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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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    CHOKEBERRY ANTHOCYANINS: HEALTH ASPECTS


    Leszek Jaszczak


    • Journal of Gluten Sensitivity Summer 2015 Issue - Originally published July 16, 2015


    Celiac.com 11/24/2015 - Polyphenols are a group of compounds produced by plants, highly variable in strucure, physical, chemical and biological properties. Currently science knows of several thousand natural phenolic compounds. A common feature of polyphenols is their ability to enable redox reactions. With their ability to transport protons and electrons, phenolic compounds not only readily get oxidized, but also, through the compounds called quinones that result from their oxidation, may mediate oxidation of other compounds that do not directly react with oxygen.


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    Anthocyanins
    Anthocyanins are a large group of plant dyes that are soluble in water and are found in flowers, fruits, leaves and stems. In the cell they are located in the vacuoles, in the form of granules of various sizes, however, the cell walls of the pulp and tissues do not contain anthocyanins. Anthocyanins give fruits and vegetables different colors like orange, red, pink, purple and dark blue.

    Anthocyanins belong to the polyphenol organic compounds. The name “anthocyanin” was first used in 1835 by Marquart to refer to the blue dye of the cornflower. The structure of anthocyanins can be very complex and diverse. Acid hydrolysis of anthocyanins leads to decay into sugars and anthocyanidins, called aglycones. The anthocyanins are natural products usually in the form of mono-, di- or tri-glycosides.

    Hundreds of natural anthocyanins are known, and over 100 could be produced synthetically. These dyes can be extracted from plants and are used as food additives to impart or reinforce the color of drinks, juices, candies and jellies.

    Anthocyanins determine the hue and color stability, for example, in strawberries the dominant dye is pelargonidin 3-glucoside. Anthocyanin synthesis is a photochemical process because the fruit which is directly irradiated by solar radiation has a more full coloration compared to fruit picked early and ripened in storage.

    Health Aspects
    The healing properties of anthocyanins have long been known in folk medicine, and now they are increasingly being used in the pharmaceutical and cosmetic industries. Anthocyanin’s name was derived from the Latin name of the plant from which the particular compound was extracted: cyanine flowers or cornflower (Centaurea cyanus L.). Anthocyanins are unstable compounds and reside in an aqueous environment and depend on pH levels that trigger changes in the color of products from which they were isolated. In acidic conditions they have a red color, in nutral conditions violet, and in alkaline they are blue.

    The structure of anthocyanin molecules has a significant impact on the hue, intensity and color stability. Irreversible changes of anthocyanin pigments are mainly due to oxidative polymerization processes and cause changes in natural red color of fruits to red-brown which is characteristic of long storage. The rate of these changes depends mainly on the presence of factors in the raw material, temperature and time.

    Chokeberry - Aronia
    The addition of these compounds to food does not raise concerns of consumers, and they are accepted. An example of a source of anthocyanins is the chokeberry, which contains a lot of polyphenol (above 20 mg/g), including anthocyanins. With a considerable amount of polyphenols, the chokeberry has a significant level of antioxidant activity. Its distinctive tart flavor comes from the high content of tannins which reduces the possibility of direct consumption of the fruit and its products. Generally it is used in combination with other fruits, or in a diluted form.

    Chokeberry fruit is used for the manufacture of nectars, drinks, wines, jams, as well as food dyes and bioactive compounds. Anthocyanins isolated from chokeberry have antimutagenic and anticarcinogenic activity, and chokeberry juice has antioxidant properties. Chokeberry juice is more and more relevant in the food industry as a source of natural red color for products that are poor in stable color.

    Products made from chokeberries are mainly aronia juice that is mixed with other fruit juices. Other applications include food coloring additives teas and syrups. In Russia, aronia and apple juices are combined and fermented to produce red wine. In Lithuania, dessert wines are produced with the use of chokeberry or chokeberry juice, which is mixed with other fruit juices. Commercial juices are produced by pressing ripe berries, then fining and filtering the juice. To reduce the tannin content gelatin may be added prior to filtration.

    Tannins sometimes form complexes, which cause clouding of clear juice. Reducing the level of tannins also makes juice have a less tart taste. Clear juice can then be bottled and pasteurized or concentrated and used as a food ingredient. The whole fruit can be used for the production of a puree that is a highly colored product of uniform consistency once the seeds and skins are removed. The product can be frozen and used as a food ingredient in sauces.

    Antioxidant Effect
    In the scientific literature, we can find a number of studies on the antioxidant properties of chokeberry, chokeberry extracts or phenolic components. Fresh chokeberry fruits have the highest antioxidant capacity of the fruit measured by ORAC method. Literature reports that chokeberry juice has the highest antioxidant capacity of beverages rich in polyphenols—four times higher than other berry juice, cranberry juice, or red wine. Anthocyanidins and procyanidins containing o-dihydroxyphenyl group are excellent metal chelators and form complexes with, for example iron (III) and copper (II). The presence of free iron and copper in biological systems catalyzed free radical reactions, such as the Fenton reaction. The ability of the phenolic components to bind divalent metal effectively reduces the concentration of these cations, and therefore their oxidative properties.

    It should be noted that the in vitro data does not say a lot about the role they can play in in vivo systems for prevention of oxidative stress. The literature also describes the antioxidant effects in animals, where chokeberry anthocyanins reduce lipid peroxidation and increase the activity of enzymes that are involved in the antioxidant defense system. It was also observed that the fraction of the red dye from chokeberry, both in vitro and in vivo. is able to prevent damage to the gastric mucosa. Antioxidant effects observed in humans, with chokeberry juice supplementation reduces oxidative damage to red blood cells produced during exercise.


    Image Caption: Image: CC---Joshua Mayer
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  • Related Articles

    Anne Marie Dunphy
    Celiac.com 03/11/2009 - I recently had an unfortunate health experience related to celiac disease.  I learned long ago that it’s my responsibility to manage my own health, so I came up with a strategy that was successful.  Along the way, I also learned some important information that really helped me understand the problem and the eventual solution.  Perhaps this information will help you avoid a similar health crisis.  I’ve included links that can give you additional information.  Disclaimer: I’m not a medical doctor.  This is information that I have gathered based on my own experiences and research.
    Celiac Disease
    I have celiac disease. I manage it quite well through my diet.  However, if I ingest anything with gluten, for instance a wayward crouton in a restaurant salad, I have a severe reaction that starts within five minutes.  All or some of the following will occur: hives from head to toe, stomach cramps, uncontrollable diarrhea, vomiting, asthma, severe lethargy.  I fall into an uncontrollable sleep that takes about four hours to run its course.  Needless to say, I avoid gluten at all costs.
    A Bit of History
    Although I am a remarkable person (like all of us), my health history has been quite unremarkable.  Nothing was ever wrong with me and I wasn’t allergic to anything.  I can count on one hand how many times I’ve taken antibiotics in my entire life.  In the past 30+ years, I never went to the doctor for an illness.  I’ve had colds, various and sundry viruses and infections, but they ran their course with slowing down, plenty of rest and fluids.  I believe that the primary strategy should be to give your body the time to heal itself first, and if that fails look for an alternative strategy from your doctor.
    Imagine my surprise when about six years ago the symptoms of celiac disease manifested themselves.  (Note: I was going through an acute stressful time in my life when this occurred.)  Along the way, other unexpected food allergies have presented themselves as well.
    One of my favorite foods was peanut butter.  Since I was a little girl, I loved feasting on “peanut butter on spoon”.  Out of the blue one day, a typical teaspoon of one of my favorite foods sent me into an anaphylactic reaction.  And then a few months after that incident, a bite of a granola bar with cashews sent me on my first ambulance ride with a rapidly constricting throat to the emergency ward.  My favorite food is now a deadly poison.
    I’ve had mild intestinal reactions to all vinegars and vinegar products (a little balsamic is OK), more than three glasses of red wine (not white wine or champagne), milk and cream (not cheese, thank the Universe!).  I’ve also realized that I’m thirsty all the time.  It seems that no matter how much water I drink, I can’t seem to quench my thirst.  I even sleep with water next to my bed and drink several glasses throughout the night and still wake up thirsty.  The water goes right through me and doesn’t seem to be absorbed.  (I have recently been prodded, poked, examined and tested by a battery of doctors as a result of my once in 50-year checkup and they all agree that I’m the picture of health.)
    Both my mom and my grandmother suffered from asthma; my grandmother dealt with it her whole life.  When I have an asthmatic reaction, my wheezing and coughing sound just like theirs!  I remembered them being armed with their inhalers and their steroids at all times.  I also remembered that these medical weapons didn’t stop the asthma attacks or the wheezing or uncontrollable coughing.  They only dealt with the symptoms, not the underlying problem.  Mom’s asthma went away when she started eating a gluten free diet.
    The Incident
    So I’ve come to enjoy cooking.  Regardless of the disastrous results of my past cooking experiences well documented by my children, close friends and family, this new hobby relaxes me at the end of the day, is creative, saves money and insures a truly gluten and allergy free diet.
    I recently made a delicious French Onion and Ham Cream Soup.  It was inspired by some wonderful French spices I bought from Penzey Spices.  I made a big pot of the soup and had it for different meals throughout the week.  I didn’t notice at the time an increased feeling of lethargy, intestinal rumblings and increased thirst that got progressively worse through the week.
    And then it happened.  About five minutes after devouring the last of my delectable French Onion and Ham Cream Soup, the tell-tale signs of an oncoming asthma attack occurred: mucous pouring into my lungs, wheezing, airways closing up, unrelenting coughing.
    In addition, I had horrible abdominal cramping.  I was tremendously thirsty, but the water just seemed to go through me and make me even thirstier.  At about 4:00 am just as I was about to get myself to the hospital, I started to slowly stabilize, meaning I wasn’t getting worse.
    I slept for a little bit, then woke up coughing uncontrollably.  My throat was so parched it felt like sandpaper.  I dragged myself through a day of work exhausted, not being able to really get a good breath and feeling so very thirsty.
    That night I literally coughed all night long sitting straight up in a chair; I couldn’t lie down because of the coughing.  I couldn’t go to work the next day.  I needed to discover why this happened, how I can prevent it from happening again and implement an immediate strategy for managing this health crisis.
    Hypothesis
    I realized there was a relationship between several factors: celiac disease, since I had no allergies until it manifested itself; cow’s milk, which I knew was a highly allergic food; asthma, as the allergic reaction, and dehydration, because of the incessant thirst.  By understanding how all of these factors related to each other, I thought I could figure out a strategy to 1) get myself into a healthy state quickly and 2) prevent this health crisis from happening again. (Even thought I knew this was an asthma attack, I wanted to make doubly sure it wasn’t pneumonia or something similar.  I had no fever, chills, aches or pains, headache, or upper respiratory infection.  I was fine one minute and not fine the next.)
    Research
    Asthma is a disease in which inflammation of the airways causes airflow into and out of the lungs to be restricted.  When an asthma attack occurs, mucus production is increased, muscles of the bronchial tree become tight, and the lining of the air passages swells, reducing airflow and producing the characteristic wheezing and coughing.  Asthma symptoms are usually worse at night.
    There is high correlation between people who have celiac disease and people who have sensitivities to proteins found in cow's milk.  Milk is one of the most common food allergens in the American diet.  And most cows eat a lot of grain and perhaps there’s a link here.  Milk allergy symptoms can occur within minutes or hours after consuming the dairy product.  They can be triggered by a very small amount of milk protein in the system. 
    There is also a relationship between celiac disease, asthma and dehydration.  People with celiac disease are often very thirsty even after drinking lots of water.  And so are people with asthma.  If fact, many doctors now think that asthma is a symptom of the body managing its water supply.
    This is how it works…
    Water is needed for every function of the body. Our bodies are 75% water and our brains are 85% water.  Because of the water used in breathing, digestion, enzyme and hormone production, immune function, toxin removal and so on, we need to replace that water frequently throughout the day or our health will suffer.
    When we start to dehydrate, histamine production increases to conserve water in our bodies. 
    This is vital since our lungs must remain moist to work properly.  Excess histamine, a defense against losing more water, makes it difficult to breath and triggers an asthma attack.  Histamine also stimulates mucous production to help seal in moisture, but that also leads to increased breathing difficulties.  Histamines are also important for immune function, but during dehydration they are mostly used to look for water.  If dehydration becomes chronic, the immune system will suffer; allergies, both inhalant and food allergies, will result because histamine is important for the proper balance of Tcells, antibodies and so on.
    Elevated histamine in the lungs causes the spasm of the bronchioles.  This conserves moisture that would normally be lost during breathing.  The mucus that clogs up the airways is the body’s attempt to keep the airways from completely drying out.  Inflammation in the airways is the result of the body bringing more “micro-circulation” to the lungs as a result of dehydration.
    Common problem foods for people with asthma are dairy and gluten.  Both are very hard to digest and require a lot of water to break down.  If there is not enough water in the digestive tract when food is taken in, water will be pulled from other parts of the body and localized dehydration will result.  This can lead to asthma, among other problems.
    Allergy symptoms of any kind are a sign that we need to drink more water.  Antihistamines and most medicines, either directly or indirectly, actually are counterproductive for the body because they further dehydrate the body and shut off the body’s search for water.  Pain, inflammation and digestive problems are also typically signs of dehydration.  Dehydration is a common cause of migraines, for example. 
    And then I unexpectedly learned about salt…
    Salt is the other half of the hydration equation.  Salt is vital for the generation of hydroelectric energy and transmission of nerve impulses in all the cells.  Salt acts as a natural antihistamine through salt-sensing nerves on the tongue and plays a major role in regulating water.  Without enough salt, water is not absorbed.
    My Strategy
    The first step was to get myself in a healthy state.  My re-hydration plans included continually drinking filtered water even through the night, teaspoons of honey to soothe my raw throat when needed and pinches of pink Australian sea salt (a Christmas gift from my wonderful mom) on my tongue throughout the day and night when I felt I needed it, although any sea salt would do.  I also had vegetable juice and fruit juice for additional fluids.
    I noticed the salt working in a couple of hours.  I was beginning to absorb the water (I didn’t have to pee every time I drank some water).  It took about two days before the thirst went away.  It was great waking up without a parched throat.  The coughing was still uncontrollable, especially at night, but instead of a constant, non-productive coughing and horrible wheezing, the mucus was beginning to become looser.  It took another three nights before I could sleep lying down, but the mucus had really broken up.  The coughing was actually allowing the mucus to get out of my lungs.  It took about six days to feel like myself again.  I did gain about five pounds.  But I lost it quickly and it was fat lost, not precious water.  Besides, there’s nothing glamorous about walking around in a dehydrated, sickly state.
    The second step is to not let this happen again.  I’m now drinking no less than 10 eight-ounce glasses of water every day with a pinch of salt on my tongue if I feel I need it.  I need about ¼ teaspoon of salt for every quart of water I drink.  After a lifetime of poor medical advice, I now know that salt is my friend.  If I drink coffee or wine or if I get the nutty idea to exercise, I have to drink more water.  And no more milk and cream - at least until I’m stabilized for awhile.
    If I feel an asthma attack coming on, the best treatment is to drink 2-3 cups of water and put a pinch of sea salt on my tongue.  This will provide my body with the water it needs and the salt will send a signal to my brain to relax the bronchioles by letting it know relief is coming. 
    Conclusion
    As difficult as this last health adventure was, I learned something that has changed the way I feel and has optimized my health.  I found the root of the problem and fixed it instead of following mainstream medical thinking and putting a band aid on the symptoms.  It’s really scary when it feels like your body is turning on you, and very empowering when you use science and knowledge to get yourself back.  I’ve always said when it comes to business, “the market speaks, just listen.”  I now need to take that advice for myself.  My body speaks; I just have to listen!

    Sayer Ji
    This article originally appeared in the Winter 2009 edition of Journal of Gluten Sensitivity.
    Celiac.com 07/17/2009 - The globe-spanning presence of wheat and its exalted status among secular and sacred institutions alike differentiates this food from all others presently enjoyed by humans.  Yet the unparalleled rise of wheat as the very catalyst for the emergence of ancient civilization has not occurred without a great price.  While wheat was the engine of civilization’s expansion and was glorified as a “necessary food,” both in the physical (staff of life) and spiritual sense (the body of Christ), those suffering from celiac disease are living testimony to the lesser known dark side of wheat.  A study of celiac disease may help unlock the mystery of why modern man, who dines daily at the table of wheat, is the sickest animal yet to have arisen on this strange planet of ours.
    The Celiac Iceberg
    Celiac disease (celiac disease) was once considered an extremely rare affliction, limited to individuals of European origin.  Today, however, a growing number of studies indicate that celiac disease is found throughout the US at a rate of up to 1 in every 133 persons, which is several orders of magnitude higher than previously estimated.   
    These findings have led researchers to visualize celiac disease as an iceberg.  The tip of the iceberg represents the relatively small number of the world’s population whose gross presentation of clinical symptoms often leads to the diagnosis of celiac disease. This is the classical case of celiac disease characterized by gastrointestinal symptoms, malabsorption and malnourishment. It is confirmed with the “gold standard” of an intestinal biopsy.  The submerged middle portion of the iceberg is largely invisible to classical clinical diagnosis, but not to modern serological screening methods in the form of antibody testing. This middle portion is composed of asymptomatic and latent celiac disease as well as “out of the intestine” varieties of wheat intolerance.  Finally, at the base of this massive iceberg sits approximately 20-30% of the world’s population – those who have been found to carry the HLA-DQ locus of genetic susceptibility to celiac disease on chromosome 6.
    The “Celiac Iceberg” may not simply illustrate the problems and issues associated with diagnosis and disease prevalence, but may represent the need for a paradigm shift in how we view both celiac disease and wheat consumption among non-celiac disease populations.
    First let us address the traditional view of celiac disease as a rare, but clinically distinct species of genetically-determined disease, which I believe is now running itself aground upon the emerging, post-Genomic perspective, whose implications for understanding and treating disease are Titanic in proportion. 
    It Is Not the Genes, But What We Expose Them To
    Despite common misconceptions, monogenic diseases, or diseases that result from errors in the nucleotide sequence of a single gene are exceedingly rare. Perhaps only 1% of all diseases fall within this category, and Celiac disease is not one of them.  In fact, following the completion of the Human Genome Project (HGP) in 2003 it is no longer accurate to say that our genes “cause” disease, any more than it is accurate to say that DNA is sufficient to account for all the proteins in our body. Despite initial expectations, the HGP revealed that there are only 30,000-35,000 genes in human DNA (genome), rather than the 100,000 + believed necessary to encode the 100,000 + proteins found in the human body (proteome).
    The “blueprint” model of genetics: one gene → one protein → one cellular behavior, which was once the holy grail of biology, has now been supplanted by a model of the cell where epigenetic factors (literally: “beyond the control of the gene”) are primary in determining how DNA will be interpreted, translated and expressed.  A single gene can be used by the cell to express a multitude of proteins and it is not the DNA itself that determines how or what genes will be expressed.  Rather, we must look to the epigenetic factors to understand what makes a liver cell different from a skin cell or brain cell.  All of these cells share the exact same 3 billion base pairs that make up our DNA code, but it is the epigenetic factors, e.g. regulatory proteins and post-translational modifications, that make the determination as to which genes to turn on and which to silence, resulting in each cell’s unique phenotype. Moreover, epigenetic factors are directly and indirectly influenced by the presence or absence of key nutrients in the diet, as well as exposures to chemicals, pathogens and other environmental influences. 
    In a nutshell, what we eat and what we are exposed to in our environment directly affects our DNA and its expression.
    Within the scope of this new perspective even classical monogenic diseases like Cystic Fibrosis (CF) can be viewed in a new, more promising light.  In CF many of the adverse changes that result from the defective expression of the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene may be preventable or reversible, owing to the fact that the misfolding of the CFTR gene product has been shown to undergo partial or full correction (in the rodent model) when exposed to phytochemicals found in turmeric, cayenne, and soybean  Moreover, nutritional deficiencies of seleniun, zinc, riboflavin, vitamin e, etc. in the womb or early in life, may “trigger” the faulty expression or folding patterns of the CFTR gene in Cystic Fibrosis which might otherwise have avoided epigenetic activation. This would explain why it is possible to live into one’s late seventies with this condition, as was the case for Katherine Shores (1925-2004). The implications of these findings are rather extraordinary: epigenetic and not genetic factors are primary in determining disease outcome. Even if we exclude the possibility of reversing certain monogenic diseases, the basic lesson from the post-Genomic era is that we can’t blame our DNA for causing disease. Rather, it may have more to do with what we choose to expose our DNA to.
    Celiac Disease Revisited
    What all of this means for celiac disease is that the genetic susceptibility locus, HLA DQ, does not determine the exact clinical outcome of the disease. Instead of being the cause, if the HLA genes are activated, they are a consequence of the disease process. Thus, we may need to shift our epidemiological focus from viewing this as a classical “disease” involving a passive subject controlled by aberrant genes, to viewing it as an expression of a natural, protective response to the ingestion of something that the human body was not designed to consume.
    If we view celiac disease not as an unhealthy response to a healthy food, but as a healthy response to an unhealthy food, classical celiac disease symptoms like diarrhea may make more sense.  Diarrhea can be the body’s way to reduce the duration of exposure to a toxin or pathogen, and villous atrophy can be the body’s way of preventing the absorption and hence, the systemic effects of chronic exposure to wheat. 
    I believe we would be better served by viewing the symptoms of celiac disease as expressions of bodily intelligence rather than deviance.  We must shift the focus back to the disease trigger, which is wheat itself.
    People with celiac may actually have an advantage over the apparently unafflicted because those who are “non-symptomatic” and whose wheat intolerance goes undiagnosed or misdiagnosed because they lack the classical symptoms and may suffer in ways that are equally or more damaging, but expressed more subtly, or in distant organs.  Within this view celiac disease would be redefined as a protective (healthy?) response to exposure to an inappropriate substance, whereas “asymptomatic” ingestion of the grain with its concomitant “out of the intestine” and mostly silent symptoms, would be considered the unhealthy response insofar as it does not signal in an obvious and acute manner that there is a problem with consuming wheat. 
    It is possible that celiac disease represents both an extreme reaction to a global, species-specific intolerance to wheat that we all share in varying degrees. celiac disease symptoms may reflect the body’s innate intelligence when faced with the consumption of a substance that is inherently toxic.  Let me illustrate this point using Wheat Germ Agglutinin (WGA), as an example. 
    WGA is glycoprotein classified as a lectin and is known to play a key role in kidney pathologies, such as IgA nephropathy.  In the article: “Do dietary lectins cause disease?” the Allergist David L J Freed points out that WGA binds to “glomerular capillary walls, mesangial cells and tubules of human kidney and (in rodents) binds IgA and induces IgA mesangial deposits,” indicating that wheat consumption may lead to kidney damage in susceptible individuals.  Indeed, a study from the Mario Negri Institute for Pharmacological Research in Milan Italy published in 2007 in the International Journal of Cancer looked at bread consumption and the risk of kidney cancer.  They found that those who consumed the most bread had a 94% higher risk of developing kidney cancer compared to those who consumed the least bread.  Given the inherently toxic effect that WGA may have on kidney function, it is possible that in certain genetically predisposed individuals (e.g. HLA-DQ2/DQ8) the body – in its innate intelligence – makes an executive decision: either continue to allow damage to the kidneys (or possibly other organs) until kidney failure and rapid death result, or launch an autoimmune attack on the villi to prevent the absorption of the offending substance which results in a prolonged though relatively malnourished life.  This is the explanation typically given for the body’s reflexive formation of mucous following exposure to certain highly allergenic or potentially toxic foods, e.g. dairy products, sugar, etc?  The mucous coats the offending substance, preventing its absorption and facilitating safe elimination via the gastrointestinal tract.   From this perspective the HLA-DQ locus of disease susceptibility in the celiac is not simply activated but utilized as a defensive adaptation to continual exposure to a harmful substance.  In those who do not have the HLA-DQ locus, an autoimmune destruction of the villi will not occur as rapidly, and exposure to the universally toxic effects of WGA will likely go unabated until silent damage to distant organs leads to the diagnosis of a disease that is apparently unrelated to wheat consumption. 
    Loss of kidney function may only be the “tip of the iceberg,” when it comes to the possible adverse effects that wheat proteins and wheat lectin can generate in the body.  If kidney cancer is a likely possibility, then other cancers may eventually be linked to wheat consumption as well.  This correlation would fly in the face of globally sanctioned and reified assumptions about the inherent benefits of wheat consumption. It would require that we suspend cultural, socio-economic, political and even religious assumptions about its inherent benefits.  In many ways, the reassessment of the value of wheat as a food requires a William Boroughs-like moment of shocking clarity when we perceive “in a frozen moment….what is on the end of every fork.”  Let’s take a closer look at what is on the end of our forks.
     
    Our Biologically Inappropriate Diet
     
    In a previous article, I discussed the role that wheat plays as an industrial adhesive (e.g. paints, paper mache’, and book binding-glue) in order to illustrate the point that it may not be such a good thing for us to eat.  The problem is implicit in the word gluten, which literally means “glue” in Latin and in words like pastry and pasta, which derives from wheatpaste, the original concoction of wheat flour and water which made such good plaster in ancient times. What gives gluten its adhesive and difficult-to-digest qualities are the high levels of disulfide bonds it contains. These same sulfur-to-sulfur bonds are found in hair and vulcanized rubber products, which we all know are difficult to decompose and are responsible for the sulfurous odor they give off when burned. 
    There will be 676 million metric tons of wheat  produced this year alone, making it the primary cereal of temperate regions and third most prolific cereal grass on the planet.  This global dominance of wheat is signified by the Food & Agricultural Organization’s (FAO) (the United Nation’s international agency for defeating hunger) use of a head of wheat as its official symbol.  Any effort to indict the credibility of this “king of grains” will prove challenging.  As Rudolf Hauschka once remarked, wheat is “a kind of earth-spanning organism.” It has vast socio-economic, political, and cultural significance.   For example, in the Catholic Church, a wafer made of wheat is considered irreplaceable as the embodiment of Christ. . 
    Our dependence on wheat is matched only by its dependence on us. As Europeans have spread across the planet, so has this grain.  We have assumed total responsibility for all phases of the wheat life cycle: from fending off its pests; to providing its ideal growing conditions; to facilitating reproduction and expansion into new territories.  We have become so inextricably interdependent that neither species is sustainable at current population levels without this symbiotic relationship.  
    It is this co-dependence that may explain why our culture has for so long consistently confined wheat intolerance to categorically distinct, “genetically-based” diseases like “celiac.”  These categorizations may protect us from the realization that wheat exerts a vast number of deleterious effects on human health in the same way that “lactose intolerance” distracts attention from the deeper problems associated with the casein protein found in cow’s milk.  Rather than see wheat for what it very well may be: a biologically inappropriate food source, we “blame the victim,” and look for genetic explanations for what’s wrong with small subgroups of our population who have the most obvious forms of intolerance to wheat consumption, e.g. celiac disease, dermatitis herpetiformis, etc.   The medical justification for these classifications may be secondary to economic and cultural imperatives that require the inherent problems associated with wheat consumption be minimized or occluded.
    In all probability the celiac genotype represents a surviving vestigial branch of a once universal genotype, which through accident or intention, have had through successive generations only limited exposure to wheat.  The celiac genotype, no doubt, survived through numerous bottlenecks or “die offs” represented by a dramatic shift from hunted and foraged/gathered foods to gluten-grain consumption, and for whatever reason simply did not have adequate time to adapt or select out the gluten-grain incompatible genes. The celiac response may indeed reflect a prior, species-wide intolerance to a novel food source: the seed storage form of the monocotyledonous cereal grasses which our species only began consuming 1-500 generations ago at the advent of the Neolithic transition (10-12,000 BC).  Let us return to the image of the celiac iceberg for greater clarification.
    Our Submerged Grain-Free Metabolic Prehistory
    The iceberg metaphor is an excellent way to expand our understanding of what was once considered to be an extraordinarily rare disease into one that has statistical relevance for us all, but it has a few limitations. For one, it reiterates the commonly held view that Celiac is a numerically distinct disease entity or “disease island,” floating alongside other numerically distinct disease “ice cubes” in the vast sea of normal health.  Though accurate in describing the sense of social and psychological isolation many of the afflicted feel, the celiac iceberg/condition may not be a distinct disease entity at all. 
    Although the HLA-DQ locus of disease susceptibility on chromosome 6 offers us a place to project blame, I believe we need to shift the emphasis of responsibility for the condition back to the disease “trigger” itself: namely, wheat and other prolamine rich grains, e.g. barley, rye, spelt, and oats. Without these grains the typical afflictions we call celiac would not exist.  Within the scope of this view the “celiac iceberg” is not actually free floating but an outcropping from an entire submerged subcontinent, representing our long-forgotten (cultural time) but relatively recent metabolic prehistory as hunters-and-gatherers (biological time), where grain consumption was, in all likelihood, non-existent, except in instances of near-starvation.
    The pressure on the celiac to be viewed as an exceptional case or deviation may have everything to do with our preconscious belief that wheat, and grains as a whole are the “health foods,” and very little to do with a rigorous investigations of the facts.
    Grains have been heralded since time immemorial as the “staff of life,” when in fact they are more accurately described as a cane, precariously propping up a body starved of the nutrient-dense, low-starch vegetables, fruits, edible seeds and meats, they have so thoroughly supplanted (c.f. Paleolithic Diet).  Most of the diseases of affluence, e.g. type 2 diabetes, coronary heart disease, cancer, etc. can be linked to the consumption of a grain-based diet, including secondary “hidden sources” of grain consumption in grain-fed fish, poultry, meat and milk products.
    Our modern belief that grains make for good food, is simply not supported by the facts.  The cereal grasses are within an entirely different family: monocotyledonous (one leaf) than that from which our body sustained itself for millions of years: dicotyledonous (two-leaf).  The preponderance of scientific evidence points to a human origin in the tropical rain forests of Africa where dicotyledonous fruits would have been available for year round consumption.  It would not have been monocotyledonous plants, but the flesh of hunted animals that would have allowed for the migration out of Africa 60,000 years ago into the northern latitudes where vegetation would have been sparse or non-existent during winter months. Collecting and cooking grains would have been improbable given the low nutrient and caloric content of grains and the inadequate development of pyrotechnology and associated cooking utensils necessary to consume them with any efficiency.  It was not until the end of the last Ice Age 20,000 years ago that our human ancestors would have slowly transitioned to a cereal grass based diet coterminous with emergence of civilization.   20,000 years is probably not enough time to fully adapt to the consumption of grains. Even animals like cows with a head start of thousands of years, having evolved to graze on monocotyledons and equipped as ruminants with the four-chambered fore-stomach enabling the breakdown of cellulose and anti-nutrient rich plants, are not designed to consume grains.  Cows are designed to consume the sprouted mature form of the grasses and not their seed storage form.  Grains are so acidic/toxic in reaction that exclusively grain-fed cattle are prone to developing severe acidosis and subsequent liver abscesses and infections, etc. Feeding wheat to cattle provides an even greater challenge:
    “Beef:  Feeding wheat to ruminants requires some caution as it tends to be more apt than other cereal grains to cause acute indigestion in animals which are unadapted to it. The primary problem appears to be the high gluten content of which wheat in the rumen can result in a "pasty" consistency to the rumen contents and reduced rumen motility.”
    (source: Ontario ministry of Agriculture food & Rural affairs)
    Seeds, after all, are the "babies" of these plants, and are invested with not only the entire hope for continuance of its species, but a vast armory of anti-nutrients to help it accomplish this task: toxic lectins, phytates and oxalates, alpha-amalyase and trypsin inhibitors, and endocrine disrupters. These not so appetizing phytochemicals enable plants to resist predation of their seeds, or at least preventing them from "going out without a punch."  
    Wheat: An Exceptionally Unwholesome Grain
    Wheat presents a special case insofar as wild and selective breeding has produced variations which include up to 6 sets of chromosomes (3 genomes worth!) capable of generating a massive number of proteins each with a distinct potentiality for antigenicity. Common bread wheat (Triticum aestivum), for instance, has over 23,788 proteins cataloged thus far.  In fact, the genome for common bread wheat is actually 6.5 times larger than that of the human genome!
    With up to a 50% increase in gluten content of some varieties of wheat, it is amazing that we continue to consider “glue-eating” a normal behavior, whereas wheat-avoidance is left to the “celiac” who is still perceived by the majority of health care practitioners as mounting a “freak” reaction to the consumption of something intrinsically wholesome.
    Thankfully we don’t need to rely on our intuition, or even (not so) common sense to draw conclusions about the inherently unhealthy nature of wheat.  A wide range of investigation has occurred over the past decade revealing the problem with the alcohol soluble protein component of wheat known as gliadin, the glycoprotein known as lectin (Wheat Germ Agglutinin), the exorphin known as gliadomorphin, and the excitotoxic potentials of high levels of aspartic and glutamic acid found in wheat. Add to these the anti-nutrients found in grains such as phytates, enzyme inhibitors, etc. and you have a substance which we may more appropriately consider the farthest thing from wholesome. 
    The remainder of this article will demonstrate the following adverse effects of wheat on both celiac and non-celiac populations: 1) wheat causes damage to the intestines 2) wheat causes intestinal permeability 3) wheat has pharmacologically active properties 4) wheat causes damage that is “out of the intestine” affecting distant organs  5) wheat induces molecular mimicry 6) wheat contains high concentrations of excitoxins.
    Wheat Gliadin Creates Immune Mediated Damage To The Intestines
    Gliadin is classified as a prolamin, which is a wheat storage protein high in the amino acids proline and glutamine and soluble in strong alcohol solutions.  Gliadin, once deamidated by the enzyme Tissue Transglutaminase, is considered the primary epitope for T-cell activation and subsequent autoimmune destruction of intestinal villi.  Yet gliadin does not need to activate an autoimmune response, e.g. Celiac disease, in order to have a deleterious effect on intestinal tissue. In a study published in GUT in 2007 a group of researchers asked the question: “Is gliadin really safe for non-coeliac individuals?”   In order to test the hypothesis that an innate immune response to gliadin is common in patients with celiac disease and without celiac disease, intestinal biopsy cultures were taken from both groups and challenged with crude gliadin, the gliadin synthetic 19-mer (19 amino acid long gliadin peptide) and 33-mer deamidated peptides.   Results showed that all patients with or without Celiac disease when challenged with the various forms of gliadin produced an interleukin-15-mediated response.  The researchers concluded: “The data obtained in this pilot study supports the hypothesis that gluten elicits its harmful effect, throughout an IL15 innate immune response, on all individuals [my italics].”
    The primary difference between the two groups is that the celiac disease patients experienced both an innate and an adaptive immune response to the gliadin, whereas the non-celiacs experienced only the innate response.   The researchers hypothesized that the difference between the two groups may be attributable to greater genetic susceptibility at the HLA-DQ locus for triggering an adaptive immune response, higher levels of immune mediators or receptors, or perhaps greater permeability in the celiac intestine. It is possible that over and above the possibility of greater genetic susceptibility, most of the differences are from epigenetic factors that are influenced by the presence or absence of certain nutrients in the diet.  Other factors such as exposure to NSAIDs like naproxen or aspirin can profoundly increase intestinal permeability in the non-celiac, rendering them susceptible to gliadin’s potential for activating secondary adaptive immune responses.  This may explain why in up to 5% of all cases of classically defined celiac disease the typical HLA-DQ haplotypes are not found. However, determining the factors associated greater or lesser degrees of susceptibility to gliadin’s intrinsically toxic effect should be a secondary to the fact that it is has been demonstrated to be toxic to both non-celiacs and celiacs.
     
    Wheat Gliadin Creates Intestinal Permeability
    Gliadin upregulates the production of a protein known as zonulin, which modulates intestinal permeability. Over-expression of zonulin is involved in a number of autoimmune disorders, including celiac disease and Type 1 diabetes.  Researchers have studied the effect of gliadin on increased zonulin production and subsequent gut permeability in both celiac and non-celiac intestines, and have found that “gliadin activates zonulin signaling irrespective of the genetic expression of autoimmunity, leading to increased intestinal permeability to macromolecules.”10   These results indicate, once again, that a pathological response to wheat gluten is a normal or human, species specific response, and is not based entirely on genetic susceptibilities.  Because intestinal permeability is associated with wide range of disease states, including cardiovascular illness, liver disease and many autoimmune disorders, I believe this research indicates that gliadin (and therefore wheat) should be avoided as a matter of principle.  
     
    Wheat Gliadin Has Pharmacological Properties
    Gliadin can be broken down into various amino acid lengths or peptides. Gliadorphin is a 7 amino acid long peptide: Tyr-Pro-Gln-Pro-Gln-Pro-Phe which forms when the gastrointestinal system is compromised.  When digestive enzymes are insufficient to break gliadorphin down into 2-3 amino acid lengths and a compromised intestinal wall allows for the leakage of the entire 7 amino acid long fragment into the blood, gl idorphin can pass through to the brain through circumventricular organs and activate opioid receptors resulting in disrupted brain function. There have been a number of gluten exorphins identified: gluten exorphin A4, A5, B4, B5 and C, and many of them have been hypothesized to play a role in autism,  schizophrenia, ADHD and related neurological conditions.   In the same way that the celiac iceberg illustrated the illusion that intolerance to wheat is rare, it is possible, even probable, that wheat exerts pharmacological influences on everyone. What distinguishes the schizophrenic or autistic individual from the functional wheat consumer is the degree to which they are affected.  
    Below the tip of the “Gluten Iceberg,” we might find these opiate-like peptides to be responsible for bread’s general popularity as  a “comfort food”, and our use of phrases like “I love bread,” or  “this bread is to die for” to be indicative of wheat’s narcotic properties.  I believe a strong argument can be made that the agricultural revolution that occurred approximately 10-12,000 years ago as we shifted from the Paleolithic into the Neolithic era was precipitated as much by environmental necessities and human ingenuity, as it was by the addictive qualities of psychoactive peptides in the grains themselves.
    The world-historical reorganization of society, culture and consciousness accomplished through the symbiotic relationship with cereal grasses, may have had as much to do with our ability to master agriculture, as to be mastered by it.   The presence of pharmacologically active peptides would have further sweetened the deal, making it hard to distance ourselves from what became a global fascination with wheat.
    An interesting example of wheat’s addictive potential pertains to the Roman army.  The Roman Empire was once known as the “Wheat Empire,” with soldiers being paid in wheat rations.  Rome’s entire war machine, and its vast expansion, was predicated on the availability of wheat.  Forts were actually granaries, holding up to a year’s worth of grain in order to endure sieges from their enemies.  Historians describe soldiers’ punishment included being deprived of wheat rations and being given barley instead.   The Roman Empire went on to facilitate the global dissemination of wheat cultivation which fostered a form of imperialism with biological as well as cultural roots.
    The Roman appreciation for wheat, like our own, may have had less to do with its nutritional value as “health food” than its ability to generate a unique narcotic reaction. It may fulfill our hunger while generating a repetitive, ceaseless cycle of craving more of the same, and by doing so, enabling the surreptitious control of human behavior.  Other researchers have come to similar conclusions.  According to the biologists Greg Wadley & Angus Martin:  “Cereals have important qualities that differentiate them from most other drugs. They are a food source as well as a drug, and can be stored and transported easily. They are ingested in frequent small doses (not occasional large ones), and do not impede work performance in most people. A desire for the drug, even cravings or withdrawal, can be confused with hunger. These features make cereals the ideal facilitator of civilisation (and may also have contributed to the long delay in recognising their pharmacological properties).”
     
    Wheat Lectin (Wga) Damages Our Tissue
    Wheat contains a lectin known as Wheat Germ Agglutinin which is responsible for causing direct, non-immune mediated damage to our intestines, and subsequent to entry into the bloodstream, damage to distant organs in our body. Lectins are sugar-binding proteins which are highly selective for their sugar moieties. It is believed that wheat lectin, which binds to the monosaccharide N-acetyl glucosamine (NAG), provides defense against predation from bacteria, insects and animals.  Bacteria have NAG in their cell wall, insects have an exoskeleton composed of polymers of NAG called chitin, and the epithelial tissue of mammals, e.g. gastrointestinal tract, have a “sugar coat” called the glycocalyx which is composed, in part, of NAG.  The glycocalyx can be found on the outer surface (apical portion) of the microvilli within the small intestine.  
    There is evidence that WGA may cause increased shedding of the intestinal brush border membrane, reduction in surface area, acceleration of cell losses and shortening of villi, via binding to the surface of the villi. WGA can mimic the effects of epidermal growth factor (EGF) at the cellular level, indicating that the crypt hyperplasia seen in celiac disease may be due to a mitogenic reponse induced by WGA.  WGA has been implicated in obesity and “leptin resistance” by blocking the receptor in the hypothalamus for the appetite satiating hormone leptin.  WGA has also been shown to have an insulin-mimetic action, potentially contributing to weight gain and insulin resistance.   And, as discussed earlier, wheat lectin has been shown to induce IgA mediated damage to the kidney, indicating that nephropathy and kidney cancer may be associated with wheat consumption.
     
    Wheat Peptides Exhibit Molecular Mimicry
    Gliadorphin and gluten exporphins exhibit a form of molecular mimicry that affects the nervous system, but other wheat proteins effect different organ systems. The digestion of gliadin produces a peptide that is 33 amino acids long and is known as 33-mer which has a remarkable homology to the internal sequence of pertactin, the immunodominant sequence in the Bordetella pertussis bacteria (whooping cough).  Pertactin is considered a highly immunogenic virulence factor, and is used in vaccines to amplify the adaptive immune response.  It is possible the immune system may confuse this 33-mer with a pathogen resulting in either or both a cell-mediated and adaptive immune response against Self.  
     
    Wheat Contains High Levels Of Excito-Toxins
    John B. Symes, D.V.M. is responsible for drawing attention to the potential excitotoxicity of wheat, dairy, and soy, due to their exceptionally high levels of the non-essential amino acids glutamic and aspartic acid.  Excitotoxicity is a pathological process where glutamic and aspartic acid cause an over-activation of the nerve cell receptors (e.g. NMDA and AMPA receptor) leading to calcium induced nerve and brain injury.   Of all cereal grasses commonly consumed wheat contains the highest levels of glutamic acid and aspartic acid.  Glutamic acid is largely responsible for wheat’s exceptional taste. The Japanese coined the word umami to describe the extraordinary “yummy” effect that glutamic acid exerts on the tongue and palate, and invented monosodium glutamate (MSG) to amplify this sensation.  Though the Japanese first synthesized MSG from kelp, wheat can also be used due to its high glutamic acid content.   It is likely that wheat’s popularity, alongside its opiate-like activity, has everything to do with the natural flavor-enhancers already contained within it.  These amino acids may contribute to neurodegenerative conditions such as Multiple sclerosis, Alzhemier’s, Huntington’s disease, and other nervous disorders such as Epilepsy, Attention Deficit Disorder and Migraines.  

    Conclusion
    In this article I have proposed that celiac disease be viewed not as a rare “genetically-determined” disorder, but as an extreme example of our body communicating to us a once universal, species-specific affliction: severe intolerance to wheat.  Celiac disease reflects back to us how profoundly our diet has diverged from what was, until only recently a grain free diet, and even more recently, a wheat free one.  We are so profoundly distanced from that dramatic Neolithic transition in cultural time that “missing is any sense that anything is missing.” The body, on the other hand, cannot help but remember a time when cereal grains were alien to the diet, because in biological time it was only moments ago. 
    Eliminating wheat, if not all of the members of the cereal grass family, and returning to dicotyledons or pseudo-grains like quinoa, buckwheat and amaranth, may help us roll back the hands of biological and cultural time, to a time of clarity, health and vitality that many of us have never known before.  When one eliminates wheat and fills the void left by its absence with fruits, vegetables, high quality meats and foods consistent with our biological needs we may begin to feel a sense of vitality that many would find hard to imagine. If wheat really is more like a drug than a food, anesthetizing us to its ill effects on our body, it will be difficult for us to understand its grasp upon us unless and until we eliminate it from our diet.  I encourage everyone to see celiac disease not as a condition alien to our own. Rather, the celiac gives us a glimpse of how profoundly wheat may distort and disfigure our health if we continue to expose ourselves to its ill effects.  I hope this article will provide inspiration for non-celiacs to try a wheat free diet and judge for themselves if it is really worth eliminating.

    Paul Smith
    This article originally appeared in the Fall 2009 edition of Journal of Gluten Sensitivity.
    Celiac.com 10/30/2009 - The major concern in producing gluten and allergen-free foods is always that of cross contamination. In my view, the only safe way to produce gluten-free meals and products is in a rigorously controlled and totally gluten-free environment where all ingredients are strictly gluten-free and all benches, utensils and equipment, etc. are dedicated and remain in a totally gluten-free condition at all times. It must always be remembered that gluten-free should mean “ totally and absolutely gluten-free,” and that there should always be an uncompromising zero tolerance for any form of gluten contamination, no matter how slight.
    In my view the same approach should be adopted for anaphylaxis inducing ingredients like peanuts, eggs, sesame seeds, shellfish and crustaceans: that it is best to exclude them entirely to eliminate the risk of accidental contamination. Any other approach requires extremely alert and well informed operators in combination with elaborate cleaning and testing protocols; all of which are prone to mistakes and failure.
    It is my view, that many people are too cavalier in their approach to the matter of gluten contamination, taking the attitude that “a little won’t hurt.” Many manufacturers, particularly restaurants, small bakers and pizza makers etc., for example, are often asked about making gluten-free products and see this as a means of expanding their businesses. Something many of them attempt without properly trained staff and without fully understanding the implications and risks of undertaking such a project. However, there are also many worthy exceptions to this comment: the difficulty is in finding them.
    In flour and bakery situations gluten is always present and is often used as an ingredient. Typical suburban bakeries tend to have flour and hence gluten everywhere. Flour and gluten are insidious and can float in the air for many hours after use and can be dislodged by banging doors and draughts. Benches, tins, trays, dough rollers, dough dividers, bread slicers, utensils, belt ovens etc., are often contaminated with gluten and many of these items are difficult to clean thoroughly. Bakeries are inherently difficult to keep clean and maintain in a gluten-free state.
    Deep fryers are also fraught with difficulty. For example, potato chips which are gluten-free by definition, can easily be contaminated with gluten from the gluten residues left in the deep fryer by cooking such products as crumbed calamari, veal schnitzel, chicken schnitzel, spring rolls, battered fish and the like in the same deep fryer. The only way to produce gluten-free potato chips is by having and maintaining an exclusively gluten-free deep fryer where only gluten-free batters and crumbs etc., are used. Extreme care must also be taken with bench surfaces and all utensils, aprons, towels etc., used and in washing hands.
    Other contentious areas are colorings, flavorings, salad dressings, thickeners, gravies, sauces, for both savory and dessert applications, as these often introduce gluten contamination to otherwise gluten-free meals and foods. If already applied to a meal these can never be fully removed by attempting to scrape them off. The meal should always be totally replaced with a sauce or whatever free meal or course.
    In my view, the consumer’s safety and well being should always be paramount: the consumer should not be imposed upon and they should be given an informed choice as to what they consume at any time. This is the basis upon which we run our business. Avoidance of all the above problems requires well trained and aware staff working under well informed and aware management in a clean and well controlled environment.

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

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


    Yvonne (Vonnie) Mostat
    Celiac.com 03/01/2016 - Did you know that even products all scientists agree to be safe may not be because when researchers experiment in a contained laboratory, they find the product to be safe...and we believe them don't we? The reality is, several of those products, like quinoa and buckwheat can often be cross-contaminated because they are processed and packaged in plants that also process regular wheat. If you visit one of these facilities and see the flour dust everywhere you will notice workers in white coats and masks to prevent dust inhalation. The employees look like they are walking around in astronaut suits, and it becomes clear that anything else processed in that plant could be contaminated with wheat.
    Whenever you have the choice to pick foods that come from facilities that are 100% dedicated gluten-free you should take it. Some foods, like Pamela's and Bob's Red Mill actually test their products twice for gluten. King Arthur Gluten Free Flour say that they test and re-test their entire line of gluten-free products, and have an on-line chat with the baker's hot line: 855-371-2253. Namaste Foods also have their gluten-free foods made in a dedicated facility that is free of gluten, wheat, soy, corn, potato, peanuts, tree nuts, dairy and casein. 1-2-3 Gluten-Free Products state "Made in a dedicated allergen-free facility (NO gluten, wheat, dairy, casein, peanuts, tree nuts, eggs and soy)." Don't just check whether an item is gluten or wheat-free, check whether it is made in a dedicated facility.
    It makes sense that companies that manufacture their products in a dedicated facility may price their products a little higher, and the cost will likely be passed on to the consumer. Pro-Cert indicates that while the expense to produce products under these dedicated protocols offers little versatility from year to year, because it is a closed loop system, but consumers shouldn't expect huge spikes in the price that never come down and only go up. I dream of the day when all gluten-free products will be made in dedicated facilities!
    Dedicated Facilities that Produce Gluten-free Oats
    Montana Mills
    Gluten-free purity protocol confirmed July 17, 2015. Oats are planted only on fields that have grown gluten-free grains for four years. Pure gluten-free seeds are planted. Fields are hand-rogued (You do know what roguing is don't you? Another grain flies in on the wind, or is trampled under foot from another field. Fairly easy to spot in the field of ripened wheat the farmers in my husband's family tell me.) to eliminate possible contamination. The grower is responsible for roguing, but is inspected by a Montana Mills inspector prior to harvest to ensure roguing was thorough and the fields are clean. Oats are transported in certified clean dedicated equipment to a dedicated facility. Redundant Elisa R5 testing is conducted before and after processing. Since 2012 Montana Mills uses the Elisa G12 approved testing.
    Avenin Foods
    Current gluten-free purity protocol confirmed July 21, 2015. They use only pedigree seeds. Growers attend workshops to learn requirements for gluten-free oats. Fields used to grow gluten-free are required to follow a specified crop rotation protocol. The fields are surrounded by isolated strips. All machinery and equipment is either cleaned or dedicated. All oats are processed in a dedicated gluten-free facility. Oats are tested using R5 Elisa 5 methadology.
    Ice Cream Slip Up
    I became very ill two weeks ago upon purchasing a soft ice cream, in a bowl of course, from a new store near our home. I should have realized that Wadden System Frozen Treats (www.icecreamflavors.com) coming from one machine but making over 20 flavors of ice cream, came from a flavor syrup that was added to the plain vanilla in the machine and that is how they got the flavored colors of ice cream. It contained wheat, and being a bit of a pig over ice cream I ordered a medium.
    The nausea came first, then the diarrhea. Within twenty-four hours my scalp was covered in dermatitis herpetiformis lesions, water filled blisters that beg to be itched, and when you comply the burning in your scalp and thighs makes you so miserable you wished you had never even thought of ice cream! I went back of course, and I e-mailed the Wadden Company and suggested they notify the franchise people of what the bottles of flavorings contain. This did not help my illness or itching though, but we learn, oh goodness I hope I learn!
    If a food allergen isn't labeled with all the proper food allergens and makes its
    way into the store shelves, the food may be subject to a recall according to FALCPA (Food Allergen Labeling and Consumer Protection Act of 2004) requirements, and you can report such foods. "Get the Facts", the USDA, U.S. Department of Agriculture, list the new allergen labeling laws that include the top eight food allergens.
    Double Check these Foods
    Imitation Sea Foods, such as imitation crab meat, imitation bacon bits, licorice, flavored coffees and teas, processed foods, some chocolates and bars, salad dressings, hot dogs, sausages, deli-meats, sauces, marinades, seasonings, and soy sauce.
    Medications
    Do what I did, take the form provided by the National Celiac Association for Pharmacists to your pharmacy and tell them you are either a celiac or gluten sensitive and ask them to find out if your medications contain gluten.
    Gluten-Free Oats
    The Gluten Free Watchdog supports the use of gluten-free oats by the celiac disease community that are produced under a purity protocol. At this time we do not support the use of regular oats that are cleaned at the "end" of production via mechanical and/or optical sorting to be "gluten free". Before we can support the use of oats "cleaned" in this manner to be gluten-free we must be provided with thorough testing data. We can then compare this data to the thorough testing data provided to us for oats grown under a purity protocol."
    The Gluten Free Watchdog, who work very hard to keep pushing companies with regards to the safety of oats, had a meeting with General Mills in July to discuss gluten-free Cheerios. Those involved with testing of the oats in Cheerios—Medallion Labs were also present. Marshall Gluten Free Milling and Pro-Cert, (Michael Marshall, President and CEO of Marshall Gluten Free Milling (www.glutenfreemilling.com) sent the Gluten Free Watchdog a letter indicating that they knew it was time to make a difference in a segment of the marketplace that needs some help. What does Marshall Gluten Free Milling do? They are the world's first company that provides ingredients to manufacturers that are produced on third party Certified Gluten Free FARMS by Pro-Cert a worldwide leader in third party organic certification.
    It is a program that closely mirrors organic certification. Each farm must be free from gluten-containing products for two full years and on the third year of production the crops can be marketed. No gluten-containing product can be stored, handled, transported or conveyed with any infrastructure or equipment on the farm. Marshall gluten-free Milling Staff then control the dedicated trucking to a gluten-free only certified cleaning facility where the product is cleaned and sized to maximize quality. The oats are then shipped in a dedicated gluten-free truck to a third party certified gluten-free mill (GFCO, Pro-Cert, etc.). So the mill, cleaner and farm are all certified. The crops available right now on this program are organic oats and flax. Interest has spread to non-organic producers as well. They are expanding their offerings to lentils, peas and possibly quinoa. They need a sustainable crop rotation for the producers in the program. Primarily right now the focus of their ingredient marketing is oats as this is where the 3rd party certification of the farm is most crucial to developing a sustainable gluten-free crop rotation.
    Michael Marshall was asked about General Mills announcing that five varieties of Cheerios were to be labeled gluten-free. The company is using regular oats cleaned at the "end" of production via mechanical separation. According to General Mills there are not enough oats grown under a purity protocol to produce Cheerios. He was asked, based on his industry experience, did he feel that mechanical/optical sorting was sufficient to ensure the gluten-free status of oats. He stated that General Mills was a trusted brand who value their name, and have done their homework on the process. But he also stated that mechanical and optical sorting equipment has been used for quality control for years as well as for food safety precautions. It is not new idea, has come a long way, but he thinks that even General Mills would have to agree it does not reduce the risk to zero. Michael Marshall is concerned about the dust control system used by General Mills. In his opinion, contaminated conventional low cost oats in gluten-free foods is risky.
    After Tricia Thompson of the Gluten Free Watchdog asked if his program guaranteed 100% pure gluten-free oats? He said, "Generally speaking, there are always going to be anomalies." However if you look at the protocols in our program there are standard operating procedures in place. These procedures include: Planting seeds that are verified pure. Using only gluten-free planting equipment. Using buffer strips around the field – At harvest, the crop within the buffer strip cannot be binned with the gluten-free product—this protects the gluten-free crop from outside contamination. Strip testing every load that comes off the field before it is binned. Sending a representing sample from every bin to the lab for testing using the R5ELISA R7001 assay (testing prior to the crop being shipped to the mill. Testing at the mill before the crop is unloaded. The bottom line being they are testing at various steps to find gluten through the entire production of the crop to mitigate or eliminate the risk of contamination before it even gets to the mill. Once at the mill hi-tech sorting or mechanical separation will be for quality versus the only fail-safe measure to assure removal of gluten. The farm will be required to be certified gluten-free by Pro-Cert. They have 25,000 acres of both organic and conventional farmland under the certification program that will be available for the market this October. There are farmers lining up to get on the program and they have not even marketed it yet. It is a big market to supply and I believe we can all benefit.
    Of course they want to follow safety guidelines! The celiac population is big business and I thank the Gluten Free Watchdog for working to develop a safety protocol for oats and working hard to obtain purity so that we can safely eat food without getting sick. But I know there will be a price to be paid for purity and safety, and it has to be passed on to the consumer, and I think there should be more tax breaks for the celiac population. AND, that is another place that the Gluten Free Watchdog and FALCPA (Food Allergen Labeling and Consumer Protection Act of 2004) can help us with keeping the costs down. No-one should have to be penalized out of their pocketbook for having a gluten sensitivity or severe gluten allergy.
    My goodness, in Great Britain tax breaks are considerable for anyone who has diabetes, celiac disease or many notable food allergies. They do not decide that you have to use a certain medication, a generic brand, because the brand prescribed by your doctor is not listed under Pharmacare like they do in British Columbia, and, in Great Britain, as soon as a woman becomes pregnant she receives free vitamins for her unborn baby and all costs during her pregnancy are covered by their Medical Insurance Coverage. Dental, glasses, and money for diapers and a clothing allowance for the first three months of the babies life are paid for. We in the United States and Canada are so far behind Europe and the Great Britain in our health coverage. I think as a celiac and somone who has multiple allergies that require severe diets, some assistance and tax adjustments should be available more than the paltry difficult to monitor cost adjustment program that is in place today in our two countries! I know, my "Bandwagon", but one you should get on board too, and so should the NFCA.

  • 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