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Celiac Disease and Gluten Intolerance
One of the most under-diagnosed causes of chronic illness is
Celiac disease. Celiac disease is a genetic, auto-immune
(self-destructive) disease that affects people when exposed to gluten.
Gluten is a protein found in wheat and wheat products. It probably
accounts for more than 60% of chronic diseases in the United States as
it affects at least 1 in 133 people.
Symptoms of this
disorder may not become apparent for years, depending upon the
patient's diet, stress levels and type of environment.
Symptoms may present as early as infancy with colic as the initial
symtom (plus chronic diarrhea and poor weight gain). The more
classic symptoms occur later in life (with presentations commoneven as
late as 70 years old). However for most patients, Celiac Disease
involves atypical presentations, which means that the symptoms do not
involve the gastrointestinal tract. Diseases such as
insulin-dependent diabetes, multiple sclerosis, osteoporosis,
endometriosis, infertility and seizure disorders may be Celiac Disease
in disguise. Unfortunately, owing to the myriad symptoms most
patients are not diagnosed for 8 to 10 years time during which the
symptoms worsen. Blood tests and intestinal biopsies may not show
changes for years. Consequently I prefer that patients do stool
testing and genetic testing. Never do I ask a patient to return
to eating gluten to repeat test results.
Gluten intolerance
is a spectrum disorder that can affect anyone at a given time depending
upon their innate health. Gluten Intolerance is NOT genetic, but a
function of gastrointestinal health. For example, if a patient
has a diet that is full of sugar and gets yeast syndrome, the integrity
of the intestinal mucosa may be compromised allowing for the “glue”
that holds the cells together to leak - this is “Leaky Gut
Syndrome”. As a by-product of this state gluten becomes an
initiator of immune response. Therefore in order to eliminate the
yeast, gluten must be eliminated as well. Once the health of the
intestinal villi have been restored, gluten may be reintroduced into
the diet. This scenario may also occur following other intestinal
infections such as parasites, viruses, bacteria as well as following a
bowel cleansing for biopsy or other surgical procedures.
Virtually any condition that causes intestinal upset or problems with
absorption is affected by the presence of gluten.
The common
denominator for both Celiac Disease and Gluten Intolerance is the
treatment with a Gluten Free Diet. For Celiacs this is a lifelong
imperative; for those with gluten intolerance this can be a temporary
state until such time as the intestinal mucosa is repaired and healthy.
The key to understanding treatment is that dietary
elimination of gluten alone will not restore good health. This is
because malabsorption of nutrients vital for the organism to function
combined with excessive needs of many of these same nutrients to effect
repair is over-looked by poorly trained health care
professionals. Vitamin B 12 becomes virtually impossible to
absorb orally because the stomach is inflamed and no longer produces
acid to convert B12 to an easily absorbable nutrient. Mega doses
of B12 orally are worthless in correcting serum and cellular
levels. Treatment requires either daily subcutaneous injections
in high doses (even if B12 levels are in the normal range) or
intravenous infusions on a weekly basis. In all cases this needs
to be administered as the active methylcobalalmin form. (See Vitamin
B12).
Every symptom that is experienced by a Celiac or
gluten-intolerant is related to missing elements in the diet.
Brain function is impaired by the lack of the body's ability to absorb
essential fatty acids. The addition of enzymes, bile and acid
will aid absorption not just of fats, but protein as well.
Minerals are also vital - every enzymatic reaction in the body has a
mineral as a cofactor. Minerals are not easily absorbed if the
stomach is not producing acid - hence the need for easily absorbable
minerals in an ionized form (as a food source preferably).
My personal preference is to test nutrients intracelluarly using the
Spectracell Laboratory; serum levels only tell you what is circulating
but not what is entering the cells. The body attempts to maintain
extracellular levels at all costs, but it is the intracellular levels
that determine body functioning. Different tissues have specific
nutrient requirements - and there is not a specific test for each body
part as yet. It is the patient's symptoms that tell us what is
amiss.
For testing minerals levels, a hair analysis is the
preferred method. As toxic metals can impair ability to repair,
removal of heavy metals becomes part of the recovery process.
The recovery and repair process takes time. It takes seven years
to renew all the cells in the body. For someone with abdominal
pain from gluten, removal of gluten should diminish pain within a 3
weeks, but it may take up to 3 months for most of the pain to
subside. Strict dietary adherence is necessary - but beware, many
prescription drugs contain gluten as a filler.
In
addition to addressing dietary issues, all people with gluten
intolerance and Celiac Disease suffer with an underactive thyroid
as well as a very stressed adrenal gland. What this means is that
compounding the effects of malabsorption are the conditions of
hypothyroidism and adrenal fatigue. This is true whether or not blood
tests confirm an underactive thyroid - oftentimes the active form of T3
is converted to something called reverse T3 and that is not routinely
tested. Also not every underactive thyroid has an elevated TSH to
make the diagnosis. The best diagnosis of hypothyroidism is made
simply by measuring body temperature - if it is below 98.6 it is not
functioning optimally. Adrenal fatigue can confirmed by saliva
testing of the diurnal pattern of cortisol and DHEA secretion.
Oftentimes the symptoms of an underacative thyroid overlap those of an
underactive adrenal. Dr. Bruce Rind has a wonderful chart where a
patient can self-assess their symptoms to see which is predominant at: matrix of symptoms
A team effort is the best way to help patients recover:
A “Functionally” trained physician
Dietician with extensive training in gluten free diets and nutrient requirements
Alternative health care practitioners for reiki, massage, acupuncture
Exercise - yoga, walking
Listening to the body and the process or recovery/discovery is a potent
teacher for us in our journey. The blessing in being a Celiac is
that becoming healthy allows us to live life fully.
Resources:
Genetics, Celiac Disease and Gluten Senstivity www.thefooddoc.com
Understanding the Genetics of Gluten Sensitivity by Dr. Scot Lewey - excellent article
article found: Clan Thompson Celiac Newsletter: Issue #99 February 21, 2007
free subscription to Clan Thompson Newsletter
Stool testing for Gluten Sensitivity/Celiac Disease and/or genetics
www.Enterolab.com
Books:
Living Gluten free for Dummies by Dana Korn
Interesting articles:
www.FinerHealth.com
Celiac information sources:
www.celiac.org
Excellent Gluten free primer from University of Virginia dieticians
NIH consensus paper 2004 on Celiac Disease
NIH information about Celiac Disease
New York Times Article May 8, 2007
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