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Good Dermatologist - Finally!

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So, I've been reading here for a while now trying to figure out what's going on. Thanks to many of you as you have helped immensely. Simply feeling like I'm not alone has been a huge help!

Like most of you I've had GI problems of and on for years. Been told I have IBS, reflux, the usual, but it never seemed right. Last summer I started to itch, insane itchy small bumps that lasted forever. They were head to toe, my knees, elbows, shoulders, tail bone, and hairline you name it. Saw my allergist and he threw out DH. Did the celiac blood test, negative. Saw a dermatologist who thought I was crazy, "that's so rare!" but agreed to biopsy. Of course after the fact, I read here how he did it wrong, it was negative. I went gluten free and the rash went away, after a few week I tried to re-introduce, got really itchy! Surprise, surprise.

I asked my primary for a recommendation on a better dermatologist and she recommended just calling the local university/medical hospital, they have a special derm department. It was a bit of a drive but the Dr. was great. He listened, said, "yes, it's rare but it does happen." The fact that steroid creams have no effect was a sign it was DH, and of course the fact that I can control the rash with the proper diet was also a clear sign it was DH. Basically, everything I described he said sounded like DH.

I did go back on gluten for just a little bit before the appointment and there was enough rash on my upper back/hairline for the punch biopsy, next to the rash I might add, but it was still negative. He nearly apologized for not being able to "officially" diagnose me with DH but said to continue the gluten free diet.

Interesting is that one other recommendation he had for the itch is benadryl. He also gave me a prescription for a stronger version of benadryl. Said to take it every night regardless and it will help. It makes you really sleepy though so I only take it when needed. It doesn't heal the DH or anything, the antihistamine simply helps take away the itch. He also mentioned the dasapone but without the official diagnosis I think he's hesitant to prescribe it which is fine, I don't think I need it anyway. He did say come back if I can't control the rash with the diet.

Though it seems like most doctors are clueless, there are a few out there that DO know about DH. It feel good to be validated by a medical professional instead of second guessing everything.

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So, I've been reading here for a while now trying to figure out what's going on. Thanks to many of you as you have helped immensely. Simply feeling like I'm not alone has been a huge help!

Like most of you I've had GI problems of and on for years. Been told I have IBS, reflux, the usual, but it never seemed right. Last summer I started to itch, insane itchy small bumps that lasted forever. They were head to toe, my knees, elbows, shoulders, tail bone, and hairline you name it. Saw my allergist and he threw out DH. Did the celiac blood test, negative. Saw a dermatologist who thought I was crazy, "that's so rare!" but agreed to biopsy. Of course after the fact, I read here how he did it wrong, it was negative. I went gluten free and the rash went away, after a few week I tried to re-introduce, got really itchy! Surprise, surprise.

I asked my primary for a recommendation on a better dermatologist and she recommended just calling the local university/medical hospital, they have a special derm department. It was a bit of a drive but the Dr. was great. He listened, said, "yes, it's rare but it does happen." The fact that steroid creams have no effect was a sign it was DH, and of course the fact that I can control the rash with the proper diet was also a clear sign it was DH. Basically, everything I described he said sounded like DH.

I did go back on gluten for just a little bit before the appointment and there was enough rash on my upper back/hairline for the punch biopsy, next to the rash I might add, but it was still negative. He nearly apologized for not being able to "officially" diagnose me with DH but said to continue the gluten free diet.

Interesting is that one other recommendation he had for the itch is benadryl. He also gave me a prescription for a stronger version of benadryl. Said to take it every night regardless and it will help. It makes you really sleepy though so I only take it when needed. It doesn't heal the DH or anything, the antihistamine simply helps take away the itch. He also mentioned the dasapone but without the official diagnosis I think he's hesitant to prescribe it which is fine, I don't think I need it anyway. He did say come back if I can't control the rash with the diet.

Though it seems like most doctors are clueless, there are a few out there that DO know about DH. It feel good to be validated by a medical professional instead of second guessing everything.

Yes, it does feel good to be supported.

My derm suspected DH but my rash was "morphed" by the steroid cream (he gave me the rx before I broke out, based on me telling him it spontaneously happens, when I went in to get a freckle/mole removed). I didn't have gi issues at the time and couldn't trace the rash back to food.

Anyway, steroids worked for me to a degree - shots did nothing but mess up my adrenals, oral prednisone would clear it but left me devastated, and topical steroids kept it "dry" and looking scabies-ish.

My derm knew it was AI, but didn't think it was DH because the steroids changed the appearance and behavior.

After I got off steroids - whoa...classic DH.

He also tried me on a very strong antihistimine that I think may have dampened the symptoms, but maybe only numbed my brain and made me sleep. It was also an antipsychotic.

My rash responds very well to gluten withdrawal, and even better to iodine withdrawal. When I figured out iodine, I knew it was DH.

I'm due to go in to my derm for another mole/freckle and will write all of it down and take pics. He was very encouraging over the phone when I talked to him after figuring out gluten and iodine. He wanted to biopsy but I never really developed another good breakout when I could get in to see him. I'm 1 year+ gluten-free, I doubt enough antibodies are left at this point.

I will always be grateful he pushed me to figure out what AI disease was causing it, instead of saying "live with it".

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You sound like me! These are the exact things I have been going through. I even go the the University Dermatology department! I've been a subject of their Grand Rounds. Still no true DH or Celiac diagnosis! I have been trying Gluten Free for almost a month now. I still have heartburn really terribly, but I feel a little better. My stomach still goes crazy up and down with D and C, and my skin is only partially cleared up due to being recently on Prednisone. My derms do think it definitely is an Auto Immune Disorder and just recently put me on an Immunosuppressant drug called Cellcept. They did try Dapsone-- and for two days my skin started to clear up, and then it reversed because I am allergic to sulphur, and a new and separate rash began on top of the DH. Not fun. They took me off Dapsone immediately. They think this Cellcept will do the trick, but I am on my fourth day of it, and my skin is beginning to get itchy again. It's tolerable, but I just wonder. I am still trying to do this Gluten Free thing, and it's not easy. 50 years of eating wheat with no thought of it being damaging is a very long lifetime habit to break. I have three good sized sons, all over six feet tall and they eat food like crazy. Bread and wheat being a staple and they love it. My hubby also loves wheat and breads. However, hubby will eat any meal I prepare and will not complain. He also cooks some and most of the things he cooks are naturally gluten-free, like grilling, and rice dishes. He makes a mean chili and I hope I can help him alter that a bit so it is gluten-free for me. I am still adjusting to this gluten-free lifestyle. I am trying to keep upbeat about it, but it is so challenging right now and expensive. A friend of mine sent me the tax deductions you can take for being a Celiac. Kind of cool, and to do it right, I want to build an Excel spreadsheet! LOL I work on Excel spreadsheets all day for my day job!

You've been gluten-free for a year now. How did you adjust to this?

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You sound like me! These are the exact things I have been going through. I even go the the University Dermatology department! I've been a subject of their Grand Rounds. Still no true DH or Celiac diagnosis! I have been trying Gluten Free for almost a month now. I still have heartburn really terribly, but I feel a little better. My stomach still goes crazy up and down with D and C, and my skin is only partially cleared up due to being recently on Prednisone. My derms do think it definitely is an Auto Immune Disorder and just recently put me on an Immunosuppressant drug called Cellcept. They did try Dapsone-- and for two days my skin started to clear up, and then it reversed because I am allergic to sulphur, and a new and separate rash began on top of the DH. Not fun. They took me off Dapsone immediately. They think this Cellcept will do the trick, but I am on my fourth day of it, and my skin is beginning to get itchy again. It's tolerable, but I just wonder. I am still trying to do this Gluten Free thing, and it's not easy. 50 years of eating wheat with no thought of it being damaging is a very long lifetime habit to break. I have three good sized sons, all over six feet tall and they eat food like crazy. Bread and wheat being a staple and they love it. My hubby also loves wheat and breads. However, hubby will eat any meal I prepare and will not complain. He also cooks some and most of the things he cooks are naturally gluten-free, like grilling, and rice dishes. He makes a mean chili and I hope I can help him alter that a bit so it is gluten-free for me. I am still adjusting to this gluten-free lifestyle. I am trying to keep upbeat about it, but it is so challenging right now and expensive. A friend of mine sent me the tax deductions you can take for being a Celiac. Kind of cool, and to do it right, I want to build an Excel spreadsheet! LOL I work on Excel spreadsheets all day for my day job!

You've been gluten-free for a year now. How did you adjust to this?

I was so desperate to fix the rash (and knew I couldn't tolerate the preferred treatment - steroids, and that no others seemed to fix it) that I would hear shaved my head and danced naked at the World Series. So....the decision was easy.

The execution took some time. I walked into gluten-free hoping it would fix the rash, and being optimistic it would help "something else". Those "somethings" being the multitude of issues that seemed to be popping up daily - exhaustion, etc. btw the nd I was seeing didn't have a clue about the rash. She would have insisted it was scabies except I'd already been down the derm path. She did suggest gluten-free because I was already dx'ed with Hashimotos and my adrenals were struggling.

Perhaps it was easier for me because I grew up in a house where 90% of the meals were cooked at home so I wasn't intimidated by cooking? I'm not saying you are, but I wasn't nervous about cooking...I was confident I could cook gluten-free. Some people aren't. And I'm comfortable not eating out.

I don't LIKE having my options limited, but I'm ok with it.

You just learn as you go. Laugh at your mistakes. Roll with the setbacks.

One thing I would suggest is to try a low iodine diet, because it is a way to "fast-track" healing if it's DH. You can find the diet info at thyca.org.

If you can get the rash to go down it will make concentrating on gluten-free much easier. IMO.

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Thanks to you both! It's always good to know your not alone!

Really good scratcher - It's been an adjustment for sure. I have two kids, one of which is also allergic to eggs, milk and soy so adding all things gluten to that list has been a challenge to say the least. I have found I need to be super strict with the diet, any little trace amount will cause a setback. My skin started to heal pretty quickly but It probably took a good 6 months to really see a difference in things like my energy level and just over all well being. For the first time in years I feel good. LIke this is how normal people go through life, not feeling like crap all the time. I'm not happy about the diet that's for sure, still get down about it from time to time but I'm finding it a necessity so what can you do but just move on the best you can.

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    Jefferson Adams
    Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown.  To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. 
    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
    For their review, the team searched Medline, PubMed, and EMBASE for the keywords ‘celiac disease,’ ‘celiac,’ ‘tissue transglutaminase antibody,’ ‘anti-endomysium antibody,’ ‘endomysial antibody,’ and ‘prevalence’ for studies published from January 1991 through March 2016. 
    The team cross-referenced each article with the words ‘Asia,’ ‘Europe,’ ‘Africa,’ ‘South America,’ ‘North America,’ and ‘Australia.’ They defined celiac diagnosis based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. The team used 96 articles of 3,843 articles in their final analysis.
    Overall global prevalence of celiac disease was 1.4% in 275,818 individuals, based on positive blood tests for anti-tissue transglutaminase and/or anti-endomysial antibodies. The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% in 138,792 individuals. That means that numerous people with celiac disease potentially remain undiagnosed.
    Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults.
    This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. 
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    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.

    Jefferson Adams
    Celiac.com 06/16/2018 - Summer is the time for chips and salsa. This fresh salsa recipe relies on cabbage, yes, cabbage, as a secret ingredient. The cabbage brings a delicious flavor and helps the salsa hold together nicely for scooping with your favorite chips. The result is a fresh, tasty salsa that goes great with guacamole.
    Ingredients:
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    Dr. Ron Hoggan, Ed.D.
    Celiac.com 06/15/2018 - There seems to be widespread agreement in the published medical research reports that stuttering is driven by abnormalities in the brain. Sometimes these are the result of brain injuries resulting from a stroke. Other types of brain injuries can also result in stuttering. Patients with Parkinson’s disease who were treated with stimulation of the subthalamic nucleus, an area of the brain that regulates some motor functions, experienced a return or worsening of stuttering that improved when the stimulation was turned off (1). Similarly, stroke has also been reported in association with acquired stuttering (2). While there are some reports of psychological mechanisms underlying stuttering, a majority of reports seem to favor altered brain morphology and/or function as the root of stuttering (3). Reports of structural differences between the brain hemispheres that are absent in those who do not stutter are also common (4). About 5% of children stutter, beginning sometime around age 3, during the phase of speech acquisition. However, about 75% of these cases resolve without intervention, before reaching their teens (5). Some cases of aphasia, a loss of speech production or understanding, have been reported in association with damage or changes to one or more of the language centers of the brain (6). Stuttering may sometimes arise from changes or damage to these same language centers (7). Thus, many stutterers have abnormalities in the same regions of the brain similar to those seen in aphasia.
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    Whatever the reason that stuttering has not been reported in the medical literature in association with gluten ingestion, a number of personal disclosures and comments suggesting a connection between gluten and stuttering can be found on the Internet. Abid Hussain, in an article about food allergy and stuttering said: “The most common food allergy prevalent in stutterers is that of gluten which has been found to aggravate the stutter” (10). Similarly, Craig Forsythe posted an article that includes five cases of self-reporting individuals who believe that their stuttering is or was connected to gluten, one of whom also experiences stuttering from foods containing yeast (11). The same site contains one report of a stutterer who has had no relief despite following a gluten free diet for 20 years (11). Another stutterer, Jay88, reports the complete disappearance of her/his stammer on a gluten free diet (12). Doubtless there are many more such anecdotes to be found on the Internet* but we have to question them, exercising more skepticism than we might when reading similar claims in a peer reviewed scientific or medical journal.
    There are many reports in such journals connecting brain and neurological ailments with gluten, so it is not much of a stretch, on that basis alone, to suspect that stuttering may be a symptom of the gluten syndrome. Rodney Ford has even characterized celiac disease as an ailment that may begin through gluten-induced neurological damage (13) and Marios Hadjivassiliou and his group of neurologists and neurological investigators have devoted considerable time and effort to research that reveals gluten as an important factor in a majority of neurological diseases of unknown origin (14) which, as I have pointed out previously, includes most neurological ailments.
    My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.
    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

    Jefferson Adams
    Celiac.com 06/14/2018 - Refractory celiac disease type II (RCDII) is a rare complication of celiac disease that has high death rates. To diagnose RCDII, doctors identify a clonal population of phenotypically aberrant intraepithelial lymphocytes (IELs). 
    However, researchers really don’t have much data regarding the frequency and significance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. Such data could provide useful comparison information for patients with RCDII, among other things.
    To that end, a research team recently set out to try to get some information about the frequency and importance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. The research team included Shafinaz Hussein, Tatyana Gindin, Stephen M Lagana, Carolina Arguelles-Grande, Suneeta Krishnareddy, Bachir Alobeid, Suzanne K Lewis, Mahesh M Mansukhani, Peter H R Green, and Govind Bhagat.
    They are variously affiliated with the Department of Pathology and Cell Biology, and the Department of Medicine at the Celiac Disease Center, New York Presbyterian Hospital/Columbia University Medical Center, New York, USA. Their team analyzed results of TCR-GR analyses performed on SB biopsies at our institution over a 3-year period, which were obtained from eight active celiac disease, 172 celiac disease on gluten-free diet, 33 RCDI, and three RCDII patients and 14 patients without celiac disease. 
    Clonal TCR-GRs are not infrequent in cases lacking features of RCDII, while PCPs are frequent in all disease phases. TCR-GR results should be assessed in conjunction with immunophenotypic, histological and clinical findings for appropriate diagnosis and classification of RCD.
    The team divided the TCR-GR patterns into clonal, polyclonal and prominent clonal peaks (PCPs), and correlated these patterns with clinical and pathological features. In all, they detected clonal TCR-GR products in biopsies from 67% of patients with RCDII, 17% of patients with RCDI and 6% of patients with gluten-free diet. They found PCPs in all disease phases, but saw no significant difference in the TCR-GR patterns between the non-RCDII disease categories (p=0.39). 
    They also noted a higher frequency of surface CD3(−) IELs in cases with clonal TCR-GR, but the PCP pattern showed no associations with any clinical or pathological feature. 
    Repeat biopsy showed that the clonal or PCP pattern persisted for up to 2 years with no evidence of RCDII. The study indicates that better understanding of clonal T cell receptor gene rearrangements may help researchers improve refractory celiac diagnosis. 
    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023

    Jefferson Adams
    Celiac.com 06/13/2018 - There have been numerous reports that olmesartan, aka Benicar, seems to trigger sprue‐like enteropathy in many patients, but so far, studies have produced mixed results, and there really hasn’t been a rigorous study of the issue. A team of researchers recently set out to assess whether olmesartan is associated with a higher rate of enteropathy compared with other angiotensin II receptor blockers (ARBs).
    The research team included Y.‐H. Dong; Y. Jin; TN Tsacogianis; M He; PH Hsieh; and JJ Gagne. They are variously affiliated with the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School in Boston, MA, USA; the Faculty of Pharmacy, School of Pharmaceutical Science at National Yang‐Ming University in Taipei, Taiwan; and the Department of Hepato‐Gastroenterology, Chi Mei Medical Center in Tainan, Taiwan.
    To get solid data on the issue, the team conducted a cohort study among ARB initiators in 5 US claims databases covering numerous health insurers. They used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for enteropathy‐related outcomes, including celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy. In all, they found nearly two million eligible patients. 
    They then assessed those patients and compared the results for olmesartan initiators to initiators of other ARBs after propensity score (PS) matching. They found unadjusted incidence rates of 0.82, 1.41, 1.66 and 29.20 per 1,000 person‐years for celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy respectively. 
    After PS matching comparing olmesartan to other ARBs, hazard ratios were 1.21 (95% CI, 1.05‐1.40), 1.00 (95% CI, 0.88‐1.13), 1.22 (95% CI, 1.10‐1.36) and 1.04 (95% CI, 1.01‐1.07) for each outcome. Patients aged 65 years and older showed greater hazard ratios for celiac disease, as did patients receiving treatment for more than 1 year, and patients receiving higher cumulative olmesartan doses.
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    Source:
    Alimentary Pharmacology & Therapeutics

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      https://celiac.org/celiac-disease/understanding-celiac-disease-2/diagnosing-celiac-disease/screening/
      https://www.celiac.com/forums/topic/91878-newbie-info-101/  
    • Are you saying you are diagnosed with Celiac disease?  
    • I developed a wheat allergy after getting quite sick and dizzy after eating bread.  Now I am afraid to eat rice, or anything that could be contaminated with wheat.  Altho I have eaten rice pasta and nothing happened.  After a week of being grain free I am starting to feel better, altho today I did get that weak shaky feeling so many have complained about.  It lasted most of the morning and is finally gone, hopefull it will get less and less, didnt have it for two or three days until today.  I am still awfully gassy if you know what I mean, hopefully this will subside soon too.  I do eat mostly fruits and veggies, once in awhile chicken.  I have done tons of reading on this subject, was wondering if anyone had a reaction to sugar?  For a few days I did have some diarrhea, but that has also stopped.  Any suggestions would be greatly appreciated. 
    • Maltodextrin is gluten-free.  But it should be listed as an ingredient. http://www.darigold.com/products/cottage-cheese/4percent-large-curd-cottage-cheese  
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