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Study Shows Gluten Intolerance Without Celiac Disease


New study on gluten intolerance without celiac disease appears in the latest AJG.

Celiac.com 02/14/2011 - In what may seem for some like an obvious finding, a team of Australian researchers has shown that people can suffer gluten intolerance without having celiac disease. Their study is published in The American Journal of Gastroenterology.

I say obvious, because many in the celiac and surrounding community have long understood and accepted the concept of gluten-intolerance as distinct from celiac disease. Surprisingly, there has been very little scientific research to establish the existence of gluten-intolerance as distinct from celiac disease. That is changing, and the recent Australian study offers some support for gluten-intolerance as distinct from celiac disease.

For their study, a team of researchers led by Peter Gibson, professor of medicine at Eastern Health Clinical School at Monash University in Australia, recruited 34 people with irritable bowel syndrome, but who were clinically proven to be free of celiac disease. All participants had previously benefited from a gluten-free diet.

The 34 volunteers were all fed bread and muffins, half of which contained gluten, half of which were gluten-free. Nearly 70 per cent of the volunteers who ate the gluten reported pain, bloating, toilet problems and extreme tiredness.

''Gluten is indeed a trigger of gut symptoms and tiredness,'' the researchers concluded. Professor Gibson said: ''These symptoms have a big impact on quality of life. But conservative medicine has not been so good at dealing with this because we haven't had any evidence.''

A number of the volunteers had sought help from alternative health practitioners, a fact that impaired recruitment of volunteers, as many of these folks had adopted a gluten-free diet without proving or disproving celiac disease via colonoscopy and biopsy.

It was important for the team to exclude celiac disease for several reasons, including the fact that although it was safe to use gluten to test people who may have an intolerance, it could harm people with celiac disease.

"If you go back on gluten while you have celiac disease - even if you only eat a few pieces of bread - you will damage your body and undo many months of healing," Professor Gibson said.

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For that reason, and also to prove gluten intolerance alone was the symptom cause, the team recruited people  clinically proven to be free of celiac disease, and who were already on gluten-free diets.

For those patients with irritable bowel syndrome, excluding celiac disease, who were symptomatically controlled on a gluten-free diet, the team crafted a double-blind, randomized, placebo-controlled re-challenge trial.

Participants received either gluten or placebo in the form of two bread slices plus one muffin per day with a gluten-free diet for up to 6 weeks. The team evaluated symptoms using a visual analog scale and markers of intestinal inflammation, injury, and immune activation monitoring.

A total of 4 men and 30 women between the ages of 29–59-years old completed the study as per protocol. Overall, 56% showed human leukocyte antigen (HLA)-DQ2 and/or HLA-DQ8. Adherence to diet and supplements was very high.

Of 19 patients (68%) in the gluten-consuming group, 13 reported that symptoms were not adequately controlled compared with 6 of 15 (40%) on placebo (P=0.0001; generalized estimating equation).

On a visual analog scale, patients were significantly worse within one week of consuming gluten for overall symptoms (P=0.047), pain (P=0.016), bloating (P=0.031), satisfaction with stool consistency (P=0.024), and tiredness (P=0.001).

In no cases did gluten-consumption trigger anti-gliadin antibodies. Moreover, there where were no significant changes in fecal lactoferrin, levels of celiac antibodies, highly sensitive C-reactive protein, or intestinal permeability. There were no differences in any end point in individuals with the DQ2/DQ8 and those without.

Gibson calls the general lack of research into gluten intolerance "almost unbelievable." He plans to now investigate the prevalence of non-celiac gluten intolerance, why it occurs and whether low levels of gluten can be eaten safely.


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12 Responses:

 
Steve Rose
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said this on
14 Feb 2011 5:19:37 AM PDT
So here we have more questions. Can our allergic community have more unknown facts about food allergies and sensitivities? There seems to be more research into foods as triggers for non-life threatening reactions. It just seems that instead of looking at the reactions, some one should be looking at the foods. Where are the food products coming from and how well regulated are they? Are the regulations in the best interest of our health too?
At least we are now seeing more GF and allergy friendly foods to help us through this uncertainty.

 
Hallie
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said this on
14 Feb 2011 7:14:12 PM PDT
5 stars for the presentation by Jefferson Adams. 2 stars for the actual researchers. Why? Because anyone who has ever been on a gluten-free diet can tell the difference between regular bread and gluten-free bread, and this may influence their complaints. So, if the researchers really wanted this to be double-blind and placebo controlled, they should have given gluten in a capsule to the experimental group, and an identical capsule containing something like rice flour to the control group.

This was bad experimental design!

 
Karen Kritchen
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said this on
21 Feb 2011 8:12:26 AM PDT
As soon as I read the article I said uh-oh, don't they know we GF's can taste the difference!

 
Lisa
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said this on
22 Feb 2011 5:15:08 PM PDT
Actually, there are GF breads which are very similar to French bread, and GF muffins which are essentially indistinguishable from regular ones. Perhaps they made the regular muffins and bread more similar to the GF controls. We'd have to read the whole article to find out.

 
Nancy Lindsey
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said this on
21 Feb 2011 7:53:41 AM PDT
Here is my concern. I have no idea which I am - celiac or gluten intolerant. For 7 months I suffered with stomach issues and lost 20 pounds. A GI doctor tested me for everything BUT celiac. I lived on noodle soup and crackers and was often violently ill. After my sister suggested I try a gluten free diet (which I had never heard of 10 years ago), I did so and became well immediately. When I attempted to see a celiac specialist, I had to wait 2 months. I was told to continue the diet until I saw the specialist. Once I saw the specialist, he told me that I had return to a gluten diet to accurately diagnose me. I told him to dig a hole and throw me in as I would not touch gluten. He then charted me as "celiac" but I truly don't know. I think the medical world in America still has a long way to go in researching possible treatment/antidote for celiac disease and gluten intolerance.

 
betsy frahm
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said this on
21 Feb 2011 11:19:39 AM PDT
I am gluten intolerant and because I do not get sick after ingesting gluten, it makes it easier for me to cheat. I can stay GF only so long and my craving for a good sandwich just takes over.It would be very nice to know that cheating occasionally isn't doing the same damage as if I were a true celiac. I agree with Hallie's comment. So far there is no GF bread or muffin that tastes the same as that made from wheat. I would agree that a pill would have been the way to go. But keep on trying with the research. I have hope that there will be something like Lactaid for milk intolerance.

 
Jo Fick
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said this on
21 Mar 2011 10:37:02 PM PDT
I can so identify with this. At this point, I'm still waiting for results of the biopsy. But an EGD showed flattening of the duodenum, which had never shown up before. I didn't even know what it meant. I have no typical celiac symptoms. In fact, I am overweight. I don't notice any ill effects from ingesting gluten. And I am a carb/bread lover from way back. Oddly enough, my brother was just diagnosed with severe celiac. He had been untreated for years, and was very ill; it was thought he had cancer. He's doing worlds better now; he is extremely cautious after having a bad reaction that left him sick for more than a week. Seems I read somewhere they are working on developing a vaccine for celiac. Wouldn't that be wonderful?
No doubt there will be a laundry list of other foods to avoid coming after they do blood testing. And every GF bread I've tried is yuck. I thought the same thing when I read about that study. I can always tell a GF product. It doesn't help that they douse a lot of the baked goods with sugar to disguise the taste. Eating GF doesn't mean eating healthy.

 
Barbara Irlbeck
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said this on
21 Feb 2011 5:19:20 PM PDT
Interesting article.

I call myself gluten intolerant though have never had an 'official' diagnosis. I tried gluten free diet three years ago, upon recommendation from my internist , as a help for peripheral neuropathy in my feet. I never tested for gluten intolerance. However, about two years after adopting the gluten free diet, I did have the test for HLA-DQ2 and HLA-DQ8 and found I was negative for being celiac. It was important to me to know because I have children and grand children.

Last summer when I was not settling in to sleep because I felt like a supplement I had taken was 'stuck in my throat', I got up and ate one piece of toast from loaf of bread that was labeled "flourless." I found out the next day that it contained wheat sprouts instead of the usual flour. After eating it, I returned to bed and fell asleep. About a half to one hour after consuming the bread, I awoke very nauseated and ended up spending the next half hour or so hanging over the toilet as I vomited up everything in my stomach. I have no real explanation for this, but decided it proved that I am definitely gluten intolerant. I now read labels more thoroughly.

The flourless bread was shelved with gluten free breads at the store and thus I did not questions it as I should have. This incident happened in the night and I was not the least sick when went to bed that night, nor was I when I got up the next morning.

By the way, I no longer have any burning in my feet and not much parastheia either. I am committed to staying on a gluten free diet.

 
Cassie
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said this on
21 Feb 2011 8:16:09 PM PDT
I would have to agree with Hallie!

 
Barbara Ross
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said this on
22 Feb 2011 4:18:11 AM PDT
Am I understanding that if you are gluten intolerant, without celiac disease, there would be no antibodies present (in blood, stool or otherwise)?
Also, agree with Hallie. Even people who have never been on gluten free diets would realize that gluten free bread is different. Those sausages with wheat fillers would have done the trick!

 
Mel
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said this on
14 May 2013 12:34:38 PM PDT
I am glad someone is at last taking this subject seriously. My four year old grandson has been tested for celiac disease but it was confirmed that he did not have it. However, we (his family) know that if he eats gluten products he becomes twitchy (really mild spasms); especially in his sleep, his intestines grumble really badly, he becomes more hyperactive and naughty and when he drinks milk it hurts his stomach. If, however, we maintain his gluten-free diet, he is calm, not at all twitchy, you never hear his stomach grumble and when he drinks milk, he is fine. It is annoying that the doctors do recognise gluten intolerance if celiac is not present. So I say well done for the research. Much more is needed, especially with children and gluten intolerance to convince the medical world.

 
Eugenia Rodgers
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said this on
05 Aug 2013 7:26:00 PM PDT
Interesting. I have severe systematic shin splints, tumor knots behind both knees and both sides of groin area, and extreme exhaustion whenever I eat gluten. This reaction has been going on since Spring 2009. Also, I deal with IBS and have been diagnosed with Rocky Mountain Spotted Fever last week. I have been looking since 2009 for someone to listen to me. Thank you.




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That makes sense...I cried with relief when I got my diagnosis just because there was finally an answer. Please know that you are not weak or crazy. Keep pushing for testing. It could still be celiac, it could be Crohns. Push your Dr's to figure this out. Best wishes.

Thank you all very much. I actually cried when I got the answer. I wanted an explanation that I could "fix." Now I'm back to thinking I'm just weak and possibly crazy. I know I'm not crazy, but you know.

From what I have read online there is about a 1-3% chance of getting a false positive for celiac disease from a blood test. Was it a blood test that you got done? It may be worth your while to get a biopsy or more testing just to confirm it. I know being gluten free is a pain but it is better than getting cancer or other auto immune disorders.

I prefer edible candy. I have glaucoma and celiac so it helps me on a daily basis for all of my medical problems. I wish I could find a strain that has laxative effects so I didn't need linsess. Leafly.com has a lot of strain information and cannabist is a good resource, too. You can use CBD or THC and not get 'stoned'. I function fine on 20 mg of the candy. I refuse to drive if I smoke though. Good luck, hope it helps.

Is it NCGS or Low stomach acid misdiagnosed Low Stomach Acid and Celiac Disease Dear Gluten Intolerant please consider Low Stomach Acid as a possible Differential Diagnosis as a possible way to achieve remission of your GI symptom's. ?Consider what I say; and the Lord give thee understanding in all things? 2 Timothy 2: 7 Low stomach acid has now been linked to a probable cause of damage to the Small Intestine before and/or occurring with a Non-Celiac Gluten Sensitivity (NCGS) or Celiac diagnosis. See this research as reported on celiac.com that discusses the increased risk of/for someone to develop celiac disease after taking PPI?s. http://www.celiac.com/articles/23432/1/Do-Proton-Pump-Inhibitors-Increase-Risk-of-Celiac-Disease/Page1.html Note how the article starts quoting ?Rates of celiac disease and the use of drugs to inhibit the secretion of stomach acid have both increased in recent decades. A research team recently set out to explore the association between anti-secretory medication exposure and subsequent development of celiac disease.? If these medicine are lowering stomach acid what cause effect relationship does/ could this have on Celaic/NCGS diagnosis is what he is postulating. He goes on to say without being very technical (read the whole article for yourself) that ?The data clearly show that patients who use anti-secretory medications are at much greater risk for developing celiac disease following the use of these medicines. The fact that this connection persisted even after the team excluded prescriptions for anti-secretory medicines in the year preceding the celiac disease diagnosis suggests a causal relationship?. If even after a year OFF these medicines your chances of developing Celiac Disease (celiac disease) not to mention even NCGS which is much more prominent surely the researcher is correct in postulating that there is a cause and effect relationship between low stomach acid and NCGS and/or Celiac disease. Surely there is something we can learn here. I now postulate some homework for the reader of this blog post. Do some research for yourself and see if achlorhydia or hypochlorhydia symptoms don?t at least resemble in some manner all of the GI symptoms you have been having. (I note some of the many symptom?s low stomach acid can present with below as referenced from Dr. Myatt?s online article ?What?s Burning You? for easy reference (It might not be what you think (my words)) It is important to note here that ?some? symptoms does not mean all but many or several. It is called a differential diagnosis. It is an important diagnostic tool in medicine. Think of the tv show ?House? where they spend the whole hour/over a week times going through the ?differential diagnosis? in short any one symptom can/have many different causes. The trick is how to quickly eliminate possible outcomes as symptoms (many) go up. All is usually never meet because that would make the disease in full outbreak and obvious even to the layman a condition described as ?frank? or ?classic? Scurvy or Rickets as an example. Sadly too often after 8 to 10+ years of testing after all the differential diagnosis?s are ruled out you are said by process of elimination to have Celiac Disease if you are lucky or maybe NCGS and not some other acronym GI disease as I like to refer to them as a group. GERD,IBS,UC, Chrons etc because if they turned down that street ? . you are/could be in/at a dead end for they stop looking at the trigger (gluten) as the cause of your gastric upset/digestive disorder(s). So in summary if 3 or 4 or 5 or 6 of these symptoms overlap ?many of? these symptoms could be Low Stomach Acid related. IF that is the cause/case for you then there is hope! For remission! From Dr. Myatts? Online article what?s burning you? From Dr. Myatts? Online article what?s burning you? http://healthbeatnews.com/whats-burning-you/ Diseases Associated with Low Gastric Function Low stomach acid is associated with the following conditions: * Acne rosacea * Addison?s disease * Allergic reactions * Candidiasis (chronic) * Cardiac arrhythmias * Celiac disease * Childhood asthma * Chronic autoimmune hepatitis * Chronic cough * Dermatitis herpeteformis * Diabetes (type I) * Eczema * Gallbladder disease * GERD * Graves disease (hyperthyroid) * Iron deficiency anemia * Laryngitis (chronic) * Lupus erythromatosis * Macular degeneration * Multiple sclerosis * Muscle Cramps * Myasthenia gravis * Mycobacterium avium complex (MAC) * Osteoporosis * Pernicious anemia * Polymyalgia rheumatica * Reynaud?s syndrome * Rheumatoid arthritis * Scleroderma * Sjogren?s syndrome * Stomach cancer * Ulcerative colitis * Vitiligo When low in stomach acid we become low in essential nutrients Quoting from Dr. Myatts ?what?s burning you? online article ?Our bodies need 60 or so essential nutrients. ?Essential? means that the body MUST have this nutrient or death will eventually ensue, and the nutrient must be obtained from diet because the body cannot manufacture it. Many of these essential nutrients require stomach acid for their assimilation. When stomach acid production declines, nutrient deficiencies begin. Calcium, for example, requires vigorous stomach acid in order to be assimilated. Interestingly, the rate of hip replacement surgery is much higher in people who routinely use antacids and acid-blocking drugs. We know that people who have ?acid stomach? were already having trouble assimilating calcium from food and nutritional supplements due to lack of normal stomach acid production. When these symptoms are ?band-aided? with drugs which decrease stomach acid even more, calcium assimilation can come to a near-halt. The result? Weak bones, hip fractures and joint complaints resulting in major surgery. Jonathan Wright, M.D., well-known and respected holistic physician, states that ?Although research in this area is entirely inadequate, its been my linical observation that calcium, magnesium, iron, zinc, copper, chromium, selenium, manganese, vanadium, molybdenum, cobalt, and many other micro-trace elements are not nearly as well-absorbed in those with poor stomach acid as they are in those whose acid levels are normal. When we test plasma amino acid levels for those with poor stomach function, we frequently find lower than usual levels of one or more of the eight essential amino acids: isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. Often there are functional insufficiencies of folic acid and/or vitamin B12.? Remember, these are essential nutrients. Deficiencies of any single one of them can cause serious health problems over time. Weak bones, diminish immune function, failing memory, loss of eyesight and many other ?diseases of aging? are often the result of decreased stomach function.? It is me again reader. So low stomach acid is the triggering agent (often) for low nutrients. Make too much sense! Now don?t take Vitamin?s for this condition where low Vitamins/Minerals are known to be low in patients who have this condition because . . . . (if you do you won?t need to keep coming back to the doctor) I can almost hear the doctor say now. Of course he/she doesn?t say that . . . just that the ?average person? doesn?t need to take Vitamins. Well I hate to break it too you . . . . but if you are having GI problems and reading this blog post on celac.com then you are not the ?average? person. You my friend or a sufferer or a friend of a sufferer still looking for answers. If that is you then consider taking either powdered stomach acid ? Betaine HCL or taking Niacinamide to help you reset your stress clock. A Canadian researcher wrote about this connection 15+ years ago but still most doctors? don?t understand this connection between about how ?Niacin treats digestive Problems? Here is the full link so you can research it more yourself. http://orthomolecular.org/library/jom/2001/articles/2001-v16n04-p225.shtml And you might not after a first reading. I didn?t believe it myself for over a year . . . but every time I thought about it ? it (Low Stomach Acid) made/makes the most sense to me. **** Note: research this yourself. Here is a link about how to take Betaine HCL (powdered stomach) for maximum effectiveness. http://20somethingallergies.com/how-much-hcl-do-i-take-learn-to-test-for-your-correct-dose/ Don?t take my blog post as medical advice. It is only what I did . . . it might not work for you but I think it is worth a try especially if you are not now taking an acid reducer. (see notes below about why this might) be more difficult if you are already taking an acid reducer . . . because the rebound wall (see chris kresser link) keeps us locked in . . . sometimes for years. Since I was not taking acid reducers at the time I took Betaine HCL my stomach problems improved and I am sharing this now in the hopes it might help yours too! Now back to (really) LOW stomach acid being diagnosed as HIGH stomach acid these days. How can we know if it truly high or low? You?ve heard the phrase timing is everything well it is here too! Timeline is important in any diagnosis. IF your stomach acid was HIGH as you often hear (everywhere) you hear take a Proton Pump Inhibitor aka acid reducer?s for heartburn/GERD (medical name for heartburn) then eating food (carbs, greasy things) wouldn?t bother you. The acid would cut it up but if it is already low/weak then even a little acid can burn your esophagus which is not coated like the stomach to protect you from high acid. BUT if it is low to start with then food will WEAKEN our/your acid so that you lose the food fight your in and things (carbs/fats) become to ferment, rancidify and cause heart burn. Leading in time to Non-Celiac disease first and with enough injury (and time) to Marsh lesions qualifying you for diagnosis as a Celiac candidate / patient. See above link between/about PPI?s in the year preceding a Celiac diagnosis. If you (can) be that patient and weight the xx number of years for all this damage to occur, there is a better way it is called digestion! A virtuous cycle can replace the vicious cycle you are now in ? it is caused digestion. Digest your food with healthy stomach acid and your body will thank you for it with the God given burp. A healthy child burps (at 6 months of age normally) and a healthy adult should too and you will again after taken Niacinamide 3/day for 6 months or this is not the right diagnosis. *********Note this is not medical advice only my experience with Niacinamide and my many years researching this topic as a fellow sufferer. Let me make these disclaimer(s). If you are a) experiencing heartburn that causing vomiting (with unintended weight loss) you may have a special case of heartburn that feels like heartburn (on steroids) that is really Bile Reflux and taking Stomach is not something you should do without medical advice and supervision. See this NYtimes article that discusses the many complications often seen with Bile Reflux patients and why it is treated as Heartburn often and why Bile Reflux is especially hard to recover from. http://www.nytimes.com/2009/06/30/health/30brod.html you are already taking an acid reducer then the chance you will get better (off of acid reducers completely) is only 50/50 on your first try but going low CARB can help your transition. Otherwise most people will get better when taking BetaineHCL for gastric support and Niacinamide to help them/you reset your digestive processes. See this online article about how Jo Lynne Shane got off Nexium for good. http://www.jolynneshane.com/how-i-got-off-nexium-for-good.html and her Epilogue http://www.jolynneshane.com/epilogue.html You will see she still struggles some but is much better when she let her natural digestive juices do their job. I call it the ?Natural Order of Things?. See this article about the digestion process being a North South Affair from the bodywisdom website http://bodywisdomnutrition.com/digestion-a-north-to-south-process/ Taking it (Niacinamide) (or any B-Vitamin) should be taken 2 to 3/day (too keep up serum levels) for 3 to 4 months (the time you can store B-Vitamins) in the liver mostly. Once you have a distinctive BURP that displaces the bloating and sense of ?I am going to explode? if I eat another bite (though you haven?t eaten half your meal) then normal digestion is occurring again. If you stool did not sink before this process (of taking Niacinamide begun) and burping became your ?new normal? then it (your stool) will begin to sink too! Burping without bloating is the ?Natural Order? of good digestion. Don?t stop this process of taking B-Vitamins as Niacimaide or Slo-Niacin 2/day for at least 4 months then you should see most of your GI symptom?s go into remission. (I did not say "cure" but remission from your cross contamination's (flares/symptom's etc.) might be possible. Because our defenses are now strong enough to cut up proteins before they reach our small intestine (where most of the damage is done). Think of a castle with a moat around it (stomach acid is designed to protect us) when it is low (the moat doesn?t protect us) and when the moat is dry the castle becomes a ruin!!! So do proteins (lactose (casein), gluten, soy, seafood etc.) to our small intestines (they become ruined) when our stomach acid (moat) is low or worse dry! I repeat again Timeline is important in any diagnosis. All heartburn is not equal. IF your stomach acid is truly high then it WILL occur between meals when there is no food to tamp down the fire (occurring in your stomach) not your esophagus. The excess pressure from fermented carbs push open the trap door allowing the low acid you have to burn the lining of your uncoated esophagus. See also this online article by Chris Kresser to study this more about why/how this could be a case of medical misdiagnosis in more detail https://chriskresser.com/what-everybody-ought-to-know-but-doesnt-about-heartburn-gerd/ This is part of a 3 part series that I think you will find very informative. This (low stomach acid) is a vicious cycle. STRONG stomach acid makes it a virtuous circle/cycle. Now food benefits you because low acid not only causes heartburn it limits your body?s absorptive ability by limiting its ability to cut up your food into digestible peptides and amino acids which are no longer harmful to your Small Intestine but helpful to your overall health because nutrients can now be absorbed because the food particles are now small enough to not cause harm to your villi. I hope this is helpful and it helps you the way it helped me. Maybe it will help you in a similar manner. I write this only as a guidepost on your way. May you find your way back to digestive peace! The ?Natural Order? of things! Praise bee to God! It is not a long way if you know the way . . . . from someone who has found his way back God being his help! There are more things I could say . . . but this post is getting kind of long but you get the gest. I noticed someone else on the celiac.com noticed the same improvement when they treated their low stomach acid and thought it was time a blog post talked about it. It is so much easier to consume all this information in one setting instead of hunting and peeking through several thread posts. Search for the posterboy on celiac.com and you will find it is my focus (how low stomach acid is misdiagnosed) and how Niacinamide helped me to restore its ?Natural Order? in the digestive process because it helped me! Here is the link to the Prousky?s abstract. 15+ years is a long time for people to continue to suffer but if the research it right then Niacinamide might help you too! http://www.yourhealthbase.com/database/niacin-treats-digestive-problems.htm Let?s hope it is not another 15 years before doctor?s and people realize low stomach acid can explain many of the same symptom?s an IBS, NCGS or even a Celiac patient might experience given a long enough time for these conditions to develop from too low a stomach acid to protect our Small Intestine. See link at start of this blog post posted here again for convenience. http://www.celiac.com/articles/23432/1/Do-Proton-Pump-Inhibitors-Increase-Risk-of-Celiac-Disease/Page1.html And it is worth noting about the time Celiac disease started (began to be more prevalent) / to increase in the population Acid reducer?s became more and more popular. *** Some plot the increase in time to Roundup usage but I am not buying it. PPI?s increase seam more plausible to me based on the relatively new research (less than 5 years old) is pretty current by research standards and the near linear response to increased first H2 stomach acid reducer?s then PPI?s in the population at large. *****Note: after I finished writing this blog post new research that in my mind confirms this connection was reported on celiac.com today that notes the link between gastric pH and impaired nutrient absorption. This very topic as I was getting ready to publish my post about low stomach acid possibly being diagnosed as Celiac disease on my posterboy blog mentions how a Celiac patient?s absorption can be impaired by gastric pH. https://www.celiac.com/articles/24738/1/Can-Celiac-Disease-Impair-Drug-Therapy-in-Patients/Page1.html Where they (researchers) say/ask discussing Celiac Disease and whether it (celiac disease) can impair drug therapy in patients. Note the opening paragraph discussing this topic quoting ?Celiac disease is associated with numerous chronic conditions, such as anemia and malabsorption of some critical vitamins. Changes in the gastrointestinal tract, rates of gastric emptying, and gastric pH are responsible for impaired vitamin and mineral absorption." i.e., low gastric pH can effect absorption. It stands to make reasonable sense to me they are related conditions and one is being diagnosed for the other often or at least one is being confused as the other and treating one (raising your stomach pH) might treat the other since many of the symptoms? are the same. *** this/these opinion(s) are my own and do not reflect an endorsement by celiac.com of these ideas, comments, thoughts or opinions. I hope this helps! You the way it did me! Good luck on your continued journey, Remember **** This is not medical advice and should not be considered such. Results may vary. Always consult your doctor before making any changes to your regimen. 2 Timothy 2:7 Consider what I say; and the Lord give thee understanding in all things. Posterboy by the Grace of God,