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  • Jefferson Adams
    Jefferson Adams

    Man's Fall in Shower Leads to Celiac Diagnosis

    Reviewed and edited by a celiac disease expert.

    Celiac.com 07/22/2016 - You think you have a crazy celiac disease diagnosis story? Try this one. When a college student fell and struck his shoulder while showering, he went to the emergency treatment center.

    There, in addition to shoulder pain from the fall, he complained of numbness in his feet, along with general weakness and fatigue in the preceding few weeks. Blood tests showed the man had mild anemia, prompting the doctor to check his vitamin B-12 level, which was also low. This was puzzling.



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    The patient was a 20-year-old, seemingly healthy Asian man, whose omnivorous diet should have provided enough B-12 to sustain normal blood levels. That meant that the next likely cause was poor B-12 absorption through the stomach or intestines.

    Besides pernicious anemia, which is marked by the absence of a protein in the stomach, the most frequent causes of B-12 malabsorption include celiac disease, HIV, chronic inflammation of the pancreas and even a type of tapeworm infection. The man's youth and general good health seems to rule out pernicious anemia.

    Although he had adhered to a more typical Chinese diet that was heavy on fish and rice, he had recently been eating a lot of pizza. Pizza means gluten. Lots of gluten. So could he have celiac disease?

    Although most commonly associated with some sort of gastrointestinal distress, such as diarrhea or abdominal cramping, celiac disease can have other symptoms, such as fatigue and numbness of extremities. Celiac often interferes with the gut's ability to absorb vitamin B-12.

    Ultimately, the patient met with a gastroenterologist who diagnosed celiac disease. The patient saw his B-12 levels return to normal when he began a gluten-free diet. The numbness has also improved.

    So, remember, celiac disease can have some vague and confusing symptoms that will usually improve significantly with a gluten-free diet.

    Have a wild celiac disease diagnosis story of your own?

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    Joanne, Agreed! I have had numbness in my left foot pad for 30 years which was undiagnosed and has now affected my balance somewhat, however not even close to where I would consider myself disabled. Very slow progress - luckily. I recently found that I have celiac disease and have been on a gluten-free diet for over 6 months. I hope this will arrest the PN progress but I have no illusions that the diet might reverse it.

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  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.


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  • Related Articles

    Scott Adams
    I have a big issue with what I believe to be a misleading headline in a recent joint press release by Domino's Pizza and the National Foundation for Celiac Awareness (NFCA)...here is the headline:
    "Domino’s Pizza Becomes First National Pizza Delivery Chain to Offer Gluten Free Crust"
    When you read the release further, starting at the 5th paragraph, which many people will never get to, it says:
    "While Domino’s new Gluten Free Crust is appropriate for those with mild gluten sensitivity, Domino’s and the NFCA do not recommend it for those with celiac disease. Domino’s and the NFCA found that while the crust is certified as gluten free, current store operations at Domino’s cannot guarantee that each handcrafted pizza will be completely free from gluten."
    So my question is this: How can the NFCA, a national organization dedicated to supporting celiacs, actually get behind this? Domino's is obviously a big corporation that has decided it wants to cash in and profit on the new gluten-free gold rush, but they cleary don't want to spend the money that it would take to make their pizzas truely gluten-free, and safe for celiacs.
    The Designations area of the NFCA's web site begins with: "Restaurants that complete GREAT Kitchens earn a designation based on their ability to meet gluten-free needs and avoid cross-contamination with gluten."  Just below this it describes their "Green Designation" and its "Amber Designation," and describes its Amber Designation as follows: "This level requires ingredient verification and basic training of wait staff and managers. Kitchen practices may vary with this designation, level one of the tier system, meaning those with celiac disease and non-celiac gluten sensitivity should ask questions and exercise judgment when dining at an establishment with an Amber Designation. Domino's has earned this designation."  So how has Domino's met "gluten-free needs and avoid cross-contamination with gluten"?
    Also, I think any celiac who watches the video Domino's made for this release will find it a bit scary...the same ovens, pizza scoopers, topping areas, etc., as where they make their regular gluten pizzas.
    I would exclude Domino's as an advertiser on Celiac.com based on this release.
    Some might think that the NFCA has sold out here. I invite them to respond using the comment field below, and I invite you to respond.
     
    Also, there is a lively discussion going on in our forum on this topic.  
    Here is the original press release:
    ANN ARBOR, Mich., May 7, 2012 – Domino's Pizza is responding to the needs of choice consumers, today launching a Gluten Free Crust available in all of its nearly 5,000 U.S. stores and becoming the first national pizza delivery chain to offer such a product.
    Domino’s Pizza (NYSE: DPZ) consulted with the National Foundation for Celiac Awareness (NFCA) to ensure its products and team member training meet the standards of the foundation’s GREAT Kitchens Amber Designation. NFCA’s GREAT Kitchens is an official credentialing program that has expanded to include restaurants offering gluten free products with varying kitchen practices, therefore suitable for those with gluten sensitivity under the Amber Designation.
    Domino’s new Gluten Free Crust provides a great-tasting option for consumers who previously could not enjoy pizza from the recognized world leader in pizza delivery because of sensitivity to gluten – a protein found in wheat, rye and barley.
    “Many of our customers have asked for a gluten free crust, and Domino’s is excited to offer a product to customers with mild gluten sensitivity – as well as partner with the NFCA, which has been instrumental to our learning more about how to take this step,” said J. Patrick Doyle, Domino’s Pizza president and CEO. “The prevalence of gluten sensitivity has become a real issue with significant impact on consumer choice, and we want to be a part of the solution. Now, the whole group can enjoy Domino’s with the addition of our new Gluten Free Crust.”
    While Domino’s new Gluten Free Crust is appropriate for those with mild gluten sensitivity, Domino’s and the NFCA do not recommend it for those with celiac disease. Domino’s and the NFCA found that while the crust is certified as gluten free, current store operations at Domino’s cannot guarantee that each handcrafted pizza will be completely free from gluten.
    “The NFCA is thrilled that Domino’s Pizza has developed a product that will improve the quality of life for many of the estimated 18 million Americans who are gluten sensitive,” said Alice Bast, NFCA founder and president. “Not only is Domino’s Gluten Free Crust a huge win for much of the gluten free community who can now get pizza delivered to their door, it’s also delicious. Customers aren’t going to believe they’re eating a pizza made on a gluten free crust when they try it. And the variety of fresh toppings that are available is a giant leap ahead.”
    In an effort to remain open and informative about Domino’s Gluten Free Crust, Domino’s has created a video on YouTube that allows customers to decide whether this product is suitable for their diet, found here: www.youtube.com/user/dominosvids.
    “Offering Domino’s Gluten Free Crust is a big step for us, and we wanted to make sure we were doing it right,” said Doyle. “Domino’s is doing that by partnering with experts at the NFCA and by empowering the gluten sensitive community with the information they need.”
    Domino’s new Gluten Free Crust is available in stores across the U.S. in a small, 10-inch size only, and prices vary by store.
    Domino’s pizza made with a Gluten Free Crust is prepared in a common kitchen with the risk of gluten exposure. The National Foundation for Celiac Awareness supports the availability of Domino’s Gluten Free Crust, but cannot recommend the pizza for customers with celiac disease. Customers with gluten sensitivities should exercise judgment in consuming this pizza.
    About Domino’s Pizza®
    Founded in 1960, Domino's Pizza is the recognized world leader in pizza delivery.  Domino’s is listed on the NYSE under the symbol “DPZ.”  As of the first quarter of 2012, through its global footprint primarily made up of locally-owned and operated franchises, Domino’s operated a network of 9,810 franchised and Company-owned stores in the United States and over 70 international markets.  During the first quarter of 2012, Domino’s had global retail sales of nearly $1.7 billion, comprised of over $830 million domestically and nearly $855 million internationally.  Domino's Pizza had global retail sales of over $6.9 billion in 2011, comprised of over $3.4 billion domestically and over $3.5 billion internationally. In May 2011, Pizza Today named Domino’s its “Chain of the Year” for the second straight year – making the company a three-time overall winner, and the first pizza delivery company to receive the honor in back-to-back years.  In 2011, Domino’s was ranked #1 in Forbes Magazine’s “Top 20 Franchises for the Money” list.  
     


    Jefferson Adams
    Celiac.com 06/01/2012 - Even as gluten-free bread continue to rise, sales of traditional wheat-based bread are falling across the globe.
    According to Paul Hetherington, a 20 year veteran of the Baking Association of Canada, the plunge is driven by numerous factors, including recent dietary shifts away from wheat and toward gluten-free diets by people who are not adverse to gluten.
    One example, major Canadian baked goods manufacturer, Maple Leaf Foods Inc., recently reported first quarter adjusted earnings of just 11¢ per share, down from 18¢ last year, and well below the 16.8¢ predicted by analysts.
    Maple Leaf president and CEO, Michael McCain, says that the decline was due to a 73% drop in adjusted first quarter earnings by the company's Bakery Products Group, which fell from $12.2-million in 2011 to $3.3-million this year.
    McCain said that his company is experiencing a fate shared across the industry as “fundamental bread consumption is down.”
    Maple Leaf’s net earnings decreased to $800,000 compared with $10.5 million last year, as the company’s adjusted operated earnings dropped 20% to $40.5 million.
    To counter the trend, Maple Leaf plans marketing initiatives to grow sales and to focus on the health benefits of bread and target growth categories, such as English muffins and bagels, he said. The company also expects to benefit from lower commodity costs, including wheat, to improve margins later in the year.
    Source:
    http://business.financialpost.com/2012/05/02/bread-sales-take-a-beating-as-more-consumers-go-gluten-free/


    Courtney Buchanan
    Celiac.com 01/21/2013 - At the end of a long day of class and meetings, Morgan Hembarsky loved to come home to her four roommates eagerly awaiting her to cook their weekly meal together. Immediately when she walked through the door the most important thing to talk about was food, conversation could wait. Was it pasta with marinara and veggies or chicken Parmesan with warm rolls night? "We try to have dinner together at least once a week to catch up," said Hembarsky, a senior at Lehigh University.
    The women sat down to a warm meal together and gossiped about their Lehigh University professors' bad jokes and the new romantic comedy in nearby Lehigh Valley theaters. Cooking and chatting: a girl's perfect way to unwind at the end of the day. But days of cooking with her roommates are gone. Early in the fall of 2011 after months of stomach pain, Hembarsky visited a doctor and received the answer to her suffering.
    The culprit, celiac disease, which is a condition in which one's body cannot digest gluten and eating it damages the small intestine. Because many of the foods Hembarsky and her friends often used to make contained gluten, like pasta and bread, that meant no more pasta nights with her friends. In October 2011 she gave up foods with gluten, the killer protein found in many grains and flours. Being diagnosed with celiac forced a change to the social calendar. "It's something you learn to live with and you learn what healthy decision you need to make," said Hembarsky. Hembarsky is not alone. For many celiacs in Bethlehem, social opportunities are hindered by dietary restrictions such as not being able to eat a hamburger bun or drink beer at a tailgate because they have gluten. Instead of going out with friends, they cook individualized meals at home. Now with more people being diagnosed as gluten-intolerant or celiac – in fact one out of 133 people in the United States is affected by celiac disease, according to the celiac disease Foundation – the choices of where to buy groceries and whether one should go to a restaurant taking the chance of feeling like a burden are at the forefront of people's minds.
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    Three weeks ago, Andrew Bench was sitting at his desk at King, Spry, Herman, Freund & Faul Law Firm in Bethlehem, Pa. , with a stomach ache when he decided to stop eating out as much as possible because of the potential cross contamination. He said many restaurants in the Lehigh Valley have cross contamination even though the waiters told him that the kitchens were being careful. Flash back to when he was diagnosed as celiac a year ago. He described the feeling as a concussion mixed with sinus pressure. Cross contamination could result in the same thing, or worse. Bench recommends Tapas on Main on North Side as a safe gluten-free option. Echavarria likes Red Robin for their protein-style burgers and La Lupita for the corn-based options while Hembarsky prefers salads at Bravo and sushi at Asian Bistro.
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    Wegmans, Giant Food and ShopRite have gluten-free aisles that provide a wide range of options. As he was giving granola samples at Wegmans, Calvin Virgillo, operations and sales at The Granola Factory, recognized a need for gluten-free, nut-free granola, which will be available in 2013. "It doesn't matter how good our granolas if there are people who won't buy it because they're gluten free or have a nut allergy," said Virgillo. With increasing options of places to purchase groceries and dine out, the community is recognizing the gap for this niche market of gluten-free consumers. A day will come when gluten-free diners won't have to worry about missing out on social life because of their diets. Until then, Hembarsky must deal with biting into a dry, hard piece of bread and baking her own treats when she wants to socialize with her roommates. "I think bread is the hardest to be gluten-free because it [the gluten-free version] doesn't taste like bread, but a majority of them aren't that great and they come frozen," said Hembarsky. "But everything else, I feel like you don't have to sacrifice at all. "


    Jefferson Adams
    Celiac.com 05/16/2013 - As more Americans then ever are looking to either reduce the amount of gluten in their diets or to eliminate it entirely, many nutritionists are saying that cutting gluten carelessly can be unnecessary and unhealthy, while others are pointing out that it is likely a waste of money for those who do not suffer from celiac disease or gluten intolerance.
    In a recent poll by market-research company NDP Group, one in three adults said they were looking to cut down or eliminate gluten from their diets. Those are the highest numbers since NDP began asking the question in 2009. In fact, in 2012, TIME magazine put the gluten-free movement at #2 on its top 10 list of food trends.
    Current estimates put the number of Americans with celiac disease (diagnosed or not) at about 3 million. Other studies indicate that as many as many as one in 16 Americans may have a less-severe sensitivity to gluten that can trigger gastrointestinal symptoms.
    For people with celiac disease or gluten-sensitivity, avoiding gluten is not merely beneficial, it is necessary for good health. For everyone else, though, avoiding gluten is unnecessary, provides questionable benefit, and can increase food costs substantially.
    One thing to remember, is that junk food is junk food, whether is contains gluten or not. Many people who do not have celiac disease or gluten-sensitivity, and who feel better after cutting gluten out of their diet, are really benefiting simply because they have eliminated junk foods and/or breaded, fried foods from their diet, not because they have a problem eating gluten.
    On the other hand, many others who do not have celiac disease or gluten-sensitivity, and who simply replace junky, processed foods with gluten-free versions are gaining little or no benefit, and are, in fact, spending money unnecessarily. That's because gluten-free foods usually cost more than their gluten-containing counterparts.
    How much more? When researchers from Dalhousie Medical School at Dalhousie University in Canada compared prices for 56 standard grocery items with similar gluten-free items, they found that the gluten-free products cost about 2½ times more than the gluten-containing versions.
    With more and more food manufacturers producing more and more gluten-free products, the gluten-free market in the United States is projected to grow from $4.2 billion last year to $6.6 billion by 2017.
    But that still doesn't add up to the NPD Group’s finding that 29% of Americans are trying to avoid gluten. The numbers suggest that many consumers are staying away from gluten simply because it’s trendy to do so.
    It is likely true that many people are following gluten-free diets unnecessarily, but it is also true that many more people with celiac disease and gluten sensitivity remain undiagnosed, and the exact nature of those conditions needs to be better understood to know who will fully benefit from a gluten-free diet. In the meantime, look for the gluten-free market to grow, and look for much of that growth to be driven by people without an official diagnosis that actually requires a gluten-free diet.
    Source:
    http://business.time.com/2013/03/13/why-were-wasting-billions-on-gluten-free-food/


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