Jump to content
  • Join Our Community!

    Do you have questions about celiac disease or the gluten-free diet?

  • Dr. Tom O'Bryan
    Dr. Tom O'Bryan

    How Much Gluten is Safe in Sensitive Individuals?

      Journal of Gluten Sensitivity Summer 2005 Issue

    Caption: Image: CC--isox4

    Celiac.com 11/02/2018 - In sensitive individuals, some foods can cause allergic or other immune system reactions.  These reactions can be as mild as a little fatigue (many physicians believe the #1 symptom of allergies is fatigue), a mild headache, some congestion, or a ‘fuzzy brain’.  Or, the reaction can be as severe as immobilizing migraines, asthmatic attacks and even life-threatening anaphylactic shock.

    Many of us have felt these types of reactions to foods.  And if I tell the truth, I am guilty of many times in the past wondering, “how far can I push this?  How much of this food (which isn’t good for me) can I eat without getting sick?”

    Researchers are now telling us, and studies are being published that gives answers to these questions.  It seems to depend on the level of sensitivity.  When a person has elevated antibodies to wheat or gluten, the evidence is suggesting ‘none at all’ is the answer to the question. 

    In a recent paper entitled ‘A Milligram of Gluten a Day Keeps the Villous Healing Away’, the authors tell the story of a 32-year-old woman.  Her symptoms of abdominal pain, diarrhea and weight loss were present for over 10 years.  She also had a history of failure to thrive in childhood (one of the smallest children in the class throughout her education), late onset of menstrual cycles, recurring anemia, and hair loss.  This is the history of a body physically ‘just barely getting by’.  A positive blood test indicated elevated antibodies, and an endoscopic examination (biopsy of the intestines) confirmed Classic Celiac Disease.

    She had followed a wheat and gluten free diet for 16 months.  Diarrhea and abdominal pain stopped completely and weight loss had been recovered.  Some of her blood work had returned to normal.  However anemia, hair loss, and increased antibodies suggestive of persistent Celiac Disease were still present.  A focused interview revealed she was not on a strict gluten-free diet because she was taking a communion wafer and had several other unintentional dietary lapses.  After discussion with her Doctor she refused to stop taking a daily fragment of communion wafer.

    Eighteen months after beginning a complete gluten-free diet, but still taking a communion wafer, her anemia, hair loss, diarrhea, and abdominal pains were gone.  Most blood work was now normal.  However some blood markers of possible Celiac Disease were borderline high.  From how her body was functioning, one would think she was healed and her Celiac Disease was gone.  However her repeat biopsy still showed the highest degree of severe intestinal damage—Marsh IV villous atrophy, and an increased number of intraepithelial lymphocytes, putting her at increased risk of osteoporosis and a severe form of cancer of the intestines (T-cell lymphoma). 

    Her Doctors were concerned.  She was following the diet perfectly.  No hidden glutens in medications or foods.  All of her symptoms were gone.  She felt very good.  But why weren’t her intestines healing?  Could it be the fragment of communion wafer she refused to give up for religious reasons?  She did not want to have this discussion and continued to refuse abstaining from the wafer fragment.

    An evaluation of the communion wafer revealed that it contained approximately 0.5 mg of Gliadin (1 milligram of gluten).  That’s about 1/16 of a thumbnail.  Now remember this woman’s symptoms had all but disappeared, she felt fine and her blood work was much improved (not quite normal, but close).  She was very reluctant to give up her daily fragment of Communion wafer.

    Eighteen months later she returned and surprised her Doctors by announcing she had given up the wafer.  A repeat biopsy now showed her intestines had healed and were completely normal.

    Discussion: What can we learn from this case?

    1. In sensitive individuals (with elevated antibodies to wheat or gluten), the symptoms are not just in the intestines.  This person had suffered for years from anemia, hair loss, failure to thrive, weight loss, and hormone irregularities.
    2. Implementing a wheat and gluten free diet brought favorable results in eliminating all of the above symptoms
    3. Even with the elimination of symptoms and the return to normal of her blood work, ongoing very serious damage was occurring in the intestines without any noticeable symptoms.
    4. It only took 1/16th of a fingernail worth of gluten per day to stop intestinal healing and create great risk to life-threatening diseases.
    5. Blood antibody values that are border line may be an indicator of more aggressive damage occurring inside the body—not identifiable without an endoscopic exam.

    Conclusions

    1. One can be completely fooled as to whether they are having serious damage occur in their body if they just go by symptoms (or a lack of symptoms).
    2. Testing for wheat allergies and Celiac Disease must include comprehensive blood work and, when indicated, an endoscopic examination.
    3. If either test comes back positive, a complete elimination of wheat and gluten is necessary—not even 1/16th of a fingernail’s worth-not even a crouton on a salad can be considered harmless.

    Personal Note
    It is a necessity to do an endoscopic exam with positive blood work to wheat and/or gluten allergies.  I’ve always thought doing the blood work was enough, especially in children.  I was wrong.  In researching this further I’ve found many studies that emphasize this necessity.  Blood work comes first, but if positive, an endoscopic exam is essential.  Otherwise, as in this study, severe damage may occur without any symptoms whatsoever.

    Edited by Scott Adams


    User Feedback

    Recommended Comments

    Can you give me a link to the recent paper. The one I found was from 2014. 

     

    Interesting that hat she did not heal until she removed 1mg of gluten. The Catassi paper from 2007 had claimed that up to 59mg gluten was 'safe'. 

    Share this comment


    Link to comment
    Share on other sites


    Join the conversation

    You are posting as a guest. If you have an account, sign in now to post with your account.
    Note: Your post will require moderator approval before it will be visible.

    Guest
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • About Me

    Tom is an internationally recognized speaker and workshop leader specializing in the complications of Non-Celiac Gluten Sensitivity, Celiac Disease, and Autoimmune Disease as they occur inside and outside of the intestines. He is the founder of www.theDr.com. He is the visionary behind the paradigm shifting The Gluten Summit - A Grain of Truth, bringing together 29 of the leading experts on the Gluten connection to diseases, disorders, a wide-range of symptoms and ages. www.theglutensummit.com

  • Related Articles

    Scott Adams
    Safe Gluten-Free Food List (Safe Ingredients)
    A
    Acacia Gum
    Acesulfame K
    Acesulfame Potassium
    Acetanisole
    Acetophenone
    Acorn Quercus
    Adipic Acid
    Adzuki Bean
    Acacia Gum
    Agar
    Agave
    Albumen
    Alcohol (Distilled Spirits - Specific Types)
    Alfalfa
    Algae
    Algin
    Alginic Acid
    Alginate
    Alkalized Cocoa
    Allicin
    Almond Nut
    Alpha-amylase
    Alpha-lactalbumin
    Aluminum
    Amaranth
    Ambergris
    Ammonium Hydroxide
    Ammonium Phosphate
    Ammonium Sulphate
    Amylose
    Amylopectin
    Annatto
    Annatto Color
    Apple Cider Vinegar
    Arabic Gum
    Arrowroot
    Artichokes
    Artificial Butter Flavor
     Artificial Flavoring
    Ascorbic Acid
    Aspartame (can cause IBS symptoms)
    Aspartic Acid
    Aspic
    Astragalus Gummifer
    Autolyzed Yeast Extract
    Avena Sativia (Oats3)
    Avena Sativia Extract (from Oats3)
    Avidin
    Azodicarbonamide
    B
    Baking Soda
    Balsamic Vinegar
    Beeswax
    Beans
    Bean, Adzuki
    Bean, Hyacinth
    Bean, Lentil
    Bean, Mung
    Bean Romano (Chickpea)
    Bean Tepary
    Benzoic acid
    Besan (Chickpea)
    Beta Glucan (from Oats)
    Betaine
    Beta Carotene
    BHA
    BHT
    Bicarbonate of Soda
    Biotin
    Blue Cheese
    Brown Sugar
    Buckwheat
    Butter (check additives)
    Butylated Hydroxyanisole
    Butyl Compounds
    C
    Calcium Acetate
    Calcium Carbonate
    Calcium Caseinate
    Calcium Chloride
    Calcium Disodium
    Calcium Hydroxide
    Calcium Lactate
    Calcium Pantothenate
    Calcium Phosphate
    Calcium Propionate
    Calcium Silicate
    Calcium Sorbate
    Calcium Stearoyl Lactylate
    Calcium Stearate
    Calcium Sulfate
    Calrose
    Camphor
    Cane Sugar
    Cane Vinegar
    Canola (Rapeseed)
    Canola Oil (Rapeseed Oil)
    Caprylic Acid
    Carageenan Chondrus Crispus
    Carbonated Water
    Carboxymethyl Cellulose
    Caramel Color
    Caramel Flavoring
    Carmine
    Carnauba Wax
    Carob Bean
    Carob Bean Gum
    Carob Flour
    Carrageenan
    Casein
    Cassava Manihot Esculenta
    Castor Oil
    Catalase
    Cellulose1
    Cellulose Ether
    Cellulose Gum
    Cetyl Alcohol
    Cetyl Stearyl Alcohol
    Champagne Vinegar
    Channa (Chickpea)
    Chana Flour (Chickpea Flour)
    Cheeses - (most, but check ingredients)
    Chestnuts
    Chickpea
    Chlorella
    Chocolate Liquor
    Choline Chloride
    Chromium Citrate
    Chymosin
    Citric Acid
    Citrus Red No. 2
    Cochineal
    Cocoa
    Cocoa Butter
    Coconut
    Coconut Vinegar
    Collagen
    Colloidal Silicon Dioxide
    Confectioner's Glaze
    Copernicia Cerifera
    Copper Sulphate
    Corn
    Corn Gluten
    Corn Masa Flour
    Corn Meal
    Corn Flour
    Corn Starch
    Corn Sugar
    Corn Sugar Vinegar
    Corn Syrup
    Corn Syrup Solids
    Corn Swetener
    Corn Vinegar
    Corn Zein
    Cortisone
    Cotton Seed
    Cotton Seed Oil
    Cowitch
    Cowpea
    Cream of Tartar
    Crospovidone
    Curds
    Cyanocobalamin
    Cysteine, L
    Dal (Lentils)
    D-Alpha-tocopherol
    Dasheen Flour (Taro)
    D
    Dates
    D-Calcium Pantothenate
    Delactosed Whey
    Demineralized Whey
    Desamidocollagen
    Dextran
    Dextrin
    Dextrimaltose
    Dextrose
    Diglycerides
    Dioctyl Sodium
    Dioctyl Sodium Solfosuccinate
    Dipotassium Phosphate
    Disodium Guanylate
    Disodium Inosinate
    Disodium Phosphate
    Distilled Alcohols
    Distilled Vinegar
    Distilled White Vinegar
    Dutch Processed Cocoa
    E
    EDTA (Ethylenediaminetetraacetic Acid)
    Eggs
    Egg Yolks
    Elastin
    Ester Gum
    Ethyl Alcohol
    Ethylenediaminetetraacetic Acid
    Ethyl Maltol
    Ethyl Vanillin
    Expeller Pressed Canola Oil
    F
    FD&C Blue No. 1 Dye
    FD&C Blue No. 1 Lake
    FD&C Blue No. 2 Dye
    FD&C Blue No. 2 Lake
    FD&C Green No. 3 Dye
    FD&C Green No. 3 Lake
    FD&C Red No. 3 Dye
    FD&C Red No. 40 Dye
    FD&C Red No. 40 Lake
    FD&C Yellow No. 5 Dye
    FD&C Yellow No. 6 Dye
    FD&C Yellow No. 6 Lake
    Ferric Orthophosphate
    Ferrous Gluconate
    Ferrous Fumerate
    Ferrous Lactate
    Ferrous Sulfate
    Fish (fresh)
    Flaked Rice
    Flax
    Folacin
    Folate
    Flavoring
    Flavoring Extracts
    Folic Acid-Folacin
    Food Starch
    Food Starch Modified
    Formaldehyde
    Fructose
    Fruit (including dried)
    Fruit Vinegar
    Fumaric Acid
    G
    Galactose
    Garbanzo Beans
    Gelatin
    Glucoamylase
    Gluconolactone
    Glucose
    Glucose Syrup
    Glutamate (free)
    Glutamic Acid
    Glutamine (amino acid)
    Glutinous Rice
    Glutinous Rice Flour
    Glycerides
    Glycerin
    Glycerol Monooleate
    Glycol Monosterate
    Glycol
    Glycolic acid
    Gram flour (chick peas)
    Grape Skin Extract
    Grits, Corn
    Guar Gum
    Gum Acacia
    Gum Arabic
    Gum Base
    Gum Tragacanth
    H
    Hemp
    Hemp Seeds
    Herbs
    Herb Vinegar
    Hexanedioic Acid
    High Fructose Corn Syrup
    Hominy
    Honey
    Hops
    Horseradish (Pure)
    HPP
    HVP
    Hyacinth Bean
    Hydrogen Peroxide
    Hydrolyzed Caseinate
    Hydrolyzed Meat Protein
    Hydrolyzed Plant Protein
    Hydrolyzed Protein
    Hydrolyzed Soy Protein
    Hydrolyzed Vegetable Protein
    Hydroxypropyl Cellulose
    Hydroxypropyl Methylcellulose
    Hypromellose
    I
    Illepe
    Iodine
    Inulin
    Invert Sugar
    Iron Ammonium Citrate
    Isinglass
    Isolated Soy Protein
    Isomalt
    J
    Job's Tears
    Jowar (Sorghum)
    K
    Karaya Gum
    Kasha (roasted buckwheat)
    Keratin
    K-Carmine Color
    K-Gelatin
    Koshihikari (rice)
    Kudzu
    Kudzu Root Starch
    L
    Lactalbumin Phosphate
    Lactase
    Lactic Acid
    Lactitol
    Lactose
    Lactulose
    Lanolin
    Lard
    L-cysteine
    Lecithin
    Lemon Grass
    Lentils
    Licorice
    Licorice Extract
    Lipase
    L-leucine
    L-lysine
    L-methionine
    Locust Bean Gum
    L-tryptophan
    M
    Magnesium Carbonate
    Magnesium Hydroxide
    Magnesium Oxide
    Maize
    Maize Waxy
    Malic Acid
    Maltitol
    Maltodextrin (except in pharmaceuticals)
    Maltol
    Maltose
    Manganese Sulfate
    Manioc
    Masa
    Masa Flour
    Masa Harina
    Meat (fresh)
    Medium Chain Triglycerides
    Menhaden Oil
    Methyl Cellulose2
    Microcrystalline Cellulose
    Micro-particulated Egg White Protein
    Milk
    Milk Protein Isolate
    Millet
    Milo (Sorghum)
    Mineral Oil
    Mineral Salts
    Mixed Tocopherols
    Modified Food Starch
    Modified Starch
    Modified food Starch
    Molybdenum Amino Acid Chelate
    Monocalcium Phosphate
    Monoglycerides
    Mono and Diglycerides
    Monopotassium Phosphate
    Monosaccharides
    Monosodium Glutamate (MSG)
    Monostearates
    MSG
    Mung Bean
    Musk
    Mustard Flour
    Myristic Acid
    N
    Natural Flavoring
    Natural Flavors
    Natural Smoke Flavor
    Niacin-Niacinamide
    Neotame
    Niacin
    Niacinamide
    Nitrates
    Nitrous Oxide
    Non-fat Milk
    Nuts (except wheat, rye & barley)
    Nut, Acron
    Nut, Almond
    O
    Oats
    Oils and Fats
    Oleic Acid
    Oleoresin
    Olestra
    Oleyl Alcohol/Oil
    Orange B
    Oryzanol
    P
    Palmitic Acid
    Pantothenic Acid
    Papain
    Paprika
    Paraffin
    Patially Hydrogenated Cottonseed Oil
    Patially Hydrogenated Soybean Oil
    Peas
    Pea - Chick
    Pea - Cow
    Pea Flour
    Pea Starch
    Peanuts
    Peanut Flour
    Pectin
    Pectinase
    Peppermint Oil
    Peppers
    Pepsin
    Peru Balsam
    Petrolatum
    PGPR (Polyglycerol Polyricinoleate)
    Phenylalanine
    Phosphoric Acid
    Phosphoric Glycol
    Pigeon Peas
    Polenta
    Polydextrose
    Polyethylene Glycol
    Polyglycerol
    Polyglycerol Polyricinoleate (PGPR)
    Polysorbates
    Polysorbate 60
    Polysorbate 80
    Potassium Benzoate
    Potassium Caseinate
    Potassium Citrate
    Potassium Iodide
    Potassium Lactate
    Potassium Matabisulphite
    Potassium Sorbate
    Potatoes
    Potato Flour
    Potato Starch
    Povidone
    Prinus
    Pristane
    Propolis
    Propylene Glycol
    Propylene Glycol Monosterate
    Propyl Gallate
    Protease
    Psyllium
    Pyridoxine Hydrochloride
    Q
    Quinoa
    R
    Ragi
    Raisin Vinegar
    Rape
    Recaldent
    Reduced Iron
    Rennet
    Rennet Casein
    Resinous Glaze
    Reticulin
    Riboflavin
    Rice
    Rice (Enriched)
    Rice Flour
    Rice Starch
    Rice Syrup
    Rice Vinegar
    Ricinoleic Acid
    Romano Bean (chickpea)
    Rosematta
    Rosin
    Royal Jelly
    S
    Saccharin
    Saffron
    Sago
    Sago Palm
    Sago Flour
    Sago Starch
    Saifun (bean threads)
    Salt
    Seaweed
    Seeds (except wheat, rye & barley)
    Seed - Sesame
    Seed - Sunflower
    Shea
    Sherry Vinegar
    Silicon Dioxide
    Smoke Flavoring
    Soba (be sure its 100% buckwheat)
    Sodium Acid Pyrophosphate
    Sodium Acetate
    Sodium Alginate
    Sodium Ascorbate
    Sodium Benzoate
    Sodium Caseinate
    Sodium Citrate
    Sodium Erythrobate
    Sodium Hexametaphosphate
    Sodium Lactate
    Sodium Lauryl Sulfate
    Sodium Metabisulphite
    Sodium Nitrate
    Sodium Phosphate
    Sodium Polyphosphate
    Sodium Silaco Aluminate
    Sodium Stearoyl Lactylate
    Sodium Sulphite
    Sodium Stannate
    Sodium Tripolyphosphate
    Sorbic Acid
    Sorbitan Monostearate
    Sorbitol-Mannitol (can cause IBS symptoms)
    Sorghum
    Sorghum Flour
    Soy
    Soybean
    Soy Lecithin
    Soy Protein
    Soy Protein Isolate
    Spices (pure)
    Spirits (Specific Types)
    Spirit Vinegar
    Starch (the single word ingredient is, by law, cornstarch)
    Stearates
    Stearamide
    Stearamine
    Stearic Acid
    Stearyl Lactate
    Stevia
    Subflower Seed
    Succotash (corn and beans)
    Sucralose
    Sucrose
    Sulfosuccinate
    Sulfites
    Sulfur Dioxide
    Sweet Chestnut Flour
    T
    Tagatose
    Tallow
    Tapioca
    Tapioca Flour
    Tapioca Starch
    Tara Gum
    Taro
    Tarro
    Tarrow Root
    Tartaric Acid
    Tartrazine
    TBHQ is Tetra or Tributylhydroquinone
    Tea
    Tea-Tree Oil
    Teff
    Teff Flour
    Tepary Bean
    Textured Vegetable Protein
    Thiamin Hydrochloride
    Thiamine Mononitrate
    Thiamine Hydrochloride
    Titanium Dioxide
    Tofu (Soy Curd)
    Tolu Balsam
    Torula Yeast
    Tragacanth
    Tragacanth Gum
    Triacetin
    Tricalcium Phosphate
    Tri-Calcium Phosphate
    Trypsin
    Turmeric (Kurkuma)
    TVP
    Tyrosine
    U
    Urad/Urid Beans
    Urad/Urid Dal (peas) Vegetables
    Urad/Urid flour
    Urd
    V
    Vinegar (All except Malt)
    Vanilla Extract
    Vanilla Flavoring
    Vanillin
    Vinegars (Specific Types - Except Malt Vinegar)
    Vitamin A (retinol)
    Vitamin A Palmitate
    Vitamin B1
    Vitamin B-12
    Vitamin B2
    Vitamin B6
    Vitamin D
    Vitamin E Acetate
    W
    Waxy Maize
    Whey
    Whey Protein Concentrate
    Whey Protein Isolate
    White Vinegar
    Wines
    Wine Vinegars (& Balsamic)
    Wild Rice
    X
    Xanthan Gum
    Xylitol
    Y
    Yam Flour
    Yeast (except brewer's yeast)
    Yogurt (plain, unflavored)
    Z
    Zinc Oxide
    Zinc Sulfate
    1) Cellulose is a carbohydrate polymer of D-glucose. It is the structural material of plants, such as wood in trees. It contains no gluten protein. 2) Methyl cellulose is a chemically modified form of cellulose that makes a good substitute for gluten in rice-based breads, etc.  

    Wendy Cohan, RN
    Celiac Disease Head to Toe
    Celiac.com 04/05/2019 (Originally published on 10/19/2009) - Gluten intolerance caused by celiac disease, or non-celiac gluten sensitivity, may affect virtually any part of the body. A culprit in multiple health disorders, gluten intolerance is a major driver of health care delivery and associated costs.  While this may seem to be an outrageous claim, a review of the many ways in which gluten intolerance can adversely affect the body will illustrate this point. So, let’s work our way down from head to toe.
    Celiac Disease Can Cause Hair Loss
    Normal, healthy hair is usually glossy and thick.  An autoimmune disorder known as alopecia areata results in abnormal loss of hair, either in patches, or totally, and is one of many autoimmune disorders associated with celiac disease. Malabsorption severe enough to cause malnutrition can also result in thin, sparse, fragile hair. One of the outward signs of hypothyroidism is thinning hair and a loss of the outer third of the eyebrow; hypothyroidism is strongly associated with celiac disease.
    How Celiac Disease Affects the Brain
    Now let’s look at the brain.  There are, unfortunately, a large number of neurological disorders associated with gluten intolerance and celiac disease, including narcolepsy, depression, ADD/ADHD, Autism Spectrum Disorders, and schizophrenia. There are also movement and balance disorders associated with gluten intolerance, including ataxia - the inability to coordinate movements and balance (gluten ataxia, celiac ataxia, some cases of sporadic idiopathic ataxia). In some cases, when symptoms are severe, this disorder mimics other disorders such as Parkinson’s, Normal Pressure Hydrocephalus, and even Alzheimer’s disease.
    Headaches Common in Celiac Disease
    Headaches are a very common symptom of wheat allergy, as well as gluten intolerance.  Migraines are common in those with celiac disease and gluten intolerance, as are sinus headaches.  These symptoms often decline dramatically after excluding gluten grains from the diet. Sinus problems are common in those with celiac disease, gluten intolerance, and sensitivity to dairy products as well, and are often reversible by making dietary changes. Some people with celiac disease seem to have an altered, highly acute sense of smell – for unknown reasons.
    Night Blindness from Vitamin A Deficiency
    Night blindness associated with vitamin A deficiency is reversible when malabsorption is resolved and with the addition of a vitamin A supplement. Xeropthalmia, or chronic, often severe, dry eyes, is also related to severe vitamin A deficiency.  It is rare in developed countries, but can be found in some people with malnutrition due to celiac disease.
    Canker Sores Common in Celiac Disease
    Apthous stomatitis is the name for the mouth ulcers associated with food allergies and intolerances, and is strongly associated with celiac disease and gluten intolerance. Even people who do not have gluten sensitivity get these once in a while but in those with gluten intolerance they are more frequent and especially long-lasting.  
    Dental Enamel Defects Can Indicate Celiac Disease
    While they are usually identified in childhood, they can continue to cause problems throughout life, because they often lead to more frequent dental cavities.  Halitosis, or bad breath, is a reflection of our internal environment and gastrointestinal health, and is often present in those with untreated celiac disease, gluten sensitivity, or gut dysbiosis – an upset in the balance of our internal microorganisms caused by poor diet and other factors. And, one of the autoimmune disorders strongly associated with celiac disease, and one of the most prevalent is Sjogren’s syndrome, which impairs the normal production of body fluids like tears, saliva, and vaginal secretions.
    Strong Link Between Celiac Disease & Eosinophilic Esophagitis
    Following the path our food takes to the stomach, we can look for effects in the esophagus too.  Eosinophilic esophagitis is a rarely encountered inflammation in the tissue of the esophagus which makes swallowing painful and difficult and can result in bleeding ulcerations.  When doctors do see it, they sometimes test for celiac disease, since there is a strong correlation.  Fortunately, in cases where this condition is caused by gluten intolerance, this painful chronic disorder clears up on a gluten free diet, too.
    GI Complaints Common in Celiac Patients
    Now we’re getting to the area most people associate with gluten intolerance – the gastro-intestinal system. In the past, celiac disease was usually described as causing gas, diarrhea, bloating, discomfort, cramping, and malabsorption.  But as you’ve already seen above, there is a whole lot more to this disorder, and we’re only halfway to the toes.
    Celiac Can Be Misdiagnosed as IBS
    In addition to the above symptoms, the body’s reaction to gluten can cause inflammation anywhere, but a common location is in the illeo-cecal junction and the cecum. This can sometimes be confused with appendicitis, or ovarian pain or an ovarian cyst in women experiencing right-sided lower abdominal discomfort.  Irritable bowel syndrome is suspected to affect at least 10-15% of adults (estimates vary). It is differentiated from IBD, or inflammatory bowel disorders (which include Crohn’s disease and ulcerative colitis). But, taken together, there are an awful lot of people out there with uncomfortable gut issues.  One fact to consider is that many of those with celiac disease were previously, and wrongly, misdiagnosed with IBS before discovering they actually had celiac disease.
    Kidney & Urinary Problems
    Let’s take a look at the urological system.  Even though gluten from the food we eat isn’t directly processed here, can it still be affected?  The answer is yes. Kidney problems in association with celiac disease are well documented, including oxalate kidney stones. Bladder problems are increasingly shown to be responsive to a gluten-free diet. This is kind of my specialty and I would estimate that about a quarter of those with interstitial cystitis, and many people with recurrent urinary tract infections, have a sensitivity to gluten. Even prostate inflammation in some men can be triggered by eating gluten grains.
    Adrenal Fatigue in Celiac Disease
    Sitting just atop the kidneys are our adrenal glands.  They have a difficult job, helping to direct our stress response system, our immune system, and our hormone output, and controlling inflammation in the body. Every time we experience a reaction to gluten, and our adrenals respond by sending out a surge of cortisol to help control inflammation, we are depleting our adrenal reserve.  When this happens chronically, over time, our adrenal system cannot keep up and becomes fatigued.  Symptoms of adrenal fatigue have far-reaching consequences throughout the body, including, of course, feeling fatigued and run down. But, adrenal fatigue can also affect our hormones, our blood sugar regulation, our mental acuity, our temperature regulation, and our ability to cope with food allergies, environmental allergies, and infections.
    Celiac Disease Common in Hepatitis Patients
    Can the liver, the body’s largest internal organ, be affected by gluten intolerance too?  One example is autoimmune hepatitis, in which can be untreated celiac disease can be found in large numbers. Early screening testing for celiac disease is now strongly recommended for patients diagnosed with autoimmune hepatitis.
    Gluten Intolerance, Pancreas and Blood Sugar
    The pancreas, which is key in blood sugar regulation, is highly affected by gluten intolerance.  Autoimmune disease triggers the development of Type I Diabetes, and is becoming more closely associated with celiac disease.  Testing for celiac disease is now becoming a routine part of examination when a child develops Type I Diabetes, and now that physicians are looking for celiac disease in juvenile diabetes, they’re finding it with greater frequency. Blood sugar regulation problems are also associated with non-diabetic hypoglycemia in those with gluten intolerance, and appear to resolve with a low-glycemic gluten free diet.
    Celiac Disease Can Affects Limbs and Extremities
    So, we’ve covered most of the body’s major internal systems. Now, let’s look at the extremities, our upper and lower limbs, where gluten-associated problems are also found. Ehlers-Danlos Syndrome, a collagen disorder resulting in shoulder, elbow, and wrist joints that dislocate easily (and other characteristics) is a genetic disorder that may also be associated with celiac disease.  I had mild symptoms of this disorder as a child, but never knew it had a name until I ran across it recently.  With a child who has this disorder, a simple game of swinging a child by the arms, or swinging a child between two sets of their parent’s arms, can result in a trip to the emergency to put their joints back into proper alignment. This is not to say that a reaction to gluten causes this genetic disorder, but that if you have a personal or family history of Ehlers-Danlos Syndrome, and symptoms that may be related to celiac disease, you should consider being tested.
    Arthritis Associated with Celiac Disease
    Rheumatoid arthritis is another of the autoimmune disorders associated with celiac disease, and often affects the fingers with crippling joint deformation. Other joints in the body can also be affected. Scleroderma is another terribly disfiguring and sometimes fatal autoimmune disorder affecting every part of the body. It is often first identified in the extremities, particularly the fingers. In scleroderma, normal tissue loses it’s flexibility as the body’s autoimmune response produces inflammation and an overproduction of collagen.  Collagen is the tough fibrous protein that helps form connective tissues including tendons, bones, and ligaments. Excess collagen is deposited in the skin and body organs, eventually causing loss of function.  Scleroderma can be associated with celiac disease.
    Skin Conditions Common in Celiac Patients
    The arms and legs are also common spots for yet another autoimmune disorder, psoriasis, to develop.  Some patients with psoriasis are responsive to a gluten-free diet, but unfortunately, not everyone. Another skin condition that often shows up on the arms is dermatitis herpetiformis (DH), although this itchy blistering skin rash can occur in other places as well.  Common sites are the backs of the elbows and the backs of the knees, or on the lower legs.
    Peripheral Neuropathy Common in Celiac Disease
    Peripheral neuropathy is a disorder that results in numbness, tingling, and sometimes severe nerve pain in the extremities.  Finger, hands, toes, feet, and lower legs may all be affected. Although usually associated with diabetes, peripheral neuropathy shows up fairly frequently in those with celiac disease, and is fortunately reversible on a gluten free diet supplemented by B-vitamins and some specific amino acids.  Peripheral neuropathy is usually associated with older people, but some of the cases I’ve observed recently have been in very young children who had severe malabsorption issues.  Fortunately they healed quickly and their neuropathy symptoms resolved completely.
    Malabsorption and Vitamin Deficiency
    There a few last symptoms related to malabsorption that tend to show up in those with celiac disease or gluten intolerance.  Easy bruising and bleeding, either due to a deficiency of Vitamin K, or to an autoimmune platelet disorder, is one. Rickets, or osteomalacia – a softening of the bones in the legs related to vitamin D deficiency – is another. As we said before, inflammation goes along with celiac disease and gluten intolerance, and a common site for inflammation is the lower extremities.  Sometimes this can be profound, and trigger doctors to think heart disease, but it’s often unresponsive to Lasix and other diuretics. This condition, too, may also clear up on a gluten-free diet.
    As for me, I’ll be happy to be gluten-free, from head to toe.

    Wendy Cohan, RN
    Celiac.com 02/21/2011 - After reading this new book by celiac nurse specialist Shelly Stuart, RN, what shines through above all is her true understanding of the complex nature of gluten-related illnesses, and her heartfelt compassion for patients who suffer from them. Her book is extremely well researched and documented. As a registered nurse and celiac herself,  Ms. Stuart is able to use her strong patient teaching experience to clearly educate the reader about even very complicated subjects. She provides excellent explanations of leaky gut and the pathophysiology of celiac disease, and she is one of the first clinicians to write in-depth about non-celiac gluten intolerance.  Importantly, she makes the point that immune mediated reactions can and do occur in non-celiac gluten intolerance, and backs this up by citing clinical evidence. Another important point made concerns pancreatic insufficiency, which can accompany celiac disease, but few know that this condition can persist even after diagnosis and transition to a gluten-free diet. Her discussion of the many, varied health disorders associated with celiac disease is very comprehensive.
    One of the most compelling aspects to “Gluten Toxicity” is the many important questions asked regarding the future of clinical research. Ms. Stuart makes it crystal clear that we need to know much more about the physical and mental health effects of gluten-related illness. This can only come about by increasing awareness both within the medical and research communities, and throughout each of our communities. We must all become advocates for greater testing and more accurate diagnosis.
    Shelly’s personal story, woven throughout the book, adds interest and a personal appeal, but never attempts to substitute anecdote for the hard science she relies on throughout the book. In fact, at first glance, the book seemed rather technical to me, and I thought it would be best-suited for clinicians, but after reading through to the end, I changed my mind. This is an excellent resource, offering really insightful and accurate explanations for anyone suffering from or attempting to treat gluten related illness. Some of you may be familiar with Cleo Libonati, RN, and the book “Recognizing Celiac Disease”, which was one of the first books to comprehensively make connections between a vast array of medical conditions and celiac disease, and back them up with clinical research citations. Shelly Stuart’s book goes quite a bit farther, to discuss the pathophysiology, symptoms, and diagnosis of a huge number of health conditions associated with celiac disease and also non-celiac gluten intolerance.  


    Sarah  Curcio
    Gluten-Free Safety Starts Here
    Celiac.com 05/24/2016 - How many of us have suffered from cross contamination? Most celiacs have felt the side effects of getting gluten in their food. If it is not your own kitchen, utensils, pots or pans it can be a bit nerve racking. It is not only extremely unpleasant, but unhealthy to our intestines as well. It can cause damage that can be very detrimental in the long run.
    This is exactly why the gluten-free label is particularly important. This gives celiacs a sense of safety, like a security blanket. However, how is that labeling decided upon? What certifications are really used? What standards are considered to ensure that it is 20 parts per million (ppm) or even less? Just think about the danger that can occur if something has to be recalled. For example, let's take a look at General Mills Cheerios versus Udi's Gluten-Free Foods.
    Now, Udi's is certified by the Gluten Free Certification Organization (GFCO), which is an industry program of the Gluten Intolerance Group (GIG.) Whereas Cheerios, takes the oats, used to make the cereal, and puts it through a proprietary, mechanical system. This is supposed to remove any cross-contamination from wheat, barley or rye, according to General Mills. How safe is this for individuals with celiac disease? This is why standards are very vital.
    Now, the GFCO requires that all finished products' ingredients, using their logo, contain 10ppm or even less of gluten. It requires a stringent review process, in order to gain approval. Plus, barley-based ingredients are absolutely not allowed, under any circumstances.
    Then, you look at Cheerios and the differences are as plain as day. Recently, there was a major recall of 1.8 million boxes due to an error where a gluten ingredient was accidentally added. General Mills issued a recall of some Original Cheerios and Honey Nut Cheerios cereal because some boxes were labeled as gluten-free but actually contained wheat.
    This is absolutely not safe for the celiac community. This improper labeling can be dangerous and there are no certifications or review processes like the GFCO. The thought of becoming ill from the cross-contamination is not on any celiac's to do list. Having certified oats versus regular oats is safer that simply having the wheat washed out. The oat fields are way too close to the wheat fields.
    In the end, which would you rather purchase? There is Certified Gluten Free Foods versus just gluten-free foods. Think about your villi because they really should be up and not down!
    References:
    Udi's Gluten Free - FAQs. Retrieved from: http://udisglutenfree.com/faq/ Gluten Intolerance Group - The Gluten-Free Certification Organization. Retrieved from http://www.gfco.org/ CNBC - General Mills recalls 1.8M Cheerios boxes for allergens. Retrieved from http://www.glutenfreeliving.com/gluten-free-foods/diet/gluten-free-cheerios/ Gluten Free Living - Gluten-Free Cheerios. Retrieved from http://www.cnbc.com/2015/10/05/general-mills-recalls-cheerios-for-allergen-issue.html

×
×
  • Create New...