Celiac.com 08/24/2018 - Last year was our first gluten-free Halloween and my older son, James (now in 5th grade) got really upset when he realized that he wouldn’t be able to eat a lot of the candy from trick or treat night. He was saying he didn’t want to trick or treat and for awhile wouldn’t pick out a costume. (Prior to this, he loved dressing up and trick-or-treating.)

We solved this problem by having an unsafe candy auction for both of our boys, at the end of the evening. I went out and bought individual candies that I knew they liked (as opposed to bags of it) and non-food treats (small toys, sillybanz - stuff you might put in their stocking at Christmas). When they came home from trick-or-treating, we emptied their bags and divided the candy up: safe pile and unsafe or questionable pile.

Then I had my bag of surprise treats - I don’t know if you are a Survivor fan, but I did it kind of like their food auction. I held up something like two containers of cotton candy and asked how many unsafe candies they would pay for it - except unlike Survivor - both boys bought it, not just one. Maybe they would shout out “five candies” - we had a separate bag for the “payment” they “paid” for all the safe candies and treats.

(My husband took the bag of unsafe candies to work where he was VERY popular.) At the end of the auction, I had something a little bigger, I can’t remember what it was (maybe a ds game?) The “payment” for the last, big treat was the rest of their unsafe candy.

I hope this helps you as Halloween approaches. My kids loved it and No-one cried.

Celiac.com 08/17/2018 - Mucosal dryness is among the top non-gastrointestinal complaints of patients with gluten intolerance and celiac disease.

Prolonged eye dryness, itching and chronic inflammation of the eye lids (blepharitis), mouth dryness, excessive thirst, frequent yeast infections, skin dryness and vaginal dryness in women may represent clinical symptoms of Sjogren’s syndrome. Named after Swedish ophthalmologist Henrik Sjögren, Sjogren’s syndrome is one the most common (and one of the most commonly underdiagnosed) rheumatic/autoimmune diseases. The disease most frequently affects women (10 women for every man) and usually appears in women around and after menopause. However, the disease can affect either gender at any age.

In addition to mucosal and skin dryness, Sjogren’s syndrome can cause joint pain and stiffness, damage to peripheral nerves leading to numbness and tingling of fingers and toes, fatigue, brain fog, inflammation of blood vessels, hair loss, poor food digestion due to pancreatic damage and various problems with the cardiac muscle and its conduction system causing arrythmia and myocarditis. Patients suffering from Sjogren’s syndrome quite frequently deal with recurring yeast infections, chronic periodontal disease, recurring canker sores and poor dental health.

The diagnosis of Sjogren’s syndrome is based on:

• Demonstration of mucosal dryness upon physical examination
• Specific blood tests (positive anti-SSA/Ro and anti-SSB/La antibodies, elevated levels of serum immunoglobulin G)
• Ultrasound imaging of salivary glands

On rare occasions, a diagnosis of Sjogren’s syndrome requires confirmation through a small salivary gland biopsy or special nuclear medicine studies.

It is well documented that patients with gluten intolerance and celiac disease have an increased risk of Sjogren’s syndrome. Similarly, patients with Sjogren’s syndrome are characterized by the increased prevalence of gluten intolerance and celiac disease.

The connection between Sjogren’s syndrome and gluten intolerance is not a coincidental one: there are well-studied molecular mechanisms explaining this link. In the late 1980s/early 1990s genetic studies in Sjogren’s patients demonstrated an increased presence of the class II major histocompatibility complex protein HLA DQ2. Furthermore, HLA DQ2 positivity was found to be associated with increased titers of Sjogren’s specific anti-SSA/Ro and anti-SSB/La antibodies. The link between gluten and Sjogren’s syndrome became obvious in the mid to late 1990s when it was discovered that HLA-DQ2 binds to deamidated gluten peptides and presents them to mucosal CD4+ T cells thus initiating a chain of events eventually leading to autoimmune responses.

The second set of data came from the discovery of BM180 protein. This protein regulates tear secretion in the lacrimal acinar cells. Suprisingly, amino acid sequence of BM180 has a similarity with alpha-gliadin and, therefore, can attract inflammatory cells activated by gluten thus contributing to the development of eye dryness.

The actual prevalence of gluten intolerance in Sjogren’s patients based on published data varies from 20% to 40% depending on the criteria used to define gluten intolerance. The data from our clinic (Institute for Specialized Medicine) indicate that gluten intolerance can affect almost half of patients with Sjogren’s syndrome. Additionally, our data show that one third of patients with gluten intolerance have evidence of mucosal dryness and Sjogren’s syndrome.

The frequency of documented celiac disease in patients with Sjogren’s syndrome is in the vicinity of 5%.

The following is a patient case history from our clinic:

• A 28 year old woman was seen in our clinic due to her complaints of long-standing irritable bowel syndrome and recent onset of eye dryness. Her initial presentation included abdominal pain, bloating and irregular bowel movements. She was seen by several gastroenterologists and underwent several upper endoscopies and colonoscopies with mucosal biopsies which were non-diagnostic. Her lab test results showed positive IgG anti-gliadin antibodies and she was told that “this is a common finding among healthy people, and is not indicative of any illnesses.” She was seen by her ophthalmologist and prescribed with contact lenses which she could not wear due to significant eye discomfort and irritation. Further eye examination showed that she had diminished tear production and was referred to our clinic to rule out Sjogren’s syndrome.

Upon physical examination in our clinic the patient not only demonstrated profound eye dryness but also showed evidence of dry mouth, fissured tongue and patchy areas of thrush as well as very dry skin. A sonographic evaluation of her major salivary glands was suspicious for moderately advanced Sjogren’s syndrome. Her laboratory test results showed: positive anti-SSA/Ro antibodies, elevated serum immunoglobulin G, low neutrophil count as well as low levels of vitamin D and ferritin (a serum marker of iron storage state). Also, the patient was found to have positive serum IgG and salivary IgA anti-gliadin antibodies as well as positive HLA DQ2 (a molecular marker associated with gluten intolerance).

Based on a combination of clinical history, physical findings and laboratory test results, the patient was diagnosed with gluten intolerance and Sjogren’s syndrome. In addition to the aforementioned tests, the patient underwent food intolerance testing based on serum IgG4 antibodies which showed not only gluten but also cow’s casein intolerance. Her treatment options included a traditional route of therapy based on drugs or an integrative approach based on dietary modifications and food supplements. She opted for the integrative approach and started a gluten-free and dairy-free diet as well as iron glycinate, vitamin D, specific probiotics and digestive enzymes.

After the first month on the diet and supplements, she reported a remarkable improvement of her irritable bowel symptoms and in three months, she started noticing an improvement of the dryness. Laboratory tests performed six months after initiation of the therapy showed normalization of the IgG level, disappearance of anti-SSA/Ro antibodies and a slightly suppressed neutrophil count. Through following the prescribed diet and supplements she is now symptom free.

Why do we need to treat Sjogren’s syndrome? Left untreated, Sjogren’s syndrome can cause debilitating dryness affecting gastrointestinal and respiratory tracts. Clinically, this manifests as difficulty in swallowing solid foods, heartburn, malabsorption of nutrients and minerals, bloating, weight loss, chronic sinus infections and prolonged dry cough. Sjogren’s syndrome also significantly increases the risk for malignancies affecting lymphatic nodules, known as lymphomas.

Therapy for Sjogren’s syndrome is based on the treatment of mucosal dryness and the autoimmune component of the disease. In addition, patients affected by Sjogren’s syndrome need to have regular screenings for malignancies (specifically lymphomas) and premalignant conditions.

Traditional therapy for Sjogren’s syndrome (treatment of dryness):

• Cyclosporin (brand name Restasis) eye drops and artificial tears for dry eyes.
• Numoisyn lozenges and liquid, as well as Caphosol for mouth dryness and mucositis.
• Cevimeline (brand name Evoxac) and pilocarpine (brand name Salagen) for systemic dryness therapy.

Treatment of autoimmune disturbances:

• Hydroxychloroquin (brand name Plaquenil).
• Leflunomide (brand name Arava).
• Severe autoimmune conditions associated with Sjogren’s syndrome are treated with the biologic drug rituximab (brand name Rituxan).
• Integrative therapy for Sjogren’s syndrome.
• Ear acupuncture (auricular therapy) and body acupuncture to stimulate tear and saliva production.
• Elimination diet based on individual food-intolerance profiles.
• Oral probiotics (for example, BLIS K12) and intestinal probiotics.
• Digestive enzymes.
• Fish and krill oils.
• Black currant seed oil.
• Cordyceps sinensis in combination with wormwood extract to treat the autoimmune component of Sjogren’s syndrome.
• Zinc and elderberry lozenges.
• N-acetyl-L-cysteine and glutathione.

Our extensive clinical experience demonstrate that early cases of Sjogren’s syndrome can be completely reversed (by both clinical and laboratory criteria) by the strict gluten-free and elimination diet. The advanced cases cannot be reversed; however, even in advanced cases the gluten-free and elimination diet can slow the progression of the disease.

If you’re concerned that dryness may represent Sjogren’s syndrome, see a rheumatologist for further evaluation and management of your condition.

References:

• Alvarez-Celorio MD, Angeles-Angeles A, Kraus A. Primary Sjögren’s Syndrome and Celiac Disease: Causal Association or Serendipity? J Clin Rheumatol. 2000 Aug;6(4):194-7.
• Asrani AC, Lumsden AJ, Kumar R, Laurie GW. Gene cloning of BM180, a lacrimal gland enriched basement membrane protein with a role in stimulated secretion. Adv Exp Med Biol. 1998;438:49-54.
• Feuerstein J. Reversal of premature ovarian failure in a patient with Sjögren syndrome using an elimination diet protocol. J Altern Complement Med. 2010 Jul;16(7):807-9.
• Iltanen S, Collin P, Korpela M, Holm K, Partanen J, Polvi A, Mäki M. Celiac disease and markers of celiac disease latency in patients with primary Sjögren’s syndrome. Am J Gastroenterol. 1999 Apr;94(4):1042-6.
• Lemon S, Imbesi S., Shikhman A.R. Salivary gland imaging in Sjogren’s syndrome. Future Rheumatology, 2007 2(1):83-92.
• Roblin X, Helluwaert F, Bonaz B. Celiac disease must be evaluated in patients with Sjögren syndrome. Arch Intern Med. 2004 Nov 22;164(21):2387.
• Teppo AM, Maury CP. Antibodies to gliadin, gluten and reticulin glycoprotein in rheumatic diseases: elevated levels in Sjögren’s syndrome. Clin Exp Immunol. 1984 Jul;57(1):73-8.

Celiac.com 08/10/2018 - You’ve heard for years that it’s wise to start your day with a healthy breakfast.  Eating food first thing in the morning gets your metabolism revved so you have energy throughout the day.  There’s also the issue of incorporating healthy foods into your first meal of the day.  Ideally, every meal should include fiber and foods from a variety of food groups.  But the reality is that most people don’t have time in the morning to create an involved meal.  You’re busy getting ready for work, packing the kids’ lunches and trying to get everyone out of the door on time.  

Don’t fret.  The task of preparing a healthy breakfast just got easier.  You can make 5-minute breakfasts and, with a little bit of planning, you can sneak fiber into those meals without spending a lot of extra time with preparation.  An ideal breakfast will include whole grains (from gluten-free cereals, breads, muffins, or uncontaminated oats), a low-fat dairy item (1% milk, low-fat yogurt, or low-fat cheese), and a source of protein (such as peanut butter or eggs).  Adding fruit is a plus.  

If you can tolerate uncontaminated oats, make a bowl of oatmeal and add a little extra fiber by stirring in chopped walnuts and dried cranberries.  If you like scrambled eggs, toss some fresh spinach (sliced into thin strips), 1 chopped canned artichoke heart, two tablespoons crumbled feta cheese, and a dash of Italian seasoning to the egg as it cooks.  
If you have time on weekends to make healthy gluten-free pancakes (which  means that you added perhaps flax seed meal or shredded apples or something that qualifies as fiber to the batter), then freeze the pancakes between sheets of wax paper, place them in a freezer bag, and freeze so they’ll be handy on busy weekday mornings.  If you don’t have time to make them prior to need, you can always use commercial frozen gluten-free pancakes.  In a bowl, mix together a few raisins, half of a chopped pear or apple, a few dashes of cinnamon and a couple of tablespoons of chopped walnuts.  Spoon this mixture down the centers of two toasted (or microwaved) pancakes, drizzle each with 1 teaspoon of pancake or maple syrup, then fold in the sides of the pancakes to make two breakfast sandwiches.

Brown rice is brown because the bran layer is still on the rice, and the bran layer is the part that’s so high in fiber.  White rice is much lower in fiber and has less nutritional value.  Brown rice isn’t just for dinner anymore.  It offers a nice breakfast alternative from traditional hot cereals.  The next time you make brown rice for dinner, make a little extra and save some for breakfast the next morning.  In the A.M., mix the rice (about 1 cup) with a few chopped pecans, a few raisins, 1/2 cup milk, 3 tablespoons pancake syrup, a dash each of vanilla and cinnamon, then microwave the mixture for 1 minute, stirring once after 30 seconds.  Let it sit for 30 seconds to thicken before eating.  Or stir together 1 cup cooked brown rice, 1/4 teaspoon cinnamon, 1/2 navel orange diced, some chopped dates, dried cranberries, and shredded coconut; heat this in the microwave and then top it off with 1/2 cup low-fat vanilla yogurt.

Just a note about using the microwave—it’s not an exact science.  Different ovens have different power levels so what cooks in 30 seconds in one person’s microwave may take 45 seconds in someone else’s unit.  Unless you want the food to splatter all over the sides of the oven, you’ll need to cover any liquids or soft foods with waxed paper.  

There will be days when you don’t have time to sit down at the table and enjoy a leisurely breakfast.  On these days, make a “grab-and-go” breakfast that you can take with you.  Gluten-free wraps keep for several weeks in the refrigerator and they make great fill-and-go containers on busy mornings.  Spread a wrap with peanut butter, sprinkle some fortified gluten-free dry cereal on top, then drizzle with a teaspoon of pancake syrup; roll up the wrap and you have the perfect dashboard dining breakfast to eat on the way to work.  Or scramble an egg, spoon it down the center of the wrap, and then top it off with a little salsa and pepper-jack cheese before rolling it up. If you only have three minutes before you have to leave the house, spoon some low-fat cottage cheese into a cup, stir in a dash of cinnamon, top with a little low-fat gluten-free granola or fortified dry gluten-free cereal, sprinkle berries or chopped peaches over the top, grab a spoon, and you’re ready to go!

Smoothies can be made in literally one minute.  Toss some frozen raspberries into a blender, add a 12-ounce container of low-fat lemon yogurt, a little milk, and two teaspoons of vanilla; blend, then pour the mixture into a large plastic cup.

If you oversleep, don’t panic.  Have some back-up foods on hand that you can grab and eat en route to work, like a gluten-free protein bar and a banana, or a bag of nuts and dried fruit, or flax seed crackers with a handful of cheese cubes, or toss some gluten-free granola over a container of yogurt and grab a spoon to take along.

All of the above suggestions can be made in five minutes or less.  Take the time to start your day off with a healthy breakfast—you deserve to do that for yourself and for your family.

Apple English Muffins by Connie Sarros

This recipe is from my newly-released book Student’s Vegetarian Cookbook for Dummies.  While this isn’t a gluten-free cookbook, most of the recipes are naturally gluten-free or can very easily be converted to gluten-free.  

Preparation time:  4 minutes.  Cooking time:  30 seconds.  Yield:  1 serving

Ingredients:

• 1 tablespoon peanut butter 
• 1 gluten-free English muffin, toasted 
• 1/8 large apple, peeled, cored and sliced thin
• ½ teaspoon butter 
• ¾ teaspoon brown sugar
• 1/8 teaspoon cinnamon

Directions:

1. Spread peanut butter on one toasted English muffin half.  Lay the apple slices on top.
2. In a small microwave safe bowl, heat the butter in the microwave on high for 15 seconds.  Stir in the brown sugar and cinnamon then nuke for another 15 seconds.  Stir until smooth.  (If necessary, pop it back into the microwave until the brown sugar melts).  
3. Drizzle the cinnamon mixture over the apple slices then place the second half of the English muffin on top.
4. Note:  If you’re out of apples, use a pear, ripe peach or nectarine, mango, or even a banana.

Celiac.com 08/04/2018 - December 16, 2000, a date that is etched in my mind forever. My husband and I went out for dinner with friends and returned to their home to play some cards for the evening. By around 9 p.m., I noticed my stomach rumbling and I began to make many trips to the bathroom with diarrhea. In fact, it was the beginning of a month-long siege of severe diarrhea. Up until that day, I never had any problems with digestion, bowel problems, or food issues. But suddenly my life was changing. After about four days, I saw my family doctor who started me out with a course of Flagyl, which did nothing to stop the diarrhea over the ensuing week. Following that was my visit to the ER, only to be told to follow up the next morning with my family doctor. When I showed up without an appointment, he told his nurse that he didn’t know what to do with me, so he didn’t see me at all. I was pushed off on the nurse practitioner, who was so sure her treatment would work that all I had to do was consume 2 TBS of water every 2 hours for 2 days, guaranteeing I would be better. My heart knew it wasn’t so, and the continued diarrhea proved it. I was losing one to two pounds a day, but no one was even paying any attention to my weight changes on each visit. After three weeks and another subsequent visit to the ER, I was down 25 pounds.

A visit with a gastroenterologist was a huge waste of time. All he could think of doing was a colonoscopy and maybe three weeks more of Flagyl. I told him that in three weeks I would be dead. I refused the colonoscopy and walked out.

All during this month, I could not eat a single thing without consequence, and by the end of the month, even water went straight through me. I did the BRAT diet (bananas, rice, applesauce, toast), but mostly stuck to the toast with a bit of butter on it. Seeing that it didn’t work, I stopped eating altogether. My husband thought my downfall with the BRAT diet was that I was spreading butter on the bread. How little we knew!!

The visits to all the doctors and ER’s were worthless, and I grew weaker by the day. I had to give up work during this time and spent most of my days in a recliner. It was the holidays and going out to eat meant I was drinking water while everyone else ate such wonderful-looking foods. After the first couple of weeks, my strength was zapped. Taking a shower wore me out, and drying my hair left me breathless. I needed to take 15 minute breaks trying to recover just so I could continue. I confided in my son that I didn’t feel I was going to live much longer, but I could not say those words to my husband. He was angry that no one was figuring out what was wrong with me. I downplayed how sick I was, but I am sure he began to wonder how badly things were going for me.

Taking matters into my own hands, I called a friend who worked for a neurosurgeon. A new doctor had just joined the practice and I thought perhaps he came from somewhere else in Ohio. To make a long story short, he grew up in Ohio and did his training here so he was able to contact those old teachers of his and get me admitted to their hospital about an hour away. Keep in mind that this man did not know me, but he had the presence of mind to know things were quite serious. Within an hour, I was at his teaching hospital and being admitted. I stayed in the hospital for five days and was now down about 30 pounds. I was nothing but a bag of bones. I took a book with me to read. How ironic it was that it was Stephen King’s novel, A Bag of Bones! At least I could make some jokes about it when a nurse or intern would stop to see me. Finally a gastroenterologist came to my room on my second day of admission and spoke with me for about 5 minutes and felt he knew what the problem was. He asked me why no one in my hometown could figure anything out in three weeks’ time, and he knew in 5 minutes. A subsequent endoscopy proved his suspicions of celiac disease.

Then came the hard part: The Gluten Free Diet!!! A dietician handed me about 30 pages of information, all of which made no sense to me. I was told to go on the internet. The first thing I did was cry! My husband and I made a trip to the grocery store and spent over two hours reading labels. I knew of no one in my area that was familiar with celiac disease. In the first two weeks home, I ate 5 jumbo bags of Lay’s Potato Chips. I didn’t know what else to eat and was literally starving to death. About four weeks into the diet, realization set in about this diet and the tears came again. I just didn’t want this disease anymore as it was much too difficult to handle.

Since no one locally could help me, I joined a support group an hour away and went once a month. It was okay, but it really didn’t fulfill my needs. It was more of a social club and I needed speakers and educators. That was when I decided to start my own group less than 3 months into my diagnosis. I took in everything I learned at the group I attended, figured out what was missing, and then decided how I wanted to format my own meetings. I had the local newspaper write a story about celiac disease and my desire to start a group. Thirty people contacted me and the group began. The very first meeting had 15 people attending, and we had samples from Kinnikinnick. Everyone thought they had died and gone to heaven, as they had all been settling for whatever was available in the local health food stores. From that point on, I never looked back and never cried again about having this disease. I now knew what it was that I needed to do, and it was to help others so they didn’t go through the same trials and tribulations that I experienced.

Over the next ten years, our small town had a support group. We didn’t need to drive an hour to a big city to get help. We had it here every month. Each year the numbers grew with more and more people coming through the group. Our meetings consisted of passing out the monthly handouts and any articles I gleaned from various publications. We would go over all the information that was passed out, discussing it along the way. As soon as that part of the meeting was finished, usually within about 15 to 20 minutes, we turned to social discussion about anything and everything. We also had speakers….lots of speakers!! We went to conferences. We had reporters in at least 3 or 4 times to do stories. We did about 13 half-hour radio shows over those years with great success. We had Gluten-Free days once a year at the hospital. We did about 9 years worth of walks…..all small in numbers but large in spirit. We had a booth for a week at our local fair for about 4 years and gave out information. Some members did a health fair occasionally. We had annual picnics and Christmas dinners. We were getting the word out and people were coming to us. Our most fantastic years were 2006 through about 2009. We were averaging up to 26 people a month. We had a low of 15 and a high of 44 in 2008. It was a great time and we all looked so forward to learning as much as possible during each meeting and telling others of our experiences eating out, shopping, and cooking, etc. At the end of each of our meetings, we would sample what others had brought in, grab a copy of the recipe if we were interested and sit back down and talk amongst ourselves until we just finally had to go home!

Everyone in the group was well educated. Books and other resources were recommended through the group and the knowledge grew. Meetings with speakers were well attended and appreciated.

But how many times can you ask the same speakers to come again and again? Many were three-time repeaters, which was good because we always had new members. Our resident dietitians came monthly and sometimes spoke as well as local doctors and gastroenterologists. We also had a physician speak who was celiac. He had visited our group at least three times. Connie Sarros, a cookbook author, came to our meeting three times. Our speakers brought in many people, but I began to see a trend happening. In the later years, the speakers weren’t drawing as many people and the attendance at regular meetings began to dwindle. It wasn’t a whole lot to start with, but the monthly average dropped in 2009, 2010, and even worse three-fourths of the way through 2011. We have come full circle and are getting back down towards the numbers we originally began with at the first meeting – 15!

As a result of what I was seeing, along with what was happening with two other support groups in neighboring counties, I could tell that the attendance was dropping off everywhere. A new group that was only about two years old brought in about 15 their first night and then it dropped severely, sometimes with only 1 or 2 showing up. We put our heads together trying to figure out what was going on. There had to be answers. The question was whether we were going to quit having meetings, have them quarterly, every other month, or perhaps just send information via email. But what would happen to those people who relied on us and did not have computer access???

I turned to the Listserv and threw out the question, asking other group leaders and members to respond. I wanted to know if they saw the same trend happening in their area. It was a resounding YES from over 60 responses that I received.

Here are some reasons why people were not attending meetings:

• Easier to find GF food on their own.
• Some come for the information packets, never to be seen again.
• Gas prices.
• Unemployment.
• The family is busy with their own/kids schedules.
• After a few months or years, they feel confident to be on their own.
• A few disliked the leaders, feeling they either monopolized meetings or couldn’t control them.
• Some didn’t want to deal with the diet.
• Summer is a bad time.
• Some didn’t care for the agenda: wanting only health information, not cooking classes or social hour.
• Others only wanted the social aspects of the meeting and didn’t want to listen to other information.
• Seating arrangements made some feel like they were at a lecture, seated in rows rather than at tables.
• They use the internet more now, have cell phone apps or go on facebook.

The following are issues voiced by group leaders:

• People do not want to come to meetings every month.
• Many are not compliant with the diet and don’t take it seriously.
• No one wants to volunteer to help out. This could involve activities the group does, such as walks, publicity, taking over a meeting occasionally, or even staying to help clean up and put things away.
• Getting burned out by having to do everything themselves.

I then decided I should survey my own support group. I did it anonymously via the internet so that everyone could answer honestly without worry. I wanted to find out what my own group thought about these same issues so that I could decide on the future of our group by the year’s end.

I sent the survey to approximately 104 people. These were people who had contacted me over the years, either via email, coming to some of the meetings, or perhaps just a telephone conversation. Fifty people did the survey. The results were quite interesting and are listed below:

44% said they have only attended between 1-5 meetings, and 23% said 13 or more. The reasons they do not attend showed 46% very comfortable with the diet, and 35% responded that their schedules were too busy to attend. Some used the group’s website while others found their information online.

The leadership and presentation of materials was rated as excellent. The discussion time was rated as good, but many wanted more time discussing issues. 100% felt the information they received was helpful in managing their diet and understanding celiac disease.

Some felt the meetings could be quarterly, but 75% stated they would not be lost if the meetings folded. At least 25% of the respondents said they never use our website to read the monthly handouts.

When asked about the need for support groups, 45% said there is a real need, while 38% stated they are nice to have around when you need them. Another 13% said they only needed them to get started on the GF diet.

An overwhelming 70% felt the best format for meetings was educational with discussions as opposed to having just a social hour with discussions.

Yet with all these answers above, it still comes down to that one person who is newly diagnosed and coming to us begging for help. How do we turn our backs on them??? I don’t think we can. I know I can’t. I have not arrived at an answer for myself, but many of the things I am considering might be having meetings either every other month or quarterly, or not having any meetings at all during the winter when I travel to Florida and have no one to take over. Even when I was in Florida, I did all the paperwork for the meetings, but attendance was down even more dramatically and those helping me had a hard time trying to run the meetings as they were not comfortable speaking in front of a group of people.

So what decision will I come to?? I don’t know yet, but I have given myself until December of this year to make some kind of decision. We are still needed, but I just don’t think it is to the extent that it used to be five or ten years ago. It is not a hardship anymore having celiac disease because so many manufacturers are on board with GF products. It is so much easier, but there are still tiny loopholes in the diet that we need to help the newly diagnosed plug up and not make mistakes that could cause them to be sick.

We will never be without the Internet, telephones, or other means of communication for obtaining information, but finding the correct information that is not outdated will sometimes be a challenge to a person searching on their own. So much is out there, but I think it still takes some form of a support chain with very strong links to help others when they call. I think I have that with my group, even if we should ever disband in the future. I am the information researcher, but I know who to send people to when they have questions regarding baking as we have two of the best bakers around, not to mention some others locally who will bake for a price. I know the parents with autistic and diabetic children and I refer people to them when needed. They are all my links in this very strong chain and I depend on them more than they can ever know. And my thanks always go out to them for being there for me.

Addendum: As I was wrapping up this article, my September support group meeting came and went. Only seventeen people attended. Many were worried about whether I would fold the group or not. What I learned from all this was that our meetings were really pretty good over the years, but people were managing on their own. It is okay if they choose not to come to the meetings, but they were possibly missing out on some very important changes. I also learned that many would like even more discussion time, so we will have to urge more people to speak up. They all felt there was a certain “core group” that kept coming to the meetings because we needed each other. We knew what the others were going through, we had new ideas, new recipes and some interesting happenings outside the group that we needed to share. And many times we just needed to “vent”. Yes, our feelings are hurt when we attend family events such as a potluck and not one person has tried to create something for us. Other times we rejoice because someone has gone above and beyond the call of duty to see that we have something to eat. In the end, what it all boiled down to was that we needed each other! So, even if our numbers are dwindling, we plan to keep on going. We will only meet from May through December with telephone and email support in between and we will continue to help those in need! So whether I am in Florida or Ohio, the support will ALWAYS BE THERE! We are the Richland County Celiac Support Group in Mansfield, Ohio...HEAR US ROAR!!

Also, as we neared the deadline for this article, Scott at Celiac.com decided to send my survey to his email list. 79 people responded. As was expected, most of their answers matched those we already had. Below is a compilation of answers and comments made.

CELIAC SUPPORT GROUP SURVEY:

How many meetings have you attended?

• 37% none
• 20% 1-5
• 13% 6-12
• 18% 13 or more
• 13% monthly

If you no longer attend meetings, why?

• 29% comfortable with diet
• 35% find info online
• 6% use website
• 19% busy schedules
• 4% don’t care for format
• 6% needs new leader
• 0% no longer follow the diet
• 29% live too far away
• 6% not interested
• 33% other

Responses:

Some do not have support groups, some chapter closed, leader retired, inconvenient time/place, understand diet, groups very hopeless and clique-y and off-putting, and cost of gas. One respondent would like to start a group in East Hampton NY 11937.

Rate the Meetings:

Leadership:

• Poor 3.8% / Fair 13.5% / Good 38.5% / Excellent 44.2%

Presentation/Materials:

• Poor 1.9% / Fair 15.4% / Good 42.3% / Excellent 40.4%

Speakers:

• Poor 9.8% / Fair 13.7% / Good 33.3% / Excellent 43.1%

Discussion Time:

Poor 2.0% / Fair 20% / Good 52% / Excellent 26%

GF Samples:

Poor 7.4% / Fair 18.5% / Good 31.5% / Excellent 42.6%

Responses:

• People are very vocal about wanting more GF restrictions and should learn to quietly educate people and try to make changes without making others feel forced to comply.
• Some material offered nothing new or do better on their own, but like hearing stories and such from other people.
• Some meetings are boring.
• Difficult to get free speakers.
• Redundant format, but good for newly diagnosed.
• A group is essential to understanding both the diet and disease.
• Food tasting is wonderful.

Have you ever attended a meeting that turned your off and you never returned?

• 13.8% yes
• 87.7% no

Responses:

• One speaker promoted a very limited diet along with being GF. She went on and on, people left, & she still kept talking.
• Prefer reading articles. Some groups get a bit quirky or boring.
• No one my age, and because I am only “intolerant” I felt not as important as everyone else. Another big factor goes back to the time and place.
• It was a peer support group and other long time members laughed at my symptoms saying they could not be gluten reactions, but others I know have the same symptoms.
• About 5 years ago I attended a meeting where a book author mentioned that cancer from celiac is very rare and it was printed in her book. I raised my hand to mention that about 4 people in our group had cancer and I had previously completed intense chemo with a bone marrow transplant which was directly from lack of diagnosis with celiac. I wanted people to know that they should not mess with cheating on the diet because they might not know if they were injuring themselves. She assured everyone that cancer was rare. I guess when you are the one with cancer, you don’t want anyone else to go through it. So, my warning to others is not to cheat. 1 person is still too many with a disease that could have been diagnosed and wasn’t. I survived, but 2 more people in town did not.... with the same cancer.
• Meetings are controlled by support group founders.
• I don’t know - I just didn’t like their attitude. Negative and closed to newcomers.
• Lots of people were gluten sensitive not celiac, & felt it was more social about eating out rather than any support or information.
• I belong to 2 support groups. One I always attend. The other lacks leadership and, thus, I find it a waste of my time.
• The first group meetings eventually dwindled to the same, very few, members and I had the diet info mastered then. Not much more was offered until a local group formed a year or so ago.
• The Healthy Villi used to be an affiliate of CSA/USA. After going to several national CSA conferences, I found their leadership to be too restrictive and decided to no longer affiliate myself with them or attend their conferences. The Healthy Villi also severed their ties with CSA.

Do you find the information you receive to be helpful in managing your diet and understanding celiac disease?

• 87.7% yes
• 12.3% no

What meeting times would suit you best?

• 43.3% monthly
• 22.4% every other month
• 22.4% quarterly
• 13.4% none

If your group folded, would you be lost without it?

• 18.5% yes
• 81.5% no

Do you ever go to your group’s website to read the updated information and articles?

• 41.3% yes
• 31.7% occasionally
• 27.0% never

What is your feeling about support groups?

• 56.8% there is a real need
• 5.4% only need them to get started
• 36.5% nice to have around when you need them
• 1.4% people can do without them now
• 0% telephone support is all that is needed.

Which format do you think would be best for a meeting?

• 70.1% educational with discussions
• 38.8% social hour with discussions
• 14.9% potluck dinners every month
• 1.5% different member taking over each month
• 4.5% dining out monthly instead of meetings
• 26.9% cooking demos by members
• 35.8% cooking demos by chefs

Responses:

• Some thought all of above and also vary the meetings.
• Discussions and speakers very helpful.
• Definitely education, but cooking demos would be interesting and open up discussions for new people, plus doctors should have packets to give to the newly diagnosed.

Celiac.com 07/27/2018 - As we all know, traveling either on driving vacations or internationally presents challenges to those of us with celiac disease.  We normally pack enormous amounts of baked goods and look somewhat silly as we travel.  I believe however that with a little research, we can now cut down on our extra “baggage”.

When we travel in Michigan, the first thing I do is Google “gluten free groceries”.  With some luck, I usually find a local specialty market with some gluten free items.  This is followed by an email with specific requests such as bread, baked goods, etc.  The markets are more than willing to share this information, and I can pack my food supply accordingly.  

I then follow up with a Google search for “gluten free restaurants”.  Again, I normally get a few responses and I look at the menu section of their websites to verify the selection.

I was very impressed with a recent trip to Marquette Michigan in the Upper Peninsula.  Since Marquette is in the very northern section of Michigan, I was worried about finding a gluten-free groceries, much less gluten-savvy restaurants.

Was I in for a surprise!  They had bakeries, groceries (Marquette Food Co-op) as well as a number of excellent restaurants that had gluten free selections. I was in heaven. Besides being in one of the most beautiful cities in Michigan, I could actually go out and have a wonderful, gluten free dinner.  Be sure to check out the Lagniappe Cajun Grille, the Border Grill, Sweetwater Café and Aubrees Pizza. All have exceptional food.

I was curious as to why the restaurants were so up to date on celiac disease so I asked at a local bar / grill.

The answer is Northern Michigan University. It seems that cities with universities are more aware of the needs of folks who want to remain gluten free.  Some of the residents have made this choice either out of necessity after being diagnosed with celiac disease or as a healthy life choice. With this in mind, it may be beneficial when travelling to look for cities close to colleges and universities for groceries and restaurants.  

Now let’s look at international travel.  Since retiring three years ago, my wife and I plan on one big trip every year. We usually alternate between cruises and land-based trips.  We have seen a dramatic increase in gluten free accommodations on board ship.  Our cruise line of choice has been Princess although I suspect other lines have similar menus. Princess gave me the next night’s menu so I could order in advance.  They would prepare what I wanted, gluten free.  As a bonus, the chef would prepare a surprise dessert every evening for me.  This is what keeps me coming back to Princess.

We recently took a cruise to Norway and again, were curious about what kind of gluten free restaurants would be available in port.  I emailed the Norwegian Youth Celiac League and received a mountain of information.  I got bakeries, restaurants, alcoholic beverages with addresses and phone numbers so I could visit these places.  They were so helpful and made the trip that much more enjoyable.

We had a funny experience on a trip to Peru a few years ago.  We had just returned from Machu Picchu and stopped at a local restaurant for a snack. I had ordered chips and guacamole and since there was so much corn farmed there, assumed they would have corn chips.  Wrong!!!  I received a plate of chips that resembled a fried, flour tortilla chip.  I gave the waiter my “I have celiac disease, please don’t make me sick “ card which he read and took to the restaurant owner.  He looked horrified and asked if I liked French fries. I indicated I like fries as long as precautions were taken.  He returned with a grin on his face along with a huge glob of guacamole with these enormous fries stuck in the glob.  Not wanting to offend our host, I ate the somewhat interesting mix and enjoyed every bite.

Whenever traveling internationally, always carry a dozen or so of these cards to give to waiters. They are available free at celiactravel.com  in all languages.

Most will go out of their way to accommodate your diet restrictions.  I think the implied message of these cards is that “If you feed me anything with gluten, I will get horribly sick on the floor and scare away your customers”. It has an enormous impact.

My final thought is that allowing celiac disease to control your leisure time is not necessary.  A little research and a few emails can save you a tremendous amount of aggravation when planning a vacation.

As more and more vacations destinations become aware of the needs of celiac patients, I believe traveling will become more enjoyable. One final note, always compliment the restaurant owner on having a gluten free menu. It will encourage both that establishment as well as others to follow suit.

Bon Appetit!

Celiac.com 06/15/2018 - There seems to be widespread agreement in the published medical research reports that stuttering is driven by abnormalities in the brain. Sometimes these are the result of brain injuries resulting from a stroke. Other types of brain injuries can also result in stuttering. Patients with Parkinson’s disease who were treated with stimulation of the subthalamic nucleus, an area of the brain that regulates some motor functions, experienced a return or worsening of stuttering that improved when the stimulation was turned off (1). Similarly, stroke has also been reported in association with acquired stuttering (2). While there are some reports of psychological mechanisms underlying stuttering, a majority of reports seem to favor altered brain morphology and/or function as the root of stuttering (3). Reports of structural differences between the brain hemispheres that are absent in those who do not stutter are also common (4). About 5% of children stutter, beginning sometime around age 3, during the phase of speech acquisition. However, about 75% of these cases resolve without intervention, before reaching their teens (5). Some cases of aphasia, a loss of speech production or understanding, have been reported in association with damage or changes to one or more of the language centers of the brain (6). Stuttering may sometimes arise from changes or damage to these same language centers (7). Thus, many stutterers have abnormalities in the same regions of the brain similar to those seen in aphasia.

So how, you may ask, is all this related to gluten? As a starting point, one report from the medical literature identifies a patient who developed aphasia after admission for severe diarrhea. By the time celiac disease was diagnosed, he had completely lost his faculty of speech. However, his speech and normal bowel function gradually returned after beginning a gluten free diet (8). This finding was so controversial at the time of publication (1988) that the authors chose to remain anonymous. Nonetheless, it is a valuable clue that suggests gluten as a factor in compromised speech production. At about the same time (late 1980’s) reports of connections between untreated celiac disease and seizures/epilepsy were emerging in the medical literature (9).

With the advent of the Internet a whole new field of anecdotal information was emerging, connecting a variety of neurological symptoms to celiac disease. While many medical practitioners and researchers were casting aspersions on these assertions, a select few chose to explore such claims using scientific research designs and methods. While connections between stuttering and gluten consumption seem to have been overlooked by the medical research community, there is a rich literature on the Internet that cries out for more structured investigation of this connection. Conversely, perhaps a publication bias of the peer review process excludes work that explores this connection.

Whatever the reason that stuttering has not been reported in the medical literature in association with gluten ingestion, a number of personal disclosures and comments suggesting a connection between gluten and stuttering can be found on the Internet. Abid Hussain, in an article about food allergy and stuttering said: “The most common food allergy prevalent in stutterers is that of gluten which has been found to aggravate the stutter” (10). Similarly, Craig Forsythe posted an article that includes five cases of self-reporting individuals who believe that their stuttering is or was connected to gluten, one of whom also experiences stuttering from foods containing yeast (11). The same site contains one report of a stutterer who has had no relief despite following a gluten free diet for 20 years (11). Another stutterer, Jay88, reports the complete disappearance of her/his stammer on a gluten free diet (12). Doubtless there are many more such anecdotes to be found on the Internet* but we have to question them, exercising more skepticism than we might when reading similar claims in a peer reviewed scientific or medical journal.

There are many reports in such journals connecting brain and neurological ailments with gluten, so it is not much of a stretch, on that basis alone, to suspect that stuttering may be a symptom of the gluten syndrome. Rodney Ford has even characterized celiac disease as an ailment that may begin through gluten-induced neurological damage (13) and Marios Hadjivassiliou and his group of neurologists and neurological investigators have devoted considerable time and effort to research that reveals gluten as an important factor in a majority of neurological diseases of unknown origin (14) which, as I have pointed out previously, includes most neurological ailments.

My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.

Sources:

1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.

2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.

3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.

4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.

5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.

6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.

7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.

8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48

9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.

10. ezinearticles.com

11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 

12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/

13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.

14. 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.

Celiac.com 11/26/2012 -  I speak to many people from across the country, and internationally, who contact me requesting help. The issues they face are summarized into three categories:

1. individuals with celiac disease who do not have their disease under good control;
2. those with gluten sensitivity who remain less than healthy despite their gluten-free diet;
3. individuals, and this is a big one, who are convinced that they have a gluten problem, due to self experimentation, but who are unable to get any corroboration or support from their doctors.

Having been immersed in this field for almost twenty years, it is frustrating not having a laboratory test that will reliably state whether someone has celiac disease or if gluten sensitivity has been ever present.

The good news is that this situation has improved. It’s not perfect, but it’s better than it has been, and I wanted to share this data with you and those you care about.

These newly available tests can have a big impact on those who need a diagnosis, as well as those who are already gluten-free but want to know why they are not enjoying the good health they desire.

I have no affiliation with either of the labs I mention so there is no conflict of interest in my recommendations.

The first lab, Cyrex Laboratories, is the newest lab specializing in gluten intolerance in the US. It currently offers four different profiles. There is a fifth one coming, hopefully very soon, that is also very exciting and a description of it follows.

I will provide the data that the lab lists in their brochure for each test along with my personal opinion as to its benefit and use. Here at HealthNOW Medical Center we have been utilizing these tests for almost five months—the lab just opened in January after three years of research and passing governmental licensing requirements.

Array 1: Gluten Sensitivity

“This is a saliva test which is recommended for patients who:

• Are suspected of having mucosal abnormality
• Have relatives with celiac disease
• Have type 1 diabetes
• Have autoimmune thyroid disorder
• Have relatives with autoimmune disorders, especially, multiple sclerosis, diabetes and arthritis.”

This is an easy screening test for those who wonder if they have gluten sensitivity or celiac disease based on their own symptoms or symptoms in their family.  As a saliva test it’s very easy to perform (no blood draw is needed) and it’s the least expensive of all the tests offered.

When utilizing saliva, a test is only as accurate as the strength of the salivary immune system. Due to this limitation, the lab also measures this as part of the panel. In the past, labs would not include this measurement, sometimes resulting in false negative results—something we all wish to avoid.

Array 2: Intestinal Barrier Integrity Screen

“Intestinal barrier integrity plays a vital role in the overall health and well-being of patients.  This blood test is recommended for patients who:

• Have gut dysbiosis, which appears to be resistant to standard therapy
• Are suspected of having intestinal mucosal damage
• Complain of food allergy and intolerance
• Present multiple symptom complaints (including chronic fatigue syndrome)
• Suffer from abnormal immune cell count and function (including autoimmune diseases)
• May suffer from depression or neuroautoimmunity [including such conditions as: thyroid disease, arthritis, myocarditis, dermatitis, endocrinopathy, osteoarthritis and pernicious anemia] ”

Healing a leaky gut is a very big part of regaining one’s health after a diagnosis of gluten intolerance. Gluten has caused damage to the lining of the small intestine and the presence of this damage is thought to be an initiator of the many “non-digestive” symptoms and diseases that are associated with gluten, including autoimmune disease.

Prior to this test two substances have been traditionally used to measure a leaky gut: lactulose and mannitol. The disappointment of the test lay within the sensitivity, or I should say lack of sensitivity, to adequately diagnose subtle leakiness vs. gross leakiness such as that found in advanced celiac disease and complete villous atrophy.

Much as an intestinal biopsy can miss the early and more subtle damage to the villi of the small intestine [its lining], so too does the lactulose/mannitol test seem to miss the more subtle changes in a leaky gut.

This test will detect increased permeability through the cells that line the small intestine, as well as increased permeability between the cells.

Clinically we use this test as a gauge of how we are progressing clinically rather than as a first tier diagnostic tool. There is no sense in measuring a leaky gut when it’s obviously there. But to prove that a clinical program is producing results or to perhaps show a less than compliant patient that their indiscretions are creating problem, this is an excellent test.

Array 3: Comprehensive Gluten Sensitivity & Autoimmunity

“To broaden the view of celiac disease and gluten sensitivity, our doctors can better diagnose the disorder by assessing antibody production against an array of protein, enzyme and peptide antigens.  This blood test is recommended for patients who:

• Have gut dysbiosis—poor probiotic balance
• Are suspected of having intestinal mucosal damage—this means damage to the lining of the small intestine
• Complain of food allergies
• Complain of chemical hypersensitivity
• Present multiple symptom complaints (including chronic fatigue syndrome and  Fibromyalgia)
• Suffer from abnormal immune cell count and function
• May suffer from depression or neuroautoimmunity [see below]
• Neuroautoimmune patients to consider: thyroid, arthritis, myocarditis, dermatitis, endocrinopathy,  polyendocrinopathy, osteoarthritis and pernicious anemia”

This panel is the broadly inclusive blood test designed to measure both celiac disease and gluten sensitivity. Because this test measures several aspects of the protein structure (rather than just the single protein fragment heretofore analyzed), we believe it will take many of the false negatives out of the picture—certainly a welcome change.

Despite feeling better when removing gluten from their diets, patients like to confirm their own experience with a third party lab test. In the past, lab tests were so riddled with false negatives that we had to encourage patients not to discount their personal experience with a gluten-free diet, despite the absence of correlation with the lab test.

This approach was not always successful and at times patients returned to gluten simply because they had no lab test to verify the truth. Inevitably they would return to us many months later, feeling worse than ever and ready to, once again, look at a gluten-free diet.

This panel is more sensitive and specific than any we have had in the past, thereby reducing false negatives greatly. A patient does have to be consuming gluten for this profile to be accurate.

Array 4: Gluten-Associated Cross-Reactive Foods

Complete normalization of gut lesions is very rare in adult patients with celiac disease (8%), despite compliance with the gluten-free diet.  This may be due to cross-reactions with an array of foods.  This blood test is recommended for patients who:

• Have gluten sensitivity or celiac disease.
• Are non-responsive on a gluten-free diet—in other words don’t feel better.
• Have gut dysbiosis [not enough healthy bacteria and too many unhealthy ones], which appears to be resistant to standard therapy.
• Have an autoimmune disorder.

This panel is very exciting and we are already seeing a dramatic impact on our patients. When one has eliminated gluten (and often dairy) from one’s diet, it obviously takes a big commitment. The last thing such a person might want to hear is that there are other foods they may also need to eliminate.

Consider this: What if a temporary dietary change of eliminating foods that are confirmed as problematic on a laboratory test resulted in the difference between continued ill health and good health? Now, perhaps, it sounds like a good idea.

That is exactly what we found in patients who were being extremely vigilant about their diet but still felt “glutenated” or just ill and the cause was not being found.

Cross-reactive foods are foods with a protein structure similar to gluten’s that, upon ingestion, confuse one’s immune system into thinking that it has ingested gluten. The proteins are confused, one for another, and the reaction is as negative as if one has consumed gluten. This panel looks at twenty five possible foods (mostly in the grain and dairy families) to which one could be experiencing a cross-reactivity reaction.

While it definitely takes a further commitment to confront more dietary change, our current patients consider it well worth it based on their health improvement.

Finally, Array 5 that is not yet released, will focus on possible autoimmune reactions occurring from gluten. Autoimmune diseases can be “in the works” so to speak for well over a decade before the body experiences its first symptom. As the third leading cause of death in this country and with no known cure, any forewarning of autoimmune activity would be an excellent tool.

This test provides another much needed tool for those patients who, although know they are gluten intolerant, cheat on their diet with seeming impunity—meaning they don’t feel any ill effects from having done so.

Array 5 will be able to reveal what is occurring on a deeper level of the body such that the patient can see where gluten may be beginning to create autoimmune tendencies in certain organs or systems that he or she cannot feel.

The second laboratory I want to mention is Enterolab. Although Enterolab is not new, they are unique. A few things make them different from all other labs I know about:

1. You don’t have to work with a doctor to receive a lab test. Enterolab works directly with the patient on-line. They will send you a test kit after you have paid them and test results are emailed to the customer.
2. Enterolab uses stool testing for their celiac and gluten sensitivity panels. They have a unique technology that allows them to test for these conditions even if the patient has not been eating gluten.
3. They offer genetic testing as well as testing for other food intolerances. Once again, no doctor referral is required.

I believe these tests offer benefit not only for those who need a diagnosis but also for those with a diagnosis who are not yet enjoying ideal health.

I hope you found this informative. Please do feel free to contact me regarding any further questions that you may have. Our clinic, HealthNOW is a destination clinic and we treat patients from across the country as well as internationally. We are here to help.

To your good health!