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Showing results for tags 'gluten intolerance'.
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Celiac.com 10/16/2024 - Celiac disease and fibromyalgia are two medical conditions that affect a significant number of people worldwide. While celiac disease is an autoimmune disorder triggered by gluten, fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain. Despite being distinct conditions, celiac disease and fibromyalgia share similar symptoms, such as fatigue, gastrointestinal issues, and muscle pain. This study aimed to investigate whether there is a relationship between the two conditions, focusing on whether individuals with celiac disease are more likely to develop fibromyalgia. Celiac Disease Overview Celiac disease is a disorder that causes the immune system to react negatively to gluten, a protein found in wheat, barley, and rye. When people with celiac disease consume gluten, their immune system attacks the small intestine, causing damage and preventing the absorption of nutrients. Celiac disease affects roughly 1% of the population, though it is more common in certain genetic groups. Symptoms of celiac disease vary and can include gastrointestinal distress, anemia, osteoporosis, skin conditions, and neurological symptoms. In many cases, people with celiac disease experience symptoms beyond the digestive tract. These extraintestinal manifestations, such as joint pain, chronic fatigue, and depression, can often resemble fibromyalgia symptoms, making it difficult to differentiate between the two conditions. Fibromyalgia Overview Fibromyalgia is a chronic condition that affects the musculoskeletal system and causes widespread pain, tenderness, and fatigue. It is estimated that fibromyalgia affects 2-5% of the population, predominantly women. Common symptoms of fibromyalgia include pain, morning stiffness, non-restorative sleep, and cognitive difficulties, often referred to as "fibro fog." Interestingly, many people with fibromyalgia also experience gastrointestinal issues, such as irritable bowel syndrome, which further blurs the line between the two conditions. This has led researchers to explore whether there is a deeper connection between fibromyalgia and other autoimmune disorders, such as celiac disease. Study Design and Methods This cross-sectional study examined 60 adult patients diagnosed with celiac disease based on criteria established by the American College of Gastroenterology. The study participants were evaluated for fibromyalgia symptoms using a series of diagnostic tools, including the Widespread Pain Index, the Symptom Severity Scale, and the Fibromyalgia Impact Questionnaire. These tools measure both the presence and severity of fibromyalgia in individuals. The study sought to determine whether there was a significant correlation between the presence of celiac disease and the development of fibromyalgia. The researchers also analyzed the relationship between specific celiac disease biomarkers, such as tissue transglutaminase antibodies and endomysium antibodies, and the likelihood of developing fibromyalgia. Results and Findings The study found no significant relationship between the clinical presentation of celiac disease and the likelihood of developing fibromyalgia. Similarly, the results showed no correlation between the severity of celiac disease and the presence of fibromyalgia. However, the study did find that individuals with positive antibody tests, such as tissue transglutaminase antibodies, were more likely to have fibromyalgia compared to those who did not test positive for these antibodies. This suggests that the immune response triggered by gluten in celiac disease may play a role in the development of fibromyalgia. Although the findings were not statistically significant in some areas, the study highlights the importance of recognizing the overlap between celiac disease and fibromyalgia symptoms. Given that both conditions share many similar symptoms, patients with celiac disease who experience extraintestinal manifestations, such as chronic pain and fatigue, may benefit from being evaluated for fibromyalgia. Discussion and Implications The potential link between celiac disease and fibromyalgia raises important questions for healthcare providers. Currently, the diagnosis of fibromyalgia is often made through exclusion, meaning that other conditions, such as autoimmune disorders, must be ruled out first. However, this study suggests that individuals with celiac disease, particularly those with positive antibody tests, may be more prone to developing fibromyalgia. The immune system's response to gluten in individuals with celiac disease could trigger or exacerbate the chronic pain and sensitivity seen in fibromyalgia. This connection suggests that treating one condition may help alleviate symptoms of the other. For instance, maintaining a strict gluten-free diet may not only improve gastrointestinal symptoms but also reduce the severity of fibromyalgia symptoms in celiac patients. Furthermore, the study underscores the importance of early diagnosis and treatment for both conditions. Since fibromyalgia is notoriously difficult to treat, identifying patients with celiac disease who may also have fibromyalgia could allow for more targeted therapies. Simultaneously managing the gastrointestinal symptoms of celiac disease and the musculoskeletal pain of fibromyalgia may lead to better overall outcomes for patients. Conclusion: What This Means for People with Celiac Disease This study's findings are particularly meaningful for individuals with celiac disease. Since celiac disease and fibromyalgia share many similar symptoms, recognizing the potential for co-occurrence could lead to earlier diagnoses and more effective treatments. For those with celiac disease, staying vigilant about extraintestinal symptoms, such as chronic pain, fatigue, and depression, may help detect fibromyalgia earlier. By working closely with healthcare providers to manage both conditions, people with celiac disease can achieve better symptom control and overall quality of life. The study also highlights the need for further research to explore the connection between these two conditions. While the results are not definitive, they provide a starting point for future studies that could lead to more comprehensive treatment approaches for individuals affected by both celiac disease and fibromyalgia. Read more at: hcplive.com
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Celiac.com 10/02/2024 - The terms "celiac disease" and "gluten sensitivity" (AKA non-celiac gluten sensitivity) are often used interchangeably, but they represent different conditions with distinct causes, symptoms, and treatments. For those experiencing digestive discomfort after eating gluten-containing foods, understanding the difference between these two conditions is crucial for proper diagnosis and management. In this article, we’ll explore the key differences, symptoms, and how you can distinguish between celiac disease and gluten sensitivity. What Is Celiac Disease? Celiac disease is an autoimmune disorder that affects at least 1% of the population worldwide. When people with celiac disease consume gluten, a protein found in wheat, rye, and barley, their immune system mistakenly attacks the lining of the small intestine. Over time, this immune response damages the villi, small finger-like projections that absorb nutrients from food. This leads to malabsorption of essential nutrients, which can result in a range of health problems. Symptoms of Celiac Disease The symptoms of celiac disease can vary greatly from person to person, but common signs include: Chronic diarrhea or constipation Abdominal pain and bloating Unexplained weight loss Fatigue and weakness Anemia due to iron deficiency Skin rashes (dermatitis herpetiformis) Joint pain Headaches Neurological symptoms such as numbness in hands and feet or brain fog It’s important to note that some people with celiac disease may be asymptomatic but still experience intestinal damage. Untreated celiac disease can lead to serious complications, such as osteoporosis, infertility, and even an increased risk of certain cancers. What Is Gluten Sensitivity? Non-celiac gluten sensitivity (NCGS), also referred to as gluten intolerance, is a condition in which individuals experience symptoms similar to celiac disease after consuming gluten but do not test positive for celiac disease or wheat allergy. Unlike celiac disease, gluten sensitivity does not involve an autoimmune response or intestinal damage, and individuals with NCGS do not show the same intestinal damage that characterizes celiac disease. Current Understanding from Published Research Despite its prevalence, the exact cause of gluten sensitivity remains elusive. Researchers are still working to determine the biological mechanisms behind this condition. Early studies suggested that gluten itself might be the culprit, triggering symptoms similar to celiac disease. However, more recent research has expanded the potential scope of triggers, including other components of wheat such as amylase-trypsin inhibitors (ATIs) and fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). Amylase-Trypsin Inhibitors (ATIs): These proteins found in wheat may play a role in triggering immune responses in people with gluten sensitivity. Unlike the autoimmune response seen in celiac disease, ATIs can cause inflammation through activation of the innate immune system, which leads to gastrointestinal symptoms in sensitive individuals. FODMAPs: Some researchers argue that symptoms attributed to NCGS could be due to poorly absorbed carbohydrates, like those found in wheat. FODMAPs can ferment in the gut, leading to symptoms such as bloating, gas, and abdominal discomfort, which are common in gluten-sensitive individuals. A low-FODMAP diet has been shown to alleviate symptoms in some patients, leading to the theory that some cases of NCGS might be misdiagnosed due to overlap with FODMAP intolerance. Variability in Symptoms and Triggers One of the challenges in studying NCGS is the variability in symptoms and the absence of specific biomarkers. Individuals with gluten sensitivity report a wide range of gastrointestinal and extra-intestinal symptoms, including bloating, diarrhea, fatigue, headaches, joint pain, and brain fog. Studies have shown that these symptoms can occur within hours to days after gluten ingestion, but the intensity and duration of symptoms vary widely from person to person. The Role of the Gut-Brain Axis Research has also suggested that the gut-brain axis may play a role in gluten sensitivity. This axis connects the digestive system and the central nervous system, and imbalances in this connection may contribute to the gastrointestinal and neurological symptoms experienced by individuals with NCGS. For example, a study published in Gastroenterology highlighted that gluten may impact the gut's permeability and immune function, leading to systemic inflammation that affects the brain, which could explain symptoms like brain fog and headaches. Lack of Diagnostic Biomarkers One of the key distinctions between NCGS and celiac disease is the absence of biomarkers for gluten sensitivity. Diagnosing NCGS is often a process of exclusion, where other conditions like celiac disease and wheat allergy must be ruled out. Currently, the diagnosis relies heavily on symptom observation and improvement following the removal of gluten from the diet. Some studies are exploring the potential for identifying biomarkers in the future, but to date, none have been conclusively linked to gluten sensitivity. The condition remains somewhat controversial, with some scientists questioning whether gluten sensitivity exists as a distinct entity, while others argue that it is a real, albeit poorly understood, condition. Emerging Research and Controversy There is ongoing debate in the scientific community about the existence and definition of gluten sensitivity. Some research has suggested that gluten may not be the only, or even the primary, cause of symptoms in individuals diagnosed with NCGS. For instance, a study conducted in 2013, known as the "Nocebo" study, found that participants who believed they were sensitive to gluten experienced symptoms even when they were given a placebo. This led to the idea that some cases of gluten sensitivity might be psychosomatic or influenced by the growing public perception of gluten as harmful. However, this does not diminish the very real symptoms that many people experience. The challenge lies in understanding the precise mechanisms at play and identifying subgroups of individuals who may be reacting to different components of wheat. In conclusion, while gluten sensitivity shares some similarities with celiac disease in terms of symptoms, it is a distinct condition with different underlying mechanisms. Research continues to explore potential causes, including other components of wheat and the role of the gut-brain axis, but much remains unknown. For now, NCGS is diagnosed through the process of exclusion, and the condition highlights the complexity of food-related disorders and the need for further scientific investigation. Symptoms of Gluten Sensitivity The symptoms of gluten sensitivity often overlap with those of celiac disease but tend to be less severe and do not cause long-term damage to the intestines. Common symptoms include: Abdominal pain and bloating Diarrhea or constipation Headaches or migraines Fatigue Joint or muscle pain Anxiety or depression Skin issues like eczema Unlike celiac disease, there is no biomarker or specific test to diagnose gluten sensitivity, which makes the condition harder to identify. Diagnosis is typically made by ruling out celiac disease and wheat allergy and observing the improvement of symptoms on a gluten-free diet. Key Differences Between Celiac Disease and Gluten Sensitivity Understanding the differences between celiac disease and gluten sensitivity is important for getting the right diagnosis and treatment. Below are the main distinctions: Immune Response: In celiac disease, gluten triggers an autoimmune response that leads to intestinal damage. In gluten sensitivity, there may be an immune reaction, but it does not cause the same kind of damage to the intestines. Intestinal Damage: Celiac disease leads to the destruction of the villi in the small intestine, impairing nutrient absorption. Gluten sensitivity does not cause such damage. Diagnosis: Celiac disease can be diagnosed through blood tests and a biopsy of the small intestine, which shows villous atrophy. Gluten sensitivity is diagnosed by exclusion, meaning celiac disease and wheat allergy must first be ruled out, and symptoms improve when gluten is removed from the diet. Long-Term Risks: Untreated celiac disease can lead to severe health complications, including malnutrition, osteoporosis, neurological issues, and an increased risk of lymphoma. Gluten sensitivity does not pose the same long-term health risks but can significantly impact quality of life. Symptoms: The symptoms of gluten sensitivity may appear faster than those of celiac disease and can be more widespread. Symptoms in celiac disease are often gastrointestinal but can also affect other parts of the body due to malabsorption. Testing and Diagnosis If you suspect you have an issue with gluten, it’s important to undergo proper testing before eliminating gluten from your diet. Removing gluten before testing can interfere with results, making a diagnosis harder. The standard approach for diagnosing celiac disease includes: Blood Tests: These tests look for specific antibodies, such as tissue transglutaminase antibodies (tTG-IgA) and endomysial antibodies (EMA-IgA), which are elevated in people with celiac disease. Biopsy: If blood tests suggest celiac disease, a biopsy of the small intestine is often performed to confirm damage to the villi. For gluten sensitivity, there is no specific test. Instead, doctors will rule out celiac disease and wheat allergy and monitor symptom improvement on a gluten-free diet. Why It Matters to Distinguish Between the Two The management of celiac disease and gluten sensitivity involves a gluten-free diet, but the long-term implications differ. For people with celiac disease, even trace amounts of gluten can cause intestinal damage, so strict adherence to a gluten-free diet is crucial. In contrast, those with gluten sensitivity may tolerate small amounts of gluten without serious consequences. Understanding the difference between celiac disease and gluten sensitivity is important for ensuring proper treatment and preventing unnecessary dietary restrictions. For people with celiac disease, lifelong gluten avoidance is essential to protect against serious complications. Those with gluten sensitivity, on the other hand, may be able to manage their symptoms with a less restrictive approach. Conclusion If you experience symptoms after consuming gluten, it is important to seek medical advice to determine whether you have celiac disease or gluten sensitivity. Proper diagnosis can help guide your dietary choices and prevent long-term health issues. While both conditions may cause discomfort, only celiac disease involves an autoimmune reaction and the potential for serious complications. For individuals with either condition, understanding the nature of their intolerance to gluten is the first step toward living a healthier and more comfortable life.
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Celiac.com 10/01/2024 - The incident involving a child's serious medical condition being disregarded by an adult at a sleepover has sparked widespread outrage. A mother is now considering pressing charges after a grandfather at a sleepover deliberately fed her celiac son wheat, causing him to become violently ill. This situation has highlighted the ongoing skepticism surrounding gluten intolerance and celiac disease, even though these conditions are medically recognized. The Dangerous Skepticism Around Celiac Disease Celiac disease is an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine. For those diagnosed with this condition, avoiding gluten is not a dietary preference but a necessity to prevent severe health issues. Despite this, there remains a segment of the population, often older generations, who dismiss gluten intolerance and celiac disease as modern-day fabrications. The elderly man in question, described as a baby boomer, exemplified this dangerous skepticism. Upon hearing about the child’s condition, he dismissed it as nonsense, citing that such issues did not exist in his youth. This denial of the child’s medical needs went beyond mere words, as he deliberately switched out the child's gluten-free breakfast to one containing wheat, resulting in the child becoming seriously ill. The Immediate Consequences When the mother picked up her son after the sleepover, she was confronted with a horrifying scene. Her son was "throwing up and green," a clear sign that he had ingested something harmful. The host mother, who was also horrified by the grandfather’s actions, informed her that he had intentionally given the child a wheat-containing breakfast. Understandably furious, the mother confronted the grandfather, who remained unapologetic. She expressed her anger, even using strong language, which she later reflected was a mild reaction considering the harm done to her son. The rest of her day was spent caring for her son, nursing him back to health after his severe reaction. Legal Considerations: Should Charges Be Pressed? The incident did not just leave the mother emotionally shaken; it also raised serious legal questions. After discussing the situation with the host mother, they both agreed that pressing charges might be necessary. The host mother, seemingly tired of the grandfather’s behavior, supported the idea of legal action, recognizing that this was not just a mistake but a deliberate act of harm. Legal experts note that the mother may have a strong case. There are laws in place, such as Elijah's Law, which mandates that schools and childcare providers adhere to children’s food allergy requirements. While this incident did not occur in a school setting, the deliberate nature of the act could potentially lead to charges of personal injury or even endangerment, given the severity of the child’s reaction and the risks associated with celiac disease. The Broader Implications: Understanding Celiac Disease This incident sheds light on a broader issue: the ongoing misunderstanding and dismissal of celiac disease and other food-related medical conditions. For individuals with celiac disease, the consequences of consuming gluten are not just discomfort but can lead to long-term health issues, including damage to the small intestine, malnutrition, and increased risk of certain cancers. Despite this, there remains a pervasive attitude, especially among some older individuals, that these conditions are overblown or imaginary. For those living with celiac disease, incidents like this are not just isolated events but a reflection of a larger societal problem. The dismissal of their medical needs can lead to serious, even life-threatening situations. This highlights the importance of education and awareness around celiac disease and gluten intolerance, particularly among those who may not have grown up with an understanding of these conditions. Conclusion: Why This Matters to the Celiac Community The story of this mother and her son is a stark reminder of the dangers that can arise when serious medical conditions are not taken seriously. For those with celiac disease, the implications of gluten exposure are severe, and the ignorance or skepticism of others can have devastating consequences. This incident serves as a call to action for better education and understanding of celiac disease, as well as for stronger protections for those who live with it. The mother’s decision to consider legal action is not just about seeking justice for her son but also about sending a message that the health and safety of those with celiac disease must be respected and protected. Read more at: yourtango.com
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Celiac.com 09/16/2024 - Celiac disease is an autoimmune condition that affects individuals when they consume gluten, a protein found in wheat, barley, and rye. In those with the disease, the ingestion of gluten triggers an immune response that damages the small intestine. One of the key enzymes involved in this process is transglutaminase 2, which modifies gluten peptides, making them more likely to cause inflammation. This study focuses on a new therapeutic approach using a transglutaminase 2 inhibitor called ZED1227, which aims to reduce gluten-induced damage in individuals with celiac disease. Objective of the Study The main goal of the study was to investigate how effective the transglutaminase 2 inhibitor ZED1227 is at preventing gluten-induced damage in the intestines of people with celiac disease. Participants in the study had been on a gluten-free diet for a long time but were given a six-week gluten challenge while also taking either ZED1227 or a placebo. Researchers analyzed biopsies from the small intestine before and after this period to assess the molecular effects of ZED1227 and its potential to protect against gluten-induced damage. Mechanism of Action Transglutaminase 2 plays a central role in celiac disease by modifying gluten peptides, making them more reactive to the immune system. This reaction leads to the activation of immune cells that cause inflammation and damage to the intestinal lining. The inhibitor ZED1227 works by blocking the activity of this enzyme, which theoretically should prevent the gluten peptides from triggering the harmful immune response. The study sought to confirm this effect at the molecular level by analyzing the genetic activity in the intestinal cells of participants. Study Methodology Participants with celiac disease were divided into two groups. Both groups underwent a gluten challenge, meaning they consumed gluten for six weeks. One group received a daily dose of ZED1227, while the other group received a placebo. Duodenal biopsies were taken from the participants both before and after the gluten challenge, and researchers performed a detailed analysis of the gene expression in these tissue samples. Key Findings The results of the study were significant. The researchers found that ZED1227 effectively prevented the majority of the harmful gene activity that gluten normally triggers in people with celiac disease. In particular, the treatment preserved the structure and function of the intestinal lining. One of the key findings was that ZED1227 blocked the immune response driven by interferon-gamma, a molecule that plays a major role in the inflammation seen in celiac disease. By inhibiting this pathway, ZED1227 protected the intestines from gluten-induced damage, including villous atrophy (the flattening of the intestinal surface) and crypt hyperplasia (an abnormal increase in the depth of the intestinal lining). Genetic Considerations The study also highlighted the role of genetics in how individuals respond to gluten. Specifically, it showed that people with certain genetic variants related to human leukocyte antigen DQ2 were more sensitive to gluten. These individuals, who carry a homozygous form of the gene, had a more intense immune response to gluten, even when taking ZED1227. This suggests that genetic factors could influence how well individuals respond to treatments like ZED1227, and some people may require higher doses or longer treatment durations to achieve optimal protection. Potential Benefits for Celiac Patients For individuals with celiac disease, the only current treatment is a strict gluten-free diet. However, following such a diet is challenging and does not always fully prevent gluten exposure or intestinal damage. This study suggests that ZED1227 could offer a new therapeutic option for these patients. By inhibiting transglutaminase 2, ZED1227 could prevent the damage caused by accidental gluten ingestion, providing an additional layer of protection for those who are highly sensitive to gluten or struggle to maintain a perfectly gluten-free diet. Study Limitations and Future Directions While the findings of this study are promising, the researchers noted a few limitations. The study involved a relatively small number of participants, and further research with larger groups will be needed to confirm the results. Additionally, the study only tested one dose of ZED1227, and future studies may explore whether higher or lower doses are more effective for different genetic subgroups of patients. Another area of interest for future research is the long-term safety and effectiveness of ZED1227. The six-week gluten challenge provided valuable insights, but longer-term studies will be necessary to understand how the treatment works over months or even years. The researchers also suggested that a more personalized approach to treatment, where doses of ZED1227 are tailored to individual genetic profiles, could enhance the effectiveness of the therapy. Conclusion and Implications for Celiac Patients This study presents a hopeful new direction for the treatment of celiac disease. ZED1227, by inhibiting transglutaminase 2, shows strong potential to prevent the intestinal damage caused by gluten. For those with celiac disease, this could mean fewer symptoms, less inflammation, and overall better intestinal health, even in cases of accidental gluten exposure. While more research is needed to confirm the long-term benefits and fine-tune the treatment for different genetic profiles, ZED1227 represents a promising step toward improving the quality of life for people with celiac disease. Read more at: nature.com
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Celiac.com 07/19/2024 - Celiac disease is a systemic, immune-mediated condition affecting the small intestine, triggered by gluten proteins found in wheat, barley, and rye. Globally, the prevalence of celiac disease is around 1.4%, but it is notably higher in Saudi Arabia at 2.7%. A strict lifelong gluten-free diet is the primary treatment for celiac disease, but adherence to this diet can lead to nutritional deficiencies, obesity, cardiovascular risks, and lower bone density. This study aims to evaluate the knowledge of health students in the Jazan region about these nutritional deficiencies and the socio-demographic factors influencing their awareness. Methods The study was conducted among health college students at Jazan University, including those from the Colleges of Medicine, Pharmacy, Nursing, Dentistry, Public Health and Health Informatics, and Allied Health Sciences. Students aged 18 and above were included, except for interns and those who did not complete the survey or refused participation. A minimum sample size of 368 was calculated, and data was collected via a self-administered electronic questionnaire. The survey was divided into two sections: socio-demographic data and knowledge about nutritional deficiencies in celiac disease. Statistical analysis was performed using SPSS software. Results The study included 369 participants, mostly aged 17-22, with a majority being female and single. Students from the College of Medicine and Applied Medical Sciences were most represented. Approximately 59.1% of participants were aware of nutritional deficiencies in celiac disease patients on a gluten-free diet. There were no significant associations between socio-demographic factors and knowledge levels. Students from the College of Pharmacy had lower knowledge compared to those from the College of Medicine. Most students recognized the need for multivitamin and vitamin D supplements for celiac patients and were aware of deficiencies in vitamin D, B12, folic acid, iron, and calcium. Discussion The study revealed that 59.1% of health students had an acceptable level of knowledge about nutritional deficiencies in celiac disease patients. This is a relatively low level of awareness considering these students are future healthcare providers. Comparable studies in Saudi Arabia and other countries have shown varying levels of knowledge among healthcare professionals and students. It is crucial for medical students to be well-educated about celiac disease to ensure proper diagnosis and treatment, thereby improving patient outcomes and reducing disease burden. Conclusions The study highlights the need for increased educational efforts to raise awareness and knowledge about celiac disease and its nutritional implications among health students. Implementing comprehensive educational programs and integrating practical training into the curriculum can empower future healthcare professionals to better manage celiac disease. Improved education will help ensure accurate diagnosis, effective treatment, and overall better health outcomes for patients with celiac disease. Significance for Celiac Disease Patients This study underscores the importance of educating future healthcare providers about the nutritional challenges faced by celiac disease patients. Enhanced knowledge and awareness among medical students can lead to improved patient care, ensuring that celiac disease patients receive the correct diagnosis and appropriate nutritional guidance to manage their condition effectively. This can ultimately reduce the disease burden and enhance the quality of life for those living with celiac disease. Read more at: cureus.com
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Celiac.com 04/25/2024 - Gluten sensitivity, also known as gluten intolerance or non-celiac gluten sensitivity, shares symptoms with celiac disease, but it's not an autoimmune disorder like celiac disease. Instead, it's a condition where the body reacts negatively to gluten without involving autoimmune proteins. Despite its prevalence, there isn't a straightforward test for gluten sensitivity or intolerance. Current testing methods primarily focus on ruling out other potential causes of symptoms, such as celiac disease, wheat allergy, irritable bowel syndrome (IBS), or inflammatory bowel disease (IBD). If celiac disease is suspected, healthcare providers typically start with blood tests to detect specific markers associated with the condition, such as anti-endomysial antibodies (EMA) or tissue transglutaminase IgA (TG-IgA). If these tests suggest celiac disease, further procedures like endoscopy and biopsy may be conducted to examine the intestines for damage. However, when celiac disease and other known conditions are ruled out, diagnosing gluten intolerance becomes more challenging. Healthcare providers may recommend starting a gluten-free diet for a period, typically around six weeks, to observe any improvements in symptoms. If symptoms alleviate during this time, it may suggest gluten intolerance as the cause. Despite the lack of definitive tests, some at-home kits claim to diagnose gluten sensitivity through stool or blood samples. Brands like EverlyWell and EnteroLab offer such tests, but their accuracy remains questionable, and the cost is usually not covered by health insurance. Understanding the distinction between celiac disease and gluten intolerance is crucial. While celiac disease requires specific diagnostic procedures and can lead to severe complications if left untreated, gluten intolerance may cause discomfort but doesn't involve autoimmune reactions. EverlyWell's Food Sensitivity Test EverlyWell offers a test called the "Food Sensitivity Test" that includes a panel for gluten sensitivity among other food sensitivities. Here are some key points about EverlyWell's test for gluten sensitivity: At-Home Test: Like other EverlyWell tests, the Food Sensitivity Test is designed for at-home use. It involves collecting a small blood sample using a finger prick and sending it to EverlyWell's partner lab for analysis. Panel for Gluten Sensitivity: The test panel includes various food items, including gluten-containing grains like wheat, barley, and rye. It tests for IgG antibodies specific to these foods, which can indicate a potential sensitivity or immune response. Detection of IgG Antibodies: IgG antibodies are part of the immune system's response and can be elevated in certain conditions, including food sensitivities. The test measures IgG antibody levels to specific foods to assess potential reactivity. Comprehensive Report: EverlyWell provides a comprehensive report based on the test results. The report typically categorizes foods into different levels of reactivity based on IgG antibody levels, ranging from low to high reactivity. Guidance and Recommendations: The test report may include guidance on dietary modifications based on the identified food sensitivities. It may recommend eliminating or reducing the consumption of foods with elevated IgG levels to see if symptoms improve. Limitations: It's important to note that the Food Sensitivity Test from EverlyWell detects IgG antibodies, which are different from the antibodies associated with celiac disease (such as anti-tissue transglutaminase antibodies). Celiac disease diagnosis typically requires specific blood tests and sometimes a biopsy of the small intestine. EnteroLab's Intestinal Antigenic Permeability Screen EnteroLab offers a stool test called the "Intestinal Antigenic Permeability Screen" that is designed to detect gluten sensitivity and other gastrointestinal issues. The test focuses on identifying antibodies to gluten and other proteins that may indicate a sensitivity or immune response. Here are some key points about EnteroLab's stool test for gluten sensitivity: Non-Invasive: The test is non-invasive and can be performed at home. It involves collecting a small stool sample and sending it to EnteroLab for analysis. Detection of Antibodies: The test looks for antibodies to gluten, as well as antibodies to other proteins like casein (found in dairy) and soy. Elevated levels of these antibodies may suggest a sensitivity or immune reaction to these proteins. Gluten Sensitivity vs. Celiac Disease: While the test can detect antibodies related to gluten sensitivity, it's important to note that it is not specifically designed to diagnose celiac disease. Celiac disease diagnosis typically involves additional tests such as blood tests for specific antibodies (e.g., anti-tissue transglutaminase antibodies) and sometimes a biopsy of the small intestine. Comprehensive Report: EnteroLab provides a comprehensive report based on the test results. This report may include interpretations of the antibody levels and recommendations regarding dietary changes if gluten sensitivity is suspected. Controversy and Criticism: It's worth mentioning that EnteroLab's testing methods and the validity of their results have been a topic of debate and controversy within the medical and scientific communities. Some experts have questioned the accuracy and clinical relevance of the stool tests offered by EnteroLab for diagnosing gluten-related disorders. In conclusion, diagnosing gluten intolerance involves a process of elimination and observation of symptom response to a gluten-free diet. Individuals experiencing symptoms should consult healthcare providers to rule out other potential causes and determine the best course of action for managing their condition.
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Celiac.com 08/20/2020 - I am afraid that the following article might not make me very popular—if I had any popularity remaining after my last one! If you saw “The Paleo Template” here on these pages, you’ll recall that its ideas rest upon the theory that humans are healthiest when eating the types and classes of foods we’ve been consuming for the overwhelming majority of the roughly two and one half million years we’ve been on this earth. It wasn’t until very, very recently, in the grand scheme, that we’ve been consuming the products of agriculture: wheat; dairy; beans; and any foods that required more than the bare minimum of processing to make them edible. To greater or lesser degrees consuming these new foods isn’t good for us. As paleo nutritionist Ray Audette put it in his book Neanderthin (St. Martin’s Press, 2000), historically we’ve only consumed those items we could get if we were “naked with a sharp stick”: meat; certain vegetables; low glycemic; high fiber fruits; and certain nuts: hunter gatherer foods. Modern diseases are reactions to those foods that have only recently been added to our diets, gluten-containing foods being the most immediately obvious to this publication’s readership. Well, here’s one modern food that may deserve the same level of scrutiny as gluten-containing grains, even given its worship by what appears to be a totality of today’s nutritionists: our beloved chocolate. Now wait a minute. What kind of sadist would want to find fault with this giver of pleasure and apparent health panacea? Well, before we go there, let’s step back a moment to the naked with a sharp stick idea. Would chocolate, cocoa, cacao—or anything remotely similar—have been consumed by our paleo ancestors? No. Even in its purest commercial forms, it does require quite a deal of processing before it is edible: drying, fermenting, roasting, powdering, etc. Raw cacao proponents would disagree with this and, even though it is a tiny, tiny fraction of the market, there are raw, unpeeled, whole beans available for purchase. But let me get to a more important point. Chocolate, cocoa, cacao, in any form, was apparently discovered by native South Americans around 3000 years ago and didn’t make its way into the European diet until the 16th century, with widespread usage delayed until the Industrial Age a little more than 100 years ago. So if you’re a native of the tropical rainforests of South America, you’ve had a very short period of time for adaptation. If you don’t fit that description, you’ve had effectively zero time to adapt to this food. So what if it’s new? The so what is this: new foods—gluten-containing grains included—are almost always the cause of modern disease and as such deserve a closer look because of their novelty. Maybe chocolate’s ok to eat, maybe not. As mentioned above, it’s not “maybe” in current nutritional culture. Chocolate is lauded as the perfect health food. A simple search on Medscape.com yields more than 380 studies touting its benefits: they say it reduces blood pressure, decreases risk for pregnancy-induced hypertension, improves vasodilation, reduces platelet adhesion, reduces cholesterol, improves post-exercise workout recovery, improves insulin sensitivity, protects smokers’ hearts, improves endothelial function, even helps with diarrhea. And to top it off, it’s apparently a wonderful aphrodisiac. Turn on your television or radio, open a newspaper or log onto an Internet site and you’re sure to see a thousand more benefits claimed. We want this stuff to be good for us. Before we go on, I want to take another step back, change the subject entirely again, and talk about depression. Wikipedia defines it as “a mental disorder characterized by a pervasive low mood and loss of interest or pleasure in usual activities.” Ron Hoggan points out in his excellent article “Food Allergies and Depression,” that this condition is a “very common symptom of celiac disease,” and by extension gluten intolerance. Why did I suddenly change the subject to depression? Here’s why: a new study out of Australia (Gordon Parker, Isabella Parker, Heather Brotchie, Mood state effects of chocolate, Journal of Affective Disorders 92, 2006, 149-159) shows that chocolate may actually cause and/or deepen depression. The study shows a link between a worsening of depressive symptoms and chocolate consumption for those “emotional eaters” who are attempting to self-medicate. As the authors put it in the conclusion of the study: "When taken in response to a dysphoric state as an 'emotional eating' strategy it may provide some transient ”comforting” role but it is more likely to prolong rather than abort the dysphoric mood. It is not, as some would claim, an antidepressant." Now we already know that celiacs and the gluten intolerant are very prone to depression. We now know that chocolate may deepen depression. But, since there’s not a whole lot of data out there linking mood, chocolate, and gluten intolerance, I decided to do a personal experiment. Of course, the data is anecdotal, but I think informative and revealing. I regularly eat a diet free of gluten, diary, legumes, and artificial fats and had been very faithful to the regimen for a few months. For the purpose of the experiment I consumed one bar of Green & Blacks 70% Cocoa Content Dark. I quickly felt contentment, even mild euphoria. I was able to concentrate for quite a long time and actually did quite a bit of research for this article. But that evening I experienced a shallow, dream-filled sleep before awaking in a fog early the next morning. I had some gas, bloating, and was itchy with what I’ll call proto-hives. Within a few hours I had gained almost a pound of water weight and felt as if I had a hangover, mild depression. And, boy, was I irritable! I also noted mild shakes and muscular tension and some knots. Again, one guy = anecdotal evidence. But this doesn’t sound at all like a food that’s good for you! As a fellow gluten intolerant, I’d like to challenge you to the same experiment. Pick up a copy of a book I recommended in my last article, Loren Cordain’s The Paleo Diet (Wiley, 2002), and follow its dietary regimen for three weeks to eliminate from your system whatever non-paleo foods you might have floating around in your body. Then try a bar of quality dark chocolate and send me an email to tell me how it made you feel. Truth is, my reaction surprised me. But should it have? Chocolate is composed of foreign substances only very recently introduced into the human diet and apparently causes an immune system reaction similar to that caused by gluten. And, like the psychoactive effects felt when one ingests gluten, the initial euphoria and increased attentiveness caused by chocolate wears off relatively quickly and, for me at least (and I suspect for quite a few of the gluten intolerant) serious after effects remain. Maybe this isn’t the miracle food it’s purported to be.
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Gluten Intolerance Affects Hormonal Balance
Dr. Vikki Petersen D.C, C.C.N posted an article in Winter 2012 Issue
Celiac.com 03/29/2018 - Fatigue is the most common symptom plaguing a majority of patients. Trouble sleeping, weight issues, PMS, headaches, fertility or libido issues, and achy joints are also very common and can all be affected by hormonal imbalance that continues after gluten has been removed from the diet. The trouble with trying to resolve such symptoms is that the root cause can vary. If every patient with fatigue had a thyroid problem, it would be easy to correct because we would know exactly where to look. If you're gluten intolerant you may have suffered from some of the complaints listed above prior to discovering your celiac disease or gluten sensitivity. But perhaps now, despite your gluten-free diet, some of these same symptoms continue to plague you. If so, read on. Let's review the list of symptoms and add a few more: Fatigue Trouble sleeping Weight trouble PMS Migraines Infertility or miscarriage Achy joints or muscles Allergies Light headedness Frequent illness Asthma While the list is long, believe it or not, there is a common cause to all of them. I'm not saying it's the only cause, but what I do wish to discuss is the reason why someone can be found gluten intolerant, successfully institute a gluten-free diet, yet continue to suffer from many of the above symptoms. There are two glands in your body called the adrenal glands. They sit atop each of your kidneys and they are the masters of multi-tasking! If I asked you if one part of your body was responsible for: Giving you energy, maintaining your weight, keeping your immune system strong, maintaining stable mood, anti-aging, controlling sleep quality, assisting with hormonal balance, keeping allergies at bay and more…what would you say? You might think to yourself that if there was one type of body part responsible for all those things then you had better start treating it well! You'd be very right in your analysis. As you've probably guessed the aforementioned adrenal glands are responsible for that very long list and, unfortunately, those very same adrenal glands tend to be quite stressed in the gluten intolerant individual. Why? Because adrenal glands are sensitive to, and get very stressed with, unstable blood sugar. Stable blood sugar comes from eating healthy food that your body finds nourishing. As you well know if you're gluten intolerant, gluten, for you, is a poison. Therefore years of eating gluten created unstable blood sugar and thereby put a tremendous strain on your adrenal glands. Because of the many, many jobs that the adrenal glands do, simply removing gluten as a stressor is typically insufficient to restore them to normal function. They need to be 're-set' with a nutritional and dietary program, to restore their good health. This explains why many who are gluten intolerant continue to suffer with the symptoms mentioned above. Therefore, even if your gluten intolerance has been diagnosed and you've instituted a strict gluten-free diet, if you haven't also found a clinician who understands and specializes in restoring health and function to the adrenal glands, you may very well continue to suffer with symptoms associated with adrenal stress. The good news is that the treatment to normalize adrenal function is not at all difficult. It is a completely natural program, when done correctly, involving no dangerous drugs or surgery. There are lab tests to determine the level of adrenal malfunction occurring but these are functional specialized lab tests rather than traditional ones. I mention this because I want to ensure that there is no confusion created when I mention adrenal function lab testing. The adrenal glands can become diseased but the disease isn't common. If you ask your traditional doctor to test for adrenal malfunction he or she will test for adrenal disease – once again a rare occurrence – and will likely pronounce your adrenal glands 'fine'. What I am discussing is malfunction vs. disease, two very different conditions. While adrenal gland disease is rare, adrenal gland malfunction is extremely common. It is this latter condition that we are discussing here. This is an important distinction because I want to make sure that if you are suffering from adrenal fatigue that you aren't given a 'clean bill of health' incorrectly. Unfortunately this happens often. If it took you a while to receive a diagnosis of gluten intolerance then you will understand this phenomenon. Sadly this area of health is fraught with misunderstanding and it is the patient who suffers, often unnecessarily. If you need any help finding a clinician to help you, feel free to contact me. Normalizing adrenal function is one of our areas of expertise and patients visit us for treatment, at our destination clinic, from across the country, as well as internationally. If we cannot find a clinician close to you that specializes in this then we are more than happy to see you here. The good news is that the treatment is natural and inexpensive. I look forward to hearing from you.- 10 comments
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Celiac.com 06/02/2022 - Many individuals with celiac disease express frustration and disappointment with the cavalier attitudes and misinformation they encounter. The objective observer may wonder what our complaint is with uninformed medical practitioners. Is it the lengthy delays to diagnosis coupled with our many years of unnecessary suffering? Is it the unnecessarily premature death of one or more of our loved ones, which may have been prevented by a greater awareness of celiac disease and its many manifestations? Is it the common refusal of appropriate testing for celiac disease? Is it the oft-heard cynicism about our diet expressed by those who have little or no experience with it? Perhaps all of these complaints contribute to the angst so often found in our community. However, I am beginning to suspect that these complaints are merely symptoms of a more sinister problem. Perhaps the underlying problem is the trivializing of gluten sensitivity and celiac disease. I have been told, by medical pundits, that people with celiac disease are still alive to be diagnosed after many years of suffering. Other, more important ailments must be ruled out earlier in the diagnostic process. Our symptoms, I’ve been told, are simply uncomfortable—not deadly. I have also been laughed at for suggesting that neurological, psychiatric, and many autoimmune diseases can result from undiagnosed and untreated celiac disease and gluten sensitivity. Some physicians claim that, given our awful diet, people need a powerful motive to follow it. Hence, painful or uncomfortable symptoms are useful prior to investigating celiac disease because they increase the likelihood of dietary compliance. There is some validity to each of these excuses. It is an inconvenient diet that many celiacs ignore. Most of us do survive for decades without a diagnosis. But a pervasive, underlying theme of minimizing and dismissing celiac disease may reflect a set of pre-conceived notions that are deeply imbedded in our collective consciousness. As a culture, we celebrate grains as the very foundation of civilization. We learn from our earliest question about cereals that they are “good” for us. They make us strong and healthy. Equally, almost 200 years ago, his colleagues in obstetrics “knew” that Ignaz Semmelweiss was just being silly with his pre-occupation with “invisible atomies” that spread infections from one patient to another. Physicians were proud of their puss-infested, blood-soaked smocks. These stains attested to their hard work and dedication. The hospital staff under Semmelweiss’ supervision participated in his research. They washed their hands with carbolic soap between each patient examination—and the frequency of child-bed fever dropped to a tiny fraction of the previous rate. Nonetheless, at the end of the study, he was dismissed and mocked for his silly notions about “invisible atomies,” and handwashing came to a stop. Today, with the benefit of microscopes and the widespread acceptance of the germ theory, Semmelweiss’ “invisible atomies” are a concept that is quite easy to accept. In another hundred years, scientists may look back on our ideas about cereals with a similar sense of superiority. The scientific evidence that condemns the foundation of our food pyramid is solid and credible. Despite that evidence, our cultural indoctrination continues to shape the thoughts and actions of those we trust to advise us on health issues. Perhaps cereals will someday be seen as a sinister conduit of disease. In the meantime, it is a challenge for us to be patient with those who continue to genuflect at the altar of Grains.
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Hi, I have just joined the forum. I have had CFS for around twenty years now.I have also suffered with depression,anxiety,paranoia,brain fog/confusion,chronic stiffness in my joints,mood swings,difficulty concentrating,racing thoughts/mania,feverish chills,shallow breath.I found it hard to stretch my body and use my muscles correctly.I had to give up yoga classes after seven years because I lacked muscle memory and was 'bypassing' my joints to try and get into poses,causing more problems. I have tried all sorts of things,had many tests done.Although the doctors have tended to view things as mental health related,I have always felt there was a physical origin to the issue.The tests showed I have reactive hypoglycemia.I cut out sugar and high sugar fruits and found it easier to manage moods by recognising when I was going hypo,which would lead to irritation,anger,frustration.I learned how to combat depression. But I still had the fatigue,the feeling of heaviness,the tension in my muscles and joints,the anxiety,paranoia and mood swings.I felt so uncomfortable in my body.I still couldn't access muscles and use them properly,I felt like my brain was bursting out of my skull.My head and neck still felt like they were held in a vice.I had a lot of tension headaches.I had to constantly remind myself to breath.I felt crap in general. I have been seeing an osteopath regularly for four years now.This has helped me to regain some flexibility. I recently visited an herbalist,who believes I am gluten and dairy intolerant.I therefore went on a gluten and dairy free diet five and a half weeks ago.Since then I have noticed an improvement in my ability to access and use my muscles correctly.I am regaining flexibility.I am feeling power returning to my body.My head feels less swollen.I am regaining my senses,which felt like they were receiving sensory data from behind a barrier. I gather that gluten can cause inflammation in individuals who have gluten sensitivity,as the body's auto-immune response kicks in to fight the threat.And this inflammation can cause many different symptoms.For myself,I appear to have had inflammation in my brain,affecting my nervous system,breathing,co-ordination,mobility. Since changing my diet,I have had some strange pains in my head/face at times.I have felt more lethargic than usual.I have been feeling emotionally volatile.I had a manic episode.(This is not normal for me,I have generally been too tired to get manic and energised,though I have had bipolar tendencies).During this episode I felt marvellous,super confident,played guitar better than ever,hardly slept in three days. I would like to ask if there are others who have had similar symptoms of gluten intolerance and/or similar experiences during the adjustment to a gluten free diet? How long did it take to feel better? And has anybody had mental health diagnoses/issues which cleared up after going gluten-free? Thanks, Shamogi
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An Evolutionary Explanation for Gluten Intolerance
Gryphon Myers posted an article in Origins of Celiac Disease
Celiac.com 07/04/2012 - It is becoming increasingly clear that celiac disease (or some form of gluten sensitivity) affects many more people in the world than estimates from the past few decades suggested. In the 1950s, celiac disease was estimated as affecting 1 in 8000 individuals worldwide, while today that number has grown to 1 in 100. Seeking to explain why this sizable portion of our population cannot tolerate gluten, Professor David Sanders, who is a Consultant Gastroenterologist at the Royal Hallamshire Hospital and University of Sheffield, looks to evolution for answers. It is hard to think of a world without bread, as even Ancient Romans harvested grain. But wheat is actually a new food for us: it was only widely introduced into the human diet roughly ten thousand years ago, which is a very small percentage (0.4%) of the 2.5 million years our species has walked the planet. So what were we eating that other 99.6% of our life as a species? We ate things that are edible raw, without the need for processing or refinement (which wheat is not). Our ability to process grains to an edible form was a technological development that did not occur until a relatively recent chapter in our history. In a sense, then, our ingenuity is ahead of our biology. As Dr. Sanders says, “... it makes sense that our bodies are still adapting to this food, and more specifically, the gluten it contains.” After millions of years of what is essentially gluten-free dieting, our bodies might be ill-equipped to process gluten, as it is still a relatively foreign substance. Source: http://www.science20.com/news_articles/being_glutenfree_determined_evolution_says_gastroenterologist-91578- 15 comments
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I am curious about Lyme Disease, and its co-infections, as are/is related to gluten intolerance/sensitivity/celiac. What is the relationship you've discovered on your journey?
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Pet Food Recall: The Tip of the Iceberg
John B. Symes, D.V.M. posted an article in Winter 2009 Issue
Celiac.com 07/17/2020 - I am saddened by the recent deaths of affected pets and the trauma this has caused their owners. However, this is the absolute best thing that could happen to the pet food companies. I could not be more excited about the potential for seeing the much-needed changes in pet food manufacturing that may finally come about as a result of this “scandal” in which Menu Foods has recalled a portion of the dog and cat food it manufactured between December 3, 2006 and March 6, 2007. This recall should serve as a huge and important warning. The latest information is that 14 pet deaths have been linked directly to the recalled foods. Six of them were cats that died in the studies conducted by Menu Foods to confirm that their food was the culprit. Mortality and morbidity rates have shown that cats are more susceptible to the effects of this food. This makes sense since cats are more strict carnivores than dogs, and would be less adapted to eating foods derived from grains. The FDA, as of this date, still holds that they do not know what the exact culprit is while the company itself has been quoted as saying that they believe it is the wheat gluten acquired from a new supplier. According to one report I read, the company has replaced the gluten and gone back to the previous formula. If that’s true, they must be convinced that the wheat gluten is the problem. Gluten can cause these health problems and more. Gluten, in sensitized individuals, can induce both chronic and acute kidney failure. This form of kidney failure is typically what we call an IgA nephropathy, in which antibodies and immune complexes formed against gluten are deposited in the kidneys, which leads to damage and ultimately failure. Again, this can be chronic leading to persistent blood (microscopic) and protein in the urine or it can be acute. In most cases of the “tainted” food deaths, the pets had been eating these foods for months before succumbing to its effects. You may have seen the emotion-charged interviews on national news that dealt with owners who thought they were doing the right thing by feeding their pets these foods. They have now learned that they were poisoning their dogs and cats. First, is it a “tainted food -one that contains a poison or a toxin? Or is it one that simply contains a form of gluten that is too powerful for pets’ (or human) consumption? I can easily believe the latter, and that they will find that this new source of gluten came from some genetically modified (GMO) or hybrid wheat that is unsuitable for human consumption and hence, cheaper. That would explain why it was chosen to replace the company’s old source of gluten. It could be the old Starlink (CRY9C) corn story all over again. You remember that one, right? This occurred in 2000 and Taco Bell became the poster child when they had to recall taco shells suspected of having this GMO corn that was intended only for animal feed. Of course that story died quickly (like I am trying to keep this one from doing) and the public never heard about the millions of dollars spent to rid our food supply of this transgenic maize (GMO corn). They recalled over 350 brands of corn products in their attempt to fix this situation. Who knows whether they were really effective? Corn allergies in humans have risen as I certainly believe they have in pets. The expressed concern was that it may cause “allergic reactions.” Well, if you call immune-mediated reactions like rheumatoid arthritis, lupus, and asthma “allergic reactions” then that might be accurate. The story of this recall, and the underlying cause, should be sending shock waves through the public and veterinary communities. But the response thus far has been limited to concern similar to that seen in an E. coli outbreak. However, if we knew that it was the wheat gluten, and if we knew what wheat gluten was capable of (like we who study celiac disease know) then we should be seeing the bigger picture here: This is just the tip of the iceberg. Dogs and cats have been dying from this stuff all along and we just haven’t known it. We need to wake up to the fact that dogs and cats should not be eating these grains to begin with, regardless of the extent to which Humankind has genetically modified these foods. The startling but well established fact is that the lectins of gluten (wheat, barley, rye) dairy products (e.g. casein, lactalbumin) soy, and corn are all capable of inducing serious health issues in those (sensitized) individuals consuming them. I am of the firm belief that these “big 4” are not healthy foods for anyone. They are simply more harmful to some individuals than others. It is a matter of when, not if, they will cause a problem. That’s why I lovingly call them the “four horsemen of the apocalypse”. You may wonder why the problems caused by these proteins do not happen immediately. That is a great question and one that sometimes keeps people from seeing the truth about these harmful glycoproteins/lectins. The fact is that the onset of the lectin-related disorder, whether it be rheumatoid arthritis, type-one diabetes, lupus, etc., is usually preceded by another event such as viral or bacterial infection. Vaccines can also act as triggers. The result of such secondary events is a sudden influx and attachment of these inflammatory proteins to various cells in the body, ushering in what we often refer to as “autoimmune” disorders. I hate that term because it implies an immune system that has gone haywire, attacking the body for no reason. Our bodies and immune systems never make that kind of mistake! These things happen for a reason and these food proteins are often the cause. Viruses also play a role, as described on my web site. All one needs to do is study celiac disease (gluten intolerance) to see how all of this works and appreciate the health implications that accompany this extremely common condition. It does occur in dogs and cats. That has become painfully obvious over the past 7 years I have been studying this issue. The Irish setter is the only known breed to suffer from gluten intolerance but it is clear that gluten is affecting many other breeds of dogs and cats. Why wouldn’t it? It is affecting us and we have had millennia to adapt to eating wheat. Our pets have only been eating wheat-based pet foods for about 20 years now. The fact is that wheat gluten can cause kidney failure. With the relatively small number of deaths that have occurred, gluten is the most likely culprit. Wheat gluten can cause an IgA nephropathy that can either result in chronic or acute kidney failure. There does not have to be another toxin involved. In fact, mold toxins primarily affect the liver and the amount of other toxins that could be present would have to be much higher to cause kidney damage. If so, many more individuals would have been affected. Thus, the FDA is correct in pointing the finger at gluten but very wrong in saying that wheat gluten cannot cause kidney failure. This leads to my final point (other than the fact that many of you are up in arms about so many of your “quality pet foods” being made by one big company in Canada): Are your pet foods really formulated “scientifically”? I used to think so. Hey, I used to parrot what I was taught - that the pet food companies spend millions of dollars and years of intense research coming up with balanced and nutritious foods. I used to warn people not to add any table food so that they did not upset this “balance”. I was one of their biggest fans...patsies. Then I woke up and wrote “Gluten Intolerance and Your Pet”. Why are we feeding dogs and cats with wheat, barley, soy, and corn (and now dairy products...again...after having removed them 20 years ago)? The manufacturers of pet foods either don’t have a clue as to what they are doing or they know better and are doing the wrong thing anyway. If I were in the pet food industry, I’d rather claim ignorance, but I’ll let readers decide for themselves. If the research and development departments of these companies that are starting to use dairy products again truly think that lactose is the culprit (rather than the lectins of casein, lactalbumin, etc), then the executives in charge need to fire the entire lot of them and start afresh. If they really don’t know what gluten can do to the kidneys, joints, intestinal tracts, brains and other organs of our beloved pets, then they all need to go back to school or find another line of work. DO NOT let this story die. It does not matter whether they ever tell us that wheat gluten caused these deaths. The fact is that it can, and does. Thus, gluten has no place in pet food. The gluten found in the non-recalled dry food versions of these foods is only incrementally better, causing sub-clinical issues that shorten our pet’s lives. Do you really want to know why the average dog’s life is 12 years and that of the cat is 13 years (in the USA) when the former can live to be nearly thirty and the latter to 40? Look no further than what we put in their bowls. In a study done in Europe, pets that were fed table scraps lived an average of 3 years longer than those fed commercial diets alone. Why? Highly processed foods cannot possibly contain all of the essential nutrients found in fresh meats, fruits and vegetables. If our veterinarians can’t understand that, then they too need a refresher course. The combination of these foods is woefully deficient in nutrients and the fact that they are downright harmful is an abomination. It is time to change this! Let this recall story be a warning sign but please do not let it die. This increased awareness of the pet food industry and how it works is actually good news for the pets and may also awaken many people to the hazards posed to humans. -
Are Enzymes Effective Against Gluten Contamination?
Dr. Albert Zickmann posted an article in Spring 2020 Issue
Celiac.com 03/06/2020 - Celiac disease has an incidence of about 1% in the general population. It is an automimmune disease triggered by a proline-rich protein, gliadin, when it enters the small intestine and leaks into the wall of the small intestine (therefore the name leaky gut). Humans cannot break down proline-rich proteins. In healthy persons, gliadin passes through the gastrointestinal tract and is excreted in stool and urine without consequences. Celiac patients, build antibodies in the small intestine and these antibodies travel through the blood stream in all areas of the body. In some patients, there are no apparent symptoms or they can be very mild, while in others the symptoms are quite severe and are even associated with an increased risk of a certain type of intestinal cancer. Researchers have identified that the body breaks down some of the components of gliadin, but the human body cannot break down and digest the components that contain the amino acid proline. There are two such segments of the gliadin molecule that are causing an inflammatory reaction and they are called 33-mer and 26-mer peptides, because they contain a 33 and respectively a 26 amino acid sequence. In an effort to prevent the gliadin molecule from leaking into the wall of the small intestine, a variety of methods have been tried. These include, closing the junctions through which gliadin leaks, encapsulating the gliadin molecule, and enzymatic degradation of the inflammatory segments of the gliadin molecule. The smallest protein chain that can cause an inflammatory reaction is 9 amino acids long, and the goal would be to break down the gliadin molecule in segments of 8 or less amino acids. This has to happen before the gliadin molecule enters the small intestine and leak into the wall of the intestine. The most commonly sold over-the counter enzymes are in the DPP-IV group, and while they are in fact very effective in breaking down gliadin's smaller segments, they cannot break down the proline rich areas in segments of less than 9 amino acids, and are therefore not effective in preventing an inflammatory reaction. The three enzymes that have shown promising results are ALV003, an enzyme combination of 2 enzymes that is currently undergoing FDA testing, AN-PEP, produced by DSM, and enzyme that was originally used to make cold brewed beer clear, and a product called KumaMax, purchased by Takeda Pharmaceuticals. At this time only AN-PEP is available in various concentrations on the market. It has been particularly effective at breaking down gluten at a low pH commonly found in the stomach, and a study has shown that AN-PEP is even more effective if combined with a food grade acid. The tests were done in healthy volunteers and under laboratory conditions and several groups of researchers came to the same conclusions that AN-PEP is very effective in cleaving the gliadin molecule. The tests are considered pertinent even if healthy volunteers were selected because enzymes work in the stomach and not systemically and in that respect, there is no difference between a celiac patient and a healthy individual. Until a few years ago, gluten-sensitivity was considered to have the same cause as celiac disease, namely the gliadin molecule and in order to avoid regulator issues, these enzymes were recommended only for gluten sensitivity but not for celiac disease. Recent work suggests that these enzymes are in fact not as effective for gluten sensitivity because the culprit of most gluten sensitivities might not be the gliadin molecule. Enzymes Do Not Change the Nature of Celiac Disease and Do Not Treat or Cure It Existing data is very encouraging and clearly proves that AN-PEP enzymes greatly reduce the concentration of gliadin and can possibly even make it undetectable. It is important to note, that these enzymes do not change the nature of celiac disease and therefore do not treat or cure it. They can only break down the molecule that is triggering a reaction and therefore help maintain a gluten-free diet when contaminants are present. Essentially, there are two ways to maintain a gluten-free diet. One way is to avoid any contaminants in the food but most authorities agree that this is almost unattainable. The second way, is to break down the contaminants before they can cause damage. The underlying immune-deficiency is not changed and adherence to a gluten-free diet can not be neglected. Clinicians are reluctant to recommend enzymes for gluten contamination and certainly not for intentional consumption without regulatory approval. The big challenge is that short term gluten challenge studies have been inconclusive because they did not prove an advantage over a placebo. In order to obtain conclusive results, patients who have been on a gluten-free diet for months or even for years before they develop symptoms or antibodies, and therefore a study to prove conclusively an advantage over a placebo, is very difficult to conduct and might take years. Given this challenge, it is unlikely that an enzyme will ever go through the FDA process. As long as enzymes are not recommended to treat or cure a disease, they do not have to be FDA approved but are regulated by the FDA and have to be registered as dietary ingredients. Enzymes Could Lead to Being Less Careful and Cause a Higher Risk of Gluten Exposure There is the concern that enzymes could lead to being less careful and therefore causing a higher risk of gluten exposure, and this is a valid argument, but the ethical question then arises whether this is enough reason to withhold the additional benefit of safety to those who are careful. A recent study suggests that there is a method to measure the impact of gluten with a blood test of interleukin-2 within a few hours of gluten ingestion, and the results could make a gluten-challenge study shorter and safer and could help investigate enzymes or other methods that support a gluten-free diet. Another very promising application for enzymes is to treat gluten-containing food products and break down the immunogenic components of gliadin. These foods could not be labeled as gluten-free but only as gluten-removed. It is currently accepted that alcoholic drinks such as vodka or whiskey that are made from gluten containing grains are considered safe because of the distillation process that removes all gluten-proteins from the final product. Current laboratory tests are very accurate in determining if a product does or does not contain gluten. Currently an enzymatically treated product is not considered at the same level of safety as when gluten (gliadin molecule) is completely removed from a food product. However, at least theoretically, there should be no difference between a product that is made from non-gluten containing ingredients and a product that has been treated in a way that the finished product has no detectable gluten molecules. In conclusion, evidence is very strong that enzymes could be recommended for the breakdown of contaminants in support of a gluten-free diet, but not to replace a gluten-free diet. This does greatly enhance the quality of life for celiac patients when eating outside of a completely controlled environment, which is not attainable for most people. Join the forum discussion on on enzymes discussed in this article. Studies on AN-PEP: Extra-Intestinal Manifestation of Celiac Disease in Children. Nutrients 2018, 10(6), 755; doi:10.3390/nu10060755 Efficient degradation of gluten by a prolyl endoprotease in a gastrointestinal model Enzymatic gluten detoxification: the proof of the pudding is in the eating! Highly efficient gluten degradation with a newly identified prolyl endoprotease: implications for celiac disease Degradation of gluten in wheat bran and bread drink by means of a proline-specific peptidase References: Hausch, F., Shan, L., Santiago, N. A., Gray, G. M. & Khosla, C. Intestinal digestive resistance of immunodominant gliadin peptides. Am. J. Physiol. Gastrointest. Liver Physiol. 283, G996–G1003 (2002) Shan, L. et al. Structural basis for gluten intolerance in celiac sprue. Science 297, 2275–2279 (2002) Greco, L. et al. Safety for patients with celiac disease of baked goods made of wheat flour hydrolyzed during food processing. Clin. Gastroenterol. Hepatol. 9, 24–29 (2011) Stoven, S., Murray, J. A. & Marietta, E. Celiac disease: advances in treatment via gluten modification. Clin. Gastroenterol. Hepatol. 10, 859–862 (2012) Gass, J. & Khosla, C. Prolyl endopeptidases. Cell. Mol. Life Sci. 64, 345–355 (2007) Mitea, C. et al. Efficient degradation of gluten by a prolyl endoprotease in a gastrointestinal model: implications for coeliac disease. Gut 57, 25–32 (2008) Shan, L., Marti, T., Sollid, L. M., Gray, G. M. & Khosla, C. Comparative biochemical analysis of three bacterial prolyl endopeptidases: implications for coeliac sprue. Biochem. J. 383, 311–318 (2004) Edens, L. et al. Extracellular prolyl endoprotease from Aspergillus niger and its use in the debittering of protein hydrolysates. J. Agric. Food Chem. 53, 7950–7957 (2005) Marti, T. et al. Prolyl endopeptidase-mediated destruction of T cell epitopes in whole gluten: chemical and immunological characterization. J. Pharmacol. Exp. Ther. 312, 19–26 (2005) Stepniak, D. et al. Highly efficient gluten degradation with a newly identified prolyl endoprotease: implications for celiac disease. Am. J. Physiol. Gastrointest. Liver Physiol. 291, G621–G629 (2006) Pyle, G. G. et al. Effect of pretreatment of food gluten with prolyl endopeptidase on gluten induced malabsorption in celiac sprue. Clin. Gastroenterol. Hepatol. 3, 687–694 (2005) Gass, J., Vora, H., Bethune, M. T., Gray, G. M. & Khosla, C. Effect of barley endoprotease EPB2 on gluten digestion in the intact rat. J. Pharmacol. Exp. Ther. 318, 1178–1186 (2006) Bethune, M. T. et al. A non-human primate model for gluten sensitivity. PLoS ONE 3, e1614 (2008). 29. Siegel, M. et al. Rational design of combination enzyme therapy for celiac sprue. Chem. Biol. 13, 649–658 (2006) Gass, J., Bethune, M. T., Siegel, M., Spencer, A. & Khosla, C. Combination enzyme therapy for gastric digestion of dietary gluten in patients with celiac sprue. Gastroenterology 133, 472–480 (2007) Siegel, M. et al. Safety, tolerability, and activity of ALV003: results from two phase 1 single, escalating-dose clinical trials. Dig. Dis. Sci. 57, 440–450 (2012) Tye-Din, J. A. et al. The effects of ALV003 predigestion of gluten on immune response and symptoms in celiac disease in vivo. Clin. Immunol. 134, 289–295 (2010) Lähdeaho, M. L. et al. ALV003, a novel glutanase, attenuates gluten-induced small intestinal mucosal injury in coeliac disease patients: a randomized controlled phase 2a clinical trial. Gut Suppl. 60, A12 (2011) Janssen, G. et al. Ineffective degradation of immunogenic gluten epitopes by currently available digestive enzyme supplements. PLos One 10, e0128065 (2015). Stenman, S. et al. Enzymatic detoxification of gluten by germinating wheat proteases: implications for new treatment of celiac disease. Ann. Med. 41, 390–400 (2009) Stenman, S. et al. Degradation of coeliac disease-inducing rye secalin by germinating cereal enzymes: diminishing toxic effects in intestinal epithelial cells. Clin. Exp. Immunol. 161, 242–249 (2010) Laparra, J. M. & Sanz, Y. Bifidobacteria inhibit the inflammatory response induced by gliadins in intestinal epithelial cells via modifications of toxic peptide generation during digestion. J. Cell. Biochem. 109, 801–807 (2010) De Angelis, M. et al. VSL#3 probiotic preparation has the capacity to hydrolyze gliadin polypeptides responsible for celiac sprue. Biochim. Biophys. Acta 1762, 80–93 (2006) Julia König et al. Is an enzyme supplement for celiac disease finally on the cards? Pages 531-533 | Received 01 Feb 2018, Accepted 02 May 2018, Accepted author version posted online: 06 May 2018, Published online: 11 May 2018 Pinier, M. et al. Polymeric binders suppress gliadin-induced toxicity in the intestinal epithelium. Gastroenterology 136, 288–298 (2009) Pinier, M. et al. The copolymer P(HEMAcoSS) binds gluten and reduces immune response in gluten-sensitized mice and human tissues. Gastroenterology 142, 316–325 (2012) Smecuol, E. et al. Gastrointestinal permeability in celiac disease. Gastroenterology 112, 1129–1136 (1997) Tripathi, A. et al. Identification of human zonulin, a physiological modulator of tight junctions, as prehaptoglobin2. Proc. Natl Acad. Sci. 106, 16799–16804 (2009) Lammers, K. M. et al. Gliadin induces an increase in intestinal permeability and zonulin release by binding to the chemokine receptor CXCR3. Gastroenterology 135, 194–204 e193 (2008) Di Pierro, M. et al. Zonula occludens toxin structure-function analysis. Identification of the fragment biologically active on tight junctions and of the zonulin receptor binding domain. J. Biol. Chem. 276, 19160–19165 (2001) Leffler, D. A. et al. A randomized, double-blind study of larazotide acetate to prevent the activation of celiac disease during gluten challenge. Am. J. Gastroenterol. 107, 1554–1562 (2012) Kelly, C. P. et al. Larazotide acetate in patients with coeliac disease undergoing a gluten challenge: a randomised placebo-controlled study. Aliment. Pharmacol. Ther. 37, 252–262 (2013) Katharina Anne et al. Novel approaches for enzymatic gluten degradation to create high-quality gluten-free products https://doi.org/10.1016/j.foodres.2016.11.021 -
Celiac.com 12/06/2016 - Neurological problems are a very common effect of gluten intolerance. Whether you have celiac disease or gluten sensitivity, there is research showing that gluten can cause nervous system problems in affected individuals. What kind of problems? When it comes to the nervous system, symptoms run the gamut from depression to schizophrenia, from migraines to brain fog, and from seizures to numbness and pain. I want to share more information with you about a particular type of nervous system ailment called peripheral neuropathy. The name basically means damage to the nerves of the extremities (arms and legs) that typically manifests in numbness and pins and needles-type pain that all of us have experienced at one time or another if we sat on our feet too long or fell asleep in a weird position and had a hand ‘go to sleep'. While these latter type incidents are normal, having such symptoms occur when no pressure is being put on the nerve is abnormal. Not only is it uncomfortable to have such sensations, but when truly numb, accidents from tripping or burning oneself can occur due to not having adequate sensation. I think it is interesting to note that the most common occurrence of peripheral neuropathy is seen in type I diabetes, an autoimmune disease. Celiac is also an autoimmune disease and according to the University of Chicago's Center for Peripheral Neuropathy, 10% of those diagnosed with celiac disease have a neurological problem, and peripheral neuropathy is quite common. Taking it a step further, we know that gluten creates a leaky gut and we know that a leaky gut is associated with autoimmune disease, through several wonderful studies brought to us by Dr. Alessio Fasano and his team. Therefore, seeing a connection between gluten and peripheral neuropathy is not unexpected based on research. Further, despite a dearth, or scarcity, of research on gluten sensitivity, doctors currently engaged in such research cite peripheral neuropathy as one of the most common symptoms associated with gluten sensitivity. In fact neurological symptoms are frequently associated with gluten sensitivity before any digestive symptoms ever develop. And in some cases, the nervous system disorders are present with no digestive disturbances. A lack of any digestive symptoms is perhaps one of many reasons why these individuals' gluten sensitivity is missed by their doctors. When it comes to comparing gluten sensitivity to celiac disease, according to Dr Fasano, 30% of the patients he diagnoses with gluten sensitivity suffer a neurological ailment, a much higher percentage than that associated with celiac disease. How Do You Know if You Have Peripheral Neuropathy? The symptoms of peripheral neuropathy are numbness, a feeling of hot/cold or a pins and needles feeling that tends to start at the ends of your body's long nerves, meaning your feet and hands, before moving upwards. The symptoms can be in legs and/or arms, right side and/or left. Certainly, considering that type 1 diabetes is the most common cause of peripheral neuropathy, with an estimated 50% suffering some type of nerve damage, that would be the first thing to rule out. What Should You Do? If you have these symptoms and your doctor has ruled out diabetes and any other obvious sources of the problem (including any drugs you may be taking that create neuropathy as side effects), you may fit into the category of "idiopathic neuropathy". This means that you have the problem but the reason is unknown. Or is it? Let's look at the result of a study where researchers worked with more than 200 individuals with neuropathy, 140 of whom fell within the ‘idiopathic' category. These smart doctors tested those 140 people for antibodies to gluten, specifically utilizing the anti-gliadin antibody test – AGA-IgA and AGA-IgG. This blood test is a general blood test that is not specific to celiac disease or gluten sensitivity, but shows that the body's immune system is reacting negatively to these proteins in gluten called gliadin. Of those tested, 34% were positive to one or both tests, compared to 12% of the general population. Interestingly, a full 9% of those tested in the ‘idiopathic' group actually had celiac disease, compared to 1% of the general population. And perhaps even more interesting, 80% of that same idiopathic group had the genes for celiac disease, either HLA-DQ2 or HLA-DQ8. 80%!! In the normal population that number is about 40%. Our takeaway message is that peripheral neuropathy has a rather high correlation to immune reaction to gluten – be it celiac disease or gluten sensitivity. Therefore anyone you know who suffers with such symptoms absolutely should be checked for gluten intolerance. Regaining one's strength and correcting nervous system abnormalities is well worth the change in diet when gluten is the cause. Such cases have been described in the literature where the only treatment that led to success was a gluten-free diet. So many diseases and symptoms can be prevented and reversed by discovering their true underlying root cause and for many of those ailments it is gluten that is the culprit. Don't continue suffering nor let you friends and family members suffer. Find out why the symptom is there rather than just masking it with a drug. If you need assistance, consider calling us for a free health analysis – call 408-733-0400. Our destination clinic treats patients from across the country and internationally. You don't need to live local to us to receive assistance. We are here to help! To your good health, References: Hadjivassiliou M. et al. Neuropathy associated with gluten sensitivity. Journal of Neurology, Neurosurgery, and Psychiatry. 2006 Nov;77(11):1262-6. Rigamonti A. et al. Celiac disease presenting with motor neuropathy: effect of gluten-free diet. Muscle & Nerve. 2007 May;35(5):675-7. University of Chicago Center for Peripheral Neuropathy. Types of Peripheral Neuropathy - Inflammatory - Celiac Disease.
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The Gluten Intolerance Group of North America, also known as GIG, is a 501©(3) non-profit organization funded by private donations including the Combined Federal Campaign, United Way Designated Giving, Employer Matching Funds; proceeds from memberships, the sale of products and our educational resources. We rely on your contributions, which are tax deductible. 85% or more of our revenue is used to support our programs. GIG is at the forefront of innovative action and is respected globally as a powerful leader in the celiac community. GIGs volunteers, staff, and Board are knowledgeable and our materials and resources are credible. Our Mission is to provide support to persons with gluten intolerances, including celiac disease, dermatitis herpetiformis, and other gluten sensitivities, in order to live healthy lives. GIG Branches help to fulfill GIGs mission on a local and regional level through programs tailored to their community. GIG VISION The vision of the Gluten Intolerance Group of North America is one of mutual support, acceptance, and respect for all persons living with gluten intolerances and working with this community. GIG envisions a united gluten intolerant community in which all persons feel they are healthy, are positively nurtured to live life to the fullest, and are involved and contributing citizens. GIG PROGRAMS FULFILLING THE MISSION GIG fulfills its mission of supporting persons living with gluten intolerances through programs directed to consumers, health professionals and the public. GIGR programs provide: Support and education Awareness and advocacy Research awareness and support GIG is dedicated to providing accurate, scientific, evidence-based information. Cynthia Kupper, RD, celiac disease, Executive Director 31214 - 124 Ave SE Auburn WA 98092 Phone: 253-833-6655 Fax: 253-833-6675 Web sites: www.gluten.net; www.GFCO.org; www.GlutenFreeRestaurants.org Email: info@GLUTEN.net
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The Osteoporosis—Gluten Intolerance Connection
Dr. Vikki Petersen D.C, C.C.N posted an article in Autumn 2009 Issue
Celiac.com 01/02/2020 - Osteoporosis is the 11th leading cause of death. 1 in 2 women and 1 in 4 men is affected. We sometimes think of our bones like the walls in a room - they hold things up but we consider them rather inert. On the contrary, our bones are very much alive, constantly remodeling themselves by getting rid of old bone cells and rebuilding with new bone cells. Further, healthy bones are needed for immune function since all our red and white blood cells are made in the marrow of our bones. There are some drugs available to “treat” osteoporosis but they are laden with side effects. Some are even cancerous. In Nutrition Reviews 2007, a study report titled “Osteoporosis and Inflammation” revealed that inflammation triggers the shift from healthy bones to osteoporosis. So let’s look at how osteoporosis is related to digestive function. A recent article in Cell 2008 entitled “When the Gut Talks to Bone” revealed that certain genes (Wnt genes) trigger signaling factors required for the development of bones and nerve structures within the body. What was most interesting was the revelation that these genes are activated by serotonin. Where is the vast majority of serotonin made? In the gut! We have previously seen correlations between the brain and the gut, such as in chronic IBS which is strongly correlated to stress. But gut serotonin actually “talks” to our bone, thereby creating a strong connection between gut health and bone Health. This is quite new in the research. It substantiates something I’ve seen in my patients for years. The more inflammation is present, the more the gut makes serotonin which in turn leads to bone breakdown – osteoporosis. What does all this mean? It means that lowering inflammation in the body is critical in the prevention of osteoporosis (not to mention heart disease and cancer but we’ll leave those connections for another article.) How do we lower inflammation? One of the biggest inflammation inducing culprits is gluten. It not only creates local inflammation in the gut but it creates systemic inflammation through its affects on the immune system in sensitive individuals. And remember, current research considers 40% of the population to be gluten sensitive. In the New England Journal of Medicine 2007 it stated that celiac disease inflamed the gut, thereby creating bone loss. The good news in all of this is that reducing inflammation is something we have control over. We can find out if we’re among the 40% of the population that is gluten intolerant. We can change our diets. We can use supplements such as omega-3 fatty acids to reduce inflammation and help heal the lining of our intestines. These tools are within our reach. Further, remember that gluten reduces absorption of certain key vitamins and minerals such as calcium and Vitamin D, which are critical to bone health. Have your Vitamin D level evaluated and supplement as needed. Osteoporosis is a very debilitating disease. Now we know it doesn’t have to be.- 3 comments
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What is Celiac Disease and the Gluten-Free Diet?
Scott Adams posted an article in Celiac Disease Basics
WHAT IS CELIAC DISEASE? Celiac disease is an autoimmune condition that affects around 1.4% of the population (91.2 million people worldwide, and 3.9 million in the U.S.A.). People with celiac disease suffer an autoimmune reaction when they consume wheat, rye or barley. The immune reaction is triggered by certain proteins in the wheat, rye, or barley, and, left untreated, causes damage to the small, finger-like structures, called villi, that line the gut. The damage occurs as shortening and villous flattening in the lamina propria and crypt regions of the intestines. The damage to these villi then leads to numerous other issues that commonly plague people with untreated celiac disease, including poor nutritional uptake, fatigue, and myriad other problems. Celiac disease mostly affects people of Northern European descent, but recent studies show that it also affects large numbers of people in Italy, China, Iran, India, and numerous other places thought to have few or no cases. Celiac disease is most often uncovered because people experience symptoms that lead them to get tests for antibodies to gluten. If these tests are positive, then the people usually get biopsy confirmation of their celiac disease. Once they adopt a gluten-free diet, they usually see gut healing, and major improvements in their symptoms. CLASSIC CELIAC DISEASE SYMPTOMS Symptoms of celiac disease can range from the classic features, such as diarrhea, upset stomach, bloating, gas, weight loss, and malnutrition, among others. LESS OBVIOUS SYMPTOMS Celiac disease can often less obvious symptoms, such fatigue, vitamin and nutrient deficiencies, anemia, to name a few. Often, these symptoms are regarded as less obvious because they are not gastrointestinal in nature. You got that right, it is not uncommon for people with celiac disease to have few or no gastrointestinal symptoms. That makes spotting and connecting these seemingly unrelated and unclear celiac symptoms so important. NO SYMPTOMS Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors. CELIAC DISEASE VS. GLUTEN INTOLERANCE Gluten intolerance is a generic term for people who have some sort of sensitivity to gluten. These people may or may not have celiac disease. Researchers generally agree that there is a condition called non-celiac gluten sensitivity. That term has largely replaced the term gluten-intolerance. What’s the difference between celiac disease and non-celiac gluten-sensitivity? CELIAC DISEASE VS. NON-CELIAC GLUTEN SENSITIVITY (NCGS) Gluten triggers symptoms and immune reactions in people with celiac disease. Gluten can also trigger symptoms in some people with NCGS, but the similarities largely end there. There are four main differences between celiac disease and non-celiac gluten sensitivity: No Hereditary Link in NCGS Researchers know for certain that genetic heredity plays a major role in celiac disease. If a first-degree relative has celiac disease, then you have a statistically higher risk of carrying genetic markers DQ2 and/or DQ8, and of developing celiac disease yourself. NCGS is not known to be hereditary. Some research has shown certain genetic associations, such as some NCGS patients, but there is no proof that NCGS is hereditary. No Connection with Celiac-related Disorders Unlike celiac disease, NCGS is so far not associated with malabsorption, nutritional deficiencies, or a higher risk of autoimmune disorders or intestinal malignancies. No Immunological or Serological Markers People with celiac disease nearly always test positive for antibodies to gluten proteins. Researchers have, as yet, identified no such antobodies or serologic markers for NCGS. That means that, unlike with celiac disease, there are no telltale screening tests that can point to NCGS. Absence of Celiac Disease or Wheat Allergy Doctors diagnose NCGS only by excluding both celiac disease, an IgE-mediated allergy to wheat, and by the noting ongoing adverse symptoms associated with gluten consumption. WHAT ABOUT IRRITABLE BOWEL SYNDROME (IBS) AND IRRITABLE BOWEL DISEASE (IBD)? IBS and IBD are usually diagnosed in part by ruling out celiac disease. Many patients with irritable bowel syndrome are sensitive to gluten. Many experience celiac disease-like symptoms in reaction to wheat. However, patients with IBS generally show no gut damage, and do not test positive for antibodies to gliadin and other proteins as do people with celiac disease. Some IBS patients also suffer from NCGS. To add more confusion, many cases of IBS are, in fact, celiac disease in disguise. That said, people with IBS generally react to more than just wheat. People with NCGS generally react to wheat and not to other things, but that’s not always the case. Doctors generally try to rule out celiac disease before making a diagnosis of IBS or NCGS. Crohn’s Disease and celiac disease share many common symptoms, though causes are different. In Crohn’s disease, the immune system can cause disruption anywhere along the gastrointestinal tract, and a diagnosis of Crohn’s disease typically requires more diagnostic testing than does a celiac diagnosis. Crohn’s treatment consists of changes to diet and possible surgery. Up to 10% of Crohn's patients can have both of conditions, which suggests a genetic connection, and researchers continue to examine that connection. Is There a Connection Between Celiac Disease, Non-Celiac Gluten Sensitivity and Irritable Bowel Syndrome? Large Number of Irritable Bowel Syndrome Patients Sensitive To Gluten Some IBD Patients also Suffer from Non-Celiac Gluten Sensitivity Many Cases of IBS and Fibromyalgia Actually Celiac Disease in Disguise CELIAC DISEASE DIAGNOSIS Diagnosis of celiac disease can be difficult. Perhaps because celiac disease presents clinically in such a variety of ways, proper diagnosis often takes years. A positive serological test for antibodies against tissue transglutaminase is considered a very strong diagnostic indicator, and a duodenal biopsy revealing villous atrophy is still considered by many to be the diagnostic gold standard. But this idea is being questioned; some think the biopsy is unnecessary in the face of clear serological tests and obvious symptoms. Also, researchers are developing accurate and reliable ways to test for celiac disease even when patients are already avoiding wheat. In the past, patients needed to be consuming wheat to get an accurate test result. Celiac disease can have numerous vague, or confusing symptoms that can make diagnosis difficult. Celiac disease is commonly misdiagnosed by doctors. Read a Personal Story About Celiac Disease Diagnosis from the Founder of Celiac.com Currently, testing and biopsy still form the cornerstone of celiac diagnosis. TESTING There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis. Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis. Also, it is now possible to test people for celiac disease without making them concume wheat products. BIOPSY Until recently, biopsy confirmation of a positive gluten antibody test was the gold standard for celiac diagnosis. It still is, but things are changing fairly quickly. Children can now be accurately diagnosed for celiac disease without biopsy. Diagnosis based on level of TGA-IgA 10-fold or more the ULN, a positive result from the EMA tests in a second blood sample, and the presence of at least 1 symptom could avoid risks and costs of endoscopy for more than half the children with celiac disease worldwide. WHY A GLUTEN-FREE DIET? Currently the only effective, medically approved treatment for celiac disease is a strict gluten-free diet. Following a gluten-free diet relieves symptoms, promotes gut healing, and prevents nearly all celiac-related complications. A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods. Still, with effort, most people with celiac disease manage to make the transition. The vast majority of celiac disease patients who follow a gluten-free diet see symptom relief and experience gut healing within two years. For these reasons, a gluten-free diet remains the only effective, medically proven treatment for celiac disease. WHAT ABOUT ENZYMES, VACCINES, ETC.? There is currently no enzyme or vaccine that can replace a gluten-free diet for people with celiac disease. There are enzyme supplements currently available, such as AN-PEP, Latiglutetenase, GluteGuard, and KumaMax, which may help to mitigate accidental gluten ingestion by celiacs. KumaMax, has been shown to survive the stomach, and to break down gluten in the small intestine. Latiglutenase, formerly known as ALV003, is an enzyme therapy designed to be taken with meals. GluteGuard has been shown to significantly protect celiac patients from the serious symptoms they would normally experience after gluten ingestion. There are other enzymes, including those based on papaya enzymes. Additionally, there are many celiac disease drugs, enzymes, and therapies in various stages of development by pharmaceutical companies, including at least one vaccine that has received financial backing. At some point in the not too distant future there will likely be new treatments available for those who seek an alternative to a lifelong gluten-free diet. For now though, there are no products on the market that can take the place of a gluten-free diet. Any enzyme or other treatment for celiac disease is intended to be used in conjunction with a gluten-free diet, not as a replacement. ASSOCIATED DISEASES The most common disorders associated with celiac disease are thyroid disease and Type 1 Diabetes, however, celiac disease is associated with many other conditions, including but not limited to the following autoimmune conditions: Type 1 Diabetes Mellitus: 2.4-16.4% Multiple Sclerosis (MS): 11% Hashimoto’s thyroiditis: 4-6% Autoimmune hepatitis: 6-15% Addison disease: 6% Arthritis: 1.5-7.5% Sjögren’s syndrome: 2-15% Idiopathic dilated cardiomyopathy: 5.7% IgA Nephropathy (Berger’s Disease): 3.6% Other celiac co-morditities include: Crohn’s Disease; Inflammatory Bowel Disease Chronic Pancreatitis Down Syndrome Irritable Bowel Syndrome (IBS) Lupus Multiple Sclerosis Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Psoriasis Rheumatoid Arthritis Scleroderma Turner Syndrome Ulcerative Colitis; Inflammatory Bowel Disease Williams Syndrome Cancers: Non-Hodgkin lymphoma (intestinal and extra-intestinal, T- and B-cell types) Small intestinal adenocarcinoma Esophageal carcinoma Papillary thyroid cancer Melanoma CELIAC DISEASE REFERENCES: Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis. Clinical Gastroenterology and Hepatology 2018;16:823–836 Celiac Disease Center, Columbia University Gluten Intolerance Group National Institutes of Health U.S. National Library of Medicine Mayo Clinic University of Chicago Celiac Disease Center- 95 comments
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I’m the parent of a nearly 15 year old daughter. 5 years ago we finally found something that made a difference in her pain. A natural doctor did a blood test showing her to be severely gluten intolerant. Regretfully, we did not know to test her for celiac before removing gluten from her diet. Without that diagnosis, many doctors have made us feel gluten intolerance isn’t that serious. Very long story. Anyway, after 5 years of strict gluten avoidance, we were on vacation and let our guard down. Served what we thought was rice, she ate a portion. It ended up being ORZO. Pasta that looks like rice. That night she was dizzy, faint, even developed a fever. She slept most of the next day not eating much at all thinking she was coming down with a cold. Then, severe stomach pain and headache. Then, she threw up everything she ate for a few days. Ready to take her to the ER, we realized it was gluten! Picked up some digestive enzymes, anti-nausea medications, ginger, peppermint, tea, you name it. Today was the first day she could eat proper in a week. Still having some discomfort. Joint pain starting now too. My main question is: Is this typical for just gluten intolerance or does it sound more like celiac? She has been severely vitamin d deficient taking as much as 10,000 iu a day in liquid D and never bringing her levels to normal and menstral cycle never regular although she started at 10. Goes for months without and then when it does come, crazy heavy lasting weeks. Doctor still wasn’t horribly concerned. Just exhausted trying to be our own doctor. Insurance constantly changing making us look for new doctors. I wish I was rich. So expensive and frustrating having to try to get enough bedside time with each new doctor to reexplain her whole journey. Any information appreciated. She was doing much better by strictly avoiding gluten all these years but this last episode has me researching again to do what I can. Again, what do you think? My gut says “Celiac” but I guess we might not ever know for sure.
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Celiac.com 11/08/2005 - York Nutritional Laboratories has introduced to the US a simple, unique and revolutionary finger-stick rapid test kit designed to detect the antibodies associated with Celiac Disease and gluten intolerance. Celiac disease is a gluten intolerance enteropathy caused by a permanent intolerance to gluten and specifically to its protein fragment known as gliadin. The ingestion of this protein in people with genetic predisposition induces a severe compromise to the intestinal mucosa that is historically characterized by one hyperplasia of cryptas with total or subtotal atrophy of the intestinal microvilli. Though the definitive diagnosis of the celiac disease is based in characteristic histological changes observed in intestinal biopsies, the serological tests, such as the detection of antibodies anti-gliadins, anti-tTG and anti-endomysium, represent methods of analyses cheaper and less invasive to the detection of the disease. According to John Kernohan, Director of York Nutritional Laboratories, This new rapid test is a great improvement over our original cdSCAN, which we introduced back in 2002. Individuals now have a even quicker, more convenient and reliable means to determine if Celiac Disease or gluten intolerance is the culprit behind their ill-health. The new and improved cdSCAN is able to analyze a tiny sample of whole blood, serum or plasma for IgA/IgG/IgM antibodies against human Tissue Transglutaminase (tTG) and IgA antibodies against gliadin. The kit can be utilized in either the comfort of ones own home or at a doctors office, and the results are available in approximately 10 minutes. In addition to the approximate 1 million Americans suffering from classical Celiac Disease, there are an equal number of individuals with silent or latent Celiac Disease who are unaware of their condition because they do not have the signs and symptoms typically associated with celiac disease. These individuals run the risk of developing full-blown celiac disease later in life and complications such as bowel cancer, infertility and autoimmune diseases, making proper and early diagnosis very important. Information about the cdSCAN is available from York Nutritional Laboratories, Inc. Please contact John Kernohan at (888) 751-3388.
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Hello, What does my results mean? Am I allergic to gluten? tTg-IgG 8.62 tTg-IgA 3.02 Anti Gliadin IgA 93.24 And what’s the normal range for each? Thank you!
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I’m new to all this Celiac and gluten free stuff so I apologize if I come off as ignorant. I’ve been to two Gastroenterologists are both have told me that my Gluten issues where not Celiac, I do get stomache cramps when I eat gluten, and if I eat gluten consistently I suddenly become allergic to my cat! Still, my symptoms are nothing compared to the pain that diagnosed Celiacs have described. I’ve taken the blood test to see if I am Celiac, and it came back negative. But Ever since my Gluten issues came about (stomach pain constantly, skin issues, other allergies) so have my diary issues. If I eat Dairy I either get constipation or diarrhea, and if I continue it for a few days I get minimal rectal bleeding, which is a little scary. This is definitely a symptom of dairy intolerance and not gluten intolerance right? I asked the Gastroenterologist about it, and they said it’s most likely just IBS. She said I’m too young for a lot of gastrointestinal issues (I’m 22, in good health). She also said rectal bleeding is really only a concern if it’s enough to fill up a toilet bowl, and mine is only when I wipe, while obviously eating dairy (or maybe gluten? I’m not sure). Has anyone experienced anything like this? I want to get a Colonoscopy at some point, although my Doctor told me I don’t really need too. But rectal bleeding is pretty scary for me.
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- celiac disease
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