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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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    VITAMIN D AND CELIAC DISEASE


    Yvonne Vissing Ph.D.


    • Co-author: Christopher Moore-Vissing. Journal of Gluten Sensitivity Summer 2016 Issue


    Celiac.com 07/25/2016 - Celiac disease is a tricky rascal. Just when you think you've got it under control, it sneaks up and manifests into new and often unexpected problems. At least, this is what we have found over the last decade. From contacts with others who have celiac disease, we know we're not alone. I'm in my early thirties and find that sometimes my body acts more like that of an old man's. For instance, I've had gout even though my diet contains almost none of the food culprits traditionally associated with that disorder. Then I learned that what gout and celiac disease have in common is that they are both auto-immune diseases. My skin is quirky and has been since I've been little; I can't wear certain types of fabric and have to use soaps and detergents for people with "sensitive skin". Celiac disease, I gather, is associated with a variety of skin problems, including psoriasis. I had to have my gall bladder removed a couple of years ago. I have elevated liver rates. Why me? I'm too young for this! Then I found that it is common for people with celiac disease to have liver and gall bladder problems.


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    This spring, I started becoming so tired that I couldn't wait to go to bed, even though the sun was still shining. I finally went in to see my MD who took my blood for testing. The results? I had no vitamin D. None. I have a good diet (see my book Going Gluten Free for proof of this!), and I know that vitamins are important. I know that sunshine is associated with vitamin D, and while I'm not outside all the time, I'm not like a vampire that only goes out at night. I do get sunshine. I also have a sun lamp over my desk. So why did my blood levels indicate I have no vitamin D? Evidently I'm in good company again – lots of people with celiac disease have vitamin D problems.

    Vitamin D is unique. Evidently Vitamin D isn't really a vitamin at all – it is a secosteroid, a hormonal precursor that is similar to other steroids that the body makes, such as cholesterol, testosterone or cortisol. Vitamin D obtained from sun exposure, food, and supplements is biologically inert and must undergo two hydroxylations in the body for activation. The first occurs in the liver and converts vitamin D to 25-hydroxyvitamin D [25(OH)D], also known as calcidiol. The second occurs primarily in the kidney and forms the physiologically active 1,25-dihydroxyvitamin D [1,25(OH)2D], also known as calcitriol. Vitamin D promotes calcium absorption and is necessary for variety of health processes, including the creation of strong bones, modulation of cell growth, neuromuscular and immune functions, and the reduction of inflammation. Vitamin D is located in the nuclei through a receptor. It impacts the creation of proteins that then transport calcium or phosphorous, which bones and other body functions require for healthy development. Vitamin D stimulates how the intestine absorbs calcium and mobilizes phosphate levels. Without vitamin D, our bodies and our lives are in trouble.

    I'm not a nutritionist – I'm a film maker. But from what I have learned, low vitamin D levels in one's body is associated with how well the body can absorb calcium. I had no idea that I was deficient in vitamin. Some people may not experience any symptoms of it at all. Symptoms of vitamin D deficiency are sometimes vague. They can include tiredness and general weakness, aches and pains, which may result in people feeling like they can't move around as well as they wish. Some folks experience frequent infections. There is no way to know if you have a vitamin D deficiency or not unless you get a blood test. Doctors measure if you're deficient in vitamin D by testing your 25(OH)D level. Getting a blood test is the only accurate way to know if you're deficient or not.

    Vitamin D deficiency is thought to be related to having a "leaky gut." Research indicates that vitamin D can be helpful to maintaining tight junctions in the small intestine that regulate what gets in and what stays out. Dr. Tom O'Bryan describes this to be similar to a rubber band wrapped around the junctions; if it gets too stretched out it may lose its elasticity and ability to snap back in place. People who are deficient in vitamin D tend to have rubber bands that aren't operating normally and allow foreign material to leak into the body, which can promote inflammation. Vitamin D seems to modulate the immune system and regulate the inflammation to keep it in check. In particular, it has been found to inhibit the development of a variety of other autoimmune diseases.

    If you've got a vitamin D deficiency, you better do something about it, otherwise you exacerbate the possibility of future health problems. Dr. Lisa Watson has found that low vitamin D levels decrease the amount of calcium that a body can absorb, and for those of us with very low vitamin D it is possible that only 10-15% of dietary calcium is absorbed (compared to 30-40% in healthy individuals). Other experts report that because people with Celiac disease have villous atrophy, we have malabsorption issues that may ultimately modify that way our immune systems react, which can lead to further autoimmune diseases. Lower absorption of calcium is also related to bone diseases, brittle bones, and osteoporosis - which makes me reconsider about why my ankle was so weak that I ended up having surgery on it a few years ago.

    So what are people like us to do? First thing is to see a doctor and have a blood test so you can get an accurate indication of if you actually have a vitamin D deficiency, and if you do how much of a deficiency you have. Don't try to self-diagnose your condition. It's tempting to do this. But go see your doc or an expert in the field. It seems that serum concentration of 25(OH)D is the best indicator of vitamin D status, so that's probably what test they will run.

    Don't go to the store and buy vitamin D and start taking it without knowing what you are doing. How much a person needs varies by the individual. There are vitamin D supplements available, but it is not wise to start self-medicating and guessing at how much you should take. Get a professional opinion and follow it. Get your serum blood levels tested regularly, monitoring it to make certain you're on the right amount. Evidently the amount of stress one is under, the time of the year, what one is eating and other factors may influence absorption levels. There is such a thing as vitamin D toxicity where people can take too much of a good thing. So find out from the doctor exactly what amounts you should be taking.

    It's important to figure out exactly why you have the vitamin D deficiency. Perhaps it is associated with your diet or lifestyle. It is possible to alter our diets and eat more foods that are in our best interests. Actually, very few foods naturally contain high amounts of vitamin D. The flesh of fatty fish like salmon, tuna, and mackerel and cod liver oils are among the best sources of vitamin D. Smaller amounts of vitamin D can be found in beef liver, cheese, mushrooms and egg yolks. Foods, like milk and milk products that are fortified with vitamin D, provide most of the vitamin D for people in the USA. If you take vitamin D supplements, addressing them could do the trick for you.

    Most of us could get out into the sun more, but if we've got a malabsorption issue the amount of vitamin D we get from the sun may actually not matter that much. It never hurts to get into the sun (with moderation, of course). Doctors may tell you to get out into the sunshine, since ultraviolet rays from the sun interface with the body to activate it through vitamin D receptors. These receptors are located throughout the body, including the brain, heart, skin, and a variety of other organs. But it's not as simple as just getting out and talking a walk. Season, time of day, length of day, cloud cover, smog, skin melanin content, and sunscreen are among the factors that affect UV radiation exposure and vitamin D synthesis. Sales of ultraviolet ray lamps have increased dramatically with people who have to stay inside doing work under them just so they can capture some Vitamin D. But for some of us with celiac disease, we can't get enough of it by being out in the sun, sitting under the lamp or eating the right diet. We have vitamin D problems mostly because our bodies can't absorb it properly.

    It's important to pay attention to what your body is telling you. When something doesn't seem quite right, it's important to then do something about it – like going to a professional who can diagnose, treat and prescribe. It could be that you, like me, keep realizing new ways that Celiac impairs our lives. Celiac is not for sissies. If you've got it, you've got to work with your body, listen to it, and take actions to honor it. By working with health professionals who know about celiac disease, keeping up with the research, being diligent and having a positive attitude, we can still live good and healthy lives.


    Based on its review of data of vitamin D needs, a committee of the Institute of Medicine concluded that persons are at risk of vitamin D deficiency at serum 25(OH)D concentrations 125 nmol/L (>50 ng/mL) are associated with potential adverse effects [1] (Table 1).

    Table 1: Serum 25-Hydroxyvitamin D [25(OH)D] Concentrations and Health* [1]

    nmol/L**

    ng/mL*

    Health status

    <30

    <12

    Associated with vitamin D deficiency, leading to rickets
    in infants and children and osteomalacia in adults

    30 to <50

    12 to <20

    Generally considered inadequate for bone and overall health
    in healthy individuals

    ≥50

    ≥20

    Generally considered adequate for bone and overall health
    in healthy individuals

    >125

    >50

    Emerging evidence links potential adverse effects to such
    high levels, particularly >150 nmol/L (>60 ng/mL)

    * Serum concentrations of 25(OH)D are reported in both nanomoles
    per liter (nmol/L) and nanograms per milliliter (ng/mL).
    ** 1 nmol/L = 0.4 ng/mL

    Reference Intakes
    Intake reference values for vitamin D and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine of The National Academies (formerly National Academy of Sciences) [1]. DRI is the general term for a set of reference values used to plan and assess nutrient intakes of healthy people. These values, which vary by age and gender, include:
    30. Recommended Dietary Allowance (RDA): average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy people.
    31. Adequate Intake (AI): established when evidence is insufficient to develop an RDA and is set at a level assumed to ensure nutritional adequacy.
    32. Tolerable Upper Intake Level (UL): maximum daily intake unlikely to cause adverse health effects.
    The FNB established an RDA for vitamin D representing a daily intake that is sufficient to maintain bone health and normal calcium metabolism in healthy people. RDAs for vitamin D are listed in both International Units (IUs) and micrograms (mcg); the biological activity of 40 IU is equal to 1 mcg (Table 2). Even though sunlight may be a major source of vitamin D for some, the vitamin D RDAs are set on the basis of minimal sun exposure.

    Table 2: Recommended Dietary Allowances (RDAs) for Vitamin D

    Age

    Male

    Female

    Pregnancy

    Lactation

    0–12 months

    400 IU
    (10 mcg)

    400 IU
    (10 mcg)

       

    1–13 years

    600 IU
    (15 mcg)

    600 IU
    (15 mcg)

       

    14–18 years

    600 IU
    (15 mcg)

    600 IU
    (15 mcg)

    600 IU
    (15 mcg)

    600 IU
    (15 mcg)

    19–50 years

    600 IU
    (15 mcg)

    600 IU
    (15 mcg)

    600 IU
    (15 mcg)

    600 IU
    (15 mcg)

    51–70 years

    600 IU
    (15 mcg)

    600 IU
    (15 mcg)

       

    >70 years

    800 IU
    (20 mcg)

    800 IU
    (20 mcg)

     

     

     

    References:



    Image Caption: Image: CC--NASA/Goddard/SDO
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    Guest Luann

    Posted

    Good Article! I was told 20 years ago Vitamin D deficiency is a side effect of celiac. Sure enough, last year I went from normal to osteoporosis, never even hit osteopenia.

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    From Dr. Heaney's blog: "2014 marks the 100th anniversary of the war on pellagra, a war that lasted nearly 25 of those years before victory could finally be declared. You have not heard of the war on pellagra? The celebration is not on your calendar? You're not alone. Why did it take so long? Was the science so intractable, like the current "war" on cancer? No. It was politics and pigheadedness that were the obstacles." Dr. Heaney says: "Nutritional deficiency was not an accepted category of disease when Goldberger started work" on his cause/cure for Pellagra, and I must also mention that it is not looked at today in those diagnosed with celiac disease. (6)
    Let's look into this more if we can. Let's see what other expert's say about this. If we look at back issues of The International Journal of Celiac Disease we see a casual link that indicates a co-morbidity of Pellagra in celiac patients of 58%. (7) Note they the International Journal of Celiac Disease is not looking for a causal link but they only report casual association. In the article entitled "Two Exceptional Complications Revealing Celiac Pellagra" the author notes: "pellagra is essentially affecting tissues with a high rate of cell turnover, such as the digestive tract and the skin, and tissues with high energy needs, such as the brain". (8) If the symptoms are so similar, it might be easy to confuse one disease for the other.
    How is this possible? The International Journal of Celiac Disease muses on this point too. When discussing the "exceptional" and not well understood reasons why Pellagra might show up in a celiac diagnosis, they say "Little progress has been made in our knowledge of pellagra...since Goldberger discovered that nicotinamide was a preventive factor in 1926...(P)roof of this is that there have been no changes in treatment or diagnostic criteria in the last 90 years." The International Journal of Celiac Disease summarizes this case of "Exceptional complications revealing celiac disease and Pellagra illustrates...rare complication revealing celiac disease". (8)
    Since up to 58 percent of celiac patients might be co-morbid with Pellagra, could it be possible that Pellagra is the "parent disease," and the those diagnosed with celiac disease have symptoms derived from Pellagra? If we follow most normal paths for adoption it will take another 20 years (a generation) for the medical community to accept Pellagra as perhaps the proper diagnosis in some cases. So there is some evidence to suggest that medical science is, perhaps in many cases, identifying the wrong disease. If one is critically low in niacin, the 3 D's of Pellagra (Dementias, Dermatitis's, and Digestive Issues) show up.
    Take the "Niacin (Niacinamide) Challenge" and see if taking it three times a day for six months don't cause a healthy GI pattern, including a once per day bowel movement that sinks and healthy burping without bloating. Taking the niacinamide Challenge may put co-morbid cases of Pellagra, including its digestive symptoms, into remission, and provide relief for many who do not recover on a gluten-free diet alone. The number one mistake people make when taking niacinamide is they don't take it for long enough. It takes 4 to 6 months to overcome a serious deficiency of this vitamin, and for your mucus membranes (GI lining) to heal itself.
    Once you recover you can maintain your health, barring some future stress/trauma that depletes your reserves, at which time heartburn/GERD/IBS/diarrhea/constipation symptoms will return, and you will lose your ability to burp easily again. And the cycle repeats and the Pellagra symptoms come back with a vengeance.
    Read more at The Case of Mistaken Identity: How Pellagra now thought to be rare became known as Celiac Disease ? A White Paper by the Celiac Posterboy.
    References:
    https://pellagradisease.wordpress.com/  http://blogs.creighton.edu/heaney/2013/11/18/pellagra-and-the-four-ds/ https://pellagradisease.wordpress.com/ http://glutenfreeworks.com/blog/2010/06/23/niacin-vitamin-b3-deficiency-in-celiac-disease/ Prousky, Jonathan E. Is Vitamin B3 Dependency a Causal Factor in the Development of Hypochlorhydria and Achlorhydria? Journal of Orthomolecular Medicine, Vol. 16, No. 4, 4th quarter 2001, pp. 225-37. http://www.orthomolecular.org/library/jom/2001/articles/2001-v16n04-p225.shtml http://blogs.creighton.edu/heaney/2013/11/18/pellagra-and-the-four-ds/ International Journal of Celiac Disease. Celiac Disease: Intestinal, Heart and Skin Interconnections. 2015, 3(1), 28-30 doi:10.12691/ijcd-3-1-6 (http://pubs.sciepub.com/ijcd/3/1/6/) International Journal of Celiac Disease. Two Exceptional Complications Revealing Celiac Disease: Ischemic Cardiomyopathy and Pellagra. International Journal of Celiac Disease. 2015, 3(1), 31-32 doi:10.12691/ijcd-3-1-5. (http://pubs.sciepub.com/ijcd/3/1/5/)

  • 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