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How Low B Vitamins can Trigger a Celiac diagnosis and be Mistaken for a Genetic Disease To Whomever May Read This, (Thank you for taking the time to read it and I hope it helps you the way it did me! and if it does tell others....is all I ask)....because I know there are many more fellow sufferers still looking for answers... (because many/most B-Vitamin deficiencies up to 80 percent of the time (especially a Thiamine Deficiency) is going undiagnosed or misdiagnosed in other diseases)....and probably a Riboflavin Deficiency too because they occur together.... Read the blog post and you will see what I mean.... Note: this Posterboy blog post will have 2 portions…. A high level summary and an Appendix/Addendum list of available resources that support these suppositions… Depending on whether you have read the other Posterboy blog post(s) will determine how you want to read this one…. If this is your first then read it all…IF you have read other Posterboy blog posts…then just jump to the Appendix where the references/additional resources are….and all the dirty details... The Posterboy blog post starts now…entitled "How Low B Vitamins can Trigger a Celiac diagnosis and be Mistaken for a Genetic Disease" For a while now (10 to 12+ years now)…..I have been studying B-Vitamins to see what role if any they (B-Vitamins) might have in regulating our Immune System and if they could be the trigger for my GI problems or could have been mistaken for my Celiac disease diagnosis…. Note: I did not say my Celiac disease….but my diagnosis as a Celiac….see Appendix for other possible triggers. I had written two previous articles/Posterboy blog posts one about Thiamine (Beri Beri) aka Vitamin B1 and one about Niacin (Pellagra) aka Vitamin B3. Provided here for easy reference.....if you want to go back and read them sometime... Both play a critical role in our immune system and down regulate inflammation pathways in the body… This Posterboy blog post/article unites the two into an "Elegant Theory" of how and why these occur together in Celiac disease. I had previously done an unpublished article/blog post on Riboflavin….which I might share in the future (but probably not at this point) This Posterboy blog post will serve as the argument (thesis) that Riboflavin deficiency is common in Celiac’s going commonly undiagnosed/misdiagnosed….much like the other B-Vitamin deficiencies of Thiamine (B1) and Niacin (B3) in Celiac’s. I have now found that it is a cascade of all three of these B-Vitamins and maybe 4 (beyond the scope of this blog post Vitamin B6)….. B1, B2, B3 work synergistically together to control inflammation in the body. I found first that Pellagra could be common in Celiac’s going undiagnosed/misdiagnosed…. Then I found that Beri Beri might also be the reason for Celiac’s thin Villi…. SO I had to write about it/that too!.....but no ONE Vitamin/Mineral answered all the questions…. So that made me think I could be wrong about the Pellagra question (in part) at least… IF there is NO SKIN issues IE DH with your Celiac diagnosis then you have NOT YET developed Pellagra…. but more appropriately Pellagra Sine Pellagra…..or Pellagra without skin issues…. And brings me to the point of my current Posterboy blog post. I believe that most Celiac’s have developed Pellagra Sine Pellagra. Now granted they developed Beri Beri FIRST….because B-Vitamin deficiencies NEVER happen alone…. It (Celiac disease) is a sequalae (aftermath) of B-Vitamin deficiencies…and possibly some Minerals like Magnesium and Zinc and Copper etc….(Again beyond the scope of this post) See this Posterboy blog post to see how nutrients (IE Vitamin and Mineral Deficiencies), Genetics and your Environment (STRESS) interact…. To produce disease… So how did I arrive at Pellagra Sine Pellagra instead of Pellagra or Beri Beri (only)…. Because you definitely develop Beri Beri (FIRST)…..why not continue on the Pellagra tack… There is a couple of distinguishing features between the two most notably the level of SKIN involvement…. Pellagra is a very VISUAL disease…..IF you don’t have DH or other Skin problems then you have not yet developed Clinical Pellagra…. But Pellagra Sine Pellagra a Riboflavin deficiency has all the same symptoms of Pellagra without the pervasive skin issues… Make no mistake about it….I had already developed Beri Beri first (horrible fatigue) and Peripheral Neuropathy etc…. They typically occur together…..because as noted earlier B-Vitamin deficiencies don’t occur alone… ONE will affect the others… And why I landed on B2 (Riboflavin) instead of B3 (Niacin)…. The 2nd clue was the pervasive Iron deficiency issues most Celiac’s develop. Is Notable that Iron Deficient Anemia aka IDA is very common in Celiac’s… And people have forgotten how Riboflavin aka Vitamin B2 plays an important role in Iron deficient anemia… https://pubmed.ncbi.nlm.nih.gov/31318024/ Riboflavin deficiency individuals often have fertility problems as well… I too had these same problems that got better after Riboflavin supplementation… Riboflavin again aka Vitamin B2 can cause people to have Hypothyroid problems…..which again was me three…. got better after Riboflavin supplementation… Reason number 4) Anxiety can be the first sign of a Riboflavin deficiency check that one off too! Reason number 5) Riboflavin is the trigger for a Homocysteine problem…..commonly diagnosed as MTHFR Gene defect…. https://chrismasterjohnphd.com/blog/2019/02/26/mthfr-just-riboflavin-deficiency/ Check, Check, Check, Check, Check….I had all the signs of a Riboflavin deficiency and the doctor’s missed them ALL! Not to mention the hallmark angular cheilitis (Leaky Lips) for years…..and the doctor could only recommend for/to me was to stop leaking my lips sooooooo much! ALL this symptom’s and more got better after supplementing with Riboflavin…. SO that is why I know Pellagra Sine Pellagra happened to me and is also happening in other Celiac’s going undiagnosed/Misdiagnosed. The Iron Deficient Anemia…..can be treated (in many if not most cases) with either/by treating your Low Stomach Acid or by taking Riboflavin and/or Copper. See this research entitled “Is achlorhydria (No Stomach Acid) an (independent) cause of iron deficiency anemia” https://pubmed.ncbi.nlm.nih.gov/25994564/ The answer was a resounding yes! So, I had developed low/NO stomach acid as the trigger for my Celiac/NCGS diagnosis… AND just what another intrepid research discovered/studied 35+ years ago and was promptly forgot and never believed….the more things change…the more they stay the same! See this research entitled “Gastric morphology and function in dermatitis herpetiformis (DH) and in Celiac disease” https://www.ncbi.nlm.nih.gov/pubmed/3992169 That should be the end of the discussion…..but It won't be....while their patients suffer...they will do more studies about it! Quoting the whole abstract for emphasis! Abstract “Gastric acid secretory capacity was evaluated in 116 patients with dermatitis herpetiformis by means of the pentagastrin test. Endoscopic gastric mucosal biopsy specimens were obtained from both the body and the antrum in 90 of them. Forty-eight patients (41%) had a maximal acid output less than 10 mmol/h, and 30 of them (26%) were achlorhydric. T he frequency of achlorhydria increased with age, and 27 out of 58 patients (47%) more than 50 years old were achlorhydric. Antrum-sparing chronic atrophic gastritis was present in 92% of the achlorhydric patients, and hypergastrinaemia and serum parietal cell antibodies were found in most of them. The prevalence of chronic gastritis of the body and of the antrum increased with age. There was no correlation between atrophic gastritis or achlorhydria and small-intestinal villous atrophy, the results of the D-xylose test, and blood folate and serum zinc determinations. The transferrin saturation index was lower in patients with achlorhydria. The frequency of achlorhydria was significantly higher in patients with dermatitis herpetiformis than in 69 patients with celiac disease.” Note: 90+ percent of Celiac’s have NO stomach acid (at all)….this is not counting the percent of Celiac’s where just Low in Stomach acid….mind you This was not in NCGS but a study of Celiac’s who were already diagnosed as Celiac’s…. But EVEN this is not enough to get some people to believe!!!! The research is out there…..this is a Classic example of Co-Morbidity….IE a Sequelae of one condition triggering the other! The aftermath of B-Vitamin and Mineral deficiencies of Zinc, Magnesium, B1 (Thiamine), B2 (Riboflavin), B3 (Niacin) and possibly Copper is being diagnosed as NCGS and/or as Celiac disease diagnosis IMHO! It is my hope by sharing this old research rediscovered that at least ONE other person will believe me (YOU) and be helped! Use a Celiac disease diagnosis as the way back. . . . not the end of the road for your health but the beginning of your way back to health! As the I have the Lord being my help! As I am fond of saying “To Educate is to truly free!” Where there is a free exchange of knowledge there is health and peace for one’s soul and body! So, what can I do NOW about this know that I know B-Vitamins might help my Celiac diagnosis? There is “No Formula” but this is the best advice I can offer you. Take a B-Complex AND a Benfotiamine (Fat Soluble B-1) or other Fat Soluble B-1s like AlliThiamine or Lipothiamine (harder to find) AND a Magnesium Citrate (with meals) or Magnesium Glycinate (anytime) 2x to 3x a day (with meals) for 3 to 6 months. (IF you are not taking an acid reducer like a PPI or H2 Blocker (better of the two kind with less long term side effects) ) you will begin to burp continuously even up to 2 hours after you have finished your meal….. and between meals with the smallest snack… producing the biggest BURPS you have had in years, and years. Don’t stop for at least 6 months….don’t stop taking them when you begin burping (again without bloating/gas distension) BUT continue for 6 months till BURPING without these other symptom’s and a regular movement will become your new normal. You are now again digesting proteins in your diet triggering a food allergy. What I didn’t know at the time was that Pellagra is a “Capstone” diagnosis and not the “Cornerstone” disease. Pellagra is definitely happening in Celiac’s because Tryptophan has been shown the ability to be a therapeutic for Celiac’s. See this research about it… https://www.eurekalert.org/pub_releases/2020-10/aaft-tri101920.php Here is another article about the same research indicating Tryptophan as Therapeutic treatment for Celiac’s… https://www.news-medical.net/news/20201023/Intestinal-microbiota-offers-new-prospects-for-treating-celiac-disease.aspx Confirming that when you develop “Leaky Gut Syndrome(s)” you have developed Pellagra. But Pellagra does not happen alone and is not the trigger….it is the combination of multiple B-Vitamin deficiencies beginning with Low Thiamine (B1), then Low B2 (Riboflavin) and finally Low Niacin (B3) aka Niacinamide presenting as DH in Celiac’s… I did not develop Pellagra but Sine Pellagra instead! Note: as to not overpower the reader (you) with too much information see addendum/appendix for more reference’s resource where you can read to your Heart’s content (as much) or as little as you need to help you understand these “Lost Connections” explaining how the Chicken came before the Egg (Diagnosis). First you develop Low B-Vitamin deficiencies (IE Thiamine deficiency or undiagnosed Beri Beri) THEN your Villi Thin and THEN you develop Pellagra Sine Pellagra a Riboflavin deficiency leading (in time) finally to a/your Celiac diagnosis! Also Note: SIBO and Cows Milk Protein IE Casein (not Lactose as is commonly believed) might also be a problem for you. See the Appendix for more details. 2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things” this included. I hope this is helpful but it is not medical advice. Posterboy by the Grace of God, ADDENDUM/Appendix Resources Thiamine the Overlooked Vitamin That Improves Autoimmune Disease And Autonomic Dysfunction https://awaken.com/2021/02/the-overlooked-vitamin-that-improves-autoimmune-disease-and-autonomic-dysfunction/ The issues/symptoms of a Thiamine deficiency hide in other diseases…. It is only suspected (tested) for in diseases with high clinical suspicion such as Alcoholics and Anorexic’s etc…. Also here is a nice overview of how to recognize a Thiamine deficiency… https://healthprep.com/articles/fitness-nutrition/guide-symptoms-thiamine-deficiency/#:~:text=Weight loss may occur in a thiamine deficiency,individuals called AMP-activated protein kinase (AMPK) becomes impaired. Here is the best thread on a Thiamine deficiency and its many presentations/faces/symptoms on Celiac.com for more resources on Beri Beri in GI diseases like Celiac disease and IBS etc. Recently Celiac.com wrote an article linking AnitGAD antibodies to Celiac disease. So that set me out to see if there was a link between Gluten Ataxia and AntiGAD antibodies…. And it turns out AntiGAD antibodies are diagnostic confirmation of a Thiamine deficiency in Celiac’s manifesting themselves as Gluten Ataxia… See this research that explains the connection… entilted “Wernicke's encephalopathy: an excitotoxicity hypothesis” https://pubmed.ncbi.nlm.nih.gov/9346467/ This confirms exactly what is happening in other GI diseases like UC and Chrons. See this research entitled "Wernicke Encephalopathy in Crohn's disease and Ulcerative Colitis" https://www.sciencedirect.com/science/article/pii/S0899900721000447 AS if often the case in WE the treatment is too little too late….let's not let the same thing apply/happen to Celiac disease patients too! IF the research on UC and Chrons’ is to be believed Low Thiamine level’s can be a predictor of disease severity and recovery. NOW a similar study needs to be done to confirm my many years of research proving once and for all…. A Thiamine deficiency is the trigger for Thin Villi! Note: The Hormones Matter website is the best Thiamine resource on the web….and EON Health is a close second. Zonulin a Marker for Niacin deficiency Links/Resources https://alobar.livejournal.com/2930798.html#%2F2930798.html Dietary Tryptophan Enhanced the Expression of Tight Junction Protein ZO-1 in Intestine: Trp enhanced tight junction protein ZO-1… https://www.researchgate.net/publication/312962348_Dietary_Tryptophan_Enhanced_the_Expression_of_Tight_Junction_Protein_ZO-1_in_Intestine_Trp_enhanced_tight_junction_protein_ZO-1 Dietary l-tryptophan alleviated LPS-induced intestinal barrier injury by regulating tight junctions in a Caco-2 cell monolayer model https://pubmed.ncbi.nlm.nih.gov/30977499/ Intestinal permeability IE Leaky Gut and oxidative stress in patients with alcoholic pellagra (reversed with Niacinamide) https://pubmed.ncbi.nlm.nih.gov/16713031/ Which is what the latest research confirms Tryptophan can be used in Celiac’s to heal Villi https://www.news-medical.net/news/20201022/Tryptophan-found-in-turkeys-can-accelerate-intestinal-healing-in-people-with-celiac-disease.aspx Does Going Gluten Free Provide Relief or All Celiacs? The answer is NO! https://medicalxpress.com/news/2021-02-gluten-free-diets-cure-all-celiac-disease.html And why I recommended B-Vitamins as an adjunct treatment for Co-Morbidities that happen in Celiac’s. This a complimentary approach. See this Posterboy blog post that discusses the B-Vitamins that might help treat a Celiac diagnosis About 40 pct of Celiacs are NOT helped when they go gluten free. This is about what else someone can do that is still triggering Villi blunting when eating gluten fee is not enough to heal your Villi??? Three or four of the most common triggers (IMO) for continued GI inflammation (Issues) in IMO are Milk (Cows’ Milk Protein) aka CMP in the literature. See this great Celiac.com article about how Milk in peoples diet can also trigger Villi Blunting… A reaction to Cows Milk Protein (Casein) can happen in up to 40 percent of Celiac’s… See this nice study on the issue of Caseins’ also triggering an Immune response in Celiac’s Entitled “IgA anti-gliadin antibody immunoreactivity to food proteins IE Cows Milk Proteins” https://www.tandfonline.com/doi/full/10.1080/09540100400003204 You can just read the abstract and not surprising it is 15+ years old and only recently Celiac.com did an article on it….. people can’t wait another 15 years for the medical community to pick up on this connection and why I am writing this blog post NOW! 2) SIBO can happen in the Majority of Celiac’s Note: This study is about SIBO happening in Celiac’s already treated with a gluten free diet. Almost 2/3 of Celiac’s symptoms got better after treating their underlying causes for a Celiac diagnosis such as SIBO in this study. 3) B-Vitamins that become low when one has SIBO You will find this a common theme…..after treating Celiac disease…..continued symptoms continued until the underlying cause(s) like SIBO, Cows Milk, Low/NO stomach acid or Medicines keep triggering Villi blunting… I can only tell you it helped me to treat my underlying cause’s like Low Stomach Acid and my B-Vitamin deficiencies going undiagnosed as part of Celiac disease diagnosis. See this new research that verify this fact from 2020 just a year old…from Chicago University https://medicalxpress.com/news/2020-02-mouse-celiac-disease-treatments.html Where they note quoting “Even while maintaining a strict gluten-free diet, 40% of celiac disease patients still show signs of inflammation and villous atrophy, or damage to the villi, the small, finger-like protrusions in the small intestine that help absorb nutrients. Therefore, treatments that can reverse or prevent the disease are greatly needed to improve quality of life for people with celiac.” Tryptophan can do that. So can B1 (Thiamine), B2 (Riboflavin) and B3 (Niacin) if you can believe the latest research on this topic. Some of it is 15 or 20 years old now….and doctors are not aware of this groundbreaking research. 4) Low/NO Stomach Acid See this research discovered 30+ years ago entitled “Gastric morphology and function in dermatitis herpetiformis (DH) and in Celiac disease” https://www.ncbi.nlm.nih.gov/pubmed/3992169 Celiac’s are suffering now and can’t wait another 10 or 15 years before they rediscover this research on their own! I wrote a Posterboy blog post about this too about how Low/NO Stomach acid could be the trigger for a subsequent Non Celiac Gluten Sensitivity diagnosis aka NCGS ….but few people seemed to understand it… Recently PPIs use has shown to trigger a Celiac diagnosis…..and yet nonchalantly this research is minimized…. among other medicines that can also trigger Villi Blunting (Atrophy) with use… See this Celiac.com thread about it…how PPIs, NSAIDS and SSRIs use were found to be associated with Villi Atrophy and subsequent Celiac diagnosis. See also this thread about how some Blood Pressure Medicine might blunt your Villi…. Back to the discussion at hand….how Zonulin can be a biological marker for a Niacin deficiency… This is important because Niacin is used in Stomach Acid production…. Zonulin as a marker for a (Low) Niacin levels aka Deficiency confirms IMHO a metabolic trigger for Pellagra going undiagnosed in Celiac disease. The IJCD noted this association of Pellagra in Celiac’s in 2015…..where they noted the majority or 58 percent approximately of Celiac’s would be Co-Morbid with their Celiac disease. It just nobody has followed up on these associations…..because you can’t see Pellagra in people until Skin Rashes develop….. by then DH has been diagnosed as a symptom of Celiac disease and by then you are too late! Doctors can’t see how these two diseases are connected but researchers can……. and fellow sufferers who have suffered at the hands of Doctor’s ignorance of the 4 Ds of Pellagra…. They get a D+ on recognizing Pellagra, Beri and Beri and Pellagra Sine Pellagra in Celiac disease today! IT is no one’s fault….IT is the process. There are not good B-Vitamin tests to determine the status of B-Vitamin deficiencies in Celiac’s and other GI patients. The FIRST good study about this is the link I noted above that confirmed the SEVERITY of the Thiamine deficiency IE Beri Beri predicted the SEVERITY of UC and Chron’s patients! Provided here again for easy reference… See this research entitled "Wernicke Encephalopathy in Crohn's disease and Ulcerative Colitis" https://www.sciencedirect.com/science/article/pii/S0899900721000447 Why would we not think it would be the same for Celiac disease! And IF the research is to be believed low Zonulin levels are an indicator of Low Niacin levels aka Pellagra in it’s most severe presentation of perfuse Skin Lesions….being diagnosed as DH today! ETA: Found only this month (week) while writing this article/blog post Very recent research Circa 2021 also confirmed that eating gluten free alone does not heal all Celiac’s making supplementation with B-Vitamins (IMHO) and Magnesium, in part, an essential treatment for those suffering from inflammation not due to gluten! See this research entitled “Do gluten-free diets provide a cure-all for celiac disease” and the answer is unequivocally NO… In a subset of Celiac’s. https://medicalxpress.com/news/2021-02-gluten-free-diets-cure-all-celiac-disease.html Quoting their conclusion(s) A significant number of patients previously thought to be well-treated by a gluten-free diet may in fact require additional interventions to fully curb their gut inflammation. Don’t be surprised if takes another 10 or 15+ years of “more study” to confirm these findings! Each generation much pass on their knowledge to the next….or it soon becomes lost again… This is my humble attempt to pass on that knowledge. To quote Isaac Newton “I do not know what I may appear to the world, but to myself I seem to have been only like a boy playing on the seashore, and diverting myself in now and then finding a smoother pebble or a prettier shell than ordinary, whilst the great ocean of truth lay all undiscovered before me.” — Isaac Newton I did this first for myself…..with the hope that it might help others someday. 3 Blessed be God, even the Father of our Lord Jesus Christ, the Father of mercies, and the God of all comfort; 4 Who comforteth us in all our tribulation, that we may be able to comfort them which are in any trouble, by the comfort wherewith we ourselves are comforted of God. It is my sincerest hope that I was able to throw a few “Starfish” back. But I fear I have not helped enough! http://www.starrbrite.com/starfish.html The Starfish Story Original Story by: Loren Eisley "One day a man was walking along the beach when he noticed a boy picking something up and gently throwing it into the ocean. Approaching the boy, he asked, What are you doing? The youth replied, Throwing starfish back into the ocean. The surf is up and the tide is going out. If I don’t throw them back, they’ll die. Son, the man said, don’t you realize there are miles and miles of beach and hundreds of starfish? You can’t make a difference! After listening politely, the boy bent down, picked up another starfish, and threw it back into the surf. Then, smiling at the man, he said I made a difference for that one!" Part 4 Additional Resources Is COVID 19 primarily a GI disease first See this research entitled “Severe COVID19 Is Fueled by Disrupted Gut Barrier Integrity” https://www.medrxiv.org/content/10.1101/2020.11.13.20231209v1.full Is “Leaky Gut Syndrome” a sign of Vitamin/Mineral deficiency See this research entitled “Regulation of the intestinal barrier by nutrients (Nutrition): The role of tight junctions” https://onlinelibrary.wiley.com/doi/10.1111/asj.13357 And this one entitled Intestinal permeability and oxidative stress in patients with alcoholic pellagra https://pubmed.ncbi.nlm.nih.gov/16713031/ See also the is Live Journal article about how Zonulin can be a “Marker for Niacin Issues”….IE is Zonulin a sign of Pellagra going undiagnosed or Misdiagnosed as Celiac disease today! https://alobar.livejournal.com/2930798.html#/2930798.html I can also recommend this blog post on Zinc deficiency by Blue Sky
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- beri beri
- low stomach acid
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Genetics Nutrition and Stress the Threeway Model of How Gluten Triggers an Immune Reaction in Severely Malnourished IE Vitamin Deficient Individuals consuming a High Calorie Diet This blog post is WTL again....I tried breaking it into to two Posterboy Blog posts but decided to go ahead.... And post it instead as one due to other things IRL that are taking up most of my time these days..... So thanks in advance to every one who actually completes it! I truly believe it will help everyone who reads it and UNDERSTANDS! This Posterboy blog post is for everyone who got lost in the “Forest of Data” and never found their way out! As I am fond of saying “To Educate is to truly free!” Where there is a free exchange of knowledge there is health and peace for one’s soul and body! The journey of a thousand miles begins with the first step….that step back to health for me was my seemingly rare and not well understood Celiac disease diagnosis… I then began my journey….to learn at least what the doctor’s knew about this diagnosis….and exceed it if I could… But I got lost in the forest of data….for years…going around in circles…or so it seemed at the time… See my first attempt to hack/machete my way out of this sad forest (of illness) I was in… https://www.celiac.com/celiac-disease/a-differential-diagnosis-how-pellagra-can-be-confused-with-celiac-disease-r3989/ But I soon learned to spot clues as I read more and more studies….trends, patterns…in the data begin to emerge… one tree (study) at a time…I was able to blaze a trail back out of the forest… I can honestly say I am out of the forest now….and by blazing this trail….I hope I have left enough markers (IE posterboy blog posts/articles etc.) to help the next person out of this forest of symptom’s….. I had over focused on every shiny thing I found (individual Vitamin Deficiency one tree at a time)…. I begin to identify each Vitamin (tree of health) in this vast forest… I had settled on the 3 alarm fire of Pellagra….I didn’t know how wrong and right I was at the same time… It would take years to figure this out (as I walked around in circles)….it is what others had concluded before… The IJCD had concluded the same thing a couple years earlier… http://pubs.sciepub.com/ijcd/3/1/6/ They confirmed for me…it was possible… They noted: on how Pellagra occurred in Celiac disease… Pellagra and celiac disease “The two diseases can be connected in two aspects. 58% of pellagra patients were shown to have malabsorption and many had intestinal pathology on biopsies [36, 37]. Alternatively, Pellagra was described in celiac disease [38]. The skin manifestations in pellagra might have some additional etiologies, since multiple nutrient deficiencies are at the origin of the cutaneous manifestations in celiac disease. The following nutritional deficiencies inducing skin rashes, were describe in celiac disease: Zinc, Iron, Vitamin A, E, B12, niacin, folate, selenium and essential fatty acids [39, 40].” So Eureka! I had found what was being misdiagnosed as Celiac disease instead… 58% was good….I was more than halfway there….being right and wrong all at the same time! Then I found that there was another disease that explained these connections even better! https://www.celiac.com/celiac-disease/how-low-thiamine-can-thin-villi-old-research-rediscovered-and-its-clinical-significance-in-celiac-disease-r5100/ Now I had found out what was really causing my problems! I thought…and once again I was right and wrong all at the same time…. While my aim was dead on….it was nutrients (or lack thereof more correctly) causing my health problems… I had become too myopic only seeing individual trees and the not the forest ….for what it was a healthy place to live and thrive and fruit for meat and leaves for medicine… It was all the trees (at least 3 in particular)….together forming a Web of Life… To pivot from the metaphor to hard science (in real life aka IRL) ….how do know this analogy is true….or truer than not! To see if this is true we have to dig deep in the forest of data….and see what it tells us… See this research entitled “Pellagra in the USA: unusual manifestations of a rare entity” https://casereports.bmj.com/content/12/9/e230972 On the surface….it is just as we would suspect…Pellagra is rare in the USA…right only in Alcoholic’s right…. But we if we dig a little deeper….we learn something from this good research… Quoting from their abstract… “They/She had adrenal function testing which revealed adrenal insufficiency. Vitamin testing revealed normal B12 and folate levels but undetectable levels of thiamine, riboflavin and niacin. Her symptoms and signs resolved entirely with appropriate vitamin supplementation. Niacin (vitamin B3) is essential for multiple metabolic pathways, and severe deficiency may cause clinical syndrome of pellagra, which is most commonly associated with diarrhoea, delirium and dermatitis.” Notice the bolded Vitamin Deficiencie(S)….not one deficiency but many deficiencies culminating the a “Capstone” disease diagnosis…. Now why did this researcher not say the patient had Beri Beri (B1 deficiency), or Pellagra Sine Pellagra (B2 deficiency) instead…they/she had ALL these deficiencies…. Because B-Vitamins don’t occur alone or uncomplicated….so I was right to say I had gone on to develop (mostly) Pellagra ….except I didn’t have Skin (dermatitis) problems like DH etc….so I had only developed Pellagra Sine Pellagra instead…(so far)… But I had already gone on to develop Thiamine deficiency aka Beri Beri and the doctor’s had already missed it…. So why should I be surprised they missed me having a Riboflavin deficiency too! What most people don’t know (even doctor’s) don’t realize today….and I have recently found out that Pellagra has been incorporated into Celiac disease today….. Celiac disease is a three alarm metabolic (deficiency syndrome/disease) ramped up by each B-Vitamin you become low in …..in time…. It is a Cascade….like falling domino’s….one falling triggers the others too fall as well… Let’s see if there is research to backup this claim…. See this research published before 1950 (15+ years) before DH was associated with Celiac disease…. https://www.jidonline.org/article/S0022-202X(15)50482-X/pdf They show that DH was successfully being treated with Nictonic Acid aka Niacin more than 15 years before DH was described in the Skin of Celiac patients… Quoting from their summary “In a series of 12 patients with dermatitis herpetiformis of various degrees of severity, the oral administration of niacin in doses of 50 to 200 mgm. four times daily relieved the pruritus (Itching) and improved the cutaneous manifestations.” Yet today we exclusively “see” through50+ years of error(s)…having forgotten that DH can be treated with Niacin…. thus confirming a Pellagra diagnosis in a Celiac patient… It is the third phase (3 alarm stage) of the Vitamin Deficiencies you have now developed…. Don’t be surprised if the doctor’s don’t see your Vitamin Deficiency even then… Because in classic genetics….the environment and nutrition is discounted as limited factors….in disease… But other researchers are now rejecting this myopic view realizing Environment (Viruses etc.) and Deficiencies IE (Vitamins and Minerals) ALSO play a part in the pathogenesis of disease in an equal 50/50 mix…. See this 2 year old research that summarizes such an hypothesis entitled… Reovirus infection triggers inflammatory responses to dietary antigens and development of celiac disease Here is the link…to this seminal and groundbreaking research… https://science.sciencemag.org/content/356/6333/44 /tab-e-letters Where Doctor Leslie M. Klevay , Prof. Emeritus, Department of Internal Medicine University of North Dakota School of Medicine and Health Sciences says quoting “In the original classification scheme, Celiac disease would have been considered a toxic deficiency (3) similar to Wernicke’s encephalopathy in which excessive ingestion of ethanol induces thiamine deficiency. Now some celiac disease can be considered a three-way cooperation among an infection, a toxin and a deficiency. Other three- and four-way cooperations have been identified.” Here is longer and probably better description how Virus's (Environment) or IE Epigenetics could/can trigger an Genetic disease like Celiac disease... https://www.gutmicrobiotaforhealth.com/virus-may-lead-celiac-disease-disruption-intestinal-immune-homeostasis/ The research is a couple years old.....also the Epstein Barr Virus has also been associated with Celiac disease. Dr. Londsdale says we need a “new Model” for Medicine… https://www.hormonesmatter.com/new-model-medicine/ I say we need a better one that acknowledges the environment and deficiencies as important or as important as genetics…. Other researchers have noticed the same thing….your environment and deficiencies are not being taken into account for Celiac’s. See this recent research that says the same thing entitled “Genetic risk factors for disease can be affected by environment” https://www.upi.com/Health_News/2017/08/16/Genetic-risk-factors-for-disease-can-be-affected-by-environment/4251502820421/ Not only are genetic risk factors for Celiac disease being affected by your environment…. they are effected by your deficiencies like Thiamine, Riboflavin and Niacin…. We know this because they have been studied (these three B-Vitamins) for toxic overload in Sepsis…. where the Auto-immune system goes haywire and results in death… See this research in Rats https://pubmed.ncbi.nlm.nih.gov/30903555/ It will take a few years for this study to be confirmed in humans….while more studies are performed more people will be dying of Vitamin Deficiencies…. Despite 8+ years ago Riboflavin has been proven to treat (MADD) disorder resulting in acute Renal Failure…. https://www.jstage.jst.go.jp/article/internalmedicine/50/21/50_21_2663/_pdf/-char/en People still think it is 70/30 genetics or even 80/20 genetics… Recent research for Celiac disease proves it is no more than 50/50 percent Genetics/Environment IE (Vitamins deficiency etc. AKA malnutrition) It is my hope that clinical practice will quickly catchup with the newest/latest research proving DNA/Genetics usually has less than 50pct of the risk factors for Celiac disease and accept many Vitamin deficiencies are prevalent as co-morbidities and need to be addressed before a Valid Celiac diagnosis can be accepted/confirmed…. See this studied that confirms this in Celiac’s https://www.genengnews.com/news/dna-has-relatively-little-say-in-disease-risk-usually/ Where they say quoting “It is becoming increasingly clear,” explained Wishart, “that the risks for getting most diseases arise from your metabolism, your environment, your lifestyle, or your exposure to various kinds of nutrients, chemicals, bacteria, or viruses.” And though Celiac disease is a disease consider to have a higher genetic factor it is now believed to be no more than 50% of the risk factor …..as once commonly believed… quoting again “There are diseases, however, for which the genetic contribution is about 40–50%. These diseases include Crohn’s disease, Celiac disease, and macular degeneration.” But I don’t believe they (doctor’s/Clinicians) will……memory has a “longtail” of approximately 18 years from new research reaching clinical practice on average… Appropriate supplementation is consider a key part of “Aftercare” for Celiac’s ….it needs to be part of appropriate disease diagnosis (IMHO)….so you don’t continue to suffer from the avoidable and treatable diseases that often in as many as 80pct of patients are found out Post-Mortem….as is the case in Wernicke Encephalopathy (WE)… etc.…and it should be NOTED 80% of WE is not diagnosed in Alcoholics….. it is happening in Celiac’s today and/or passed off as other GI diseases like Chrons, IBS, UC etc. and psychiatric or neurogenerative diseases today…. https://www.hormonesmatter.com/beriberi-the-great-imitator/ see this current research on Thiamine Deficiency and Benfotiamine Therapy in Brain Diseases https://biomedgrid.com/fulltext/volume3/thiamine-deficiency-and-benfotiamine-therapy-in-brain-diseases.000621.php You will fell half-dead if you continue to have these deficiencies if they doctor don’t also treat you for these co-morbidities despite being on a gluten free diet! I know I did….Ignorance kills!....but It maims us first! I hope this is helpful but it is not medical advice…. Posterboy by the Grace of God At this point I am only making one Posterboy blog post....see following/below for more technical studies...... Showing how and why this is true and how the doctor's missed it! Note to Self::::::))))) Put this a Part 1 of the Blog post and then link the Smoking Gun research on Tryptophan… ADDENDUM IF this analysis is true and a good working Theory and not just a good hypothesis we would find research that shows Tryptophan is important in the pathogenesis of Celiac disease and new research in 2020 confirmed this analysis. Celiac.com ran a summary of the research but I will link a good synopsis for others to read for themselves showing how Celiac’s have impaired metabolism of Tryptophan. https://www.celiac.com/celiac-disease/tryptophan-in-turkey-meat-can-speed-gut-healing-in-celiac-disease-r5338/ This good synopsis of this working theory shows how Tryptophan speeds gut healing in Celiac IMHO proving Pellagra is happening in Celiac’s. I would recommend reading it ALL when you get a chance. https://www.gutmicrobiotaforhealth.com/gut-microbes-in-celiac-disease-show-impaired-metabolism-of-dietary-tryptophan-according-to-researchers-at-mcmaster-university/ And like most “All” good medical research….they always conclude “more research/study” is needed…. Well people can’t want another 10 or 15 years until this research is again confirmed (and again) See this research entitled “Kynurenine pathway metabolites in humans: disease and healthy States” https://pubmed.ncbi.nlm.nih.gov/22084578/ This connection was established at least 10+ years ago….and now we can say for SURE IMHO that this metabolic breakdown is triggering inflammation in Celiac’s leading, in time, to a Leaky Gut! Again, I want to say (make note) that the International Journal of Celiac disease aka IJCD first noticed this connection 5 years ago…will it take another 10 or 15 years before it is “accepted” medical research??? I hope not: but I AM honestly not encouraged!!! This was meant to be a 2 part blog post….so It doesn’t get too long and too technical…but I have decided to publish it all at once now that I am working through some other health issues at the moment! If this is true….there should be studies about these facts….and there is…. I have argued IT is ONE immune system with multiple presentations of the difference Phases of Vitamin Deficiencies…. We see how this works in the LUPUS Inflammation Model I wrote a Posterboy blog post about these connections…. https://www.celiac.com/blogs/entry/2709-the-lupus-inflammation-model-for-sickness-beginning-with-b-vitamin-deficiencies-in-celiacs-and-other-inflammation-triggered-diseases…/ Here is the recent research it is based on…describing how IL-2 and IL-6 combine to help control the immune system…. We see this Alcoholic’s too…in how Niacin can help Leaky guts… See this Celiac.com thread about this topic… https://www.celiac.com/forums/topic/126496-intestional-permability-could-a-vitamin-deficiency-cause-it/?tab=comments#comment-1009633 And that is exactly what we want to fix in Celiac’s right….well B-Vitamins do that! And we see B-Vitamins are low in other chronic inflammation GI diseases like IBS, Chron’s and UC…because there is ONE Immune System! See this research entitled “Blood Concentrations and Renal Clearance of Water-Soluble Vitamins in Outpatients With Ulcerative Colitis” https://pubmed.ncbi.nlm.nih.gov/30906550/ Quoting “The blood concentrations of vitamins B2, C, niacin and folate were markedly lower in the patients with UC than those in the control group, and the renal clearance of vitamins B1, B6, B12 and folate was notably higher in the UC cohort. It was concluded that vitamins B2, C, niacin and folate were at significantly lower concentrations in patients with UC following adjustment for coexisting factors. The lower levels of niacin may be partially due to impaired reabsorption. Chronic inflammation, common in patients with(my words and/or chrons, IBS etc. and Celiac disease), with UC may contribute to the lower levels of other vitamins by rendering amino acid and carbohydrate metabolism into a hypermetabolic state. As the role of vitamins in metabolic activity is constant and pervasive, nutritional management including the application of water-soluble vitamins appears important for patients suffering from UC.” It is me again….why wouldn’t we think this would be the same in Celiac’s…..and why I believe the new research that shows Tryptophan helps heal Celiac Villi is key to understanding/proving Celiac is Pellagra in disguise in the 21st Century! It is time testing is done to confirm these same B-Vitamin deficiencies in Celiac’s is all I am saying so the Co-morbidities can be treated…leaving a true diagnosis… If not the same Vitamin Deficiencies could be confused for Celiac and you will never be sure if you ever received the proper diagnosis…. I have had to figure this out on my own….this is written so you won’t have t o suffer like I did for year’s going undiagnosed despite a Celiac diagnosis…. Two front wars are rarely winnable. Disguise is a great trick of the enemy. For if you get the wrong diagnosis then the symptom’s never getting better and the battle/war rages on. But What If you have the wrong disease? Would you get better? This is dedicated to those still suffering who are willing to ask why? am I still suffering GI symptom’s on a Gluten free diet? Since (auto-immune) or disease in general rarely occur alone it only makes sense to tackle the easiest one’s first. There are two camps/type of people. (It is true in many things of life). Supplementing or not to supplement is the 64K dollar question. The one’s who believes in supplementing readily attack the front (symptom’s) on/from whatever artillery (vitamins and minerals) they can find to shore up their defenses. The other camp prefers to hunker/bunker down and wait for reinforcement/symptom’s to get better and the battle/siege to pass. But in war there is an old saying. “A city besieged is a city taken”. I know there is a lot of confusion out there. … I have been YOU! I am just trying to help those who are still suffering (losing the war). For a battle the war was lost. And many battles’ are lost from confusion…. Knowledge is power …..know you have to power to move forward! It is been said Doctor’s miss Celiac’s in 90% of their patients… https://www.celiac.com/articles/24919/1/Are-Doctors-Missing-90-of-Celiac-Disease-Cases/Page1.html It is equally true about how often Vitamin Deficiency are missed in Celiac’s… “How could this be? One reason is that even classic Celiac disease symptom, such as abdominal pain, bloating, gas, diarrhea, anemia and weight losscan mimic other conditions. Less classic symptoms such as fatigue, low vitamin C, D and calcium levels can be misleading.” Lupus is known as the great imitator disease. And Celiac or is it Pellagra could be called the same in 87% of cases if you are lucky. And so is Beri Beri… https://www.hormonesmatter.com/beriberi-the-great-imitator/ Imitation is the sincerest form of flattery — Unless it is medicine then it is the unkindest cut. . . How do we know this is true…we can predict that Pellagra would develop in Sorgen’s disease aka SLE or LUPUS and it does…where they ask how confident are you of your diagnosis…explaining DH in detail (IF) you did not know it also described Pellagra instead (Rough Skin)… https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/pellagra/ Dermatology doctor’s get it because a Niacin deficiency is 90% classically described as a skin disorder first and foremost…. But Beri Beri and Pellagra GI’s problems are a forme fustre of WE’s….FIRST a Thiamine deficiency and finally a Niacin deficiency when it present’s as DH today! See this research that explains how the first signs of these Vitamin Deficiencies are GI related… .entitled“Gastrointestinal Beriberi: A Forme Fruste of Wernicke's Encephalopathy?” https://pubmed.ncbi.nlm.nih.gov/29982183/ I can only hope what I have shared here has lifted the tide of knowledge a little and your boat/that has been lifted enough for you to freely sail again. Learn from my mistakes! No body is so dumb who won’t learn from other people’s mistakes! A valid I dare say standard “process” of modern/good medicine is the differential diagnosis. If it is not the doctor has not done justice for you or YOU for yourself . … A “differential diagnosis” makes more sense. They have not done YOU justice. Isn’t that what we all want – to know just what we need to do to get better that is justice/peace and good medicine. We are our own best advocate! I share that other’s may know to look for these Vitamin Deficiencies if you too received a Celiac diagnosis and the Doctor’s don’t “See” it in your face….like those of nearly 70 years ago who were treated for DH by Niacin(amide)…… 15+ years before DH was ever linked to Celiac disease Remember **** This is not medical advice and should not be considered such. Results may vary. Always consult your doctor before making any changes to your regimen. 2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things” this included. As I am fond of saying “To Educate is to truly free!” Where there is a free exchange of knowledge there is health and peace for one’s soul and body! Let’s all make peace for to educate is to empower to change. Change is not easy . . especially if you have a bunker mentality I grant . . . but possible with education for with education comes understanding! 2 Corinthians (KJV) 1:3,4 3) “Blessed be God, even the Father of our Lord Jesus Christ, the Father of mercies, and the God of all comfort; 4) who comforteth us in all our tribulation, that we may be able to comfort them which are in any trouble (starfish/sufferer), by the comfort wherewith we ourselvesare comforted of God.” Posterboy by the Grace of God, EPILOGUE We know this is a good working theory because both B1 (Thiamine) and B3 (Niacin) are used in the production of stomach acid. Quoting from the Celiac.com article on How Low Thiamine Can Thin Villi How Low Thiamine Can Thin Villi: Old Research Rediscovered and its Clinical Significance in Celiac Disease - Celiac.com “Via the Parasympathetic Nervous System (PNS) the neurotransmitter "acetylcholine" regulates our organ functions throughout the body, and could be why both undiagnosed celiac disease and Beri Beri affect so many organs in the body. Without enough thiamine our body can’t synthesize enough acetylcholine to regulate it’s organs, which may cause the body to go into high alert mode and trigger a runaway auto-immune reaction like celiac disease. Another study shows a connection with the microvilli that line organs and how they can trigger auto-immune reactions throughout the body.” B3 aka Niacin via Histamine is used to trigger stomach acid production and why an H2 Blocker is used to treat stomach acid issues….and can be used for other immune mediated conditions like allergies etc… Low Thiamine (B1) triggers the Auto-Immune Cascade….leading to low B2 (Riboflavin) and finally resulting in Low B3 (Niacin)…. who’s production in the body is regulated by Tryptophan via the Knyneurine Pathway and why Tryptophan recently was shown to help heal Villi in Celiac’s. And why just over 7 years ago PPIs were shown to be able to trigger a Celiac diagnosis. Do Proton Pump Inhibitors Increase Risk of Celiac Disease? - Celiac.com See my previous Posterboy blog post about why this so. Is there a Type I and Type II Celiac Disease IF so what is your Type: What the Diabetic Model can tell us about Celiac Disease Subtypes? - Celiac.com Niacin (B3) and Thiamine both help control the Biofeedback loop in the body and why being low in either one will trigger an auto-immune cascade! And Note: it is not just humans who need Thiamine to live/survive ALL animals need it even Bacteria and Fungus. See this latest research from 2020 entitled "Born to be wild: Fungal highways let bacteria travel in exchange for thiamine" that shows/explains how Bacteria and Fungi or Fungus use Thiamine as "Currency" along "Life's" highway.... https://www.sciencedaily.com/releases/2020/09/200924114128.htm Dr. Lonsdale called Thiamine the "Spark of Life".....I have called it the "Currency of Life"....because your health will be poor without IT! So we know this is true! Even at the microscopic level! You will feel half-dead if you continue to have these deficiencies if they doctor don’t also treat you for these co-morbidities despite being on a gluten free diet! I know I did….Ignorance kills!....but It maims us first! Lord willing it has been helpful and will it will help someone before the medical community catches up with the latest research on the topic. As always 2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things” this included. Posterboy by the Grace of God
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To Whomever Might Read This, This is metaphor only …not intended to diagnosis or treat anyone but to educate…. There is an old joke told about Jaguar cars in the 1980s’ and early 1990s etc… that you needed two to drive one… Kia might have been in/on that same boat…when first introduced in circa 1992 but since the early 2000s IE this Millennium or so…. They have improved tremendously….and truth be told soooo have Jaguar’s ….but you might still want to have more than one on hand….if you still want to drive one etc… This is because both Medicines (Jaguars)/Vitamins (KIAs) etc… often work better in pairs…the strength of a team can be described best in this phrase….two can do the work of three….it is additive… So two often in medicine and with vitamins ….everyone who reads my posterboy blog posts know I have over emphasized (probably) Niacin…over the other B-Vitamins…. See this blog post about how and why supplementing with B-Vitamins might be helpful for those still suffering with GI problems on a gluten free diet… And why I still think it is a good theory…one I admittedly can’t prove (easily) or at least is hard too…. So I punted that strategy….sometimes a punt is a good play… Or why B-complexes are a better play than a monotherapy/star regimen…because teamwork and health/life work’s better when we work together… When we get low in B-Vitamins we develop something called the “Hidden Hunger”…commonly found in 3rd world countries….but it has a KIA problem in the US…still here…but rarely recognized… See this link about how Biofortication called “Enrichment” in which white bread has helped keep this hidden hunger in check mostly in the US….unless we have too much stress or other stressors like sickness that can trigger a Secondary Pellagra diagnosis https://onlinelibrary.wiley.com/doi/full/10.1111/1541-4337.12491 I also recommend this article on “enriched” white bread and why it was called “Wonder Bread” in it’s day…because it really was wonderful in it’s day… https://www.chicagomag.com/city-life/March-2014/How-Wonder-Bread-Became-the-Healthand-then-the-Ill-Healthof-the-State as it turns out there is a reason why “enrichment” programs included Thiamine, Riboflavin, and Niacin….because we get really sick when we don’t get enough… the biggest issue today is we have forgotten what these Vitamin deficiencies look like today in the US because almost nobody alive today has seen what they look like….except in history or text books… (K) B1 aka Thiamine has a Knowledge problem… (I) B3 aka Niacin has an Image issue (A) B2 aka Riboflavin has an Awareness Issue Vitamins have the same problem as KIA’s today…most don’t even know they exist…if they do they have an Image problem…still left over from the 1940s and 1950s etc.…(vestigial) …or if they have overcome their image problem ….most are not even aware…KIA still sells cars in the US because they though they failed ….when Daewoo left the US….think the way a healthy person doesn’t need Vitamins today… A hard image to fight for sure…. What I am trying to say….in an around the barn kind of way….get yourself tested for these deficiencies…you might still (probably) have them today… and don’t even know it… The Global Concerns with B Vitamin Statuses and their hidden hunger link has the standard test for these B-Vitamin deficiencies… This link says it well…. “Pellagra an Almost Forgotten Differential Diagnosis of Chronic Diarrhea More Prevalent Than We Think in US” https://onlinelibrary.wiley.com/doi/abs/10.1002/ncp.10418 this paper was from last month (October 2019) in the US…. And there was one (another case study) the month before too in September… Entitled “Pellagra in the USA: unusual manifestations of a rare entity” https://casereports.bmj.com/content/12/9/e230972 Now two cases in two months is not rare…just rarely looked for …today….remember the Knowledge, Image Awareness problem.. And I will focus my attention to this (KIA) research going forward… The abstract in it’s entirety…. Pellagra in the USA: unusual manifestations of a rare entity: Abstract “The case involves a 62-year-old female native of the USA with a history of bipolar disorder and chronic obstructive pulmonary disease who presented with intractable diarrhoea. Prior to the index admission, she was admitted to the intensive care unit and required pericardiocentesis for an idiopathic pericardial effusion with tamponade physiology. Following discharge, she suffered intractable diarrhoea and represented for medical evaluation. She had a painful, swollen tongue as well as persistent hypoglycaemia and required glucose infusions. She had adrenal function testing which revealed adrenal insufficiency. Vitamin testing revealed normal B12 and folate levels but undetectable levels of thiamine, riboflavin and niacin. Her symptoms and signs resolved entirely with appropriate vitamin supplementation. Niacin (vitamin B3) is essential for multiple metabolic pathways, and severe deficiency may cause clinical syndrome of pellagra which is most commonly associated with diarrhoea, delirium and dermatitis. Additional physiological derangements may include adrenal insufficiency, insulin hypersensitivity and pericarditis.” Pickuped by count them ONE news outlet/agency….you probably never heard of it…an Awareness issue for sure… Note: she had already tried the Jaguar method of multiple medical referrals’ …..and they still had one sick patient….all well supported by the medical community… And after trying the KIA (vitamin) model ….her symptom’s improved… And why I have shared my story on/in my posterboy blog post’s to try and help those still suffering…few listen about 1 in 7 if I am lucky…about as many as the number of news outlet’s that picked up this abstract….Pellagra has an Knowledge, Image and Awareness issue…Pellagra Sine Pellagra aka Ariboflavinosis -- a Riboflavin deficiency has an even bigger Awareness Issue! I have tried hard to education on the Awareness side,……but the Image is still faded to most people….having little or no knowledge of any one having being diagnosed with Pellagra in their lifetimes….when It does happen…nobody recognizes it… Except when one or two Intrepid researches (in as many months)….go looking for it …they find it… Yes KIA’s are still being made today…they even have a high performance STINGER model that goes toe to toe with Jaguars and BMW’s today….but most people are just NOT aware of KIA’s even today despite them having been sold for 25+ years in the USA…people just don’t recognize them when they see (them/it (Pellagra) unless they start looking for it (Pellagra or more commonly Pellagra Sine Pellagra)…two intrepid researchers in the last two months have figured this out… ****** This is not medical advice and should not be considered such. Results may vary. Always consult your doctor before making any changes to your medical regimen and verify with appropriate testing if these things are so for you ….but if you have intractable GI problems or (chronic diarrhea see link above) for 6 months or more (after going gluten free) your doctor’s should test for or you yourself should encourage your doctor’s to test you for B Vitamin deficiencies…if you still feel being gluten free still has not helped your GI symptom’s….which improve for most people on a gluten free diet in that time frame…and long enough to be considered intractable or IE chronic for most people… 2 Tim 2:7 “Consider what I say; and the Lord give thee understanding in all things” this included. Posterboy by the Grace of God, P.S…I must stop for now headed out to do farm work one of the 4F's in my life…if I have time I will update this with a part 2…probably in a month or two…about the complicated manner in which Pellagra presents itself in a nod to KG….the patient had B1, B2, and B3 deficiencies…not an easy uncomplicated B3 deficiency alone by itself…NO man or Vitamin is an Island….
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