Mike1972

You are wrong again. Just off of the top of my head I can think quite a few other food intolerances, such as to gluten, soy, corn or maltose. But don't believe me:

Here is a reference to soy intolerance:

Open Original Shared Link

See the bottom of this page:

Open Original Shared Link

and here you can get testing done for corn intolerance:

Open Original Shared Link

York Labs offers testing for up to 113 different food intolerances:

Open Original Shared Link

The reality is that you can have a food intolerance to almost anything, and you are much better off finding out what food issues you have and not eating them. Most of the people here who have continued problems after going gluten-free actually have additional food intolerance--and they do not have psychological problems.

You are also missing a huge number of other documented symptoms that can occur with food intolerance, such as migraine headaches:

Audit of Food Intolerance Supports York Nutritional Laboratories' Finger-Stick IgG ELISA Test for Relieving Symptoms Associated with Migraines

and these symptoms:

Open Original Shared Link

It's a common misconception that you can be intolerant to anything. You can be allergic to anything, with the classic allergic reaction symptoms, but not intolerant.

Admin wrote: "Symptoms of food intolerance

* Nervousness, tremor

* Sweating

* Palpitations

* Rapid breathing

* Headache, migraine

* Diarrhoea

* Burning sensations on the skin

* Tightness across the face and chest

* Breathing problems - asthma-like symptoms

* Allergy-like reactions."

You do realize that all of these are symptoms of allergy and not intolerance. In fact nervousness and tremor, palpitations, rapid breathing, migraine are all due to release of histamine which causes vasodilation and a drop in blood pressure, which activates the sympathetic nervous system and produces these signs. Burning sensation on the skin, breathing problems are also caused by histamine because histamine activates the pain nerve endings and causes bronchospasms (hence dificulty breathing).

Ursula wrote: " Now that must be one of the most ridiculous, ignorant statements I've ever come across. The reality is, that you can potentially be intolerant or allergic to anything at all. I've read of kids that are allergic to water!"

Care to back up your opinion with scientific facts or articles? Or are you just calling me ignorant because I disagree with you? By the way, you can't be allergic to water because the water molecule is too small to be recognized by the IgE molecule. .

Mike.

Do you even read your own references? On the site you posted it says:

"General surveys report that as many as 25-30% of households consider at least 1 family member to have a food allergy. This high rate is not supported by controlled studies in which food challenges are used to confirm patient histories...Severe anaphylactic reactions, including death, can occur following the ingestion of food. Typical symptoms observed in a food-induced anaphylactic reaction involve the skin, gastrointestinal tract, and respiratory tract. Frequently observed symptoms include oropharyngeal pruritus, angioedema (eg, laryngeal edema), stridor, dysphonia, cough, dyspnea, wheezing, nausea, vomiting, diarrhea, flushing, urticaria, and angioedema. Fatalities result from severe laryngeal edema, irreversible bronchospasm, refractory hypotension, or a combination thereof. Food allergy has been confirmed in approximately one third of the patients with anaphylaxis presenting to the emergency department at the Mayo Clinic."

So you are saying that someone with unexplained prolonged diarrhea, vomiting, etc., isn't also subject to depression, fatigue or weight loss? Obviously the symptoms mentioned at your reference site are "glutening symptoms" that "mimick celiac disease," so that part of your claim also looks silly on its face with just the information that you provided at this reference site.

Scott,

I've read my own references and please point me to the section of my reference where it says that allergies are assosciated with depression, weight loss or fatigue. I am allergic to peanuts and if I eat them (even in some commercial food preperations which use peanut oil) I get a swollen lip, wheezing and diarrhea. I know that I've eaten peanuts almost immediately. I don't get depression, fatigue, weight loss. These symptoms cannot be caused by food allergies. Most people on this board who claim to be allergic don't complain of any of the symptoms listed in my reference (like angioedema, pruritus, dysphonia, cough, etc.) , but only that they feel "glutened" meaning depressed, confused, fatigued, etc. which are not symptoms of an allergy.

When I said casein intolerance (casein allergy is a better term) doesn't exist in adults I was wrong. I should've said it's extremely rare in adults. I can see from your reference that casein allergy causes eosinophil and lymphocyte infiltration into the epithelial layer of the mucosa. So where's the damage? Villous atrophy is damage, simple infiltration doesn't equal damage. Eosinophil infiltration is more consistent with a delayed allergic response to IgE.

Casein allergy would produce immediate diarrhea, angioedmea, wheezing, cough, stridor, etc. upon ingestion of milk due to the release of histamine from the IgE response. Once again people who claim to be allergic to casein don't complain of these symptoms.

Another point of confusion is the difference between a food allergy and a food intolerance. A food allergy is caused by IgE, and food intolerances are due to enzymatic defects or food additives. Food intolerances may cause depression. Only a couple of food intolerances exist: lactose intolerance, disaccharidase intolerance (extremely rare), and intolerances due to additives like MSG. There are no other intolerances besides these.

Here's a reference:

Food allergies and food intolerances.Ortolani C, Pastorello EA.

Istituto Allergologico Lombardo, Piazza Monsignor Moneta 1, 20090 Cesano Boscone, Milan, Italy. all@ambrosianacdc.it

Adverse reactions to foods, aside from those considered toxic, are caused by a particular individual intolerance towards commonly tolerated foods. Intolerance derived from an immunological mechanism is referred to as Food Allergy, the non-immunological form is called Food Intolerance. IgE-mediated food allergy is the most common and dangerous type of adverse food reaction. It is initiated by an impairment of normal Oral Tolerance to food in predisposed individuals (atopic). Food allergy produces respiratory, gastrointestinal, cutaneous and cardiovascular symptoms but often generalized, life-threatening symptoms manifest at a rapid rate-anaphylactic shock. Diagnosis is made using medical history and cutaneous and serological tests but to obtain final confirmation a Double Blind Controlled Food Challenge must be performed. Food intolerances are principally caused by enzymatic defects in the digestive system, as is the case with lactose intolerance, but may also result from pharmacological effects of vasoactive amines present in foods (e.g. Histamine). Prevention and treatment are based on the avoidance of the culprit food.

The fact that some people's problems here encompass more than just celiac disease does not discount the real possibility that people with one autoimmune disease are much more likely to have additional autoimmune diseases--in fact they are much more likely to have additional disorders than the normal population.

Here you go again sounding authoritative, but failing to cite any studies to back up your mistaken claims:

Not only can other food intolerance mimic the symptoms of celiac disease, but casein intolerance can also create the same type of intestinal damage that celiac disease can cause. Since you are a GI Tract Ph.D. researcher and don't know this, you obviously have some more research to do...but it's ok, I can help you... that is what I'm here for:

Yes, the current problem with the formal diagnosis of celiac disease is that it can only be made if both the antibodies are present, and the intestinal lesion (damage) had reached a crtical point, otherwise doctors will say "no celiac disease." Although clinically they may be correct, there is a much larger grey area called gluten intolerance, which may make up as much as 12-15% of the population. This groups has the genetic markers for celiac disease, and may or may not have the antibodies present, or may have some of the antibodies and some milder form of intestinal damage, or no intestinal damage. They still benefit from a gluten-free diet, and many in this group, if they continue to eat gluten, may one day end up in the full-blown celiac disease group.

Hey, just trying to help you become a good doctor, and not another bad one. We need more good ones. Please be a good scientist from now on and provide studies to back up your claims.

Take care,

Scott

It's true that some people with celiac sprue have additional associated diseases, especially autoimmune diseases, maybe even food allergies. However food allergies do not cause depression, fatigue, weight loss, or glutening symptoms and they don't mimick celiac disease. Since you asked for a reference here's one: Open Original Shared Link

Casein intolerance only occurs in children less than 10 years of age and is caused by sensitization of the fetal immune system by the consumption of milk by the mother. I don't see any evidence in those studies that they produce villous atrophy and nor that it can mimick the symptoms of celiac disease in adults.

The antibodies and the biopsy are not needed both for diagosis of celiac disease and most doctors will diagnose it based on highly elevated antibody levels. A newer method of performing the biopsy is currently being introduced, it involves looking at the ratio of gammadelta lymphocyes in the epithelial or submucosal layer of the duodenum. This test has the ability to detect all cases of celiac disease even without villous atrophy or conclusive blood test results.

I don't claim to be an expert on candida, but you are mistaken here. Celiacs can often get SIBO:

Bacterial Overgrowth of Small Intestine Common in Treated Celiac Disease

Candida is a fungus not a bacteria and it's not involved in producing small intestinal bacterial overgowth.

JerseyAngel wrote:

"You were actually half right! I believe (and I'm no expert, here) that IgG is also called "delayed food allergy"--but the symptoms are really those of intolerance, not classic allergy. "

Food allergy is a hypersensitivity type I response which is caused by IgE, in some cases the food allergy may have a delayed response but it's not IgG mediated but due to more lymphocytes arriving to the area due to the inital release of histamine. It's simillar to the delayed response in asthma. IgG is not involved in food allergies or intolerances.

Mike

BUT if I inadvertently get gluten in my diet (not purposely), I find out by getting sick. Meaning, I don't expect to get sick, it happens. Meaning, that obviously your 'placebo effect' argument holds no water at all. Because if you were right, inadvertent exposure to gluten wouldn't effect me at all, since I wouldn't know about it.

Yes, but at the same time when you feel glutened do you start to look over your foods for sources of gluten that you could have ingested. And if you find none do you blame it on cross-contamination, inhaling gluten, cosmetic products, microscopic gluten. IF you rule these out do you start to look for other diseases or conditions that make you feel bad? Do you blame feeling bad on other allergies? Thinking like this doesn't mean you're crazy but it will send you on a wild goose chase for years or even decades and you will be no better off than before you started the gluten free diet. You'll just invent more diseases besides celiac disease to explain your symptoms. I've heard some good ones on this forum: like adrenal fatigue, Lyme disease, Candida among others. What people need here, and I am not a doctor so this is just my personal opinion, is psychotherapy. I am not saying people are crazy on this forum, just that some people have major anxiety about diseases and things that could harm them (specifically people who tested negative on blood tests and biopsies and have multiple food allergies/intolerances). Addressing the anxiety, possibly depression will address the physical symptoms that people have.

BY the way, here are some misconceptions that I've found reading this forum:

1. other food allergies could cause celiac like symptoms. Allergies cause the release of histamine through IgE so they could cause diarrhea, but they don't cause depression, or any other glutening like symptoms. They also cause hives, edema in the throat, mouth, lips and these symptoms are life threatening. Most people who here who claim to be allergic don't have these signs.

2. there's a disease called gluten insensitivity. This disease doesn't exist, what exists though is latent celiac disease. These people would have the antibodies without the villous atrophy. Latent celiac disease can be demonstrated by taking a biopsy of the duodenum and finding an abnormal ratio of certain lymphocytes, called gammadelta lymphocytes, but no villous atrophy.

3. an overgrowth of candida can produce diarrhea, fatigue, depression, and celiac disease like symptoms. Small intestinal candida overgrowth only occurs in severly immunocompromised patients including those with AIDS, congenital defects in the immune system, GI tract cancer, steroid therapy, uncontroled diabetes or broad spectrum antibiotic use. It causes life threatening diarrhea, with rapid weight loss not to mention fever, and vomiting.

To answer you other question, I am researcher with a PHD in Immunology and I specialize in physiology of the GI tract. The reason I am on this forum is because I've had celiac sprue since the age of 2 and I want to educate other people about the misconceptions regarding celiac.

Mike.

Hello Mike1972:

Sure, the placebo effect is real, and works in a number of ways. You can probably even convince some people with terminal cancer that their pain is less by giving them a sugar pill--but that doesn't mean that they don't have cancer now does it? If you had spent a little more time digging in medical articles you might have found some of these--studies that show that Irritable Bowel Syndrome (IBS) can result from undiagnosed celiac disease, and that all patients with IBS should be screened for celiac disease:

Take care,

Scott

I would go even farther and say that some people (a small minority) with terminal cancer have been healed by giving a placebo. Mostly because the patients mental state influences the immune system and stress leads to a reduction in the immune response which allows the cancer to spread. Giving a placebo relaxes these patients and gives them hope which restores the immune system to its normal levels and helps fight off the cancer.

As much as 30-50% of the beneficial effect of any medication/diet/or medical intervention is due to the placebo effect.

You know, Toni, most people with fibro have IBS as well. As we all know, IBS is what doctors call it when they haven't got a clue what's wrong. Irritable bowel symptoms are caused by something.

I was also diagnosed with fibromyalgia in 2000. I was on 50 mg codeine contin (sometimes 100 mg, I was allowed to up the dosage when needed, which it often was at night to sleep) twice a day. It's slow, 12-hour-release, so the pain relief would be around the clock. I was in awful pain all the time. Joint pain, muscle pain, terrible backache, headaches...........The codeine barely took the edge off. Often I'd have to supplement with extra strength Tylenol.

IBS is also called psychogenic diarrhea because between 70% of patients with IBS are healed after taking a placebo (like sugar pills/ gluten free diet).

Here are some links to the causes of IBS:

1.The placebo effect in irritable bowel syndrome trials: a meta-analysis.Patel SM, Stason WB, Legedza A, Ock SM, Kaptchuk TJ, Conboy L, Canenguez K, Park JK, Kelly E, Jacobson E, Kerr CE, Lembo AJ.

Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.

BACKGROUND: Despite the apparent high placebo response rate in randomized placebo-controlled trials (RCT) of patients with irritable bowel syndrome (IBS), little is known about the variability and predictors of this response. OBJECTIVES: To describe the magnitude of response in placebo arms of IBS clinical trials and to identify which factors predict the variability of the placebo response. METHODS: We performed a meta-analysis of published, English language, RCT with 20 or more IBS patients who were treated for at least 2 weeks. This analysis is limited to studies that assessed global response (improvement in overall symptoms). The variables considered as potential placebo modifiers were study design, study duration, use of a run-in phase, Jadad score, entry criteria, number of office visits, number of office visits/study duration, use of diagnostic testing, gender, age and type of medication studied. FINDINGS: Forty-five placebo-controlled RCTs met the inclusion criteria. The placebo response ranged from 16.0 to 71.4% with a population-weighted average of 40.2%, 95% CI (35.9-44.4). Significant associations with lower placebo response rates were fulfillment of the Rome criteria for study entry (P=0.049) and an increased number of office visits (P=0.026). CONCLUSIONS: Placebo effects in IBS clinical trials measuring a global outcome are highly variable. Entry criteria and number of office visits are significant predictors of the placebo response. More stringent entry criteria and an increased number of office visits appear to independently decrease the placebo response.

2. A controlled crossover study of the selective serotonin reuptake inhibitor citalopram in irritable bowel syndrome.Tack J, Broekaert D, Fischler B, Oudenhove LV, Gevers AM, Janssens J.

Department of Internal Medicine, Division of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium. jan.tack@med.kuleuven.ac.be

INTRODUCTION: Selective serotonin reuptake inhibitors (SSRIs) are frequently used in the treatment of irritable bowel syndrome (IBS) although evidence of their efficacy is scarce. AIM: Twenty three non-depressed IBS patients were recruited from a tertiary care centre and included in a crossover trial comparing six weeks of treatment with the SSRI citalopram (20 mg for three weeks, 40 mg for three weeks) with placebo. IBS symptom severity was the primary outcome measure, and depression and anxiety scores were also measured. The effect of acute administration of citalopram on colonic sensitivity and on colonic response to feeding was investigated as a putative predictor of symptomatic response to the drug. RESULTS: After three and six weeks of treatment, citalopram significantly improved abdominal pain, bloating, impact of symptoms on daily life, and overall well being compared with placebo. There was only a modest effect on stool pattern. Changes in depression or anxiety scores were not related to symptom improvement. The effect of acute administration of citalopram during a colonic barostat study did not predict clinical outcome. Analysis of the first treatment period as a double blind parallel arm study confirmed the benefit of citalopram over placebo. CONCLUSIONS: The SSRI citalopram significantly improves IBS symptoms, including abdominal pain, compared with placebo. The therapeutic effect is independent of effects on anxiety, depression, and colonic sensorimotor function.

Mama2ToBoys,

Did you doctor ever consider Munchausen Syndrome by Proxy? It would seem to me that this is the probable diagnosis in your case.