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How Gluten Impairs Drug Absorption
Jefferson Adams posted an article in Additional Celiac Disease Concerns
Celiac.com 05/13/2015 - In addition to being a common ingredient in many commercial food products, gluten is also used in numerous medications, supplements, and vitamins, often as an inert ingredient known as an excipient. Because chronic gluten-related inflammation and damage impairs absorption of nutrients, and likely causes malabsorption of oral medications, it is extremely important for people with celiac disease to review the nutrition labels of all foods and beverages, as well as the package inserts (PI) for information about gluten content. Most oral medications depend on absorption through the small intestine via passive diffusion. GI-tract damage may shift this diffusion process into systemic circulation, which can result in increased or decreased absorption, depending on the drug molecules. Since drug molecules have varying and unique chemical properties, it is hard to determine the exact means of drug absorption in celiac patients, and also hard to determine the impact of celiac disease on drug absorption. Based on their molecular properties, researchers suspect the absorption of a number of drugs is impaired by gluten sensitivity. These drugs include: acetaminophen, aspirin, indomethacin, levothyroxine, prednisolone, propranolol, and certain antibiotics. For these reasons, it is important for doctors to monitor serum drug levels for medications with narrow therapeutic indexes in people with celiac disease. If you have celiac disease, please let your doctor know before you take these drugs. Source: US Pharmacist. 2014;39(12):44-48.-
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Using Bomb Calorimetry to Establish Normative Intestinal Absorption Levels in Healthy Adults
Jefferson Adams posted an article in Celiac Disease & Gluten Intolerance Research
Celiac.com 05/13/2013 - Intestinal absorption capacity is currently regarded as the best way to assess overall digestive intestinal function. Earlier reference values for intestinal function in healthy Dutch adults were based on a study that was conducted in an inpatient metabolic unit setting in a relatively small series. A team of researchers recently used bomb calorimetry to measure normative values of intestinal absorption in healthy ambulant adults. The research team included N. J. Wierdsma, J. H. C. Peters, M. A. E. van Bokhorst-de van der Schueren, C. J. J. Mulder, I. Metgod & A. A. van Bodegraven They are variously affiliated with the Department of Nutrition and Dietetics, the Department of Gastroenterology, Small Bowel Unit, and the Department of Clinical Chemical Laboratory at VU University Medical Centre in Amsterdam, and the Department of Gastroenterology and Hepatology of Red Cross Hospital in Beverwijk, The Netherlands. The present study aimed to readdress and describe the intestinal absorption capacity of healthy adults, who were consuming their usual (Western European) food and beverage diet, in a standard ambulatory setting. The researchers evaluated twenty-three healthy subjects, ranging form 22–60 years old, using a 4-day nutritional diary to determine levels of nutritional intake (energy and macronutrients). They then collected fecal samples over three days to measure mean fecal losses of energy (by bomb calorimetry), fat, protein and carbohydrate. Finally, they calculated intestinal absorption capacity by determining the differences between intake and losses. They found that average (SD) daily feces production was 141 grams, of which, 49 grams (29%) was dry weight, Overall, the samples contained 891 (276) kJ [10.7 (1.3) kJ g1 wet feces; 22.6 (2.5) kJ g1 dry feces], 5.2 (2.2) g fat, 10.0 (3.8) g protein and 29.7 (11.7) g carbohydrates. Mean (SD) intestinal absorption capacity of healthy subjects was 89.4% (3.8%) for energy, 92.5% (3.7%) for fat, 86.9% (6.4%) for protein and 87.3% (6.6%) for carbohydrates. They found that average intestinal energy absorption was approximately 90%. These data serve as normative values for both stool nutrient composition and intestinal energy and macronutrient absorption in healthy adults on a regular Dutch diet in an ambulatory setting. Source: J Hum Nutr Diet. doi:10.1111/jhn.12113