Angular Chelitis

[AIW]

Hi, I’m new here so thanks for letting me join. I am a type one diabetic and also have Hashimoto’s thyroiditis. I have had rashes on and off for years which has turned out to be Dermatitis Herpetiformis. Anyway I also have angular chelitis (sore cracks at the corners of the mouth and heard it can also be a symptom of celiac. Anyone here had angular chelitis  at diagnosis and how did you get rid of it? 

[trents]

Welcome to the forum, AIW!

Have you been officially diagnosed with celiac disease? Celiac disease is the only known cause for DH but I was wondering if you have also had either celiac antibody testing done or endoscopy with biopsy or both? Have you begun a gluten-free diet yet and if so, how long have you been on it?

If you intend to pursue other means of an official celiac diagnosis, please realize you must not begin a gluten-free diet until all testing is complete.

Edited October 28, 2022 by trents

[AIW]

2 hours ago, trents said:

Welcome to the forum, AIW!

Have you been officially diagnosed with celiac disease? Celiac disease is the only known cause for DH but I was wondering if you have also had either celiac antibody testing done or endoscopy with biopsy or both? Have you begun a gluten-free diet yet and if so, how long have you been on it?

If you intend to pursue other means of an official celiac diagnosis, please realize you must not begin a gluten-free diet until all testing is complete.

Hi, thank you for the welcome. I did have have a blood test which was low for antibodies, it was only the one test. I had stopped eating gluten ten days prior to the test as the rash was so bad but my doc still wanted to do the blood test. The rash is confirmed as DH by punch biopsy. I  have been referred for an endoscopy but have no idea how long the wait is. I will be advised when to start eating gluten again by the hospital 

[trents]

According to the Mayo Clinic guidelines, you would need to reinstate daily gluten consumption in the amount or equivalent amount of 2 pieces of wheat bread daily for at least two weeks prior to the endoscopy/biopsy. It is unfortunate that you discontinued gluten prior to the antibody test and it is unfortunate that the physician ordered only one antibody test instead of a full celiac panel. Now you have some difficult decisions to make.

[AIW]

31 minutes ago, trents said:

According to the Mayo Clinic guidelines, you would need to reinstate daily gluten consumption in the amount or equivalent amount of 2 pieces of wheat bread daily for at least two weeks prior to the endoscopy/biopsy. It is unfortunate that you discontinued gluten prior to the antibody test and it is unfortunate that the physician ordered only one antibody test instead of a full celiac panel. Now you have some difficult decisions to make.

I know, it’s so frustrating. The endoscopy/biopsy could be months away. I have autoimmune thyroiditis and autoimmune diabetes and my brother has celiac disease and I get only one blood test 

[trents]

Concerning your angular chelitis, and some other of your health issues, realize that celiac disease generally creates vitamin and mineral deficiencies because of the damage done to the villi of the small bowel. Most of us are on a number of gluten free vitamin and mineral supplements to counteract that, particularly B12, B-complex, D3 and magnesium. Zinc also and C also.

[AIW]

7 minutes ago, trents said:

Concerning your angular chelitis, and some other of your health issues, realize that celiac disease generally creates vitamin and mineral deficiencies because of the damage done to the villi of the small bowel. Most of us are on a number of gluten free vitamin and mineral supplements to counteract that, particularly B12, B-complex, D3 and magnesium. Zinc also and C also.

Any recommendations for a supplement that I could buy? I had also heard that supplements with iodine should be avoided with DH, don’t know if that’s true 

[trents]

Yes, iodine should be avoided with DH. Costco's Kirkland Signature and Nature Made brands are generally good choices. They will state gluten free on the bottle if they are and most of them will be. I get Doctor's Best High Absorption Magnesium (magnesium glycinate) from Amazon and zinc picolate from Amazon also. Titrate up in the magnesium as it an have a laxative effect if you take too much. 5000IU for D3 daily should be about right. It pays to do a little research on vitamins and minerals to see what are the most readily absorbed. Those forms are a little more spendy but otherwise you can be wasting your money if your body isn't taking them up well. Don't worry about toxicity on the B vitamins as they are water soluble and you just pee out any excess. May turn your pee yellow but that is good.

[AIW]

6 minutes ago, trents said:

Yes, iodine should be avoided with DH. Costco's Kirkland Signature and Nature Made brands are generally good choices. They will state gluten free on the bottle if they are and most of them will be. I get Doctor's Best High Absorption Magnesium (magnesium glycinate) from Amazon and zinc picolate from Amazon also. Titrate up in the magnesium as it an have a laxative effect if you take too much. 5000IU for D3 daily should be about right. It pays to do a little research on vitamins and minerals to see what are the most readily absorbed. Those forms are a little more spendy but otherwise you can be wasting your money if your body isn't taking them up well. Don't worry about toxicity on the B vitamins as they are water soluble and you just pee out any excess. May turn your pee yellow but that is good.

Thanks for the suggestions. 5000 of D seems like a lot. I’ve taken B vitamins before so i’m acquainted with the yellow pee ☺️. I understand that zinc helps support immune function but why the magnesium? I think the problem may be finding a multivit without iodine but they must be out there. I also have Hashimoto’s so avoid iodine supplements anyway. Perhaps i should take single supplements instead of a multivit? The mouth cracks are so sore. 

[trents]

Multivites are not that important IMO because they aren't very potent. Early on, medical science was very conservative with D3 amounts but it is now recognized that the caution was overdone. D3 is very important to many processes in the body and most on this forum will tell you 5000IU is quite safe. Magnesium is necessary to support the assimilation of thiamine which B-complex is generally high in. Magnesium also supports bone health as does D3.

Edited October 29, 2022 by trents

[AIW]

14 minutes ago, trents said:

Multivites are not that important IMO because they aren't very potent. Early on, medical science was very conservative with D3 amounts but it is now recognized that the caution was overdone. D3 is very important to many processes in the body and most on this forum will tell you 5000IU is quite safe. Magnesium is necessary to support the assimilation of thiamine which B-complex is generally high in. Magnesium also supports bone health as does D3.

Makes sense. Thanks for all the help, I appreciate it. I will have to shop for supplements and wait for the biopsy. I’m the meantime I may go back to my doc and request a full celiac panel not just IGA

[trents]

There is more than one IGA antibody test. Here is a primer: https://celiac.org/about-celiac-disease/screening-and-diagnosis/screening/

But if you have already begun a gluten-free diet it would be a waste of time. You would need to go back on gluten in the equivalent of 2 slices of wheat bread daily for 6-8 weeks before a valid antibody test is possible.

Edited October 29, 2022 by trents

[knitty kitty]

@AIW,

Angular cheilitis can be caused by deficiencies in Riboflavin Vitamin B2, Pyridoxine B6, Niacin B3, Cobalamine B12, and/or iron.

People who have type one or type two diabetes are notoriously low in Thiamine Vitamin B1.  

People with Hashimoto's are also deficient in Thiamine.  My thyroid problems have improved with Thiamine.

People with Diabetes or anemia can have false negatives on their antibody tests because thiamine deficiency and anemia affect the production of antibodies.

I have Type Two Diabetes, anemia and DH, and had serionegative test results.  I've also had angular cheilitis.  I was very deficient in vitamins and minerals.  I chose a genetic test which showed I have two genes for Celiac Disease.  

I keep my diabetes under control with diet and high dose Thiamine.  I corrected my angular cheilitis with Riboflavin.  I found Niacin (the flushing kind) helps my DH.  I also avoid iodine.  

There are eight B vitamins in the B Complex.  They all are interdependent on each other.  These vitamins cannot be made by our bodies so we must get them through diet and supplementation.  

Because Celiac Disease damages the small intestine where these vitamins are absorbed, we can suffer from nutritional insufficiencies or outright deficiencies.  

Doctors do not recognize nutritional deficiencies.  They are not given much training in vitamins and deficiencies.  Doctors are trained in medical institutions funded by big pharmaceutical companies.  Doctors are trained to prescribe pharmaceuticals.  

Vitamins cannot be patented, so doctors cannot make money by prescribing vitamins.  You are not deficient in pharmaceuticals.  You are deficient in micronutrients, vitamins and minerals.  

Blood tests for vitamin deficiencies are not accurate because vitamins are used inside the cells and tissues.  Blood levels of vitamins can reflect how much of the vitamins you've consumed in the past 24-48 hours. 

The World Health Organization WHO says a Thiamine deficiency diagnosis can be made if a patient is given thiamine and improvement is seen.  500-2000mg a day of Thiamine for several months may be needed to correct and keep thiamine at a functional level.  Because diabetics excrete more thiamine in urine, I take high dose Thiamine.  I take Benfotiamine and TTFD another form of thiamine that helps with neurological symptoms.  

Do talk to your doctor about checking for vitamin and mineral deficiencies.  Talk to a nutritionist about a nutrient dense gluten free diet when all your testing is done.  

Here are some articles you might find interesting...

This one is about diabetes and thiamine deficiency....

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

This one is about high dose Thiamine for diabetes....this is from Dr. Lonsdale, a pioneer in Thiamine supplementation...this saved my life...

http://www.hormonesmatter.com/diabetes-thiamine-treatment-opportunity/

This is about hashimoto's and thiamine...

https://www.verywellhealth.com/hashimotos-disease-fatigue-thiamine-levels-3232754

Hope this helps.  Keep us posted on your progress.  We're happy to answer further questions.

[AIW]

1 hour ago, knitty kitty said:

@AIW,

Angular cheilitis can be caused by deficiencies in Riboflavin Vitamin B2, Pyridoxine B6, Niacin B3, Cobalamine B12, and/or iron.

People who have type one or type two diabetes are notoriously low in Thiamine Vitamin B1.  

People with Hashimoto's are also deficient in Thiamine.  My thyroid problems have improved with Thiamine.

People with Diabetes or anemia can have false negatives on their antibody tests because thiamine deficiency and anemia affect the production of antibodies.

I have Type Two Diabetes, anemia and DH, and had serionegative test results.  I've also had angular cheilitis.  I was very deficient in vitamins and minerals.  I chose a genetic test which showed I have two genes for Celiac Disease.  

I keep my diabetes under control with diet and high dose Thiamine.  I corrected my angular cheilitis with Riboflavin.  I found Niacin (the flushing kind) helps my DH.  I also avoid iodine.  

There are eight B vitamins in the B Complex.  They all are interdependent on each other.  These vitamins cannot be made by our bodies so we must get them through diet and supplementation.  

Because Celiac Disease damages the small intestine where these vitamins are absorbed, we can suffer from nutritional insufficiencies or outright deficiencies.  

Doctors do not recognize nutritional deficiencies.  They are not given much training in vitamins and deficiencies.  Doctors are trained in medical institutions funded by big pharmaceutical companies.  Doctors are trained to prescribe pharmaceuticals.  

Vitamins cannot be patented, so doctors cannot make money by prescribing vitamins.  You are not deficient in pharmaceuticals.  You are deficient in micronutrients, vitamins and minerals.  

Blood tests for vitamin deficiencies are not accurate because vitamins are used inside the cells and tissues.  Blood levels of vitamins can reflect how much of the vitamins you've consumed in the past 24-48 hours. 

The World Health Organization WHO says a Thiamine deficiency diagnosis can be made if a patient is given thiamine and improvement is seen.  500-2000mg a day of Thiamine for several months may be needed to correct and keep thiamine at a functional level.  Because diabetics excrete more thiamine in urine, I take high dose Thiamine.  I take Benfotiamine and TTFD another form of thiamine that helps with neurological symptoms.  

Do talk to your doctor about checking for vitamin and mineral deficiencies.  Talk to a nutritionist about a nutrient dense gluten free diet when all your testing is done.  

Here are some articles you might find interesting...

This one is about diabetes and thiamine deficiency....

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

This one is about high dose Thiamine for diabetes....this is from Dr. Lonsdale, a pioneer in Thiamine supplementation...this saved my life...

http://www.hormonesmatter.com/diabetes-thiamine-treatment-opportunity/

This is about hashimoto's and thiamine...

https://www.verywellhealth.com/hashimotos-disease-fatigue-thiamine-levels-3232754

Hope this helps.  Keep us posted on your progress.  We're happy to answer further questions.

Thank you so much for taking the time to answer my question. Your answer and information does help a lot. I was beginning to think Ian just crazy. I will look at the links and start looking for good supplements. My doctor is great she does listen so I’m not worried about asking her for more tests. I have had a total of three negative blood tests over the past two years and was told to keep eating gluten. Yet geh rash, joint pains, mental fog kept coming back but I had no GI symptoms so that was that. Mind you they also told me there was nothing wrong with my thyroid either lol 

[knitty kitty]

You're very welcome.

Yes, it is frustrating that doctors don't realize that Celiac Disease can cause other symptoms besides gastrointestinal ones, over three hundred!

I take Benfotiamine, a form of thiamine that has been scientifically proven to be helpful in diabetes.  I also take Thiamax, a form of thiamine that helps with  neurological problems.  

Get a good B Complex and magnesium glycinate (helps thiamine work), Vitamin D, and Vitamin C.  

Keep us posted on your progress! 

[AIW]

55 minutes ago, knitty kitty said:

You're very welcome.

Yes, it is frustrating that doctors don't realize that Celiac Disease can cause other symptoms besides gastrointestinal ones, over three hundred!

I take Benfotiamine, a form of thiamine that has been scientifically proven to be helpful in diabetes.  I also take Thiamax, a form of thiamine that helps with  neurological problems.  

Get a good B Complex and magnesium glycinate (helps thiamine work), Vitamin D, and Vitamin C.  

Keep us posted on your progress! 

I will do that! I am waiting for my doc yo see my blood test result. My one and only test lol and go from there. If in fact she feels there is anywhere else to go