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Breastfeeding?


brizzo

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brizzo Contributor

I have celiac, and my mother has celiac. Now, my wife is pregnant , and I pray that my child isn't.

I have heard from several sources that children of celiacs are supposed to be stictly gluten-free for the first 6 months of thier life, while thier immune system is forming, if they are at high risk for developing celiac (like my child will be due to genetics.) That's all fine and dandy, but here's where it gets tricky. My wife is NOT gluten-free. Will her breast milk carry gluten to the baby since she eats gluten? Does my wife need to be gluten-free while she breats feeds? I know this is kinda "out there". Just want my baby to have the best chance possible. Thanks!


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Michi8 Contributor
I have celiac, and my mother has celiac. Now, my wife is pregnant , and I pray that my child isn't.

I have heard from several sources that children of celiacs are supposed to be stictly gluten-free for the first 6 months of thier life, while thier immune system is forming, if they are at high risk for developing celiac (like my child will be due to genetics.) That's all fine and dandy, but here's where it gets tricky. My wife is NOT gluten-free. Will her breast milk carry gluten to the baby since she eats gluten? Does my wife need to be gluten-free while she breats feeds? I know this is kinda "out there". Just want my baby to have the best chance possible. Thanks!

Regardless of whether your wife is gluten free or not, breastfeeding is the best choice for baby, and will not change whether your child has inherited the genes. There is some evidence that breastfeeding is actually protective of baby's gut (encourages proper bacterial growth and provided much needed immunity) and may significantly delay the onset of active celiac disease. I don't know, however, whether your wife going gluten free (during pregnancy as well as breastfeeding) would even further delay the onset of celiac disease...something worth doing some further investigation. :)

Michelle

eKatherine Apprentice
I have celiac, and my mother has celiac. Now, my wife is pregnant , and I pray that my child isn't.

I have heard from several sources that children of celiacs are supposed to be stictly gluten-free for the first 6 months of thier life, while thier immune system is forming, if they are at high risk for developing celiac (like my child will be due to genetics.) That's all fine and dandy, but here's where it gets tricky. My wife is NOT gluten-free. Will her breast milk carry gluten to the baby since she eats gluten? Does my wife need to be gluten-free while she breats feeds? I know this is kinda "out there". Just want my baby to have the best chance possible. Thanks!

The age at which gluten is introduced does make a small difference in whether a baby develops celiac. However, it's also true that some babies seem to be born with celiac, possibly having to do with prenatal exposure to gluten fractions that pass through the placental barrier. The infant formulas that substitute for breast milk are inferior. Since there's a good chance the baby may regardless develop the disease, perhaps you should try to convince your wife to take a year off of gluten. Is that a possibility?

brizzo Contributor

Thanks Michelle! :)

eKatherine.....Thanks for the reply. As much as I would like to see my wife go gluten-free, I think it would be like trying to suck the juice out of a turnip. Even if she tried, it might last a week with her. God love her! :P

tarnalberry Community Regular

If it turns out that your child is celiac (and that can be very difficult to determine, with clinical tests, prior to age 2), your wife must eat gluten free if she is going to breast feed - and breast feeding is best for celiac babies just like any other (assuming gluten-free breastmilk).

CarlaB Enthusiast

Another vote FOR breastfeeding! The best thing a formula manufacturer can say is that their product is "close" to breastmilk. It's simply not as good as the real thing, even for non-celiacs. If your wife won't go gluten-free while she's pregnant, I'd at least go gluten-lite.

AndreaB Contributor

I definately encourage breastfeeding irregardless of whether your wife goes gluten free or not.

Definately try to encourage her not to make a mainstay of gluten though. I way overdid gluten and soy and my last child (now 10 months) developed eczema around 2-2 1/2 months. He's the one who led us to be diagnosed sensitive through enterolab.

If your baby develops a problem with gluten while breastfeeding, I would hope that would give your wife the encouragement to go gluten free so the baby could continue breastfeeding. I'm a proponent of breastfeeding for as long as the child wants (within reason). I weaned my oldest at 2 years 10 months. I went through my second pregnancy breastfeeding my first one, and 1/2 way through my third pregnancy breastfeeding my second one. My goal was three years.


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Suzie-GFfamily Apprentice
Thanks Michelle! :)

eKatherine.....Thanks for the reply. As much as I would like to see my wife go gluten-free, I think it would be like trying to suck the juice out of a turnip. Even if she tried, it might last a week with her. God love her! :P

I'd agree with breastfeeding being the best too, by far. There is evidence to suggest that it can either reduce the risk that a child will get celiac disease, or perhaps reduce the severity of the disease or delay the onset.

As far as I know- there is no research available to answer the question you have asked. There is some evidence from Europe that if babies are introduced to solid foods that contain gluten at an early age (ie before 4 months) they have a greater risk of developing celiac disease. But I don't know of any research that compares breastfeeding mothers who are gluten-free vs eating a regular diet- it just has not been studied.

If you look at Dr. Peter Green's book- I believe that he suggests mothers DON'T need to eliminate gluten while breastfeeding. ("Celiac Disease: A Hidden Epidemic")

However, if your baby seems to be showing any signs of gluten-intolerance at a young age- ie slow growth rate, reflux, mucousy stools, etc. pehaps it might be worthwhile having your wife eliminate the gluten from her diet and see if it helps. And I'd bet her willingness to do this may surprise you..... once your wife gets to hold the baby she might be willing to do just about anything to keep the baby safe and healthy, those maternal hormones will go into overdrive once the baby is born. :D

Another option would be to have your wife express some milk and you could test it for gluten. I have a sample of breastmilk in my freezer that I saved before I went gluten-free. I believe there are gluten test kits available on the internet from a company in the UK. I just haven't bothered to buy a test kit and test the frozen milk yet.

BTW- I breastfed each of my 3 kids. I was eating a regular diet when they were all born. I first suspected that I might have celiac disease when my 3rd child was 4 mos old. My 2 oldest children do have celiac disease- they have both been recently diagnosed. But my case may be different from your wife's. I believe that my gut may have been leakier because of the untreated celiac disease and therefore more gliadin could have passed into my bloodstream and then gotten into my milk. I wonder if this may have been a factor in my children developing the disease. Or maybe it just wouldn't have mattered if I had been gluten-free when I breastfed my older children. I just don't know.

On the plus side, none of my kids have been sick. So maybe the breastfeeding has helped to prevent them from developing classic celiac disease- ie diarrhea, severe malnutrition, etc.

Good luck,

Suzie

Guest cassidy

Gluten does go through breast milk. Wheat/gluten is the only allergen that affects the baby if the mom is eating it. So, if you child does have celiac at birth and your wife breast feeds and is eating gluten, it will get the child sick. I talked to my mom last night and she was saying how I had D every time she fed me. We didn't know then that I had celiac, but I'm pretty sure that was why. I'm pregnant now and will obviously be gluten-free when I'm breastfeeding.

I would recommend doing more research to see if delaying gluten is beneficial. If you find that it is, then I would highly recommend that your wife going gluten-free while breastfeeding. I realize it will be tough but I'm sure parenting in general is tough and we all make sacrifices for our children. Totally a personal decision whether she breastfeeds or decides that she doesn't want to go gluten-free but please do the research so you are making an informed decision.

IrishKelly Contributor
I have celiac, and my mother has celiac. Now, my wife is pregnant , and I pray that my child isn't.

I have heard from several sources that children of celiacs are supposed to be stictly gluten-free for the first 6 months of thier life, while thier immune system is forming, if they are at high risk for developing celiac (like my child will be due to genetics.) That's all fine and dandy, but here's where it gets tricky. My wife is NOT gluten-free. Will her breast milk carry gluten to the baby since she eats gluten? Does my wife need to be gluten-free while she breats feeds? I know this is kinda "out there". Just want my baby to have the best chance possible. Thanks!

If baby is gluten intolerant, yes mom will have to be completely gluten-free if she wants to breastfeed. I was just telling someone on here earlier how my neighbor's baby had a horrible reaction that caused him to end up in the ER at the hospital, because the mom didn't know that he had a wheat allergy and she was eating all kinds of wheat/gluten while she started nursing him. Neither her or her husband have a wheat allergy so they didn't even see it coming...it can be very dangerous for a baby so be very aware!!

Michi8 Contributor
Gluten does go through breast milk. Wheat/gluten is the only allergen that affects the baby if the mom is eating it.

There are other allergens that can affect baby through breastmilk. Peanut is one...it is recommended that, if there is a risk for peanut allergy, then the mother should avoid eating it during breastfeeding (peanut protein does get into breastmilk)...and probably during pregnancy as well. Milk in mom's diet can also affect baby, as can any gassy foods. If baby is experiencing spitting up and/or colic eliminating problem foods can help a lot.

Michelle

ylimaf Rookie

La Leche League can give you a list of foods and meds that will go through moms milk. They can also tell you the severity of the danger involved in the milk with each item. Gluten is gluten no matter how much baby gets. Yes it will pas through the milk. My 1 year old nearly died becouse he was slowly starving to death. However the pediatrician did say that something about breastfeeding was keeping the severity down and buying us time to get the gluten under control. Yes breast feed. If baby has issues with it than you will have an opportunity to get it straightened out without interupting the breastfeeding. Hang tuff.

FeedIndy Contributor

I posted this question a few weeks ago after my breastfed baby was diagnosed celiac. I ignored most of the advice, but if I had a "heavy" wheat day I could see a difference in her behavior and diapers. I have been virtually wheat free for weeks no. I say virtually because I haven't messed with hidden gluten in my own lifestyle. If I cheat (and, yes, sometimes I'm bad) I regret that pizza exactly 24 hours later. Every single time. It is always 1 full day after I have bread that she gets fussy and has problems pooping. I'm now convinced-gluten free is the only way if I want to keep my baby healthy and safe. It sucks, but I'm sucking it up for the next few months, at least.

Potato chips and popcorn are my friends! I mostly eat/cook fresh, skip the bread, and snack in between to get my starches.

CarlaB Enthusiast
I posted this question a few weeks ago after my breastfed baby was diagnosed celiac. I ignored most of the advice, but if I had a "heavy" wheat day I could see a difference in her behavior and diapers. I have been virtually wheat free for weeks no. I say virtually because I haven't messed with hidden gluten in my own lifestyle. If I cheat (and, yes, sometimes I'm bad) I regret that pizza exactly 24 hours later. Every single time. It is always 1 full day after I have bread that she gets fussy and has problems pooping. I'm now convinced-gluten free is the only way if I want to keep my baby healthy and safe. It sucks, but I'm sucking it up for the next few months, at least.

Potato chips and popcorn are my friends! I mostly eat/cook fresh, skip the bread, and snack in between to get my starches.

I read your sig and see you kids have airborn allergies. My 18 year old daughter went gluten-free for a while even though she had no symptoms, or so she thought. Her seasonal allergies COMPLETELY went away. When she got to college, she ate some gluten, allergies came back. She stays gluten-free now. Seasonal allergies were her only symptom and we never had connected it to gluten before.

Mayam Apprentice

Hi,

I breastfed all 3 of my children until 14 mos. old. I wasn't diagnosed with celiac disease until after I was finished breastfeeding my 2nd child. My oldest daughter had mucousy bowel movements, almost since birth, which the dr. could never figure out. She also had mild reflux. My 2nd had terrible reflux and mucousy diapers, as well. My oldest was diagnosed at age 3 (a month after I was) and my middle had pos. bloodwork and neg. biospy (inconclusive) at 20 mos. (I believe she does have celiac disease). My youngest has been gluten-free since birth and will remain that way until he is old enough to eat gluten and be able to tell if he has a negative reaction to it.

It is a difficult decision for you, especially since you won't be the one breastfeeding :) Like Suzie said, your wife could breastfeed and look for signs of celiac disease. Or, as others suggested, maybe she would be willing to go gluten-free. There is so much development that occurs in the early years, it's scary to think of compromising your child's health. I keep my son gluten-free because I saw how my daughters (my oldest esp.) were affected at such an early age. It may be controversial to keep your child gluten-free when you have no way of knowing whether or not they will develop celiac disease, but I feel that I am responsible to give my son the best and healthiest start possible.

This is just my experience. Best wishes for a healthy and happy baby!

Rachel diagnosed and gluten-free since 2003

daughter, age 6 (diagnosed and gluten-free since age 3)

daughter, age 4 (gluten-free since 20 mos.)

son, age 2 (gluten-free since birth)

Suzie-GFfamily Apprentice

Hi Rachel,

We're keeping our 3rd child gluten-free too. She's only 11 months old now, and we've never fed her any gluten-containing foods since starting solids. She has an older brother and sister who are both celiac, plus me too.

I don't know what we'll do in the future- it'll depend on whether she wants to do a gluten-trial when she's older.

brizzo Contributor

Thanks for all the good replies....I will definately take it one day at a time and try to pry the bread from my wife's post partum hands =) I'll keep you all informed brizz

Suzie-GFfamily Apprentice

There are alot of replies to your post that suggest your wife be gluten-free or restrict her gluten intake while breastfeeding.

Here's something to think about:

1) Breastfeeding is the only thing I know about that has a protective effect (other than never eating the toxic grains). The exact effect doesn't seem to be known- does it prevent someone from ever developing celiac disease? or does it delay the onset? I don't think these things are known yet... but breastfeeding seems to be very beneficial.

2) I'd bet that most of the breastfeeding mothers in those research studies would have been on a regular diet (ie eating gluten)- and the findings are that breastfeeding is beneficial.

3) One common reason for women to stop breastfeeding is because they feel that they can not eat or drink the things they'd like to while breastfeeding. If a woman perceives breastfeeding as restrictive, she may not want to continue.

Now I'm going to throw a real curve ball....

What if trace amounts of gluten in breastmilk are actually advantageous in most cases?

We don't know how breastfeeding protects against celiac disease. There are lots of different possibilities- and maybe it's a combination of many different factors. What if one of those factors is exposure to trace amounts of gluten in combination with human milk?

Perhaps the human milk can help the digestive system handle the toxic gliadins, and perhaps under "normal" circumstances the baby is only exposed to extremely small amounts. But maybe it could act like a vaccination against gluten.

The thing is we just don't know how breastmilk helps protect. But it'd certainly be a lot better for your baby to be breastfed- regardless of your wife's diet (ie gluten-free or not)- and maybe gluten in the mother's diet could be a good thing (but there may be some exceptions with extremely sensitive babies where this is not the case).

Suzie

SarahTorg Apprentice

I'd say that your wife should eat as normal. If the baby is having problems, she can cut out the gluten.

My baby also had poo issues, and a constant rash. She will get a hive like rash in her diaper area after consuming gluten.

She was a horrible sleeper until I became gluten free.

Breastfeeding is always superior, and the longer a mother can breast feed, the better.

I'd play it by ear, and try not to worry too much until you know for sure.

Sarah

TCA Contributor

Just wanted to add in a little different perspective. My son was born with celiac and my daughter's was triggered after her open heart surgery. We didn't figure it out with my son until he was 3, but at the same time my daughter was having issues so they kinda co-diagnosed each other and I went gluten-free while nursing her and her symptoms improved. We tried multiple formulas and NOTHING could be tolerated by either of them. I fully intended to breast feed, but my daughter's health meant I had to pump, and I did so for 17 mos. There were many times that my supply ran dangerously low, so we would try to supplement with formula. Even the elemental and hypallergenic ones made her very sick. At 16 mos. she was finally able to tolerate Neocate and is still on that. Just make sure the baby can tolerate formula if your wife decides not to breastfeed. I would have pumped for Megan either way, but I really didn't have a choice. I think that is fairly common in celiac babies. My son didn't have her heart problems, but the very few formulas we tried him on made him very ill. I just gave up on the formulas and nursed him until he was 20 mos. It was easier with him becuase he could nurse and my supply wasn't an issue. Hope some of this helps!

and CONGRATULATIONS!!!!! :D:D:D:D:D

Michi8 Contributor
Just wanted to add in a little different perspective. My son was born with celiac and my daughter's was triggered after her open heart surgery. We didn't figure it out with my son until he was 3, but at the same time my daughter was having issues so they kinda co-diagnosed each other and I went gluten-free while nursing her and her symptoms improved. We tried multiple formulas and NOTHING could be tolerated by either of them. I fully intended to breast feed, but my daughter's health meant I had to pump, and I did so for 17 mos. There were many times that my supply ran dangerously low, so we would try to supplement with formula. Even the elemental and hypallergenic ones made her very sick. At 16 mos. she was finally able to tolerate Neocate and is still on that. Just make sure the baby can tolerate formula if your wife decides not to breastfeed. I would have pumped for Megan either way, but I really didn't have a choice. I think that is fairly common in celiac babies. My son didn't have her heart problems, but the very few formulas we tried him on made him very ill. I just gave up on the formulas and nursed him until he was 20 mos. It was easier with him becuase he could nurse and my supply wasn't an issue. Hope some of this helps!

This is where a milk bank may have helped...when mom is struggling to provide pumped milk for a sick baby, and artificial baby milk (formula) is inappropriate or not tolerated.

I had the benefit of using donated milk when my eldest was first born. We didn't want to introduce formula because of the potential for allergies, but his weight had dropped too much and my milk wasn't coming in yet due to my c-section (delays milk by a few days.) I was very fortunate that, once the milk was in my supply was more than adequate and my son regained his lost weight quickly. But it was good to know that the milk bank was available (in Vancouver, BC)...and especially good to know that the babies that really needed it (premies, infants with serious health problems, allergies, intolerances, etc) could get donated milk to help them heal, rather than relying on supplementing mom's milk with artificial baby milk.

There really needs to be more milk banks in North America (milk banks are currently located here: Open Original Shared Link). However, the milk banks are struggling to stay open and available as they are...and are always in need of donations of milk from healthy moms and in need of funding.

Michelle

Guest cassidy
There are other allergens that can affect baby through breastmilk. Peanut is one...it is recommended that, if there is a risk for peanut allergy, then the mother should avoid eating it during breastfeeding (peanut protein does get into breastmilk)...and probably during pregnancy as well. Milk in mom's diet can also affect baby, as can any gassy foods. If baby is experiencing spitting up and/or colic eliminating problem foods can help a lot.

Michelle

I talked to a geneticist a fww weeks ago and asked her about the peanut thing. She said it is a myth that mom should avoid peanuts when pregnant. She said the only reason a pregnant mom should avoid peanuts is if she herself has a peanut allergy, not if there is a risk for one. I also read this in "Baby 411" on Sunday. Baby 411 also said that restricting peanuts when breastfeeding does not reduce the risk of the baby developing a peanut allergy. They again say that you only need to avoid foods that you are allergic to. They do say if your baby has sensitive skin to not use lotions that contain peanuts.

Michi8 Contributor
I talked to a geneticist a fww weeks ago and asked her about the peanut thing. She said it is a myth that mom should avoid peanuts when pregnant. She said the only reason a pregnant mom should avoid peanuts is if she herself has a peanut allergy, not if there is a risk for one. I also read this in "Baby 411" on Sunday. Baby 411 also said that restricting peanuts when breastfeeding does not reduce the risk of the baby developing a peanut allergy. They again say that you only need to avoid foods that you are allergic to. They do say if your baby has sensitive skin to not use lotions that contain peanuts.

Studies on peanut proteins in breastmilk found exactly that: peanut proteins in breastmilk. Open Original Shared Link This is one of many sources I found during my search, and was big news the year after I had my second son. I already new that I needed to watch what I ate during breastfeeding when I had my first son 2 years before that.

Of course avoiding peanut products during pregnancy & breastfeeding for me was easy since I was allergic. A friend of mine wasn't so lucky. She had no problems with eating peanuts with her first child, and ate peanuts constantly during her second pregnancy and during breastfeeding of her second child. He ended up with a severe peanut reaction to his first food introduction to peanuts. Perhaps the studies are wrong, and her ingestion of peanuts played no role in it, but wouldn't it make sense, if there is a family history of allergies, to be careful about your own diet and what you feed your child to reduce the risk of developing specific allergies?

Michelle

Michi8 Contributor
I also read this in "Baby 411" on Sunday. Baby 411 also said that restricting peanuts when breastfeeding does not reduce the risk of the baby developing a peanut allergy. They again say that you only need to avoid foods that you are allergic to. They do say if your baby has sensitive skin to not use lotions that contain peanuts.

I don't know much about "Baby 411" since it wasn't around when I had my babies. I will take a peek at the book at the store, but given the reviews I read, it sounds as if the advice is quite one-sided and some of the practices they advocate are opposite to my style of parenting. If you are looking for a good resource book, "The Baby Book" by Dr. William Sears is a good all-around book for baby care. I found the style was very supportive of many choices in parenting, and gave good, balanced information. It's got good info on breastfeeding, calming baby, observing for allergy issues, etc. Dr. Sears also has good books on pregnancy and birth. Dr Sears also has website with tons of good info: Open Original Shared Link

Michelle :)

Guest cassidy
I don't know much about "Baby 411" since it wasn't around when I had my babies. I will take a peek at the book at the store, but given the reviews I read, it sounds as if the advice is quite one-sided and some of the practices they advocate are opposite to my style of parenting. If you are looking for a good resource book, "The Baby Book" by Dr. William Sears is a good all-around book for baby care. I found the style was very supportive of many choices in parenting, and gave good, balanced information. It's got good info on breastfeeding, calming baby, observing for allergy issues, etc. Dr. Sears also has good books on pregnancy and birth. Dr Sears also has website with tons of good info: Open Original Shared Link

Michelle :)

I agree with you that baby 411 isn't my style of parenting. I was given the book for hosting a shower. I do read the Dr. Sears books and it was in the Dr. Sears sleep book where I read that the only allergen that could affect a baby through breast milk is wheat/gluten. I'm not doubting that peanuts/milk/soy and other things go through the milk, but from what I have read if the baby will end up being allergic to peanuts/milk/soy and the mom eats those things while breastfeeding, the baby won't get sick. However if the baby has celiac and the mom eats gluten the baby will get sick. You said below that your friend's second baby got sick when he first had peanuts, but not when she was breastfeeding. That was the only point I was trying to make, that the baby wouldn't get sick from breastfed peanuts.

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      What you're describing is indeed familiar to many in the Celiac community, especially in the early stages of healing. When the intestinal villi are damaged from Celiac disease, they struggle to properly digest and absorb fats, a condition known as bile acid malabsorption. This can cause exactly the kind of cramping and spasms you're seeing, as undigested fats can irritate the sensitive gut lining. It is highly plausible that her reactions to dairy and eggs are linked to their higher fat content rather than the proteins, especially since she tolerates lean chicken breast. The great news is that for many, this does improve with time. As her gut continues to heal on a strict gluten-free diet, her ability to produce the necessary enzymes and bile to break down fats should gradually return, allowing her to slowly tolerate a wider variety of foods. It's a slow process of healing, but your careful approach of focusing on low-fat, nutrient-dense foods like seeds and avocado is providing her system the best possible environment to recover. Many people with celiac disease, especially those who are in the 0-2 year range of their recovery, have additional food intolerance issues which could be temporary. To figure this out you may need to keep a food diary and do an elimination diet over a few months. Some common food intolerance issues are dairy/casein, eggs, corn, oats, and soy. The good news is that after your gut heals (for most people who are 100% gluten-free this will take several months to two years) you may be able to slowly add some these items back into your diet after the damaged villi heal. This article may be helpful: Thank you for sharing your story—it's a valuable insight for other parents navigating similar challenges.
    • Beverage
      I had a very rough month after diagnosis. No exaggeration, lost so much inflammatory weight, I looked like a bag of bones, underneath i had been literally starving to death. I did start feeling noticeably better after a month of very strict control of my kitchen and home. What are you eating for breakfast and lunch? I ignored my doc and ate oats, yes they were gluten free, but some brands are at the higher end of gluten free. Lots of celics can eat Bob's Red Mill gluten-free oats, but not me. I can now eat them, but they have to be grown and processed according to the "purity protocol" methods. I mail order them, Montana Gluten-Free brand. A food and symptoms and activities log can be helpful in tracking down issues. You might be totally aware, but I have to mention about the risk of airborne gluten. As the doc that diagnosed me warned . . Remember eyes, ears, nose, and mouth all lead to your stomach and intestines.  Are you getting any cross contamination? Airborne gluten? Any pets eating gluten (they eat it, lick themselves, you pet them...)? Any house remodeling? We live in an older home, always fixing something. I've gotten glutened from the dust from cutting into plaster walls, possibly also plywood (glues). The suggestions by many here on vitamin supplements also really helped me. I had some lingering allergies and asthma, which are now 99% gone. I was taking Albuterol inhaler every hour just to breathe, but thiamine in form of benfotiamine kicked that down to 1-2 times a day within a few days of starting it. Also, since cutting out inflammatory seed oils (canola, sunflower, grapeseed, etc) and cooking with real olive oil, avocado oil, ghee, and coconut oil, I have noticed even greater improvement overall and haven't used the inhaler in months! It takes time to weed out everything in your life that contains gluten, and it takes awhile to heal and rebuild your health. At first it's mentally exhausting, overwhelming, even obsessive, but it gets better and second nature.
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