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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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    ARE GLUTEN-FREE FOODS A WASTE OF MONEY FOR MOST PEOPLE?


    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.


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    Photo: CC--Ron J. AnejoIn 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:


    Image Caption: Photo: CC--Ron J. Anejo
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    Guest Jamie

    Posted

    Only all those stupid, copycat morons out there that use gluten-free food other than having celiac disease are making the gluten-free industry look bad. I for one have had several genetic tests both ethnic and medical and they both said I have celiac tendency, as well as genetic matches in Finland and Ireland where celiac disease is highest and originates from. I can't go too long or feel too well without some gluten-free food.

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    Guest R. M.

    Posted

    I have read that research shows that, while approximately 1% of the population has celiac disease, approximately 30% of the population has the gene giving them the potential to have celiac disease. Isn't it possible that the 29% of the population (mentioned in the article) who think they do better on a gluten-free diet actually do have some gluten sensitivity?

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    I have celiac disease. Gluten-free is not a fad for me. What is most disconcerting about the proliferation of the new gluten-free products on the market is how many contain too much sugar, sodium, and preservatives; in essence they are copies of products containing gluten but without wheat, barley, rye or oats or derivatives of those products. Hence, they are just as unhealthy.

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    Guest Gillian

    Posted

    A gluten-free diet has completely liberated me from a whole host of undesirable symptoms though I have not been diagnosed as celiac/gluten intolerant. When I had tests they came back negative as I had already been gluten-free for three months and I am just not prepared to eat gluten again just to have a certified diagnosis, for me it is sufficient that without the gluten-free diet my symptoms make life not worth living. Having an official diagnosis would not change anything as the only treatment is a gluten-free diet, which I am already benefiting from. As for those on a gluten-free diet for other reasons I don't think that it will do them any harm, and if not forced to stick to it like the celiac/gluten intolerant, after a while, they will probably get fed up with this new fad and go back to their old foods.

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    Guest Ethan

    Posted

    Jefferson you make the statement "...For everyone else, though, avoiding gluten is unnecessary, provides questionable benefit..." I know that you may have others who agree, but with all due respect I strongly disagree. Gluten is bad for everyone. And shame on any nutritionists who claim it's healthy. Are you gluten sensitive or celiac? if so, then you ought to have a more informed point of view here. As a gluten sensitive person whose blood test and intestinal biopsy are all negative, but the celiac DNA test is very high (having both genes), going first gluten free and eventually completely grain free has magically cured a barrage of debilitating symptoms plaguing my entire life. But gluten isn't just bad for me it's bad for everyone and here's why. Going truly gluten free has at least some degree of benefit for everyone. Ultimately only time will tell the truth since this is a newly emerging field of research. For now, take the fact that gluten spikes blood sugar more than table sugar, this applies to everyone not just gluten sensitive folks or celiacs. Which leads to the next point, consider the fact that the majority of our population is over-fat; now eliminate gluten and everyone loses weight and feels better with less blood sugar spikes. (oops I think we just helped prevent type 2 diabetes too!). This applies to everyone, not just the gluten sensitive or celiac folks. Remember that eating highly processed “junk†food labelled gluten free is still bad! Also take the fact that lectins in gluten and other grains can cause intestinal permeability (leaky gut) in everyone not just celiacs, leading to a myriad of other health consequences. The list of problems caused by and linked to gluten goes on. Have you been convinced yet? A paleo-like diet is no joke, there's many reasons why it's making those who try it feel better and no gluten is among the top of that list! If you don't believe me try it. But be careful, you might waste your money going gluten free when it's of questionable benefit.

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    Guest Layla

    Posted

    Because of the Thyroid-Gluten connection more research is showing that a much higher number of people have gluten intolerance than previously estimated. If you read the article The Gluten-Thyroid Connection by Chris Kesser he explains why gluten intolerance has been so difficult to reliable test. He states the research done by Dr. Kenneth Fine done at Entero Labs indicates by more accurately testing people's stool samples that estimates closer to 1 in 3 Americans are Gluten intolerant. Also if you read any number of Forums on Thyroid disease you will find a huge number of people commenting on the fact that when they took Gluten 100% out of their diet their symptoms became significantly better. These are people who have been suffering sometimes for many many years and because thyroid issues are so misunderstood and misdiagnosed are trying to find ways of relieving their pain. I don't think they are following a fad.

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    http://community.statesmanjournal.com/blogs/menumatters/2012/01/27/oregon-subways-add-gluten-free-menu-options/

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    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

    Jefferson Adams
    Celiac.com 04/16/2018 - A team of researchers recently set out to investigate whether alterations in the developing intestinal microbiota and immune markers precede celiac disease onset in infants with family risk for the disease.
    The research team included Marta Olivares, Alan W. Walker, Amalia Capilla, Alfonso Benítez-Páez, Francesc Palau, Julian Parkhill, Gemma Castillejo, and Yolanda Sanz. They are variously affiliated with the Microbial Ecology, Nutrition and Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), C/Catedrático Agustín Escardin, Paterna, Valencia, Spain; the Gut Health Group, The Rowett Institute, University of Aberdeen, Aberdeen, UK; the Genetics and Molecular Medicine Unit, Institute of Biomedicine of Valencia, National Research Council (IBV-CSIC), Valencia, Spain; the Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire UK; the Hospital Universitari de Sant Joan de Reus, IISPV, URV, Tarragona, Spain; the Center for regenerative medicine, Boston university school of medicine, Boston, USA; and the Institut de Recerca Sant Joan de Déu and CIBERER, Hospital Sant Joan de Déu, Barcelona, Spain
    The team conducted a nested case-control study out as part of a larger prospective cohort study, which included healthy full-term newborns (> 200) with at least one first relative with biopsy-verified celiac disease. The present study includes 10 cases of celiac disease, along with 10 best-matched controls who did not develop the disease after 5-year follow-up.
    The team profiled fecal microbiota, as assessed by high-throughput 16S rRNA gene amplicon sequencing, along with immune parameters, at 4 and 6 months of age and related to celiac disease onset. The microbiota of infants who remained healthy showed an increase in bacterial diversity over time, especially by increases in microbiota from the Firmicutes families, those who with no increase in bacterial diversity developed celiac disease.
    Infants who subsequently developed celiac disease showed a significant reduction in sIgA levels over time, while those who remained healthy showed increases in TNF-α correlated to Bifidobacterium spp.
    Healthy children in the control group showed a greater relative abundance of Bifidobacterium longum, while children who developed celiac disease showed increased levels of Bifidobacterium breve and Enterococcus spp.
    The data from this study suggest that early changes in gut microbiota in infants with celiac disease risk could influence immune development, and thus increase risk levels for celiac disease. The team is calling for larger studies to confirm their hypothesis.
    Source:
    Microbiome. 2018; 6: 36. Published online 2018 Feb 20. doi: 10.1186/s40168-018-0415-6