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Celiac.com 12/23/2016 - Before my dog Amber's health started to fall apart, I had observed friends and family members on their gluten free journeys without ever considering this could be a solution for me. Years of periodic juice fasting, vegan and vegetarian diets, and then finally a GMO-free, semi-vegetarian lifestyle, had never led me to consider complete and total gluten free eating, until Amber. At nine years old she began to have a chronic yeast and skin infection and she stunk. Her stools became bloody, she was fat, her walking was slow and labored, and the vet said that if we didn't find out what was wrong with her soon she'd be dead within a year. He referred me to a woman in Eugene, OR who worked with animals and might know what I could do. The woman told me to immediately change her diet from dog food that contained grains, to gluten-free. She said that most retrievers and labs will carry on as if healthy for years with no issue, and then suddenly begin to fall apart when they reach senior ages. Their bodies can no longer tolerate gluten at that point, and a bundle of symptoms will appear. We began shopping at Animal Crackers, a store in town that sells a variety of high quality animal foods. Amber began eating gluten-free Orijen dog food, and within three months her skin lesions and yeast infection had healed. Also, all stink was gone, her stools were normal, and she was suddenly bounding around the park with puppy energy again. No doubt a dietary change had healed her. Soon afterward, at 47 years old, I suddenly decided to not eat anything with gluten in it. It wasn't even a plan or necessity, it was just like, one day I found myself buying gluten-free muffins and trying them. For some unexplainable reason I stuck to no gluten for a while, and by day three I noticed I was feeling happier. A lack of longing for traditional bread surprised me, because I love baking, and eating homemade bread. To omit my beloved goodies seemed extreme, and I was always of the opinion that organic and GMO-free wheat and gluten was sufficient unto itself, if one didn't have celiac disease. Yet here I was, day four and feeling fantastic. Actually, I wasn't sure what changes were occurring. I felt lighter, with an absence of discontent in my body. I experienced frequent bursts of 'anti-depression', akin to joyful energy rushes, which I never related to hyperactive sensations. Sleep became easy and relaxing. I would awaken with recharged emotional and physical well being. I began to crave junk food less, my stomach flattened, and all jitters went away. I found myself patiently standing in long lines, an unfamiliar feeling to me, and my mind cleared up, pleasurably. After about two weeks of observing these lovely 'feel-good' transformations, I discovered a divine intervention had occurred with bladder control. Years of frustration and concern, even discussions with a doctor about surgical intervention, had led me to believe that I was cursed with a life long issue of urinary stress incontinence. Yet, now I was noticing that a gluten-free change had all but dissolved my problem! Even as a 'wheat bellied' child I'd had incontinence issues, and this only exacerbated after two natural child births. Months of yoga, kegal exercises, and daily trampoline jumping helped some, but it never entirely went away. With a gluten-free dietary change, bloating and mild incontinence are now absent. This calm, non jittery, focused, new me, experimented ever so cautiously with jogging around the block, and nothing happened! About a month into it, I decided to eat a wheat bun with a hamburger, just to see if I would feel any different. After a couple hours, my mind went to dull and foggy mode, my body felt a little heavier and 'full', and what must have been a chronic urinary tract inflammation for years, returned again to nag at me. Minor leakage reared it's bothersome head again, but only for as long as it took to get gluten out of my system. The difference was like going from "Ah!" to "blah." A surprising factor in my gluten-free experience is that I've always been a healthy and happy person. I never seriously considered taking beloved gluten filled foods out of my diet, because I love those foods and never got sick eating them, OR so I thought. Aches and pains I figured were genetic curses, and part of my natural aging. Oh how wrong I was! After a year of gluten-free living, every organ in my body approves of this change, including bowels and nervous system. Best of all, I've experienced a seeming miraculous, non surgical intervention, with hardly any effort. And there's more to my story: Before gluten-free my cholesterol was high. I'd tried diet and natural supplements to no avail, and finally went on a statin medication to control it. It remained high and challenging until I changed my diet to gluten-free. With virtually no decrease in my fat intake, this life style change has brought the cholesterol level down. My latest labs shows normal levels, and once I accomplish a goal of eating more vegetables (than all these darn delicious gluten-free baked goods), and staying on a clean, low fat diet, I will explore going off cholesterol medication, once and for all. I continue to get caught up in all the numerous gluten-free pizza crust, pastry and bread recipes available. My salad creations are sorely neglected and I know this is my next challenge. But I won't beat myself up too much for enjoying this new exploration of 'all foods gluten free', (including beer- I recommend Omission). As for ever going backward, I have zero desire whatsoever, to return to a gluten filled lifestyle. I LOVE the way I feel now. When tempted by gluten-filled foods, I think of how I can now jog as long as I want to, with no leakage, for the first time in over twenty years. And I remember how surgery is out of the picture when it was once in my future, which is fantastic! I'm aware now that the source of my incontinence was a chronic, low level inflammation caused by gluten. The inflammation attacked various organs and areas all over my body, especially the bladder and urinary tract. Gluten even effected my cholesterol level in negative ways. So no way to that whole wheat bread, because I feel terrific now and I want to stay this way.
This article originally appeared in the Spring 2010 edition of Celiac.com's Journal of Gluten-Sensitivity. Celiac.com 10/22/2010 - More and more we’re hearing from frustrated patients who, despite being vigilant about their gluten-free diet, continue to suffer health problems. I have been involved in the field of celiac and gluten sensitivity for over 15 years and am delighted by much of the recent increased awareness and attention given to the area. But I’m also concerned about the lack of assistance given to many patients who have been definitively diagnosed with either celiac disease or gluten sensitivity. While being correctly given the advice to not eat gluten, they are not provided with a follow-up program to address and treat the secondary effects of gluten sensitivity. This oversight condemns many to ongoing ill health. The focus of this article is on the types of conditions we see clinically with our patients, some of the recent research that corroborates our findings, and steps you can take to address the underlying root cause of these problems. Leaky GutAlso known as increased intestinal permeability, a leaky gut refers to a loss of integrity of the lining of the small intestine. Recall that the small intestine is approximately 23 feet in length and has the surface area of a tennis court.Gluten, in the sensitive individual, is a known cause of leaky gut, but in a perfect world the elimination of gluten would allow healing to occur resulting in an intact, healthy intestinal lining. Alas, we do not live in a perfect world and other factors contribute to the health of the gut. Infections in the form of parasites, amoebas, bacteria, and the like, can certainly contribute to continued increased permeability. Likewise, other food reactions, chief among them dairy, can cause persistent irritation and thereby prevent healing. Imbalance of the beneficial bacteria or microbes that comprise the microbiota of the intestine, as well as nutritional and pancreatic enzyme deficiencies, are also suspected to limit healing. Let’s take a look at each of these individually: InfectionsWhether one has celiac disease or is gluten sensitive, one thing is for sure, one’s immune system has been overtaxed due to the presence of gluten in the diet. Depending on the age at diagnosis, it is often several decades of stress that the immune system has undergone.Such an overburdened immune system is unable to be as vigilant as a healthy one and as a result it allows such organisms as parasites, amoebas or bacteria to infiltrate the body. Some estimates suggest that the digestive tract is normally exposed to a pathogenic organism every 10 minutes. A healthy intestinal immune system is able to identify and eradicate those organisms as part of its normal activities. An unhealthy immune system often “misses” such organisms and they happily take up residence in the small intestine. Interestingly, some of these organisms create crypt hyperplasia and villous atrophy that appears the same as that caused by gluten. Imagine the frustration of a patient who is being told by their doctor that they are not following their diet when indeed they are. What’s being missed? The presence of an infectious agent. In the 2003 American Journal of Gastroenterology, researchers reported a large percentage of small intestinal bowel overgrowth (SIBO) in celiac patients with persistent GI symptoms despite adherence to a gluten-free diet. These patients were off gluten, as instructed, but were still having diarrhea due inhospitable organisms in their intestines. This segues nicely into the next area I want to discuss – dysbiosis or imbalance of the friendly bacteria in the small intestine. DysbiosisThe population of organisms found in the intestines of celiac patients (treated with a gluten-free diet or not) is different from that found in healthy control groups. The ratio of good bacteria to bad was found to be reduced in celiac patietnts regardless of whether their celiac disease was active or inactive. Because the “bad” bacteria are pro-inflammatory in nature, they can be responsible for creating some of the initial problems with celiac disease, as well as helping to perpetuate them despite following a gluten-free diet.In the August 2009 Scientific American, Dr Fasano made a very interesting statement regarding these microbes or probiotics as relates to the age of initiation of celiac disease. He stated: “Apparently they [probiotics] can also influence which genes in their hosts are active at any given time. Hence, a person whose immune system has managed to tolerate gluten for many years might suddenly lose tolerance if the microbiome changes in a way that causes formerly quiet susceptibility genes to become active. If this idea is correct, celiac disease might one day be prevented or treated by ingestion of selected helpful microbes.” Isn’t this fascinating? If you haven’t read the complete article I encourage you to do so, but it is sufficient to say there is scientific discussion that entertains the notion that a healthy microbiome or probiotic population is not only anti-inflammatory (a good thing to help prevent many diseases) but may actually act as a “switch” that turns on and off the expression of certain genes. Therefore, part of our program is to examine the population of the microbiome through laboratory testing, and supplement as needed, to support a healthy anti-inflammatory population. In the past we typically prescribed probiotics only for a few short months following the eradication of a pathogenic organism. But in the last several years it has become clear that our patients’ clinical profile is much more stable with continued probiotic supplementation. Dairy SensitivityIt can be difficult to confront major changes in one’s diet. Removing gluten is definitely a big challenge and sometimes my patients look at me forlornly when I simultaneously recommend the elimination of dairy products. I try to encourage them by promising that organic butter is allowed and by quickly recommending my favorite coconut ice cream, as well as cheese and milk substitutes.Contrary to the passing thought that I wish to be cruel, there is excellent documentation to back up what we’ve seen clinically for years - gluten and dairy are truly not our friends. The majority of the world’s people are lactose intolerant. Populations such as Asians, African Blacks, those of Jewish descent, Mediterraneans, Mexicans and North American Blacks all exceed 70% intolerance to lactose. Note that many drugs and supplements may contain lactose as well, so be vigilant. Estimates suggest that we retain the enzyme to digest our human mother’s milk for 2 to 5 years and after that milk from any mammal is likely toxic because it’s too high in protein and phosphorus, making proper digestion impossible. Human milk is very low in protein but rich in essential fatty acids. Casein, a protein from milk, is strongly associated with allergic reactions. Therefore putting lactose and casein together presents double jeopardy to the body. In this country, milk contains more toxins per gram than any other food, so you can see that there’s great cause for concern. Earlier we spoke of leaky gut. Dairy stops the formation of glucosamine in the intestine making it one of the primary causes of leaky gut. I could expand on this further but perhaps we’ll save that for a future article. Nutritional DeficienciesWhen we eat, the ultimate goal is that the food will be broken down into components that can be assimilated into the bloodstream and delivered as fuel to all our trillions of cells. Discovering that one is sensitive to gluten and eliminating it goes a long way toward achieving this goal. However, some vitamins and minerals should be tested to ensure that their levels are normalizing on a gluten-free diet. Otherwise good health may be a fleeting target.Folic acid, vitamin B12, Iron and Vitamin D levels are all very important to measure. Supplementation is often needed to optimize the levels of these substances. Follow-up testing ensures that this objective has been achieved or maintained and should be part of a comprehensive program. Discovering that you’re gluten sensitive and following the diet should be rewarded with dramatically improved health. If that is not the result, other problematic factors need to be isolated and treated. Such a program is not difficult and is well worth the effort. Please let me know if I can answer any further questions. To your good health!