• Join our community!

    Do you have questions about celiac disease or the gluten-free diet?

  • Ads by Google:
     




    Get email alerts Subscribe to Celiac.com's FREE weekly eNewsletter

    Ads by Google:



       Get email alertsSubscribe to Celiac.com's FREE weekly eNewsletter

  • Member Statistics

    77,274
    Total Members
    3,093
    Most Online
    GFsista
    Newest Member
    GFsista
    Joined
  • 0

    Can Enzyme Supplements Really Break Down Gluten?


    Jefferson Adams

    Celiac.com 11/02/2011 - With the rise in celiac disease diagnoses, increasing awareness of gluten-free issues, and an explosion of gluten-free related products, it is no surprise that supplements claiming to break down gluten would find their way onto the market.


    Ads by Google:




    ARTICLE CONTINUES BELOW ADS
    Ads by Google:



    In fact, a number of supplements currently on the market claim to do just that: to break down gluten after it has been consumed.

    Photo: CC--ITA Image LibraryAre these claims accurate? Are these products in any way helpful for people following a gluten-free diet? Finally, do these supplements offer a safe alternative to a gluten-free diet for people who suffer from celiac disease and/or gluten-sensitivity?

    For example, GlutenEase, made by Enzymedica Inc., contains a blend of enzymes, including amylase, glucoamylase and dipeptidyl peptidase-4 (DDP-IV) — that are intended to "digest both gluten and casein, a protein found in milk," according to the company.

    The website for GlutenEase says that the supplement can "support" people who have trouble digesting gluten. However, and most importantly, the site says that GlutenEase is "not formulated" for people with celiac disease.

    Gluten Defense, made by Enzymatic Therapy Inc., contains a similar blend of enzymes that includes DDP-IV, lactase and amylase.

    The site for Gluten Defense says the product is "specifically formulated to defend against hidden gluten" that can cause gas, bloating and indigestion.

    But what does that mean? Does that mean that taking the supplement might offer people with celiac disease some extra protection against accidental gluten contamination? That seems doubtful, and unproven from a scientific standpoint.

    Unlike GlutenEase, Gluten Defense offers no specific disclaimer for people with celiac disease. There is also no claim that the product is safe, or in any way formulated for people with celiac disease.

    Dave Barton, whose title is "Director of Education" for Enzymedica, claims that many people who say they have celiac disease see improvement when taking product, and that some even manage to begin eating wheat again.

    However, Barton is quick to warn consumers that there's "no way to guarantee that it would break down 100% of gluten proteins."

    But that's the problem isn't it? It would need to break down nearly all of the gluten proteins in order for those proteins to not cause damage to the person with celiac disease.

    The fact is that these enzyme supplements may break down a few molecules of gluten protein, but no supplement exists that will make it safe for people with celiac disease to eat gluten again.

    According to Dr. Stefano Guandalini, professor of pediatrics and director of the University of Chicago Celiac Disease Center, "[t]he amount of gluten that these would be able to digest is ridiculously low. For people with celiac disease, these are something to completely avoid."

    Dr. Peter Green, director of the Columbia University's Celiac Disease Center, agrees that current enzyme supplements would digest only a small percentage of gluten molecules.

    However, Green adds, the basic concept is sound. Pharmaceutical companies are spending hundreds of millions of dollars to create an enzyme-based drug that would permit people with celiac disease to consume gluten. However, Green points out, the companies wouldn't be spending that money if a successful over-the-counter alternative already existed.

    Bottom line: Enzymes currently claiming to help break down gluten protein will not permit people with celiac disease to safely consume products made with wheat, rye or barley. Any benefit these enzymes may provide for people with celiac disease is strictly theoretical, and likely minimal at best.

    A completely gluten-free diet is currently the only proven treatment for celiac disease. Talk with your doctor before making any changes to your gluten-free diet for celiac disease treatment.

    Source:

    0


    User Feedback

    Recommended Comments

    Guest Maureen McCabe

    Posted

    I had celiac disease as a child and took enzyme pills. This would have been in the 1960s.

    Share this comment


    Link to comment
    Share on other sites

    Very good information, especially since there seems to be a new "gluten enzyme" tablet appearing every month or so.

    Share this comment


    Link to comment
    Share on other sites

    I don't know if these products work, though they may be helpful for people with mild non-celiac gluten intolerance or for anyone with gluten intolerance who gets an accidental exposure. But I wanted to respond to your comment:

     

    "Pharmaceutical companies are spending hundreds of millions of dollars to create an enzyme-based drug that would permit people with celiac disease to consume gluten. However...the companies wouldn't be spending that money if a successful over-the-counter alternative already existed."

     

    Unfortunately, this is completely untrue. Pharmaceutical companies have the goal of making money and they can't make money off of supplements because they can't patent them. So not only do they spend countless dollars creating drugs to do things that supplements may already do, they also spend money to create versions of supplements that they can call drugs and patent. Then they spend countless more dollars convincing doctors and medical organizations that supplements don't work, unless it's their version, and that only prescription products are appropriate.

     

    So I wouldn't make assumptions about the credibility of an OTC product based on what pharmaceutical companies choose to do. What I would like to see are some studies testing the enzyme products in a variety of real world situations, as well as in more controlled ways.

     

    Though at this point I'd be happy to see even a solid collection of anecdotes, since those don't seem to be out there (I don't count what's on the companies' websites). I was hoping your article would start this process, but it seems to be mostly guesswork.

    Share this comment


    Link to comment
    Share on other sites
    Guest ourGFfamily

    Posted

    I don't know if it is true that "companies would not be spending that money if a successful over the counter product existed." Over the counter plant based enzymes can't be patented so often they have to isolate the components to make a drug that can make money. There are ton of prescription and over the counter medications that are based on the active ingredient is a herb or supplement that is isolated. For instance Deplin, a drug for depression, is just a form of folate you can buy as a supplement. The supplement existed before Deplin made it a pharmaceutical. The company that makes deplin just did the research studies to prove it worked. So, just to reiterated, companies do take products that already exist and make them drugs to bring to mainstream markets. Great article. Thanks.

    Share this comment


    Link to comment
    Share on other sites

    Anecdotally, Gluten Defense has helped our family suffer less from contamination issues when eating out. Of course it doesn't let you go and knowingly eat gluten, it's not claiming to do that and anyone who does that is just silly. We know the only treatment is a life-long gluten free diet. But in terms of minimizing discomfort when you want to go out for a meal with friends or something, I think it's helpful.

    Share this comment


    Link to comment
    Share on other sites

    Good article, Jeff. I actually take the digestive enzymes from Enzymedica currently for regular meals, but I too find the idea of digesting the gluten enzymes to be a BAD thing to market. Not only does this give those of us with celiac the false impression that it is safe to consume some wheat again, but at best this product would help ease symptoms of "accidental" glutening through cross contamination and what not.

     

    I wish America in general would get off of the "wheat, corn, and soy or bust" mentality that leads to these kinds of product developments for Celiac's. Sure, I'm sure most of us are crying on the inside with the loss of wheat (2 years gluten free myself), but after all we're forced to learn when trying to heal we know how unhealthy wheat can be.

    Share this comment


    Link to comment
    Share on other sites

    I keep some of the supplements in my purse and take some if I think there might be a chance I was exposed to gluten accidentally. I figure, what the heck, it might help, who knows? I would never purposefully eat gluten and then try to counter it with these products, though.

    Share this comment


    Link to comment
    Share on other sites
    Guest Michele

    Posted

    All I can say is that my husband has not had his biopsy yet, so unsure if celiac, but he DEFINITELY has a gluten intolerance. He has used Gluten-ese when he has consumed accidental gluten (a contaminated food), and if he takes it at the first sign of problems - as soon as he realizes there is an issue - the symptoms quickly subside. I am not saying that damage wasn't done, but he believes that it helps minimize it. He now also takes it if we go out to eat. He will still order gluten free foods, but this helps him in case of cross-contamination, which seems to happen more often than not in restaurants....

    Share this comment


    Link to comment
    Share on other sites

    After breaking out in dermatitis herpetiformis and the usual bowel distress the last 2 times I tried to eat in restaurants that assured me my food was gluten free I've learned I simply can never eat in restaurants. This makes life difficult to say the least as it limits any traveling. If this would help to neutralize that unsuspected crumb in my food because of cross contamination in a restaurant kitchen it would be worth using. I would like to know if used for that purpose if it is effective. I might risk supposedly gluten free restaurant food again if it is.

    Share this comment


    Link to comment
    Share on other sites
    After breaking out in dermatitis herpetiformis and the usual bowel distress the last 2 times I tried to eat in restaurants that assured me my food was gluten free I've learned I simply can never eat in restaurants. This makes life difficult to say the least as it limits any traveling. If this would help to neutralize that unsuspected crumb in my food because of cross contamination in a restaurant kitchen it would be worth using. I would like to know if used for that purpose if it is effective. I might risk supposedly gluten free restaurant food again if it is.

    I am in the same situation. The DH makes us much more aware of what we are consuming, but it makes it impossible to eat in anything except a gluten free establishment. I also would love to have something that would keep minute amounts from getting into my system and causing my DH to react.

    Share this comment


    Link to comment
    Share on other sites
    Guest Jeff Kelly

    Posted

    The emphasis on safety is extremely well placed in this article and those thinking otherwise are only kidding themselves. Of course, Stanford University has been working on two types of enzymes for years. And even though I agree the basic concept is sound--in practice this may not be the best and most likely--if and when it can get to market--the larezotide acetate(ie, zonulin blocker) will do the trick, but there again, only if taken properly to cover mealtimes. We all need to keep on Teva Pharm. to keep the ball rolling for AT1001!!(Alba->Cephalon->Teva: company rights purchase history).

    Share this comment


    Link to comment
    Share on other sites

    Maybe the people in the celiac community should conduct our own trials using these enzymes, since no one wants to commit to anything working except a gluten-free diet! It makes me so mad every time I read that line... Like we don't know that we can't eat bread! We just want to be able to eat gluten free meals without added fear of cross-contamination! I have read many positive reviews of these enzyme products from people using them as that "safety-net." My husband is a university student who eats at the dining hall. He hasn't been able to go a week at school without cross-contamination! He verifies every item with the chef, who has been so kind as to start labeling things gluten-free, but still can't go a week without the migraines, narcolepsy, and GI symptoms. I bought [an enzyme brand] for him two weeks ago and he hasn't had an issue since.

    Share this comment


    Link to comment
    Share on other sites
    Guest aleynairey@gmail.com

    Posted

    I take these enzymes every time I eat out to avoid cross contamination. Even though waiters/waitresses try, sometimes I get poisoned. These enzymes really help me if I take them with a meal. I still order all gluten free.

    Share this comment


    Link to comment
    Share on other sites
    Guest yellowoctopus

    Posted

    "The fact is that these enzyme supplements may break down a few molecules of gluten protein, but no supplement exists that will make it safe for people with celiac disease to eat gluten again."

     

    Admittedly I'm as skeptical as the author is, but this is not a fact. There is no scientific evidence that proves that these enzyme breaks down only 'a few molecules of gluten protein'.

     

    More investigation is needed to study the role of these enzymes, especially how they work within the GI tract before anyone should completely dismiss it.

    Share this comment


    Link to comment
    Share on other sites
    Guest gfleslye

    Posted

    This info was great. I've been trying to decide if I want to try enzymes. After reading some of the posts I'm going to do it. Eating out has been nearly impossible. My husband is a CEO of a hospital and his job requires us to take people to dinner meetings and I keep getting sick from cross contamination. I never eat out unless I have to but I hope the enzymes help.

    Share this comment


    Link to comment
    Share on other sites

    I think the main thing is digesting blood bound whole proteins, something that supplements could do fairly easily. If you're taking it 3 times a day, your blood will not be burdened by it. Personally, I think papain or bromelain could do this cheaper. This is really how enzymes work, and it's a mistake to think it should try and digest the actual meal. Even so, whether this will help mild, mid or severe celiacs is only gonna be known by trying it.

    Share this comment


    Link to comment
    Share on other sites

    I take them and as long as I take one and actually pour it on the food and swallow another one, I do great. I have noticed that I feel a lot better from many hidden gluten products. I don't sell these.

    Share this comment


    Link to comment
    Share on other sites

    I'm beginning to wonder if enzyme deficiencies are really the bodies signallying to us that we have over consumed.

    Share this comment


    Link to comment
    Share on other sites


    Your content will need to be approved by a moderator

    Guest
    You are commenting as a guest. If you have an account, please sign in.
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • Popular Contributors

  • Ads by Google:

  • Who's Online   18 Members, 1 Anonymous, 1,121 Guests (See full list)

  • Related Articles

    Jefferson Adams
    Celiac.com 02/08/2011 - Valentine's Day is upon us once again, and, once again, the options are many. Dine in? Dine out? Sweets or no sweets? Chocolates? Cakes? Candies? How to make sure it's all gluten-free?
    The choices can be daunting enough, but for people with a gluten-free spouse or loved one, those choices can make or break a Valentine's Day celebration.
    To make things easier and to help you have the best possible gluten-free Valentine's Day, celiac.com has prepared this list of ideas and tips.
    Candy:
    For a comprehensive list of gluten-free candies, please see Celiac.com's Gluten-friendly and Gluten-Free Candy and Treats.
    Dine-in:
    For an easy, intimate Valentine's dinner at home, try gluten-free Cornish Game Hens.
    Dessert:
    Gluten-free Chocolate Valentine's Mousse
    Ingredients:
    8 strawberries (optional)
    Chocolate Hearts (optional)
    1/3 cup sugar
    3 tablespoons cornstarch
    1 cup milk
    ½ cup water
    4 egg yolks, beaten
    1 ¾ cups Hershey's Semi-Sweet Chocolate Chips or Hershey's Milk Chocolate Chips
    1 teaspoon vanilla extract
    ¾ cup whipping cream, whipped
    ½ cup whipping cream, whippedDirections:

    Prepare Chocolate Hearts. Stir together sugar and cornstarch in medium heavy saucepan. Stir in milk and water. Cook and stir over medium-high heat until boiling. Stir about half of hot mixture into beaten egg yolks. Return all to saucepan. Boil gently 1 minute, stirring constantly. Remove from heat. Add chocolate chips and vanilla to hot mixture; stir until chocolate is melted. Pour into small metal bowl. Set bowl inside a larger bowl filled with ice water. Beat on high speed of mixer about 5 minutes or until chocolate mixture is completely cooled. Fold in the whipped ¾ cup cream. Spoon into martini glasses or dessert dishes. Cover lightly with plastic wrap. Refrigerate 30 minutes or up to 2 days. Just before serving, top each with a dollop of the whipped ½ cup cream and a strawberry, if desired. Peel chocolate hearts from wax paper; place one on each dessert. 8 servings. Chocolate Hearts: Place ¼ cup Hershey's Semi-Sweet Chocolate Chips or Milk Chocolate Chips and ½ teaspoon shortening (do not use butter, margarine, spread or oil) in small microwave-safe bowl. Microwave at HIGH (100%) 45 seconds; stir until melted. Let stand 2 minutes. Pour into heavy duty small plastic bag, Cut off a tiny corner of the bag. Squeeze bag to pipe mixture into heart shapes on wax paper. Refrigerate until firm.Tip: To form perfectly shaped chocolate hearts, trace around a small heart-shaped cookie cutter on a piece of white paper. Tape wax paper over the white paper; pipe chocolate on wax paper following the outline.
    For an alternative to chocolate mousse, gluten-free baked apples make a great Valentine's treat.
    If baking is the path to the heart of your beloved, then try making this flowerless chocolate cake.

    Flourless Chocolate Valentine's Cake
    Ingredients:
    8-10 strawberries
    1/2 cup water
    1/4 teaspoon salt
    3/4 cup white sugar
    1 tablespoon of powdered sugar
    18 ounces bittersweet chocolate in small pieces
    1 cup unsalted butter
    6 eggs
    Sprig of mint (garnish)Directions:
    Heat oven to 300 degrees F (150 degrees C).
    Grease one 10 inch round cake pan and set aside.
    In a small saucepan over medium heat combine the water, salt and sugar. Stir until completely dissolved and set aside.
    Use a double boiler or a microwave oven to melt the bittersweet chocolate.
    Pour the melted chocolate into a mixing bowl.
    Cut the butter into small pieces and beat the butter into the chocolate, 1 piece at a time. Beat in the hot sugar-water. Slowly beat in the eggs, one at a time.
    Pour the mixture into the greased cake pan.
    Fill a pan that is larger than the cake pan halfway with boiling water.
    Place the cake pan and mixture into the pan with the boiling water.
    Bake cake in the water bath at 300 degrees F (150 degrees C) for 45 minutes. When the cake is done, the center will still look wet.
    Remove the pan from the water and place in a refrigerator overnight. To release from the mold, place the bottom of the cake pan in hot water for 10-15 seconds and flip onto a serving plate. Dust with powdered sugar. Garnish each slice with strawberry, and a sprig of mint.
    Gluten-free Valentine Cookie Delivery:
    If baking is the key to your gluten-free Valentine's heart, yet you have no time to bake, try ordering some delicious gluten-free cookies from Beautiful Sweets, the cookies Al Rokker calls "the most beautiful cookies in the world."
    Dine-out:
    Dining out at a romantic restaurant is a time-honored way to put a smile on your Valentine's face. You'll get extra points if you can pull off a romantic Valentine restaurant dinner for your gluten-free loved one.
    Remember, certain types of cuisine are more naturally gluten-free than others. Generally speaking, Asian, Mexican, Central- and South American cuisines are a good bet. However, with a bit of scouting, even Italian can deliver a great gluten-free Valentine's dinner.
    Many full-service Italian restaurant feature secondi piatti, such as roasted meats, seafoods, and risottos, Many of these are gluten-free, or can be prepared without flour.
    Whatever cuisine you choose, be sure to call ahead to the restaurant, and to ask about any menu item, or method of preparation if you are not sure about the gluten status.
    So, the key to a great gluten-free Valentine's Day is a bit of planning, some double-checking, and dash of pure romance.
    With those things in your favor, your'e sure to deliver a great gluten-free Valentine's Day!


    Jefferson Adams
    Celiac.com 11/27/2014 - A growing desire to avoid gluten is changing the food industry in myriad ways, so says an article in the Oct 25th 2014 edition of the Economist.
    The article points to a fast rising consumer demand for gluten-free products that began with sufferers of celiac disease, but has quickly grown to include large numbers of health conscious eaters, and which shows no sign of slowing down.
    They cite a recent survey by market research firm Mintel, which says sales of gluten-free food and drink in the U.S. have surged from $5.4 billion to $8.8 billion since 2012, and are set to grow a further 20% by 2015.
    They note that Mintel forecasts a 61% growth in gluten-free food sales in America by 2017, with similar increases expected in other rich countries, and they also point to double-digit sales growth of gluten-free products in most European countries--with Britain leading the way.
    Basically, gluten-free food is a strong enough influence on businesses that it is changing the offerings at food markets and eating establishments across the board.
    Grocers are giving precious shelf space, and restaurants are shifting their menus to incorporate gluten-free offerings. It was recently reported that more than half of restaurants in the U.S. will include gluten-free items on this menus by the end of 2014.
    And, as the Economist notes, Europe is following suit. “Even small convenience stores in remote parts of rural Ireland and Italy now stock ranges of gluten-free bread and cakes,” the magazine points out. The big losers here, in terms of market share are other specialty products, such as vegetarian and meat replacement products, whose sales have fallen flat.
    Interestingly, the trend is being ruled not by fad dieters, but largely by people worried about their health. The Economist points to a survey by the research firm Kantar, which found that only about 1 in 5 people who buy gluten-free food say they buy it for non-medical reasons.
    Read the complete article in The Economist.

  • Recent Articles

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

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

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

    Jefferson Adams
    Celiac.com 06/13/2018 - There have been numerous reports that olmesartan, aka Benicar, seems to trigger sprue‐like enteropathy in many patients, but so far, studies have produced mixed results, and there really hasn’t been a rigorous study of the issue. A team of researchers recently set out to assess whether olmesartan is associated with a higher rate of enteropathy compared with other angiotensin II receptor blockers (ARBs).
    The research team included Y.‐H. Dong; Y. Jin; TN Tsacogianis; M He; PH Hsieh; and JJ Gagne. They are variously affiliated with the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School in Boston, MA, USA; the Faculty of Pharmacy, School of Pharmaceutical Science at National Yang‐Ming University in Taipei, Taiwan; and the Department of Hepato‐Gastroenterology, Chi Mei Medical Center in Tainan, Taiwan.
    To get solid data on the issue, the team conducted a cohort study among ARB initiators in 5 US claims databases covering numerous health insurers. They used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for enteropathy‐related outcomes, including celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy. In all, they found nearly two million eligible patients. 
    They then assessed those patients and compared the results for olmesartan initiators to initiators of other ARBs after propensity score (PS) matching. They found unadjusted incidence rates of 0.82, 1.41, 1.66 and 29.20 per 1,000 person‐years for celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy respectively. 
    After PS matching comparing olmesartan to other ARBs, hazard ratios were 1.21 (95% CI, 1.05‐1.40), 1.00 (95% CI, 0.88‐1.13), 1.22 (95% CI, 1.10‐1.36) and 1.04 (95% CI, 1.01‐1.07) for each outcome. Patients aged 65 years and older showed greater hazard ratios for celiac disease, as did patients receiving treatment for more than 1 year, and patients receiving higher cumulative olmesartan doses.
    This is the first comprehensive multi‐database study to document a higher rate of enteropathy in olmesartan initiators as compared to initiators of other ARBs, though absolute rates were low for both groups.
    Source:
    Alimentary Pharmacology & Therapeutics

    Jefferson Adams
    Celiac.com 06/12/2018 - A life-long gluten-free diet is the only proven treatment for celiac disease. However, current methods for assessing gluten-free diet compliance are lack the sensitivity to detect occasional dietary transgressions that may cause gut mucosal damage. So, basically, there’s currently no good way to tell if celiac patients are suffering gut damage from low-level gluten contamination.
    A team of researchers recently set out to develop a method to determine gluten intake and monitor gluten-free dietary compliance in patients with celiac disease, and to determine its correlation with mucosal damage. The research team included ML Moreno, Á Cebolla, A Muñoz-Suano, C Carrillo-Carrion, I Comino, Á Pizarro, F León, A Rodríguez-Herrera, and C Sousa. They are variously affiliated with Facultad de Farmacia, Departamento de Microbiología y Parasitología, Universidad de Sevilla, Sevilla, Spain; Biomedal S.L., Sevilla, Spain; Unidad Clínica de Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Celimmune, Bethesda, Maryland, USA; and the Unidad de Gastroenterología y Nutrición, Instituto Hispalense de Pediatría, Sevilla, Spain.
    For their study, the team collected urine samples from 76 healthy subjects and 58 patients with celiac disease subjected to different gluten dietary conditions. To quantify gluten immunogenic peptides in solid-phase extracted urines, the team used a lateral flow test (LFT) with the highly sensitive and specific G12 monoclonal antibody for the most dominant GIPs and an LFT reader. 
    They detected GIPs in concentrated urines from healthy individuals previously subjected to gluten-free diet as early as 4-6 h after single gluten intake, and for 1-2 days afterward. The urine test showed gluten ingestion in about 50% of patients. Biopsy analysis showed that nearly 9 out of 10 celiac patients with no villous atrophy had no detectable GIP in urine, while all patients with quantifiable GIP in urine showed signs of gut damage.
    The ability to use GIP in urine to reveal gluten consumption will likely help lead to new and non-invasive methods for monitoring gluten-free diet compliance. The test is sensitive, specific and simple enough for clinical monitoring of celiac patients, as well as for basic and clinical research applications including drug development.
    Source:
    Gut. 2017 Feb;66(2):250-257.  doi: 10.1136/gutjnl-2015-310148.