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  • Scott Adams
    Scott Adams

    A Gluten-Free Diet May Not Stop Gut Inflammation for all Celiac Disease Patients

    Reviewed and edited by a celiac disease expert.

    New study shows that a gluten‐free diet may not be enough to curb gut inflammation in all celiac disease patients.

    A Gluten-Free Diet May Not Stop Gut Inflammation for all Celiac Disease Patients - Image: CC BY 2.0--Güel - Centro de Wellness Murcia
    Caption: Image: CC BY 2.0--Güel - Centro de Wellness Murcia

    Celiac.com 03/08/2021 - When people with celiac disease eat gluten, it triggers adaptive immune cells, which cause damage to the lining of the small intestine. Doctors gauge the severity of celiac disease through histological assessment of the intestinal damage via intestinal biopsy. To confirm diagnosis and to test drug efficacy in clinical trials, doctors rely on a gluten challenge. However, patients respond with different magnitudes to the same gluten challenge. This is a problem that a group of researchers looked at recently, in a study of 19 well‐treated celiac patients.

    The research team included Jorunn Stamnaes; Daniel Stray; Maria Stensland; Vikas K. Sarna; Tuula A. Nyman; Knut E. A. Lundin; and Ludvig M. Sollid. They are variously affiliated with the K.G. Jebsen Coeliac Disease Research Centre, University of Oslo, Oslo, Norway; the Department of Immunology, University of Oslo and Oslo University Hospital‐Rikshospitalet, Oslo, Norway; and the Department of Gastroenterology, Oslo University Hospital‐Ullevål, Oslo, Norway. 
     
    In the study patients, proteome analysis of total tissue, or isolated epithelial cell compartment from formalin‐fixed paraffin embedded biopsies, collected before and after 14‐day gluten challenge, shows that patients with strong mucosal response to gluten challenge have signs of ongoing tissue inflammation prior to the gluten challenge. 

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    This low‐level tissue inflammation at baseline is mirrored by increased gluten specific CD4+ T‐cells in the gut, and a low‐level blood inflammatory profile. 

    This study shows that even well‐treated celiac disease commonly features ongoing low‐grade inflammation and anti-gluten immunity in the gut mucosa, and that histology assessment alone is not a good measure of full recovery and gut mucosal healing in celiac patients. 

    The findings raise a concern that even a vigilant gluten‐free diet might not be enough to curb gut inflammation in all celiac disease patients.

    Read more at Wiley Online Library

    Edited by Scott Adams



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    trents

    One take away from this is we may need to more often give the benefit of the doubt to those who post on the forum and are adamant about being gluten free.

    We have also had a large number of people post on the forum recently who have new onset of celiac symptoms after being largely asymptomatic for years once going gluten free. The article makes me wonder if there is more going on than just having develop intolerances/allergies to non gluten foods.

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    Guest diagnosed with problems

    Posted

    I was diagnosed in 2010 and continue to have diarrhea and now constipation issues no matter that I adhere to a strict diet and have had proof of villa renewed.  Why some people continue to have T cell activity could be due to other autoimmune diseases? I also have RA. 

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    sc'Que?
    On 3/10/2021 at 7:06 PM, trents said:

    One take away from this is we may need to more often give the benefit of the doubt to those who post on the forum and are adamant about being gluten free.

    We have also had a large number of people post on the forum recently who have new onset of celiac symptoms after being largely asymptomatic for years once going gluten free. The article makes me wonder if there is more going on than just having develop intolerances/allergies to non gluten foods.

    Could you better clarify that last bit?  I'm trying to full grasp what you mean. 

     

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    sc'Que?

    I've been gluten-free since 2009 after being gluten-sick since 2007.  Around 2014 to 2016, I developed what I thought was ringworm on my neck and scalp.  After various OTC treatment regimens failed, I began to consider seeking a dermatologist in late 2019. Having not had a GP since high-school... well, I'm sure you know how that went. 

    Didn't get to see a GP until May or June 2020... who, of course, wanted to cover up symptoms and collect money rather than track down the problem.  The dermatologist I was then able to access--the entire medical system is so fraught with gateway nepotism, and I don't understand how it's legal--at least looked at what the GP was trying to prescribe and laughed at him.  But he, too, was merely addressing the symptoms as it turned out, not seeking to find the cause. 

    November 2020, I figured out that the strange narcoleptic symptoms I'd been having for nearly a year were definitely food-related. And by happenstance, I figured out that potatoes were part of the problem. After in-home testing and dietary elimination, it became clear that I'm now also allergic to nightshade vegetables: tomatoes, potatoes, eggplant, goji berries, peppers of all varieties and tobacco.  

    I'd always been sensative to cigarette smoke, though less so to pipes and cigars. So I always figured it was the chemicals.  But once I was off nightshades for a month or so, my narcoleptic strangeness disappeared, and the "7-year itch" on my neck, scalp and shoulders finally went away!

    My diet is now severely limited. I can no longer eat most prepared foods. Almost everything contains un-named "spices" and "natural flavors" which generally lead back to paprika (or other peppers) and/or tomatoes.  And potatoes are used quite a bit in gluten-free baking and as thickening agents in all sorts of mainstream and gluten-free foods.  Quite literally, nightshades were at least 90% of my diet.  The change is dramatic. No more Sichuan, no more Italian. Even seemingly bland Germanic foods aren't safe. Mayonnaise and prepared mustard. Boxed meat stock.  50% of the spices on my extensive spice rack. 

    So, now I'm wondering... what comes next?   Am I just now completely pre-disposed to immune-system overdrive?  What's the next thing I'm going to suddenly become allergic to?  

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    trents
    1 hour ago, sc'Que? said:

    Could you better clarify that last bit?  I'm trying to full grasp what you mean. 

     

    I don't know how to make it clearer than to just say immune system factors other than what can be contributed to what we eat, whether gluten or non gluten containing foods. I just get the feeling after reading that article and after reading the testimonies of many forum contributors that for more than a few people who start out with a celiac disease or gluten sensitivity diagnosis there are other autoimmune gut disease forces that kick in at some point that are food independent, things poorly understood at this time.

    Edited by trents
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    sc'Que?

    @trents, I do not disagree. I was hoping to coax out any further info/opinions that you might have felt awkward about sharing. I'm trying to understand the thing myself. 

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    knitty kitty

    It's thiamine deficiency.  

    Thiamine Deficiency Promotes T Cell Infiltration in Experimental Autoimmune Encephalomyelitis: the Involvement of CCL2

    Open Original Shared Link

    Thiamine deficiency causes a more severe reaction to antigens than seen in the thiamine sufficient.  

     

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    trents
    1 hour ago, knitty kitty said:

    It's thiamine deficiency.  

    Thiamine Deficiency Promotes T Cell Infiltration in Experimental Autoimmune Encephalomyelitis: the Involvement of CCL2

    Open Original Shared Link

    Thiamine deficiency causes a more severe reaction to antigens than seen in the thiamine sufficient.  

     

    The study you sight concerns T Cell/mast cell proliferation in MS patients, not those with celiac disease or other bowel disorders. I doubt if thiamine deficiency alone can explain what many in the celiac population are experiencing with regard to resurfacing of their symptoms after years of gluten free living. I don't think thiamine supplementation is the silver bullet, one size fits all answer to this phenomenon, especially (and I'm guessing here) many of these people are supplementing heavily with B vitamins.

    Edited by trents
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    knitty kitty

    Yeah, well, I didn't think you'd like the studies done of fish, either.  

    An antigen is an antigen.  It causes an immune response in MS (also an autoimmune disease), in fish presented with a fish antigen, in Celiac Disease.  Thiamine helps down regulate the immune system so fewer t cells react.  

    Vitamin deficiencies can occur after years on the gluten free diet.  

    And, no, thiamine supplementation isn't the silver bullet solution, but it's a place to start.  All the B vitamins are needed because they all work together.  Supplementation may be beneficial because absorption of nutrients can be badly affected in Celiac Disease.  

    The doctors who did the study in Scott's article above didn't investigate the nutritional status of the patients in the study to see if the groups had deficiencies or not.  Vitamins just aren't on doctors' radar.  And that's a shame.

    Not everything is caused by gluten contamination either.  

     

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    trents
    37 minutes ago, knitty kitty said:

    And, no, thiamine supplementation isn't the silver bullet solution, but it's a place to start. 

    But in your previous post you said, "It's thiamine deficiency." That's pretty unequivocal. That's what I had a problem with.

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    knitty kitty

    I'm sorry you had a problem with that article.  Maybe this one.....it does include bowel diseases....in humans.....

      The Overlooked Vitamin That Improves Autoimmune Disease and Autonomic Dysfunction

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    Unequivocally, Thiamine Deficiency is one of  the "other autoimmune gut disease forces that kick in at some point that are food independent, things poorly understood at this time."

    But it is dependent on food, at least on absorption of nutrients....

    Definitely overlooked, definitely.

     

     

     

    Edited by knitty kitty
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    AnonyousCda
    On 3/15/2021 at 2:18 PM, Guest diagnosed with problems said:

    I was diagnosed in 2010 and continue to have diarrhea and now constipation issues no matter that I adhere to a strict diet and have had proof of villa renewed.  Why some people continue to have T cell activity could be due to other autoimmune diseases? I also have RA. 

    Check out research on Berberine supplement 1500 mg a day. Its for good gut bacteria. 

    Once you get your gut bacteria to somewhat normal double dose on Vitamin B12, B6 (breaks down carbs), Biotin, L-Citruline (breaks down meats), iodine. 

    Wish you good health. 

     

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  • About Me

    Scott Adams

    Scott Adams was diagnosed with celiac disease in 1994, and, due to the nearly total lack of information available at that time, was forced to become an expert on the disease in order to recover. In 1995 he launched the site that later became Celiac.com to help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives.  He is co-author of the book Cereal Killers, and founder and publisher of the (formerly paper) newsletter Journal of Gluten Sensitivity. In 1998 he founded The Gluten-Free Mall which he sold in 2014. Celiac.com does not sell any products, and is 100% advertiser supported.


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