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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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I've never struggled to control my emotions, love people, love being busy and am generally easy going.

But since being gluten free 3 weeks now, I've just been sad. I've had 3 or 4 public tears, well meltdowns actually. :) Just feeling like I can't anymore, emotionally.

My symptoms have subsided since being gluten free, which makes my body happier, but my emotions are really struggling.

I can't think of anything else that it can be, other than maybe tiredness, cause I'm not sleeping that well. Is that normal, to be so emotionally unstable after starting a gluten free diet?

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I am sure it is normal... I've shed tears too. Once just because someone made something gluten free for me and I didn't expect it. There is definitely a grieving process especially when you have a life change like this. I've heard others talk about this too. You need a HUG!!! :)

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Hi Brigit, you are going through a grieving process yes, but for a lot of us it can be from gluten withdrawal also. Just hang in there and one morning you'll wake up and it'll be gone.

Wish you well.

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I had several emotional meltdowns in the beginning because I felt like everything had to be from scratch and really complicated. Since that has since been disproven ;) it's all good. :) Give yourself time. It does get easier.

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I've been gluten free almost 4 weeks now. First 3 were brutal. I'm just now starting to feel a bit of light at the end of the tunnel. Headaches aren't as bad and I'm not all over the place emotionally (the sunny warm might have something to do with it though). From what I hear, it can take a few months to really feel better. That's the only thing keeping me going at this point. This week, I FEEL better, but I want gluten foods very badly. I'm hoping the craving phase goes away by this weekend. Luckily, my favorite wine is gluten free! That should help!

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Thanks ladies!

I struggled to get up this morning and was miserable all the way through my puffed rice cereal. :) But on the way to work decided to put a brave face on and celebrate and be thankful for the good things that are happening because I've cut out gluten.

So I'll start celebrating soon... maybe after a glass of wine or two ;)

Seriously though, thanks for the advice and encouragement, it's really appreciated. When I told my husband how I was feeling, he answered; "why don't you ask The Forum, maybe someone there can tell you if it's normal and what to expect." :) Yay for this forum! :)

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Have you had all your nutrient levels checked, Brigit? I ask because I have always been a positive, upbeat person but was finding myself feeling very teary and sorry for myself, would almost start crying if someone showed some empathy - like when I went to my doc who is great and I love her. I was almost what they would call emotionally labile (I worked in a psychiatric clinic once :D ). One of the problems was my thyroid which I made her check, and the result was that not only was it low but I I was really low in B12, folate and Vit. D, amongst other things (which I also made her check - and the reason I say she is great is not because she knows a lot but she will do what I ask :) ) This is why I say we all have to be as informed as, if not better than, our doctors about this condition because we need to tell them what we need. So everything was below par, and once I got my body on an even keel all this emotional stuff went away. This is one reason I rail on about doctors who blame everything on stress and female hormones and emotions, when in actual fact it is imbalances in our bodies that is causing the emotions and none of them are trained to recognize this. Medical schools - teach your doctors basic nutrition!!! :ph34r: I swear to God they must have a class in medical school about female emotions and how to pat them on the shoulder and say "there, there" :wacko: I actually had one do that to me once :huh: He never saw my face in his door again.

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I like your attitude! :) I've not had my levels checked, the period leading up to this time, the doctor had me on iron drips every two weeks and doing all sorts of other checks on me, none that came back positive as they weren't anything to do with Celiac, so because of all the doctors visits we are financially strapped now for a month or two.

It was definitely that same attitude the whole time, like I must just be stressed or depressed. Meanwhile, my body isn't working the way it should be.

Once we have money, I'll be going for more help, right now I'm just doing what I can.

I've been given a name of a doctor who is a homeopath with medical background, she has worked extensively with autistic children who she had on gluten free diets and lots of patients with various other diet issues. So I'm looking forward to being able to see her and to be helped properly.

Until then, I've upped my mineral & vitamin doses, cut out gluten and using all your advice which is serving me well!

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You are likely going through withdrawl and hopefully it will lift soon. It also is a big change and many of us do go through a grieving process as the others have mentioned. By the time you have the financial means to see the homeopathic doctor you may be feeling great. Do be aware that not all naturopathic doctors are as up on celiac and how sensitive we are as they should be. I saw one who had the rep of being the best in my state and he glutened me with every very expensive thing he 'prescribed' me. He had the attitude that 'just a little bit' in his remedies won't hurt. They did and not just my body but also my pocketbook. Not saying yours won't be good but wanted you to be careful and to research what she may give you.

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Hey lady! Hang in there. I think we were both diagnosed around the same time. No joking, it can be rough. Here is what I learned that has helped with the sadness. I got tested for B12, iron deficiency, and Vit D. The results: I have stage 2 iron deficiency (close to iron anemia) and a Vit D deficiency. thank goodness my B12 is ok. But these are common things with Celiac. So my MD had me start some supplements. After reading up on these issues I learned that ANY deficiency can contribute to mood. Meaning sadness, irritability, tiredness, depression. It made a LOT of sense for me! I do feel a LOT better with the added supplements. Not sure if you have been tested or not, but would suggest you ask your doctor, if not. I feel SO much better, happier, and such. So yes, hang in there, you can do it! Wish you the best, Emma

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Hey lady! Hang in there. I think we were both diagnosed around the same time. No joking, it can be rough. Here is what I learned that has helped with the sadness. I got tested for B12, iron deficiency, and Vit D. The results: I have stage 2 iron deficiency (close to iron anemia) and a Vit D deficiency. thank goodness my B12 is ok. But these are common things with Celiac. So my MD had me start some supplements. After reading up on these issues I learned that ANY deficiency can contribute to mood. Meaning sadness, irritability, tiredness, depression. It made a LOT of sense for me! I do feel a LOT better with the added supplements. Not sure if you have been tested or not, but would suggest you ask your doctor, if not. I feel SO much better, happier, and such. So yes, hang in there, you can do it! Wish you the best, Emma

IF your B12 level was below 500 you may want to try a sublingual B12 even if the levels say that you are in the normal range. It can take a long time for the blood levels to drop even after we are unable to utilize the B12. Some doctors still use the 250 lower level, mine did. B12 is water soluable so taking too much is not going to hurt you as you will simply excrete what the body can't use. Do use the sublingual form as you won't absorb it from swallowed vitamins until you have healed.

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You are likely going through withdrawl and hopefully it will lift soon. It also is a big change and many of us do go through a grieving process as the others have mentioned. By the time you have the financial means to see the homeopathic doctor you may be feeling great. Do be aware that not all naturopathic doctors are as up on celiac and how sensitive we are as they should be. I saw one who had the rep of being the best in my state and he glutened me with every very expensive thing he 'prescribed' me. He had the attitude that 'just a little bit' in his remedies won't hurt. They did and not just my body but also my pocketbook. Not saying yours won't be good but wanted you to be careful and to research what she may give you.

Thank you! I'll definitely research the doctors advice. I've spent a lot of time on the internet since being gluten free!

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Hey lady! Hang in there. I think we were both diagnosed around the same time. No joking, it can be rough. Here is what I learned that has helped with the sadness. I got tested for B12, iron deficiency, and Vit D. The results: I have stage 2 iron deficiency (close to iron anemia) and a Vit D deficiency. thank goodness my B12 is ok. But these are common things with Celiac. So my MD had me start some supplements. After reading up on these issues I learned that ANY deficiency can contribute to mood. Meaning sadness, irritability, tiredness, depression. It made a LOT of sense for me! I do feel a LOT better with the added supplements. Not sure if you have been tested or not, but would suggest you ask your doctor, if not. I feel SO much better, happier, and such. So yes, hang in there, you can do it! Wish you the best, Emma

Hi Emma,

thanks for the kind words! I am needing to up my supplements, but I stupidly bought supplements from a pharmacy, and since learned that their doses are ridiculously low for my needs. I've since found a healthshop that has what I need, so I'll be getting what I need there.

Crazy hey, how some basic mineral and vitamin shortage can mess with us so dramatically!

All the best to you to - trust to hear wonderful stories of success from you in the future. :)

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Hi Emma,

thanks for the kind words! I am needing to up my supplements, but I stupidly bought supplements from a pharmacy, and since learned that their doses are ridiculously low for my needs. I've since found a healthshop that has what I need, so I'll be getting what I need there.

Crazy hey, how some basic mineral and vitamin shortage can mess with us so dramatically!

All the best to you to - trust to hear wonderful stories of success from you in the future. :)

Check out Pilgrams Pride online they show their ingredients so you can confirm it's gluten free. All their bottles are buy one get one free and I think they are much cheaper than any vitamin store/health food store in my area.

I too am rather broke so I've been bargain hunting. :)

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Hi Brigit!

YES! I am feeling the same moodiness (totally unlike my happy personality :blink: ) and have been fighting off depression and tears. I was crying every day for 3 years :unsure: before I stopped the gluten. Sometimes, I even had RAGE :blink: but at least now, it has been better. And I KNOW why I was so "nutsy". It never made any sense to me, although I also have chronic pain, so I was "down",,,but this continued gloominess was certainly connected to the gluten. I am feeling the clouds "lifting" gradually and so, I feel reassured it will resolve. (BTW, I refused anti-depressants from doctors who felt that all of this illness was "in my head" HA!) Idiots!

If you are eating well, taking vitamins, and staying off the gluten, it WILL get better.

One thing I know, my HORMONES took a big whack from the gluten---not just thyroid, but female hormones and so, it is likely everything inside of you is realigning, balancing and reorganizing.

Doctors underestimate the widespread damage gluten does to the body. It affects EVERYTHING--organs, tissues, mucosa--and so, as it leaves the body, the gut repairs and the neurotransmitters, like seratonin--will start to work as they should in your brain.

You may be having trouble sleeping right now, but it will subside as well. I could not sleep well for YEARS, at one point, only 1 or 2 hours a night!! but now, I am starting to get almost 6. I celebrate this and see the connection to how long I am gluten-free! (almost 3 months)

I wish it would happen faster :) because it is difficult to be moody and weepy (who likes that??! UGH!) yet I feel certain it will level off as time passes. Almost all of these women have told me the same thing...time heals all of the things that have been affected by the celiac.

I went to a Naturopath for 2.5 years before my diagnosis. I spent thousands of dollars on supplements. My husband and I were desperate for me to be well and no one in the mainstream medical world could help me. The supplements did nothing for me---the gluten was the key --and all the supplements in the world are useless when the gut cannot absorb them. I would hate to see you waste money as well. JUST MY HUMBLE OPINION.

Taking Vit. D-3 and B-12 usually resolve the low feelings. when you can afford it, it would not hurt to have your thyroid levels checked, but they too level off after being gluten free sometimes.

Give your body some time, hon. You are still in withdrawal!! You are young, so you will heal faster!! Hang in there. Here's a ((HUG)).

best wishes!! :)

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Hi Brigit!

YES! I am feeling the same moodiness (totally unlike my happy personality :blink: ) and have been fighting off depression and tears. I was crying every day for 3 years :unsure: before I stopped the gluten. Sometimes, I even had RAGE :blink: but at least now, it has been better. And I KNOW why I was so "nutsy". It never made any sense to me, although I also have chronic pain, so I was "down",,,but this continued gloominess was certainly connected to the gluten. I am feeling the clouds "lifting" gradually and so, I feel reassured it will resolve. (BTW, I refused anti-depressants from doctors who felt that all of this illness was "in my head" HA!) Idiots!

If you are eating well, taking vitamins, and staying off the gluten, it WILL get better.

One thing I know, my HORMONES took a big whack from the gluten---not just thyroid, but female hormones and so, it is likely everything inside of you is realigning, balancing and reorganizing.

Doctors underestimate the widespread damage gluten does to the body. It affects EVERYTHING--organs, tissues, mucosa--and so, as it leaves the body, the gut repairs and the neurotransmitters, like seratonin--will start to work as they should in your brain.

You may be having trouble sleeping right now, but it will subside as well. I could not sleep well for YEARS, at one point, only 1 or 2 hours a night!! but now, I am starting to get almost 6. I celebrate this and see the connection to how long I am gluten-free! (almost 3 months)

I wish it would happen faster :) because it is difficult to be moody and weepy (who likes that??! UGH!) yet I feel certain it will level off as time passes. Almost all of these women have told me the same thing...time heals all of the things that have been affected by the celiac.

I went to a Naturopath for 2.5 years before my diagnosis. I spent thousands of dollars on supplements. My husband and I were desperate for me to be well and no one in the mainstream medical world could help me. The supplements did nothing for me---the gluten was the key --and all the supplements in the world are useless when the gut cannot absorb them. I would hate to see you waste money as well. JUST MY HUMBLE OPINION.

Taking Vit. D-3 and B-12 usually resolve the low feelings. when you can afford it, it would not hurt to have your thyroid levels checked, but they too level off after being gluten free sometimes.

Give your body some time, hon. You are still in withdrawal!! You are young, so you will heal faster!! Hang in there. Here's a ((HUG)).

best wishes!! :)

:) :) :) Thank you!

I've been copying and pasting parts of all your posts for my husband to see, so he to can see there is a brighter future awaiting. :)

Thank you, I really appreciated your response.

All the best to you, trusting you'll be going from strength to strength as well!

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I do not know if you have ever read my whole story, but the many symptoms that developed in me took years. I have a long journey to heal all that has gone awry. I am in grueling physical therapy.

But, you! You are young and have been diagnosed early. This is GOOD because it will prevent you from acquiring more autoimmune disease. I am certain you will feel better and better in the coming months.

I trust you are under the care of the doctor who diagnosed you?

We are very blessed because we have husbands who love us very much and are sticking by us . :D Others have been deserted by their spouses or families and that has made their healing all the more difficult. Very sad.

Take care and please feel free to "talk" to me anytime! :)

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I am on here looking for something to tell me that my depression will go away when I stop eating gluten but it doesn't seem like that's going to happen overnight huh? (I'm still eating gluten until my endoscopy in April.)

I have had ups and downs in the past but the past few days I've been having the worst depression ever. Since I got the blood test results I have been blaming my moods on celiac but honestly I don't know what is wrong with me.

I'm unhappy about everything in my life, and just a few months ago I felt normal/happy. At first my feeling about the endoscopy was fear that I won't wake up from the anesthesia (I get paranoid about that kind of thing) but today I was actually thinking wouldn't that be nice if I didn't wake up. I don't really want to die but that's how I feel right now.

I can't stop crying and I don't have anyone to talk to; everyone close to me has worse problems than mine (mom and sister both going through divorces for example) and my husband is at work all the time. My little boy today saw me crying and I had to say "I'm just tired." I feel like a failure as a mother/wife/human being. I hope it does get better after I quit gluten and I don't get into an even worse funk...

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I am on here looking for something to tell me that my depression will go away when I stop eating gluten but it doesn't seem like that's going to happen overnight huh? (I'm still eating gluten until my endoscopy in April.)

I have had ups and downs in the past but the past few days I've been having the worst depression ever. Since I got the blood test results I have been blaming my moods on celiac but honestly I don't know what is wrong with me.

I'm unhappy about everything in my life, and just a few months ago I felt normal/happy. At first my feeling about the endoscopy was fear that I won't wake up from the anesthesia (I get paranoid about that kind of thing) but today I was actually thinking wouldn't that be nice if I didn't wake up. I don't really want to die but that's how I feel right now.

I can't stop crying and I don't have anyone to talk to; everyone close to me has worse problems than mine (mom and sister both going through divorces for example) and my husband is at work all the time. My little boy today saw me crying and I had to say "I'm just tired." I feel like a failure as a mother/wife/human being. I hope it does get better after I quit gluten and I don't get into an even worse funk...

Oh hon, you are not alone! You are not a failure!!

There are many posts about this on here and many success stories of those feelings disappearing.

Many of us have depression and anxiety and those are BOTH gluten related!! It will get better once you can stop ingesting it.

I have uttered those same words, but I did not mean it. I do not want to die, but I felt very low from being so ill and in pain. I used to cry every single day and I was the happiest woman in the world. That's how I KNEW something was going on inside of me.

Please keep telling your husband how you feel. Talk to your doctor.

Is your doctor aware of your depressed moods? Someone needs to know you are feeling so low, Marie....you should not suffer through this alone.

I wish I could reassure you more. Keep coming on here and talking to US. We are here for you!

I promise you, it does get better.

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I am so sorry you have to keep torturing yourself for a while longer, and feeling so sad and depressed while you are doing it. The good news is that as soon as you stop eating the gluten that depression should start to lift. Perhaps you can get some meds from your doctor in the meantime to see you through so you do not feel so miserable. Better days ARE ahead, we promise you, although it may not seem like it now. Hang in there, and don't be afraid to ask for help. Virtual {{{{hugs}}}}

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I can't talk to my husband, he doesn't really get it. When I went through this before, being depressed, he would worry about me and call me during the day to ask "how I'm feeling" in a way that seems patronizing even though I know he doesn't mean to be. I can't take that right now.

I have asked (begged) him to put off some household projects that he's working on during the weekends, so that he can help me more with the kids, and to stop working so much overtime (to pay for all his projects) but he doesn't really listen to me.

Since I've had kids I am afraid to tell a doctor I'm depressed. Like they are going to come and take my kids away if I'm depressed. I know that sounds crazy. I'm realizing how crazy I sound as I am writing this. I think I have just been tired/sick for too long and it's starting to get to me. And I feel alone. I'm really glad I found this forum, people who understand how I feel. Thank you for your encouraging words, and for letting me rant. :)

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None of this sounds crazy to me!!

Depression is a major symptom of celiac. That is a fact. No doctor who is treating you for celiac will think you are making that up or will take your children away. Tell your husband that you need help right now. You both need to realize that this is not your fault---it is the disease and you need support, hon!

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Me too, Brigit. I've been off gluten for a little over a week as part of a detox diet, but got my diagnosis yesterday and am kind of reeling. Not having a good attitude. I am teary and feel sort of bitter and on one hand it seems kind of trivial to me (come on, its just a diet) but on the other hand I am just so sad about things like not being able to eat at friends' houses anymore. And not eating my favorite bread anymore.

I think I am also just weary from being sick...I was already getting teary last week about not being able to eat without getting sick, and feeling so hungry and tired.

Thanks for posting. You are not alone. Hope we start cheering up together soon enough.

Jade

I've never struggled to control my emotions, love people, love being busy and am generally easy going.

But since being gluten free 3 weeks now, I've just been sad. I've had 3 or 4 public tears, well meltdowns actually. :) Just feeling like I can't anymore, emotionally.

My symptoms have subsided since being gluten free, which makes my body happier, but my emotions are really struggling.

I can't think of anything else that it can be, other than maybe tiredness, cause I'm not sleeping that well. Is that normal, to be so emotionally unstable after starting a gluten free diet?

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    • Feeneyja and Captain NCGS, and Ironictruth It could be SIBO or it could be NCGS as Captain NCGS pointed out. see this research that matches your 84% of SIBO patients. https://www.celiac.com/articles/24058/1/Large-Number-of-Irritable-Bowel-Syndrome-Patients-Sensitive-to-Gluten/Page1.html Below I summarize their findings I quote “nearly 84% of the gluten- free placebo group showed a significant improvement in symptoms compared to just under 26% for the gluten consuming group.  This study confirms that a large number of patients diagnosed with irritable bowel syndrome are sensitive to gluten.  The team (of doctors) suggest that the term of IBS might be misleading (you think) and may change or delay an “effective and well-targeted treatment strategy in gluten sensitive patients”. “ This is in IBS patients already who fulfilled Rome III (lesion) criteria.  They should at least be considered Non-Celiac Gluten Sensitivity (NCGS) but that would be to admit NCGS is a real condition. If you are having NCGS symptom’s (Marsh Lesion) aka Rome III lesions then why is the diagnosis not NCGS instead of IBS?  The problem is most NCGS (apparently 84%) is misdiagnosed as IBS in a large number of cases or possibly SIBO in your case Feeneyja. Even when 84 % of those with IBS show sensitivity to gluten the diagnosis of Non-Celiac Gluten Sensitivity is not confirmed by a simple gluten antibody test and people  consider Non-Celiac Gluten Sensitive (NCGS at least in the medical community apparently) a myth rather they diagnosis someone’s digestive problems with IBS of an unknown cause instead of admitting gluten is the trigger thus allowing them to avoid what is considered a mythical diagnosis to some in the medical community. By all means if  you have been given an IBS or SIBO diagnosis insist at the least on a gluten antibody test and you may save yourself many years’ of suffering before the doctor’s figure out that Gluten is the trigger then you have hope for recovery if you get the right disease. And I don't mean NCGS. Because even this too is confusing low stomach acid I believe with IBS, NCGS and even SIBO. See my posterboy blog post about why  I think this is. JMG aka Captain NCGS I referenced the Columbia University Medical Center (CUMC)  research on NCGS that I think proves your point and mine. here is the care2 article that I think summarizes it well. http://www.care2.com/causes/new-study-confirms-existence-of-non-celiac-gluten-sensitivity.html NCGS is on the "Celiac Spectrum". quoting dr. hyman from the huffpost 5+ years ago and still people seem them as different diseases (or at least deny the existence of the one over the other) http://www.huffingtonpost.com/dr-mark-hyman/gluten-what-you-dont-know_b_379089.html "When you get these tests, there are a few things to keep in mind. In light of the new research on the dangers of gluten sensitivity without full blown celiac disease, I consider any elevation of antibodies significant and worthy of a trial of gluten elimination. Many doctors consider elevated anti-gliadin antibodies in the absence of a positive intestinal biopsy showing damage to be “false positives.” That means the test looks positive but really isn’t significant. We can no longer say that. Positive is positive and, as with all illness, there is a continuum of disease, from mild gluten sensitivity to full-blown celiac disease. If your antibodies are elevated, you should go off gluten and test to see if it is leading to your health problems." and the columbia research bears this out. ironictruth you want to catch it at the NCGS stage before it becomes full blown (villi burned to the ground) Celiac disease. You are right to run from the burning house (antibodies) causing you a weak but "positive" diagnosis. This concept of the biopsy "proven" diagnosis is archaic at best and barbaric at worse in this age of serology proven diagnosis of NCGS before the villi burns to the ground so to speak. see this online article by dr. rodney ford that discusses why this is today. http://drrodneyford.com/extra/documents/236-no-gold-standard.html and he too (though in minority) is forward enough thinking to diagnose his patients with serology alone. Why would we use a standard 60+ years old when modern medicine can diagnose the disease much better and much, much sooner than what till there is stage 3 marsh lesions. The dgp test you had can diagnose it the intraepithelial lymphocytes (IEL)  stage. That is good news.  The villi are already smoking (using my analogy) of a burning house from antibodies attacking the body. Problem is and I mean this as a complement to SIBO girl and Captain NCGS (I was this in an article about the ZIKA outbreak patients talking how much more they (those affected by the disease) knew than their doctor's who where treating them at the time) we (us) have become doctor's without diplomas'. One of us each has become an expert at recognizing SIBO, NCGS and Pellagra. The question is which one is right??? Maybe we are all right by degrees. I believe NCGS can be confused for SIBO. But I also believe and the research confirms it in my mind that low stomach acid mimics many of the symptom's of both SIBO and NCGS. So that tells me there is still a disease not yet correctly identified. To me the disease that answer's the most questions in my mind is Pellagra. Ironictruth, Freneyja, JMG taking a b-complex can disprove or prove this theory. here is the full paper by Prousky. http://orthomolecular.org/library/jom/2001/articles/2001-v16n04-p225.shtml decide for yourself but people routinely get better in 3 months time of taking  niacinamide 2 to 3 times daily or a b-complex and niacinamide 3/day for 3 months. The dosage does not matter.  It is the frequency. And a month will be enough to see improvement (100 count bottle).  I used to recommend to my friends a 100 count bottle because it was the most common way to find either Niacin/Niacinamide or a b-complex but when I found out your body could store 3 months worth in the liver and my experience with b-2 (riboflavin) and angular cheilitis (look it up on google images if you don't know what it is) for years probably 5+ I could not get rid of it for nothing. And I took b-2 (for a 100 count round) once before but learned b-vitamins needed to be taken frequently for best effect. So I bought a 300 count bottle (3 months worth) and took them (b-2/riboflavin) 2 to 3 day and the angular cheiliitis (leaking lips, cracked fissures at the side of the mouth) and it was nice and crusty went away and they have never come back since. but this was after I took the B-3 Niacinamide for a couple months firsts then I was able to absorb the b-2 (riboflavin) now and I put this condition in remission (i did not say cure) because if I get low again it might come back but remission. The same thing happened to my GI problems associated with NCGS (serology positive celiac diagnosis) without a biopsy proven (thank God) diagnosis. And that is my story. I would suggest jmg, feeneyja and you too too ironictruth buy a b-complex and see if a couple three months regimen might help put your GI symptom's in remission. we already know from research 5+ years ago that b-vitamins help celiac's with their well being. https://www.celiac.com/articles/21783/1/B-Vitamins-Beneficial-for-Celiacs-on-Gluten-Free-Diet/Page1.html quoting "For 6 months, patients received daily doses of either a placebo, or of B vitamins in the amount of 0.8 mg folic acid, 0.5 mg cyanocobalamin and 3 mg pyridoxine." They summarize quoting "These improvements, the normalization of tHcy levels, together with the substantial increase in well-being, led the research team to conclude that people living gluten-free with long-term celiac disease do indeed benefit from daily supplemental doses of vitamin B, and that doctors should consider advising the use of B vitamins supplements for these patients." So I am just saying what the doctor's recommend when recommending Niacinamide for your GI problems that Pellagra could be mimicking (masking the true cause) hence the 58% of celiac also have pellagra (that a majority) of Celiac's also are known to have. I am not a doctor.  But You can be a professor though with a masters so while I do preach Pellagra as a co-morbid condition of NCGS/Celiac disease it is only because the doctor's with diploma's research bears this out. So I try and make more people aware of this fact. (no I do not have  a master's either though a friend once said who has a masters said my research would qualify me if I had taken the courses) (And yes I know B-3 was not studied in this paper) but maybe now is the time to point out it should bee! Or SIBO girl, and Captain NCGS you can try it (B-3) for yourselves and see if it helps you the way it did the Pellagra kid/posterboy. If you want to study this topic more I summarized many of thoughts in this posterboy post https://www.celiac.com/gluten-free/blogs/entry/2103-why-and-how-pellagra-is-often-confused-with-celiac-disease-andor-other-gidigestive-problems-the-science-of-pellagra-a-hidden-epidemic-in-the-21st-century-presentingrevealing-as-ncgs-andor-possbily-celiac-disease/ I wrote a blog post that also said "I had Celiac disease but developed Pellagra" but I really think it is the other way around. (it is linked in the above post) if you want to read it there so I won't post it again. I was a pellagrain who was diagnosed first as a celiac.  The same way a SIBO might first be diagnoses as a IBS or NCGS patient.  Or the way a NCGS is first diagnosed as a IBS patient 84% of the time. Remission is possible I believe if and when you find the right/correct disease. And any of these GI conditions can be confused for the other and SIBO girl and Captain NCGS makes good points. But it seems to me Pellagra can be confused for not only the SIBO, NCGS, but if the research is right 58% (the majority) of Celiac's and it is easily reversible in 3 months time. You will not know if you are not willing to try it. **** this is not medical advice just deep research and my own experience with taking Niacinamide. But I will say  I am not the only one who has been helped on this board taking Vitamin B-3. I want you Iroinctruth, Feeneyja, Jmg to be the next ones. I know this post is way too long as usual but I had a lot of ground to cover. quoting a friend 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,
    • After my crash and burn gluten challenge of 2016, I wander off yet again Into the land of eastern and alternative medicine to heal. While I am grateful to many (not all) western medicine  Dr s of the past , for the past 2 decades the ones who give me relief for my lifetime ails are the alternative/eastern practitioners. I'm not starting a debate as both branches have their strengths, often the shame is they are seperated in healthcare, for likely humanity and public health imo would be best served by their encouraged collaboration/mutual recognition,but alas not my problem to solve. Much bigger then me and quite frankly, I'm too busy healing to tackle that mountain. Regardless, I now have "shoes that fit my carpet bag " of decades of multiple misdiagnosis /undiagnosis collection. They can be combined and labeled celiac and fibromyalgia. I was shocked at first at the news, I consider those really serious. Is AWOL really that ill? I've read up more  on both disciplines descriptons etc for these conditions, I'm in shock for the "shoes" fit perfectly . I know based on western test results I'm far from textbook/ gold standard celiac (but I failed to get past day 6 of my gluten challenge -likely speaks for itself) and fibromyalgia is quite demeaned/dismissed from my past knowledge amongst the western medicine world and greater society. (Friends /family in western medical fields) Is this still the case? My lifetime gi issues, the 30 plus years multiple chemical sensitivities ( go back to childhood-I keep very close to the vest), 20 plus years symptoms of muscle issues / myalgia, now have the names of celiac & fibromyalgia. Mixture of feelings of relief to be recognized, but also knowing my named illnesses are likely not recognized or are minimised by my western medicine trained family and friends and greater society. Can anyone offer some encouragement to help me cope at this time of healing? My accupuncture visits have been truly helpful, but my last visit is giving me a lot to process chemically, biologically, and spiritually. It's like someone unleashed the flood gates of all the symptoms of both illnesses at once in a combined package for me to experience in a one transparent package.  Very enlightening and to be blunt I feel like crap. So it's time to accept the package names and all, the curtain was lifted and the waxing and waning symptoms of fibromyalgia we're released. Please share any positive support or stories you have on coping with celiac recovery, celiac/fibromyalgia, and  healing by accupuncture. It will be much appreciated. As it is abundantly clear AWOL is here to stay on the celiac.com forums. Thanks  
    • https://www.celiac.com/gluten-free/topic/116482-supplement-and-foods-you-take/ ^ I did this a while back where some of us have posted what we take and eat to get our nutrients. Mines changed a bit since then since I can not eat any grains, sugars or fruits.
    • I take 2 Slice of Life gummy multivitamins and drink 2 Ensure high protein per day. Both are gluten free.
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