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    Top 4 Tips to Get Started With Your Gluten-Free Diet


    Christine Rudolph


    • Journal of Gluten Sensitivity Summer 2016 Issue


    Celiac.com 08/01/2016 - If you are diagnosed with celiac disease, you have to completely avoid gluten for life. However, cutting out all gluten from your diet may seem quite daunting at first, but a gluten-free diet is the only remedy and treatment for this condition. Now you must be wondering what you can eat on a daily basis? Here are some tips to help you getting started with your gluten-free diet.

    Tip 1: Look for Healthy Food Items


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    There are numerous food items which are naturally gluten-free. Stop worrying about the "off-limits" items, as there are plenty of healthy and gluten-free alternatives. These include the energetic ones such as meat, vegetables, fruits, poultry, fish, eggs, cheese, dairy items, nuts, legumes and beans. Above all, you should always consider eating food items that are healthy, and will help you maintain your physical fitness and body tone, rather than unhealthy replacements for the items you miss.

    Tip 2: Avoid Eating Items Containing Gluten

    Wheat gluten is one of the staple food items and is enemy number one for people who are suffering from gluten sensitivity. You should avoid foods that contain any gluten. It is not just wheat that is harmful for those with celiac disease, harmful gluten is also present in barley, rye, bulgur, seitan, and many other foods in for form of additives and thickeners in things like chicken broth, salad dressings, malt vinegar, soy sauce, etc.

    However, not all grains need to be avoided, and you can eat foods made from corn, buckwheat, teff, amaranth, millet and quinoa, which are naturally gluten-free. Of course you need to be sure that you get uncontaminated versions, as some grains can be contaminated during processing.

    Tip 3: Make a Habit of Reading the Food Labels

    Now that you know that you must avoid gluten, it is time to take care of your diet. When going grocery shopping you should make a habit of reading the ingredient labels, which all foods should have on their labels.

    While reading it, you will get an idea whether or not the product is suitable for you or not. You should carefully look out for ingredients including rye, wheat, barley, or any ingredient containing gluten. If you find any of these ingredients, avoid purchasing them and opt for other alternatives.

    Tip 4: Be Vigilant When You Eat Out

    Having celiac disease and being on a gluten free diet, does not mean that you should avoid going to restaurants and eating out. You can eat out but you need to be careful with the food items that you choose to eat, and how you order your food. Try to stick with a gluten-free menu if they have one, or foods that you understand the basic preparation methods and ingredients, for example steamed vegetables and grilled meats. Above all be sure that you are sticking to your gluten-free diet to maintain your health and fitness. When there is no gluten-free menue it might make sense to avoid eating fried items and foods containing sauces, because they can be a source of hidden gluten. It is always wise to inform your chef beforehand about the dietary restrictions for a safe gluten-free eat-out.

    People with celiac disease can sometimes feel miserable due to their restricted diet, but they should not be sad because gluten-free meals can also be delicious and healthy, and often taste just as good as the foods that contain gluten.

    Now that you know these tips, we hope you will be able to get started with your gluten-free diet effectively.

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    Guest Gluten-Free Bebe

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    You forgot to mention the book 3 Steps to Gluten-Free Living! It's the perfect book that answers the question "Where do I start?" after diagnosis of celiac or gluten intolerance.

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    Scott Adams
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    A Gluten-Free Kitchen
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    Bathroom Checklist:
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    Food Diary
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    Final Thoughts
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    Gluten-Free Quick-Check:
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    Tina Turbin
    Celiac.com 08/25/2016 - You just got diagnosed Celiac and are wondering how serious this really is. What if there is just a little gluten in your food? What if you use the same toaster for your gluten-free bread as your wife's/husband's regular bread? What if those french fries are gluten-free but they fry them in the same fryer as those nice gluten coated onion rings?
    Well, my answer is always that no amount of gluten is "safe". Items that are certified gluten-free must be tested and must pass, having less than 20 parts per million (ppm) of gluten. That means that less than .002% parts of that item contain gluten. That is quite a small amount but not necessarily small enough to not have a reaction to it. Some products even test as low as 10 ppm or 5ppm.  Anything lower than 3ppm is undetectable by any test out there right now. Some products state they are less than 20ppm but you really don't know if that is 19ppm or 5ppm so I always assume the worst just in case.
    So let's assume these french fries are nice and crispy and they share that fryer with those delicious onion rings. The answer is, stay away. You most definitely will end up consuming gluten. You may not have a reaction that you notice from these french fries, as some people are more sensitive or less sensitive, but that does not mean they are not causing an autoimmune reaction and causing damage internally.
    My advice: get your own dedicated gluten-free toaster; ask and ask again if sauces contain gluten; ask if the fryer shares space with gluten containing items and even let your server know you have celiac disease and to let the chef know. Your server may not know enough about gluten and celiac disease, but chefs almost always do and will understand the severity of it. I have had much better luck eating out when I have my server actually let the chef know I am celiac. There have been many occasions where my server said something was gluten-free without asking the chef and in the end I ended up sick in bed because of it.

    Miranda Jade
    Celiac.com 10/06/2016 - You do not need to be celiac to need to stay away from gluten. Wheat isn't just harmful to celiac or gluten-sensitive individuals. Did you know that just one slice of wheat bread raises one's blood sugar higher than 3 teaspoons of table sugar? That is equivalent to 12 grams of sugar! Talk about diabetes waiting to happen!
    I am very diligent in reading over even the gluten–free ingredients of products to ensure they are indeed gluten-free. I decided to start grabbing items off of the shelf to read the other listed ingredients as well. Wow, was I surprised! Sugar, high fructose corn syrup, corn syrup, fructose etc.! Sweetener and especially sugar are added to so many things; it is really horrible. No wonder Americans are addicted to it. We have many new diagnoses and physical disorders stemming from the standard American Diet, the "improper diet", not to mention a rapid rise in obesity statistics and diagnosed diabetes.
    Americans love bread, gluten-free or not. Go to a restaurant and what is the first thing brought to the table? Bread! Can you imagine being brought some cut up cucumbers and celery instead? Now THAT would be a nice change! I often ask for this by the way and suggest you do as well.
    Kids products are the worst! To give a tiny or growing body with a rapidly developing brain that needs proper nutrition all that junk, additives and unhealthy ingredient are a crime. If your child has been having trouble focusing in school, I highly advise you to look at the ingredients list of the food and snacks he or she eats and check out the children's menu at a restaurant. Gluten-free foods as well.
    You may not have any issues with gluten and wheat type bread but it is harming your body in one way or another and I strongly advise you to stay away from it and keep your family off of it too. I also highly suggest you start being diligent and read your gluten-free product's ingredients list. Going gluten-free is the first step as a diagnosed celiac or one who is gluten intolerant, but getting healthier or staying healthy is of utmost importance to a long and healthy lifestyle. Your body's future is in your hands.

    Miranda Jade
    Celiac.com 11/01/2016 - Homeopathy has been around for quite some time. You even see it in drug stores these days. Here are some basics behind homeopathy.
    Certain substances that create a reaction in a healthy person can cure a sick person with the same symptoms. Unlike conventional medicine, homeopathy is considered more effective when the substance is diluted and shaken and is considered more effective each time this dilution and shaken process is done. This also makes it much safer as there is so little of the active ingredient actually in the homeopathy. It is tailored to each person depending on their health record, physical symptoms, emotional state, etc. Not just a one size fits all approach. One point that is great about homeopathy as opposed to "regular" medicine is the side effects are next to nothing.  The dosages are so small and contain so little of the active ingredient that the worst thing to happen would be that no beneficial effect occurs.

    If your child is celiac, then you have probably had plenty of issues with ingredients in medications as well as sensitivities with substances in them that aren’t even gluten. I have run into many kids who are celiac who cannot handle all sorts of other substances due to their gut. The good thing about homeopathic preparations is that many of them are gluten-free. I actually have never come across one with gluten so far. This makes it very easy to find remedies that your celiac child can handle. No strange ingredients that are made in a laboratory either.

    I specifically use chamomile and arnica for my son when he is teething. There is a combination of specific ones for teething but the individual dosages always work best for my toddler. I see a large difference in his overall attitude and pain level when I administer these two. 

    Of course there is always a place for standard medicine but I try to avoid drugs when I can.  Especially with my damaged gut from being misdiagnosed for 17 years! This allows the body to learn and adapt to properly fighting germs so there is less of a chance in getting sick the next time a bug is being passed around. Plus, have you read some of the warning labels on these drugs that doctors recommend? Pretty scary, horrible side effects! Worse than the sickness you are treating.

    Give homeopathy a try and see if it gives you, your celiac child or your family any comfort.

    Jefferson Adams
    Celiac.com 04/05/2017 - To mark the start of Coeliac Awareness Week, Coeliac Australia and Nestlé Professional have launched Gluten Free Online Training – an interactive learning resource for foodservice professionals looking to expand their understanding of gluten free food practice throughout the hospitality industry.
    Under the guidance of Australian chef and author Tobie Puttock, the project will train up to 30,000 students at all TAFEs and culinary institutes in the protocols for gluten-free food preparation and service.
    People who successfully complete the training earn a Certificate of Achievement, which covers them for three years under Coeliac Australia's Gluten Free Standard for Foodservice Providers.
    Cathy Di Bella, special projects officer at Coeliac Australia, says training in safe gluten-free food prep and handling practices is a huge stepping stone to meet the future needs of the foodservice industry.
    Karen Kingham, dietitian and brand nutritionist at Nestlé Professional, says that the online training is intended to help people working in foodservice to become familiar with gluten-free customer and prep and server issues.
    The goal is to promote gluten-free awareness and protocols to culinary and food industry workers, to benefit them, the industry, and its patrons.
    "As most of us know celiac disease is real and symptoms are easily triggered, and I believe this should be treated the same as someone with perhaps a peanut allergy, and therefore food handling is of the utmost importance," said Puttock.
    It's good to see such influential figures in the food industry bringing such seriousness and professionalism to the preparation and handling of gluten-free foods. Stay tuned for more on this and other gluten-free stories.
    For more information: Australia's Gluten Free Online Training.

    Yvonne Vissing Ph.D.
    Celiac.com 05/05/2017 - What do you say to someone who doesn't "get" the fact that gluten makes people sick? It's not that people are intentionally callous and uncaring. They simply don't understand that going gluten-free isn't a fad or a choice for most people. This means that all too often when it comes to eating, they are perfectly content to go their merry way and eat whatever they want and if you're with them, well, you'll figure out something to eat. They don't mean to be insensitive jerks, but sometimes they present that way. As many of us have learned, when someone you love has a gluten sensitivity, the response of "it's their problem and it's not my issue" simply isn't good enough. Love means that you try to understand the experience and challenges of the person you care about.
    Celiac disease and gluten sensitivities are sneaky buggers. They are expert at masking what's really going on. So it's no surprise that parents and loved ones often screw up when it comes to understanding the physical and emotional experiences of someone whose got gluten issues. Maybe we heard about gluten issues, but it's one thing to read information and look at it intellectually as an abstract phenomenon and it's extra hard when you don't know anyone whose had gluten related problems.
    I grew up with pasta, home-made bread smothered with butter, cookies, and a sense these were comfort foods - not something that could make you deathly ill. No surprise, when my children didn't feel well, I'd pull out the crackers and chicken noodle soup, with a little mac-n-cheese for good measure. The children would snarf them down, and I had a self-inflated sense of motherly pride for having fixed them healing foods. Little did I know that my culinary delights were responsible for giving them GI track upset, migraines, skin problems, and the precursors to Celiac disease. There was no way of knowing back then that autoimmune problems ran on their father's side of the family, since we divorced when they were wee. In fact, most people don't really have their heads wrapped around the autoimmune disease thing at all, because as we say in New England, "it's wicked complicated!" Not knowing, in hindsight, makes the saying "killing them with kindness" take on new meaning.
    Today the dangers of glutening someone are well-recognized by most people, even if they don't understand all the sheer dynamics of what the cause-and-effects of it are. The problem is, unless you've seen someone writhing in distress from ingesting gluten by accident, your understanding of being glutened remains an intellectual, abstract mental exercise. The difference between knowing about being glutened and the actual experience of it are worlds apart. So if you have a family member, loved-one, colleague, or someone you're responsible to/for (as are teachers, day-are providers), what are you to do to show people with gluten issues that you care? Here are some suggestions.
    Talk to the person. Really talk with them. Ask them questions about what their experience of being glutened is like. Find out about what they perceive to the be causes of it. Listen to them talk about their emotions and how they feel when they are sick – and how they feel about others who help them or are contributors to their distress. Once they open up, they will likely tell you about things that frustrate them about trying to eat normally, problems they've encountered, and how they have to monitor their lives to avoid getting sick. People with Celiac disease or gluten issues are experts. They will look you in the eye and tell you what it's like in a way that inspires a caring person to pay more attention to what's going on so they can do better not to make someone sick. Inquire what you could do – and not do – that may prevent glutening someone. They will also give you big hints about what to say and do (and what NOT to do). Read. There is a lot of information available about what gluten is, where it is found, what it does to people, and alternatives for it. It's in books, magazines, online websites galore, and even sometimes on television. In our book, Going Gluten Free, we list a bunch of sites for you. Given the large amount of information that's freely available, there is no excuse for not knowing about gluten is, what it does, and how it should be handled so people don't get sick. Take the time to educate yourself about gluten, celiac, what it does, and how to live gluten-free in a harmonious and healthy manner. Others will feel that you genuinely care when you tell them about what you've learned and the information you've accessed! Pay attention. Once you know about glutening people, start paying attention to menus at restaurants, ingredient lists of food products, and what and how food is being served. Even "safe" foods can be cross-contaminated and served in ways that can make someone with gluten sensitivity sick. Sometimes those fixing or serving food aren't as savvy as they coulda-shoulda-oughta be about gluten-free dining. If you go somewhere and the server looks foggy when you ask about their gluten-free options, don't order anything that is remotely questionable. Size up the whole dining ambiance, see if you can get a glimpse at the kitchen, ask if they have a gluten-free menu or policy. If your intuition blinks "danger!", listen to it. Better to be safe than sorry. Be annoying. Many people with Celiac or gluten issues are sweet-hearts and don't want to inconvenience others. So be prepared, when appropriate, to ask questions, push the envelope, and do background check to ensure that your loved one doesn't get glutened. Being able to eat safely is a human rights issue. You are not being annoying by asking questions or demanding that you (or your loved one) are served food that can be consumed without negative outcomes. Others don't have the right to make you sick. It's as simple as that, so learning to stand up for yourself or others is a good practice to get into!

  • Recent Articles

    Jefferson Adams
    Celiac.com 06/19/2018 - Could baking soda help reduce the inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease? Scientists at the Medical College of Georgia at Augusta University say that a daily dose of baking soda may in fact help reduce inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease.
    Those scientists recently gathered some of the first evidence to show that cheap, over-the-counter antacids can prompt the spleen to promote an anti-inflammatory environment that could be helpful in combating inflammatory disease.
    A type of cell called mesothelial cells line our body cavities, like the digestive tract. They have little fingers, called microvilli, that sense the environment, and warn the organs they cover that there is an invader and an immune response is needed.
    The team’s data shows that when rats or healthy people drink a solution of baking soda, the stomach makes more acid, which causes mesothelial cells on the outside of the spleen to tell the spleen to go easy on the immune response.  "It's most likely a hamburger not a bacterial infection," is basically the message, says Dr. Paul O'Connor, renal physiologist in the MCG Department of Physiology at Augusta University and the study's corresponding author.
    That message, which is transmitted with help from a chemical messenger called acetylcholine, seems to encourage the gut to shift against inflammation, say the scientists.
    In patients who drank water with baking soda for two weeks, immune cells called macrophages, shifted from primarily those that promote inflammation, called M1, to those that reduce it, called M2. "The shift from inflammatory to an anti-inflammatory profile is happening everywhere," O'Connor says. "We saw it in the kidneys, we saw it in the spleen, now we see it in the peripheral blood."
    O'Connor hopes drinking baking soda can one day produce similar results for people with autoimmune disease. "You are not really turning anything off or on, you are just pushing it toward one side by giving an anti-inflammatory stimulus," he says, in this case, away from harmful inflammation. "It's potentially a really safe way to treat inflammatory disease."
    The research was funded by the National Institutes of Health.
    Read more at: Sciencedaily.com

    Jefferson Adams
    Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown.  To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. 
    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
    For their review, the team searched Medline, PubMed, and EMBASE for the keywords ‘celiac disease,’ ‘celiac,’ ‘tissue transglutaminase antibody,’ ‘anti-endomysium antibody,’ ‘endomysial antibody,’ and ‘prevalence’ for studies published from January 1991 through March 2016. 
    The team cross-referenced each article with the words ‘Asia,’ ‘Europe,’ ‘Africa,’ ‘South America,’ ‘North America,’ and ‘Australia.’ They defined celiac diagnosis based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. The team used 96 articles of 3,843 articles in their final analysis.
    Overall global prevalence of celiac disease was 1.4% in 275,818 individuals, based on positive blood tests for anti-tissue transglutaminase and/or anti-endomysial antibodies. The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% in 138,792 individuals. That means that numerous people with celiac disease potentially remain undiagnosed.
    Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults.
    This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. 
    This review demonstrates a need for more comprehensive population-based studies of celiac disease in numerous countries.  The 1.4% rate indicates that there are 91.2 million people worldwide with celiac disease, and 3.9 million are in the U.S.A.
    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.

    Jefferson Adams
    Celiac.com 06/16/2018 - Summer is the time for chips and salsa. This fresh salsa recipe relies on cabbage, yes, cabbage, as a secret ingredient. The cabbage brings a delicious flavor and helps the salsa hold together nicely for scooping with your favorite chips. The result is a fresh, tasty salsa that goes great with guacamole.
    Ingredients:
    3 cups ripe fresh tomatoes, diced 1 cup shredded green cabbage ½ cup diced yellow onion ¼ cup chopped fresh cilantro 1 jalapeno, seeded 1 Serrano pepper, seeded 2 tablespoons lemon juice 2 tablespoons red wine vinegar 2 garlic cloves, minced salt to taste black pepper, to taste Directions:
    Purée all ingredients together in a blender.
    Cover and refrigerate for at least 1 hour. 
    Adjust seasoning with salt and pepper, as desired. 
    Serve is a bowl with tortilla chips and guacamole.

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

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