General Chat Unrelated to Celiac Disease - Discuss most things here EXCEPT Celiac Disease / Gluten-Free Diet. Keep it light and avoid controversial topics like global warming, gay marriage, gun control, euthanasia, speed limits on the Autobahn, prisoner torture, etc.
Celiac.com 08/20/2018 - Following a gluten-free diet is critical for people with celiac disease. However, the factors that influence gluten-free diet success for people with celiac disease are not well understood on a population-wide scale.
A team of researchers recently set out to assess the factors that influence gluten‐free diet adherence in patients with celiac disease. The research team included E. P. Halmos, M. Deng, S. R. Knowles, K. Sainsbury, B. Mullan, and J. A. Tye‐Din.
The team asked celiac patients to complete an online survey that included the validated Celiac Dietary Adherence Test, along with questions on demographics, details of diagnosis and management and assessment of diet knowledge, quality of life and psychological distress. The team then reviewed the survey data for predictors of adherence and quality of life.
There were a total of 7,393 survey responses, with 5,310 people completing the Celiac Dietary Adherence Test, and 3,230 of whom were following a gluten‐free diet.
Multivariate regression showed that predictors of gluten-free dietary adherence included older age, being male, symptoms severity after gluten consumption, above average gluten-free food knowledge, and lower risk of psychological distress. People with celiac disease who followed a gluten-free diet also reported better quality of life.
Respondents who reported having poor food knowledge were more likely to wrongly identify gluten‐free foods, though they could still recognize gluten‐containing foods. This indicates that poor overall food knowledge may lead people with celiac disease to over‐restrict their diet. Poor understanding of gluten‐free diet and stressful psychological well-being were the main modifiable risk factors for failure to follow a gluten‐free diet in patients with celiac disease.
From these responses, the team concluded that access to a dietitian and mental health care professional, in cases of psychological stress, is likely necessary to improve gluten-free dietary observation, and thus to improve overall patient health and well-being.
Read more at: Alimentary Pharmacology & Therapeuticsdoi.org/10.1111/apt.14791
The researchers in this study are variously affiliated with the Department of Gastroenterology, The Royal Melbourne Hospital in Parkville, Victoria, Australia, the Department of Gastroenterology, Central Clinical School, Monash University in Melbourne, Victoria, Australia, the Cartovera Pty. Ltd. in Adelaide, SA, Australia, the Department of Psychological Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology in Hawthorn, Victoria, Australia, the Department of Mental Health, St Vincent's Hospital in Fitzroy, Victoria, Australia, the Department of Psychiatry, University of Melbourne in Parkville, Victoria, Australia, Institute of Health and Society, Faculty of Medical Sciences, Newcastle University in Newcastle Upon Tyne, UK, the Health Psychology & Behavioural Medicine Research Group, School of Psychology, Curtin University in Bentley, WA, Australia, the Immunology Division, The Walter and Eliza Hall Institute of Medical Research in Parkville, Victoria, Australia, and the Department of Medical Biology, University of Melbourne in Parkville, Victoria, Australia.
Celiac.com 08/18/2018 - This happy marriage of tangy lemon, salty capers and spices turn ordinary chicken breasts into an extraordinary entree. Easy to make and sure to appeal to even picky eaters, this creamy, tangy recipe will take your chicken from seven to eleven in no time.
4 chicken cutlets
1½ cups chicken broth
5 tablespoons potato starch
2 tablespoons olive oil
3 tablespoons capers
4 cloves garlic, minced
1 teaspoon kosher salt
1 teaspoon ground black pepper
1 teaspoon lemon pepper
1 splash heavy cream
Zest and juice of 1 lemon
Parsley, for garnish, as desired
On a plate, combine kosher salt, pepper, lemon pepper and 2 tablespoons of potato starch.
Cover the chicken cutlets in potato starch mixture and place on a separate plate.
Sprinkle half of the lemon zest over the cutlets and gently pat it on.
Heat oil in a large skillet over medium heat.
Brown chicken until cooked through, about 3-4 minutes on each side.
Move browned cutlets to a fresh plate.
In a bowl, whisk lemon juice, chicken broth, capers, garlic and remaining zest until smooth.
Pour into skillet with drippings and whisk until blended.
Add cream, as desired and stir until blended and smooth.
Return chicken to pan and heat for about 2 minutes.
Serve cutlets on white rice with your favorite vegetables on the side.
Spoon sauce over cutlets and garnish with parsley, as desired.
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.
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.
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 08/16/2018 - What is the significance of vitamin D serum levels in adult celiac patients? A pair of researchers recently set out to assess the value and significance of 25(OH) and 1,25(OH) vitamin D serum levels in adult celiac patients through a comprehensive review of medical literature.
Researchers included F Zingone and C Ciacci are affiliated with the Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; and the Celiac Center, AOU San Giovanni di Dio e Ruggi di Aragona, University of Salerno, Department of Medicine and Surgery, Salerno, Italy.
Within the wide spectrum of symptoms and alteration of systems that characterizes celiac disease, several studies indicate a low-level of vitamin D, therefore recent guidelines suggest its evaluation at the time of diagnosis. This review examines the data from existing studies in which vitamin D has been assessed in celiac patients.
Our review indicates that most of the studies on vitamin D in adult celiac disease report a 25 (OH) vitamin D deficiency at diagnosis that disappears when the patient goes on a gluten-free diet, independently of any supplementation. Instead, the researchers found that levels of calcitriol, the active 1,25 (OH) form of vitamin D, fell within the normal range at the time of celiac diagnosis.
Basically, their study strongly suggests that people with celiac disease can recover normal vitamin D levels through a gluten-free diet, without requiring any supplementation.
Dig Liver Dis. 2018 Aug;50(8):757-760. doi: 10.1016/j.dld.2018.04.005. Epub 2018 Apr 13.
Celiac.com 08/15/2018 - Grain-free food has been linked to heart disease in dogs. A canine cardiovascular disease that has historically been seen in just a few breeds is becoming more common in other breeds, and one possible culprit is grain-free dog food.
The disease in question is called canine dilated cardiomyopathy (DCM), and often results in congestive heart failure. DCM is historically common in large dogs such as Great Danes, Newfoundlands, Irish Wolfhounds, Saint Bernards and Doberman Pinschers, though it is also affects some Cocker Spaniels. Numerous cases of DCM have been reported in smaller dogs, whose primary source of nutrition was food containing peas, lentils, other legume seeds or potatoes as main ingredients. These reported atypical DCM cases included Golden and Labrador Retrievers, a Whippet, a Shih Tzu, a Bulldog and Miniature Schnauzers, as well as mixed breeds.
As a result, the U.S. Food and Drug Administration's Center for Veterinary Medicine, along with a group of veterinary diagnostic laboratories, is investigating the possible link between DCM and pet foods containing seeds or potatoes as main ingredients. The good news is that in cases where the dog suffers no genetic component, and the disease is caught early, simple veterinary treatment and dietary change may improve heart function.
According to Nutritional Outlook, an industry publication for makers of dietary supplements and healthy foods and beverages, there is a growing market for “free from” foods for dogs, especially gluten-free and grain-free formulations. In 2017, about one in five dog foods launched was gluten-free. So, do dogs really need to eat grain-free or gluten-free food? Probably not, according to PetMD, which notes that many pet owners are simply projecting their own food biases when choosing dog food.
Genetically, dogs are well adapted to easily digest grains and other carbohydrates. Also, beef and dairy remain the most common allergens for dogs, so even dogs with allergies are unlikely to need to need grain-free food.
So, the take away here seems to be that most dogs don’t need grain-free or gluten-free food, and that it might actually be bad for the dog, not good, as the owner might imagine.
Stay tuned for more on the FDA’s investigation and any findings they make.
Read more at Bizjournals.com
I have not had your experience.
So I might not be able to help you but I did have recurrent mouth ulcers. And I have had the furry white tongue common with tonsillitis. .. .though it was diagnosed as thrush instead. Probably because my tonsils where not also inflamed.
They may not be linked conditions but when I began studying your condition it seemed the two most likely causes were bacterial (in that case the antibiotics) will work or Viral and in that case the antibiotics won't work.
Have your doctor (before your tonsil surgery) check your EBV levels to make sure it is not viral in nature.
Epstein Barr Virus is common in reoccurring Tonsillitis.
Here is the research entitled Detection of Epstein-Barr virus in recurrent tonsillitis.
Epstein Barr Virus can cause a wide spectrum of problems.
The prevalence of EBV in adults is considered rare in the Western World (Non-Japanese) but that may be because no body is looking for it.
From the above link on the difference between strep (bacterial) and mono (viral) they note quoting
"In most of the patients, the condition gets resolved completely; only 10% (of adults) can get chronic relapsing syndrome."
Recent research on celiac disease and EBV indicates it shows up in Celiac's at a higher rate than expected.
Here is a thread on the celiac.com forum when this research came out about the EBV and possible Celiac connection.
I hope this is helpful but it is not medical advice.
As always “Consider what I say; and the Lord give thee understanding in all things” this included. 2 Timothy 2: 7
I share your concern with the surgery. Testing to see if it (the tonsillitis) is viral in nature can guide you about what is best for you!
He/She (the doctor) should of swabbed you to get an idea of the origin of the tonsillitis (bacterial or viral) . .. but it is not too late yet to find out!
There is probably more research I could add to the above research but sometimes as I am learning . . ..less is more.
This will be enough to get you started in the right direction. Is it bacterial in origin or is it viral in origin?
And if you are not comfortable with the surgery yet put it off for now. . . till you know the best course of action for you!
Again this is not medical advice but I hope it is helpful.
Posterboy by the grace of God,