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  • Jefferson Adams
    Jefferson Adams
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    Current Celiac Enzyme Supplements Fail to Fully Break Down Gluten

    Caption: Current enzymes come up short in breaking down gluten. Photo: CC--Superfantastic

    Celiac.com 10/02/2015 - Many people with celiac disease or gluten-intolerance take digestive enzymes, hoping for some protection against accidental gluten-contamination.

    Photo: CC--SuperfantasticPost-proline cutting enzymes have been shown to effectively degrade the immunogenic gluten peptides and have been proposed as oral supplements. Several existing digestive enzyme supplements also claim to aid in gluten degradation.

    However, not all gluten proteins are the same. The gluten proteins that are particularly active in triggering an adverse immune reaction in celiac disease are known as immunogenic 33-mer from α-gliadin and a 26-mer from γ-gliadin.

    So, how effective are currently available digestive enzyme supplements ineffective in breaking down these specific gliadins that triggers immune reactions in people with celiac disease? A team of researchers recently set out to determine the effectiveness of such existing enzyme supplements in comparison with a well characterized post-proline cutting enzyme, Prolyl EndoPeptidase from Aspergillus niger (AN-PEP).

    The research team included G.Janssen, C. Christis, Y. Kooy-Winkelaar, L. Edens, D. Smith, P. van Veelen, and F. Koning. They are variously affiliated with the Department of Immunohematology and Blood Transfusion at Leiden University Medical Centre in Leiden, The Netherlands, DSM Food Specialties, Delft, The Netherlands, and DSM Food Specialties in South Bend, Indiana, USA.

    For their study, the team subjected each of the five commercially available digestive enzyme supplements along with purified digestive enzymes to 1) enzyme assays and 2) mass spectrometric identification. Gluten epitope degradation was monitored by 1) R5 ELISA, 2) mass spectrometric analysis of the degradation products and 3) T cell proliferation assays.

    Their findings show that, due to the high proline content of gluten molecules, gastrointestinal proteases are unable to fully degrade them leaving large proline-rich gluten fragments intact, including an immunogenic 33-mer from α-gliadin and a 26-mer from γ-gliadin.

    Basically, none of the currently available digestive enzyme supplements are effective in degrading immunogenic gluten epitopes. This means that these enzymes are not likely to be helpful to people with celiac disease.

    Share your thoughts in our comments section below.

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    From your reference article:

    "Finally, we have investigated a novel type of prolyl endoprotease from the food grade fungus Aspergillus niger (AN-PEP) [6,10,11]. AN-PEP efficiently degrades gluten under the conditions mimicking the gastrointestinal tract [11] and was found to be safe both in animal studies and in humans [10,12]. Thus in vitro and in vivo experiments indicate that enzymes can be identified that degrade gluten proteins efficiently"

    So the glut&go proylyl endopetidase ANPEP by Bricker Labs works and withstands low PH degration in the stomach. I am going to be using this supplement regularly as my intestinal street sweeper of incidental gliadin intake while continuing the gluten free diet. A most valuable of the year supplement for Celiac persons everywhere in my opinion and study should use this tool to keep gliaden free.

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    Just threw my bottle of enzymes away. Sigh.

    I don't think you need to do that, as they do help break things down, but apparently don't do the job fully.

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    From your reference article:

    "Finally, we have investigated a novel type of prolyl endoprotease from the food grade fungus Aspergillus niger (AN-PEP) [6,10,11]. AN-PEP efficiently degrades gluten under the conditions mimicking the gastrointestinal tract [11] and was found to be safe both in animal studies and in humans [10,12]. Thus in vitro and in vivo experiments indicate that enzymes can be identified that degrade gluten proteins efficiently"

    So the glut&go proylyl endopetidase ANPEP by Bricker Labs works and withstands low PH degration in the stomach. I am going to be using this supplement regularly as my intestinal street sweeper of incidental gliadin intake while continuing the gluten free diet. A most valuable of the year supplement for Celiac persons everywhere in my opinion and study should use this tool to keep gliaden free.

    AN-PEP has only been shown to fully break down gluten in healthy subjects, not in people with celiac disease. Is it better than nothing? Probably, but don't count on it to do the job fully. The maker is working to get AN-PEP to work effectively for celiac patients, but tests don't show success on that yet.

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  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, and science. He previously served as Health News Examiner for Examiner.com, and provided 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.

  • Related Articles

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

    http://www.latimes.com/health/la-he-skeptic-gluten-supplements-20110926,0,2998711.story

    Tina Turbin
    Gluten-Digesting Enzymes
    Celiac.com 01/23/2012 - After their diagnosis, celiac patients are put on the gluten-free diet, which is the only treatment option currently available. The diet requires total elimination of gluten, a protein found in wheat, barley, and rye, which when ingested causes an autoimmune reaction in celiacs which results in damage to the absorptive finger-like projections that line the small intestine, which are called villi. As diligent as celiacs can be, avoiding gluten can be a challenge, and slip-ups can happen, especially when eating out. In my research, I've come across gluten-digesting enzymes as a new medical treatment option for later down the line and have shared this good news with the gluten-free community. However, gluten-digesting enzymes are already available over the counter to help celiacs and gluten-sensitive people with managing their gluten-free diet. Dr. Nan Kathryn Fuchs, who helped to formulate the Advanced Bionutritionals product, Gluten Sensitivity Formula, shares some information regarding these enzymes and clears up a couple of misconceptions regarding their use.

    Furthermore, not all enzyme formulas containing DPP-IV are the same in terms of strength. Dr. Fuchs had her supplement creators formulate a gluten-digesting enzyme that was stronger than the other ones available on the market. The result was Gluten Sensitivity Formula. In her pamphlet, "How to Tell If You're Gluten Sensitive.And What to Do About It If You Are," Dr. Fuchs offers advice on how to take the supplement.
    Dr. Fuchs emphasizes that Gluten Sensitivity Formula isn't intended to replace a gluten-free diet; it is, however, designed to reduce or get rid of a reaction to "small amounts" of what would presumably be unintentionally ingested gluten, such as one may encounter at a restaurant or a dinner party due to cross-contamination. She also recommends taking one or two capsules of the formula "as insurance" before eating meals that might possibly be contaminated with gluten.
    Dr. Fuchs also clears up a myth regarding hydrocholoric acid (HCl), which has been believed to counteract digestive enzymes; this misconception has led to the incorrect advice that one shouldn't take hydrochloric acid and enzymes together. Hydrochloric acid is taken, according to Dr. Fuchs, in order to help with digesting proteins and minerals, for example calcium and iron. She says the supplement is more common among people over the age of 50. In fact, enzymes can only cancel out the benefits of hydrochloric if they alter the pH of the stomach by neutralizing its acids. Dr. Fuchs says that while animal-based enzymes can accomplish this, they are usually formulated with a protective coating or in a form that will prevent this from occurring. What's more, many enzymes, especially gluten-digesting ones, are made from plants. "So you can take them with HCl," Dr. Fuchs says.
    According to Dr. Fuchs, taking gluten-digesting enzymes "can make the difference between being successful on a gluten-free diet and failing." When used correctly, it can help alleviate the symptoms of a reaction caused by accidental gluten ingestion or prevent the reaction from occurring. As a celiac myself, I can say that inadvertent gluten ingestion is still a challenge I face on the gluten-free diet, even though I've been on the diet for years. Dr. Fuch's Gluten Sensitivity Formula is thus a welcome product that will make the lives of the gluten-free community a lot easier.
    Resources:
    Fuchs, Nan Kathryn, PhD. "How to Tell If You're Gluten Sensitive.And What to Do About It If You Are." Advanced Bionutritionals, 2010. "Digest This: Enzymes Can Help Your Food Intolerance." Living Without: August/September 2010. Food Reactions: Food Intolerance http://www.foodreactions.org/intolerance/index.html

    Jefferson Adams
    Celiac.com 08/13/2014 - Even though some folks suffering from symptoms of celiac disease will claim they would welcome death, most people will not actually die from the immediate symptoms of celiac disease; no matter how bad those symptoms get.
    However, left untreated, celiac disease can lead to numerous other conditions, several of which are potentially fatal. Remember, many people experience few, or no classic symptoms of celiac disease. These folks may find it easy to keep eating gluten with relatively few noticeable consequences; at least for a time.
    So, for people with celiac disease who ignore either their doctors, or their bodies, the risks can be huge. They can even lead to death by one of the following:
    1) Cancer—Nobody wants cancer, and especially nobody wants the type of cancer that can strike people with gut damage that comes with long-untreated celiac disease.
    People with untreated celiac disease are at risk of developing any number of associated conditions, including gastrointestinal cancer at rates of 40 to 100 times those of the general population. Chief among these types of cancer are a type known as Enteropathy-Associated T-cell Lymphoma (EATL). EATL is a gut cancer that often ends in death. People with celiac disease also need to watch out for non-Hodgkins lymphoma.
    2) Thyroid Disease - There is a 2.5-fold increased risk of papillary cancer of thyroid for celiac patients.
    The good news is that papillary cancer of the thyroid has a high cure rate, with 10-year survival rates estimated at 80% to 90% for any given patient. Still, the dark side is that 10-20% of patients with papillary cancer of the thyroid don’t survive.
    3) Epilepsy - Rare form of celiac disease.
    Patients with an autoimmune disease faced a nearly four-fold higher risk for epilepsy. In some cases, people with epilepsy can suffer from sudden unexpected death (SUDEP).
    SUDEP are still poorly understood, it is possibly the most common cause of death as a result of complications from epilepsy, accounting for between 7.5 to 17% of all epilepsy related deaths and 50% of all deaths in refractory epilepsy.
    4) Heart Failure - Celiac disease doubles the risk of coronary artery disease, which can, in many cases prove fatal.
    5) Diabetes - Diabetes can cause numerous complications, some of which can be fatal. People with celiac disease have higher rates of diabetes than people without celiac disease. Moreover, long-term celiac disease increases death rates in people with diabetes.
    There is also some evidence that a gluten-free diet can lower rates of Type 1 diabetes.
    In the end, for people with T1D, having a celiac disease diagnosis for at least 15 years was associated with a 2.80 times greater risk of death
    6) Obesity - Recent studies suggest that people with celiac disease are likely to be overweight or obese at the time of presentation.
    Studies show that nearly 40% of people diagnosed with celiac disease are actually overweight, not underweight. Also, a full 30% of celiac disease patients are obese at the time of their diagnosis.
    Of course, long term obesity can increase the likelihood of fatality in numerous categories. People treating celiac disease with a gluten-free diet are more likely to have a healthier weight. 
    So, while celiac disease won't kill anyone in the short term, it can have devastating consequences if it remains untreated for a long period of time. Share your thoughts on these ways to die from untreated celiac disease, or add additional insights in the comments section.

    Jefferson Adams
    Why All the Hate for Celiac Disease Drug Treatments?
    Celiac.com 09/18/2015 - That old saw about death and taxes might need a bit of amending to include complaints about pharmaceutical companies working on celiac drug treatments.
    One interesting facet of our coverage of the development of various drugs to treat and/or cure celiac disease has been the regular presence of comments questioning the motives,and actions of the companies involved.
    It's funny, but no one complains that companies still make money selling aspirin, and that no one has cured a headache, and that there must be some conspiracy to profit off of those who suffer a headache.
    There's no doubt that there's money to be made producing drugs that treat disease. But, if a company can develop and produce a safe drug to protect celiacs against contamination, or to help reduce symptoms, what's wrong with that?
    Just like an aspirin, I can take it or not take it.
    In the old days, ten years ago or more, people with celiac disease generally suffered in silence, with scant gluten-free food choices, and little information. However, in just a decade, we've got a wealth of information, and multi-billion dollar gluten-free foods market and a number of companies developing drugs to treat or cure celiac disease.
    To me, that's a good thing. Still, there are naysayers. Here's a rundown of comments by readers who seem less than enthused about celiac drugs in development.
    Our recent article, An Update on Every Celiac Disease Drug Currently in Development included the comment:
    "Article's fine. Concept's disturbing. Eating a gluten-free diet is the free, already-proven cure for celiac and gluten-intolerance. They don't have to torture mice and likely other animals to find a 'cure' for something that there already is a cure for. I imagine there is $$ for the researchers here and $$ for the animal labs and $$ for the pharmaceuticals."
    Of our article entitled, How Close Are New Celiac Disease Treatments? one reader wrote:
    "I would be very cautious about taking any of these until it was proven absolutely to have no side effects. There always are some and history has shown some to be deadly." Commenting on our article ALV003 Reduces Gluten Damage in Celiac Disease Patients, one reader commented:
    "I only want to know: how long until random internal organs begin to fail or malfunction as a result of yet another new mystery drug? I'd rather starve to death than be a guinea pig for big pharma again."
    Our article on NexVaxx, entitled Is a Vaccine for Celiac Disease Just Around the Corner? included the following comments:
    "Totally agree with vhill seems like a ploy to poison people with GMO foods that come up with a supposed "'cure'. Eat healthy whole foods this is not a curse its a wake up call to be healthy if you didn't have celiac you'd probably be eating processed crap." Balm wrote: "Thanks but no thanks. I'll remain a celiac and continue to eat healthy. While trying to fix one problem, some will end up with far worse problems." Jonnys wrote: "Stupid idea! Just another way to make more money off of people." These are but a few of the largely positive comments we receive, and we hope you enjoyed them as much as we do.

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    Thank you so much for replying I really appreciate it 💗
    I have a theory about my lipomas. I have just recently been diagnosed with hashimotos which is an auto immune disorder. Apparently having one auto immune disorder puts you at greater risk for other immune disorders. I believe cancerous tumors come from the immune system trying to contain and fight the cancer. And my theory is that lipomas come from the immune system targeting fat cells thinking they are bad invaders so they get contained just as a malignant tumor would. I have several lipomas on my lower arms and thighs. I have just been put on a gluten free diet by my doctor for my hashimotos as well as having to take selenium, probiotics and L glutamine daily. Anyways, I believe lipomas are just another auto immune disorder that just might also be fixed by diet and fixing gut issues since the immune system is tightly connected to gut health. Just my two cents.
    Again Primal Kitchen is canola free, they use Avocado Oil in all their mayo, dressings, sauces. I would suggest them for Mayo, Salad Dressings, Sauces, and Condiments. They are grain free also with Paleo Diet base (diet of our ancestors)
    https://thrivemarket.com/brand/primal-kitchen
    https://www.primalkitchen.com/collections
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