Celiac.com 10/26/2018 - Did you know that a new study shows people with celiac disease are more likely to suffer nerve damage? Jonas E. Ludvigsson, a clinical epidemiology Professor in Sweden, discovered that women with celiac disease are 2.5 times more likely to develop neuropathy or nerve damage. There is a real association between celiac disease and nerve damage. "We have precise risk assessments in a way we haven't had before" he stated last year. Yet even Sweden has its quandaries. 60% of women in Sweden who have celiac disease have neuropathy and they do not totally know why! Statistics vary from country to country, and even vary between specialists within that country. Nerve damage is no laughing matter, it presents with numbness and tingling of exterior areas (extremities).

Basically, numbness in the nerve endings of the fingers and toes and other frustrating areas. Just try picking up pencils, or something hot out of the oven. If you do not feel the heat you will know that you may have nerve damage. Following a rigid gluten-free diet, however, can alleviate this problem to a certain degree, and that is why we keep repeating the mantra: “Eat Clean & Gluten-Free!” However, sometimes accidents happen, and people who have celiac disease, gluten sensitivity, or dermatitis herpetiformis get exposed to gluten.

How to Recover From Accidental Gluten Exposure
Kathy Holdman, M.S., R.N. and Certified Nutritional Therapist lists numerous ways to recover after gluten exposure. You need to take into account  the amount of gluten exposure, length of time from last exposure, degree of gluten intolerance present, health of the digestive tract, existing inflammation or infection in the body and overall health status. Some  people say they can recover in a few days, others say they may experience significant setbacks in their health that lasts weeks to months. For those with positive celiac disease it may take years for complete healing of the small intestine after gluten exposure, although "outward symptoms" may resolve sooner. 

Nurse Holdman suggests the following 10 tips to help alleviate symptoms from gluten exposure, and hopefully speed up recovery:

1. Drink plenty of water, and this cannot be emphasized enough. Water is an essential nutrient for every cell in the body for proper function. Many people live in a state of chronic dehydration, which of course results in constipation. Then they take something to rid themselves of constipation and take too much and lose potassium, magnesium and throw out the balance of the salts in their body. When you have celiac disease you learn something new every week. Last week an Internist told me, after incurring my second bladder infection in eight weeks, that it could possibly be from the diarrhea following being glutened, and not totally washing myself. That made me a little sick just thinking about it. But, she told me an interesting fact about urinary tract infections and celiac disease. Celiacs do incur more frequent urinary tract infections due to more frequent diarrhea, no matter how meticulously clean we are. Taking four or five "Craisins" with each meal several times a day can limit the amount of bladder infections. I told her that I was also taking Cranberry tablets and she told me to throw them out because they are "useless."  She said that you do not need to buy fresh cranberries, as they are  "sour and expensive." Just buy a bag of the dried Craisins and eat some either before or after meals. Ingredients in the pure dried cranberries helps prevent bladder infections from occurring. Studies done in several Nursing Homes where many incontinent patients lived were given five Craisins either alone or in a salad twice daily and the decrease in urinary tract infections was nothing less than amazing.
2. Get extra sleep and rest. Sleep is the time your body repairs itself. Avoid strenuous exercise, (the type that causes you to sweat). Exercise in moderation is what I think she wants to tell us.
3. Drink bone broth. It is rich in minerals and gelatin and other nutrients that are soothing to the digestive system and nourishing to the entire body.  Another health benefit of bone broth is hydration, and the more liquid intake the better. You can dress up bone broth with onions and garlic to improve the taste. 
4. Take epson salt baths. They contain magnesium, a mineral that can help the body to relax. The sulphate minerals found in Epson Salts are detoxifying, and they can stimulate the lymphatic system and support the immune system. Nurse Holdman also urges us to take digestive enzymes which can help modulate the symptoms of celiac disease.
5. Take digestive enzymes. If taken immediately following the accidental consumption of gluten, some people believe that digestive  enzymes can help to modulate the symptoms of celiac disease. It is well known that digestive enzymes soothe the stomach lining and ease the abdominal pain.
6. Drink ginger or peppermint tea. They are both known to help relieve nausea and can be soothing to the digestive system. Drink a cup if you are having nausea or other gastrointestinal symptoms.
7. Take activated charcoal. It is an over-the-counter-supplement that may be beneficial if taken immediately after an attack. It helps by binding with the offending food and preventing it from being absorbed into the body. This supplement can bind with medications so be sure to consult your licensed health care professional prior to taking it, especially if you take medications for other diseases or conditions. 
8. Eat fermented foods. Who knew!? Possibly the Koreans and their staple Kim Chi, or the Ukrainians/Romanians with their fermented red cabbage coleslaw of course! Fermented foods are high in nutrients that nourish the entire body. Start out with a small amount of fermented food and slowly increase it.
9. Drink nettle leaf tea. It is an antispasmodic with antihistamine properties. It can help relieve muscle and joint pain, and relax your body naturally. Neither gluten intolerance nor celiac disease are mediated by histamine, but some people report that nettle leaf can help relieve symptoms of rash and itching following gluten exposure. It is a gentle diuretic and can be detoxifying. So if you experience dehydration symptoms it is time to drink more water.
10. Get acupuncture treatments. It may relieve inflammation, especially in the abdominal area, and it can be relaxing. Only you can tell how many treatments are beneficial, and you need to take into consideration the cost factor because most health insurance plans do not cover acupuncture.

Tips to Help People with Dermatitis Herpetiformis Recover from Accidental Gluten Exposure
A suggestion from Me: If you have itching from dermatitis herpetaformis, try Scalpacin. I have been using it for years and nothing stops the itching in such a short time span. Once the sores start to appear, even just a slight "itch" is like a doorbell warning you ahead of time. I apply Scalpacin lotion, which is not a cream, but is a clear liquid. At first it stings but that is how I know that I have an impending outbreak. It is a non-fragrant liquid. You can use it on your scalp without totally ruining your hair style. Don't wash you hair with it, search out the spots, or, if you have a partner, they may be able to help you with the sores in your scalp, and you can point out itchy areas. 

For dermatitis herpetiformis itch you can also try a mix of baking soda and water by making it into a paste. This is not great for your scalp and hair, but it will ease the itching. It can be a little messy when it dries and the white powder flakes off on your floors, but you do not have to use it for hours at a time; it is a temporary method for temporary relief.

You can also ask your physician if he or she will prescribe the prescription drug "Atarax" for you. It is a strong allergy medication and must be taken exactly as directed. It really helps the itch, but it can be sedating, especially when first trying it. Don't over-use the prescribed dosage. I would not suggest driving a car while taking Atarax, but if the itching, scabbing and bleeding have become so severe it definitely is the one allergy medication that helps with the itching from dermatitis herpetiformis. I have tried Benadryl, Claritin and other over the counter  allergy medications, and nothing works as well as Atarax.  Talk to your family physician about a prescription and read the instructions carefully.

Hopefully these tips will prove helpful in the unfortunate event that you ever get cross-contaminated by gluten. I certainly hope this never happens to you!

Celiac.com 10/17/2018 - In the interviews I conducted last year, the Celiac.com viewers shared with me some disturbing stories about how others either sabotaged their gluten-free diet or how their gluten-free requirements are continually scrutinized and doubted. Here are a few examples:

• A co-worker at my office ate a gluten-containing burrito and thought it would be funny to cross-contaminate my work space.  With his gluten-coated hands, he touched my phone, desk, pencils, pens, etc. while I was not at my desk.  I came back and was contaminated.  I had to take several days off of work from being so sick.
• The waiter at a restaurant where I was eating dinner asked me if I was really “a celiac” or if I was avoiding gluten as a “fad dieter.” He told me the food was gluten-free when he served it, only to come up to me after I ate the dinner and admit there was “a little” gluten in it.
• My cleaning people were eating Lorna Doones (gluten-containing cookies) while cleaning my gluten-free kitchen, cross-contaminating literally everything in it. When I noticed I exclaimed, “I am allergic to gluten, please put your cookies in this plastic bag and wash your hands.”  They chided, “You have insulted our food.  We are hungry and we will eat anything we want to, when we want to.”
• At a family dinner, Aunt Suzie insisted that I try her special holiday fruit bread. In front of everyone around the table, she brushed off my protests and insisted that I over exaggerated my food sensitivities saying, “a little bit wouldn’t hurt you.”  

These are but a few of an exhaustive list of situations that we regularly contend with. What can possibly be the rationale for any of this conduct?  I’m providing some recent headlines that may impact the attitudes of those we interact with and would like to hear what you think influence this behavior (see questions below). 

• Recently, the New York Times published an article entitled, “The Myth of Big, Bad Gluten.”  The title alone casts doubt on the severity of gluten exposure for those with CD (Myth, 2015)  
• In his political campaign, Senator Ted Cruz stated that if elected President, he would not provide gluten-free meals to the military, in order to direct spending toward combat fortification (Wellness, 2/18/16). 
• Business Insider.com called Tom Brady’s gluten, dairy free diet “insane” (Brady, 2017).
• Michael Pollen is quoted as saying that the gluten-free diet was “social contagion.” Further, he says, “There are a lot of people that hear from their friends, ‘I got off gluten and I sleep better, the sex is better, and I’m happier,’ and then they try it and they feel better too.  [It’s] the power of suggestion” (Pollan, 2014).
• Jimmy Kimmel said, “Some people can’t eat gluten for medical reasons… that I get. It annoys me, but that I get,” and proceeded to interview people following a gluten-free diet, asking them “what is gluten.” Most interviewed did not know what gluten is. (ABC News, 2018).

Do headlines like this enable others to malign those of us making our dietary needs known?  Do these esteemed people talking about gluten cast doubt on what we need to survive? 

Humans are highly influenced by others when it comes to social eating behavior. Higgs (2015) asserts that people follow “eating norms” (p. 39) in order to be liked. Roth, et al. (2000) found that people consumed similar amounts of food when eating together.  Batista and Lima (2013) discovered that people consumed more nutritious food when eating with strangers than when eating with familiar associates. These studies indicate that we are hypersensitive of what others think about what we eat. One can surmise that celebrity quips could also influence food-related behaviors. 

Part of solving a social problem is identifying the root cause of it, so please weigh in by answering the following questions:  

1. How do you handle scrutiny or sabotage of others toward your dietary requirements?
2. Please speculate on what cultural, religious or media influences you suppose contribute to a rationalization for the sabotage and/or scrutiny from others when we state we are observing a gluten-free diet? Are people emulating something they heard in church, seen on TV, or read online?   

We welcome your answers below.

References:

• ABC. (2018). Retrived from https://abcnews.go.com/Health/video/jimmy-kimmel-asks-what-is-gluten-23655461 
• Batista, M. T., Lima. M. L. (2013). Who’s eating what with me? Indirect social influence on ambivalent food consumption. Psicologia: Reflexano e Critica, 26(1), 113-121. 
• Brady. (2017). Retrieved from https://www.businessinsider.com/tom-brady-gisele-bundchen-have-an-insane-diet-2017-2 
• Higgs, S. (2015). Social norms and their influence on eating behaviors. Appetite 86, 38-44.
• Myth. (2015). Retrieved from https://www.nytimes.com/2015/07/05/opinion/sunday/the-myth-of-big-bad-gluten.html 
• Pollan, M. (2014). Retrieved from https://www.huffingtonpost.com/2014/05/14/michael-pollan-gluten-free_n_5319357.html 
• Roth, D. A., Herman, C. P., Polivy, J., & Pliner, P. (2000). Self-presentational conflict in social eating situations: A normative perspective. Appetite, 26, 165-171.
• Wellness. (2016). Retrieved from  https://www.huffingtonpost.com/entry/ted-cruz-gluten-free-military-political-corectness_us_56c606c3e4b08ffac127f09f

Celiac.com 10/04/2018 - Do a reality check. Remember, this is a choice you have to commit to. If you want to feel lousy for the rest of your life and potentially get worse as time goes on, that’s your choice—but I wouldn’t recommend it for many reasons. The goal is 100 percent. Yes, it is a process, but the ultimate goal is to be 100 percent free of gluten and any other food allergens and intolerances. This is the only way your body will heal, so let’s start the healing journey! 

Did you know that, as we mentioned earlier, once the gluten intolerant body is exposed to the tiniest amount of gluten it sets off your B cells, which causes an inflammatory response that can take several months to calm down? That’s why the goal is 100 percent. For some food intolerances, such as eggs, for example, you would want to wait at least three to six months then bring them back in and retest to see how the body responds. This is a sensitive experiment, so please work with someone who specializes in this area. As far as gluten, based on what I know and have seen, there is no reason to ever go back to eating wheat. 

Give it time.  Healing takes time. I’ve been on my gluten free journey for more than ten years now, and I have to say I have never purposely eaten gluten but I can sure tell when I get cross-contamination. I’m one of those people who is all in—100 percent—once I make up my mind on something. I guess if you have been seriously ill for a while like I was, you will do what it takes to be healthy again. For some, that’s not the case; it takes many tries to get there and that’s okay, as long as the long-term goal is always in mind. If you are better with shorter-term goal setting, do a sixty-day challenge. Within this time frame you will notice the brain fog getting better. Your body will start adjusting to a healthy weight. In most cases, you will lose the bloating and weight around your middle, as it is typically linked to dysbiosis (overgrowth of harmful bacteria).

One of my patients who has celiac disease was overweight by at least forty pounds. She carried most of the extra weight in her midsection. She was only about twenty years old at the time and was having skin rashes, dizzy spells, and nausea. We got her off gluten and within a few months she was a new person. She lost all the extra weight and her skin cleared up. She had no more dizzy spells and now looks amazing! She is committed and can definitely tell when her body gets cross-contaminated with gluten.

Don’t be discouraged if it takes a little longer than expected to feel 100 percent. Think of peeling that onion one layer at a time. That’s the journey to wellness I tell my patients about continually. A general rule is: for every year you deal with a health issue, it takes at least a month to start healing. Because everyone is unique, it could take longer for you or it could happen a lot sooner than you think: for example, I spoke with a woman who lost seventy pounds in just a few months after going gluten free and has kept it off for years. And I had one patient who went off gluten and his headaches went away immediately! However, it happens for you, it’s worth it! For me, it took a while because I had so many layers to work through. But I will say, I was seeing a lot better and my eyes started healing within a few months. When I went back to the eye doctor he was blown away at the difference and asked what I had done. I told him I went off gluten for starters! You should have seen the confused look in his eyes. That was the beginning of my amazing journey.

Keep a food journal. You may need to keep a food journal for a week or two if you don’t have one already. It doesn’t have to be time consuming. A one-page journal example is included at the end of this book—or you can download one of many different journaling apps on your smart phone or do it online. When working with my patients, I find reviewing their journals to be a very useful tool. The key is to keep track of what you’re eating and how you feel, which is especially important for those who do not get food intolerance panels done. Journaling helps you stay in tune with what you put in our body on a daily basis. It also helps identify the foods that work for you and that offer optimal healing—I call these the medicine foods. We tie emotions into the journals because anxiety is often related to food sensitivity. To take your journal to another level, include environmental influences such as mold exposure, seasonal flare ups, body care products, cleaning products, etc. This is part of a home revamp which we will talk about below.

Stick to whole foods to heal the gut. We have options depending on how much inflammation is going on in the gut and, quite honestly, how fast we want to heal. I suggest you drop bakery goods as well as all processed foods and sugar for a while to allow your gut to heal. Eating cooked foods in addition to drinking a quality bone broth is very healing to the gut. This helps calm things down when we are inflamed. A lot of raw foods are awesome but the body has to work hard at digesting them— which isn’t a bad thing, unless you have some inflammation going on in the gut. So, take it easy on raw foods for a while. The Recipes section has some good recipes that use functional ingredients. Treat yourself to exotic organic dark chocolate that is GF. Look for 70 percent or higher. Dark chocolate is full of antioxidants. The darker the chocolate, the less sugar. Keep in mind that chocolate is on the cross-reactive list, in case you have a reaction to it. Some raw treats such as kale chips are a much better choice than potato chips or crackers. I will say when I give into chips I opt for the non-GMO ones that are either baked or cooked in coconut oil. Be on the lookout for healthy meals on your current menus or the menus of friends and family that are naturally gluten free—roasted chicken (without seasoning), baked sweet potatoes and steamed veggies, for example—and make them a staple on your new menus. Surf the internet, watch cooking shows, and browse magazines for ideas you can adapt as you see fit. Karmic Health (www.karmic-health.com) has a great resource and links page with a list of gluten free food companies, blogs, and recipe sites under Holistic Resources. We also have a recipe page.

Go through your pantry and refrigerator at home. Make a list of foods and meals already in your diet that are gluten free. Be sure to list condiments, produce, snacks, and other foods. This list will be helpful as you create menus around your new restrictions, and will give you encouragement that you’re already on the right track and have choices! We have a great video under the Media page on www.karmic-health.com with yours truly talking about optimal foods.

At the same time, clear out all foods that have gluten, wheat, wheat flour, oats, oat flour, rye, semolina, or modified food starch as an ingredient. If in doubt, throw it away. If you have family members living with you who will not go gluten free, you might consider giving the offending edibles to them to be put in another part of the house while you learn to live and think gluten free. This step becomes very important if you are dealing with celiac disease. With that being said, your toaster can be a problem if you are sharing it with someone who is not gluten free. They do have toaster bags you can purchase to protect your gluten free bread. I personally don’t have gluten in my house—it’s just my husband and myself, which is obviously a lot easier than having a large family. Do what you can to protect yourself. The same goes for pots and pans and utensils. More on this in the cross-contamination section.

The goal is to cook for the entire family without using gluten. Most of the time they won’t be able to tell the difference—and they may be surprised they actually like gluten free, healthy meals. They will feel better and the taste might pleasantly surprise them.  Ideally, the whole family will join you on this journey from the beginning—at the least at home. We can’t always control how they’ll eat outside the house. In most cases, once everyone understands the importance of going gluten free and its potential for healing, they will be on board. I don’t have any gluten or cow dairy in my house and my husband is fine with it—not to mention a lot healthier because of it. He does have his cheats occasionally, but he does pay for it with a swollen belly.

Give yourself permission to eat things you may have restricted from your diet before your diagnosis, as long as you are not experiencing inflammation.  Tortilla chips or cookies may not be appropriate for some people, but they are a treat in a GF diet—in small doses, of course. This becomes important with children. As soon as you can get comfortable, opt for healthier snacks. The Recipes section includes some great treats for both kids and adults, as well as a list of wonderful recipe blogs you can find on the internet. The sooner you can get to using functional ingredients, the more quickly you will heal. I see a lot of people in social media groups posting their gluten free food options, but honestly, a lot of those may be unhealthy and full of other inflammatory ingredients. Be careful.

An excerpt from Sandi Star’s book Beyond Gluten – A Healing Transition walks you through healthy steps in going gluten free.

Celiac.com 09/28/2018 - MIT researchers have found that intestinal stem cells removed from mice after fasting for 24 hours and grown in culture have twice the regenerative capacity of stem cells grown in culture from non-fasting mice. The study provides evidence that fasting induces a metabolic switch in the intestinal stem cells, switching from utilizing carbohydrates to burning fat. Switching these cells to fatty acid oxidation enhances their function significantly. The study also found that the beneficial effects of fasting can be reproduced by treating mice with a molecule that mimics the effects. Stem cell regeneration is dramatically improved by fasting in both young and older mice.

Intestinal stem cells in humans lose their ability to regenerate as humans age, making it more difficult for older people to recover from gastrointestinal disease and disorders. Fasting and/or the use of drugs to mimic the regenerative effects of fasting on intestinal stem cells may, therefore, be useful to improve recovery from intestinal injury in older patients if the mice study findings are shown applicable to humans.

This study brings to mind past research on the protein R-spondin1 which showed great potential in completely regenerating and restoring the intestinal lining. R-spondin1 was being developed as a drug by Nuvelo, Inc. of San Carlos, CA designated as NU206 in 2005. Despite early successful human safety clinical trials in 2008, research was shelved and the promising drug has continued to sit idle on the shelf for years. The patent for NU206 is now owned by ARCA Biopharma http://arcabio.com/ of Westminster, CO after a merger with Nuvelo, Inc. in 2009.

Fasting to regenerate the intestinal lining is free and requires no FDA approvals (though physician supervision may be advised.)

Fasting may provide other potential health benefits. A Yale study found that during dieting or fasting the compound beta-hydroxybutyrate is produced which inhibits the inflammatory response in several disorders including autoimmune diseases, type 2 diabetes, Alzheimer's disease, atherosclerosis, and autoinflammatory disorders.

Fasting can also affect the activation of T cells. T cells are leukocytes, white blood cells. T cells are activated by antigens from pathogens presented to T cell receptors which initiates an immune response against the pathogens. In autoimmune disease, antigen presented to T cell receptors initiates an immune response which results in damage to the body itself. A Luxembourg Institute of Health study found that glutathione, important for metabolic waste disposal and detoxification, also acts as a switch which stimulates T cell energy metabolism while keeping T cells clear of metabolic wastes. Without glutathione, T cells remain inactive and sit in a hibernation state. T cell inactivity is undesirable for fighting off an infection, but, otherwise, keeping T cells inactive may ward off harmful effects of autoimmune disease.

Fasting lowers the body's glutathione level as the body constantly consumes glutathione. In one 7-day fasting study involving healthy humans, a progressive decline in total glutathione concentration in leukocytes was found during seven days of starvation due to a decrease in free glutathione content. This study provides proof that fasting lowers glutathione levels in T cells. Hence, based on the Luxembourg study, fasting can reduce or stop the activity of T cells. Thus, fasting can be used to relieve the symptoms of autoimmune disease resulting from a T cell immune response, providing that the subject is otherwise infection free and has no condition requiring an active T cell response.

Finally, as shown in a University of Southern California study, multiple fasting cycles lasting 2 to 4 days over a period of 6 months in both mice and humans work to rid the body of older and damaged white blood cells and trigger white blood stem cells to self-regenerate and fully repopulate the immune system with new white blood cells. Besides having applications to recovery from immune system damage caused by cancer chemotherapy toxicity, these immune system rejuvenation effects from fasting may have potential benefit applicable to treatment of autoimmune disorders.

Sources:

Fasting boosts stem cells' regenerative capacity.
A drug treatment that mimics fasting can also provide the same benefit, study finds.
Anne Trafton - MIT News Office
May 3, 2018
http://news.mit.edu/2018/fasting-boosts-stem-cells-regenerative-capacity-0503

Fasting Activates Fatty Acid Oxidation to Enhance Intestinal Stem Cell Function during Homeostasis and Aging.
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Mitogenic influence of human R-spondin1 on the intestinal epithelium.
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Nuvelo, Inc. Announces Positive Results from Phase 1 Clinical Trial of NU206 in Healthy Volunteers.
Published: Dec 10, 2008
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Anti-inflammatory mechanism of dieting and fasting revealed.
By Karen N. Peart
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Master detox molecule boosts immune defenses.
Scientists discover an unknown immune mechanism.
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Glutathione Primes T Cell Metabolism for Inflammation.
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Fasting triggers stem cell regeneration of damaged, old immune system
BY Suzanne Wu - USC News
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Prolonged Fasting Reduces IGF-1/PKA to Promote Hematopoietic-Stem-Cell-Based Regeneration and Reverse Immunosuppression
Chia-Wei Cheng, Gregor B. Adams, Laura Perin, Min Wei, Xiaoying Zhou, Ben S. Lam, Stefano Da Sacco, Mario Mirisola, David I. Quinn, Tanya B. Dorff, John J. Kopchick, Valter D. Longo
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