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Multi Hospital Visits..


MerryA

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MerryA Rookie

My Husband was diagnosed 15 years ago when there wasn't a lot of information out there about Celiac Disease.  His Gastrologist Didn't even have a pamphlet on the Disease & just said look on line for information. We have always tried our best to have no Gluten in his Diet but I'm aware it happens sometimes when eating out.  For the last several years my husband has been experiencing Chest pains in center of chest and has recently moved to left side causing more alarms for Heart issues. Once again we rush off to the Hospital for multiple test to find out everything is ok with the heart again. His stress level is elevated, blood pressure is high (on BP meds) he does have IBS & Acid Reflux.  We have been going back & forth from one Dr. to the next Cardiologist, Gastrologist, Pulmonologist, and now try to plan and seek out a Celiac Specialist Dr. Does anyone else that has been diagnosed for some time have any Chest pains, Shortness of Breath, Continued Stomach pains while living a 98% Gluten Free lifestyle?  I'm desperate for help as my husband lives almost daily with this pain and some days he doesn't get out of bed as it gets so bad. Any suggestions?? Thanks..


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knitty kitty Grand Master

@MerryA,

Welcome to the forum!

So sorry to hear about your husband.  

I had similar symptoms, high blood pressure and was put on meds, IBS symptoms, Gerd/reflux, shortness of breath, tachycardia, anxiety and panic attacks.  My symptoms resolved when I took high dose Thiamine Vitamin B1.  

The Gluten Free diet can be deficient in certain vitamins and minerals.  Eating a diet high in gluten free carbohydrates can deplete thiamine because gluten free facsimile foods are not enriched with vitamins and minerals like their gluten containing counterparts.  Thiamine is needed to turn carbohydrates, fats and proteins into energy for the body.  

We need more thiamine during periods of illness and emotional stress.  So being glutened in a restaurant can deplete thiamine further.  

Doctors don't recognize thiamine deficiency symptoms because they were taught it only happens in starving third world countries or only in alcoholism.  Celiac Disease damages the small intestine resulting in malabsorption of essential vitamins like thiamine and minerals like magnesium.  

I'm including some informative articles you can share with your husband's doctors.  

Beriberi (Thiamine deficiency)

https://www.healthline.com/health/beriberi#causes

And...

Hiding in Plain Sight: Modern Thiamine Deficiency

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8533683/

And...

Hypertension, the Autonomic System, and Thiamine

https://www.hormonesmatter.com/hypertension-the-autonomic-system-and-thiamine/

trents Grand Master

MerryA, welcome to the forum!

Recent studies have demonstrated that most people who claim to be eating gluten-free are actually eating lower gluten. They are unaware that they are getting gluten contamination from various sources even though they are (somewhat) conscious of trying to avoid gluten. The studies show that the number one source of this gluten contamination is eating out in restaurants. I don't mean to sound mean but 98% gluten-free is not good enough and if you are aware that it is happening when he eats out then he needs to stop eating out. When you eat out you have no control over "cross contamination". You may order things that are naturally gluten free but you have no idea whether or not the kitchen staff is cooking, stirring, slicing and handling the naturally gluten free things you ordered in the same pot, the same grill, the same tongs, the same knife, etc. that they are using for the gluten containing foods they are also cooking. 98% gluten-free means enough gluten contamination is happening to keep the inflammation in the gut smoldering.

Also, look at oats and dairy as foods that are causing a celiac-like reaction. Many celiacs find they react to these same foods like they do to gluten. Eggs too.

MerryA Rookie
2 hours ago, knitty kitty said:

@MerryA,

Welcome to the forum!

So sorry to hear about your husband.  

I had similar symptoms, high blood pressure and was put on meds, IBS symptoms, Gerd/reflux, shortness of breath, tachycardia, anxiety and panic attacks.  My symptoms resolved when I took high dose Thiamine Vitamin B1.  

The Gluten Free diet can be deficient in certain vitamins and minerals.  Eating a diet high in gluten free carbohydrates can deplete thiamine because gluten free facsimile foods are not enriched with vitamins and minerals like their gluten containing counterparts.  Thiamine is needed to turn carbohydrates, fats and proteins into energy for the body.  

We need more thiamine during periods of illness and emotional stress.  So being glutened in a restaurant can deplete thiamine further.  

Doctors don't recognize thiamine deficiency symptoms because they were taught it only happens in starving third world countries or only in alcoholism.  Celiac Disease damages the small intestine resulting in malabsorption of essential vitamins like thiamine and minerals like magnesium.  

I'm including some informative articles you can share with your husband's doctors.  

Beriberi (Thiamine deficiency)

https://www.healthline.com/health/beriberi#causes

And...

Hiding in Plain Sight: Modern Thiamine Deficiency

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8533683/

And...

Hypertension, the Autonomic System, and Thiamine

https://www.hormonesmatter.com/hypertension-the-autonomic-system-and-thiamine/

Thank you very much for all the information. 

Nutricost Vitamin B1 (Thiamine) 500mg, 120 Capsules is this what mg. you recommend?

I still learn something everyday with Celiac information..

 

knitty kitty Grand Master
27 minutes ago, MerryA said:

Thank you very much for all the information. 

Nutricost Vitamin B1 (Thiamine) 500mg, 120 Capsules is this what mg. you recommend?

I still learn something everyday with Celiac information..

 

No!  Not Thiamine Mononitrate!

Thiamine Mononitrate is the least bioavailable form of thiamine.  

You want Thiamine Hydrochloride. like this for example...

https://www.nowfoods.com/products/supplements/vitamin-b-1-100-mg-tablets

Or Benfotiamine....

https://www.lifeextension.com/search#q=benfotiamine&t=coveo4A2453FD

Or Allithiamine...

https://www.lifeextension.com/vitamins-supplements/item26106/allithiamine

All are available on line.

knitty kitty Grand Master

A B Complex supplement containing all eight B vitamins is a good idea.  Because if you're low in one B vitamin, you're probably low across the board.  The eight B vitamins all work together.  They are water soluble and are nontoxic.  Any excess is excreted in urine.

A Magnesium citrate or magnesium glycine supplement should be added, too, because thiamine needs magnesium to function properly.  

 

plumbago Experienced

There's not really enough information (labs, vitals, age, weight, social history, etc etc) here for any of us to offer meaningful advice. It sounds like a horrible situation and based on what you wrote, the greatest thing going for your husband is you, and with your continued persistence and hopefully widening network of interested people, you will be able to put a picture together eventually. I would be concerned about the shortness of breath and would really try to press on with that. High blood pressure is also something you do not want, not that you need me to tell you that, and obviously should be addressed now.

Gastroenterologists are only now (barely) coming round to taking celiac disease seriously. The ones who scoped me (upper and lower were separate procedures in my case) did not give a fig about it and couldn't even talk meaningfully about it. It was likely a way for them to diagnose people. There are not even many other kinds of docs who take celiac disease that seriously. They exist, but they're rare.

Plumbago


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C4Celiac Contributor

98% aint good enough

Kate333 Rising Star

I second what others have said about potential cross-contamination risks.  Restaurants--even those touting gluten-free menus--are a BIG problem, as are processed/packaged foods.  The big problem with both is lax regulation.  Most companies and restaurants essentially operate on the "honor system" (i.e., they are not really regulated to ensure those gluten-free claims/labels are accurate).

Also, your husband should get an updated TTG/IgA blood test to assess his current gluten antibody level.  If it is above normal, he should avoid eating out, try to buy/cook only fresh, unprocessed/unpackaged foods.

One last thing, constant stress results in MANY physical symptoms, including those you describe.  See anxietycentre.com for a detailed description of the mind-body link.  Since your husband has multiple health issues, and it's so important to keep his BP down, probably a good idea to request referral for evaluation for chronic stress/anxiety to see if he would benefit from short-term counseling/medication.  Multiple trips to ER followed by--thankfully!--normal test results suggest he has possibly developed a health anxiety/panic disorder, which is treatable with counseling and/or meds.  

I hope he feels better soon.

C4Celiac Contributor

It's all or nothing.   That 2% Gluten is gonna make you sick

Wheatwacked Veteran

Could be gall bladder. Deficient choline can cause this.

Could we be overlooking a potential choline crisis in the United Kingdom?

On 6/1/2022 at 7:45 AM, MerryA said:

Chest pains in center of chest and has recently moved to left side

 

 

 

Quote

I do not know if this really works or not, but I can tell you my experience:
Fatty liver is rampant in my family, especially for the 3 members who had to have their gall bladders removed. I started to get a constant pain on my left side where the liver is located. Started taking these as a supplement to help my liver break down the fats. Been using it now 2 tablets a day for 2 weeks, and the pain I had for months has stopped. I recommend consulting your doctor first, but it seems to have worked for me.   Amazon.com: Standard Process Choline - Liver Support, Gallbladder Support, and Nervous System Supplement with Choline Bitartrate and Honey - 90 Tablets : Health & Household

 

knitty kitty Grand Master
(edited)

But the liver (and gallbladder) are on the right side of the body.

The pancreas is on the left.

Edited by knitty kitty
Typo correction
Wheatwacked Veteran

Referred Pain?

Pain may also radiate to the back or occur under the shoulder blades, behind the breastbone, or on the left side. Gallbladder Disease and Gallstones

Quote

 

What does gallbladder pain feel like? Pain location:  The pain is usually felt in your upper right abdomen but can spread to your upper back or shoulder blade.

Some people also experience pain in the center of their abdomen, just below their breastbone. This discomfort can last several minutes to a few hours.

A 2012 research review showed that up to 15 percent of adults in the United States have or will have gallstones.

 

 

MerryA Rookie
On 6/1/2022 at 10:46 AM, trents said:

MerryA, welcome to the forum!

Recent studies have demonstrated that most people who claim to be eating gluten-free are actually eating lower gluten. They are unaware that they are getting gluten contamination from various sources even though they are (somewhat) conscious of trying to avoid gluten. The studies show that the number one source of this gluten contamination is eating out in restaurants. I don't mean to sound mean but 98% gluten-free is not good enough and if you are aware that it is happening when he eats out then he needs to stop eating out. When you eat out you have no control over "cross contamination". You may order things that are naturally gluten free but you have no idea whether or not the kitchen staff is cooking, stirring, slicing and handling the naturally gluten free things you ordered in the same pot, the same grill, the same tongs, the same knife, etc. that they are using for the gluten containing foods they are also cooking. 98% gluten-free means enough gluten contamination is happening to keep the inflammation in the gut smoldering.

Also, look at oats and dairy as foods that are causing a celiac-like reaction. Many celiacs find they react to these same foods like they do to gluten. Eggs too.

I realize how hard it is for everyone trying to make sure you don't get cross contamination when eating out and we really try to be careful. We have a company that takes us out of town so it can't be avoided.  There is so much he can't eat I feel sorry for him. He is also lactose Intolerant and has Diabetes. I have never heard of a egg problem, geez there goes his omelets. There is something going on that no one has found and I worry it is something someone has over looked. Just tired of the run arounds and was wondering if anyone else had similar concerns.

MerryA Rookie
On 6/1/2022 at 2:42 PM, plumbago said:

There's not really enough information (labs, vitals, age, weight, social history, etc etc) here for any of us to offer meaningful advice. It sounds like a horrible situation and based on what you wrote, the greatest thing going for your husband is you, and with your continued persistence and hopefully widening network of interested people, you will be able to put a picture together eventually. I would be concerned about the shortness of breath and would really try to press on with that. High blood pressure is also something you do not want, not that you need me to tell you that, and obviously should be addressed now.

Gastroenterologists are only now (barely) coming round to taking celiac disease seriously. The ones who scoped me (upper and lower were separate procedures in my case) did not give a fig about it and couldn't even talk meaningfully about it. It was likely a way for them to diagnose people. There are not even many other kinds of docs who take celiac disease that seriously. They exist, but they're rare.

Plumbago

His labs has been done the only thing they found was his Potassium was low and gave him a script.  He's 62 20l0bs but not sure what you mean about Social History, we have been married for 42 years. My problem is I took him in with the same problems we left with. They did all the test and never find anything. Just seeing if anyone else was having similar issues.

MerryA Rookie
7 hours ago, Wheatwacked said:

Could be gall bladder. Deficient choline can cause this.

Could we be overlooking a potential choline crisis in the United Kingdom?

 

 

 

 

I know his Gallbladder is fine but we did just find out he does have a Fatty Liver. 

Thanks for the info

plumbago Experienced
19 minutes ago, MerryA said:

His labs has been done the only thing they found was his Potassium was low and gave him a script.  He's 62 20l0bs but not sure what you mean about Social History, we have been married for 42 years. My problem is I took him in with the same problems we left with. They did all the test and never find anything. Just seeing if anyone else was having similar issues.

That's good. I'd also recommend posting a query on one of the many reputable diabetes dialogue boards / forums. Some are quite excellent.

I am a nurse and I work with a lot of patients with diabetes. Again, the most concerning thing I hear from you is the SOB and high blood pressure. Your husband would certainly qualify for a good cardiac work up (I would think). It sounds like you are wondering if there is a connection between celiac disease and the symptoms. Unfortunately I cannot answer that - others may be able to weigh in on pathophysiology of the connection between SOB and celiac disease.

It is good of you to reach out, but -- we are a voiceless, faceless bunch here, (we don't know each other from Adam) and my own personal tendency is to urge caution before taking any advice on the Internet. That's all I meant.

Plumbago

Wheatwacked Veteran
26 minutes ago, MerryA said:

his Potassium was low and gave him a script.

The recommended potassium intake for an average adult is 4,700 milligrams (mg) per day. If he is on blood pressure meds what are they? Some cause hypokalemia and some cause hyperkalemia and some do not.

"in the journal Hypertension, showed that for each 0.5 milliequivalent-per-liter (MEq/L) decrease in serum potassium, there was a 45 percent increased risk of diabetes. None of the people in the group receiving the fake drug developed low potassium levels." Potassium Loss From Blood Pressure Drugs May Explain Higher Risk Of Adult Diabetes - https://www.hopkinsmedicine.org/news/media/releases/potassium_loss_from_blood_pressure_drugs_may_explain_higher_risk_of_adult_diabetes

The FDA has limited OTC potassium supplementation to <100 mg because it can cause intestinal lesions. A 100 gram banana has 358 mg of potassium.

 

MerryA Rookie
8 hours ago, knitty kitty said:

But the liver (and gallbladder) are on the right side of the body.

The pancreas is on the left.

Thats what I was thinking..

MerryA Rookie
10 minutes ago, Wheatwacked said:

The recommended potassium intake for an average adult is 4,700 milligrams (mg) per day. If he is on blood pressure meds what are they? Some cause hypokalemia and some cause hyperkalemia and some do not.

"in the journal Hypertension, showed that for each 0.5 milliequivalent-per-liter (MEq/L) decrease in serum potassium, there was a 45 percent increased risk of diabetes. None of the people in the group receiving the fake drug developed low potassium levels." Potassium Loss From Blood Pressure Drugs May Explain Higher Risk Of Adult Diabetes - https://www.hopkinsmedicine.org/news/media/releases/potassium_loss_from_blood_pressure_drugs_may_explain_higher_risk_of_adult_diabetes

The FDA has limited OTC potassium supplementation to <100 mg because it can cause intestinal lesions. A 100 gram banana has 358 mg of potassium.

 

Losartan/HCTZ 100/25mg Tablets once a day. Wow you guys are better than the FBI... Never get any responses or suggestions from the Doctors.. Thanx

Wheatwacked Veteran

Hypokalemia. Most widely recognized, the first adverse effect of thiazide diuretics is hypokalemia. As discussed above, hypokalemia is a sequela of the aldosterone-mediated actions of the Na/K pump in the CT. Hypokalemia can be life-threatening and requires monitored during the first 2-3 weeks of HCTZ therapy.   https://www.ncbi.nlm.nih.gov/books/NBK532918/#:~:text=Hypokalemia.,3 weeks of HCTZ therapy.

Out of curiosity do you know his homocysteine level and vitamin D plasma?

knitty kitty Grand Master
(edited)

@MerryA,

Losartan/HCTZ 100/25mg Tablets 

HCTZ is hydrochlorothiazide.  It is a diuretic.  Diuretics can cause Thiamine deficiency.  Thiamine is flushed out of the body with urine.

I was prescribed HCTZ and my doctors did not recognize the ensuing thiamine deficiency symptoms.  I knew what was happening because I had learned about Thiamine deficiency at university whilst getting a degree.

I agree, don't take advice from strangers on the internet.  That's why I give references to peer-reviewed published scientific studies and articles you can take to your doctor to discuss further.  

Like these....

Diuretic use: a risk for subclinical thiamine deficiency in elderly patients

https://pubmed.ncbi.nlm.nih.gov/10842416/

And...

A Retrospective Case Series of Thiamine Deficiency in Non-Alcoholic Hospitalized Veterans: An Important Cause of Delirium and Falling?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037750/

And...

Shoshin Beriberi Induced by Long-Term Administration of Diuretics: A Case Report

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106092/

And...

Thiamine Level in Type I and Type II Diabetes Mellitus Patients: A Comparative Study Focusing on Hematological and Biochemical Evaluations

https://www.cureus.com/articles/31208-thiamine-level-in-type-i-and-type-ii-diabetes-mellitus-patients-a-comparative-study-focusing-on-hematological-and-biochemical-evaluations

And...

Thiamine deficiency in diabetes mellitus and the impact of thiamine replacement on glucose metabolism and vascular disease

https://pubmed.ncbi.nlm.nih.gov/21564442/

 

Hope this helps!

P.S.  I have Type Two Diabetes and keep off medications by taking Benfotiamine and Thiamine HCl.  Metformin I was prescribed caused thiamine deficiency, too.  

Edited by knitty kitty
Added post script
knitty kitty Grand Master

Forgot the Fatty Liver...and thiamine studies....

High-dose vitamin B1 therapy prevents the development of experimental fatty liver driven by overnutrition

https://pubmed.ncbi.nlm.nih.gov/33608323/

And...

OCT1 in hepatic steatosis and thiamine disposition

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4353231/

 

knitty kitty Grand Master

Shortness of breath is a symptom of Thiamine deficiency.

Thiamine deficiency is called Beriberi....from....

"the Arabic words buhr, meaning “asthma,” and bahri, meaning “sailor” (“Sailor’s asthma”)."

 

Pathophysiology, prevention, and treatment of beriberi after gastric surgery

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7666909/

 

Post-gastric surgery patients have malabsorption.  Celiac Disease patients have malabsorption.

Beverage Rising Star

I had a lot of success with the strategies in this article...he may not have a hiatal hernia, but the things here help regardless.

https://drjockers.com/hiatal-hernia/

If he is taking any antacids, not good, we need acid in our stomach to absorb many vitamins, for example, vitamin D.

I had great success with the heel thumping maneuver, also elevating head of bed by placing two 2x4's under feet at head of bed, and especially drinking a sip of Bragg's apple cider vinegar before any meals with protein. 

I also chew two DGL tablets if needed after meals, they coat, they don't reduce acid.  I use this one, as it has the least sugar:

https://www.amazon.com/Integrative-Therapeutics-Rhizinate-Deglycyrrhizinated-Licorice/dp/B001WUC406?pd_rd_w=QfKKe&content-id=amzn1.sym.bc622850-a717-4d94-96c3-7cc183488298&pf_rd_p=bc622850-a717-4d94-96c3-7cc183488298&pf_rd_r=63ZFZM8X13J3ZRG0C9J2&pd_rd_wg=m5E72&pd_rd_r=23417c98-8254-4fa8-9d37-3f2cfc622fd9&pd_rd_i=B001WUC406&psc=1&ref_=pd_bap_d_rp_1_t

 

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      Beans in desserts are a fantastic way to add moisture, structure, and protein while keeping recipes gluten-free. Black bean brownies are a classic, but other beans like adzuki and pinto can also work well—adzuki beans are naturally sweet and often used in Asian desserts, making them great for cookies or cakes. Lentils, especially red lentils, blend smoothly into batters and can replace flour in recipes like blondies or muffins. Since you’re allergic to chickpeas, you might try navy beans or cannellini beans for a milder flavor in vanilla-based desserts. For less crumbliness, blending cooked beans into a paste helps bind the dough, and adding a bit of xanthan gum (if tolerated) can improve texture. If you’re experimenting, start with recipes that replace half the flour with bean purée before going fully flourless. Have you tried using aquafaba (bean liquid) as an egg substitute? It works wonders in gluten-free baking too!
    • lmemsm
      This may make you feel better about cross-contamination: https://nationalceliac.org/celiac-disease-questions/do-i-need-new-designated-pans-plates-and-utensils/ https://theceliacscene.com/rethinking-cross-contamination-no-need-to-be-so-careful/ I use Tom's of Maine or a toothpaste that states it's gluten free.  I have allergic reactions to some toothpastes so some of the toothpastes in health food stores are usually safer for me. They're typically gluten free as well. Spices can contain cross-contamination from gluten.  There are a few lists online of spices that are safe for celiacs.  I also grow my own herbs and use them in place of store bought when I can.  I think Badia lists their spices as gluten free and Spice Lab has some gluten free too. Knitty Kitty has a great point about nutritional deficiencies and B vitamins.  I got a lot of aches and pains when I got off gluten.  I tried to replace wheat with other healthy grains like teff, buckwheat and sorghum.  Limiting one's diet too much and not getting enough vitamins, can make someone feel worse.  A lot of the gluten free foods in the stores are made with lower quality ingredients than the wheat varieties.  I try to replace all my foods with homemade options.  Then I know the quality of the ingredients and which vitamins I may be high or low in.  Probiotics or prebiotics can help with bathroom issues.  Better to get them in foods if possible and not pill form.  My doctors keep recommending magnesium too.  It's not supposed to be taken alone, but they don't seem to care about that.  It's easy for vitamin D to be low too.  That was another thing doctors told me to take.  Unfortunately, they didn't monitor it and it went too high.  Again, better from natural sources like food and sunlight.  However, supplementing can help if you're not getting enough.  Some sources say to take D with K2.  You may want to have iodine levels checked.  If you add iodine, make sure to get sufficient selenium for thyroid.  You can get iodine naturally in most seaweed.  Nori may also be one of the few non-animal sources for B12.  Brazil nuts are a good source of selenium and you only need a few a day to meet RDA.  Some brands of nuts specifically say gluten free.  Unfortunately, there are issues with Brazil nut production and they're much harder to find this year. The more you can vary your diet the better.  One study said aim for at least 30 different foods in a week.  You might want to try kiwi fruit.  There were some studies that said eating kiwi improved mood.  It also has a covering which most people don't eat, so that should protect what's inside from contamination. I've limited my diet quite a bit over the years because of migraines, so I know how uncomfortable it can be finding safe foods.  However, I'm afraid limiting diets like that may actually be causing more harm than good.  It's something I'm trying to work on.  I keep trying to expand the number of foods I eat and my recipe repertoire.  I made a list of brands of foods that I've found that are gluten free so I have a guide when I'm shopping.  
    • knitty kitty
      Hello, @Dora77, I agree with you that your doctors aren't very knowledgeable about Celiac Disease.  My doctors didn't recognize nutritional deficiencies either.  I became very deficient in vitamins before I was diagnosed, so having experienced similar, I understand what a difficult time you're having.   Poor absorption of essential nutrients is caused by the damage done to the intestines by Celiac Disease.  The gluten free diet can be low in essential nutrients, so supplementing to boost your absorption is beneficial.  New symptoms can develop or worsen as one becomes more and more deficient.   There's eight essential B vitamins that our bodies cannot make, so they must come from our food and supplements.  These eight B vitamins work together, like instruments in an orchestra.  They need to be supplemented together with essential minerals like magnesium.   Deficiencies in the B vitamins can have overlapping symptoms.  Some symptoms can be traced to specific B vitamins.  OCD can be traced to low Pyridoxine Vitamin B 6.  Yes, I had OCD and washed my hands until my skin cracked and bled.  ADHD symptoms can be traced to low Thiamine Vitamin B 1.  ADHD is something one is born with.  People who are born with ADHD have a metabolic problem with getting sufficient thiamine into their brain cells.  People who develop symptoms of ADHD later in life are more likely to be low in Thiamine.  The same symptoms appear if one is not getting sufficient thiamine from the diet.  Yes, I developed symptoms of ADHD.  These symptoms improved and disappeared after supplementing with Thiamine and the other essential nutrients. I was diagnosed with Type Two Diabetes.  99% of diabetics of both types are deficient in Thiamine because our kidneys don't re-absorb thiamine properly.  Thiamine is needed to make insulin and digestive enzymes in the pancreas.  Poor digestion (floating, undigested stools) can result with insufficient pancreatic enzymes.  The gall bladder (upper right quadrant) needs thiamine to make and release bile which also helps with digestion.  Constipation is also a symptom of Thiamine and magnesium deficiencies.  The thyroid is another organ that uses lots of Thiamine, too.  Low thyroid hormones can be due to insufficient thiamine, selenium, iron, and iodine.  Swelling of hands, face and feet are also symptoms of thiamine insufficiency.   Our bodies use thiamine to make energy so organs and tissues can function.  Thiamine cannot be stored longer than three weeks.  If our stores are not replenished every day, we can run out of Thiamine quickly.  If we do get some thiamine from our diet, symptoms can wax and wane mysteriously, because a twenty percent increase in dietary thiamine causes an eighty percent improvement in brain function and symptoms.  Thiamine interacts with all the other vitamins in some way.  Many other vitamins and their metabolic processes won't work without thiamine.  In Celiac Disease you are apt to be low in all the essential nutrients, not just thiamine, but thiamine deficiency symptoms may appear first. Talk to your dietician about eating a nutritionally dense gluten free diet.  Keep in mind that processed gluten free foods do not contain sufficient vitamins to be useful.  Processed gluten free foods are filled with saturated fats and excess fiber (that could explain your constipation).  Dairy products, milk and cheese can cause problems because Casein, the protein in dairy, causes the same autoimmune reaction that gluten does in some.  Your current restricted diet is dangerous to your health.  I followed the Autoimmune Protocol Diet (Dr. Sarah Ballantyne).  It's a Paleo diet that promotes intestinal healing.   Discuss with your doctors about correcting nutritional deficiencies as soon as possible.   Interesting reading... https://pubmed.ncbi.nlm.nih.gov/34165060/ https://pubmed.ncbi.nlm.nih.gov/21816221/#:~:text=Lipid-soluble thiamin precursors can,and attention deficit%2Fhyperactivity disorder.
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