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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 What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes Where can I buy gluten-free stuff? Support this site by shopping at The Celiac.com Store.

Fear Of Food
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Starting about 4 - 5 years ago I started to avoid food because of the pain it brought. My eating habits led to eating about once or twice a day. Post dx as of February, I have not been able to correct my food intake. I eat once a day and a very small amount. Even though food does not cause pain anymore, I have no appetite and avoid eating.

Fast forward to this past Monday. I finally talked to my therapist about this and as I suspected, it is psychological. I equation food with pain and it is classic avoidance.

Her advice is to think of food as medicine. Although I agree this is very good advice, I really hate having to take my medications also.

I was wondering if anyone might have some suggestions on how to overcome this. Knowing the problem has not been able to make me change this avoidance to food.

I am getting more and more desperate to resolve this as I continue to have health problems. I am now dealing with cancer and afraid that my immune system is failing.

Any help is greatly appreciated.

Colleen.

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Starting about 4 - 5 years ago I started to avoid food because of the pain it brought. My eating habits led to eating about once or twice a day. Post dx as of February, I have not been able to correct my food intake. I eat once a day and a very small amount. Even though food does not cause pain anymore, I have no appetite and avoid eating.

Fast forward to this past Monday. I finally talked to my therapist about this and as I suspected, it is psychological. I equation food with pain and it is classic avoidance.

Her advice is to think of food as medicine. Although I agree this is very good advice, I really hate having to take my medications also.

I was wondering if anyone might have some suggestions on how to overcome this. Knowing the problem has not been able to make me change this avoidance to food.

I am getting more and more desperate to resolve this as I continue to have health problems. I am now dealing with cancer and afraid that my immune system is failing.

Any help is greatly appreciated.

Colleen.

Colleen...I am not an overly mushy person but I wish I could just descend and give you a big, fat hug!!!!!! My heart goes out to you, having to deal with this and now cancer? :o

Are you continuing to not eat well because of depression that you may have from trying to deal with all this? I understand the eat=pain thing because I did the same thing for years only not badly enough that I headed to an eating disorder. I totally get that, though. What foods do you like to eat? I can only suggest that you start small and try to eat good food every couple of hours....just little amounts to stir up your metabolism and appetite. Maybe a good protein shake with added ice cream or whatever will agree with you? Can you do dairy? I find that drinking calories is easier and you can make a shake very calorie dense. Do you view drink the same as food?

I am so deeply sorry you are having to deal with this. I hope we can all be of help to you, in any way we can!

OK...after posting I see that you are dairy free this year. Almond milk is great in shakes...adds a lot of flavor.

Did you know that melanoma is one of those cancers that Celiacs seem to be prone to? That was in Peter Green's book. You have to put your fighting gloves on now so that means good nutrition. Would thinking of that help you to become focused on eating better? I apologize if I sound stupid but I want you to fight back and get better! :)

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Oh you poor dear, that must be awful. Trying to think of ideas for you...

Do you think if you set out a specific (and reasonable) amount of food each day, say a Kind Bar, a small bag of nuts, a cookie, an apple -- things that you would normally like to eat -- and tell yourself that these must be consumed by the end of the day, that would help?? Leave them some place where you would walk by them and be reminded of the need to eat. Put a picture of a really scrawny person and a normal size person on the refrigerator door??? :) Just thoughts.

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So sorry you are having to go through so much.

I have the food aversion thing also. I usually eat just once a day. I call it Pavlov's dog in reverse.

I was able to reverse things a bit when I was finishing up school but have since backslid. :ph34r:

What I did that worked was what was suggested by the other poster. I ate very small amounts of foods I knew I tolerated. At first it was an accomplishment to eat a single strawberry and leave the house but eventually I worked up to eating an actual lunch. So try small amounts of food you know is safe for you like cut up fruit or veggies, a half a sandwich, a cup of soup etc. You need the best nutrition you can get to fight the fight you have to fight right now.

I am sure others will be on to give you some good tips also.

Sending postive thoughts your way.

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I have a fear of food related allergies... so yeah, i understand fully.

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Think of it as routine maintenance, like gassing up the car and changing the oil and filling the windshield wiper fluid. No fuel, no go.

I decided to do 2 outdoor activities early in the morning in the past month, which were going to cause me to exert myself. Because I also am not carbohydrate or sugar tolerant, this meant I had to eat early, eat very carefully, really hydrate myself up with liquids also, and then be careful to take along safe recovery snacks if I needed them. Getting up before dawn I'm used to, but eating enough food to last me until noon was just plain obnoxious. My gut needed to be in perfect function, which meant I had to then eat all this nutritious crap extra slowly. So I made a vegetable smoothie with some banana, and made myself drink it. I ended up doing some of the protein as I drove to the venues. But I pulled it off. Other people just get up and eat some cereal and grab some electrolytes. LOL. :P

Although it was funny, when one of the other participants came in, having done a much longer distance at a much faster pace (she won her category) she was standing, bent over the recording desk at the finish line, and the record keeper tried to say, helpfully, "over there on the table is a lot of great food we have for you to eat, and you can get something to drink" (they had this really nice recovery table loaded with fresh fruit, doughnuts, and bagels and all sorts of sports beverages, sodas, and water) but "oh, no, I think I'm going to throw up" was the reply.... :blink:

If you can exercise at all, you might try getting out and going for a walk. Initially, exercising will act a bit like an appetite suppressant, but then once your body gets used to it, you will get pretty hungry a few hours afterwards. If you eat when you're hungry, you reward yourself, so you can re- wire some of your reactions that way.

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I don't have the same fear with liquids. For instance, my kitchen is the center of our condo, I pass one of the counters all day long. I put our fresh fruit there. So, I will get a bit jittery and know I need a bite. I will go up to the banana, know I need to eat it, even reach for it then bam, I grab a soda from the fridge instead.

My usual go to snacks are raisins, sunflower seeds and applesauce. That equates to a meal in my brain. My Hubs has started to shove a scrambled egg in my lap in the morning. If I do eat it, that is my meal for the day.

My depression and anxiety, well the depression has been stable with med management. The anxiety is over the top, I take ativan daily but does not even touch it.

I do enjoy juicing and I have a protein powder mix. Problem is my brain thinks, it's too much trouble, just grab a soda.

My fallback meal is a spinach salad with egg, sunflower seeds and cheese with dressing, I am doing good with dairy now. I experience the same aversion but it's my favorite food and if I'm starving I will eventually eat one, maybe 2 times a week.

I do take a vitamin, probiotics, fish oil, papyra enzymes, along with my meds.

I am just so frustrated.

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Perhaps a ban on sodas??? Some small juice boxes instead? That way there is no fallback position - i.e., you have to get nutrition :D I do admit I have never been afraid of food (except when I see the dreadful IHOP commercials on TV :ph34r: -- those churn my stomach) so I cannot speak to the place where you are coming from. But it seems to me so long as you give yourself a way out you will take it instead of facing the dreaded food.

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Colleen, it looks like lots of people need hugs today. I'm sending you one.

What about smoothies? It sounds like you have a good DH. He could make it and stick it in the fridge and you could sip a bit here and there.

Recipe - 1/2 cup strawberries, 1/2 cup mango, 1/2 banana, 1/2 cup yogurt or almond milk or soy milk or sorbet (any flavor but mango would be good). I use frozen strawberries and mango chunks from Trader Joes. There are a lot of other recepies out there or maybe others could suggest.

You could also add protein powder to almond milk or just with water.

You could also try premade smoothies (Odwalla, Jamba Juice) or yoplait I think has one. Sometimes they are sold in the frozen food section.

Have you tried broth-based soups? Home-made are pretty easy. Boil chicken breast in chicken broth/stock until cooked, remove chicken to cool while adding rice to broth. Shred chicken and add to rice. Yum.

Have you tried hypnosis or a relaxation dvd?

Hang in there!

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Colleen, it looks like lots of people need hugs today. I'm sending you one.

What about smoothies? It sounds like you have a good DH. He could make it and stick it in the fridge and you could sip a bit here and there.

Recipe - 1/2 cup strawberries, 1/2 cup mango, 1/2 banana, 1/2 cup yogurt or almond milk or soy milk or sorbet (any flavor but mango would be good). I use frozen strawberries and mango chunks from Trader Joes. There are a lot of other recepies out there or maybe others could suggest.

You could also add protein powder to almond milk or just with water.

You could also try premade smoothies (Odwalla, Jamba Juice) or yoplait I think has one. Sometimes they are sold in the frozen food section.

Have you tried broth-based soups? Home-made are pretty easy. Boil chicken breast in chicken broth/stock until cooked, remove chicken to cool while adding rice to broth. Shred chicken and add to rice. Yum.

Have you tried hypnosis or a relaxation dvd?

Hang in there!

Hi CyberProf,

Smoothies, this actually sounds doable to me. Hubs could whip up a batch in the morning. I'm assuming it would last all day. Would it keep overnight? And what about adding the protein powder to the smoothie instead?

I will definitely talk to hubs about this.

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Perhaps a ban on sodas??? Some small juice boxes instead? That way there is no fallback position - i.e., you have to get nutrition :D I do admit I have never been afraid of food (except when I see the dreadful IHOP commercials on TV :ph34r: -- those churn my stomach) so I cannot speak to the place where you are coming from. But it seems to me so long as you give yourself a way out you will take it instead of facing the dreaded food.

Mushroom, I am so with you on IHOP, hurling. Juice is still tough on me so I kinda, maybe alot, stay away. Ban my sodas? I would certainly die on the spot :D

On the plus side, I have a water bottle in my hand at all times and I do enjoy tea occasionally.

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Hi CyberProf,

Smoothies, this actually sounds doable to me. Hubs could whip up a batch in the morning. I'm assuming it would last all day. Would it keep overnight? And what about adding the protein powder to the smoothie instead?

I will definitely talk to hubs about this.

I think the smoothie would taste good all day - you might have to stir it. You could try it but after 12 hours it might not taste as good. It wouldn't go bad if it was kept in the fridge. I keep mine in an insulated mug with a straw.

And yes, I've added protein powder to smoothies no problem.

Hope it works - good luck and let us know.

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Something i learned while i was in theraphy when i was younger was to analyze why i stress out over things.

First look at the item (or event or whathaveyou).

Food.

Define it.

Something good for the body.

Do i need to do it (eat it, smash it, what have you it)

yes

Why am i anxious or stressed about it

I am afriad that i will have an allergic reaction or it will cause me pain.

Put it in a positive light with coping thoughts

I have had these things before and i KNOW they will not hurt me

Even though this does help, i still do stupid things (like placing peanutbutter on the back of my hand to make sure it won't cause a reaction, or watch the clock after i ate something).

My doctors know about it and just tell me to try to eat. So thats part of the reason why i eat similar things for lunch and dinner.

Oh and this same fear goes for medications as well.

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If smoothies work, how about pureed vegetable soups? They can be more like a liquid than a solid. You could drink them from a cup. You can get your nutrition from fruit smoothies and vegetable soups to start with. Meanwhile you can work on adding small amounts of more solid food, and work your way up. I wish you well.

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Tip for the smoothies? Try picking up a small blender that's designed for single servings, and the blender jar comes off the stand for you to drink out of. There are some very decent ones out there for a good price, they're not too loud, and they can make it fun to make a smoothie. The pitcher is easy to clean and can go right in the fridge. There are piles of food blogs and threads here on c.com about smoothie ideas. And YES put that protein powder in there! Great idea!

I have not had this issue ever (I have always suffered from extreme, debilitating, FEED ME hunger) but I wish I could come and hug you all up.

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Although new to celiac for the last 6 weeks, I was not eating in the beginning. I couldn't find things to satisfy me so I ended up, without consciously doing it, eating far less than I should. I quickly turned that around by something I read online. It described the condition of fearing food and equating food to fuel. Without that fuel we'll worsen our condition and we won't have the energy to enjoy life. I refused to give up just because my food choices changed so I adjusted to more fruits and other foods naturally free of gluten. I eat all day, but it's nuts, fruit and other things. I don't eat a daytime meal until dinner, but I refuse to stop eating. I keep putting small amounts of fuel in my body to give it the energy to fight this nasty disease. Without that energy, the disease wins.

I'm sure it's difficult to change your personal perception, especially when the driver is psychological. I get those jolts of fear around different situations, especially eating out. In the end, I refuse to lose and I just try to make the best choice I can in the situation I'm in, but it always includes eating something (even if I have to stop somewhere different after I leave the situation just to make sure I eat).

Your body is a furnace and it produces heat. You can't make heat without fuel and food is that fuel. The vitamins and other supplements are also fuel you're not getting completely from food. It's all important and you win the battle when you take in enough fuel to make it through the day. If you burn what goes in, nothing is wasted and no weight is gained...and you win! Your body is the only one you have...denying the body of energy will only make things worse and deteriorate muscle, teeth, hair, energy, bones, etc. It's important and I hope you can work through it with your therapist to get on the road to the best health possible, even if it's tough and trust is hard to give at meal time. I just hope you don't let the disease and your mind be overcome by those scary choices you're forced to make each day.

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Sweetie,

In addition to all the good advice you have received, you know I am sending you all positive thoughts for recovery from your surgery.

I give you ((cyber hugs)) all the time, but now I am going to go all "mother hen" on you.

Eat. Please eat. Drink protein smoothies, too.

You simply cannot get the muscle pain you have under control or have the anxiety and depression resolve or have the strength to fight cancer if your body is not nourished, honey. Sugary sodas have no nutritional value. And they may be fueling your agitation. Supplements are not going to give you enough energy for your body to heal.

I had the same temporary food aversion when I was very ill and even for a few months post-DX. My GI tract was in flames and I was afraid of food hurting me or coming out in some unpleasant way.

But I knew if I did not eat, I would not get out of pain and reverse the damage done to my muscles.

Try a fruit smoothie with chopped, frozen kale thrown in for breakfast. Almond milk or So Delicious Coconut milk is great tasting and has calcium.

Set a timer for 3 hours, then try something else. Peanut or almond butter on an apple maybe. You need protein.

Set a timer for 3 hours, have some soup maybe.

And do this all day long until you come to see that food is not your enemy, rather it is your ticket to recovery. You need food to get well. It's just that simple.

You can do this!

xxoo

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IH,

The timer idea is great especially since I already have my phone reminder set for four times a day for meds. And yes, throw the kale in the smoothie.

Hubs is going to make me a big pot of the chicken and rice soup. I can freeze servings and pop it the microwave. What type of rice? Minute rice or a different rice.

Good news is I grabbed a banana off the counter this morning. I sat with it in my hand or on my lap while drinking coffee. Took about a half hour but I managed to eat half. Small victory but ill take what I can get.

I'm gonna leave my container of sunflower seeds and raisins on the counter, eventho I HATE a cluttered counter. That reminds me. I have a butternut squash siting on the counter also. Just don't know what to do with. I would like to make a soup out of it, just don't know how.

I feel like I'm climbing a mountain with all these issues and since it is snow covered, I keep falling to the bottom. I often wonder if maybe this is how it will be till I die. I'm not sure anymore if it's worth it

On a funny note. I asked my psych doc if maybe since my first round of ECT's took out have my memory, if a second round would erase the food issue too. He just looked at me. No expression, then continued to wright scripts. I was laughing and laughing.

Hubs will be stuffing me and my leg into the golf cart this afternoon so I can get out and enjoy the nice weather.

All the hugs and good wishes bring me to tears. I am sending hugs and good wishes right back to all of you

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We're here for you baby!

Thanks Bunny, I have a feeling I am going to need more help along to road.

Thanks again

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I said tearfully, aloud and often to hubs before DX: "I just can't be this way for the rest of my life! I can't!" I changed it around. You can, too. You know my story. I could not eat or lift a soup can or even walk much. I lived in hell.

If you give in to that negative mentality, you surely will be "this way for the rest of your life".

Come on now, sweets, smear peanut butter on the other half of that banana before you go out. You need protein, Colleen. No soda.

water, water, water!!

See my pom-poms? I am rooting for you. :)

Let's go, kiddo.... eat, get in the cart and get some fresh air.

Loving hugs to you.

Later, here's what to do with that squash

http://www.cookinglight.com/food/top-rated-recipes/healthy-butternut-squash-recipes-00400000055219/

And to answer your question, use whatever rice you have. Just eat.

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mY mom has a problem eating. A dietician said that when you haven't eaten much for awhile, you loose your hungry feeling and foods don't always taste good. Not eating enough leads to a depression, too. Big explanation of why but to get a normal appetite back you have to force yourself to eat.

You need to eat lots of protein. You need to eat a 2 bite snack every hour as well as scheduled meals. The 2 bite snack can be most anything, even candy but it should have about 100 calories. If it has protein, even better. So 2 crackers with PB, almond buuter or cheese. A whole banana. Make a batch of smoothies and portion some into cups and put in the freezer for later. Add hidden calories to things - a sprinkle of olive oil or butter on veggies, full fat salad dressing or hummus to dip carrots. You can eat 2 strawberries but they should be dipped in chocolate syrup. A pudding cup. Ice cream. Add protein powder to the salad dressing, cereal milk, smoothie, any milk product you like to drink. My neighbor adds chocolate protein powder to her coffee.

The main thing is, you will have to want to do this and make yourself do it.

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gluten-free Lover,

My thoughts are with you more than you know...I too (and many others on this wonderful forum) have fears about eating. For me, I know that it took my hubby putting food in front of me for awhile to eat :( Sad but true. I still get "scared" to eat sometimes.

You have alrady gotten some *great* advice--So I'll just share some thoughts :P

The one thing I did was make a "safe list" for me...The foods that I was "sure" I could eat and not have a physical reaction to them. You mention some positive things you are doing! Keep the positive things going! :)

Soda does give you calories. Unfortunately, soda does not give you nutrition. That is what food is to our bodies--the "gas" that runs our bodies. Without nutrition, we run out of thinking power, get depressed, irritable, jittery, and *many more things*... For me, I think of food as nutrition. (I do not like meds either, but accept them when needed). The thing with food, is it is not a medication that you can "quit taking". We need nutrition every day--several times a day.

Nutrition means we must eat. It is What we eat that we can control! With that control, we can choose healthy foods, and more foods a bit at a time slowly but surely. Fear is our biggest enemy. It makes us feel weak, powerless, and helpless. Eat bites often--of the food that is safe for your body! :D Often, Often, Often!!! :) Sips of the smoothies. And scrambled eggs are wonderful and full of protein!

I too, want to give you a big hug...and encourage you to keep talking here. And, yes, keep tastes of nutrition around you! :D

I have found more support here than I can imagine!

Welcome to this amazing forum! :D

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First let me say, I'm so sorry for what you are going thru. Our minds work in funny ways. I'll tell you how I overcame my challenge back when i was a teenager.

When I was anorexic (many many yrs ago), it was a control thing. I COULD control how much food I didn't eat, even if I couldn't control other things. To overcome this I made eating calories a control. I.E. I COULD eat 500 calories a day, the invisible force wouldn't win, I would because I would learn to eat enough, 100 calories at a time.

My issue was all about control, not being scared of food. But in truth yours could be to if you think of it as your going to let the fear and cancer win.

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First let me say, I'm so sorry for what you are going thru. Our minds work in funny ways. I'll tell you how I overcame my challenge back when i was a teenager.

When I was anorexic (many many yrs ago), it was a control thing. I COULD control how much food I didn't eat, even if I couldn't control other things. To overcome this I made eating calories a control. I.E. I COULD eat 500 calories a day, the invisible force wouldn't win, I would because I would learn to eat enough, 100 calories at a time.

My issue was all about control, not being scared of food. But in truth yours could be to if you think of it as your going to let the fear and cancer win.

That's interesting. My therapist said I was controlling this because everything else was out of my control.

So then you gave yourself a max you had to eat and that would put you back in control because the disease doesn't get what it wants either, correct?

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    • Alright, so I'm 3 months into being gluten free, And in terms of how I feel, the "best fit" line on the graph would be a very slow incline, which is good, but day to day, I would mark as all over the place. I don't understand. I pretty much do the same things every day, and eat the same things every day at around the same times, even in the same order. I cook all my own food and am super careful about CC. I even have my own pans, cutting boards, even my own sponge for washing my own aforementioned kitchen supplies. What I eat is very limited. I don't even do dairy, grains, or added sugar. (for now) Yesterday I actually felt okay. The brain fog was fairly thin, I felt more based in reality, rather than like I was in the matrix, on drugs, or in a dream. Today I'm back in the matrix again. I can't think, I have anxiety, I'm overly emotional, short fused, angry, and scared of my own shadow. This up and down for no apparent reason stuff seems to be the norm for me. Is this unheard of or somewhat common? It seems like how I feel is completely out of my control, and the disease just does whatever it wants. I know 3 months isn't that long in the usual recovery time frame, but I want to get off this ride. I just need to know if it's normal to be so up and down day to day during the recovery, or if I should give in to my assumed unfounded panic attacks and be worried. As a side note, I'd much rather have the typical gastro issues usually associated with celiac. Blowing chunks and crapping my pants constantly would be way easier for me to deal with than all the neurological problems mine manifested as. Ugh.
    • Ha, Ha!!!!!!  If I wouldn't get in trouble for practicing without a license, I would!     I get it because that is what they did to me for years.  I never had acid reflux but had enough other symptoms that all screamed Celiac but no.........they told me that my severe stomach pain might be acid reflux so take this script and go away. They never even tried to figure it out past the 10 minutes allowed for the appointment. I'll never forget one doctor that I pushed back on and told her I was not there for meds but to find out what was actually wrong and she got so mad she left the room and never came back. All they kept doing was trying to shove pills down my throat.   I am guessing that the procedure is the one where they tighten the sphincter muscle at the entrance to your stomach? I know so many people who had that done because it's become so common to push that if the meds aren't working well. Follow the money........ If acid reflux becomes that bad, then you have to start looking at food, period.
    • Here's a link that discusses Mast Cell Activation Syndrome (histamine intolerance) and recommended tests.  http://www.thepatientceliac.com/tag/mast-cell-activation-syndrome/ This article explains how POTS is related to MCAS. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3545645/#!po=35.0000 "In another clinical situation, Shibao et al. and colleagues studied a small cohort of patients who had evidence of mast cell activation as evidenced by elevated urine levels of N-methylhistamine after flushing episodes and who had orthostatic intolerance (69). Detailed studies revealed a profound hyperadrenergic response to standing characterized by tachycardia and hypertension consistent with postural orthostatic tachycardia syndrome, or POTS. This phenomenon is felt to be due the release of vasoactive mediators such as histamine that act locally on sympathetic nerves; autonomic function was assessed to be normal in these patients. The authors have used methyldopa, an alpha-adrenergic agonist, with some success in these patients along with standard medications to block mast cell mediators. They caution against the use of beta-blockers, which may exacerbate mast cell activation."   Vitamin and mineral deficiencies often occur with Celiac Disease.  Celiac Disease causes malabsorption which results in malnutrition.  It's important to correct nutritional deficiencies after a Celiac Crisis like you endured with your gluten challenge.   Vitamin D is so important!  Vitamin D tells the mast cells to turn off histamine production.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154631/ Vitamins C and E and B6 help, too. https://www.ncbi.nlm.nih.gov/pubmed/21244748 The eight B vitamins are water soluble and need to be replenished every day.  Not enough B vitamins can make one grouchy (or seemingly an alien).  Just watch "Naked and Afraid" on Discovery channel.  The contestants who don't get protein (chock full of B vitamins) get grouchy, depressed, and irritable.  Some contestants have to be removed because their personality changes to the point they become dangerous.  This is a drastic example of vitamin deficiencies that develop over a short period of time, three weeks.  Now imagine having a subclinical deficiency over a long period and a slower health disintegration.   I lost my faith in doctors when my deficiency diseases were not recognized and addressed.  So, I used my food journal and the low histamine diet guidelines to get my inflammation down and my vitamins and minerals up.  Hope this helps.      
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