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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 Celiac.com's FREE weekly eNewsletter   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 What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes

Posterboy

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  1. Thyroid problems - maybe?

    Janewholovesrain, This is to the hair loss question since it doesn't seem to be thyroid related. Their is another thread on the celiac.com forum that talks about this very thing (hair loss). Knitty Kitty has done some great research about Vitamin/nutrient deficiencies that contribute to the problems you are experiencing. here again is the link for ease of reference. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5315033/#b2-dp0701a01 Be sure to look at each of the 3 tables. It is the heart of the research and simply list's associated conditions in summary form with each deficiency and whether "hair loss" is one of those symptoms. ***this is not medical advice but I hope this is helpful (((((hugs)))))) and you feel better soon. posterboy,
  2. Thyroid problems - maybe?

    JanewholovesRain, 96.2 is probably a little on the low side. I have a friend's who is lower than yours. . . but they do not have hair loss (unless you count a receding hair line) It is true your body temperature will fluctuate during the day. My body temperature is lowest in the morning but I consider my afternoon temperature my "true temperature". I hug 98.6 + or_ half a point in the evening but am well under that by a point or point and a half first thing in the morning when I awaken. but within the first hour of wakening up my thermostat (thyroid) perks up my body temperature by a whole point or more. It didn't use to do that. I/it was sluggish all day. I think beverage mentioned this. Selenium should be researched to help your thyroid not just Iodine. chris kresser has a free ebook on the topic of how to prickup you thyroid to normal levels. Brazil nuts are a good source of Selenium. He said selenium should be taken before Iodine (I don't remember why). You can buy some deluxe mixed nuts (Brazil nuts are in this mix) or by them separately and eat them as your snack. ***** this is is not medical advice but I hope it is helpful. I only know it helped my thyroid. good luck on your continued journey. posterboy by the grace of God,
  3. LilyR, Here are some threads that might be of help to you if you are struggling with IDA. https://www.celiac.com/gluten-free/topic/119240-diagnosed-with-ttg-iga-level-of-128-three-days-ago-trying-to-conceive-or-should-i-hold-off/?tab=comments#comment-981475 and this one that help explain your question about burping and bloating together. but in short yes. It is better when burping happens without being bloated. CARBS typically can be a trigger for bloating because they ferment. Other people on this board have noticed this effect they tolerate carbs better (Rice etc) when they eat either/or carbs not carbs and fats together. According to the Mayo Clinic Bloating maybe related to “eating fatty foods, which can delay stomach emptying and make you feel uncomfortably full . . . With bloating, you may also have abdominal pain that can vary from mild and dull to sharp and intense” http://www.mayoclinic.org/diseases-conditions/gas-and-gas-pains/in-depth/gas-and-gas-pains/ART-20044739 and could explain when you ate mashed potatoes (CARBS) alone you didn't have any problems but combined with fat you had a problem. It also explains why/when people who go Ketogenic or just plan oh low carb many of their GI problems improve (bloating etc). I think someone said the Suzanne Summers diet emphasized the "not mixing of fat and carbs" in the same meal. I hope this is helpful but this is not intended to be medical advice. posterboy by the grace of God,
  4. LilyR, "But I do think I might have to avoid corn". This is about the possible corn issue. It is an old forgotten disease but if you think you are having trouble with corn you need to research about Pellagra. You have probably never heard about it. see my blog post about it where I talk about how I had celiac disease but developed Pellagra. Knitty Kitty also talks about how she had Pellagra. Here is where celiac.com ran an article about how Pellagra can be confused for Celiac disease. https://www.celiac.com/articles/24658/1/A-Differential-Diagnosis-How-Pellagra-Can-be-Confused-with-Celiac-Disease/Page1.html The term is co-morbid. You can have both that occur in the same person though it is considered rare mainly because doctor's don't know to look for it today and have not studied it extensively. It probably don't explain the gluten problem however it most certainly can explain the corn problem(s) if you are having trouble with corn. I hope this is helpful and good luck on your continued journey. 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,
  5. Thyroid problems - maybe?

    Janewholovesrain, You can test you thyroid theory in one of two ways. Typically doctor's always took your temperature. They don't always do this now. But you can and verify your suspicions. A variation of 1 + or - of one point from a normal body temperature can tell you how your thyroid is working. And why doctor's historically test/take your temperature (and obviously if it is very high) fighting an infection. So paint a 1" size circle on your abdomen or thigh (somewhere you can see it easily) of Iodine and that is relatively hairless like your upper arm. If it disappears after 8 hours then your low in Iodine. It is called an Iodine loading test. Don't think it will interview with your TSH levels. You would have to treat over a 1/3 of your body to effect your thyroid. This is only to test if you body is low in iodine. I used to be low in Iodine and after my body stopped absorbing it through my skin my thyroid ( and body temperature) returned to normal levels. If you are only taking the B-complex once a day try upping it to 2/day or with each meal. It will take 3 months to make a notice difference when taking B-Vitamins. see this thread about inflammation and celiac disease that talks about the importance of taking your B-Vitamins with each meal. Again this will only need to be done for a cycle of 3 to 6 months for most people. here is the link for easy reference. https://www.ncbi.nlm.nih.gov/pubmed/7477807 quoting the abstract. (B-)Vitamin supplementation for 1 year improves mood. Benton D1, Haller J, Fordy J. Author information Abstract The possibility that the taking of vitamin supplements may influence mood was explored. One hundred and twenty-nine young healthy adults took either 10 times the recommended daily dose of 9 vitamins, or a placebo, under a double-blind procedure, for a year. Males taking the vitamins differed from those taking the placebo in that they reported themselves as feeling more 'agreeable' after 12 months. After 12 months the mood of females taking the vitamin supplement was significantly improved in that they felt more 'agreeable', more composed and reported better mental health. These changes in mood after a year occurred even though the blood status of 9 vitamins reached a plateau after 3 months: this improvement in mood was associated in particular with improved riboflavin and pyridoxine status. In females baseline thiamin status was associated with poor mood and an improvement in thiamin status after 3 months was associated with improved mood. Magnesium should be taking the same way 3/day as a Magnesium Glycinate to help improve your moods. here is the link https://www.ncbi.nlm.nih.gov/pubmed/16542786/ quoting from the abstract. "Case histories are presented showing rapid recovery (less than 7 days) from major depression using 125-300 mg of magnesium (as glycinate and taurinate) with each meal and at bedtime." I hope this is helpful. Except for Magnesium which I still take. Every Vitamin/Mineral I have ever taken has been for a cycle. It might be a 3 month cycle (as in B-Vitamin) or it might be for only a Month or it might be a cycle off 6 months. I don't know how long it will take for you. But It will only be a cycle. You won't take it forever if it is the right/missing nutrient. Taking it will improve your health if your body is missing in it. Again I hope this is helpful. *****this is not medical advice only my experience with some of the same issues and how supplementing helped me. you are on a good regime and people have given you good advice I might only try these things with each meal or 2/day if that is not convenient. good luck on your continued journey. 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,
  6. Janewholovesrain, I agree it can be quite confusing sometimes. They set the level so low that every "healthy person" it seems needs statin's these days. It is worse if you are prediabetic or diabetic. My cholesterol did not go too normal levels for a healthy person until I took Vitamin K though I never here anybody talk about how it can help. It might be the reason for the "French Paradox" of why they can eat fatty foods and still have low cholesterol. Butter is an excellent Vitamin K source and we villify it in the western diet. If you can't handle dairy in your diet try Ghee a dairy free form of Butter. Low fat is not all it is cracked up to be. Or else why does people who eat a ketogenic (fats and proteins) diet have great cholesterol levels. We need fat soluble vitamins i n our diet to keep us healthy. ****this is not medical advice but I have learned to love fat in moderation. Especially healthy fats. posterboy,
  7. Victoria1234, I think it is just "robo" generated leads. While/if you are reading this article then you might also read these articles with similar content. In one of the links they mention. "Celiac disease is diagnosed with both a blood test and biopsy. In one Canadian study, the average delay between symptoms starting and diagnosis was up to 12 years, Case said." supporting the research in the article that 90% of Canadians are/go undiagnosed for celiac disease. oddly enough they have the same article title (which is confusing) for both links but different content in the body of the article and might be part of your confusion. Because I know it confused me at first. I hope this is helpful. posterboy,
  8. Icelandgirl, I think I mentioned this before but Vitamin K really helped my cholesterol. I also had a friend who really swore by high dose Vitamin E but it didn't seem to help me. Raw Almonds and Sesame seeds are a good source of Vitamin E. Here is the Japanese research on Vitamin K. People who took K2 had excellent results at 6 months. http://journals.lww.com/ajnonline/Pages/articleviewer.aspx?year=1998&issue=06000&article=00049&type=Fulltext As if you are having trouble with Kidney stones you might try taking some Boron. https://www.ncbi.nlm.nih.gov/pubmed/25110210 here is the algaecal site summary on some of the possible boron benefits. https://www.algaecal.com/algaecal-ingredients/boron/boron-benefits/ And load up on Magnesium (3/day with meals) as Magnesium Citrate and/or Magnesium Glycinate preferably if cost is not an issue for you (glycinate can be more expensive) but doesn't have diarrhea issue Citrate can cause in higher doses. Here is Dr. Wilson's summary of why when low in Magnesium then calcium overloads/calcifies our organs. Note: he noted K (potassium) in this electrolyte balancing act. a K deficiency (Potassium) can be corrected by taking Magnesium. **** this is not medical advice but on one of the best articles (dr. Wilson) I have ever read on why being low in Magnesium creates so many problems. dr. wilson's summary. Summary: "Disorders of electrolyte homeostasis are known at many diseases and clinical situations. They have serious consequences for the cell. Mg-deficiency is followed by a K-deficiency, which cannot be equalized by K alone: a refractory hypokalemia always needs additional Mg supply for its restitution. From K, Mg-deficiency a Na/Ca-overload of the cell with aggravating consequences will follow: impaired activity and vitality with electric instability. Mg, which is responsible for development of a Ca-overload is also able to restore electrolyte homeostasis by sufficient supply competitively. The pathophysiologic relations for development of a cellular imbalance and its restitution concern the Na/K-pump, the Ca-pump and the Na/Ca-exchange. The clinical applications of Mg therefore are manifold: recovery under diuretic treatment, coronary heart disease, arrhythmias, perioperative electrolyte therapy, transcellular shifts, coronary dilatation and so on." I hope this is helpful. posterboy,
  9. Gluten_free_01, I have been out of pocket for a few days due to all my time being taken up doing some harvesting. But I wanted to respond to your question. For B-complex's it is not so much the amount b-50, b-100 etc as much as the frequency think with each meal or twice a day if that is not convenient. see this link https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772032/ entitled "B Vitamins and the Brain: Mechanisms, Dose and Efficacy—A Review". Read it all (the links) when you get a chance. see section 2.1. Brain Specific Roles of B Vitamins quoting section 2.1 "The brain is by far the most metabolically active organ in the body, representing only 2% of body weight but accounting for over 20% of the body’s total energy expenditure [38]. The B vitamins’ general metabolic functions, alongside their roles in neurochemical synthesis, may therefore be conceived as having a particular impact on brain function. Indeed, the importance of the B vitamins for brain function is illustrated by the fact that each vitamin is actively transported across the blood brain barrier and/or choroid plexus by dedicated transport mechanisms. Once in the brain, specific cellular uptake mechanisms dictate distribution, and, whilst the B vitamins all have high turnovers, ranging from 8% to 100% per day, their levels are tightly regulated by multiple homeostatic mechanisms in the brain [39,40]. This guarantees that brain concentrations remain comparatively high. For example, the concentration of methyltetrahydrofolate (the principal circulating form of folate) in the brain is four times that seen in plasma [39], whereas biotin and pantothenic acid exist in the brain at concentrations of up to 50 times that seen in plasma [41]." The point I want you take out of this is the bold. B-Vitamins as ravenwoodglass mentioned are water soluble and as such we "leak" out or consume/use up them every day at a 100% rate. Technically every 2 to 3 hours you can absorb more B-Vitamins and why it is best to take them with each meal to overcome a deficiency (if possible) if not twice a day will do. Especially if you use up a lot of energy (have a lot o stress) in your life. see also this link https://www.ncbi.nlm.nih.gov/pubmed/7477807 entitled "Vitamin supplementation for 1 year improves mood". which is a little misleading if you don't read the whole abstract. quoted here for context. Vitamin supplementation for 1 year improves mood. Benton D1, Haller J, Fordy J. Author information Abstract "The possibility that the taking of vitamin supplements may influence mood was explored. One hundred and twenty-nine young healthy adults took either 10 times the recommended daily dose of 9 vitamins, or a placebo, under a double-blind procedure, for a year. Males taking the vitamins differed from those taking the placebo in that they reported themselves as feeling more 'agreeable' after 12 months. After 12 months the mood of females taking the vitamin supplement was significantly improved in that they felt more 'agreeable', more composed and reported better mental health. These changes in mood after a year occurred even though the blood status of 9 vitamins reached a plateau after 3 months: this improvement in mood was associated in particular with improved riboflavin and pyridoxine status. In females baseline thiamin status was associated with poor mood and an improvement in thiamin status after 3 months was associated with improved mood." again see the bold. Taking B-Vitamins improves mood. . . . in only 3 months time. Coincidentally That is the approximate time/length our body can store our B-Vitamin's mostly in the liver. Notice though B-Vitamin levels peaked at 3 months (store in liver repleated) mood continue to improve for a year with supplementation meaning the body continued to benefit by B-Vitamin supplementation. I also point to dr.heaney's piece on things that control vitamin absorption. http://blogs.creighton.edu/heaney/2013/06/25/some-rules-for-studies-evaluating-nutrient-effects/ he has a great and illustrative piece where he brakes down Vitamin D and calcium interactions in the body. where he points very effectively quoting " Diets inadequate in one nutrient are almost always inadequate in several others as well." and how quoting where he mentions co-agents of absorption "Finally, studies may be null because of failure to optimize co-nutrient status." and why often (my words) we find studies (but he summarizes well) that "healthy individuals" do not benefit from supplementation. In his (Dr. Heaney's) words "Above that point more vitamin D does not produce more absorption. It has further been shown that even maximal vitamin D status will not compensate for calcium intakes below a certain level, i.e., even maximal absorption of not very much ingested calcium will result in not very much absorbed calcium." This explains why B-Vitamins are best taken as complexes because the low status of one vitamin can effect the status of the other vitamin's absorption. This one of the reason Folic acid levels are capped at 400mcg or 800 mcg because it can mask the effects of a B-12 deficiency. I know this is a lot to digest. But I hope this is helpful. *****this is not medical advice only my own experience and research with vitamin/minerals. I no longer take a b-complex but did 2 or 3/day for 3 or 4 months because after 3 months my liver had filled up it's reserve but I still benefit from repleting my B-Vitamin deficiencies. (I think year(s) later IMHO). If you want to read more about my experience with taking the B-Vitamin Niacin as the non-flushing Niacinamide form you can read my blog post on celiac.com People really shouldn't be afraid of/a B-Vitamin(s) but many people still are! OH I have had similar luck with Magnesium and I do still take Magnesium Glycinate 200mg 3/day and probably always will. see this link here how Magnesium helps with depression. https://www.ncbi.nlm.nih.gov/pubmed/16542786/ I only know it helped me. And I pray to God it helps you too! I really believe God helped me to understand these things for myself 2 Tim 2:7 and I am just trying to help others’ as I have received help of God 2 Cor 1: 3,4 . the Lord being my help. posterboy by the grace of God,
  10. cristiana and whitepaw, here is a good livestrong article link on marshmallow tea. http://www.livestrong.com/article/117015-marshmallow-root-tea-benefits/ if you scroll down the link they also have similar tea's like comfrey that they talk about. Look up Mucilage's and you will see several digestive aides. You are probably most familiar with Licorice. Mucilages occur in a class of herbs called demulcent's. this link has a good overview of demulcent herbs. https://thenaturopathicherbalist.com/herbal-actions/b-d/demulcent-2/ It is/should come as no surprise slippery elm is in that class of herbs. I hope this is helpful. **** this is not medical advice. posterboy,
  11. whitepaw, I think cristiana commented on this thread. It is about IDA that talks about some of the same issues. If you get a chance you might read through it. some of the same issues are mentioned. I would point out this link in the topic as a good article about stomach acid and how many people get locked into taking it for much longer than ever intended. https://chriskresser.com/what-everybody-ought-to-know-but-doesnt-about-heartburn-gerd/ it is actually a three part series this is only the overview. Originally PPI's etc were only ever to be used for those who have an ulcer to give time for the stomach to heal . . . but now people take them soo long they develop acid rebound reflux when they try and stop them. Going low carb or ketogenic is the easiest way to transition off of them . . . but even that doesn't work for some people as Ennis_tx mentioned. For those still having trouble digestive enyzmes/aides are a good alternative like the slippery elm or marshmallow people use instead. Many people find sipping on Marshmallow tea works well. I don't know where it is currently but there is an exhaustive thread between me and Ennis_tx that discusses the pros and con's he mentioned of continuing or discontinuing and the challenges with each course. Maybe when I have more time I will look it up or maybe Ennis_tx can post it. I hope this helpful. posterboy,
  12. Feenyja, Have you tried B-12 for the tingling in the extremities. I used to have the same problem. see this link "Multiple sclerosis and vitamin B12 metabolism." https://www.ncbi.nlm.nih.gov/pubmed/1430153 but I found when I addressed my Vitamin(s) deficiencies my condition (nerve inflammation) got better and why I love Vitamin(s). It is the natural way for us to manage stress which leads to inflammation . . . thus disease in time. *** this in not medical advice but I found it helped my tingling (especially at night) when it would wake me from my sleep a classic sign of Pernicious Anemia. the way I see it (my own opinion) if after taking a vitamin/mineral the condition that remains (if it remains) is the true disease. For example Magnesium Citrate helped my fatigue to the point I no longer have Chronic Fatigue syndrome symptom's thus I deduce I had low Magnesium levels. The same way B-12 helped my tingling (though I tested low for it) and was officially diagnosed for Pernicious Anemia but no longer have that diagnosis now that the symptom's have gone away. And pernicious anemia if not properly diagnosed might could be considered MS in some patients. I hope this is helpful. 2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things” posterboy,
  13. ironictruth, I want to follow up on Knitty Kitty's reasoning. I read over it the first time I read your post. When I saw her post on PPI's then it struck me. I think it is the Zantac. see this link https://www.ncbi.nlm.nih.gov/pubmed/15455980 quoting "Our observations support the probability that the profound hypochlorhydria induced by omeprazole may indeed impair the optimal absorption of orally administered iron in iron-deficient individuals, precluding them from obtaining therapeutically adequate amounts to establish the positive balance necessary for the resolution of anemia and the replenishment of stores." and this link quoting https://www.ncbi.nlm.nih.gov/pubmed/21150767 "Omeprazole and possibly all proton pump inhibitors decrease the absorption of oral iron supplementation. Iron-deficient patients taking proton pump inhibitors may have to be treated with high dose iron therapy for a longer duration or with intravenous iron therapy." And I know Zantac is H-2 blocker and not a PPI's but the effect is the same. I wrote about my experience with low stomach acid being diagnosed as high stomach in my posterboy blog post. https://www.celiac.com/gluten-free/blogs/entry/2106-is-ncgs-andor-celiac-disease-really-low-stomach-acid-misdiagnosed/ And I know why people take it . . . to relieve the symptom's but if they (symptom's) keep coming back when you stop taking them you are having acid rebound a classic symptom of stopping the medicine. chris kresser covers this topic well. https://chriskresser.com/what-everybody-ought-to-know-but-doesnt-about-heartburn-gerd/ going low carb can help or even ketogenic (low carb on steroids) if removing carbs helped the heartburn then it will also help lessen the rebound symptom's. I hope this his helpful. . . but I find most people when they start acid reducer's rarely get off of them. It is called attachment rate in medical lingo and it acid rebound of (PPI's) are part of the reason why they replaced H-2 in the marketplace because they block more of the stomach acid than H-2 blockers and are thus harder to get off of once started. If your stomach acid was truly high as you hear. Eating food would only lower the stomach acid improving the condition. Timeline say's it is already too low to absorb Iron and thus lowering if further by taking an H-2 blocker lowered your Iron levels to critical levels because you could no longer absorb the food you were eating. I think of Stomach acid like lime on a field. It changes the pH to an optimal level to absorb nutrients. Low Stomach Acid equals low Nutrient absorption especially those nutrients that need a strong acid (like Iron) for absorption. This is the best research article I have seen on the subject. entitled "Association of Long-term Proton Pump Inhibitor Therapy with Bone Fractures and effects on Absorption of Calcium, Vitamin B12, Iron, and Magnesium" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974811/ see their section on Iron absorption. Again I hope this is helpful. posterboy,
  14. ironictruth, I see people have already mentioned the Vitamin C trick to help iron absorption. Read this thread about IDA I think you will find it very informative if you have not already read it. https://www.celiac.com/gluten-free/topic/119240-diagnosed-with-ttg-iga-level-of-128-three-days-ago-trying-to-conceive-or-should-i-hold-off/?tab=comments#comment-981475 I linked to this research in the thread but I never see anybody else mention this but Beta Carotene think Carrots is very good about changing the pH at which Iron can be absorbed thus improving digestion. Here is the research on Beta Carotene. http://jn.nutrition.org/content/128/3/646.full entitled "Vitamin A and β-Carotene Can Improve Nonheme Iron Absorption from Rice, Wheat and Corn by Humans" they note quoting "Solubility tests demonstrated that vitamin A and β-carotene are capable of solubilizing iron at pH 6. It seems that β-carotene is more efficient that vitamin A at least for ferrous fumarate. This is may be due to a greater stability of β-carotene to storage, handling and pH changes." I hope this is helpful. Also you didn't say what form of Magnesium you are taking. Magnesium Citrate or preferably Magnesium Glycinate works best (no diarrhea issues sometime citrate's can cause) ***this is not medical advice but I do hope it helps you with your IDA/iron levels. posterboy,
  15. cyclinglady, you are right to resist statins for your hubby. I went from fatty liver to pre-diabetes taking statins and have managed as you say "eating to my meter" my blood sugar with good results every since. Statins are especially bad/worse (or at least they admit for women) for women and they might be the same for men if they studied "this safest of all drugs" for this condition/side effect of possibly increasing the (pre)diabetes it meant to stop by making the fatty liver better but people get diabetes at a higher rate when taking statins. https://www.sciencedaily.com/releases/2017/03/170315094520.htm quoting "UQ (University of Queensland) School of Public Health researcher Dr Mark Jones said women over 75 faced a 33 per cent higher chance of developing diabetes if they were taking statins. The risk increased to over 50 per cent for women taking higher doses of statins." I told my friend about this same issue who went diabetic from taking stains and developed UC from taking metformin. She has horrible diarrhea especially when she misses doses of metformin being diagnosed as UC instead of a side effect of this "most safe" of front line medicines for diabetes. She developed diabetes after two years of taking statins. Inflammation is a killer the problem is it is often from medicine meant (thought) to help often one thing while making some other condition worse like her GI problems. posterboy,