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      Frequently Asked Questions About Celiac Disease   04/07/2018

      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 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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    HOW GLUTEN SENSITIVITY CAN CAUSE OBESITY


    Dr. Vikki Petersen D.C, C.C.N


    • Journal of Gluten Sensitivity Autumn 2013 Issue


    Celiac.com 01/19/2017 - When celiac disease was originally described, one of its hallmark presenting signs was extreme underweight. Along with diarrhea, digestive pain and bloating, the severe weight loss was understood to 'always' be present. Fast forward over 100 years and things have changed. Not only are many celiacs overweight, but those with gluten sensitivity are increasingly falling into that category as well.


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    Sadly, too often doctors miss testing for these life-long conditions because of a patient's weight status. Stuck in the historical definition, these doctors have missed the current face of celiac and gluten sensitivity – a person can be any weight, and they frequently have weight to lose.

    We often speak of the leaky gut, formally known as a condition of increased intestinal permeability, found in the small intestine. This situation is seen most often in those with an intolerance to gluten due to their upregulation of a protein only made by humans, called zonulin. Zonulin was discovered by Dr. Alessio Fasano and his team.

    The zonulin molecule dictates the opening and closing of the 'gates' of the small intestine. With a surface area of over 3,000 square feet, that involves a lot of gates!

    While only humans make zonulin, not all humans produce it. Twenty percent do not, 50 percent has a single copy of the gene and 30 percent of the population has both copies of the gene. Those with both copies are in the unenviable position of being two times more likely to die from all causes, and the diseases they do get tend to be more severe.

    When a lab test was done on rats highly predisposed to develop type 1 diabetes, two thirds of them never developed the disease when they were given a drug that inhibited zonulin. I know you're going to ask, so here's the answer: A drug does not yet exist for humans that performs this function. However, it is being developed, along with a test for zonulin, by Dr Fasano.

    A study published last Fall in Nutrition Research titled "Potential mechanisms for the emerging link between obesity and increased intestinal permeability” and lead by TF Teixeira, found a link that could well explain the obesity issue so commonly seen.

    Those with an intolerance to gluten not only tend to have a leaky gut due to the above mentioned zonulin connection, but they also have weakened immune systems due to the constant assault by gluten. The weakened immune system, predominantly housed in the small intestine, is thus less able to defend the body against the normal barrage of bacteria, amoeba, parasites and the like. Why do I call the presence of these organisms 'normal'? Because it is. Now, with that said, it is NOT normal for such organisms to gain a foothold in the intestine and procreate there, but their presence is a normal byproduct of eating food, putting one's fingers in one's mouth, etc. (These are microscopic organisms so don't get too grossed out.) The point is, that a healthy immune system easily kills them; an unhealthy immune system is unable to do its job. The result is a gut full of endotoxins (toxins released from inside bacteria when they disintegrate) or other inhospitable organisms.

    These bad organisms thereby fight against the good ones. The good bacteria in the gut (called the microbiome) literally have a population that exceeds the number of cells in the human body by 10 times. The genes associated with this population exceeds that of the human body by 100 times. We are talking about a part of the human body, long under-appreciated, that is now being considered influential enough to be considered an 'organ' in its own right.

    Emerging research reveals that when this organ is overwhelmed by toxins in the gut, its composition changes as far as the balance of certain organisms (probiotics), as does its ability to absorb nutrients and expend energy (burn calories). The result is not only weight gain but increased cholesterol, triglycerides, and insulin resistance – the latter leads to diabetes, heart disease and obesity.

    Intestinal permeability is also thought to be influenced by a high fat and high fructose diet, plus certain nutritional deficiencies such as zinc.

    Another study from the Journal of Parenteral and Enteral Nutrition titled "Gut Microbiota, Intestinal Permeability, Obesity-Induced Inflammation and Liver Injury” found much the same data.

    They found that eating a poor diet (high fat, high fructose) could affect the microbiome in as little as one to two days – the result being heart disease and obesity.

    So, how do we keep our microbiome happy?

    • Discover if you have a gluten or dairy intolerance. If so, avoid those foods.
    • Avoid excess, bad fats including fast food, trans fats, preprocessed, prepackaged foods, etc.
    • Avoid ALL fructose. I'm not talking about the natural fructose in fruit, of course, but all added fructose, especially high fructose corn sweeteners.
    • If you can, get your gut tested for the presence of any inhospitable organisms that have gotten a foothold in your system. This same test will evaluate the health of your microbiome.
    • Another test that's good, as a verifier that you're on the right track, is one for a leaky gut. We tend to recommend this one once you've been on a reparative program for a while, to confirm that we are accomplishing our goal.
    • Do ingest 9 servings of organic vegetables and fruits each day. These are naturally healing and prebiotic, meaning that they give strength and nourishment to your probiotic population.
    • Ensure that you are not deficient in any major vitamins and minerals such as B's, D, zinc, magnesium, calcium, etc.

    While it seems like a 'no brainer' to take probiotics, here's a couple of things to keep in mind.

    • a. Use a human strain
    • b. Get a combination of organisms such as acidophilus, bifidus, etc.
    • c. Due to dairy products being such a commonly sensitive food, get probiotics that are free of all dairy.
    • d. Sometimes, if you have an infection in the gut, you may feel worse on probiotics. If this occurs, stop them, of course, but realize that you should look into step 4 above. I'm happy to help you!

    Don't cheat. I'm sorry, but being 'good' Monday through Friday and going crazy on the weekends just isn't going to cut it if you want to be healthy. And if your health is already compromised somewhat, cheating just isn't worth the dangerous repercussions. That microbiome can change in a day or two when you've been eating a poor diet. Remember that.

    I hope you found this helpful. It is interesting how much we are discovering about how the health of the gut dictates so much about our general health or tendency towards disease. And it's also quite revealing how much of a culprit gluten can be when trying to optimize the function of the small intestine and its immune system.

    Please send me your questions or comments. I am here to help!

    My clinic, HealthNOW Medical Center, is a destination clinic. You don't need to live locally to receive help with your health. You are welcome to call us anytime for a free health analysis – 408-733-0400.

    References:

    • Nutrition Research. 2012 Sep;32(9):637-47. Potential mechanisms for the emerging link between obesity and increased intestinal permeability.Teixeira TF, Collado MC, Ferreira CL, Bressan J, Peluzio Mdo C.
    • Journal of Parenteral and ENteral Nutrition 2011. Gut Microbiota, Intestinal Permeability, Obesity-Induced Inflammation and Liver Injury. Thomas H. Frazier, MD1; John K. DiBaise, MD, and Craig J. McClain, MD. Volume XX Number X


    Image Caption: Image: CC--Tony Alter
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    admin

    This article appeared in the Winter 2006 edition of Celiac.coms Scott-Free Newsletter.
    Celiac.com 07/10/2006 - Three years ago my father was diagnosed with celiac disease and I was told by my mother that it is hereditary and that I too should get screened for it. I did some research and immediately knew that I had this disease. I wouldn't admit it to anyone at the time because how on earth could I possibly live without pasta and fresh-baked bread for the rest of my life?! You should know that I have been sick for my entire life—I had colic until I was six, got ulcers when I was eight, appendicitis at 14, calcium bone spurs at 17, 19, 24 and 36, infertility at 24, gall stones at 37—just to mention a few of the conditions Ive had that were likely related to my untreated celiac disease.
    About six months later I decided to go see my doctor—I was in a severe state of depression, and I had lost the ability to think—much less talk. Carrying on a full conversation was nearly impossible because of my inability to speak in full sentences. I was extremely sick with a severe cold, and I had an infection or the flu at least once each month for the preceding two to three years. I told my doctor that I thought that he should test me for celiac disease. Since I weighed in at over 300 pounds he literally laughed at this idea. According to him there was absolutely no way that I could have celiac disease—because I was fat!
    Shortly after that my parents came to visit and tried to talk me into eating gluten-free—at least during the time that they were here. I agreed because I had to cook gluten-free for them anyway. Within three days of starting a gluten-free diet I felt like a million bucks. My depression lifted and within a month I was losing weight and my brain started working again. I have been gluten-free for three years now—not only do I feel like a million bucks, but I have lost over 100 pounds. I shudder at the idea that I was literally eating myself to death—and it was not because I didn't have any will power or that I was eating bad food—it was because my body couldnt process and absorb the food that I was eating. My personal experience, combined with my research, has left me completely convinced that celiac disease is (and will continue to be) a significant cause of obesity—and that this will continue to be the case until there is a better understanding of the disease and its relationship to obesity.
    What is Celiac Disease?
    Celiac disease is a permanent intolerance to gluten1, which is a protein found in, wheat, rye, and barley. When gluten is ingested the digestive system is unable to properly break it down, and an autoimmune response is triggered in the gut that causes the villi of the small intestine to become damaged—leading to malabsorption of crucial nutrients. There is no cure, and the only way to control it is through a 100% gluten-free diet.
    The disease has a vast array of symptoms, and it is rare that two people will exhibit the same ones. Some will have diarrhea while others will have constipation, and some will not have either but instead may have osteoporosis, diabetes, headaches, fatigue, autoimmune thyroid disorder or any number of other conditions and symptoms found to be associated with it. In many cases these symptoms are associated with the inability to gain weight—children with celiac disease are often small and fail to thrive 1.
    Nearly every source that I consulted for this paper referred to malabsorption and how most people with celiac disease lost weight or couldn't gain weight. Only a few sources even mentioned obesity—and when they did it was only in passing. As celiac disease awareness steadily increases and more research is done on it hopefully it will become apparent that many cases of obesity are also related to it.
    The Common Thread
    Autoimmune thyroid disease has recently been linked to celiac disease. Recent research has demonstrated that 3.4% of patients with autoimmune thyroid disease also have celiac disease2. The thyroid gland secretes hormones to control the body's metabolic rate3, and to accomplish this it must have iodine. When celiac disease is present along with autoimmune thyroid disorder, the body does not have the ability to absorb the iodine to produce the necessary hormones. Additionally there are many different disorders such as obesity, diabetes, allergies, weight-loss, gastrointestinal problems, etc., that can be caused by having a damaged or compromised thyroid gland3 (all of these disorders, by the way, can be related to celiac disease). It has been known for years that obesity has been linked to thyroid problems, and that the thyroid produces 5-monodeiodinase, the bodys natural method of conserving fuel during shortage," and the body "elicits the same physical reaction as famine," which can then cause the affected person to gain weight3.
    Another disorder commonly associated with celiac disease is malabsorption, which can also lead to malnutrition. When someone with celiac disease eats foods that contain gluten it results in damage to the surface of the small intestine and destruction of their nutrient-absorbing villi. This can lead to leaky gut and an inability for them to absorb vital nutrients from their food. By continuing to eat foods containing gluten, eventually vital organs including the brain, thyroid, liver, kidneys—essentially any organ that depends heavily on nutrients—will be starved, which will leave them susceptible to other diseases and conditions. I personally experienced brain malfunctions, gall bladder problems, and was diagnosed numerous times with an under-active thyroid. Naturally treatments for this proposed thyroid condition didnt work because their true cause had not yet been found. At one point a doctor asked me to consider the idea that my obesity was the result of my bodys attempt to cope with malnourishment4. This phenomenon is similar to yo-yo dieting, where dieters who have deprived themselves or proper nutrition for too long gain weight at faster rates than non-dieters after they resume eating normally. I always thought that I had fallen victim to yo-yo dieting, and that I had dieted myself into a permanent state of obesity. I now understand that it was because I had undiagnosed celiac disease, and my body was actually malnourished.
    Under normal nutritional conditions humans only absorb about 80 percent of the nutrients from the food they eat, and the rest of the nutrients pass through the body4. With celiac disease, however, the body is unable to absorb the necessary nutrients, which causes some peoples bodies to become a super-efficient machine that begins storing as much fat as possible in order to survive. This nutrient deficiency convinces the body that it is starving to death, which sends it into starvation-mode. Since humans need a certain percentage of body fat reserves to stay alive—and because it takes more work for the body to burn fats than carbohydrates—a body that is in starvation mode tends to crave carbohydrates and more efficiently convert them to fat for later use4.
    There has been much research that links celiac disease to diabetes. Diabetes occurs when the bodys cells are unable to absorb enough blood sugar5. Although the cause is different, the resulting malabsorption is similar to that seem in celiac disease—although in the latter the malabsorption is not just limited to sugar. The connection between diabetes and celiac disease as described by Marschilok:
    Both diseases have genetic and environmental origins. This means an individual is more at risk of developing either problem when a close relative also has it. On the genetic side, development of one reveals the pre-existing and larger risk that the genes for the other may be present. At least two genes and gene locations are connected with each disease. One gene for each disease is near one gene for the other on the same chromosome. Nearby genes are more likely to pass together to offspring.
    However, while the genes are necessary, they are not sufficient to produce the diseases. On the environmental side, researchers know gluten is needed to produce celiac disease, but they also know its not the only environmental cause. With diabetes, the environmental causes are being extensively studied for prevention and cure. Roughly ten percent of celiacs either have Type I diabetes or might develop Type II diabetes6 .
    An astonishing 40% of people with diabetes are also obese—even though there was not very much in the way of medical research to indicate why this is so. Diabetes is described as your cells inability to produce or absorb insulin, which leads to an excess of sugar in the blood stream7. If a person injects or produces too much insulin it will increase the level of hunger and cause obesity. I personally find this information disturbing as there are some in the medical community who still blame obesity on character flaws—I cant begin to tell you how many times I have been told: if you just didn't eat so much you wouldn't be fat.
    A number of overweight and obese acquaintances of mine have asked me how I managed to lose over 100 pounds and look so healthy while doing it. I explained my celiac disease diagnosis and gluten-free diet to them, and how the diet has made me not feel hungry for the first time in my life—due to the fact that I am now absorbing nutrients properly. Six of these extremely obese people have actually gone to their physicians to get tested for celiac disease—and each was met with the same skepticism as me. They persisted and finally got their doctors to perform the necessary tests—and to the surprise of all each were diagnosed with celiac disease! Immediately after going on the gluten-free diet they all experienced a decrease in hunger and massive weight-loss. For the first time they were eating only when their bodies were truly hungry, instead of eating too much due to starvation signals caused by malabsorption.
    This could also be part of the reason that high protein, low carbohydrate diets work so well for many people. By removing the carbohydrates from ones diet you generally remove a large portion of the gluten as well, which can cause those with celiac disease who are obese to lose weight quickly—at least for a month or so. However, on the high protein diet you are still not removing all gluten which will eventually cause them to gain the weight back—even though they are still on the diet. This was my experience with the low carbohydrate diet, and I suspect that a lot of others who are obese and have undiagnosed celiac disease had or will have the same experience.
    Conclusion
    I once had a family member literally yell at me about my weight and ask me why I was being so selfish and not thinking about my husband and daughter—they told me that I should just lose the weight. I was devastated, I truly had tried every diet on the face of the earth and each and every time I would loose 20-30 pounds quickly (regardless of the type of diet), only to gain it back (while still following the program)—sometimes as much as two fold! Since being diagnosed with celiac disease three years ago I have not only lost the weight but I have also kept it off, and each week a little bit more comes off. I am completely convinced that celiac disease does and will continue to be a common cause of obesity until the medical community—through scientific research—realizes that there is a connection.
    Many obese people might not be overweight if they were just properly diagnosed and treated. Certainly it is not the case that all obese people are that way because they just plain eat too much and do not have any will power. I suspect that there are better medical reasons to explain most cases of obesity, and celiac disease is just one of them. Not too long ago it was estimated that celiac disease only affected 1 in 10,000 Americans8. That figure was then revised to 1 in 5,000, and now, after much research, it is at least 1 in 133. The actual diagnosis rate, however, is only about 1 in 5,000, which is only a small fraction of those who have it. Similarly, the causes of obesity in America are not fully understood, and more research needs to be done to determine just how many cases of obesity are caused by untreated celiac disease. I believe that a significant percentage of obese people have undiagnosed celiac disease, and that celiac disease screening should be part of ordinary blood workups for all obese people.
    References:
    Adams, S. (May 2005). A Celiac Disease and Gluten-Free Resource since 1995. Retrieved May 18, 2005, from www.celiac.com. Collin, Kaukinen, Valimaki & Salmi, (2002). Endocinological Disorders and Celiac Disease, Endocrine Reviews (pp 1-38).
    3. Life Extension, Thyroid Deficiency, Online reference for Health Concerns. Retrieved May 26, 2005 from www.lef.org/protocols/prtcls-txt/t-prtcl-104.html. Balley, L. (June 2004) Obesity in Developing Countries Compares to U.S. Yo-Yo Dieting. Retrieved June 16, 2005 from: http://www.eurekalert.org/pub_releases/2004-06/uom-oid060804.php. Katz H., (2005). Hope for Obesity and Diabetes. Retrieved June 19, 2005 from http://www.reporter-archive.mcgill.ca/Rep/r3112/mice.html. Marschilok, K., (1997). Diabetes and celiac Disease. Gluten-free Living. Hoover, J., (2001). Obesity Causes Diabetes–Fat Chance! Diabetes Health Magazine. Retrieved June 19, 2005 from http://www.diabeteshealth.com/read,1009,2168.html Vogren, C.L., (September 15, 2003). Awareness Can Be Best Medicine: Parents who lost son to celiac disease want to shed light on often-overlooked ailment. The Gazette. Retrieved June 19, 2005 from http://www.csaceliacs.org/CDintheNews/COSpringsGazette091503.php

    Dr. Ron Hoggan, Ed.D.

    This article appeared in the Spring 2006 edition of Celiac.coms Scott-Free Newsletter.
    Celiac.com 07/10/2006 - Increased consumption of gluten, according to Dr. Michael Marsh, raises the risk of celiac disease symptoms1. Although these symptoms may not indicate celiac disease, they reflect some biological realities. Grain-based foods simply do not offer the nutrients necessary to human health and they damage the human body. USDA and Canada Food Guides notwithstanding, if people eat grain-laden diets, they may develop symptoms of celiac disease (but in most cases, without the diagnostic intestinal lesion). The connection between eating disorders and celiac disease is well known and well documented2,3,4,5. Thus, the dynamics at work in celiac disease may offer insight into the broader realm of obesity, especially among those who are eating the recommended, daily quantities of grain-derived foods, while attempting to keep their weight down by eating low-fat foods.
    The primary, defining characteristic of celiac disease is gluten induced damage to the villi in the intestinal lining. Since malabsorption of vitamins and minerals are well known in the context of celiac disease, it should not be surprising that some celiac patients also demonstrate pica (Pica is an ailment characterized by eating dirt, paint, wood, and other non-food substances). Other celiac patients eat excessive quantities of food, coupled with a concurrent failure to gain weight. Yet another, perhaps larger, group of celiac patients refuse to eat (One may wonder if the latter find that eating makes them feel sick so they avoid it).
    Perhaps the most neglected group is that large portion of untreated celiac patients who are obese. Dr. Dickey found that obesity is more common than being underweight among those with untreated celiac disease6. When I ran a Medline search under the terms "obesity" and "celiac disease" 75 citations appeared. A repeated theme in the abstracts and titles was that celiac disease is usually overlooked among obese patients. While obesity in celiac disease may be common, diagnosis appears to be uncommon. Given the facts, I certainly believe that some of the North American epidemic of obesity can be explained by undiagnosed celiac disease. However, that is only a small part of the obesity puzzle, and I suspect that celiac disease may offer a pattern for understanding much of the obesity that is sweeping this continent.
    One example, a woman diagnosed by Dr. Joe Murray when he was at the University of Iowa, weighed 388 pounds at diagnosis7. Dr. Murray explained her situation as an over-compensation for her intestinal malabsorption. I want to suggest a two faceted, alternative explanation which may extend to a large and growing segment of the overweight and obese among the general population. As mentioned earlier, anyone consuming enough gluten will demonstrate some symptoms of celiac disease. If large scale gluten consumption damages the intestinal villi—but to a lesser degree than is usually required to diagnose celiac disease—fat absorption will be compromised. Deficiencies in essential fatty acids are a likely consequence.
    The natural response to such deficiencies is to crave food despite having absorbed sufficient calories. Even when caloric intake is huge, and excess calories must be stored as body fat, the need to eat continues to be driven by the bodys craving for essential fats. Due to gluten-induced interference with fat absorption, consumption of escalating quantities of food may be necessary for adequate essential fatty acid absorption. To further compound the problem, pancreatic glucagon production will be reduced, compromising the ability of the individual to burn these stored fats, while the cells continue to demand essential fats.
    Poor medical advice also contributes to the problem. The mantra of reduced fat continues to echo in the offices of health professionals despite a growing body of converse research findings. In February of this year, the results of a powerful, eight year study of almost 49,000 women showed little difference between the health of women consuming low fat diets when compared to those consuming normal diets8. Alarmingly, this low fat diet seems to have resulted in weight gain, a well recognized risk factor for a variety of diseases.
    For some of us, this result was predictable. The likely result of a low-fat diet is an increased intake of carbohydrates while food cravings are fuelled by a deficiency of essential fatty acids. If my sense of the underlying problem (caloric excess combined with essential fatty acid deficiency due to fat malabsorption at the microvilli) is accurate, then a low fat diet is exactly the wrong prescription. Many obese persons are condemned, by such poor medical advice, to a life of ever deepening depression, autoimmune diseases, and increasing obesity.
    At the end of the day, when these folks drop dead from heart attacks, strokes, or some similar disaster, the self-righteous bystanders will just know that the problem was a lack of willpower.
    I watched my mom steadily gain weight for 35 years. I watched her exercise more will power beyond the capacity of most folks. Still, she could not resist her compulsive eating. I have seen her take something from the freezer and chew on it while agreeing that she had just eaten a very large meal and should feel full.
    In December of 1994 I was diagnosed with celiac disease. According to the published experts in this area, my mom should also have been invited for testing. Yet, when asked for testing, her doctor refused her. Through persistence, and a pervasive faith in her son, mom finally (after months of negotiation) swayed her doctor to do the anti-gliadin antibody blood test. Despite the fact that she had been on a reduced gluten diet for the past year, her antibody levels were elevated.
    She never sought a biopsy diagnosis, and the EMA and tTG were not available here in Canada at that time. However, she has been gluten-free for the past seven years or so. She dropped a considerable amount of weight.
    Her weakness was never will power. She was battling an instinct so basic that few of us could have resisted. That, I think, is the story behind much of North American obesity. The widespread, excessive consumption of gluten at every meal, in addition to the low-fat religion that has been promulgated throughout the land, is resulting in intestinal damage and a widespread deficiency in essential fats is among North Americans.

    Ron Hoggan is an author, teacher and diagnosed celiac who lives in Canada. His book "Dangerous Grains" can be ordered at www.celiac.com. Rons Web page is: www.DangerousGrains.com
    References:
    Marsh, Michael N. Personal communication. 2002. Ferrara, et. al. "Celiac disease and anorexia nervosa" New York State Journal of Medicine 1966; 66(8): 1000-1005. Gent & Creamer "Faecal fats, appetite, and weight loss in the celiac syndrome" Lancet 1968; 1(551): 1063-1064. Wright, et. al. "Organic diseases mimicking atypical eating disorders" Clinical Pediatrics 1990; 29(6): 325-328. Grenet, et. al. "Anorexic forms of celiac syndromes" Annales de Pediatrie 1972; 19(6): 491-497. Dickey W, Bodkin S. Prospective study of body mass index in patients with coeliac disease. BMJ. 1998 Nov 7;317(7168):1290. Murray, J. Canadian Celiac Association National Conference. 1999. Howard BV, Van Horn L, Hsia J, et. al. Low-fat dietary pattern and risk of cardiovascular disease: the Womens Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006 Feb 8;295(6):655-66.

    Jefferson Adams
    Celiac.com 05/18/2016 - Common clinical wisdom, and some data, indicate that patients with celiac disease are likely to be underweight. However, data from west suggest that anywhere from 8% to 40% of celiac patients can be overweight or obese.
    What about normal weight? Can people with celiac disease also have normal body weight? A research team recently set out to determine if people with celiac disease can be normal weight. The research team included I Singh, A Agnihotri, A Sharma, AK Verma, P Das, B Thakur, V Sreenivas, SD Gupta, V Ahuja, and GK Makharia.
    They are variously affiliated with the Department of Gastroenterology and Human Nutrition, the Department of Pathology, the Department of Biostatistics, and the Department of Gastroenterology and Human Nutrition at the All India Institute of Medical Sciences in Ansari Nagar in New Delhi, India.
    To answer that question, a team of researchers recently reviewed data on body mass index (BMI) of patients with celiac disease so they could correlate BMI with other celiac characteristics. For their retrospective study, the team reviewed case records of 210 adolescent and adult celiac patients who were seen at the team's Celiac Disease Clinic.
    To classify BMI as underweight, normal weight, overweight, or obese, they used the Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians for those with age >18 years and revised Indian Association of Pediatrics BMI-for-age charts for those between 12 and 18 years.
    Their results showed that, of 210 patients, 115 patients were normal weight, while 76 patients were underweight, 13 were overweight, and 6 were obese. There was no difference in the proportion of underweight between male and female patients with celiac disease.
    The mean age of underweight patients was similar to those who were normal or overweight. Regardless of weight, there was no difference between any of the patients in terms of average duration of symptoms; frequencies of diarrhea, anorexia, and weakness; anemia; titer of anti-tissue transglutaminase antibody; and severity of villous atrophy in those with underweight or normal weight or overweight.
    Of the celiac disease patients in this clinic, only one third of patients with celiac disease actually had low BMI. More than half had normal BMI, while the rest were either overweight or obese.
    Physicians should not discount the possibility of celiac disease based solely on BMI. Patients with normal and high BMI can also have celiac disease.
    Source:
     Indian J Gastroenterol. 2016 Jan;35(1):20-4. doi: 10.1007/s12664-016-0620-9. Epub 2016 Feb 18.

    Dr. Vikki Petersen D.C, C.C.N
    Celiac.com 12/06/2016 - Neurological problems are a very common effect of gluten intolerance. Whether you have celiac disease or gluten sensitivity, there is research showing that gluten can cause nervous system problems in affected individuals.
    What kind of problems? When it comes to the nervous system, symptoms run the gamut from depression to schizophrenia, from migraines to brain fog, and from seizures to numbness and pain.
    I want to share more information with you about a particular type of nervous system ailment called peripheral neuropathy. The name basically means damage to the nerves of the extremities (arms and legs) that typically manifests in numbness and pins and needles-type pain that all of us have experienced at one time or another if we sat on our feet too long or fell asleep in a weird position and had a hand ‘go to sleep'. While these latter type incidents are normal, having such symptoms occur when no pressure is being put on the nerve is abnormal.
    Not only is it uncomfortable to have such sensations, but when truly numb, accidents from tripping or burning oneself can occur due to not having adequate sensation.
    I think it is interesting to note that the most common occurrence of peripheral neuropathy is seen in type I diabetes, an autoimmune disease. Celiac is also an autoimmune disease and according to the University of Chicago's Center for Peripheral Neuropathy, 10% of those diagnosed with celiac disease have a neurological problem, and peripheral neuropathy is quite common.
    Taking it a step further, we know that gluten creates a leaky gut and we know that a leaky gut is associated with autoimmune disease, through several wonderful studies brought to us by Dr. Alessio Fasano and his team. Therefore, seeing a connection between gluten and peripheral neuropathy is not unexpected based on research.
    Further, despite a dearth, or scarcity, of research on gluten sensitivity, doctors currently engaged in such research cite peripheral neuropathy as one of the most common symptoms associated with gluten sensitivity. In fact neurological symptoms are frequently associated with gluten sensitivity before any digestive symptoms ever develop. And in some cases, the nervous system disorders are present with no digestive disturbances. A lack of any digestive symptoms is perhaps one of many reasons why these individuals' gluten sensitivity is missed by their doctors.
    When it comes to comparing gluten sensitivity to celiac disease, according to Dr Fasano, 30% of the patients he diagnoses with gluten sensitivity suffer a neurological ailment, a much higher percentage than that associated with celiac disease.
    How Do You Know if You Have Peripheral Neuropathy?
    The symptoms of peripheral neuropathy are numbness, a feeling of hot/cold or a pins and needles feeling that tends to start at the ends of your body's long nerves, meaning your feet and hands, before moving upwards. The symptoms can be in legs and/or arms, right side and/or left.
    Certainly, considering that type 1 diabetes is the most common cause of peripheral neuropathy, with an estimated 50% suffering some type of nerve damage, that would be the first thing to rule out.
    What Should You Do?
    If you have these symptoms and your doctor has ruled out diabetes and any other obvious sources of the problem (including any drugs you may be taking that create neuropathy as side effects), you may fit into the category of "idiopathic neuropathy". This means that you have the problem but the reason is unknown. Or is it?
    Let's look at the result of a study where researchers worked with more than 200 individuals with neuropathy, 140 of whom fell within the ‘idiopathic' category. These smart doctors tested those 140 people for antibodies to gluten, specifically utilizing the anti-gliadin antibody test – AGA-IgA and AGA-IgG. This blood test is a general blood test that is not specific to celiac disease or gluten sensitivity, but shows that the body's immune system is reacting negatively to these proteins in gluten called gliadin.
    Of those tested, 34% were positive to one or both tests, compared to 12% of the general population. Interestingly, a full 9% of those tested in the ‘idiopathic' group actually had celiac disease, compared to 1% of the general population. And perhaps even more interesting, 80% of that same idiopathic group had the genes for celiac disease, either HLA-DQ2 or HLA-DQ8. 80%!! In the normal population that number is about 40%.
    Our takeaway message is that peripheral neuropathy has a rather high correlation to immune reaction to gluten – be it celiac disease or gluten sensitivity. Therefore anyone you know who suffers with such symptoms absolutely should be checked for gluten intolerance. Regaining one's strength and correcting nervous system abnormalities is well worth the change in diet when gluten is the cause. Such cases have been described in the literature where the only treatment that led to success was a gluten-free diet.
    So many diseases and symptoms can be prevented and reversed by discovering their true underlying root cause and for many of those ailments it is gluten that is the culprit.
    Don't continue suffering nor let you friends and family members suffer. Find out why the symptom is there rather than just masking it with a drug.
    If you need assistance, consider calling us for a free health analysis – call 408-733-0400. Our destination clinic treats patients from across the country and internationally. You don't need to live local to us to receive assistance. We are here to help!
    To your good health,
    References:
    Hadjivassiliou M. et al. Neuropathy associated with gluten sensitivity. Journal of Neurology, Neurosurgery, and Psychiatry. 2006 Nov;77(11):1262-6. Rigamonti A. et al. Celiac disease presenting with motor neuropathy: effect of gluten-free diet. Muscle & Nerve. 2007 May;35(5):675-7. University of Chicago Center for Peripheral Neuropathy. Types of Peripheral Neuropathy - Inflammatory - Celiac Disease.

    Jefferson Adams
    Celiac.com 04/06/2017 - A new study showing connections between anorexia nervosa and celiac disease, both before and after celiac diagnosis, is raising eyebrows and inviting questions. Results of the study appear in the April 3 issue of Pediatrics.
    Because the two conditions share a number of symptoms, including abdominal pain, bloating, diarrhea, and underweight, doctors can have some difficulty telling them apart.
    Until now, previous data linking anorexia with celiac disease came mostly from individual case reports. To get a better picture, Karl Mårild, MD, PhD, from the Barbara Davis Center, University of Colorado, Aurora, and colleagues conducted a cohort and case-control investigation examining the connection between celiac disease and timing of diagnosis for anorexia nervosa.
    To do this, the research team reviewed records from Sweden's 28 pathology departments. They looked at 17,959 cases of small intestinal biopsy-verified celiac disease in women from 1969 through 2008, and compared them with 89,379 sex- and age-matched population-based controls. The team confirmed cases of anorexia nervosa through inpatient and hospital-based outpatient records.
    They also looked at individuals undergoing biopsy who showed small intestinal inflammation or normal mucosa, but tested positive for celiac-related autoantibodies. They recorded educational level, socioeconomic status, and type 1 diabetes status.
    Their results showed that the hazard ratio for developing anorexia nervosa after a celiac diagnosis was 1.46, which fell to 1.31 beyond the first year after celiac diagnosis (with a 95% confidence interval for both). The odds ratio for association of previous anorexia nervosa diagnosis among people with a diagnosis of celiac disease was 2.18, with a 95% CI.
    The findings remain the same, even after the team adjusted for type 1 diabetes status and socioeconomic levels. Women who had positive celiac serology, but with no signs of villous atrophy, were also more likely to be diagnosed with anorexia nervosa, both before and after celiac diagnosis.
    The researchers propose three explanations for these findings: First, celiac disease may have been misdiagnosed earlier as anorexia nervosa, or vice versa. Second, it's possible that closer scrutiny of patients diagnosed with one condition may have prompted a bias in detecting the second condition. Third, it's possible that people with a shared genetic susceptibility may face a higher risk of developing both conditions.
    Whatever the reason behind the association, the study indicates that the connections between the two conditions are likely complex, and definitely invites further study.
    In the meantime, the researchers write that the "bidirectional association between diagnosis of anorexia nervosa and celiac disease warrants attention in both the initial assessment, and in the follow-up of women with these illnesses."
    As a result of this study, the team encourages "physicians to closely monitor these patients and calls for heightened understanding of factors that contribute to their co-occurrence."
    Source:
    Pediatrics. Published online April 3, 2017

    Jefferson Adams
    Celiac.com 06/24/2017 - A long-time pasta lover with celiac disease is desperately fundraising for surgery after losing half his body weight on a gluten-free diet.
    Years of eating lots of pasta and high calorie meals had left Christopher DeLorenzo weighing over 400 pounds. "My grandparents were Italian so I grew up eating lots of pasta…all I would do was eat, eat, eat always pasta and pizza, my stomach was like an endless pit," said the Phillipsburg, New Jersey, native.
    DeLorenzo's battle with portions and weight began early. At just 12 years old, he already tipped the scales at 250 pounds. His struggles with food led to years of dieting, and numerous attempts to lose weight.
    "My digestive system was terrible before weight loss surgery. I was forever complaining to doctors that there was something wrong but I was told that I was eating too much," says DeLorenzo.
    DeLorenzo found some improvement with weight loss surgery, but it wasn't until he was diagnosed with celiac disease and gave up gluten that he saw his health return. "Now I believe I can attribute a lot of the problems I was having to my body reacting badly to gluten."
    Still, the experience has left DeLorenzo with a mass of excess skin that looks, he says, like a 'deflated airbag.'
    He is currently seeking donations to fund surgery to remove the excess skin.
    Read more at Entertainmentdaily.co.uk

  • Recent Articles

    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

    Jefferson Adams
    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    First, the team used liquid chromatography-tandem mass spectrometry (LC/MS) to analyze amino acid levels in fasting plasma samples from 141 children with celiac disease and 129 non-celiac disease controls. They then crafted a general linear model using age and experimental effects as covariates to compare amino acid levels between children with celiac disease and non-celiac control subjects.
    Compared with the control group, seven out of twenty-three children with celiac disease showed elevated levels of the the following amino acids: tryptophan; taurine; glutamic acid; proline; ornithine; alanine; and methionine.
    The significance of the individual amino acids do not survive multiple correction, however, multivariate analyses of the amino acid profile showed significantly altered amino acid levels in children with celiac disease overall and after correction for age, sex and experimental effects.
    This study shows that amino acids can influence inflammation and may play a role in the development of celiac disease.
    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764

    Jefferson Adams
    Celiac.com 04/18/2018 - To the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service animals.
    If you’ve flown anywhere lately, you may have seen them. People flying with their designated “emotional support” animals. We’re not talking genuine service animals, like seeing eye dogs, or hearing ear dogs, or even the Belgian Malinois that alerts its owner when there is gluten in food that may trigger her celiac disease.
    Now, to be honest, some of those animals in question do perform a genuine service for those who need emotional support dogs, like veterans with PTSD.
    However, many of these animals are not service animals at all. Many of these animals perform no actual service to their owners, and are nothing more than thinly disguised pets. Many lack proper training, and some have caused serious problems for the airlines and for other passengers.
    Now the major airlines are taking note and introducing stringent requirements for service animals.
    Delta was the first to strike. As reported by the New York Times on January 19: “Effective March 1, Delta, the second largest US airline by passenger traffic, said it will require passengers seeking to fly with pets to present additional documents outlining the passenger’s need for the animal and proof of its training and vaccinations, 48 hours prior to the flight.… This comes in response to what the carrier said was a 150 percent increase in service and support animals — pets, often dogs, that accompany people with disabilities — carried onboard since 2015.… Delta said that it flies some 700 service animals a day. Among them, customers have attempted to fly with comfort turkeys, gliding possums, snakes, spiders, and other unusual pets.”
    Fresh from an unsavory incident with an “emotional support” peacock incident, United Airlines has followed Delta’s lead and set stricter rules for emotional support animals. United’s rules also took effect March 1, 2018.
    So, to the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service and emotional support animals.
    Source:
    cnbc.com

    admin
    WHAT IS CELIAC DISEASE?
    Celiac disease is an autoimmune condition that affects around 1% of the population. People with celiac disease suffer an autoimmune reaction when they consume wheat, rye or barley. The immune reaction is triggered by certain proteins in the wheat, rye, or barley, and, left untreated, causes damage to the small, finger-like structures, called villi, that line the gut. The damage occurs as shortening and villous flattening in the lamina propria and crypt regions of the intestines. The damage to these villi then leads to numerous other issues that commonly plague people with untreated celiac disease, including poor nutritional uptake, fatigue, and myriad other problems.
    Celiac disease mostly affects people of Northern European descent, but recent studies show that it also affects large numbers of people in Italy, China, Iran, India, and numerous other places thought to have few or no cases.
    Celiac disease is most often uncovered because people experience symptoms that lead them to get tests for antibodies to gluten. If these tests are positive, then the people usually get biopsy confirmation of their celiac disease. Once they adopt a gluten-free diet, they usually see gut healing, and major improvements in their symptoms. 
    CLASSIC CELIAC DISEASE SYMPTOMS
    Symptoms of celiac disease can range from the classic features, such as diarrhea, upset stomach, bloating, gas, weight loss, and malnutrition, among others.
    LESS OBVIOUS SYMPTOMS
    Celiac disease can often less obvious symptoms, such fatigue, vitamin and nutrient deficiencies, anemia, to name a few. Often, these symptoms are regarded as less obvious because they are not gastrointestinal in nature. You got that right, it is not uncommon for people with celiac disease to have few or no gastrointestinal symptoms. That makes spotting and connecting these seemingly unrelated and unclear celiac symptoms so important.
    NO SYMPTOMS
    Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors. 

    CELIAC DISEASE VS. GLUTEN INTOLERANCE
    Gluten intolerance is a generic term for people who have some sort of sensitivity to gluten. These people may or may not have celiac disease. Researchers generally agree that there is a condition called non-celiac gluten sensitivity. That term has largely replaced the term gluten-intolerance. What’s the difference between celiac disease and non-celiac gluten-sensitivity? 
    CELIAC DISEASE VS. NON-CELIAC GLUTEN SENSITIVITY (NCGS)
    Gluten triggers symptoms and immune reactions in people with celiac disease. Gluten can also trigger symptoms in some people with NCGS, but the similarities largely end there.

    There are four main differences between celiac disease and non-celiac gluten sensitivity:
    No Hereditary Link in NCGS
    Researchers know for certain that genetic heredity plays a major role in celiac disease. If a first-degree relative has celiac disease, then you have a statistically higher risk of carrying genetic markers DQ2 and/or DQ8, and of developing celiac disease yourself. NCGS is not known to be hereditary. Some research has shown certain genetic associations, such as some NCGS patients, but there is no proof that NCGS is hereditary. No Connection with Celiac-related Disorders
    Unlike celiac disease, NCGS is so far not associated with malabsorption, nutritional deficiencies, or a higher risk of autoimmune disorders or intestinal malignancies. No Immunological or Serological Markers
    People with celiac disease nearly always test positive for antibodies to gluten proteins. Researchers have, as yet, identified no such antobodies or serologic markers for NCGS. That means that, unlike with celiac disease, there are no telltale screening tests that can point to NCGS. Absence of Celiac Disease or Wheat Allergy
    Doctors diagnose NCGS only by excluding both celiac disease, an IgE-mediated allergy to wheat, and by the noting ongoing adverse symptoms associated with gluten consumption. WHAT ABOUT IRRITABLE BOWEL SYNDROME (IBS) AND IRRITABLE BOWEL DISEASE (IBD)?
    IBS and IBD are usually diagnosed in part by ruling out celiac disease. Many patients with irritable bowel syndrome are sensitive to gluten. Many experience celiac disease-like symptoms in reaction to wheat. However, patients with IBS generally show no gut damage, and do not test positive for antibodies to gliadin and other proteins as do people with celiac disease. Some IBS patients also suffer from NCGS.

    To add more confusion, many cases of IBS are, in fact, celiac disease in disguise.

    That said, people with IBS generally react to more than just wheat. People with NCGS generally react to wheat and not to other things, but that’s not always the case. Doctors generally try to rule out celiac disease before making a diagnosis of IBS or NCGS. 
    Crohn’s Disease and celiac disease share many common symptoms, though causes are different.  In Crohn’s disease, the immune system can cause disruption anywhere along the gastrointestinal tract, and a diagnosis of Crohn’s disease typically requires more diagnostic testing than does a celiac diagnosis.  
    Crohn’s treatment consists of changes to diet and possible surgery.  Up to 10% of Crohn's patients can have both of conditions, which suggests a genetic connection, and researchers continue to examine that connection.
    Is There a Connection Between Celiac Disease, Non-Celiac Gluten Sensitivity and Irritable Bowel Syndrome? Large Number of Irritable Bowel Syndrome Patients Sensitive To Gluten Some IBD Patients also Suffer from Non-Celiac Gluten Sensitivity Many Cases of IBS and Fibromyalgia Actually Celiac Disease in Disguise CELIAC DISEASE DIAGNOSIS
    Diagnosis of celiac disease can be difficult. 

    Perhaps because celiac disease presents clinically in such a variety of ways, proper diagnosis often takes years. A positive serological test for antibodies against tissue transglutaminase is considered a very strong diagnostic indicator, and a duodenal biopsy revealing villous atrophy is still considered by many to be the diagnostic gold standard. 
    But this idea is being questioned; some think the biopsy is unnecessary in the face of clear serological tests and obvious symptoms. Also, researchers are developing accurate and reliable ways to test for celiac disease even when patients are already avoiding wheat. In the past, patients needed to be consuming wheat to get an accurate test result. 
    Celiac disease can have numerous vague, or confusing symptoms that can make diagnosis difficult.  Celiac disease is commonly misdiagnosed by doctors. Read a Personal Story About Celiac Disease Diagnosis from the Founder of Celiac.com Currently, testing and biopsy still form the cornerstone of celiac diagnosis.
    TESTING
    There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.
    Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis. Also, it is now possible to test people for celiac disease without making them concume wheat products.

    BIOPSY
    Until recently, biopsy confirmation of a positive gluten antibody test was the gold standard for celiac diagnosis. It still is, but things are changing fairly quickly. Children can now be accurately diagnosed for celiac disease without biopsy. Diagnosis based on level of TGA-IgA 10-fold or more the ULN, a positive result from the EMA tests in a second blood sample, and the presence of at least 1 symptom could avoid risks and costs of endoscopy for more than half the children with celiac disease worldwide.

    WHY A GLUTEN-FREE DIET?
    Currently the only effective, medically approved treatment for celiac disease is a strict gluten-free diet. Following a gluten-free diet relieves symptoms, promotes gut healing, and prevents nearly all celiac-related complications. 
    A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods. Still, with effort, most people with celiac disease manage to make the transition. The vast majority of celiac disease patients who follow a gluten-free diet see symptom relief and experience gut healing within two years.
    For these reasons, a gluten-free diet remains the only effective, medically proven treatment for celiac disease.
    WHAT ABOUT ENZYMES, VACCINES, ETC.?
    There is currently no enzyme or vaccine that can replace a gluten-free diet for people with celiac disease.
    There are enzyme supplements currently available, such as AN-PEP, Latiglutetenase, GluteGuard, and KumaMax, which may help to mitigate accidental gluten ingestion by celiacs. KumaMax, has been shown to survive the stomach, and to break down gluten in the small intestine. Latiglutenase, formerly known as ALV003, is an enzyme therapy designed to be taken with meals. GluteGuard has been shown to significantly protect celiac patients from the serious symptoms they would normally experience after gluten ingestion. There are other enzymes, including those based on papaya enzymes.

    Additionally, there are many celiac disease drugs, enzymes, and therapies in various stages of development by pharmaceutical companies, including at least one vaccine that has received financial backing. At some point in the not too distant future there will likely be new treatments available for those who seek an alternative to a lifelong gluten-free diet. 

    For now though, there are no products on the market that can take the place of a gluten-free diet. Any enzyme or other treatment for celiac disease is intended to be used in conjunction with a gluten-free diet, not as a replacement.

    ASSOCIATED DISEASES
    The most common disorders associated with celiac disease are thyroid disease and Type 1 Diabetes, however, celiac disease is associated with many other conditions, including but not limited to the following autoimmune conditions:
    Type 1 Diabetes Mellitus: 2.4-16.4% Multiple Sclerosis (MS): 11% Hashimoto’s thyroiditis: 4-6% Autoimmune hepatitis: 6-15% Addison disease: 6% Arthritis: 1.5-7.5% Sjögren’s syndrome: 2-15% Idiopathic dilated cardiomyopathy: 5.7% IgA Nephropathy (Berger’s Disease): 3.6% Other celiac co-morditities include:
    Crohn’s Disease; Inflammatory Bowel Disease Chronic Pancreatitis Down Syndrome Irritable Bowel Syndrome (IBS) Lupus Multiple Sclerosis Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Psoriasis Rheumatoid Arthritis Scleroderma Turner Syndrome Ulcerative Colitis; Inflammatory Bowel Disease Williams Syndrome Cancers:
    Non-Hodgkin lymphoma (intestinal and extra-intestinal, T- and B-cell types) Small intestinal adenocarcinoma Esophageal carcinoma Papillary thyroid cancer Melanoma CELIAC DISEASE REFERENCES:
    Celiac Disease Center, Columbia University
    Gluten Intolerance Group
    National Institutes of Health
    U.S. National Library of Medicine
    Mayo Clinic
    University of Chicago Celiac Disease Center

    Jefferson Adams
    Celiac.com 04/17/2018 - Could the holy grail of gluten-free food lie in special strains of wheat that lack “bad glutens” that trigger the celiac disease, but include the “good glutens” that make bread and other products chewy, spongey and delicious? Such products would include all of the good things about wheat, but none of the bad things that might trigger celiac disease.
    A team of researchers in Spain is creating strains of wheat that lack the “bad glutens” that trigger the autoimmune disorder celiac disease. The team, based at the Institute for Sustainable Agriculture in Cordoba, Spain, is making use of the new and highly effective CRISPR gene editing to eliminate the majority of the gliadins in wheat.
    Gliadins are the gluten proteins that trigger the majority of symptoms for people with celiac disease.
    As part of their efforts, the team has conducted a small study on 20 people with “gluten sensitivity.” That study showed that test subjects can tolerate bread made with this special wheat, says team member Francisco Barro. However, the team has yet to publish the results.
    Clearly, more comprehensive testing would be needed to determine if such a product is safely tolerated by people with celiac disease. Still, with these efforts, along with efforts to develop vaccines, enzymes, and other treatments making steady progress, we are living in exciting times for people with celiac disease.
    It is entirely conceivable that in the not-so-distant future we will see safe, viable treatments for celiac disease that do not require a strict gluten-free diet.
    Read more at Digitaltrends.com , and at Newscientist.com