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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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    HOW DO GLUTEN-FREE BEERS COMPARE TO CONVENTIONAL BEERS?


    Jefferson Adams

    Celiac.com 11/04/2011 - For many folks, fall means changing leaves, crisp weather, football, and beer. Or just crisp weather and beer. Fortunately, for those with gluten sensitivities, the explosion of diagnoses for celiac disease and gluten-intolerance has given rise to an explosion of gluten-free products, including a number of gluten-free beers.


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    "People are becoming more knowledgeable of the symptoms in which gluten can cause on one's health," said New Planet Beer Marketing Director Danielle Quatrochi, "so people are being diagnosed sooner and more often than before. There's also been a lot of press around the benefits of a gluten-free diet, opening the door for companies to add gluten-free options to their product mix."

    Photo: CC--ipolinskyGluten-free beers have often lacked depth compared to their wheat and barley-infused cousins, and sorghum, a key grain in many gluten-free beer recipes, imparts a distinctly tart flavor. Some gluten-free brewers try to offset the tartness of the millets by using various malts. Others use corn, rice and sugars in place of sorghum.

    Writer Harold Swaney, together with is wife, Erin, and good friend, Kit Hansen, recently set out to do some taste assessments of gluten-free beers. He gathered all the gluten-free beers from all the breweries he could find. In total, they tasted twelve beers by seven brewers.

    The trio tasted Toleration Ale, Redbridge Gluten Free Sorghum Beer, New Planet's Off the Grid Pale Ale, 3R Raspberry Ale, and Tread Lightly Ale, St Peter's Sorghum Beer, Bard's Sorghum Malt Beer, New Grist Beer, and Green's Gluten Free Dubbel Dark Ale, Tripel Blonde Ale, and Amber Ale.

    First up was Redbridge, by Anheuser-Busch. Redbridge is a gluten-free version of a basic American-style lager, made from sorghum, hops, gluten-free yeast. Swaney writes that Redbridge "a clean beer with solid body and nice, subtle finish; the lack of a real sorghum bitter finish." The trio gave Redbridge a thumbs up.

    Next came New Grist, Lakewood Brewery's offering of sorghum, hops, rice and gluten-free yeast grown on molasses. All three tasters were unimpressed. Swaney wrote that New Grist has a "very light body and is eminently forgettable," with one taster comparing it to a "very light, carbonated sake."

    After New Grist came Bards Sorghum Malt Beer, which is brewed from sorghum, yeast and hops.

    Swaney writes that Bards is "strong up front, with notes of caramel and fruit. But, unlike most gluten-free beers that have a distinctly bitter finish, Bards has really no finish. Overall with a solid malt backbone and a nice body." He calls Bards a "respectable gluten-free beer."

    Next came three beers brewed by Green's. All three use millet, buckwheat, rice, sorghum, hops and yeast.

    Of Green's Dubbel Dark Ale, Swaney writes that it has "a slight sorghum finish, but it is sweet up front and passes nicely for a Belgian-style dubbel." Of the Tripel Blonde Ale has notes "fruit up front and…the characteristic mouthfeel of a true tripel."  Swaney reserves his highest accolades for Green's Amber Ale, a medium-bodied ale with "notes of caramel," very little sorghum finish, that he calls "the most balanced of the three."

    The group next sampled Toleration from Nick Stafford's Hambleton Ales in England, which is crafted from Challenger, Liberty and Cascade hops, top-fermenting yeast and specially prepared sugars. Swaney wrote that Toleration "didn't taste much like beer. More like a slightly hoppy barleywine. It had an aroma of dates and figs and was very sweet, but it had almost no carbonation."  His wife, Erin, "compared it to a port."

    Next up was New Planet's Off the Grid Pale Ale, 3R Raspberry Ale, and Tread Lightly Ale. All three are made with sorghum, hops and yeast. The Pale Ale adds brown rice extract and molasses, 3R Raspberry Ale adds corn extract, natural Oregon raspberry puree, and orange peel, while Tread Lightly Ale adds corn extract, and orange peel.

    Among the New Planet offerings, Swaney had the highest regard for Off the Grid Pale Ale. He commended its "malty backbone and hoppy finish." saying that it was "hard to tell it was a gluten-free beer." Swaney says his friend, Kit, who had not tasted a real beer for four years, was "blown away by how much it reminded him of a true pale ale."

    Swaney characterizes Tread Lightly Ale as "a very light beer with a distinct sorghum finish," while the 3R Raspberry Ale is a very carbonated, light ale that evokes a raspberry cider.

    St. Peters, which is made with Sorghum, hops, water. Swaney notes that folks who like European lagers will like this beer. "It starts very bitter, with a distinct grassy aroma," he says, noting that St. Peter's is "definitely a beer that paired well with food."

    Read Harold Swaney's full article at Herald.net.



    Image Caption: Photo: CC--ipolinsky
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    Nice review of the beers! Having had all of them, Greens Double Dark, Greens Amber, and New Planet's Off the Grid Pale Ale are my favorites - they taste the most like a 'real beer'. The others are ok; all the New Planet's are pretty tasty, but the Pale Ale tastes the most like a beer. St. Peter's is quite bitter, and they're right that the New Hambleton doesn't really taste like a beer, but it's not unpleasant.

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    St. Peters is hands down the best. The others are bad to outright repulsive (especially the Green's beers - more like champagne - oh my they are awful). I was particularly disappointed with the much-hyped New Planet beers when I finally tracked them down in Oklahoma (for some reason they are not distributed to Texas). They were not vastly different from Redbridge and Bards with that terrible sorghum aftertaste. A huge disappointment.

     

    The hoppiness of St Peters helps overcome the unpleasant aftertaste left by sorghum. I always liked hoppy and bitter beers, so this does not bother me. It is very difficult to find St Peters in Dallas. I know the Whole Foods at Park Lane had it the last time I went there.

     

    All that said, I'm finding I would rather just drink the Crispin Artisanal Reserve ciders, particularly the one that uses the Irish stout yeast. If you're going to drink sweet carbonated alcoholic beverages, may as well go with the ones that are intended to be that way IMO.

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    Thanks for this comparison. There are two gluten free beers from Spain which were not reviewed, Estrella Damm Daura and Ambar. I have had several of the beers reviewed here, but Daura and Ambar are better by far. If they are not available in the US that is a shame. We can get them here in England.

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    Guest Debbie Sadel

    Posted

    Thanks for the article. I've been drinking Red Bridge which I like a bit better than New Grist. I'll have to try Greens and New Planet brews if I can get them in my area. Now if they'd just have them on tap in bars. I guess I'm dreaming!

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    Ohhh I can't wait to try these! I'm not a true fan of beer, BUT there are times when one gets a craving for an ice cold, perfectly chilled beer. Now to find them. Here in Scranton I have tried a drink called Woodchuck. It is a hard cider that is pretty good, but it's not beer. Thanks for this article!

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    Thank you for the article. There is also a pretty good blonde pale ale made in in Quebec, Canada called La Messagere. It's made with rice & buckwheat. You can search on-line for the company or La Messagere Beer. The company, Microbrasserie Nouvelle France, actually makes 3 different gluten-free beers. I stock up when I visit Montreal.

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    Guest Edouard McGrath

    Posted

    Well written article. To followup, Brunehaut Brune and Blonde is now imported in the US. Brewed from Barley, this Belgium Beer IS real beer.

     

    This year, the Brunehaut Amber won a Gold Medal at the US Beer Open. The Blonde won Silver.

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    Great article. I have tried most of what was reviewed. Unfortunately, I have not seen St. Peter's for sale. I live in Delaware and travel to Maryland for Bard's since it's not sold here. I was shocked to find Redbridge receiving such high ratings. It finishes extremely in bitter tones & has a very metallic taste. This is aside from the fact that it's made by Anheuser-Busch. Go for Bard's if you can find it--independent brewer by 2 guys with Celiac, nice cherry finish in my opinion. It's 100% sorghum, how different can one really make that?

     

    Agreed Green's is always a good choice, just wish it wasn't such a big bottle. I am a fan of New Grist for an easy drinking beer. Just found New Planet being sold in Maryland. Agreed, if you like hops you'll love Off the Grid Pale Ale!

     

    Estrella is offered here but it's just ok. Too pricey because an import. If I was across the pond I'd probably drink it more. Agree with another rating--don't leave out the ciders. Really good stuff coming out of WA state and NY. Spire is a new favorite, it's not sweet!

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    Guest Neil

    Posted

    I'm a non-drinker currently hanging out in Spain, and recently tried Ambar Green gluten-free alcohol-free beer. I don't have gluten sensitivity or celiac disease - was just interested. It was just about passable, but I really wouldn't choose it unless my health dictated it.

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    Guest gguess

    Posted

    Sorghum malt does not cause a bitter flavor by itself, a bit of a funky aftertaste perhaps. Unfortunately, commercial craft brewers seem to think that people want a bitter beer, when I have found that nearly everyone else prefers a non-bitter to very lightly bitter beer.

     

    I have tried most of the beers on the list, and like most. Bards is one with a bitter aftertaste but a shallow starting taste. Redbridge started off 5years with a nice American style beer, then went very bitter which killed their sales. They reformulated and now produce a gluten-free beer with only a modest bitter aftertaste. Estrella is another beer with a strong bitter finish.

     

    Greens is a great beer although pricy. New Grist is a great session beer that is moderately priced. The New Planet Tread lightly and Raspberry are excellent, full-flavor beers. The raspberry is not any where as sweet as the reviewer states.

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    Guest Donna

    Posted

    As a previous responder mentioned, Estrella Damm Daura is absolutely the best gluten-free beer available, at least to my taste. I despise sorghum beers generally; they are not worth the calories and are not just unsatisfying, but downright unpleasant. Daura faintly reminds me of a fresh bottle of Heineken - none of the other gluten-free beers taste like beer at all, and the ciders are barely passable. But Daura is refreshing on a hot summer day, and quite enjoyable, plus offering a heady high. I discovered it at a local gluten-free store where is was pretty pricey. I took the label into my local health food coop, and they now keep it stocked at a very reasonable price. I live in Milwaukee, WI, so Daura is certainly easily available in most US cities if you get the ball rolling at a cooperative retail establishment. I would encourage anyome to try this fine gluten-free beer.

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    admin

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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.
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    NO SYMPTOMS
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    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