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      Frequently Asked Questions About Celiac Disease   09/30/2015

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to FREE Celiac.com email alerts What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease? - list blood tests, endo with biopsy, genetic test and enterolab (not diagnostic) Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet Free recipes: Gluten-Free Recipes Where can I buy gluten-free stuff? Support this site by shopping at The Celiac.com Store.
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About this blog

Not eaten gluten in 4 years . . . has my villi healed enough to eat gluten again

Entries in this blog

Posterboy

Is it NCGS or Low stomach acid misdiagnosed

Low Stomach Acid and Celiac Disease

Dear Gluten Intolerant please consider Low Stomach Acid as a possible Differential Diagnosis as a possible way to achieve remission of your GI symptom's.

“Consider what I say; and the Lord give thee understanding in all things”  2 Timothy 2: 7

Low stomach acid has now been linked to a probable cause of damage to the Small Intestine before and/or occurring with a

Non-Celiac Gluten Sensitivity (NCGS) or Celiac diagnosis.

See this research as reported on celiac.com that discusses the increased risk of/for someone to develop celiac disease after taking PPI’s.

http://www.celiac.com/articles/23432/1/Do-Proton-Pump-Inhibitors-Increase-Risk-of-Celiac-Disease/Page1.html

Note how the article starts quoting

“Rates of celiac disease and the use of drugs to inhibit the secretion of stomach acid have both increased in recent decades.

A research team recently set out to explore the association between anti-secretory medication exposure and subsequent development of celiac disease.”

If these medicine are lowering stomach acid what cause effect relationship does/ could this have on Celaic/NCGS diagnosis is what he is postulating.

He goes on to say without being very technical (read the whole article for yourself) that

“The data clearly show that patients who use anti-secretory medications are at much greater risk for developing celiac disease following

the use of these medicines.

The fact that this connection persisted even after the team excluded prescriptions for anti-secretory medicines in the year preceding the celiac disease

diagnosis suggests a causal relationship”.

If even after a year OFF these medicines your chances of developing Celiac Disease (celiac disease) not to mention even NCGS which is much more prominent

surely the researcher is correct in postulating that there is a cause and effect relationship between low stomach acid and NCGS and/or Celiac disease.

Surely there is something we can learn here.

I now postulate some homework for the reader of this blog post.

Do some research for yourself and see if achlorhydia or hypochlorhydia symptoms don’t at least resemble in some manner all of the GI symptoms

you have been having. (I note some of the many symptom’s low stomach acid can present with below as referenced from Dr. Myatt’s online article

“What’s Burning You” for easy reference (It might not be what you think (my words))

It is important to note here that “some” symptoms does not mean all but many or several.

It is called a differential diagnosis.

It is an important diagnostic tool in medicine. Think of the tv show “House” where they spend the whole hour/over a week times going through the

‘differential diagnosis’ in short any one symptom can/have many different causes.

The trick is how to quickly eliminate possible outcomes as symptoms (many) go up.

All is usually never meet because that would make the disease in full outbreak and obvious even to the layman a condition described as “frank” or

“classic” Scurvy or Rickets as an example.

Sadly too often after 8 to 10+ years of testing after all the differential diagnosis’s are ruled out you are said by process of elimination to have Celiac Disease

if you are lucky or maybe NCGS and not some other acronym GI disease as I like to refer to them as a group.

GERD,IBS,UC, Chrons etc because if they turned down that street … . you are/could be in/at a dead end for they stop looking at the trigger (gluten)

as the cause of your gastric upset/digestive disorder(s).

So in summary if 3 or 4 or 5 or 6 of these symptoms overlap “many of’ these symptoms could be Low Stomach Acid related.

IF that is the cause/case for you then there is hope! For remission!

From Dr. Myatts’ Online article what’s burning you?

From Dr. Myatts’ Online article what’s burning you? http://healthbeatnews.com/whats-burning-you/

Diseases Associated with Low Gastric Function

Low stomach acid is associated with the following conditions:

* Acne rosacea

* Addison’s disease

* Allergic reactions

* Candidiasis (chronic)

* Cardiac arrhythmias

* Celiac disease

* Childhood asthma

* Chronic autoimmune hepatitis

* Chronic cough

* Dermatitis herpeteformis

* Diabetes (type I)

* Eczema

* Gallbladder disease

* GERD

* Graves disease (hyperthyroid)

* Iron deficiency anemia

* Laryngitis (chronic)

* Lupus erythromatosis

* Macular degeneration

* Multiple sclerosis

* Muscle Cramps

* Myasthenia gravis

* Mycobacterium avium complex (MAC)

* Osteoporosis

* Pernicious anemia

* Polymyalgia rheumatica

* Reynaud’s syndrome

* Rheumatoid arthritis

* Scleroderma

* Sjogren’s syndrome

* Stomach cancer

* Ulcerative colitis

* Vitiligo

When low in stomach acid we become low in essential nutrients

Quoting from Dr. Myatts “what’s burning you”  online article

“Our bodies need 60 or so essential nutrients. “Essential” means that the body MUST have this nutrient or death will eventually ensue,

and the nutrient must be obtained from diet because the body cannot manufacture it. Many of these essential nutrients require stomach acid

for their assimilation. When stomach acid production declines, nutrient deficiencies begin.

Calcium, for example, requires vigorous stomach acid in order to be assimilated. Interestingly, the rate of hip replacement surgery is much higher

in people who routinely use antacids and acid-blocking drugs. We know that people who have “acid stomach” were already having trouble assimilating

calcium from food and nutritional supplements due to lack of normal stomach acid production. When these symptoms are “band-aided” with drugs

which decrease stomach acid even more, calcium assimilation can come to a near-halt. The result? Weak bones, hip fractures and joint complaints

resulting in major surgery.

Jonathan Wright, M.D., well-known and respected holistic physician, states that “Although research in this area is entirely inadequate, its been my

linical observation that calcium, magnesium, iron, zinc, copper, chromium, selenium, manganese, vanadium, molybdenum, cobalt, and

many other micro-trace elements are not nearly as well-absorbed in those with poor stomach acid as they are in those whose acid levels are normal.

When we test plasma amino acid levels for those with poor stomach function, we frequently find lower than usual levels of one or more of the eight

essential amino acids: isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. Often there are functional

insufficiencies of folic acid and/or vitamin B12.”

Remember, these are essential nutrients. Deficiencies of any single one of them can cause serious health problems over time. Weak bones, diminish

immune function, failing memory, loss of eyesight and many other “diseases of aging” are often the result of decreased stomach function.”

It is me again reader.

So low stomach acid is the triggering agent (often) for low nutrients.

Make too much sense!

Now don’t take Vitamin’s for this condition where low Vitamins/Minerals are known to be low in patients who have this condition because . . . .

(if you do you won’t need to keep coming back to the doctor) I can almost hear the doctor say now.

Of course he/she doesn’t say that . . . just that the “average person” doesn’t need to take Vitamins.

Well I hate to break it too you . . . . but if you are having GI problems and reading this blog post on celac.com then you are not the

“average” person. You my friend or a sufferer or a friend of a sufferer still looking for answers.

If that is you then consider taking either powdered stomach acid – Betaine HCL or taking Niacinamide to help you reset your stress clock.

A Canadian researcher wrote about this connection 15+ years ago but still most doctors’ don’t understand this connection between about

how “Niacin treats digestive Problems”

Here is the full link so you can research it more yourself. http://orthomolecular.org/library/jom/2001/articles/2001-v16n04-p225.shtml

And you might not after a first reading.

I didn’t believe it myself for over a year . . . but every time I thought about it – it (Low Stomach Acid) made/makes the most sense to me.

**** Note: research this yourself. Here is a link about how to take Betaine HCL (powdered stomach) for maximum effectiveness.

http://20somethingallergies.com/how-much-hcl-do-i-take-learn-to-test-for-your-correct-dose/

Don’t take my blog post as medical advice. It is only what I did . . . it might not work for you but I think it is worth a try especially

if you are not now taking an acid reducer. (see notes below about why this might) be more difficult if you are already taking an acid reducer . . .

because the rebound wall (see chris kresser link) keeps us locked in . . . sometimes for years.

Since I was not taking acid reducers at the time I took Betaine HCL my stomach problems improved and I am sharing this now in the hopes

it might help yours too!

Now back to (really) LOW stomach acid being diagnosed as HIGH stomach acid these days.

How can we know if it truly high or low? You’ve heard the phrase timing is everything well it is here too!

Timeline is important in any diagnosis.

IF your stomach acid was HIGH as you often hear (everywhere) you hear take a Proton Pump Inhibitor aka acid reducer’s for heartburn/GERD

(medical name for heartburn) then eating food (carbs, greasy things) wouldn’t bother you.

The acid would cut it up but if it is already low/weak then even a little acid can burn your esophagus which is not coated like the stomach

to protect you from high acid.

BUT if it is low to start with then food will WEAKEN our/your acid so that you lose the food fight your in and things (carbs/fats) become to ferment,

rancidify and cause heart burn.

Leading in time to Non-Celiac disease first and with enough injury (and time) to Marsh lesions qualifying you for diagnosis as a Celiac candidate

/ patient. See above link between/about PPI’s in the year preceding a Celiac diagnosis.

If you (can) be that patient and weight the xx number of years for all this damage to occur, there is a better way it is called digestion!

A virtuous cycle can replace the vicious cycle you are now in – it is caused digestion.

Digest your food with healthy stomach acid and your body will thank you for it with the God given burp.

A healthy child burps (at 6 months of age normally) and a healthy adult should too and you will again after taken Niacinamide 3/day for 6 months

or this is not the right diagnosis.

*********Note this is not medical advice only my experience with Niacinamide and my many years researching this topic as a fellow sufferer.

Let me make these disclaimer(s).

If you are a) experiencing heartburn that causing vomiting (with unintended weight loss) you may have a special case of heartburn that feels like

heartburn (on steroids) that is really Bile Reflux and taking Stomach is not something you should do without medical advice and supervision.

See this NYtimes article that discusses the many complications often seen with Bile Reflux patients and why it is treated as Heartburn often and

why Bile Reflux is especially hard to recover from. http://www.nytimes.com/2009/06/30/health/30brod.html 

you are already taking an acid reducer then the chance you will get better (off of acid reducers completely) is only 50/50 on your first try but going low CARB

can help your transition.

Otherwise most people will get better when taking BetaineHCL for gastric support and Niacinamide to help them/you reset your digestive processes.

See this online article about how Jo Lynne Shane got off Nexium for good. http://www.jolynneshane.com/how-i-got-off-nexium-for-good.html

and her Epilogue  http://www.jolynneshane.com/epilogue.html

You will see she still struggles some but is much better when she let her natural digestive juices do their job. I call it the “Natural Order of Things”.

See this article about the digestion process being a North South Affair from the bodywisdom website http://bodywisdomnutrition.com/digestion-a-north-to-south-process/

Taking it (Niacinamide) (or any B-Vitamin) should be taken 2 to 3/day (too keep up serum levels) for 3 to 4 months (the time you can store B-Vitamins) in the liver mostly.

Once you have a distinctive BURP that displaces the bloating and sense of “I am going to explode” if I eat another bite (though you haven’t eaten half your meal)

then normal digestion is occurring again.

If you stool did not sink before this process (of taking Niacinamide begun) and burping became your “new normal” then it (your stool)

will begin to sink too!

Burping without bloating is the “Natural Order” of good digestion.

Don’t stop this process of taking B-Vitamins as Niacimaide or Slo-Niacin 2/day for at least 4 months then you should see most of your

GI symptom’s go into remission. (I did not say "cure" but remission from your cross contamination's (flares/symptom's etc.) might be possible.

Because our defenses are now strong enough to cut up proteins before they reach our small intestine (where most of the damage is done).

Think of a castle with a moat around it (stomach acid is designed to protect us) when it is low (the moat doesn’t protect us) and when the moat

is dry the castle becomes a ruin!!!

So do proteins (lactose (casein), gluten, soy, seafood etc.) to our small intestines (they become ruined) when our stomach acid (moat) is low or worse dry!

I repeat again Timeline is important in any diagnosis.

All heartburn is not equal. IF your stomach acid is truly high then it WILL occur between meals when there is no food to tamp down the fire

(occurring in your stomach) not your esophagus.

The excess pressure from fermented carbs push open the trap door allowing the low acid you have to burn the lining of your uncoated esophagus.

See also this online article by Chris Kresser to study this more about why/how this could be a case of medical misdiagnosis in more detail

https://chriskresser.com/what-everybody-ought-to-know-but-doesnt-about-heartburn-gerd/

This is part of a 3 part series that I think you will find very informative.

This (low stomach acid) is a vicious cycle. STRONG stomach acid makes it a virtuous circle/cycle.

Now food benefits you because low acid not only causes heartburn it limits your body’s absorptive ability by limiting its ability to cut up your food

into digestible peptides and amino acids which are no longer harmful to your Small Intestine but helpful to your overall health because nutrients

can now be absorbed because the food particles are now small enough to not cause harm to your villi.

I hope this is helpful and it helps you the way it helped me.

Maybe it will help you in a similar manner.

I write this only as a guidepost on your way. May you find your way back to digestive peace! The “Natural Order” of things! Praise bee to God!

It is not a long way if you know the way . . . . from someone who has found his way back God being his help!

There are more things I could say . . . but this post is getting kind of long but you get the gest.

I noticed someone else on the celiac.com noticed the same improvement when they treated their low stomach acid and thought

it was time a blog post talked about it.

It is so much easier to consume all this information in one setting instead of hunting and peeking through several thread posts.

Search for the posterboy on celiac.com and you will find it is my focus (how low stomach acid is misdiagnosed) and how Niacinamide helped me

to restore its “Natural Order” in the digestive process because it helped me!

Here is the link to the Prousky’s abstract. 15+ years is a long time for people to continue to suffer but if the research it right then

Niacinamide might help you too!

http://www.yourhealthbase.com/database/niacin-treats-digestive-problems.htm

Let’s hope it is not another 15 years before doctor’s and people realize low stomach acid can explain many of the same symptom’s an IBS, NCGS

or even a Celiac patient might experience given a long enough time for these conditions to develop from too low a stomach acid to

protect our Small Intestine.

See link at start of this blog post posted here again for convenience.

http://www.celiac.com/articles/23432/1/Do-Proton-Pump-Inhibitors-Increase-Risk-of-Celiac-Disease/Page1.html

And it is worth noting about the time Celiac disease started (began to be more prevalent) / to increase in the population Acid reducer’s

became more and more popular.

*** Some plot the increase in time to Roundup usage but I am not buying it. PPI’s increase seam more plausible to me based on the relatively

new research (less than 5 years old) is pretty current by research standards and the near linear response to increased first H2 stomach acid reducer’s

then PPI’s in the population at large.

*****Note: after I finished writing this blog post new research that in my mind confirms this connection was reported on celiac.com today

that notes the link between gastric pH and impaired nutrient absorption.

This very topic as I was getting ready to publish my post about low stomach acid possibly being diagnosed as Celiac disease on my posterboy blog

mentions how a Celiac patient’s absorption can be impaired by gastric pH.

https://www.celiac.com/articles/24738/1/Can-Celiac-Disease-Impair-Drug-Therapy-in-Patients/Page1.html

Where they (researchers) say/ask discussing Celiac Disease and whether it (celiac disease) can impair drug therapy in patients.

Note the opening paragraph discussing this topic quoting

“Celiac disease is associated with numerous chronic conditions, such as anemia and malabsorption of some critical vitamins.

Changes in the gastrointestinal tract, rates of gastric emptying, and gastric pH are responsible for impaired vitamin and mineral absorption."

 i.e., low gastric pH can effect absorption.

It stands to make reasonable sense to me they are related conditions and one is being diagnosed for the other often or at least one is being

confused as the other and treating one (raising your stomach pH) might treat the other since many of the symptoms’ are the same.

*** this/these opinion(s) are my own and do not reflect an endorsement by celiac.com of these ideas, comments, thoughts or opinions.

I hope this helps! You the way it did me!

Good luck on your continued journey,

Remember **** This is not medical advice and should not be considered such. Results may vary. Always consult your doctor before

making any changes to your regimen.

2 Timothy 2:7 Consider what I say; and the Lord give thee understanding in all things.

Posterboy by the Grace of God,

Posterboy

Why and How Pellagra is (often) Confused with Celiac Disease and/or Digestive Problems ; The Science of Pellagra a Hidden Epidemic in the 21st Century presenting/revealing as Celiac Disease.

When I was gluten intolerant following a Gluten Free diet religiously and newly diagnosed as a Celiac I began studying to see if there was a “cure” for this disease.

About 3 years into my study of Celiac disease I begin to match up/cross reference symptoms of Low Stomach acid – Hypochlorhydria. It seemed obvious my symptoms were the same.

See the link by Dr. Dana Myatt “What’s Burning You” that explains why this is so.

https://www.drmyattswellnessclub.com/WhatsBurningYou.htm

It was on that day the seed was planted that if I could begin to digest my food again then gluten would be cut up into harmless peptides.

It would take another year before I had the courage of my conviction to actually try gluten again knowing the five alarm bathroom visit I would set off if I was wrong …

but the research was clear the doctor’s had the wrong disease.

I had become/was low in Stomach Acid.

This post/thread on Celiac.com talks about the effects of leaky gut when your stomach acid is not strong enough to digest proteins – it is known as hydrolysis – to cleave by water

and it explains why a healthy baby burps at 6 months of age and a healthy adult should too.

https://www.celiac.com/gluten-free/topic/117026-leaky-gut-intestinal-barrier-impairment-help/#comment-969684

(I didn’t know this at the time) but Celiac.com reported on this finding that Proton Pump Inhibitors can contribute to a Celiac Diagnosis.

See this link

https://www.celiac.com/articles/23432/1/Do-Proton-Pump-Inhibitors-Increase-Risk-of-Celiac-Disease/Page1.html

Where the researchers concluded “Patients prescribed both proton pump inhibitors and histamine-2 receptor antagonists had an even higher risk for celiac disease .. .

The data clearly show that patients who use anti-secretory medications are at much greater risk for developing celiac disease following the use of these medicines.

The fact that this connection persisted even after the team excluded prescriptions for anti-secretory medicines in the year preceding the Celiac disease diagnosis suggests a causal relationship.”

So this confirmed my hunch and over 3+ years of research.

So with faith in myself and God that He had led me to this wisdom (2 Timothy 2:7) I began my journey back to peace with Gluten and health I had not known in over three decades.

And after a year of being able to put my cross contamination issues in remission (no accident poisoning’s when dining out) – defeating my mortal enemy gluten

I began to write about my opus /journey back to peace with gluten. “I Know World Peace is Easier”.

Someone who I was explaining this too (or trying to explain this to) asked me but “why does this happen” and I didn’t have an answer for them.

So that set me off again. If I could figure out by God’s Grace why this was happening then imagine all the suffering that could be avoided by people?

Well after much study and the Grace of God – I did. STRESS!

What happens when we are stressed – we burn energy and a lot of it? Fight or Flight right?

All this fighting takes energy and lots of it to survive the body takes our energy reserves from other parts’ of the body when it does this too much or too often over a 3 to 4 month period

our body becomes STRESSED out.

This is the same amount of time our body can store B Vitamins usually in the Liver. Is there anything we can do to help with this STRESS we are experiencing or is it hopeless.

No it/we are not helpless or hopeless if we will supplement (or feed our cravings) of the missing ingredient/nutrient then we can meet our need and remission from too much stress is obtained.

Hence the Niacinamide Challenge I have mentioned elsewhere in this blog.

Prousky talks about this in his seminal work “Is Vitamin B3 Dependency a Causal Factor in the Development of Hypochlorhydria and Achlorydia” linked here

http://orthomolecular.org/library/jom/2001/articles/2001-v16n04-p225.shtml where he theorizes (note this is research 15+years old) and still we don’t know/understand this

connection or it is not widely talked about enough that Niacinamide supplementation can help digestive problems and that quoting prousky “The primary somatic complaints of individuals

with vitamin B3 dependency are be gastrointestinal disturbances with hypochlorhydria presenting as one of the early clinical signs of the vitamin dependency.

The only way to confirm a clinical suspicion of a vitamin B3 dependency is to provide optimal doses of the vitamin, and see if the clinical problems improve or resolve.”

Or be tested for Pellagra. Which the Doctor’ are not looking for today. Like the doctor’s did not look for Celiac disease 15 or 20 years ago neither is Pellagra looked for today

because they don’t know to look for it anymore.

See this blog post by Dr. Heaney of Creighton University that talks about why this is so today.

http://blogs.creighton.edu/heaney/2013/11/18/pellagra-and-the-four-ds/

where he (Dr. Heaney) says correctly that “In the United States, at least, pellagra is a disease of the past – fortunately – and it is doubtful today that most health professionals

would recognize it if a case happened to come to their attention.” And that is unfortunate for GI patients of all stripes and kinds (IBS, Heartburn aka GERD, Non-Celiac Gluten Sensitivity etc.)

because doctor’s today don’t know to look for Pellagra anymore as a GI disease.

How do we know this? We can’t for sure unless we are willing to take the missing nutrient according to Prousky “a vitamin B3 deficiency occurs when the intake of the vitamin

is below a known minimal amount that guards against pellagra. A vitamin B3 dependency occurs when there is an increased metabolic need for the vitamin requiring treatment

with megadose amounts”. Or have our doctor’s test us for a Niacin deficiency.

A deficiency is why we enrich/fortify are bread with Niacin our milk with Vitamin D and our salt with Iodine. A dependency is when are bodies don’t function properly due to

high stress levels requiring high or increased metabolic need as quoted by Prousky above.

What does this look like in human beings?

If one is critically low in Niacin the 3 D’s of Pellagra (Dementias, Dermatitis’s, and Digestive Issues) show up.

As cited in the International Journal of Celia Disease http://pubs.sciepub.com/ijcd/3/1/5/ from the article “Two Exceptional Complications Revealing Celiac Pellagra

and Ischemic Cardiomyopathy … “pellagra is essentially affecting tissues with a high rate of cell turnover, such as the digestive tract and the skin,

and tissues with high energy needs, such as the brain”.

Now if the symptoms’ are similar it is easy to confuse one disease for the other and if not well understood they might be considered “exceptional” or, i.e., not well understood.

How do we know this? The same Journal of Celiac in another issue entitled Celiac Disease Intestinal Heart and

Skin Interconnections http://pubs.sciepub.com/ijcd/3/1/6/ when listing common aspects of both diseases’ says and I quote

“The two diseases can be connected in two aspects. 58% of pellagra patients were shown to have malabsorption and many had intestinal pathology on biopsies [36, 37].

Alternatively, Pellagra was described in celiac disease.”

Not only did/does the Journal of Celiac cite common symptom’s 58 percent of the time in Celiac and Pellagra but they also cite that Pellagra has been described in a Celiac Disease diagnosis.

I would argue that it should be the other way around if the majority (58 Percent) of the time Pellagra symptoms are described in a Celiac diagnosis

it stands to reason that medical science is identifying the wrong disease.

Quoting the Celiac Posterboy “Pathology presumably would qualify the Pellagra patient as a Celiac Patient if the Pellgarin was first diagnosed as a Celiac first as often is the case TODAY!”

I ask if you have the wrong disease would you get better Or Is Non-Celiac Gluten Sensitivity and/or Celiac Disease really Pellagra in disguise in the 21st Century?

Suffering by another name hurts just as much???? Does it not?

Pellagra being confused for Celiac disease in the Majority of those being diagnosed as Celiacs’ today -- hurt’s as much Does it not . ..

and probably worse because then/now you have ruled out a valid differential diagnosis.

Why is this? Or how is this possible?

The International Journal of Celiac Disease muses on this point too? when discussing the “exceptional” (not well understood) reason why Pellagra

shows up in a Celiac Diagnosis. They say “Little progress has been made in our knowledge of pellagra …

since Goldberger discovered that nicotinamide was a preventive factor in 1926” of Pellagra.

Continuing the citation “Proof of this is that there have been no changes’ in treatment or diagnostic criteria in the last 90 years” for Pellagra.

As the International Journal of Celiac Disease summarizes this case of “Exceptional Complications Revealing Celiac Disease and Pellagra “illustrates …

rare (I would say common) complication revealing celiac disease”.

Because it is not YET well understood that 58 percent of Celiac patients are Co-Morbid with Pellagra. Common enough I believe to declare Pellagra

as the Parent disease and the subsequent Celiac patient the child meaning every one (95 plus percent probably) of those diagnosed with Celiac disease

has symptoms derived from Pellagra though it is not now commonly understood in the medical community.

If we follow most normal paths’ for adoption it will take another 15 or 20 years (a generation) for the medical community to accept Pellagra as the proper diagnosis.

Don’t suffer in the meantime! If the International Journal of Celiac Disease is right and Pellagra is Co-Morbid revealing as Celiac disease the majority of the time?

Then take the “Niacinamide Challenge” for yourself and see if you don’t begin burping in 6 months or less depending on how many times a day you take it

and potentially put your IBS/GERD/NCGS and possibly ??? dare I say it Celiac in remission along with your Co-Morbid Pellagra symptoms

aka (the 3 D’s) 75+ years ago if one is being diagnosed as the other.

It will take one more test to make a valid determination or else we can’t know for sure which disease we really have since they are eerily similar

in their clinical presentations.

The Mdguidelines website outlines why this is so see their link

http://www.mdguidelines.com/pellagra

Where they (Mdguidlines) say quoting

“The diagnosis of pellagra is straightforward when the classic rash is present but may be (more/my word) elusive if there are only gastrointestinal and/or neurological manifestations.”

The LTO website gives an good overview of the B-Complex test than be performed to confirm if Pellagra is presenting as Celiac disease.

See this link

https://labtestsonline.org/understanding/analytes/b-vitamins/tab/test

As I have said before in this blog. A healthy child burps at 6 months of age and you can too in six months by taking the Niacinamide putting your

Co-Morbid Pellagra (digestive) symptom’s into remission if indeed we can believe the International Journal of Celiac Disease and your Celiac Disease

is presenting as Pellagra the majority of the time.

See this article feature on Celiac.com that explains in more details why this is so.

https://www.celiac.com/articles/24658/1/A-Differential-Diagnosis-How-Pellagra-Can-be-Confused-with-Celiac-Disease/Page1.html

Keep in mind the more times a day you take it (Niacinamide) the quicker the desired effect.

You will begin burping and your stool will sink if does not already.

See my other blog post where I say I was a Pellagra patient diagnosed as a Celiac patient to learn more about how to take Niacinamide properly and what signs too look for

when it is working and the natural order of things has been restored and you are now digesting your food again.

Remember **** This is not medical advice and should not be considered such. Results may vary. Always consult your doctor before making any changes to your regimen.

This will not work if are already taking a PPI (proton pump inhibitor) like Prilosec, Nexium or one of their generics or other acid reducers for hearburn/GERD but if you

are only taking antacid’s like Rolaids or Tums then burping will occur where it is most likely not occurring now.

You will need to take stomach acid to get you over rebound wall that comes on when you stop taking your acid reducers. See prousky link about how to do this or

check with Dr. Google where there are websites that explain how to do this.

But new research by Washington University strongly suggest that you need to work with your doctor to get off you PPI’s and do it as quickly as possible where

they say the “ Popular heartburn drugs (PPIs are) linked to gradual yet 'silent' kidney damage Most patients don't experience acute kidney problems beforehand”

https://www.sciencedaily.com/releases/2017/02/170222082252.htm

This is only the latest bad news for Proton Pump Inhibitors. So if you are taking them for gastric support they may be doing more harm than good in the long run.

But I prefer to talk about Vitamins because they are safer to take and are at the root cause for most diseases and yes Pellagra being diagnosed as Celiac’s today.

What have you got to loose there is better than a 50/50 chance your doctor will find Pellagra is the correct disease or at least you will eliminate the contributing concomitant

Pellagra symptom’s greatly controlling your Pellagra flare up’s (the 3 D’s – dementia(s), digestive issue(s) dermatitis issue(s)) being confused/revealing as your Celiac disease by mistake.

If you have never heard of Pellagra you are not alone. Many doctors have not either and that is why they don’t find it. You only find what you are looking for!

Perhaps with this education/awareness you now have the doctor’s/patients will be more aware now that the presenting symptoms of Celiac disease and Pellagra

are eerily familiar and one disease is being confused for the other. Or at least they were in my case.

As I am fond of saying “To Educate is to Truly Free”. YOU don’t have to have all 3 D’s to have Pellagra any one of the D’s like C and D is enough to confirm Pellagra

in the absence of Dermatitis issues etc. See md guideline quote above.

Quoted again here for easy reference Where they (Mdguidlines) say quoting

“The diagnosis of pellagra is straightforward when the classic rash is present but may be (more/my word) elusive if there are only gastrointestinal and/or neurological manifestations.”

I couldn’t agree more. Your path to the knowledge of a Celiac diagnosis as we know is a long one for most people. It doesn’t have to be a long path back if you know the way.

Knowledge of Pellagra is fairly poor (elusive) today the way Celiac disease was 15 or 20 years but the path to a valid/correct diagnosis of Pellagra

doesn’t have to be a long one if you will have your doctor test you for It (Pellagra) to see if your Pellagra is like the 58% of Celiac’s according to

the Journal of Celiac Disease is masking/presenting as Celiac disease today.

Let’s take the mask of Celiac disease off and reveal the true diagnosis if you will and get tested for a Niacin deficiency proving that Pellagra is contributing to your poor

patient experience i.e. super sensitivity etc.

The gluten free works website covers this topic well. A niacin deficiency in Celiac’s.

https://glutenfreeworks.com/blog/2010/06/23/niacin-vitamin-b3-deficiency-in-celiac-disease/

Where they quote old research (again this is not new information) but the awareness is low that a “niacin deficiency itself sensitizes the intestinal

mucosa of rats to gluten in wheat, barley, rye, oats and corn and induces susceptibility to gluten toxicity by means of cellular dysfunction.3”

This research is 30+ years old. How much longer will we suffer in ignorance of this fact?

They say and I couldn’t agree more! “Human research needs to investigate this effect of niacin deficiency in human celiac disease”

or at least it is high time that Celiac’s are also tested to see if co-morbid Pellagra is contributing to their Celiac Diagnosis.

And Prousky did 15+ years ago (did human research on Niacin and digestive issues) but people still suffer today because it still not

well known (understood) today that Pellagra a Niacin deficiency treats digestive problems.

This blog post is about awareness of this fact that medical doctor’s today are not looking for Pellagra in Celiac’s and therefore people continue to suffer because of it.

Good luck to those who are still on our journey who come across this blog post and find it helpful. I hope it helps you on your journey to find at least

one was able to find (their way back)/help himself /herself/themselves of their GI problems by taking a Vitamin for a rarely diagnosed disease today --

Pellagra but is eerily similar to the way Celiac disease presents/is diagnosed today.

If you still have questions after reading this blog post about my journey of how I learned Pellagra is being diagnosed as Celiac Disease today

then visit the website in my profile to read more about why doctors are ignorant of this fact today but there is only so much you can put in one blog post.

But I hope this is enough to pique your curiosity. Or search for the posterboy on celiac.com to read all my posts or comment threads about why Pellagra

is being diagnosed as Celiac Disease today. Knitty Kitty also comments a lot about how Niacin helped her DH symptoms. It is my hope it will help you too

to know that there is an alternative diagnosis.

It is said ignorance is bliss. Well in this case it is dangerous. If you had cancer wouldn’t you want to know . . . of course you would!

If you have Pellagra the ignorance of this fact can kill as surely as Cancer. The 4th D of Pellagra is death. So please have yourself tested to see if Pellagra

is contributing to your Celiac disease symptom’s is my advice to you and maybe just maybe you too like me will have a good/favorable

response and your cross contamination issues will go into remission.

Praise bee to God! To those who will hear and listen!

I am just trying to help those who are still suffering.

I am that boy walking along the shore throwing starfish back or trying too!

The Starfish Story Original Story by: Loren Eisley

“One day a man was walking along the beach when he noticed a boy picking something up and gently throwing it into the ocean (world wide web) …

Son, the man said, don’t you realize there are miles and miles of beach and hundreds of starfish?

You can’t make a difference!

After listening politely, the boy bent down, picked up another starfish, and threw it back into the surf. Then, smiling at the man,

he said I made a difference for that one.” . . . I hope that one is you reader -- fellow sufferer from a former Pellagra sufferer diagnosed as Celiac disease.

2 Corinthians (KJV) 1:3,4 3) “Blessed be God, even the Father of our Lord Jesus Christ, the Father of mercies, and the God of all comfort;

4) who comforteth us in all our tribulation, that we may be able to comfort them which are in any trouble (starfish), by the comfort wherewith we ourselves are comforted of God.”

2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things” this included.

posterboy by the Grace of God,

Posterboy

Prologue I never know what to call a post. What Else Could it Be; Co-Morbidity in Celiac disease and what else could be causing your Celiac like symptoms or I had Celiac Disease and developed Pellagra. This is my story yours may be similar. I have tried to write as much as I could of this beforehand to summarize some of my experience and research since I was first serology confirmed a Celiac and why I think Pellagra explains if not all the complications a Celiac develops at least many of them seem common in undiagnosed Pellagra but I find formatting and links can be a challenge.

This is not meant to be an answer to all your questions but a beginning,

posterboy by God’s Grace. See post that follows “I had Celiac disease and developed Pellagra”.

Good luck on your journey. 2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things”.

 

I had Celiac Disease and developed Pellagra

I try and educate about how Pellagra can be confused for Celiac disease and/or GI problems like IBS, GERD, Ulcer’s, UC etc. after having received a Celiac diagnosis and my symptom’s improved greatly after taking Niacinamide (the non-flushing form of Niacin).

And almost without fail people do not see the connection. They say but I have … . fill in the blank.

They don’t see the connection.

But if I say it this way maybe it will help you “I am a Celiac who developed Pellagra” or fill in the blank … . heartburn, IBS, UC, Chron’s etc.

I named this post this because another board/forum member said as much in a thread post on this forum and it struck with me. She had the digestive problems of a Celiac but also the dermatitis issues of DH and her itching got better after taking Niacin.

What we fail to understand often with any diagnosis there is continuum of disease/symptoms.

Since this happens gradually you develop heartburn first then you have IBS, and Constipation and diarrhea then maybe an ulcer etc we don’t often see the connection.

But all along it was the same disease in a more pronounced condition.

If we catch it early enough say at IBS then the ulcer or UC might not develop.

When we think spectrum of disease it helps us to understand these diseases’ can be and are more related that we often understand.

They are all bound by STRESS. Do not all these conditions worsen when you are stressed does not the heartburn turn into IBS i.e. your constipation and diarrhea flare up?

Yet we think of them as separate diseases Right?

No there is a continuum of disease bound by STRESS and TIME.

The longer the stress the more your symptom’s Right!

You just haven’t stopped to think about the relationship.

Relationship and time is important to a proper diagnosis.

So how are these related?

Our mucus membranes are always in a constant state of repair either of repairing or rebuilding what is broken or maintaining our bodies defenses.

This takes energy and lots of it and one is not able to make enough energy to repair the lining of our stomach without enough Niacin and Pellagra develops.

I am not even saying I have been cured of Celiac disease. I say my GI symptoms are in remission which leads me to Pellagra as a cause and effect relationship of stress and our environment — Epigenetics.

I am saying I was/am a Celiac who developed Pellagra.

The International Journal of Celiac disease notes that both Pellagra and Celiac disease does often occur in the same person.

How do we know this?

The Journal of Celiac in an issue entitled Celiac Disease Intestinal Heart and Skin Interconnections http://pubs.sciepub.com/ijcd/3/1/6/ when listing common aspects of both diseases’ says and I quote “The two diseases can be connected in two aspects. 58% of pellagra patients were shown to have malabsorption and many had intestinal pathology on biopsies [36, 37]. Alternatively, Pellagra was described in celiac disease.”

Which also explains why a Genetic disease can increase in two or three generations because our stress changes our genes.

There is a trigger. Stress — it is not your day to day stress. We can handle all that kind of stuff but TRAUMA lasting 3 or 4 more months at a time. Think when Celiac disease was first studied as a Disease? It was during and directly after WWII and I dare say a stressful time to say the least.

Not to mention all the energy needed day to day to just survive. Europe almost starved after the war.

So much so he U.S. government had to step in and help deliver/air drop humanitarian aid to Europe.

It was called the Marshall Plan named after the man who devised the relief plan and it is credited with keeping Europe alive after WWII and averting another possible world war because of the infighting that would have developed from a starving Europe.

3 to 4 months is approx. the exact time we can store B Vitamins. Anything that triggers the fight or flight high energy response (TRAUMA) that depletes our bodies reserve’s.

Stress is coincidently what Niacin helps us control. It (Niacin) helps control our stress response’s in the body without which cellular disfunction happens (are membranes brake down). Like the alternating constipation and diarrhea you have had for years if you have developed Celiac disease.

Things like a Car Accident, difficult divorce, injury to our kids, extended care giving, surgery etc. can and often does trigger GI problem’s. And yes the stress of pregnancy.

And it (STRESS) is common with with/before a pregnant lady gives birth triggering heartburn.

A good example is pregnant women in their 3rd trimester often develop heartburn that’s goes away when the child is born.

Those who are predisposed continue to have heartburn and GI problems because their body couldn’t meet their need. Half of pregnant women develop heartburn during pregnancy that goes away in all but about 1/3 of those who get heartburn when the child is born.

Think of Heartburn as infant Celiac disease if it helps you to think in these terms. The older/longer the heartburn persists or the more GI symptom’s (heartburn/GERD/IBS, Constipation, diarrhea, ulcer etc) reoccur the more serious the conditions and diagnosis becomes.

The genetic component is that 1/3 are predispose to high Niacin consumption when stressed.

It is those1/3 of us who had Pellagra and Celiac disease developed is who I am trying to help.

But it should be noted up and until your Celiac diagnosis things like the Ulcer, UC, IBS etc can/could be helped also if Pellagra is the Parent diseases and all these other diseases are its children.

Co-Morbidity is the term.

A B-Vitamin deficiency can be inherited but does not have to be permanent. It is a reversible condition.

See this new research that ties eczema in babies to low Niacinamide in the mother during pregnancy. Nicotinamide is usually the way Europeans spell Niacinamide. Both names refer to the same amide form of Niacin.

https://www.sciencedaily.com/releases/2016/09/160923092924.htm

The very definition of a Vitamin (especially in the case of B vitamins) a vital (life giving) nutrient/substance needed in a minimum amount without which we become sick.

Your continuum of diseases are completely reversible if your symptom’s look like Pellagra (digestive, dermatitis and dementia’s) in nature and your respond (BURP in 3 to 4 months) to Niacinamide you might have Pellagra and the doctors have not figured it out in a clinical setting (they are sub-clinical) yet or at least you (may) have Pellagra and Celiac Diseases Co-Morbid.

If one is critically low in Niacin the 3 D’s of Pellagra (Dementias, Dermatitis’s, and Digestive Issues) show up. Really there are 4 D’s more on that latter but we are trying to catch Pellagra before it gets that far.

The International Journal of Celiac Disease notes this co-morbidity when they note in 58% of Celiac -- Pellagra ALSO occurs.

See this link http://pubs.sciepub.com/ijcd/3/1/6/

Quoting their paragraph 3 on the Co-Morbidity of Celiac and Pellagra together

3. Pellagra and Celiac Disease

“The two diseases can be connected in two aspects. 58% of pellagra patients were shown to have malabsorption and many had intestinal pathology on biopsies [36, 37]. Alternatively, Pellagra was described in celiac disease [38]. The skin manifestations in pellagra might have some additional etiologies, since multiple nutrient deficiencies are at the origin of the cutaneous manifestations in celiac disease. The following nutritional deficiencies inducing skin rashes, were describe in celiac disease: Zinc, Iron, Vitamin A, E, B12, niacin, folate, selenium and essential fatty acids [39, 40]. “

58% of the time (that is a majority folks) Celiac’s go on to develop Pellagra too!

Or is it really the other way around? Have you had Pellagra all along and now you have developed Celiac from it (Pellagra) undiagnosed.

The later may be more true than you know.

Ask your friends if they have ever heard of Pellagra. I dare say it a low percentage that knows Pellagra a once rampant disease especially in the rural south can cause many of the GI problems you are now experiencing as a Celiac disease patient or even the Non-Celiac Gluten Sensitivity (NCGS) patients that have not yet received a Celiac diagnosis.

And it maybe a lower percentage today that know what Pellagra (or even that they could have it) is than have heard of Celiac disease or think they have Celiac disease instead.

Think beri beri, rickets, scurvy etc all complex diseases completely forgotten about today that were/are completely reversible conditions.

As Dr. Heaney points out about Pellagra today!

That as Creighton’s University Dr. Heaney says “In the United States, at least, Pellagra is a disease of the past – fortunately – and it is doubtful today that most health professionals would recognize it if a case happened to come to their attention.” See Dr. Heaney’s Professor of Medicine post here at this link

http://blogs.creighton.edu/heaney/2013/11/18/pellagra-and-the-four-ds/

The knowledge of Pellagra (if you have ever heard of it) is in that same state of forgotten diseases now thought relegated to the history books.

If you have Pellagra co-morbid then you just have to take a Vitamin to get rid of this morbidity.

This is a summary of my 10 year journey.

I researched these things for 3 to 4 year (2 Tim 2:7) before I had the courage in my conviction to test this Pellagra theory.

But I think most people would rather hear from some who has suffered like them and has been able to help themselves. This is not theory anymore for me. It is my story.

In case this is the only post you read I will repeat here for knowledge sakes ****** the number one mistake people make when taking Niacinamide is they don’t take it often or long enough. It should be taken UNTIL you are burping. Most people will burp when taking Niacinamide in 3 to 4 months or less taking it 3/daily — ie with each meal.

What do I mean by burping? This confuses some people sometimes.

I don’t mean the little burp you get with drink some carbonated beverage or burp a little in the first 20 minutes after eating but also are bloated.

But your new normal BURPING the natural order of things burping – The burp will come later after the meal the longer you take the vitamin. Burping will occur the more frequently the less you eat. Soon water will cause you to burp -- Burping without the bloat and distension (pain from gas) that comes later.

When your stool begin sinking your body is digesting the carbs and proteins that were causing you the backwash (heartburn/GERD/IBS) before when you only burped a little or occasionally or when you drank something carbonated.

Now BURPING will occur two hours after you ate something. Long after you have finished your meal you will burp if you have taken the Niacinamide 3/day for 3 to 4 months at a minimum.

Dr. Prousky proved this 15 years ago this past November that Niacinamide treats digestive problems.

http://www.yourhealthbase.com/database/a124b.htm

Yet 15 years later people still are bemused when you mention Pellagra let alone that Pellagra could be contributing to your Co-Morbid Celiac disease.

I for one will tell those will listen. I am a Celiac who developed Pellagra.

Learn from my mistakes so you don’t have to repeat them and get your doctor to test you for a Niacin deficiency.

Pellagra once rampant early in the 20th Century is now known TODAY as Celiac disease in the 21st Century (I believe) or at least in a good majority of cases could be.

To paraphrase William Shakespeare “Disease by another name hurts just as much” and maybe more because if you get the right disease you can get better!

You know have the power to help yourself forum reader (because knowledge is power) the question is what will you do about it?

This blog post is a store house of 10 years of research learned from life experiences. The blog’s author has been stung so you don’t have to be.

Learn from my mistakes.

No man is so dumb as the man who won’t learn from other people’s mistakes. Take as much honey (knowledge) as you can from my mistakes so bad health will not sting your quality of life.

Is it any wonder God’s promised land was described as a land flowing with milk and honey?

Where knowledge flows there is health of mind and body.

Feel free to ladle and dollop your life with the sweet stickiness of the truth (knowledge) found/ gained today. For honey like truth stick to you once in contact and you can’t just wash it away.

Don’t let them the doctor’ almost kill you before you are willing to take a Vitamin to see if it is really the Co-Morbid Pellagra as the International Journal of Celiac Disease notes that could be causing your Celiac symptom’s in the MAJORITY of Celiac patients if the International Journal of Celiac disease is correct.

Quoting again from the IJCD “The two diseases can be connected in two aspects. 58% of pellagra patients were shown to have malabsorption and many had intestinal pathology on biopsies [36, 37]. Alternatively, Pellagra was described in celiac disease [38].”

See this link provided again for easy reference http://pubs.sciepub.com/ijcd/3/1/6/

Stop the madness! Admit the MAJORITY of Celiac Patients today are Co-Morbid with Pellagra and if you treat the co-morbid disease you can get better from that morbidity.

The Celiac Posterboy might say “(Unfortunately) for most patients it (Pellagra) is not recognized as Disease TODAY! By their admission (a professor of medicine/health professionals/doctors) Pellagra is OMITTED as a disease in most doctor’s differential diagnosis TODAY!”

If you have (a) Celiac disease diagnosis then you have been stung with/by this ignorance. That as Creighton’s Dr. Heaney says “In the United States, at least, Pellagra is a disease of the past – fortunately – and it is doubtful today that most health professionals would recognize it if a case happened to come to their attention.”

See Dr. Heaney’s Professor of Medicine discussion about why Pellagra is not diagnosed today here at this link

http://blogs.creighton.edu/heaney/2013/11/18/pellagra-and-the-four-ds/

This blog post is about the ignorance (of) Pellagra cost’s you when the doctor’s diagnose you with Celiac Disease/NCGS when 58% of their patients is/are Co-Morbid with Pellagra and they get the wrong “key” diagnosis.

**** This is not medical advice and should not be considered such. Results may vary. Always consult your doctor before making any changes to your medical regimen. But I have found and my friends have found if you take it (Niacinamide) like an antibiotic (UNTIL BURPING) and your stool SINK then 95% of your GI stress will be in remission.

You could still have other things that are bothering you but it won’t be Pellagra. If you take fiber and still have GI trouble then eliminating supplemental dietary fiber for 30 days (like you did to see if gluten was your’ problem) might help you figure out whether the fiber is helping or hurting your GI problems. People do have bad reactions to fiber sometimes that can be confused for IBS problems and unless you try eliminating it for 30 days you won’t know for sure if it is causing or contributing to the remaining GI problems you might still be having after taking Niacin until burping if any.

As I am fond of saying “To Educate is to truly Free”.

But do not do as I did! Learn from my mistakes.

DO NOT take Niacin or Niacinamide or any form of Niacin UNTIL you have your doctor’s test you for it (Pellagra).

If you notice the IJCD link these were clinical observations only.

Quoting the IJCD again “It is the first description of celiac disease . . . .and Pellagra in the same person, however, only associative linkscan be established, but not cause and effect relationships. Unfortunately, the patient was not diagnosed biochemically as pellagra and died before gluten free diet was initiated.”

You probably know this by now if you are a Celiac or even a NCGS patient the diagnosis rate for Celiac disease can be a horrible and if you have Pellagra it is even worse because the doctor’s like Celiac disease 15 or 20 years ago are not even looking for it today.

One more test needs to be done to differentiate Pellagra from Celiac and it is not being done today as Dr. Heaney correctly noted. Doctor’s don’t know to look for it (Pellagra) much less in a Celiac patient.

See this link to the Merck Manual a commonly used traditional desk reference for Physician’s when they need to look up a diagnosis.

http://www.merckmanuals.com/professional/nutritional-disorders/vitamin-deficiency,-dependency,-and-toxicity/niacin

Quoting from the Merck Manual “If available, laboratory testing can help confirm the diagnosis, particularly when the diagnosis is otherwise unclear. Urinary excretion of N1-methylnicotinamide (NMN) is decreased; < 0.8 mg/day (< 5.8 mcmol/day) suggests a niacin deficiency.”

No, doctors don’t know everything they have to look things up from time to time too. And when they do look up Pellagra when you ask them to test you for it the way some people on this board went to their doctor’s to have them test for Celiac disease instead of accepting as Gemini on this board said and say you had IBS instead “I Be Stumped” they learned/were taught by their patient’s that Celiac is not as rare as once thought.

And neither is Pellagra.

Quoting the Celiac Posterboy “Pathology presumably would qualify the Pellagra patient as a Celiac Patient if the Pellgarin was first diagnosed as a Celiac first as often is the case TODAY!”

Why is this?

The pellagra disease blog explains why this is https://pellagradisease.wordpress.com/

Quoting Niki Frost “Since pellagra is (thought to be my words) such a rare disease today, few people recognize it based on their symptoms alone (any of the three D’s: dementia, dermatitis, and diarrhea). Pellagra patients are consequently (constantly being my words) referred to specialists in fields that are ultimately unrelated to the underlying nutritional deficiency and metabolic nature of the disease.”

So the cycle repeats. Since these specialists don’t consider you in a subgroup that is prone to be diagnosed with Pellagra then Celiac/NCGS disease is diagnosed if you are lucky and not some other GI problem like chrons, IBS, UC etc because in these cases the GI specialists is not even looking for Gluten as a possible trigger.

This is not to even mention the other D’s of Pellagra today being diagnosed as various degrees’ of Dermatitis like ezcema, psorsias, Dermatitis Herpetiformis (DH) etc which are related to skin presentations of Pellagra. Pellagra when it was first named means rough/sour skin in Italian and people forget that today.

Or the dementia’s of Pellagra like depression (40 percent of Celiac’s are depressed) or the “brain fog” a Celiac develops after being “glutened” I could go on and on but you get the idea.

But unless you are tested for it your doctor’ won’t know to look for it in their next Celiac patient because they do not know to look for it in GI patients today remember the war on Pellagra ended 75+years ago so they don’t look for (see) Pellagra anymore in a clinical setting unless you are in a subgroup like being an alcoholic etc . The same way they didn’t or might not of known to test their IBS patients for a Celiac diagnosis 10 or 15 years ago.

I am not saying this will help you the way it seemed to help me. But I am saying have your doctor verify these things for you before doing these things because if you are a Celiac that has developed Pellagra also then it needs to be documented.

If you want to read more about my story search for the posterboy on this board to read my other forum threads or visit the website in my profile.

I have specifically left out dosage amounts because the frequency you take a B-Vitamin is more important than the amount you take of it.

Because B-Vitamins are water soluble 2 or 3 hours later if one is deficient in that Vitamin then the body can absorb more of it. So taking higher doses don’t necessary help you any more than lower doses. They (higher doses 500mg) can be easier to find especially if you are taking it (Niacin) for cholesterol management but it doesn’t help you any quicker than smaller amounts more frequently and higher Niacin causing flushing (which can be mitigated to some degree by taking Niacin with food) where the Niacinamide form doesn’t.

In fact taking smaller amounts frequently 3/day with meals will help approximately 40 percent faster than one larger 500mg capsule/tablet only once daily.

And why if given a specific amount and you retain it (is low in the urine) is a sign you are low in Niacin. I do prefer the Niacinamide form because it is a naturally flush free form.

The Merck Manual notes this quoting “Nicotinamide is usually used to treat niacin deficiency, because nicotinamide, unlike nicotinic acid (the most common form of niacin ), does not cause flushing, itching, burning, or tingling sensations. Nicotinamide is given in doses in doses of 250 to 500 mg po daily.”

But a Slo-Niacin can work just as well.

The Townsend Letter makes note of this in their Feb/Mar 2003 edition.

http://www.townsendletter.com/FebMar_2003/inositol0203.htm

This will be a cycle. You will take it until burping 2 hours after you finish your meal and your stool sinks where before it floated and even water now causes burping without bloating or gas or distension.

It might be 3 or 4 months for some people or it might be even 6 months or longer for some people. But it is a cycle. Usually people feel better when they begin burping for the first time in years and their stool now sinks when before it always floated.

I do not now take Niacinamide and haven’t for several years since my symptoms’ are in remission.

I stopped taking it when I had rebound acid reflux. By that I mean I begin to have acid reflux symptoms when I had no food in my stomach that when away when I ate something.

Timeline is important in any diagnosis.

All heartburn is not equal.

IF your stomach acid was HIGH as you often hear then eating food (carbs, greasy things or your other triggers) wouldn’t bother you because it would only weaken it.

BUT if it is low to start with then food will WEAKEN our/your acid so that you lose the food fight you are in and things (carbs/fats) become to ferment, rancidify and cause heart burn.

The excess pressure from fermented carbs push open the trap door allowing the low acid you have burn the lining of your esophagus.

TRUE heartburn from too HIGH acid happens between meals when there is no food in your stomach to tamp it down and will occur if you take Niacinamide too long and how I knew I needed to stop taking Niacinamide.

When low in stomach acid for too long in time this can lead to Non-Celiac disease first and with enough injury to Marsh lesions qualifying you for diagnosis as a Celiac candidate/patient.

How do we know this?

Low stomach acid has now been linked to a probable cause of damage to the Small Intestine before and/or occurring with a Non-Celiac Gluten Sensitivity (NCGS) or Celiac diagnosis.

Celiac.com reports these findings

http://www.celiac.com/articles/23432/1/Do-Proton-Pump-Inhibitors-Increase-Risk-of-Celiac-Disease/Page1.html

Note how the researcher’s starts the article

“Rates of celiac disease and the use of drugs to inhibit the secretion of stomach acid have both increased in recent decades. A research team recently set out to explore the association between anti-secretory medication exposure and subsequent development of celiac disease.”

If these medicine are lowering stomach acid what cause effect relationship does/ could this have on Celaic/NCGS diagnosis is what they are postulating.

They go on to say without being very technical (read the whole article for yourself) that

“The data clearly show that patients who use anti-secretory medications are at much greater risk for developing celiac disease following the use of these medicines.” . . .. Summarizing their findings

“The fact that this connection persisted even after the team excluded prescriptions for anti-secretory medicines in the year preceding the celiac disease diagnosis suggests a causal relationship”.

Now the term causal is not used lightly. To prove causal is much harder than casual (occurring with) like the 58% of Celiac who are also casually observed as having Pellagra.

Gluten Free works summarizes a casual association of a Niacin deficiency very well at this link

https://glutenfreeworks.com/blog/2010/06/23/niacin-vitamin-b3-deficiency-in-celiac-disease/

They only note a casual association only noting similar symptoms occur in Pellagrin’s too.

Quoting “ Inadequate levels of niacin slows metabolism and impairs functioning of the brain and nervous system, digestion, skin, DNA repair and other key cell processes, and steroid and sex hormone production. Severe deficiency of niacin causes the disease pellagra.2 “

I can not prove that Niacin helped me because I did not know to test for it or have the doctor test me for it but you can teach your doctor to look for i it in you if you are an IBS, NCGS, or Celiac patient by sharing the information in the Merck Manual with him/her.

To prove causal you will have to have your doctor test you for a Niacin deficiency verifying the International Journal of Celiac disease casual observation that the majority of Celiac are co-morbid with Pellagra establishing if not a causal link that it at least contributes to your concomitant GI conditions in at least the 50 percent of Celiacs’ who are low in Niacin and don’t know it.

Taking the Niacinamide as the Merck Manual notes in their key points for doctors can confirm the diagnosis.

Quoting “Use nicotinamide/Niacinamide to treat the deficiency; a favorable response can confirm the diagnosis.”

If you want to research more about Pellagra and how it can present as so many different diseases and its clinical presentation(s).

I say presentation(s) because if it begins with a “D” i.e., dementia, dermatitis or Digestive Disorders(s) (I added the S to Digestive Disorder because I think it speaks to the spectrum of diseases) that Pellagra can and is often confused for in modern medicine. And could be added to dementia(s) and dermatitis (s) see above about depression and Celiac and Pellagra meaning rough/sour skin in Italian and the Hindai link below to do more research on Pellagra if this blog post is not enough to answer all of your questions.

Read this great Hindawi article linked below for a great synopsis of Pellagra

https://www.hindawi.com/journals/cggr/2012/302875/

where they pose the question what role does Pellagra play in contemporary disease (today)

In one of their breakout paragraphs talking about Pellagra today! They discuss how Pellagra is still prevalent today in contemporary disease pathways entitled “Is Subclinical Pellagra Relevant to Contemporary Disease?”

And they list a dozen plus ways it is and I whole-heartily agree and I hope you do too after reading this post. And doing some of the research listed therein.

It bears repeating though I said it earlier **** Note: This is not medical advice and should not be considered such. Results may vary. Always consult your doctor before making any changes to your medical regimen.

Good luck on your journey and I hope it helps you the way it seemed to help me.

Posterboy by God’s Grace!

2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things” this included.

Blessed are those who will hear and take a Vitamin for their health or at least have their doctor check their Vitamin levels so they can get better from that morbidity if indeed as the International Journal of Celiac disease notes – Celiac’s are co-morbid with Pellagra in the Majority of celiac patients and the doctor’s don’t know yet to test for it but by having your doctor test your urine for low levels of Niacin it indicates you are retaining Niacin to maintain and repair your membranes the doctor can treat you for this morbidity a sign of undiagnosed Pellagra today.

Posterboy
I was/had been gluten free for 4 years.

I have heard that (maybe urban myth) that gluten doesn't bother me anymore.

How do I know gluten is bothering me again before it is too late?

I am still regular even when I ingest gluten accidently or can't resist cheating.

All I can think is my gluten allergy has gone away.

Is this possible? Or am I just pressing my luck for I relapse in to gluten sensitivity again,

Posterboy,