten free found at the regular grocery store.  Corn tortillas are cheap and have many uses, including for sandwich wraps.  Beans are a nutrient-rich starch substitute, as are lentils. Eat whole foods.  Whether you are gluten-free or not, it is healthier not to eat packaged, processed foods.  Just because a product is marked gluten free doesn’t mean it’s good for you.  Processed gluten-free products often lack nutrients.  Limit these to a couple times per week or less. Eat foods that are in season.  This means they had to travel less far to reach your grocery store, therefore they will be cheaper. Grow your own.  Learn how to can and/or jar the extras.  Live in a cool climate?  Some veggies can be started inside. Make a soup.  Soups are filling, and they are a great way to use up items in the fridge. Eat more vegetarian and vegan meals.  Eliminating meat from two dinners per week will save you quite a bit of money. Eat breakfast for dinner.  Make a frittata – cook 3 strips of bacon in a skillet.  Set aside and drain off most of the fat.  Add diced onions.  Cook for 5 minutes.  Add diced red pepper.  Cook another 5 minutes.  Add a package of thawed, drained frozen spinach.  Salt and pepper to taste.  Add bacon back in.  Beat 5 eggs and pour them all over the filling.  Top with cheese and bake at 350 for 8 – 12 minutes, or until the eggs are set.  Serves 2 – 3. Get creative.  For thickening sauces or gravy, substitute equal amounts of cornstarch for flour.  Mashed potato flakes also make a great, inexpensive thickener and binder in place of breadcrumbs. Xanthan gum is used in many gluten-free recipes to serve as the “glue” to hold the product together; use 2 tsp. unflavored gelatin to replace 1tsp. xanthum gum in some recipes such as cookies. Cornmeal or crushed potato chips can be substituted when a recipe calls for a coating or crunchy topping. Buy in bulk.  Once you found something you like, save big by buying in a large quantity.  The Gluten-Free Mall  has bulk discounts and many other ways to save you money. See their "Shop Smart & Save Money!" section on the top-right corner of their site.
    Create or join a bulk buying group.  Ask around at your local support group, or link up with local folks online.  If you like the same products buy a bulk order and split it. Cook ahead and freeze meals in individual or family-size servings.  If you are not someone that cooks and you are watching your budget, it makes sense to learn. Invest in a good vacuum food sealer.  This will help keep leftovers fresh for longer = less waste. Bake 1-2 times per month.  Things like Pizza crusts, bread, and pie crusts will freeze well if wrapped properly. Make gluten-free cookie dough from scratch and freeze in a roll.  Cut and bake what you need.  This will curb your desire to buy an expensive mix. Start a gluten-free dinner swap (like a holiday cookie swap).  Get a few families to cook up a large quantity of gluten-free meals and swap them for variety! Join a food co-op.  Co-ops are groups who use their purchasing power to get lower prices. Make your own blend of gluten-free flours ahead of time and store in an air tight container. To prevent contamination, purchase extra appliances (like a toaster) from Craig’s List or Goodwill. Track your purchases.  Seeing it in black and white can be very revealing. Consult with your employer’s human resources department.  Do they offer a flexible spending account (FSA) benefit?  These accounts hold your money pre-tax for medical purchases.  If so, will the FSA recognize gluten free food (and related shipping charges)?  Get it in writing!  If your employer doesn’t offer this benefit, ask them to look into it.  This will save you about 30%. If you are not using an FSA and you spend a lot of money on medical expenses, consult with your accountant.  Are a portion of your gluten-free food purchases tax deductible?  Shipping charges often can be reimbursed from this account, as can mileage to and from specialty stores.

    Rick Lenger
    Celiac.com 10/12/2009 - It has been 9 months since my celiac diagnosis. It seems hard for me to believe that until January 23, 2009 I had never even heard of celiac disease. I have made up for lost time in the past few months. Hopefully, my story will help others who are newly diagnosed with celiac disease to hang on to hope and be encouraged that things are going to get better – much better as they move into a gluten free lifestyle. 
    In 1971 I had a panic attack. I have never been the same since that day. I won’t go into the details of it because most people know what a panic attack is like.  So I had a complete physical which included blood panels for the first time. When I got the results I found out I had an extremely elevated alkaline phosphatase level (400), normal is 80-130. My first thought was, “What the heck is alkaline phosphatase?”  The doctor was alarmed.  He ran more tests and suggested a liver biopsy.  He thought I might have liver cancer. No liver disease was found. From that panic attack until my celiac diagnosis I was always anxious about my liver. I also fought the fear of more panic attacks.   Nothing was ever conclusive. It just hung out there for over 35 years.  Every time I changed doctors and had my blood tested I went through the same series of tests and concerns. Nothing definitive was ever diagnosed.  Finally, my doctor told me my elevated counts were “normal for me.”
    Fast forward to the year 2003.  Without any reason I lost 20 lbs. over an 8 week period. I thought it was kind of cool to be “skinny”. I had always being kind of “doughy.” When I had a physical I found my alk-phos was now over 400.  I was anemic and more fatigued than ever.  My doctor wanted me to have a colonoscopy and an endoscopy. He said he was more worried about the anemia than the high alkaline phosphate. I had a colonoscopy, but refused the endoscopy on grounds that I couldn’t bear the thought of having a tube put down my esophagus.  What a mistake!  I could have gotten this diagnosis 6 years earlier.  The colonoscopy revealed no disease. When I did finally have an endoscopy in 2009 I was totally sedated and the test took about 4 minutes. It was the easiest test I’ve ever had.  My doctor thought I was depressed and put me on anti-depressants.  After adjusting to the meds I think I felt a little better, but deep down I knew something major was going on.  I figured if I were the President I would be sent to the Mayo Clinic for a couple of weeks and they would find out what was plaguing me. I thought my problem could be found only by the best doctors in the world and it would be at great expense – more than I could afford, so I decided to just live the best I could.
    Before my diagnosis I was not absorbing many, if any, nutrients.  At 6’2” I was a gaunt 156 lbs.  I had rapid heart beat, shortness of breath, fatigue, anemia, terrible muscle cramps all the intestinal issues known to man. Numerous blood counts were way off. The 98 lb. weakling at the beach could have kicked sand in my face all day long. My wife told me she couldn’t look at me anymore. It’s hard to look at someone who is suffering from serious malnutrition.  Everything I ate went right through me.  I didn’t think about it at the time, but as I reflect back on it I know I would have died by now if I hadn’t gotten off the gluten. Now I can see signs of celiac since childhood. I was delayed in reaching puberty until I was a junior in high school. I also had fears that we not reasonable.  There were some things going on neurologically for sure.

    I began feeling better within a few days after being diagnosed and going gluten free last January.  My weight began going up, and I just knew the anemia would go away and so would the high alk-phos.  6 weeks after diagnosis (March 2009) I went in for a blood test.  I was convinced the bloodwork would show normal levels in every category. I was proud and giddy.  I couldn’t wait to get the results.  Surprise, surprise!  The blood count for anemia had not changed and the alkaline phosphatase was over 600! What the heck was going on!  At least I felt better.
    I stumbled across a couple of articles on the internet about high alkaline phosphatase in celiacs and possible reasons.  Many celiacs have low calcium and vitamin D, and in some cases it causes high alk-phos.  Without getting too technical it seems that the alk-phos plays a role in bone growth and can go into overdrive when calcium and Vitamin D are extremely low. The solution for us may be in taking lots of calcium and Vitamin D supplements.  I know this is controversial, but I decided to go directly to the source of vitamin D (the Sun) for 15 minutes of sunlight each day.  I also have been taking a great gluten free calcium/magnesium supplement for the past 6 months.  Last week I went in for more bloodwork.  I know I continue to feel better all of the time, but after my last blood work I’m a little nervous about the actual results.  The nurse called me the day after the blood was drawn and told me my count for anemia is now in the low normal range and the alkaline phosphatase is 300!  It had dropped 300 points in 6 months.  I think I’m on to something.  I feel like I’m on the right track and will continue the supplements. I haven’t mentioned how low my cholesterol was in January.  The LDL was 33 and the HDL was 18.  The total cholesterol was 61. The doctor said it was the lowest cholesterol he had ever seen! Now it has gone up to a total of 140!  Something is definitely working!  I think just being gluten free for 9 months has been better than anything else, but I continue to be hopeful about the calcium and vitamin D supplements.
     I have gained 50 healthy lbs. since discovering I’m a full blown, card carrying celiac. I’m working out every other day with weights and I figure of the 50 extra lbs. about 25 of it is muscle and the rest is fat.  Oh well.  I do look better.  My wife can look at me again and I can even look at myself once in a while. I had no idea what it was like to feel normal.  Good things can be found through every struggle. Were it not for these trials I would not have found my faith and learned to trust God. I wouldn’t change that for anything. Everything happens for a reason. I do wonder what I may have done with my life had I been gluten free from birth.  I don’t spend too much time thinking about it, though, since I can do nothing to change it. I consider it miraculous that I could have been in education as a teacher and administrator for 32 years before I hit the wall in 2005.   I’m 60 years old now.  I really look forward to the future. I feel like my best years are ahead of me.


    Jefferson Adams
    Celiac.com 02/10/2011 - Like a lot of people, Lenord Dorr loves beer.  In fact, Lenord Dorr loves beer so much, he opened his own homebrew store. Unlike most people, though, who love beer and open beer-brewing shops, Lenord Dorr also has celiac disease.
    Now, in general, loving beer and brewing beer does not jibe well with having celiac disease, since people with celiac disease have bad reactions to the wheat, and barley so central to the brewing process.
    For Dorr, however, celiac disease and the love of beer and brewing is driving spark behind his own homebrew store.
    "In 2001, I got sick with celiac, and gluten-free beers were just not available," said Dorr. "So I started brewing my own beers."
    Ultimately, Dorr said, brewing gluten-free beers became a passion that "grew into my own business."
    Dorr's shop offers the beginners through the professional brewer a complete range of ingredients and equipment for making wine or beer. Everything from Colorado grains, specialty sugars, malt extracts, and the equipment needed to magically turn those ingredients into a favorite brew.
    Of course, Dorr offers plenty of ingredients to make gluten-free beers.
    "There are more brewers than I thought," Dorr said. "There are a lot out there and many more who want to be."
    Dorr and his wife, Rebecca, opened the doors to the Homebrew Connection just after Thanksgiving, and they have since sold 14 new beer-brewing kits.
    "We'll have 14 new brewers after Christmas. That's exciting," Dorr said.
    The Homebrew Connection is located just off Main Street at 20 S. Nevada Avenue in Montrose, Colorado. Store hours are 10 a.m. to 6 p.m. Tuesday through Friday and 10 a.m. to 5 p.m. Saturday.
    Link: www.thehomebrewconnection.com


  • Recent Articles

    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.

    Dr. Ron Hoggan, Ed.D.
    Celiac.com 06/15/2018 - There seems to be widespread agreement in the published medical research reports that stuttering is driven by abnormalities in the brain. Sometimes these are the result of brain injuries resulting from a stroke. Other types of brain injuries can also result in stuttering. Patients with Parkinson’s disease who were treated with stimulation of the subthalamic nucleus, an area of the brain that regulates some motor functions, experienced a return or worsening of stuttering that improved when the stimulation was turned off (1). Similarly, stroke has also been reported in association with acquired stuttering (2). While there are some reports of psychological mechanisms underlying stuttering, a majority of reports seem to favor altered brain morphology and/or function as the root of stuttering (3). Reports of structural differences between the brain hemispheres that are absent in those who do not stutter are also common (4). About 5% of children stutter, beginning sometime around age 3, during the phase of speech acquisition. However, about 75% of these cases resolve without intervention, before reaching their teens (5). Some cases of aphasia, a loss of speech production or understanding, have been reported in association with damage or changes to one or more of the language centers of the brain (6). Stuttering may sometimes arise from changes or damage to these same language centers (7). Thus, many stutterers have abnormalities in the same regions of the brain similar to those seen in aphasia.
    So how, you may ask, is all this related to gluten? As a starting point, one report from the medical literature identifies a patient who developed aphasia after admission for severe diarrhea. By the time celiac disease was diagnosed, he had completely lost his faculty of speech. However, his speech and normal bowel function gradually returned after beginning a gluten free diet (8). This finding was so controversial at the time of publication (1988) that the authors chose to remain anonymous. Nonetheless, it is a valuable clue that suggests gluten as a factor in compromised speech production. At about the same time (late 1980’s) reports of connections between untreated celiac disease and seizures/epilepsy were emerging in the medical literature (9).
    With the advent of the Internet a whole new field of anecdotal information was emerging, connecting a variety of neurological symptoms to celiac disease. While many medical practitioners and researchers were casting aspersions on these assertions, a select few chose to explore such claims using scientific research designs and methods. While connections between stuttering and gluten consumption seem to have been overlooked by the medical research community, there is a rich literature on the Internet that cries out for more structured investigation of this connection. Conversely, perhaps a publication bias of the peer review process excludes work that explores this connection.
    Whatever the reason that stuttering has not been reported in the medical literature in association with gluten ingestion, a number of personal disclosures and comments suggesting a connection between gluten and stuttering can be found on the Internet. Abid Hussain, in an article about food allergy and stuttering said: “The most common food allergy prevalent in stutterers is that of gluten which has been found to aggravate the stutter” (10). Similarly, Craig Forsythe posted an article that includes five cases of self-reporting individuals who believe that their stuttering is or was connected to gluten, one of whom also experiences stuttering from foods containing yeast (11). The same site contains one report of a stutterer who has had no relief despite following a gluten free diet for 20 years (11). Another stutterer, Jay88, reports the complete disappearance of her/his stammer on a gluten free diet (12). Doubtless there are many more such anecdotes to be found on the Internet* but we have to question them, exercising more skepticism than we might when reading similar claims in a peer reviewed scientific or medical journal.
    There are many reports in such journals connecting brain and neurological ailments with gluten, so it is not much of a stretch, on that basis alone, to suspect that stuttering may be a symptom of the gluten syndrome. Rodney Ford has even characterized celiac disease as an ailment that may begin through gluten-induced neurological damage (13) and Marios Hadjivassiliou and his group of neurologists and neurological investigators have devoted considerable time and effort to research that reveals gluten as an important factor in a majority of neurological diseases of unknown origin (14) which, as I have pointed out previously, includes most neurological ailments.
    My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.
    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

    Jefferson Adams
    Celiac.com 06/14/2018 - Refractory celiac disease type II (RCDII) is a rare complication of celiac disease that has high death rates. To diagnose RCDII, doctors identify a clonal population of phenotypically aberrant intraepithelial lymphocytes (IELs). 
    However, researchers really don’t have much data regarding the frequency and significance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. Such data could provide useful comparison information for patients with RCDII, among other things.
    To that end, a research team recently set out to try to get some information about the frequency and importance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. The research team included Shafinaz Hussein, Tatyana Gindin, Stephen M Lagana, Carolina Arguelles-Grande, Suneeta Krishnareddy, Bachir Alobeid, Suzanne K Lewis, Mahesh M Mansukhani, Peter H R Green, and Govind Bhagat.
    They are variously affiliated with the Department of Pathology and Cell Biology, and the Department of Medicine at the Celiac Disease Center, New York Presbyterian Hospital/Columbia University Medical Center, New York, USA. Their team analyzed results of TCR-GR analyses performed on SB biopsies at our institution over a 3-year period, which were obtained from eight active celiac disease, 172 celiac disease on gluten-free diet, 33 RCDI, and three RCDII patients and 14 patients without celiac disease. 
    Clonal TCR-GRs are not infrequent in cases lacking features of RCDII, while PCPs are frequent in all disease phases. TCR-GR results should be assessed in conjunction with immunophenotypic, histological and clinical findings for appropriate diagnosis and classification of RCD.
    The team divided the TCR-GR patterns into clonal, polyclonal and prominent clonal peaks (PCPs), and correlated these patterns with clinical and pathological features. In all, they detected clonal TCR-GR products in biopsies from 67% of patients with RCDII, 17% of patients with RCDI and 6% of patients with gluten-free diet. They found PCPs in all disease phases, but saw no significant difference in the TCR-GR patterns between the non-RCDII disease categories (p=0.39). 
    They also noted a higher frequency of surface CD3(−) IELs in cases with clonal TCR-GR, but the PCP pattern showed no associations with any clinical or pathological feature. 
    Repeat biopsy showed that the clonal or PCP pattern persisted for up to 2 years with no evidence of RCDII. The study indicates that better understanding of clonal T cell receptor gene rearrangements may help researchers improve refractory celiac diagnosis. 
    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023

    Jefferson Adams
    Celiac.com 06/13/2018 - There have been numerous reports that olmesartan, aka Benicar, seems to trigger sprue‐like enteropathy in many patients, but so far, studies have produced mixed results, and there really hasn’t been a rigorous study of the issue. A team of researchers recently set out to assess whether olmesartan is associated with a higher rate of enteropathy compared with other angiotensin II receptor blockers (ARBs).
    The research team included Y.‐H. Dong; Y. Jin; TN Tsacogianis; M He; PH Hsieh; and JJ Gagne. They are variously affiliated with the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School in Boston, MA, USA; the Faculty of Pharmacy, School of Pharmaceutical Science at National Yang‐Ming University in Taipei, Taiwan; and the Department of Hepato‐Gastroenterology, Chi Mei Medical Center in Tainan, Taiwan.
    To get solid data on the issue, the team conducted a cohort study among ARB initiators in 5 US claims databases covering numerous health insurers. They used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for enteropathy‐related outcomes, including celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy. In all, they found nearly two million eligible patients. 
    They then assessed those patients and compared the results for olmesartan initiators to initiators of other ARBs after propensity score (PS) matching. They found unadjusted incidence rates of 0.82, 1.41, 1.66 and 29.20 per 1,000 person‐years for celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy respectively. 
    After PS matching comparing olmesartan to other ARBs, hazard ratios were 1.21 (95% CI, 1.05‐1.40), 1.00 (95% CI, 0.88‐1.13), 1.22 (95% CI, 1.10‐1.36) and 1.04 (95% CI, 1.01‐1.07) for each outcome. Patients aged 65 years and older showed greater hazard ratios for celiac disease, as did patients receiving treatment for more than 1 year, and patients receiving higher cumulative olmesartan doses.
    This is the first comprehensive multi‐database study to document a higher rate of enteropathy in olmesartan initiators as compared to initiators of other ARBs, though absolute rates were low for both groups.
    Source:
    Alimentary Pharmacology & Therapeutics