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    • Scott Adams

      Frequently Asked Questions About Celiac Disease   04/24/2018

      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 is Celiac Disease and the Gluten-Free Diet? 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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  • Related Articles

    Jefferson Adams
    Celiac.com 09/21/2009 - Failure of the hepatitis B vaccine in people with celiac disease is common. In fact, vaccine failure occurs in about 50% of all attempts to vaccinate people with celiac disease against hepatitis B. Research shows that age at celiac diagnosis and other factors can influence response rates.
    The August 12 issue of the medical journal Vaccine features a timely article on failure of the hepatitis B vaccine in people with celiac disease, which asks the very sensible question of whether it is time to reevaluate our current vaccine procedures.
    One of the most important signs of non-responsiveness to the hepatitis B vaccine is a genetic marker called human leukocyte antigen (HLA) phenotype DQ2. It's interesting that people with celiac disease often carry these same genetic markers, and that fact is at the center of one hypothesis about why celiac patients are less able to respond to the hepatitis B vaccine.
    A team of researchers recently set out to assess responsiveness rates to the hepatitis B vaccine among patients with celiac disease. The team was made up of S. Leonardi, M. Spina, L. Spicuzza, N. Rotolo, and M. La Rosa of the Broncho-Pneumology & Cystic Fibrosis Unit of the Department of Pediatrics at the University of Catania, in Catania, Italy.
    The team describes the results of a retrospective study on celiac patients vaccinated with three intramuscular injections of recombinant hepatitis B vaccine (Engerix in doses of 10mug at 3, 5 and 11 months of age.
    Their results showed that half of the celiac disease patients (50%) failed to respond to the vaccine course, and that those who did best were less than 18 months of age at the time of diagnosis for celiac disease; that group showed a significantly higher response rate to the vaccine.
    The study confirms that celiac patients have a far higher failure rate for hepatitis B vaccination than healthy control subjects. These results strengthen the call to re-evaluate current hepatitis B vaccine strategies for patients with celiac disease and to assess whether to recommend a course of re-vaccination.
    Source: Vaccine - August 12, 2009.


    Jefferson Adams
    Celiac.com 06/12/2014 - Here are five things people with celiac disease need regular folks to know about celiac disease:
    We are NOT on a Fad Diet—Celiac disease is not some vague, make-believe condition. Celiac disease is a potentially serious immune disorder that, if left untreated, can lead to a very deadly types of stomach, intestinal, and other cancers. Just because a bunch of people seem to think that gluten is the new high fructose corn syrup, doesn’t mean that I’m one of them. Remember, for people with celiac disease, gluten is no joke, and avoiding gluten is the only way to stay healthy. We Won’t Be Getting Over It—Currently, there is no cure for celiac disease, and the only treatment is a gluten-free diet. That’s the only way to avoid the gut damage, lower risks for other types of auto-immune conditions, and minimize the risk of various types of cancer associated with celiac disease. Celiac Disease is a Serious Condition—Since the effects of untreated celiac disease unfold slowly over time, it’s tempting for some people to look at celiac disease as a minor inconvenience. However, it’s important to understand that celiac disease is a potentially serious autoimmune disorder that, if left untreated, can leave people susceptible to other autoimmune conditions, and to deadly types of stomach, intestinal, and other cancers.  A ‘Little Gluten’ Might Hurt Me—There’s no such thing as ‘a little gluten’ to people with celiac disease. Gut damage happens with as little as 20 parts of gluten per million. That is a microscopic amount. A 'gluten-free' diet means no gluten. Period. When in Doubt, Ask—If you’re not sure if I can safely eat a certain ingredient, or a certain food, just ask. Figuring out what is or is not gluten-free can be tricky, even for me. So, it's best to ask if you're not positive. Can you think of others?
     

    Jefferson Adams
    Celiac.com 10/06/2014 - Anyone who has ever had difficulty ordering gluten-free food at a restaurant can likely appreciate the scene that recently played out at a San Francisco restaurant called SO.
    After back-to-back problems with “rude customers,” employees of the eatery staged a walkout. The next morning, the management posted a sign that not only made their feelings clear about the situation, but let no doubt about they position on MSG, organic food, and gluten-free food.
    The sign read:

    We are CLOSED
    Because of You
    (Customers)
    SO…
    *YES we use MSG!
    SO…
    *We don’t believe in organic food
    AND…don’t give a
    s$#& about gluten free
    The walkout allegedly occurred after one party refused to pay for food they said was ‘too spicy,’ and another cursed at the owner.
    Granted, the dustup likely has more to do with rude patrons than with difficult gluten-free diners, but the management is making it clear that this is one place you will not be getting gluten-free food.
    It’s too early to tell whether the SO will suffer any blowback from their actions, but stay tuned for further updates.
    Here is the Yelp! page for SO.
    In the meantime, what do you think? Are you offended at the owner’s attitude? Or maybe happy they have made their position so clear? Or confused to see gluten-free lumped in with MSG and organic food?

    Jefferson Adams
    Celiac.com 05/13/2015 - In addition to being a common ingredient in many commercial food products, gluten is also used in numerous medications, supplements, and vitamins, often as an inert ingredient known as an excipient.
    Because chronic gluten-related inflammation and damage impairs absorption of nutrients, and likely causes malabsorption of oral medications, it is extremely important for people with celiac disease to review the nutrition labels of all foods and beverages, as well as the package inserts (PI) for information about gluten content.
    Most oral medications depend on absorption through the small intestine via passive diffusion. GI-tract damage may shift this diffusion process into systemic circulation, which can result in increased or decreased absorption, depending on the drug molecules.
    Since drug molecules have varying and unique chemical properties, it is hard to determine the exact means of drug absorption in celiac patients, and also hard to determine the impact of celiac disease on drug absorption.
    Based on their molecular properties, researchers suspect the absorption of a number of drugs is impaired by gluten sensitivity.
    These drugs include: acetaminophen, aspirin, indomethacin, levothyroxine, prednisolone, propranolol, and certain antibiotics.
    For these reasons, it is important for doctors to monitor serum drug levels for medications with narrow therapeutic indexes in people with celiac disease. If you have celiac disease, please let your doctor know before you take these drugs.
    Source:
    US Pharmacist. 2014;39(12):44-48.

  • Recent Articles

    Jefferson Adams
    Celiac.com 05/24/2018 - England is facing some hard questions about gluten-free food prescriptions for people with celiac disease. Under England’s National Health Plan, people with celiac disease are eligible for gluten-free foods as part of their medical treatment. 
    The latest research shows that prescription practice for gluten-free foods varies widely, and often seems independent of medical factors. This news has put those prescribing practices under scrutiny.
    "Gluten free prescribing is clearly in a state of flux at the moment, with an apparent rapid reduction in prescribing nationally," say the researchers. Their data analysis revealed that after a steady increase in prescriptions between 1998 and 2010, the prescription rate for gluten free foods has both fallen, and become more variable, in recent years. Not only is there tremendous variation in gluten free prescribing, say the researchers, “this variation appears to exist largely without good reason…”
    Worse still, the research showed that those living in the most deprived areas of the country are the least likely to be prescribed gluten-free products, possibly due to a lower rate of celiac diagnosis in disadvantaged groups, say the researchers.
    But following a public consultation, the government decided earlier this year to restrict the range of gluten free products rather than banning them outright. As research data pile up and gluten-free food becomes cheaper and more ubiquitous, look for more changes to England’s gluten-free prescription program to follow. 
    Read more about this research in the online journal BMJ Open.

    Jefferson Adams
    Celiac.com 05/25/2018 - People with celiac disease need to follow a lifelong gluten-free diet. However, once their guts have healed, they can still be sensitive to gluten. Sometimes even more sensitive than they were before they went gluten-free. Accidental ingestion of gluten can trigger symptoms in celiac patients, such as pain in the gut and diarrhea, and can also cause intestinal damage. 
    A new drug being developed by a company called Amgen eases the effects of people with celiac disease on a gluten-free diet. Researchers working on the drug have announced that their proof-of-concept study shows AMG 714, an anti-IL-15 monoclonal antibody, potentially protects celiac patients from inadvertent gluten exposure by blocking interleukin 15, an important mediator of celiac disease, and leads to fewer symptoms following gluten exposure.
    The drug is intended for people with celiac disease who are following a gluten-free diet, and is designed to protect against modest gluten contamination, not to permit consumption of large amounts of gluten, like bread or pasta.
    AMG 714 is not designed for celiac patients to eat gluten at will, but for small, incidental contamination. Francisco Leon, MD, PhD, study director and consultant for Amgen, says that their team is looking at AMG 714 “for its potential to protect against modest contamination, not deliberately eating large amounts of gluten, like bread or pasta.” 
    Amgen hopes that AMG 714 will help celiac patients on a gluten-free diet to experience fewer or less sever gluten-triggered events.
    Findings of the team’s first phase 2 study of a biologic immune modulator in celiac disease will be presented at the upcoming Digestive Disease Week 2018. 
    Read more at ScienceDaily.com

    Jefferson Adams
    Celiac.com 05/23/2018 - Yes, we at Celiac.com realize that rye bread is not gluten-free, and is not suitable for consumption by people with celiac disease!  That is also true of rye bread that is low in FODMAPs.
    FODMAPs are Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. FODMAPS are molecules found in food, and can be poorly absorbed by some people. Poor FODMAP absorption can cause celiac-like symptoms in some people. FODMAPs have recently emerged as possible culprits in both celiac disease and in irritable bowel syndrome.
    In an effort to determine what, if any, irritable bowel symptoms may triggered by FODMAPs, a team of researchers recently set out to compare the effects of regular vs low-FODMAP rye bread on irritable bowel syndrome (IBS) symptoms and to study gastrointestinal conditions with SmartPill.
    A team of researchers compared low-FODMAP rye bread with regular rye bread in patients irritable bowel syndrome, to see if rye bread low FODMAPs would reduce hydrogen excretion, lower intraluminal pressure, raise colonic pH, improve transit times, and reduce IBS symptoms compared to regular rye bread. The research team included Laura Pirkola, Reijo Laatikainen, Jussi Loponen, Sanna-Maria Hongisto, Markku Hillilä, Anu Nuora, Baoru Yang, Kaisa M Linderborg, and Riitta Freese.
    They are variously affiliated with the Clinic of Gastroenterology; the Division of Nutrition, Department of Food and Environmental Sciences; the Medical Faculty, Pharmacology, Medical Nutrition Physiology, University of Helsinki in Helsinki, Finland; the University of Helsinki and Helsinki University, Hospital Jorvi in Espoo, Finland; with the Food Chemistry and Food Development, Department of Biochemistry, University of Turku inTurku, Finland; and with the Fazer Group/ Fazer Bakeries Ltd in Vantaa, Finland.
    The team wanted to see if rye bread low in FODMAPs would cause reduced hydrogen excretion, lower intraluminal pressure, higher colonic pH, improved transit times, and fewer IBS symptoms than regular rye bread. 
    To do so, they conducted a randomized, double-blind, controlled cross-over meal study. For that study, seven female IBS patients ate study breads at three consecutive meals during one day. The diet was similar for both study periods except for the FODMAP content of the bread consumed during the study day.
    The team used SmartPill, an indigestible motility capsule, to measure intraluminal pH, transit time, and pressure. Their data showed that low-FODMAP rye bread reduced colonic fermentation compared with regular rye bread. They found no differences in pH, pressure, or transit times between the breads. They also found no difference between the two in terms of conditions in the gastrointestinal tract.
    They did note that the gastric residence of SmartPill was slower than expected. SmartPill left the stomach in less than 5 h only once in 14 measurements, and therefore did not follow on par with the rye bread bolus.
    There's been a great deal of interest in FODMAPs and their potential connection to celiac disease and gluten-intolerance. Stay tuned for more information on the role of FODMAPs in celiac disease and/or irritable bowel syndrome.
    Source:
    World J Gastroenterol. 2018 Mar 21; 24(11): 1259–1268.doi:  10.3748/wjg.v24.i11.1259

    Jefferson Adams
    Celiac.com 05/22/2018 - Proteins are the building blocks of life. If scientists can figure out how to create and grow new proteins, they can create new treatments and cures to a multitude of medical, biological and even environmental conditions.
    For a couple of decades now, scientists have been searching for a biological Rosetta stone that would allow them to engineer proteins with precision, but the problem has remained dauntingly complex.  Researchers had a pretty good understanding of the very simple way that the linear chemical code carried by strands of DNA translates into strings of amino acids in proteins. 
    But, one of the main problems in protein engineering has to do with the way proteins fold into their various three-dimensional structures. Until recently, no one has been able to decipher the rules that will predict how proteins fold into those three-dimensional structures.  So even if researchers were somehow able to design a protein with the right shape for a given job, they wouldn’t know how to go about making it from protein’s building blocks, the amino acids.
    But now, scientists like William DeGrado, a chemist at the University of California, San Francisco, and David Baker, director for the Institute for Protein Design at the University of Washington, say that designing proteins will become at least as important as manipulating DNA has been in the past couple of decades.
    After making slow, but incremental progress over the years, scientists have improved their ability to decipher the complex language of protein shapes. Among other things, they’ve gained a better understanding of how then the laws of physics cause the proteins to snap into folded origami-like structures based on the ways amino acids are attracted or repelled by others many places down the chain.
    It is this new ability to decipher the complex language of protein shapes that has fueled their progress. UCSF’s DeGrado is using these new breakthroughs to search for new medicines that will be more stable, both on the shelf and in the body. He is also looking for new ways to treat Alzheimer’s disease and similar neurological conditions, which result when brain proteins fold incorrectly and create toxic deposits.
    Meanwhile, Baker’s is working on a single vaccine that would protect against all strains of the influenza virus, along with a method for breaking down the gluten proteins in wheat, which could help to generate new treatments for people with celiac disease. 
    With new computing power, look for progress on the understanding, design, and construction of brain proteins. As understanding, design and construction improve, look for brain proteins to play a major role in disease research and treatment. This is all great news for people looking to improve our understanding and treatment of celiac disease.
    Source:
    Bloomberg.com

    Jefferson Adams
    Celiac.com 05/21/2018 - Just a year ago, Starbucks debuted their Canadian bacon, egg and cheddar cheese gluten-free sandwich. During that year, the company basked in praise from customers with celiac disease and gluten-sensitivity for their commitment to delivering a safe gluten-free alternative to it’s standard breakfast offerings.
    But that commitment came to an ignoble end recently as Starbucks admitted that their gluten-free sandwich was plagued by  “low sales,” and was simply not sustainable from a company perspective. The sandwich may not have sold well, but it was much-loved by those who came to rely on it.
    With the end of that sandwich came the complaints. Customers on social media were anything but quiet, as seen in numerous posts, tweets and comments pointing out the callous and tone-deaf nature of the announcement which took place in the middle of national Celiac Disease Awareness Month. More than a few posts threatened to dump Starbucks altogether.
    A few of the choice tweets include the following:  
    “If I’m going to get coffee and can’t eat anything might as well be DD. #celiac so your eggbites won’t work for me,” tweeted @NotPerryMason. “They’re discontinuing my @Starbucks gluten-free sandwich which is super sad, but will save me money because I won’t have a reason to go to Starbucks and drop $50 a week,” tweeted @nwillard229. Starbucks is not giving up on gluten-free entirely, though. The company will still offer several items for customers who prefer gluten-free foods, including Sous Vide Egg Bites, a Marshmallow Dream Bar and Siggi’s yogurt.
    Stay tuned to learn more about Starbucks gluten-free foods going forward.