May is Celiac Awareness Month!

Going gluten free appears to be the latest fad for many people and celebrities alike however there is a lot of misinformation surrounding gluten free and the reasons to give it a try.  As May is Celiac Awareness Month, this article serves to answer the most common questions about celiac and gluten issues in regards to health and disease.  Not all people who have a problem with gluten containing foods have celiac’s disease so keep reading to learn more.

1.       Celiac is the inherited autoimmune disease that causes damage and destruction to the small intestines when gluten containing foods are eaten.  This damage causes a lot of malabsorption of vitamins and minerals leading to symptoms and long term health issues.  Currently, being 100% gluten free is the treatment to eliminate the symptoms and heal the intestines.

2.       It is estimated that 1 in 100 (give or take) people have celiac disease.  It is strongly associated with other endocrine conditions such as thyroid disease, type 1 diabetes, bone problems, skin problems, iron deficient anemia, growth problems, delayed-puberty, neurological complaints, infertility and miscarriage, and more.  Celiac is not just a disease of the intestines therefore some people do not have intestinal complaints.

3.     Testing for celiac is controversial and confusing – there are blood tests such as the tissue transglutaminase(tTG) or anti-endomysial antibody test (EMA) however false negatives are common.  Many doctors want an intestinal biopsy to determine if the intestinal cells are inflamed and damaged however those who are already gluten free will have to eat gluten again daily for several weeks to months in order for the damage to return on the biopsy results.  As celiac is genetic, the HLA-DQ2 and DQ8 gene tests can be ordered to see IF someone has the risk.  Having the gene does not mean celiac is positive (just like having the breast cancer gene does not mean someone develops breast cancer).  Talk with your health care provider about this.

4.        Diagnosis at a young age is critical.  The University of Chicago, Celiac Disease Center reports, “children who are diagnosed between the ages of 4 and 12 have a 17% risk; from 12-20 years of age the risk goes up to 27% and an individual diagnosed above the age of 20 has a 34% chance of developing another autoimmune disorder.”  It is estimated that some 3 million Americans have celiac disease but 97% are undiagnosed.

5.       A new category, commonly called ‘non-celiac gluten sensitivity’ or gluten intolerance is not an autoimmune disease causing intestinal damage however these people still have an unfavorable response when they eat gluten containing foods.  Therefore their celiac testing may be negative however a gluten free diet eliminates many of their symptoms.

If you suspect that gluten containing foods are causing your symptoms, or if you look back at your family history and several of the conditions overlap with the ones listed above, talk with your doctor about getting tested for celiac disease.  Do this first before considering a gluten free diet as you may feel better but will have to eat gluten foods again for the celiac testing.  If you are considering a gluten free diet, please consult an expert such as a dietician, nutritionist, or Naturopathic Physician and take advantage of the incredible online celiac/gluten-free websites and books to increase your awareness and education about making the switch while continuing to maintain a healthy, balanced diet.  Gluten free donuts or cookies do not make them any healthier!  It just makes them gluten-free.

 

Read more at the women's health website, Empowher!

References:

1.       Philip, R., Patidar, P, Saran, S., Agarwal, P., Arya, T., and Gupta, K.  (2012).  Endocrine manifestations of celiac disease.  Indian J Endocrinol Metab. 16(Suppl 2): S506–S508.

2.       University of Chicago, Celiac Disease Center.  (2013).  Fact sheets.  Retrieved from http://www.cureceliacdisease.org/living-with-celiac/guide/fact-sheets

New Vitamin D Guidelines - Update or Bogus?

In the October 2012 issue of the science journal PLOS ONE, researchers determined that the appropriate level of Vitamin D for the average American is above 20 ng/ml which is 10 points lower than the original cut-off of 30ng/ml.  These new lab values have been picked up and supported by the Institute of Medicine and subsequently several insurance companies however other groups, such as the Endocrine Society, maintains 30 ng/ml and above is adequate.

There is a lot of research in general about Vitamin D.  It is touted as a vitamin (actually, it's a hormone) that helps with bone strength and support, muscles, mood (think seasonal depression in the cold winter months), autoimmune conditions (most all of them) and cancer protection/prevention.  The Institute of Medicine reports that the evidence is 'too conflicting' to really support a higher Vitamin D level in the blood yet reputed groups such as The Vitamin D Council and Life Extension coupled with the Endocrine Society think otherwise.

Does it matter?

I think so.  If research can point to higher levels of Vitamin D (as in the 50-100 ng/ml) range as even *possibly* helpful for bones, mood, autoimmune and cancer without side effects (assuming one does not overdose on Vitamin D), then let's support the *possibly* and take Vitamin D.  Anecdotally, patients often report just 'feeling better' at higher levels (as in above 20 ng/ml).

Either way, talk with your health care provider and request Vitamin D testing.  Vitamin D is a fat-soluble vitamin and does require other nutrients such as magnesium, zinc and Vitamin K, to work more effectively.    The Vitamin D3 form known as cholecalciferol, is the more appropriate form to take.

References:
Holly Kramer, Chris Sempos, Guichan Cao, Amy Luke, David Shoham, Richard Cooper, Ramon Durazo-Arvizu. Mortality Rates Across 25-Hydroxyvitamin D (25[OH]D) Levels among Adults with and without Estimated Glomerular Filtration Rate <60 .="." 7="7" font="font" nbsp="nbsp" one.="one." plos="plos">