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To All, Who might read this Posterboy blog post. Some house keeping to start with by way of some notes: This is as I see it currently so this a "Cliff Notes" version as a working hypothesis to keep it short enough to read…. I didn’t mention Magnesium or explain how Magnesium Is necessary for the body to use….Thiamine as an example… see Addendum at the end if you have more interest of learning how Pellagra, Beri Beri and Pellagra Sine Pellgra presents today ALL together in the same person today in America as NCGS and/or Celiac disease with or without DH as a presenting symptoms and How and Why this is possible! If their is interest this Posterboy blog post can be made into an article....I am just trying to get it out their in "Grey Paper" format... As a Posterboy blog post.... .in my eclectic, rambling style.... So people can find it.....and react to it if they wish....my forum time has been reduced lately...so I am just sharing to get this "off my chest" so to speak....and I hope Lord willing, it helps someone else......I can't be the only one! The B-Vitamin and Immune Health document mentioned B5 Panothenic Acid and Biotin being important as well possibly Folic Acid…. but I am not sure how they fit in the model. I think it is as least 6 to 8 things (Vitamins/Minerals) that are needed to regulate our immune system… I have identified these 4 four In this Posterboy blog post B1, B2, B3, and Zinc…..with Magnesium definitely being a fifth one (beyond the scope of this blog post)….. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478888/ Maybe Knitty Kitty can pick up the mantle and add to this discussion…. At least one researcher also mentions a Cooper deficiency as a possible cause of Villous atrophy….but they might be just noticing the Zinc deficiency common in Celiac's since Zinc/Copper have a symbiotic relationship in the body.... Kind of like Vitamin D/Calcium or Magnesium/Calcium.....they are Co-Factors for each other...and why this is very hard to figure to out! but you can only cover so much in one blog post… But I think these 5 are a great place to start (Note: I include Magnesium) in this list as a Co-factor for Thiamine but I don’t’ have time to explain it here in this blog post… If you want to see more how Magnesium is important in Chronic Fatigue specifically see this online article about Magnesium’s role in ME/CFS. http://simmaronresearch.com/2015/08/epstein-barr-virus-the-magnesium-connection/ As always, I hope this is helpful but it is not medical advise. This blog post starts now..... This Posterboy blog post was triggered by the thread “Unique antibody profile differentiates people between non celiac gluten sensitivity aka NCGS and Celiac disease” This theory, opinion and hypotheses are not endorsed by Celiac.com they are the ideas of the Posterboy alone and should not be considered medical advice. I am not trying to diagnose by sharing my insights, ideas and research but only to educate and inform that B-Vitamins, in part, help regulate our Immune System and this idea needs further study and research on this topic to confirm this working hypothesis. It is based on this latest research entitled “Metabolism of Dietary and Microbial Vitamin B Family in the Regulation of Host Immunity” published in the Frontiers of Nutrition Circa 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478888/ The problem is we can’t wait another 20 years if this is right….people are suffering from B-Vitamin deficiencies today! It will be at least that long before Clinical practice catches up with the research that Host Immunity IE Celiac disease can, in part, be triggered by low B-Vitamin status. I have learned to say in, in part……. This is only part of the equation….but it is an important part of the equation….that has been too long overlooked! Now back to the thread that triggered this thought idea… We know B1 can thin Villi… From the above thread we know that Vitamin B2 kicks up our immune response. From a previous thread/research we know Vitamin B3 can treat a Leaky Gut in Alcoholics… See this research entitled “Intestinal permeability (IE Leaky Gut) and oxidative stress in patients with alcoholic pellagra” https://pubmed.ncbi.nlm.nih.gov/16713031/ See this thread where this topic is discussed in more detail… In this thread user/moderator kareng pushed me to be more inclusive/comprehensive in my views…. Not restricting myself to one Vitamin alone……so, in part, this is a response to this criticism… IF the data doesn’t fit the facts you must iterate… Here is what is happening (IMO)….B1 (Thiamine), B2 (Riboflavin), B3 (Niacin) vitamin deficiencies are being diagnosed as Celiac disease today… Think of it as a 3 alarm fire! The first alarm is Vitamin B1 aka Thiamine….you get thin villi and your immune system is triggered and you develop NCGS. The 2nd alarm is Vitamin B2 aka Riboflavin….your auto-immune response is ratcheted up…. And you are diagnosed as having Celiac disease. The 3rd alarm is Vitamin B3 aka Niacin or Niacinamide….your GI tract begins to leak from the Oxidative stress it is now under… What I don’t is how and what other Vitamins play in this auto-immune reaction…. At least, in part, Zinc plays a role in host immunity by changing/modifying the Th1/Th2 balance….IE Immune Homeostasis…. which almost 60% of Celiacs’ are low in at the time of their diagnosis… See this research from the Journal of Infectious diseases entitled “Effects of Zinc Deficiency on Th1 and Th2 Cytokine Shifts” https://academic.oup.com/jid/article/182/Supplement_1/S62/2191506 It shouldn’t surprise us/you by now that this research is 20 years old….because doctor’s don’t know how to incorporate Vitamins in to a genetic model! Being low in Vitamins/Minerals are making us sick, sometimes very sick! Again, see this research 20 years old (not surprisingly) has been overlooked for 20 years… Entitled “Zinc-Altered Immune Function and Cytokine Production” from the Journal of Nutrition…. https://academic.oup.com/jn/article/130/5/1407S/4686394 And since Zinc Is not a medicine (Or other B-Vitamins to be matter of Fact)…..it can be ignored as a possible treatment… See this recent research on low Zinc blood levels in Corona virus patients… Entitled “Lower zinc levels in the blood are associated with an increased risk (2.3x rate) of death in patients with COVID-19” https://medicalxpress.com/news/2020-09-zinc-blood-death-patients-covid-.html How long can we afford to overlook the fact that nutrition governs our genes…. Can you wait another 20 years before medical science wakes up to the fact that B-Vitamins are important for Immune Homeostasis! And could be triggering a 3 alarm metabolic fire showing up eventually as Pellagra being misdiagnosed as DH instead. Let’s recap for easy review…B-Vitamins never deficiencies never occur alone IE uncomplicated. B-1 deficiency occurs with a B-2 deficiency. Having one or both will lead to Villous Atrophy and a subsequent NCGS or Celiac disease depending on the stage of the metabolic fire. Is it a stage 1 alarm fire or a stage 2 alarm fire! If it is a stage 3 fire IE a stage three alarm fire then you have developed Pellagra being diagnosed as DH instead today! How do we know this…because DH was once treated with Niacin (hence we can say for sure DH is Pellagra in disguise today) and not just once….but good studies exist from more than 15 years before antibodies tied DH to Celiac disease…? In fact, as late the 1950’s DH was regularly being treated with Niacin! Being conservative we know it was until the late 60’s and early 70’s until antibodies tied DH to Celiac disease seemingly for good discarding approx.. .. 15 plus years of good clinical practice of using Niacin(amide) to treat DH! IE, Of DH responding to Niacin(amide) treatment…has been lost to history for 50+ years! The Dermatology Advisor confirms this reporting DH responding to Niacinamide treatment in less than a month or 2 to 3 three weeks on average when Dapsone treatment fails for the treatment of DH. https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/dermatitis-herpetiformis-duhring-disease/ Here is the link to the original research if there is any interest… https://core.ac.uk/download/pdf/82674034.pdf Every now and then an intrepid researcher will rediscover this fact…..that DH can be treated with Niacin(amide)…. but it promptly is forgotten! or not believed??? or Dismissed as being a "Small Study".... See this research entitled “Two Cases of Dermatitis Herpetiformis Successfully Treated with Tetracycline and Niacinamide” as published in 2018 https://pubmed.ncbi.nlm.nih.gov/30390734/ This is good news! And should be shouted from the roof tops! But people get hit with a “genetic” dumb stick because we don’t think Vitamins can regulate our genes…. but about 90% of the time today we think it is a one way street… But we get stuck in our genetic silos believing it is our destiny! See the a the movie “The Knights Tale for this logic/way of thinking our “destiny in written in our Genes/Stars”…. Well it is time to realize/admit our nutritional status can and does affect our genes and trigger disease! He changed his “Stars” destiny fortune and you can change your health too if you are willing to try and take some B-Vitamins for health! I did mine! PTL! It is a two way street, Genes and Vitamins interact to regulate our health! If you want a big picture view (analogy) of how this happens see happens see this Posterboy blog post about how I lay this out analogy as a child that grows up into adult hood (Pellagra) as the disease develops through its stages! 2 Timothy 2:7 As always, “Consider what I say; and the Lord give thee understanding in all things” this included. I hope this is helpful, but it is not medical advice. Posterboy by the grace of God, ADDENDUM: This from the thread “Been severely let down and at my wits end” started by the user Never Like Rollercoasters…. and how you can feel when you low are in B-Vitamins! I will quote from it IE from the Posterboy (me) because it summarizes well what I said in a few short paragraphs with out me having to retype everything again… Never Liked Roller Coasters and Cyclinglady et Al, I have written a Posterboy blog post that might help you. I have tried to share my experience so that others might be helped by my suffering going undiagnosed. The symmetrical rash could be the first sign that Pellagra is developing.... It (Pellagra) like Cyclinglady notes about Beri Beri too is hard to diagnose by tests.....instead just taking the B-Complex with Benfotaimine is usually enough to treat the symptom's and/or with Magnesium Glycinate/Citrate (as a Co-factor) to help active the the fat soluble Thiamine IE Benfotiamine you are now taking! Cyclinglady (correct me if I am wrong) JM34 (Or someone close to that name) once tested for a Niacin deficiency and they found him to be borderline low....then we lost contact with him.... B-Vitamin deficiencies don't happen in uncomplicated way (usually) they occur together.... See this article about a case of Pellagra in America... https://casereports.bmj.com/content/12/9/e230972 I will quote the test results... "Vitamin testing revealed normal B12 and folate levels but undetectable levels of Thiamine (B1), Riboflavin (B2) and Niacin (B3). Her symptoms and signs resolved entirely with appropriate vitamin supplementation. Pellagra in Italian means "rough skin" and hence the name that comes to us... The clinical delay in recognizing vitamin deficiencies in Celiac's is causing many treatable co-morbidities like fatigue to go untreated when a simple supplementation program can help in addition to going gluten free.... These are complimentary things.... Micronutrients are low in Celiac's.....it is not well known but recent research is now bearing this out... And it should be noted that Low Thiamine levels has been shown to Thin Villi in Mammals.... Here is an article about it... I would also recommend this youtube link to you...entitled "Is Thiamine Deficiency Destroying Your Digestive Health Why B1 Is ESSENTIAL For Gut Function" It is little over an hour....so I will give you some notes (bookmark) of things to look for that I made for myself.... so you won't have to watch it all.....and give you some points to look at briefly... 30 minutes GI or Intestine contractions 35 minute reduces brush border enzymes like Lactose Interolance Note: they were diagnosed with Pellagra a CAPSTONE diagnosis but they had already developed Beri Beri and Pellagra Sine Pellagra (which is what happened to me) evidenced by undetectable levels of Riboflavin and Niacin. Meaning they (the doctors) had already missed two CORNERSTONE diseases triggered by B-Vitamin deficiencies BEFORE the capstone symptom's developed of per fuse skin lesions....(see research from the 1950s above) showing how Niacin treats DH! As I once said in a Posterboy blog post Vitamins these days have a KIA problem....Knowledge, Image and Awareness problem. As always I hope this is helpful but it is not medical advise. I could go on and on and on . .. but there is no need for that. I need to stop for now. Either you will believe and be helped or go on suffering needlessly if indeed Pellagra and Beri Beri is the parent disease(s) and GERD, IBS, UC, Chrons, NCGS and Celiac disease it‘s unruly children. 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, by the comfort wherewith we ourselves are comforted of God.” ****Again this is not medical advice but it is too easy, simple and cheap not to try and see if it works for you . . . Remember Occams’ Razor. . . The Simple answer is a Vitamin. But convincing people of that fact has not been simple or easy. I can’t convince you either way. You will have to decide for yourself . . . I only know it help’s those (of my friends) who have tried it for themselves with their heartburn aka GERD and IBS, UC, NCGS etc.. .(for those not already on an acid reducer like a PPIs already....) Praise bee to God and I want other’s still suffering from Pellagra (if you have developed DH) and Beri Beri disease if the research is to be believed being diagnosed as Celiac disease or NCGS to be the next to be helped Praise bee to God! But I know now you will have to discover it for yourself. I stand as your witness. I tried! As always, “Consider what I say; and the Lord give thee understanding in all things” 2 Timothy 2:7, this included. Posterboy by the Grace of God,