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Celiac.com 06/06/2023 - Celiac disease, osteopenia and osteoporosis are conditions that have been found to be connected. A research team recently described celiac disease-induced osteoporosis in an attempt to enlighten new and lesser-known aspects, including the influence of the intestinal microbiome and sex-related differences, on bone health. The team included Lisa Lungaro, Francesca Manza, Anna Costanzini, Marianna Barbalinardo, Denis Gentili, Fabio Caputo, Matteo Guarino, Giorgio Zoli, Umberto Volta, Roberto De Giorgio, and Giacomo Caio. They are variously affiliated with the Department of Translational Medicine, University of Ferrara in Ferrara, Italy; the National Research Council, Institute for the Study of Nanostructured Materials (CNR-ISMN) in Bologna, Italy; the Department of Medical and Surgical Sciences, University of Bologna, in Bologna, Italy; the Mucosal Immunology and Biology Research Center, Massachusetts General Hospital—Harvard Medical School in Boston, MA, USA. Their review describes the role of celiac disease in the development of skeletal alterations, in order to provide physicians with an updated overview on this debated topic, and to improve the management of osteoporosis in celiac disease. It is important to note that not all individuals with celiac disease will develop osteoporosis. The risk varies depending on factors such as the duration and severity of the disease, adherence to a gluten-free diet, and individual variations in bone health and genetics. However, individuals with celiac disease should be aware of the increased risk of osteoporosis and take steps to manage their bone health, including ensuring adequate calcium and vitamin D intake, monitoring bone density through regular screenings, and maintaining strict adherence to a gluten-free diet. Several important connections between the conditions highlighted by the researchers include: Malabsorption Celiac disease is characterized by damage to the small intestine, leading to impaired absorption of nutrients, including calcium and vitamin D, which are essential for maintaining healthy bones. Malabsorption of these nutrients can result in reduced bone mineral density and increased risk of osteoporosis. Inflammatory Response Celiac disease triggers an immune response in the presence of gluten. This immune response involves the production of pro-inflammatory molecules, which can contribute to bone loss and increased bone turnover, leading to osteoporosis. Calcium Imbalance The malabsorption of calcium in individuals with celiac disease can disrupt the balance of calcium in the body. When there is insufficient calcium intake or absorption, the body may draw calcium from the bones, weakening them and increasing the risk of osteoporosis. Calcium intake in the young age is an essential determinant of the bone mass peak. Calcium metabolism defects are common in untreated children with celiac disease, and they return to normal with a gluten-free diet. Vitamin D Deficiency Vitamin D plays a crucial role in calcium absorption and bone health. Celiac disease can lead to reduced vitamin D absorption due to intestinal damage. Vitamin D deficiency further exacerbates the risk of osteoporosis. Gluten-Induced Autoimmunity Celiac disease is an autoimmune disorder, and individuals with autoimmune diseases, including celiac disease, have a higher risk of developing additional autoimmune conditions such as autoimmune osteoporosis. Autoimmune mechanisms may contribute to bone loss and the development of osteoporosis in individuals with celiac disease. Hormonal Imbalance Celiac disease can disrupt the endocrine system, leading to hormonal imbalances. Hormones such as estrogen and testosterone play a crucial role in maintaining bone health. Imbalances in these hormones can accelerate bone loss and increase the risk of osteoporosis. Sex Differences Women with celiac disease are at a higher risk of osteoporosis due to both indirect and direct effects. The indirect effects include factors such as early menopause and amenorrhea (absence of menstruation), which can have a negative impact on bone health. Early menopause refers to the cessation of menstruation before the age of 45, which can occur in women with celiac disease due to various factors, including hormonal imbalances and inflammation. Early menopause is concerning for bone health because estrogen, a hormone that helps maintain bone density, decreases significantly during menopause. Lower estrogen levels can accelerate bone loss and increase the risk of osteoporosis. Therefore, women with celiac disease who experience early menopause should be particularly vigilant about managing their bone health. Physicians should be aware of bone conditions linked to celiac disease that might contribute to the worsening of BMD, and should treat them promptly. There is little evidence regarding osteopenia and pharmacological osteoporosis treatment, specifically in celiac disease. Probiotic supplementation might become a novel strategy in preventing bone alterations, although the role of gut microbiota is still uncertain and not well-established yet. In the full report, the researchers offer a comprehensive dive into each of the areas mentioned above. Read more in Nutrients. 2023 Mar; 15(5): 1089 doi: 10.3390/nu15051089

Celiac.com 06/01/2023 - The rising popularity of gluten-free diets has captured public attention in recent years. With claims of weight loss, improved digestion, and increased energy, many individuals have jumped on the gluten-free bandwagon. However, it's important to base dietary decisions on scientific evidence, rather than mere trends. To shed some scientific light on the subject, a team of researchers conducted a controlled study to investigate the effects of gluten intake on body weight, body composition, resting energy expenditure, and the changes in nutrient intake caused by gluten-free diets. Study on Effects of Gluten Intake The research team included Hirla Karen Fialho Henriques, Luana Moreira Fonseca, Karine Silva de Andrade, Nitin Shivappa, James R. Hébert, Adaliene Versiani Matos Ferreira & Jacqueline Isaura Alvarez Leite. They are variously affiliated with the Department of Biochemistry and Immunology - ICB, Federal University of Minas Gerais, Belo Horizonte, Brazil; the Department of Nutrition, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Brazil; the Department of Biochemistry and Immunology - ICB, Federal University of Minas Gerais, Belo Horizonte, Brazil; and the Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA. Their study enrolled twenty-three women, who adhered to a gluten-free diet for a duration of six weeks. During this period, the participants were provided with muffins containing either 20 grams of gluten isolate (known as the gluten period) or gluten-free muffins (the gluten-free period) in a crossover, single-blind, non-randomized trial. The researchers assessed the subjects' habitual diet, including gastrointestinal symptoms, food frequency questionnaires, body composition, resting energy expenditure, and recorded daily food intake for the entire six-week duration. The Findings - Increase in Fat and Sodium Intake Surprisingly, the data showed that body weight, body composition, gastrointestinal symptoms, and resting energy expenditure remained similar during both the gluten and gluten-free periods. These results indicate that consuming up to 20 grams of gluten per day does not affect body weight or composition in healthy women without caloric restriction, at least over a relatively short period of three weeks. However, the team saw some concerning changes when the nutrient composition of the gluten-free period was compared to the participants' habitual diet. The gluten-free diet led to an increase in fat and sodium intake, while reducing the intake of fiber, as well as vitamins B1, B6, B12, and folate. This imbalance in nutrient intake resulted in an elevated dietary inflammatory index, indicating a higher inflammatory potential associated with gluten-free diets. These findings highlight the importance of considering the overall nutritional quality of a diet, rather than focusing solely on the absence of gluten. While a gluten-free diet may be necessary for individuals with specific medical conditions, such as celiac disease, the results suggest that adopting a gluten-free diet without medical necessity may have adverse effects on nutrient intake and potentially contribute to inflammation. The study offers some potentially valuable insights into the impact of gluten intake and gluten-free diets on health, especially with regards to nutrient intake, but it's important to note that it has certain limitations. The small sample size and the short duration of the trial invite further research with larger populations and longer intervention periods, to validate and expand upon these findings. Additionally, the study focused solely on healthy women, so the results may not be generalizable to other populations, or those with specific health conditions. It's also important to note that following a gluten-free diet can lead to imbalances in nutrient intake, particularly a reduction in fiber and essential vitamins, and an increase in dietary inflammation potential, even in non-celiacs. As with any dietary decision, it's best to consult with a healthcare professional or registered dietitian to ensure a well-rounded and nutritionally adequate diet that suits individual needs. Read more in the J Am Nutr Assoc. 2022 Nov-Dec;41(8):771-779.

Celiac.com 02/22/2023 - When people with celiac disease consume wheat or gluten, they typically suffer damage to the lining of the small intestine, along with associated symptoms of the damage, including nutritional deficiencies. Most women with celiac disease follow a gluten-free diet. But, we still don't know very much about the potential long-term impact of a gluten-free diet on the nutritional, body composition, and other factors in women with celiac disease. To better understand the issue, a team of researchers took a closer look at this issue. The team studied a group of just over fifty adult Saudi females with celiac disease, all of whom had followed a gluten-free diet for more than one year. The study included a complete analysis of anthropometric data, levels of vitamins B12 and D, and a complete blood count. Even though it's a small study, the results are concerning. That's because all of the patients were deficient in micro and macro-nutrients, including vitamin D, folate, calcium, and iron. Moreover, nearly half of the patients had reduced total body fat, while nearly two out of three had decreased levels of visceral fat. We already know that most adult celiacs suffer from micronutrient deficiencies. We also have a good idea of which deficiencies are the most common. The team's findings echo those of earlier studies, which have shown that gluten-free foods often have poorer nutritional quality than similar non-gluten-free foods. This means that people with celiac disease who follow a gluten-free diet may be at risk for poor nutrition or malnutrition. To ensure proper nutrition for people with celiac disease, especially women, it's important to remain extra vigilant about getting food with enough nutrition, fiber, and other essential nutrients to promote good health. This may include working with a dietitian or nutritionist to create a well-balanced meal plan, and supplementing with vitamins and minerals, as needed. Women with celiac disease who are following a gluten-free diet, and those who care for them, should take this study seriously, share it with your doctor or nutritionist, and take steps to make sure they remain healthy. Read more in Nutrients

Celiac.com 01/02/2023 - There's been a good bit of research to show that a gluten-free diet can reduce symptoms in some patients with irritable bowel syndrome (IBS), but there are currently no good answers for why that might be. To get a better idea for the reasons, a team of researchers recently set out to compare the effects of a gluten-free and gluten-containing diet on IBS symptoms and the gut microenvironment, and to identify predictors of response to the gluten-free diet in IBS. Here's what they found. The research team included Joost P. Algera; Maria K. Magnusson; Lena Öhman; Stine Störsrud; Magnus Simrén; and Hans Törnblom. They are variously affiliated with theDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; the Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden; and the Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. Randomized Controlled Trial For their randomized controlled trial, the team followed twenty patients with IBS, along with 18 healthy control subjects, all of whom followed a gluten-free diet during two 14-day intervention periods, during which they received meals sprinkled with either gluten, totaling 14 grams a day, or rice flour powder. Main outcomes included effects of the interventions on IBS symptoms and bowel habits. Secondary outcomes included effects of gluten-free diet on fecal microbiota and metabolite profile. IBS symptoms improve on gluten-free diet IBS symptoms improved during the gluten-free diet period, but not the gluten-containing period, with no difference between the interventions. Among other things, IBS patients on a gluten-free diet reported fewer loose stools. Meanwhile, patients with IBS and healthy control subjects showed specific metabolite profiles related to the gluten-free diet. True responders showed a reduction of IBS symptoms of 50 or greater solely after gluten-free period. The team distinguished non-responders based on microbiota and metabolite profiles resulting from the gluten-free diet. Based on the patient's metabolite profile before the intervention, the team was able to predict patient response to a gluten-free diet. Gluten-free diet seems to improve gut health From their findings, the team concludes that a gluten-free diet seems to improve the gut biome, and may help to reduce symptoms in some patients with IBS, especially with respect to bowel habits. Patient metabolite profiles can predict responsiveness to the gluten-free diet. This study is important for people with IBS, as it provides some good data for the benefits of a gluten-free diet in many cases. Read more in Aliment Pharmacol Ther. 2022;56(9):1318-1327

Celiac.com 12/07/2022 - What is the nutritional and health impact of a long-term gluten-free diet on people with celiac disease? A team of researchers recently set out to take a deep look at the influence of a long-term gluten-free diet on nutritional status, body composition, and associated factors in adult Saudi females with celiac diseases. One Year Study of Fifty-one Diagnosed Celiac Patients For their study, the team included fifty-one diagnosed celiac patients who had followed a gluten-free diet for over one year. They collected data on patient dietary patterns, along with a complete analysis of anthropometric parameters, levels of vitamins B12 and D, and complete blood count (CBC). The data show that all patients suffered from an insufficient intake of all micro and macro-nutrients, including vitamin D, folate, calcium, and iron. Otherwise, their bloodwork fell within the expected ranges. While one-third of patients were slim, nearly half showed decreased total body fat, more than half of the patients showed low waist/hip ratios, and more than sixty-percent showed decreased levels of visceral fat. On the whole, patients with poor nutritional status also tended to have poor educational levels and some psychosocial factors that may have influenced their results. However, the team did find that a gluten-free diet in women with celiac disease negatively affects their nutritional intake and anthropometric indices, and leads to a deficiency in major nutrients, vitamins, and ions. Study Conclusions This study confirms other studies that show that gluten-free foods often have poorer nutritional quality than their non-gluten-free counterparts, and that many people with celiac disease suffer from poor nutrition or malnutrition. The results highlight the need for women, but also for all celiacs on a gluten-free diet, to be extra vigilant about making sure to get enough nutrition, fiber and nutrients. Nutrients 2022, 14(10), 2090 The research team included Aeshah Ibrahim Alhosain, Ghedeir M. Alshammari, Barakat Lafi Almoteri, Mohammed A. Mohammed, Manal Abdulaziz Binobead, and Mohammed Abdo Yahya. They are variously affiliated with theDepartment of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University in Riyadh, Saudi Arabia, and the Department of Gastroenterology, Buraidah Central Hospital, Ministry of Health in Buraydah, Saudi Arabia.

Celiac.com 04/05/2019 (Originally published on 10/19/2009) - Gluten intolerance caused by celiac disease, or non-celiac gluten sensitivity, may affect virtually any part of the body. A culprit in multiple health disorders, gluten intolerance is a major driver of health care delivery and associated costs. While this may seem to be an outrageous claim, a review of the many ways in which gluten intolerance can adversely affect the body will illustrate this point. So, let’s work our way down from head to toe. Celiac Disease Can Cause Hair Loss Normal, healthy hair is usually glossy and thick. An autoimmune disorder known as alopecia areata results in abnormal loss of hair, either in patches, or totally, and is one of many autoimmune disorders associated with celiac disease. Malabsorption severe enough to cause malnutrition can also result in thin, sparse, fragile hair. One of the outward signs of hypothyroidism is thinning hair and a loss of the outer third of the eyebrow; hypothyroidism is strongly associated with celiac disease. How Celiac Disease Affects the Brain Now let’s look at the brain. There are, unfortunately, a large number of neurological disorders associated with gluten intolerance and celiac disease, including narcolepsy, depression, ADD/ADHD, Autism Spectrum Disorders, and schizophrenia. There are also movement and balance disorders associated with gluten intolerance, including ataxia - the inability to coordinate movements and balance (gluten ataxia, celiac ataxia, some cases of sporadic idiopathic ataxia). In some cases, when symptoms are severe, this disorder mimics other disorders such as Parkinson’s, Normal Pressure Hydrocephalus, and even Alzheimer’s disease. Headaches Common in Celiac Disease Headaches are a very common symptom of wheat allergy, as well as gluten intolerance. Migraines are common in those with celiac disease and gluten intolerance, as are sinus headaches. These symptoms often decline dramatically after excluding gluten grains from the diet. Sinus problems are common in those with celiac disease, gluten intolerance, and sensitivity to dairy products as well, and are often reversible by making dietary changes. Some people with celiac disease seem to have an altered, highly acute sense of smell – for unknown reasons. Night Blindness from Vitamin A Deficiency Night blindness associated with vitamin A deficiency is reversible when malabsorption is resolved and with the addition of a vitamin A supplement. Xeropthalmia, or chronic, often severe, dry eyes, is also related to severe vitamin A deficiency. It is rare in developed countries, but can be found in some people with malnutrition due to celiac disease. Canker Sores Common in Celiac Disease Apthous stomatitis is the name for the mouth ulcers associated with food allergies and intolerances, and is strongly associated with celiac disease and gluten intolerance. Even people who do not have gluten sensitivity get these once in a while but in those with gluten intolerance they are more frequent and especially long-lasting. Dental Enamel Defects Can Indicate Celiac Disease While they are usually identified in childhood, they can continue to cause problems throughout life, because they often lead to more frequent dental cavities. Halitosis, or bad breath, is a reflection of our internal environment and gastrointestinal health, and is often present in those with untreated celiac disease, gluten sensitivity, or gut dysbiosis – an upset in the balance of our internal microorganisms caused by poor diet and other factors. And, one of the autoimmune disorders strongly associated with celiac disease, and one of the most prevalent is Sjogren’s syndrome, which impairs the normal production of body fluids like tears, saliva, and vaginal secretions. Strong Link Between Celiac Disease & Eosinophilic Esophagitis Following the path our food takes to the stomach, we can look for effects in the esophagus too. Eosinophilic esophagitis is a rarely encountered inflammation in the tissue of the esophagus which makes swallowing painful and difficult and can result in bleeding ulcerations. When doctors do see it, they sometimes test for celiac disease, since there is a strong correlation. Fortunately, in cases where this condition is caused by gluten intolerance, this painful chronic disorder clears up on a gluten free diet, too. GI Complaints Common in Celiac Patients Now we’re getting to the area most people associate with gluten intolerance – the gastro-intestinal system. In the past, celiac disease was usually described as causing gas, diarrhea, bloating, discomfort, cramping, and malabsorption. But as you’ve already seen above, there is a whole lot more to this disorder, and we’re only halfway to the toes. Celiac Can Be Misdiagnosed as IBS In addition to the above symptoms, the body’s reaction to gluten can cause inflammation anywhere, but a common location is in the illeo-cecal junction and the cecum. This can sometimes be confused with appendicitis, or ovarian pain or an ovarian cyst in women experiencing right-sided lower abdominal discomfort. Irritable bowel syndrome is suspected to affect at least 10-15% of adults (estimates vary). It is differentiated from IBD, or inflammatory bowel disorders (which include Crohn’s disease and ulcerative colitis). But, taken together, there are an awful lot of people out there with uncomfortable gut issues. One fact to consider is that many of those with celiac disease were previously, and wrongly, misdiagnosed with IBS before discovering they actually had celiac disease. Kidney & Urinary Problems Let’s take a look at the urological system. Even though gluten from the food we eat isn’t directly processed here, can it still be affected? The answer is yes. Kidney problems in association with celiac disease are well documented, including oxalate kidney stones. Bladder problems are increasingly shown to be responsive to a gluten-free diet. This is kind of my specialty and I would estimate that about a quarter of those with interstitial cystitis, and many people with recurrent urinary tract infections, have a sensitivity to gluten. Even prostate inflammation in some men can be triggered by eating gluten grains. Adrenal Fatigue in Celiac Disease Sitting just atop the kidneys are our adrenal glands. They have a difficult job, helping to direct our stress response system, our immune system, and our hormone output, and controlling inflammation in the body. Every time we experience a reaction to gluten, and our adrenals respond by sending out a surge of cortisol to help control inflammation, we are depleting our adrenal reserve. When this happens chronically, over time, our adrenal system cannot keep up and becomes fatigued. Symptoms of adrenal fatigue have far-reaching consequences throughout the body, including, of course, feeling fatigued and run down. But, adrenal fatigue can also affect our hormones, our blood sugar regulation, our mental acuity, our temperature regulation, and our ability to cope with food allergies, environmental allergies, and infections. Celiac Disease Common in Hepatitis Patients Can the liver, the body’s largest internal organ, be affected by gluten intolerance too? One example is autoimmune hepatitis, in which can be untreated celiac disease can be found in large numbers. Early screening testing for celiac disease is now strongly recommended for patients diagnosed with autoimmune hepatitis. Gluten Intolerance, Pancreas and Blood Sugar The pancreas, which is key in blood sugar regulation, is highly affected by gluten intolerance. Autoimmune disease triggers the development of Type I Diabetes, and is becoming more closely associated with celiac disease. Testing for celiac disease is now becoming a routine part of examination when a child develops Type I Diabetes, and now that physicians are looking for celiac disease in juvenile diabetes, they’re finding it with greater frequency. Blood sugar regulation problems are also associated with non-diabetic hypoglycemia in those with gluten intolerance, and appear to resolve with a low-glycemic gluten free diet. Celiac Disease Can Affects Limbs and Extremities So, we’ve covered most of the body’s major internal systems. Now, let’s look at the extremities, our upper and lower limbs, where gluten-associated problems are also found. Ehlers-Danlos Syndrome, a collagen disorder resulting in shoulder, elbow, and wrist joints that dislocate easily (and other characteristics) is a genetic disorder that may also be associated with celiac disease. I had mild symptoms of this disorder as a child, but never knew it had a name until I ran across it recently. With a child who has this disorder, a simple game of swinging a child by the arms, or swinging a child between two sets of their parent’s arms, can result in a trip to the emergency to put their joints back into proper alignment. This is not to say that a reaction to gluten causes this genetic disorder, but that if you have a personal or family history of Ehlers-Danlos Syndrome, and symptoms that may be related to celiac disease, you should consider being tested. Arthritis Associated with Celiac Disease Rheumatoid arthritis is another of the autoimmune disorders associated with celiac disease, and often affects the fingers with crippling joint deformation. Other joints in the body can also be affected. Scleroderma is another terribly disfiguring and sometimes fatal autoimmune disorder affecting every part of the body. It is often first identified in the extremities, particularly the fingers. In scleroderma, normal tissue loses it’s flexibility as the body’s autoimmune response produces inflammation and an overproduction of collagen. Collagen is the tough fibrous protein that helps form connective tissues including tendons, bones, and ligaments. Excess collagen is deposited in the skin and body organs, eventually causing loss of function. Scleroderma can be associated with celiac disease. Skin Conditions Common in Celiac Patients The arms and legs are also common spots for yet another autoimmune disorder, psoriasis, to develop. Some patients with psoriasis are responsive to a gluten-free diet, but unfortunately, not everyone. Another skin condition that often shows up on the arms is dermatitis herpetiformis (DH), although this itchy blistering skin rash can occur in other places as well. Common sites are the backs of the elbows and the backs of the knees, or on the lower legs. Peripheral Neuropathy Common in Celiac Disease Peripheral neuropathy is a disorder that results in numbness, tingling, and sometimes severe nerve pain in the extremities. Finger, hands, toes, feet, and lower legs may all be affected. Although usually associated with diabetes, peripheral neuropathy shows up fairly frequently in those with celiac disease, and is fortunately reversible on a gluten free diet supplemented by B-vitamins and some specific amino acids. Peripheral neuropathy is usually associated with older people, but some of the cases I’ve observed recently have been in very young children who had severe malabsorption issues. Fortunately they healed quickly and their neuropathy symptoms resolved completely. Malabsorption and Vitamin Deficiency There a few last symptoms related to malabsorption that tend to show up in those with celiac disease or gluten intolerance. Easy bruising and bleeding, either due to a deficiency of Vitamin K, or to an autoimmune platelet disorder, is one. Rickets, or osteomalacia – a softening of the bones in the legs related to vitamin D deficiency – is another. As we said before, inflammation goes along with celiac disease and gluten intolerance, and a common site for inflammation is the lower extremities. Sometimes this can be profound, and trigger doctors to think heart disease, but it’s often unresponsive to Lasix and other diuretics. This condition, too, may also clear up on a gluten-free diet. As for me, I’ll be happy to be gluten-free, from head to toe.

Celiac.com 05/08/2007 - One of the strategies for developing alternative therapies for treating celiac disease centers on the identification of antagonist peptides that might inhibit the abnormal immune response caused by gliadin peptides in celiac disease. A recent study published in the journal Pediatric Research indicates that a peptide that occurs naturally in durum wheat may protect against the effects of celiac disease by acting as an antagonist against gliadin peptides associated with abnormal immune response. The study was conducted by a team of Italian researchers made up of Drs. Marco Silano, Rita DiBenedetto, Antonello Trecca, Gioachhino Arrabiato, Fabiana Leonardi, Massimo De Vincenzi. The research team set out to assess the antagonistic effects of 10mer, a decapeptide (sequence QQPQDAVQPF) from the alcohol–soluble protein portion of durum wheat, and to evaluate its prospects for preventing gliadin peptides from activating celiac peripheral blood lymphocytes. The team extracted peripheral blood mononuclear cells from children with celiac disease who tested DQ2-positive, and from a healthy control group. These samples were then incubated with the peptic-tryptic digest of bread wheat gliadin (GLP) and peptide 62-75 from [alpha]-gliadin, both alone and separately with 10mer. PBMC proliferation, release of pro-inflammatory Th1 cytokines interferon-[gamma] and tumor necrosis factor-[alpha], release of immuno-regulatory cytokine IL-10, and analysis of CD25 expression as indexes of lymphocytes activation were performed. Exposure to wheat gliadin peptide and peptide 62-75 from [alpha] gliadin both showed increased activation of lymphocytes. However, the incubation samples with 10mer showed inhibited lymphocyte action. The study indicates that naturally occurring peptide 10mer in durum wheat may protect against lymphocyte activity in patients with celiac disease, and that further study and evaluation of these findings is warranted. Pediatric Research. 61(1):67-71, January 2007.

Celiac.com 06/13/2020 - The effects of celiac disease can vary, depending on whether the patient is following a gluten-free diet. Many of the effects of celiac disease disappear or improve significantly when the patient begins a gluten-free diet. Untreated celiac disease can lead to numerous problems, including serious associated medical conditions, some fatal. Untreated Celiac Disease Can be Life-Threatening People with untreated celiac disease are more likely to be afflicted with problems relating to malabsorption, including osteoporosis, tooth enamel defects, central and peripheral nervous system disease, pancreatic disease, internal hemorrhaging, organ disorders (including gall bladder, liver, and spleen), and gynecological disorders, like amenorrhea, and spontaneous abortions. Celiac Disease May Affect Fertility Celiac disease may also affect fertility. Some researchers are convinced that gluten intolerance, whether or not it results in full-blown celiac disease, can impact mental functioning in some individuals and cause or aggravate autism, Aspergers syndrome, attention deficit disorder (ADD), and schizophrenia. We've done a number of articles on Fertility, Pregnancy, Miscarriage and Celiac Disease over the years. Gluten-Free Diet Crucial to Good Celiac Health Some of the damage may be healed or partially repaired after time on a gluten-free diet. For example, problems with infertility may be reversed. Celiacs who do not maintain a gluten-free diet also stand a much greater chance of getting certain types of cancer, especially intestinal lymphoma. Celiac Disease and Depression There is a building amount of medical literature showing links between Depression and Celiac Disease. We know that Untreated Celiac Disease Often Suffer Depression, and low quality of life scores. Anxiety, depression and fatigue are common complaints in patients with untreated celiac disease and contribute significantly to lower quality of life. While aspects of these conditions may improve within a few months after starting a gluten-free diet, some patients continue to suffer from significant psychological morbidity. Higher Depression Risk in Women with Celiac Disease Studies have shown that women with celiac disease face higher risk for depression. Higher Suicide Rates in Celiac Disease Patients Several studies have shown that people with celiac disease have a higher risk for suicide than non-celiacs. Celiac Disease is Tied to Depression in Adolescents Celiac disease is associated with depression in adolescents. Children and Teens with Newly Diagnosed Celiac Disease Can Face Extra Challenges Researchers recently assessed Health-Related Quality of Life in children with celiac disease, and to compare it against data for healthy children and children with non-celiac gastrointestinal (GI) problems using established data. Temporary Lactose Intolerance Common for Celiacs Untreated celiac disease can cause temporary lactose intolerance. Lactose is a sugar found in dairy products. To be digested it must be broken down by an enzyme called lactase. Lactase is produced on the tips of the villi in the small intestine. Since gluten damages the villi, it is common for untreated celiacs to have problems with milk and milk products. (Yogurt and cheese are less problematic since the cultures in them break down the lactose). A gluten-free diet will usually eliminate lactose intolerance. However, a number of adults (both celiacs and non-celiacs) are lactose intolerant even with a healthy small intestine; in that case a gluten-free diet will not eliminate lactose intolerance. Multiple Food Sensitivities Common for Celiacs Celiacs often suffer from other food sensitivities. These may respond to a gluten-free diet--or they may not. Soy and MSG are examples of food products that many celiacs have trouble with. However, it should be noted that these other sensitivities, while troublesome, do not damage the villi. As far as we know, only gluten causes this damage. Headaches With or without a gluten-free diet, headaches are a common feature of celiac disease. Ten Most Common Complaints of Celiac Patients Some of the effects of celiac disease can be seen in the ten most common physical complaints of people who have celiac disease. Those are: Osteopenia/Osteoporosis; Anemia; Cryptogenic hypertransaminasemia; Diarrhea; Bloating; Aphthous stomatitis; Alternating bowel habit; Constipation; Gastroesophageal reflux disease and Recurrent miscarriages. This category has a more complete listing of related disorders.

Celiac.com 06/25/2012 - If you have received a celiac disease diagnosis while taking heart pressure medication, it turns out you might not actually have celiac disease. An investigation led by Dr. Joseph Murray has shown that certain blood pressure medication can cause symptoms not unlike those commonly attributed to celiac disease, and going off the drug can stop the symptoms. Between 2008 and 2011, 22 patients on the blood pressure medication olmesartan (sold as Benicar) exhibited clear symptoms of celiac disease: intestinal inflammation and abnormalities, chronic diarrhea and weight loss (median weight loss of 39 pounds). One of the patients lost an astounding 125 pounds, and fourteen of the patients exhibited symptoms so severe as to require hospitalization. All of the patients were diagnosed with celiac disease based on symptoms and intestinal biopsy results, but gluten-free diet caused no improvement in any of the patients. Furthermore, their blood tests came back with results that did not match up with a celiac disease diagnosis. After taking the patients off olmesartan, all of their symptoms showed dramatic improvement. Eighteen of the 22 had subsequent intestinal biopsies, which revealed improvement in that area as well. It would seem then, that the medication causes celiac-like symptoms. Some in the medical community have questioned the causal relationship of olmesartan to the symptoms though. As Dr. Franz Messerli of St. Luke's-Roosevelt Hospital, New York argues, “Only re-exposure [to the drug] can confirm the GI side effects were indeed due to olmesartan.” The sample size has also been called into question by Dr. Henry Black of NYU-Langone Medical Center, who claims that the side effects are highly uncommon and that he uses the drug all the time with no adverse effects. Some have even proposed that the reaction is the result of a drug allergy rather than symptoms related to the mechanism of the drug itself. The conclusion one can draw from Dr. Murray's findings and subsequent criticisms, is that it is highly likely that olmesartan can cause celiac-like symptoms, but it is not entirely clear how often or why. Those who take it and experience such symptoms (or have gotten a celiac diagnosis while on the drug) should discuss switching to another medication with their doctors. It is still unclear if these symptoms are specific to olmesartan, or can be caused by the entire ARB family of drugs. As Dr. Murray says, "it's really an awareness issue. We want doctors to be aware of this issue, so if they see a patient who is having this type of syndrome — they think about medications as a possible association." Sources: http://abcnews.go.com/Health/blood-pressure-drug-olmesartan-linked-gi-side-effects/story?id=16620314#.T-SpQLUXLR9 http://www.mayoclinic.org/news2012-rst/6956.html?rss-feedid=1

Celiac.com 06/06/2011 - The interplay among the different immune cells mediating intestinal inflammation in celiac disease is complicated indeed. A subset of T regulatory (Treg) cells that express the Foxp3 protein are present in higher numbers in the intestines of patients with active celiac disease than in healthy controls. Treg cells act to suppress the immune system, providing tolerance to self-antigens. A recent report in the American Journal of Gastroenterology demonstrates that these cells proliferate upon the ingestion of gluten in order to suppress an overactive inflammatory response, but that their suppression is in turn suppressed by interleukin-15. First they confirmed that there is in fact increased expression of Foxp3+ cells in the intestinal mucosa of untreated celiac patients; happily, they write that "no significant differences were noted in the number of Foxp3+ cells in biopsy samples of treated celiac disease in comparison with biopsy samples of non-celiac disease controls." Next, they used an in vitro gliadin challenge system - no celiac patients were harmed during the course of this study! - to see if the increase in this cell population was dependent on gliadin, and it was. T cells are so named because they are made in the thymus; this demonstration that they can originate in the small intestine lamina propria is interesting. Treg cells are generally immunosuppressive, and the Treg cells isolated from celiac guts demonstrated this immunosuppressive ability in vitro. So the researchers wondered: why is there still so much inflammation in untreated celiac disease patients? They found that the cytokine IL-15 could suppress the proliferation of Treg cells, and completely shut down their ability to produce interferon gamma (IFN- γ ). This is at least partially because Treg cells from celiac patients turn out to have a significantly higher surface density of receptors for IL-15 than Treg cells from healthy controls, rendering them more sensitive to IL-15's effects. Zanzi et al bolstered their findings by achieving the same results using two independent experimental methods. It is not yet clear how IL-15 impairs the suppressive activity of Treg cells. But these scientists are actively working on it. Source: Am J Gastroenterol advance online publication, 5 April 2011; doi: 10.1038/ajg.2011.80

Celiac.com 06/30/2010 - Presently, the only proven treatment for celiac disease is a lifelong gluten-free diet. As part of a gluten-free diet, people with celiac disease are encouraged to avoid consuming foods containing rye, along with avoiding wheat and barley. However, there is surprisingly little evidence to document the adverse effects of rye in cases of celiac disease. To address this deficiency, a team of clinicians set out to determine conclusively whether rye should be excluded from the celiac diet. The team included S. M. Stenman, K. Lindfors, J. I. Venäläinen, A. Hautala, P. T. Männistö, J. A. Garcia-Horsman, A. Kaukovirta-Norja, S. Auriola, T. Mauriala, M. Mäki, and K. Kaukinen They are affiliated variously with the Department of Pediatrics, and the Pediatric Research Center of the Medical School University of Tampere, the Department of Gastroenterology and Alimentary Tract Surgery at Tampere University Hospital, the Department of Pharmacology and Toxicology, the Department of Pharmaceutical Chemistry at the University of Kuopio, the Division of Pharmacology and Toxicology, the Division of Pharmaceutical Chemistry at the University of Helsinki, and Technical Research Centre of Finland. The goal of the team was to determine whether rye secalin triggers toxic reactions in vitro in intestinal epithelial cell models to the same degree as wheat gliadin. Moreover, they examined whether the harmful effects of secalin can be reduced by germinating cereal enzymes from oat, wheat and barley to hydrolyze secalin into short fragments as a pretreatment. The data showed that secalin did trigger toxic reactions in intestinal Caco-2 epithelial cells in a similar manner to gliadin. Secalin triggered epithelial cell layer permeability, tight junctional protein occludin and ZO-1 distortion, and actin reorganization. High-performance liquid chromatography and mass spectroscopy (HPLC-MS), showed that germinating barley enzymes best degraded the secalin and gliadin peptides. Further in vitro analysis showed that germinating barley enzyme pretreatment ameliorated all toxic secalin-triggered reactions. From these results, the team concludes that germinating enzymes from barley offer efficient degradation of rye secalin. In future, these enzymes might be utilized as a novel medical treatment for celiac disease or in food processing in order to develop high-quality celiac-safe food products. Such enzyme treatments might pave the way for either new treatments for celiac disease, or, new methods of processing rye for production of new, celiac-safe foods. SOURCE: Clinical & Experimental Immunology DOI:10.1111/j.1365-2249.2010.04119.x