Starting the Gluten Challenge - Help

[Ginger38]

Not sure if this is the right forum to post this in but here I go:

I am starting the gluten challenge for an upcoming EGD and colonoscopy with biopsies. I have not done a gluten challenge before, as I fell through the cracks and was told to go off gluten before seeing an GI doc.
I am not excited about it. Gluten makes me very sick with all sorts of symptoms. I’m actually quite terrified of what this will do to me. I am also diabetic so I am concerned about that as well during this long process. I also have a few specific questions .. 

1. What is the minimum amount of time and minimum amount of gluten I need to consume to get a reliable biopsy? He said he will take about 5 biopsies while in there. He is also looking for Crohn’s disease 

2. Any tips for trying to function and work and be a mom and just survive during this process? I have terrible GI symptoms , increased reflux, not able to digest foods like salads and veggies, nausea, sour stomach, horrible bloating, diarrhea, gas, terrible exhaustion and brain fog, tachycardia, palpitations, rashes among others.

3. I also didn’t know if I should stick to a more bland diet and easier to digest foods since I’m intentionally harming my gut.

4.  Should I be taking or not taking anything during this time? Antacids, Imodium, gas ex, nausea meds, pain relief, probiotics, l-glutamine, all my vitamins? 

5. Should I go for the minimum amount of gluten or is it better to just pig out? 

Thanks in advance! Im really nervous about it all 

[Ginger38]

Is 5 weeks of eating gluten enough to get a reliable biopsy? 

[Scott Adams]

Here is more info about how to do a gluten challenge for a celiac disease blood panel, or for an endoscopy:

  Quote

"...in order to properly diagnose celiac disease based on serology and duodenal histology, doctors need patients to be on gluten-containing diets, even if they are causing symptoms, and this is called a "gluten challenge."

• Eat gluten prior to celiac disease blood tests: The amount and length of time can vary, but is somewhere between 2 slices of wheat bread daily for 6-8 weeks and 1/2 slice of wheat bread or 1 wheat cracker for 12 weeks 12 weeks;
• Eat gluten prior to the endoscopic biopsy procedure: 2 slices of wheat bread daily for at least 2 weeks;

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and this recent study recommends 4-6 slices of wheat bread per day:

 

 

[Ginger38]

  On 8/22/2024 at 10:44 PM, Scott Adams said:

Here is more info about how to do a gluten challenge for a celiac disease blood panel, or for an endoscopy:

and this recent study recommends 4-6 slices of wheat bread per day:

 

 

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Thank you for this information! 

[knitty kitty]

Hey, @Ginger38,

How are you doing?  

A Gluten Challenge recommends  at least 10 grams of gluten per day for a minimum of two weeks, but more is better.   Remember different foods can contain different amount of gluten.  Cookies and cakes have less gluten than chewy breads like thick pizza dough and artisan breads.  

Avoid salads and raw veggies as they are hard to digest.  Spicy and greasy foods should be avoided, too.  

Yes, well-cooked soft foods are easier to digest.  Crock pot meals or casseroles (chicken, or beef roast, veggies) are time savers when you're too ill to stand over a stove.  Cook the night before or overnight, and reheat if you're not home to monitor cooking.  

Small, frequent meals will help relieve the nausea and reflux.  Taking a magnesium supplement after meals can reduce reflux.  Eating a protein with the gluten may help some gastrointestinal symptoms.  

In half of Celiac people, the Casein in Dairy can cause an autoimmune reaction just like gluten does.  Some have found cutting out or adding dairy (depending on desired results) during a challenge helpful.  

Keep taking the B vitamins and stay hydrated.  The B vitamins are water soluble and are easily lost when we have diarrhea.  Stay well hydrated. 

Horrible bloating, diarrhea, gas, terrible exhaustion, brain fog, tachycardia, and palpitations can be symptoms of Celiac Disease, and also Thiamine deficiency.  Thiamine is needed to turn carbs into usable energy.  An increase in carbohydrates means a bigger demand for Thiamin (Benfotiamine).  

Most diabetics are deficient in Thiamine.  I have diabetes also.  Our kidneys don't absorb thiamine in the kidneys, so we lose a lot of Thiamine in urine. 

Metformin will block the Thiamine/Folate receptors on cells, preventing Thiamine and Folate from entering the cells, which can precipitate a Thiamine deficiency disorder.   

I was not a diagnosed Celiac when I was prescribed Metformin which contributed to my developing Thiamine deficiency.  Metformin is also a Sulfa drug.  It is not uncommon for people with Celiac Disease to develop Sulfite Sensitivity, a Type Four Hypersensitivity reaction, which can manifest as gastrointestinal symptoms and rashes.  Since switching to the AIP diet, I have been able to control my blood glucose levels with diet and Benfotiamine, and have discontinued antidiabetic pharmaceuticals.

For pain relief, a combination of Thiamine, Pyridoxine B6 and Cobalamine B12 have analgesic effects.  

I hope you get through okay.  We're all cheering you on! 

Eat a croissant for me!  

Edited August 23, 2024 by knitty kitty
Typo correction

[Ginger38]

  On 8/23/2024 at 11:46 AM, knitty kitty said:

Hey, @Ginger38,

How are you doing?  

A Gluten Challenge recommends  at least 10 grams of gluten per day for a minimum of two weeks, but more is better.   Remember different foods can contain different amount of gluten.  Cookies and cakes have less gluten than chewy breads like thick pizza dough and artisan breads.  

Avoid salads and raw veggies as they are hard to digest.  Spicy and greasy foods should be avoided, too.  

Yes, well-cooked soft foods are easier to digest.  Crock pot meals or casseroles (chicken, or beef roast, veggies) are time savers when you're too ill to stand over a stove.  Cook the night before or overnight, and reheat if you're not home to monitor cooking.  

Small, frequent meals will help relieve the nausea and reflux.  Taking a magnesium supplement after meals can reduce reflux.  Eating a protein with the gluten may help some gastrointestinal symptoms.  

In half of Celiac people, the Casein in Dairy can cause an autoimmune reaction just like gluten does.  Some have found cutting out or adding dairy (depending on desired results) during a challenge helpful.  

Keep taking the B vitamins and stay hydrated.  The B vitamins are water soluble and are easily lost when we have diarrhea.  Stay well hydrated. 

Horrible bloating, diarrhea, gas, terrible exhaustion, brain fog, tachycardia, and palpitations can be symptoms of Celiac Disease, and also Thiamine deficiency.  Thiamine is needed to turn carbs into usable energy.  An increase in carbohydrates means a bigger demand for Thiamin (Benfotiamine).  

Most diabetics are deficient in Thiamine.  I have diabetes also.  Our kidneys don't absorb thiamine in the kidneys, so we lose a lot of Thiamine in urine. 

Metformin will block the Thiamine/Folate receptors on cells, preventing Thiamine and Folate from entering the cells, which can precipitate a Thiamine deficiency disorder.   

I was not a diagnosed Celiac when I was prescribed Metformin which contributed to my developing Thiamine deficiency.  Metformin is also a Sulfa drug.  It is not uncommon for people with Celiac Disease to develop Sulfite Sensitivity, a Type Four Hypersensitivity reaction, which can manifest as gastrointestinal symptoms and rashes.  Since switching to the AIP diet, I have been able to control my blood glucose levels with diet and Benfotiamine, and have discontinued antidiabetic pharmaceuticals.

For pain relief, a combination of Thiamine, Pyridoxine B6 and Cobalamine B12 have analgesic effects.  

I hope you get through okay.  We're all cheering you on! 

Eat a croissant for me!  

Expand Quote  

Thank you so very much for all this helpful information!! I really appreciate it!! I am hanging in there as best I can. I have almost been constipated at times since starting the gluten challenge. Is that normal? 
I’m super fatigued and exhausted with brain fog and concentration issues. I’ve been itching. My allergies are all flared up. I feel like I’ve gained 10 pounds. Reflux has definitely increased. And I just feel sore and places are tender to touch, all over, especially my abdomen. I’m hungry like all the time. 
One of the biggest issues for me since starting the gluten challenge has been my blood sugars!! They have been so high and won’t come down much. Any idea why that is?? 
Thanks again for all your help!!! 

[knitty kitty]

@Ginger38,

Magnesium citrate or Magnesium Glycinate chelates can help with the constipation. 

Benfotiamine will help with Gastroparesis, edema, reflux, brain fog and fatigue.  Benfotiamine won't lower your blood glucose, but it will help your body use insulin.

I take Bilberry supplements from Nature's Way to lower blood glucose levels.  I take one or two.  If you take Bilberry close to when you take Metformin, your blood glucose level can drop very low.  Be Careful!!!   

Be sure to stay well hydrated.  I found warm tea (no sugar) after meals helps with keeping things moving through.  Oolong tea is very relaxing for the anxiety.  Some people people say it has a laxative effect.   

Benfotiamine, B12 and Pyridoxine B6  when taken together results pain relief comparable to aspirin and NSAIDs.  (NSAIDs and aspirin will tear up your digestive system).

An antihistamine can help with the allergies. 

A hot water bottle works wonders on abdominal pain, too.

Sending encouragement.  Put your feet up and relax.  You'll be through this soon.  I'll be here if you need anything.

[Ginger38]

  On 8/24/2024 at 5:23 PM, knitty kitty said:

@Ginger38,

Magnesium citrate or Magnesium Glycinate chelates can help with the constipation. 

Benfotiamine will help with Gastroparesis, edema, reflux, brain fog and fatigue.  Benfotiamine won't lower your blood glucose, but it will help your body use insulin.

I take Bilberry supplements from Nature's Way to lower blood glucose levels.  I take one or two.  If you take Bilberry close to when you take Metformin, your blood glucose level can drop very low.  Be Careful!!!   

Be sure to stay well hydrated.  I found warm tea (no sugar) after meals helps with keeping things moving through.  Oolong tea is very relaxing for the anxiety.  Some people people say it has a laxative effect.   

Benfotiamine, B12 and Pyridoxine B6  when taken together results pain relief comparable to aspirin and NSAIDs.  (NSAIDs and aspirin will tear up your digestive system).

An antihistamine can help with the allergies. 

A hot water bottle works wonders on abdominal pain, too.

Sending encouragement.  Put your feet up and relax.  You'll be through this soon.  I'll be here if you need anything.

Expand Quote  

Thank you!! What helps with this horribly painful  bloating??? Should I do a stool softener or gentle laxative for the partial constipation issue? And how much benfotiamine?? 

[knitty kitty]

Magnesium supplements can help with the constipation.  Magnesium softens the stool.  Magnesium is often one of the minerals that can be deficient in people with Celiac Disease.

Start with 100 mg of Benfotiamine with meals.  I take a 250 mg Benfotiamine with two meals.  

Everyone is different and has different nutritional needs.  Find what works for you.

https://ods.od.nih.gov/factsheets/Magnesium-Consumer/

And...

https://ods.od.nih.gov/factsheets/Thiamin-Consumer/

[Ginger38]

  On 8/28/2024 at 4:44 AM, knitty kitty said:

Magnesium supplements can help with the constipation.  Magnesium softens the stool.  Magnesium is often one of the minerals that can be deficient in people with Celiac Disease.

Start with 100 mg of Benfotiamine with meals.  I take a 250 mg Benfotiamine with two meals.  

Everyone is different and has different nutritional needs.  Find what works for you.

https://ods.od.nih.gov/factsheets/Magnesium-Consumer/

And...

https://ods.od.nih.gov/factsheets/Thiamin-Consumer/

Expand Quote  

Thanks! The benfotiamine I have is 200 mg per soft gel??

Is there nothing much to help with the bloating? 

[knitty kitty]

Your 200 mg Benfotiamine sounds fine. 

The best thing I found for the bloating is to follow the Autoimmune Protocol Diet (AIP diet).  The AIP diet has you remove carbohydrates from the diet.  If you remove carbohydrates, the intestinal bacteria that feed on carbohydrates and produce gas as an end product will be starved out.  More beneficial bacteria will replace them.  

The AIP diet removes all grains, veggies like corn and potatoes, and also beans (legumes) and pulses (lentils), ancient/alternative grains, and grasses (rice).  Also all processed foods are removed.  No processed meat like sausages.  The bloating symptoms improve quickly after a little while on the AIP diet.

The AIP diet reduces inflammation and gives the body a chance to heal.  Dairy and eggs are also removed as they can be inflammatory.  Nightshades (potatoes, peppers, tomatoes and eggplant) are removed because they promote zonulin production and increase intestinal permeability (leaky gut syndrome).

Just meat, veggies and some fruit.  Smaller meals closer together helps with hunger, as does including Omega Three healthy fats (olive oil, flaxseed oil, avocado oil, coconut oil).  

After the bloating and other symptoms abate, you can slowly add in more foods.  But be careful, if you go back to a high carbohydrate diet, the bloat causing bacteria may repopulate the gut and symptoms may return. 

Learning how to feed your tummy in a new way can take a great deal of mental adjustment, but it's very worthwhile.  You'll see the benefits quickly and you have lots of support here.

[Scott Adams]

We've done an article on the AIP dies here:

 

[Ginger38]

  On 8/29/2024 at 10:05 AM, knitty kitty said:

Your 200 mg Benfotiamine sounds fine. 

The best thing I found for the bloating is to follow the Autoimmune Protocol Diet (AIP diet).  The AIP diet has you remove carbohydrates from the diet.  If you remove carbohydrates, the intestinal bacteria that feed on carbohydrates and produce gas as an end product will be starved out.  More beneficial bacteria will replace them.  

The AIP diet removes all grains, veggies like corn and potatoes, and also beans (legumes) and pulses (lentils), ancient/alternative grains, and grasses (rice).  Also all processed foods are removed.  No processed meat like sausages.  The bloating symptoms improve quickly after a little while on the AIP diet.

The AIP diet reduces inflammation and gives the body a chance to heal.  Dairy and eggs are also removed as they can be inflammatory.  Nightshades (potatoes, peppers, tomatoes and eggplant) are removed because they promote zonulin production and increase intestinal permeability (leaky gut syndrome).

Just meat, veggies and some fruit.  Smaller meals closer together helps with hunger, as does including Omega Three healthy fats (olive oil, flaxseed oil, avocado oil, coconut oil).  

After the bloating and other symptoms abate, you can slowly add in more foods.  But be careful, if you go back to a high carbohydrate diet, the bloat causing bacteria may repopulate the gut and symptoms may return. 

Learning how to feed your tummy in a new way can take a great deal of mental adjustment, but it's very worthwhile.  You'll see the benefits quickly and you have lots of support here.

Expand Quote  

My current issues are this horrible feeling of being overly stuffed all the time which is causing reflux so bad I have vomit in the back of my throat. Like when I eat it just feels like here is no where for my food to go. Im miserable and can’t get relief.

Im also having issues with bathroom habits. One day I will be somewhat constipated, like I just don’t feel like I’m emptying my bowels completely but then the next day I am having horrible episodes of diarrhea multiple times a day. So idk what to do. I have many more weeks of this to go 😩😩