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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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    MIAMI HEAT GUARD RAY ALLEN CREDITS TEN-POUND WEIGHT LOSS TO GLUTEN-FREE DIET


    Jefferson Adams

    Celiac.com 11/27/2013 - After dropping 10 pounds over the summer, Miami Heat shooting guard Ray Allen is touting the benefits of his gluten-free, Paleo diet.


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    Photo--Wikimedia_CommonsThe 6-foot-5 Allen, who enters the 2013-2014 NBA season at his former college weight of 197 pounds, says that weight loss was not his goal when he embarked on the gluten-free diet.

    At 38, Allen stresses the importance quick recovery from rigorous training sessions and NBA games. His gluten-free Paleo eating plan emphasizes high-quality animal protein, fat (including healthy saturated fats), vegetables and fruits, and excludes sugar, gluten, dairy, legumes, starches, alcohol and processed foods.

    Allen told the Miami Herald that "Recovery...is so much more important now that I’ve gotten older. I’ve learned how to manage my body from an eating standpoint. And I’ve always done it, but now I realize there’s another level."

    He adds that he's "always prided myself in coming back in great shape, burning myself out conditioning-wise, running the treadmill, riding my bike, finding different ways to push…never have I added the nutrition part of this."

    Even though he is seems to be benefiting from his diet, Allen clearly still misses some favorite foods. "I haven’t had a pizza at all this year, so I miss it," he said. "This past week, I just added pancakes back into my routine because I can’t go through a season without carbs."

    Hopefully, those are gluten-free pancakes!

    At any rate, it's interesting to see gluten-free diets get such praise from professional athletes. It will be interesting to see what the science has to say about the situation, once we can get some solid data. What do you think? Can avoiding gluten improve athletic performance? Or is there something else going on? Share your commons below.

    Source:


    Image Caption: Photo: Wikimedia Commons
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    I know a lot of the NBA players who summer in Miami used the meal delivery Primal Organic. They used to deliver right to the gym.

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    admin

    Ernesto Guifaldes, M.D. of the Pontificia Unicersidad Catolica de Chile has sent me much information, is particularly knowledgeable in this area. If you have any questions about this subject, please contact Ernesto at: eguirald@lascar.puc.cl
    The following is a letter dated March 10, 1996, and was sent to the Presidents of the Episcopal Conferences from the Vatican. It represents the official position of the Catholic Church with regard to gluten and the Eucharist.
    Your Eminence/Excellency:
    In recent years, this Dicastery has followed closely the development of the question of the use of low-gluten altar breads and mustum as matter for the celebration of the Eucharist.
    After careful study, conducted in collaboration with a number of concerned Episcopal Conferences, this Congregation in its ordinary session of June 22, 1994 has approved the following norms, which I am pleased to communicate:
    I. Concerning permission to use low-gluten altar breads: A. This may be granted by Ordinaries to priests and lay persons affected by celiac disease, after presentation of a medical certificate. Conditions for the validity of the matter: 1) Special hosts quibus glutinum ablatum est are invalid matter for the celebration of the Eucharist; 2) Low-gluten hosts are valid matter, provided that they contain the amount of gluten sufficient to obtain the confection of bread, that there is no addition of foreign materials, and that the procedure for making such hosts is not such as to alter the nature of the substance of the bread. II. Concerning permission to use mustum: A. The preferred solution continues to be Communion per intinctionem, or in concelebration under the species of bread alone. B. Nevertheless, the permission to use mustum can be granted by Ordinaries to priests affected by alcoholism or other conditions which prevent the ingestion of even the smallest quantity of alcohol, after the presentation of a medical certificate. C. By mustum is understood fresh juice from grapes, or juice preserved by suspending its fermentation (by means of freezing of other methods which do not alter its nature). D. In general, those who have received permission to use the mustum are prohibited from presiding at concelebrated Masses. There may be some exceptions however: in the case of a Bishop or Superior General; or, with prior approval of the Ordinary, at the celebration of the anniversary of priestly ordination or other similar occasions. In these cases, the one who presides is to communicate under both the species of bread and that of the mustum, while for the other concelebrants a chalice shall be provided in which normal wine is to be consecrated. E. In the very rare instances of lay persons requesting this permission, recourse must be made to the Holy See. III. Common Norms: A. The Ordinary must ascertain that the matter used conforms to the above requirements. B. Permissions are to be given only for as long as the situation continues which motivated the request. C. Scandal is to be avoided. D. Given the centrality of the celebration of the Eucharist in the life of the priest, candidates for the priesthood who are affected by celiac disease of suffer from alcoholism of similar conditions may not be admitted to Holy Orders. E. Since the doctrinal questions in this area have now been decided, disciplinary competence is entrusted to the Congregation for Divine Worship and the Discipline of the Sacraments. F. Concerned Episcopal Conferences shall report to the Congregation for Divine Worship and the Discipline of the Sacraments every two years regarding the application of these norms. With warm regards and best wishes, I am Sincerely yours in Christ.

    The leader of the fight for Celiacs in the Catholic Church has recently died. Archbishop Derek Worlock of Liverpool was diagnosed in the 1980s with celiac disease and presented a strong case in Rome for celiac sufferers to be allowed to receive special hosts at Communion, which was reluctantly granted. He died of lung cancer on February 8, 1996.

    admin

    By Kelly Rohlfs Celiac.com 09/29/2004 - The Childrens Digestive Health and Nutrition Foundation (CDHNF) with the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) announced the launch of a new educational campaign on Celiac Disease, one of the most common genetic digestive conditions possibly affecting as many as three million Americans (up to 1 percent). Since it has been proven that early detection and intervention can prevent long-term consequences, CDHNF and NASPGHAN are focusing on accurate and timely diagnosis and treatment in children.
    We plan to raise greater awareness about celiac disease and urge physicians to add it to their screening checklist, said Alessio Fasano M.D., chair of the CDHNF Celiac Disease Campaign, NIH Consensus speaker and director of the Mucosal Biology Research Center for the University of Maryland School of Medicine Center for Celiac Research. We now have the information we need on how to diagnose and treat this disease and we need to start applying that knowledge into practice.
    To help spread the word, the campaign will include physician materials such as a celiac disease physician CME slide set, a nationwide Grand Rounds program, and a soon-to-be released NASPGHAN Clinical Practice Guideline on the Evaluation and Management of Celiac Disease in Children, in the fall of 2004. In addition, a new web site http://www.celiachealth.org will provide resources for the medical professional community and the general public.
    They have put together a comprehensive slide set (Acrobat and PowerPoint) available on their website http://www.celiacfacts.org. Although somewhat specific for pediatricians and pediatric gastroenterologists, the material is applicable to all stages and ages of celiac disease. Topics include: Definition, Associated Conditions, Clinical Manifestations and Complications, Diagnosis, Epidemiology, Pathogenesis, Prevention, and Treatment.

    Jefferson Adams
    Celiac.com 05/06/2009 - Like so many people with celiac disease, Elisabeth Hasselbeck of ABC's The View has a story to tell. Like so many people with celiac disease, that story involves a long, slow, painful journey from suffering to understanding, to self-empowerment and recovery. In between were periods of confusion, doubt, isolation and malaise. Hasselbeck describes that journey in her new book: The gluten-free Diet: A Gluten-Free Survival Guide.
    Hasselbeck's odyssey began during her sophomore year of college, when she fell ill after returning from a three-week-long trip to Belize. She was diagnosed with a severe bacterial intestinal infection which, her doctor said, was a result of her travels in Central America. The illness put in the school infirmary for nearly a week, with an immensely distended belly and a 103+ fever. Once the initial infection subsided, she was naturally relieved, and thought the worst was over. Little did she know that a long road lay ahead.
    As an athlete, Hasselbeck was eager to get back into shape after she was discharged. Her body had other ideas. During this period, she says she felt absolutely ravenous, yet the only dining hall foods that seemed appealing were soft-serve vanilla frozen yogurt and Rice Krispies. Food had lost its appeal.
    Hasselbeck grew up in an Italian-American neighborhood in Providence, RI, in a family that prized all things bread and pasta, so she wasn't about to give up the appetite and food battle without a fight.
    However, no matter what she ate nothing satisfied her hunger—and everything seemed to upset her stomach. After nearly every meal, she had the classic bloating, and sharp, gassy pains in her gut that are all too familar to most celiacs. Cramps, indigestion and diarrhea were familiar companions; sometimes all at once. Often, she would become too tired to move.
    It was about this time that she became a contestant on Survivor: The Australian Outback. While enduring the trials of surviving in the outback, Hasselbeck was deprived of her normal, gluten-rich American diet, and forced to subsist on things she would never willingly eat at home. Yet, her symptoms were gone, and she had never felt better. Once she returned to the U.S., she narrowed the scope of her quest. She eliminated nearly everything from her diet and introduced items one at a time.
    After nearly forty days basically starving herself, she sought solace in her pre-Australia diet, with dire consequences. After the joy of knowing a healthy, happy gut for the first time in years, she suddenly found herself feeling worse than ever, and spending days in her room, bedridden, save for urgent trips to the bathroom.
    She saw a doctor and received a diagnosis of "irritable bowel syndrome." Suspicious of what she saw as an acknowledgement of symptoms masquerading as a diagnosis, she began to look for connections on her own.
    Fortunately for Hasselbeck, she began to make a connection between the illness she had suffered for so long and the food she was eating. She noticed that when ate starchy foods, her symptoms returned with a vengeance.
    An Internet search told her that she might be suffering an adverse reaction to wheat. She quickly moved to eliminate wheat from her diet. Her experience, as so many with celiac disease know all too well, was an educational one, filled with occasional episodes that left her feeling inexplicably ill.
    Unable to figure out exactly what was making her sick, she undertook more research and stumbled upon some information about gluten intolerance and celiac disease.
    In 2002, after five years of suffering, Hasselbeck diagnosed diagnosed herself with celiac disease, an autoimmune condition triggered by gluten, the protein found in wheat, rye and barley.
    Celiac disease can cause acute damage to the small intestine and the digestive system, and, left untreated, it can leave sufferers at risk for certain types of cancer and other associated conditions. The only known treatment is a lifelong diet free from wheat rye and barley gluten. Once she realized what had been tormenting her for so many long, she set about eliminating all wheat, barley, oats, and rye from her diet.
    Still, even after she made her diagnosis, she faced a long line of skeptical doctors. In fact, it was eight years after her symptoms first began until she found a doctor who was willing to listen, and who had answers.
    Her move  to New York City put her into contact with Dr. Peter Green, the director of the Celiac Disease Center at Columbia University, who confirmed what she'd suspected for years: Elisabeth Hasselbeck has celiac disease. After waiting for years for a sensible explanation to her symptoms, Dr. Green was the first doctor to look for the cause, not simply to treat the symptoms. Despite the same mistakes and accidents that most of us celiacs have also experienced, her perseverance paid off in the end and she remains gluten-free to this day.
    You can watch Elisabeth Hasselbeck daily on ABC.com's The View. Hasselbeck's book is now available at Celiac.com.
    Source: ABC News


    Dr. Ron Hoggan, Ed.D.
    Below is Ron Hoggan's reply the editor of the Montreal Gazette regarding the article: "Is gluten really something that most people should avoid?"
    Dear Health Editor:
    Mr. Dunning represents corn as a choice for bread-making prior to the advent of wheat, rye, and barley cultivation. However, the evidence suggests that corn was not yet available 10 to 15 thousand years ago when wheat, the earliest of these three grains, was first cultivated so it wasn’t available more than 20 thousand years ago when wild barley was first exploited ( 1 ). The evidence also indicates that corn was not available in the Near East, where wheat was first cultivated, as corn was a New World food developed by Mesoamerican indigenous peoples ( 2 ) half a world away.  In short, corn was not a discarded option for bread making when and where gluten grains were first cultivated.
    Perhaps Mr. Dunning should be forgiven such a relatively minor mistake. After all, he is a journalist, not a cereal scientist. However, as he is identified, in the article in question, as a science writer and a critical analyst, that should set the bar a little higher. Surely we may expect him to conduct basic research in an area by at least glancing at some of the peer reviewed reports on this topic. The one time he does this, he harkens to a report on autism as a tool for arguing against the connection between ADHD and gluten*.  For instance, he decries the adoption of a gluten free diet by those without celiac disease, gluten induced neuropathy, or wheat allergy.  Yet more than 90% of those with celiac disease currently go undiagnosed in the USA (3) and the average delay between onset of symptoms and diagnosis is 11 years (4). Here in Canada, we have very long delays before most of us can get to see a gastroenterologist, so our delays to diagnosis may be even longer.  This suggests that our rates of diagnosis are even lower than those of the USA. Perhaps Mr. Dunning’s querulous rhetoric could be more constructively directed at these long delays and the alarming rates of under-diagnosis of celiac disease. 
    In the interim, it seems very sensible for those with undiagnosed celiac disease to follow a gluten free diet and experience the improved health and quality of life which Mr. Dunning admits are available to these individuals through a gluten free diet.  This is an issue that might be revisited when our health care system is providing a timely diagnosis to at least a majority of cases of celiac disease.
    Recent research has also shown that those with non-celiac gluten sensitivity, which afflicts about 12% of the general population ( 5), experience even higher rates of morbidity and early mortality than those with celiac disease (6 ). Yet this group is either entirely ignored in Mr. Dunning’s  article, or, more likely, it is the unstated focus of his attack.
    Mr. Dunning also seems to be unaware that humans lack the full compliment of enzymes necessary for full digestion of gluten proteins thus making many of the constituent amino acids beyond our ability to metabolize when he states that gluten is “a protein that your body uses.” He further asserts that there is no good reason to avoid gluten if one does not have one of the three conditions he lists. Yet my own work suggests that the morphine-like opioids derived from gluten grains may be a contributing factor in several types of malignancy ( 7).    
    I was pleased to read that Mr. Dunning had at least glanced at data on gluten sensitive idiopathic neuropathy, but chagrined to read his speculation regarding the prevalence of this condition. I have devoted many years to the study of gluten’s impact on human health and have yet to read any work suggesting its prevalence. Perhaps Mr. Dunning could at least hint at his source when making such contentious claims.
    Nonetheless, there is clear evidence that a majority of those who experience gluten sensitive idiopathic neuropathy (5) do so in the presence of non-celiac gluten sensitivity, an autoimmune dynamic. Closer to home, our own Scott Frazer has demonstrated that consumption of gluten proteins is a potent force behind the development of many cases of type 1 diabetes (8). Reports of the causal connection between gluten consumption and autoimmune disease abound in the peer reviewed literature and are too numerous to warrant citing.
    Mr. Dunning also asserts “there is no evidence that incidence of disease increased worldwide once wheat became a staple.”  The field of Archaeology differs dramatically with Mr. Dunning’s claim. In general, it is quite well established that pre-agricultural, hunter-gatherers were much taller and had stronger bones than their descendants who adopted agriculture (9). For instance, a common finding in the skeletal remains of early farmers is a condition of porotic hyperostosis (10).
    Mr. Dunning also seems to be unaware that fats, per gram, provide more than twice the energy available in either carbohydrates or proteins and this ignores the added weight of indigestible fibre. The increased caloric density of fats is a principle that most students learn in high school Biology classes. Yet Mr. Dunning asserts that bread was a source of high energy and light weight.
    While science requires scepticism and criticism to function, polemic rhetoric based on personal bias generates more heat than light.  Mr. Dunning’s report is rife with errors and emotion. Publication of such dogma does little to enhance either the Gazette’s or Mr. Dunning’s credibility. Newspapers are given considerable credence as many readers, myself included, assume that journalists are exercising due diligence in checking their facts prior to publication of these reports. It is only when I read an article such as this one, that is deeply flawed and falls within my area of expertise, that my faith in journalists and the media is undermined.  
    *note: The only report I could find that fits the meagre description provided by Mr. Dunning is one that involved 15 children who were studied over a 12 week period (11). If this is, indeed, the study Mr. Dunning referred to, it hardly provides conclusive evidence of anything beyond the obvious need for more comprehensive study in this area. His use of these data as a springboard for his absolutist claims seems highly questionable, to say the least.
    Sincerely,
    Ron Hoggan, Ed. D.
    Royal Roads University, Continuing Studies
    co-author: Dangerous Grains ISBN: 978158333-129-3 www.dangerousgrains.com
    editor: Journal of Gluten Sensitivity www.celiac.com     
    editor/co-author: Cereal Killers  http://tiny.cc/s7neg
    Sources:
    http://en.wikipedia.org/wiki/Wheat http://en.wikipedia.org/wiki/Maize     Fasano A, Berti I, Gerarduzzi T, Not T, Colletti RB, Drago S, Elitsur Y, Green PH, Guandalini S, Hill ID, Pietzak M, Ventura A, Thorpe M, Kryszak D, Fornaroli F, Wasserman SS, Murray JA, Horvath K. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med. 2003 Feb 10;163(3):286-92 Green PHR, Stavropoulos SN, Panagi SG, Goldstein SL, Mcmahon DJ, Absan H, Neugut AI. Am J Gastroenterol. 2001 Jan;96(1):126-31 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. Anderson LA, McMillan SA, Watson RG, Monaghan P, Gavin AT, Fox C, Murray LJ. Malignancy and mortality in a population-based cohort of patients with celiac disease or "gluten sensitivity". World J Gastroenterol. 2007 Jan 7;13(1):146-51. Hoggan R. Considering wheat, rye, and barley proteins as aids to carcinogens. Med Hypotheses. 1997 Sep;49(3):285-8. http://www.ohri.ca/profiles/scott.asp Lutz W. [The carbohydrate theory]. Wien Med Wochenschr. 1994;144(16):387-92. Wright L, Chew F, Porotic Hyperostosis and Paleoepidemiology: A Forensic Perspective on Anemia among the Ancient Maya. Am Anthro. 1998 Dec; 100: 924-939. Elder JH, Shankar M, Shuster J, Theriaque D, Burns S, Sherrill L.    The gluten-free, casein-free diet in autism: results of a preliminary double blind clinical trial. J Autism Dev Disord. 2006 Apr;36(3):413-20.

  • Recent Articles

    Jefferson Adams
    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    First, the team used liquid chromatography-tandem mass spectrometry (LC/MS) to analyze amino acid levels in fasting plasma samples from 141 children with celiac disease and 129 non-celiac disease controls. They then crafted a general linear model using age and experimental effects as covariates to compare amino acid levels between children with celiac disease and non-celiac control subjects.
    Compared with the control group, seven out of twenty-three children with celiac disease showed elevated levels of the the following amino acids: tryptophan; taurine; glutamic acid; proline; ornithine; alanine; and methionine.
    The significance of the individual amino acids do not survive multiple correction, however, multivariate analyses of the amino acid profile showed significantly altered amino acid levels in children with celiac disease overall and after correction for age, sex and experimental effects.
    This study shows that amino acids can influence inflammation and may play a role in the development of celiac disease.
    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764

    Jefferson Adams
    Celiac.com 04/18/2018 - To the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service animals.
    If you’ve flown anywhere lately, you may have seen them. People flying with their designated “emotional support” animals. We’re not talking genuine service animals, like seeing eye dogs, or hearing ear dogs, or even the Belgian Malinois that alerts its owner when there is gluten in food that may trigger her celiac disease.
    Now, to be honest, some of those animals in question do perform a genuine service for those who need emotional support dogs, like veterans with PTSD.
    However, many of these animals are not service animals at all. Many of these animals perform no actual service to their owners, and are nothing more than thinly disguised pets. Many lack proper training, and some have caused serious problems for the airlines and for other passengers.
    Now the major airlines are taking note and introducing stringent requirements for service animals.
    Delta was the first to strike. As reported by the New York Times on January 19: “Effective March 1, Delta, the second largest US airline by passenger traffic, said it will require passengers seeking to fly with pets to present additional documents outlining the passenger’s need for the animal and proof of its training and vaccinations, 48 hours prior to the flight.… This comes in response to what the carrier said was a 150 percent increase in service and support animals — pets, often dogs, that accompany people with disabilities — carried onboard since 2015.… Delta said that it flies some 700 service animals a day. Among them, customers have attempted to fly with comfort turkeys, gliding possums, snakes, spiders, and other unusual pets.”
    Fresh from an unsavory incident with an “emotional support” peacock incident, United Airlines has followed Delta’s lead and set stricter rules for emotional support animals. United’s rules also took effect March 1, 2018.
    So, to the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service and emotional support animals.
    Source:
    cnbc.com

    admin
    WHAT IS CELIAC DISEASE?
    Celiac disease is an autoimmune condition that affects around 1% of the population. People with celiac disease suffer an autoimmune reaction when they consume wheat, rye or barley. The immune reaction is triggered by certain proteins in the wheat, rye, or barley, and, left untreated, causes damage to the small, finger-like structures, called villi, that line the gut. The damage occurs as shortening and villous flattening in the lamina propria and crypt regions of the intestines. The damage to these villi then leads to numerous other issues that commonly plague people with untreated celiac disease, including poor nutritional uptake, fatigue, and myriad other problems.
    Celiac disease mostly affects people of Northern European descent, but recent studies show that it also affects large numbers of people in Italy, China, Iran, India, and numerous other places thought to have few or no cases.
    Celiac disease is most often uncovered because people experience symptoms that lead them to get tests for antibodies to gluten. If these tests are positive, then the people usually get biopsy confirmation of their celiac disease. Once they adopt a gluten-free diet, they usually see gut healing, and major improvements in their symptoms. 
    CLASSIC CELIAC DISEASE SYMPTOMS
    Symptoms of celiac disease can range from the classic features, such as diarrhea, upset stomach, bloating, gas, weight loss, and malnutrition, among others.
    LESS OBVIOUS SYMPTOMS
    Celiac disease can often less obvious symptoms, such fatigue, vitamin and nutrient deficiencies, anemia, to name a few. Often, these symptoms are regarded as less obvious because they are not gastrointestinal in nature. You got that right, it is not uncommon for people with celiac disease to have few or no gastrointestinal symptoms. That makes spotting and connecting these seemingly unrelated and unclear celiac symptoms so important.
    NO SYMPTOMS
    Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors. 

    CELIAC DISEASE VS. GLUTEN INTOLERANCE
    Gluten intolerance is a generic term for people who have some sort of sensitivity to gluten. These people may or may not have celiac disease. Researchers generally agree that there is a condition called non-celiac gluten sensitivity. That term has largely replaced the term gluten-intolerance. What’s the difference between celiac disease and non-celiac gluten-sensitivity? 
    CELIAC DISEASE VS. NON-CELIAC GLUTEN SENSITIVITY (NCGS)
    Gluten triggers symptoms and immune reactions in people with celiac disease. Gluten can also trigger symptoms in some people with NCGS, but the similarities largely end there.

    There are four main differences between celiac disease and non-celiac gluten sensitivity:
    No Hereditary Link in NCGS
    Researchers know for certain that genetic heredity plays a major role in celiac disease. If a first-degree relative has celiac disease, then you have a statistically higher risk of carrying genetic markers DQ2 and/or DQ8, and of developing celiac disease yourself. NCGS is not known to be hereditary. Some research has shown certain genetic associations, such as some NCGS patients, but there is no proof that NCGS is hereditary. No Connection with Celiac-related Disorders
    Unlike celiac disease, NCGS is so far not associated with malabsorption, nutritional deficiencies, or a higher risk of autoimmune disorders or intestinal malignancies. No Immunological or Serological Markers
    People with celiac disease nearly always test positive for antibodies to gluten proteins. Researchers have, as yet, identified no such antobodies or serologic markers for NCGS. That means that, unlike with celiac disease, there are no telltale screening tests that can point to NCGS. Absence of Celiac Disease or Wheat Allergy
    Doctors diagnose NCGS only by excluding both celiac disease, an IgE-mediated allergy to wheat, and by the noting ongoing adverse symptoms associated with gluten consumption. WHAT ABOUT IRRITABLE BOWEL SYNDROME (IBS) AND IRRITABLE BOWEL DISEASE (IBD)?
    IBS and IBD are usually diagnosed in part by ruling out celiac disease. Many patients with irritable bowel syndrome are sensitive to gluten. Many experience celiac disease-like symptoms in reaction to wheat. However, patients with IBS generally show no gut damage, and do not test positive for antibodies to gliadin and other proteins as do people with celiac disease. Some IBS patients also suffer from NCGS.

    To add more confusion, many cases of IBS are, in fact, celiac disease in disguise.

    That said, people with IBS generally react to more than just wheat. People with NCGS generally react to wheat and not to other things, but that’s not always the case. Doctors generally try to rule out celiac disease before making a diagnosis of IBS or NCGS. 
    Crohn’s Disease and celiac disease share many common symptoms, though causes are different.  In Crohn’s disease, the immune system can cause disruption anywhere along the gastrointestinal tract, and a diagnosis of Crohn’s disease typically requires more diagnostic testing than does a celiac diagnosis.  
    Crohn’s treatment consists of changes to diet and possible surgery.  Up to 10% of Crohn's patients can have both of conditions, which suggests a genetic connection, and researchers continue to examine that connection.
    Is There a Connection Between Celiac Disease, Non-Celiac Gluten Sensitivity and Irritable Bowel Syndrome? Large Number of Irritable Bowel Syndrome Patients Sensitive To Gluten Some IBD Patients also Suffer from Non-Celiac Gluten Sensitivity Many Cases of IBS and Fibromyalgia Actually Celiac Disease in Disguise CELIAC DISEASE DIAGNOSIS
    Diagnosis of celiac disease can be difficult. 

    Perhaps because celiac disease presents clinically in such a variety of ways, proper diagnosis often takes years. A positive serological test for antibodies against tissue transglutaminase is considered a very strong diagnostic indicator, and a duodenal biopsy revealing villous atrophy is still considered by many to be the diagnostic gold standard. 
    But this idea is being questioned; some think the biopsy is unnecessary in the face of clear serological tests and obvious symptoms. Also, researchers are developing accurate and reliable ways to test for celiac disease even when patients are already avoiding wheat. In the past, patients needed to be consuming wheat to get an accurate test result. 
    Celiac disease can have numerous vague, or confusing symptoms that can make diagnosis difficult.  Celiac disease is commonly misdiagnosed by doctors. Read a Personal Story About Celiac Disease Diagnosis from the Founder of Celiac.com Currently, testing and biopsy still form the cornerstone of celiac diagnosis.
    TESTING
    There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.
    Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis. Also, it is now possible to test people for celiac disease without making them concume wheat products.

    BIOPSY
    Until recently, biopsy confirmation of a positive gluten antibody test was the gold standard for celiac diagnosis. It still is, but things are changing fairly quickly. Children can now be accurately diagnosed for celiac disease without biopsy. Diagnosis based on level of TGA-IgA 10-fold or more the ULN, a positive result from the EMA tests in a second blood sample, and the presence of at least 1 symptom could avoid risks and costs of endoscopy for more than half the children with celiac disease worldwide.

    WHY A GLUTEN-FREE DIET?
    Currently the only effective, medically approved treatment for celiac disease is a strict gluten-free diet. Following a gluten-free diet relieves symptoms, promotes gut healing, and prevents nearly all celiac-related complications. 
    A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods. Still, with effort, most people with celiac disease manage to make the transition. The vast majority of celiac disease patients who follow a gluten-free diet see symptom relief and experience gut healing within two years.
    For these reasons, a gluten-free diet remains the only effective, medically proven treatment for celiac disease.
    WHAT ABOUT ENZYMES, VACCINES, ETC.?
    There is currently no enzyme or vaccine that can replace a gluten-free diet for people with celiac disease.
    There are enzyme supplements currently available, such as AN-PEP, Latiglutetenase, GluteGuard, and KumaMax, which may help to mitigate accidental gluten ingestion by celiacs. KumaMax, has been shown to survive the stomach, and to break down gluten in the small intestine. Latiglutenase, formerly known as ALV003, is an enzyme therapy designed to be taken with meals. GluteGuard has been shown to significantly protect celiac patients from the serious symptoms they would normally experience after gluten ingestion. There are other enzymes, including those based on papaya enzymes.

    Additionally, there are many celiac disease drugs, enzymes, and therapies in various stages of development by pharmaceutical companies, including at least one vaccine that has received financial backing. At some point in the not too distant future there will likely be new treatments available for those who seek an alternative to a lifelong gluten-free diet. 

    For now though, there are no products on the market that can take the place of a gluten-free diet. Any enzyme or other treatment for celiac disease is intended to be used in conjunction with a gluten-free diet, not as a replacement.

    ASSOCIATED DISEASES
    The most common disorders associated with celiac disease are thyroid disease and Type 1 Diabetes, however, celiac disease is associated with many other conditions, including but not limited to the following autoimmune conditions:
    Type 1 Diabetes Mellitus: 2.4-16.4% Multiple Sclerosis (MS): 11% Hashimoto’s thyroiditis: 4-6% Autoimmune hepatitis: 6-15% Addison disease: 6% Arthritis: 1.5-7.5% Sjögren’s syndrome: 2-15% Idiopathic dilated cardiomyopathy: 5.7% IgA Nephropathy (Berger’s Disease): 3.6% Other celiac co-morditities include:
    Crohn’s Disease; Inflammatory Bowel Disease Chronic Pancreatitis Down Syndrome Irritable Bowel Syndrome (IBS) Lupus Multiple Sclerosis Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Psoriasis Rheumatoid Arthritis Scleroderma Turner Syndrome Ulcerative Colitis; Inflammatory Bowel Disease Williams Syndrome Cancers:
    Non-Hodgkin lymphoma (intestinal and extra-intestinal, T- and B-cell types) Small intestinal adenocarcinoma Esophageal carcinoma Papillary thyroid cancer Melanoma CELIAC DISEASE REFERENCES:
    Celiac Disease Center, Columbia University
    Gluten Intolerance Group
    National Institutes of Health
    U.S. National Library of Medicine
    Mayo Clinic
    University of Chicago Celiac Disease Center

    Jefferson Adams
    Celiac.com 04/17/2018 - Could the holy grail of gluten-free food lie in special strains of wheat that lack “bad glutens” that trigger the celiac disease, but include the “good glutens” that make bread and other products chewy, spongey and delicious? Such products would include all of the good things about wheat, but none of the bad things that might trigger celiac disease.
    A team of researchers in Spain is creating strains of wheat that lack the “bad glutens” that trigger the autoimmune disorder celiac disease. The team, based at the Institute for Sustainable Agriculture in Cordoba, Spain, is making use of the new and highly effective CRISPR gene editing to eliminate the majority of the gliadins in wheat.
    Gliadins are the gluten proteins that trigger the majority of symptoms for people with celiac disease.
    As part of their efforts, the team has conducted a small study on 20 people with “gluten sensitivity.” That study showed that test subjects can tolerate bread made with this special wheat, says team member Francisco Barro. However, the team has yet to publish the results.
    Clearly, more comprehensive testing would be needed to determine if such a product is safely tolerated by people with celiac disease. Still, with these efforts, along with efforts to develop vaccines, enzymes, and other treatments making steady progress, we are living in exciting times for people with celiac disease.
    It is entirely conceivable that in the not-so-distant future we will see safe, viable treatments for celiac disease that do not require a strict gluten-free diet.
    Read more at Digitaltrends.com , and at Newscientist.com

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