Podcasts about health activism

Join Daniel Maté, an award-winning composer and playwright, into a rich journey through musical theater, mental health and activism. Co-author of 'The Myth Of Normal' with his father Dr. Gabor Maté, Daniel shares insights on 'getting unstuck' through his unique mental chiropractice and his compassionate approach to Israeli-Palestinian dialogue. His viral debates on Zionism have resonated worldwide. This episode also explores musical activism for vulnerable populations, Daniel & Gabor's upcoming book "Hello Again" which explores the quality of the adult parent-child relationship, and perspectives on trauma, healing and modern medicine.⭐ Please consider leaving us a review on apple podcasts to help us grow.

In this episode of Uncommon Sense with Ginny Robinson, we're back with Justin Hans for Part 2 of our deep dive into two big topics on everyone's minds: the upcoming election and the state of American health. Join us as we unpack the issues, talk through the challenges, and explore what's really at stake for our country. If you're looking for some fresh, grounded insights into how our political choices and health policies intersect, you won't want to miss this conversation.--https://noblegoldinvestments.com/who-we-are/--https://www.whitehouse.gov/briefing-room/speeches-remarks/2022/09/29/remarks-by-vice-president-harris-after-tour-of-the-korean-demilitarized-zone/--Follow Justin on X: https://x.com/blackhawkce457

In the first episode of our special series on mental health in honor of Mental Health Awareness Month, we discuss maintaining emotional health while continuing your activism. Many activists burn out quickly due to compassion fatigue, secondary traumatic stress, and a lack of emotional self-care. In this episode, Jonathan Walton opens up about his own journey from unhealthy activism driven by unresolved personal wounds to a more sustainable practice of emotionally healthy activism.Jonathan's wisdom stems from an understanding of complex intersecting identities and a belief that authentic activism flows from an affirmation of one's full humanity.Whether you're an avid activist feeling depleted or simply want to integrate more sustainable practices, this conversation will inspire you. Jonathan's framework for emotionally healthy activism allows room for hope, rest, and wholeness as we work toward collective liberation. His insights offer a path for activists to fully show up—not just for causes but also for themselves and their loved ones.About Jonathan WaltonJonathan Walton is the creator of the Emotionally Healthy Activist Course and podcast and the author of 5 books, including "Twelve Lies That Hold America Captive." He is also a co-founder of KTF Press and co-host of the Shake the Dust podcast. He has a degree in Creative Writing from Columbia University and an MA from the City University in New York in the Study of the Americas.Currently, he also works as a Senior Resource Specialist in InterVarsity's Multi-Ethnic Initiatives Department and leads the Emotionally Healthy Activist Team. He focuses on developing resources around Justice, Equity, Diversity, and Inclusion, including executing one-off workshops, cohort experiences, and conferences.Connect with Jonathan WaltonWebsite | LinkedIn | Emotionally Healthy Activist Patreon | KTF Press Newsletter and PodcastAbout Host Maria Bryan Maria Bryan is a trauma-informed storytelling trainer. She helps nonprofit leaders tell powerful and impactful stories that resist harm. Maria has over fifteen years in marketing communications in the public sector. She has a Master's Degree in Public Administration, a Bachelor's Degree in Journalism, and is professionally certified in Trauma & Resilience, Trauma-Informed Space Holding, and Somatic Embodiment & Regulation. Maria is a firm believer that storytellers make the world a healthier, safer, cleaner, and happier place. Connect with MariaSpeaking & Training | LinkedIn | Email

Greetings Glocal Citizens! This month we've traveled to three continents on our herstory tour and our final destination is the west coast of the US by way of The Gambia. My guest, Kadiatou Sibi, started in the world of work after finding her voice (literally), in university when she began traveling the world as a lead singer of the band, Belizbeha. Following a successful career in media, entertainment, and teaching, she focused on entrepreneurism to launch A Web of Wellness (AWOW). With over 24 years of experience as an Ayurvedic Wellness and Performance Coach at AWOW, Kadiatou helps clients achieve optimal health and well-being through personalized diet, lifestyle, and meditation practices. She is a board-certified Ayurvedic practitioner by the National Ayurvedic Medical Association (NAMA), and a Chopra Certified Health Teacher and Student at Chopra Global, where she learns from the renowned Deepak Chopra and his team of experts. Her involvement with the National Ayurvedic Medicine Association includes participation on the DEI committee reflecting her dedication to inclusivity within the field. Additionally, she has authored articles, led DEI workshops, and extended her expertise to cater to a diverse clientele. This conversation was a breath of fresh Spring air and I hope that many of the tips that Kadi has to offer in conversation and at AWOW (https://www.awebofwellness.com/) will help you to build better, wholistic wellness practices for you and your loved ones. Where to find Kadi? On LinkedIn (https://www.linkedin.com/in/kadiatousibi/) On Instagram (https://www.instagram.com/awebofwellness/) On Facebook (https://web.facebook.com/kadiatou.sibi) On YouTube (https://www.youtube.com/channel/UCzVOYsaYtJhWy4Jhv4zV8gQ) What's Kadi watching? Needle in a Haystack (https://en.wikipedia.org/wiki/Needle_in_a_Timestack#:~:text=Needle%20in%20a%20Timestack%20is,Orlando%20Bloom%2C%20and%20Jadyn%20Wong.) The Banker (https://en.wikipedia.org/wiki/The_Banker_(2020_film)) What's Kadi reading? Who Not How: The Formula to Achieve Bigger Goals Through Accelerating Teamwork (https://a.co/d/aIXZtUS) by Dan Sullivan and Dr. Benjamin Hardy Other topics of interest: Belizbeha Band Reunion (https://www.youtube.com/watch?v=QuEUaqnl3qM) About Julangel. Gambia (https://web.facebook.com/JulangelMVA/?_rdc=1&_rdr) About Leimert Park (https://leimertparkvillage.org) and Africa Town (http://www.africatownnow.com) About Nasya in Ayurveda (https://ayurveda.com/nasya/) About the Chakras (https://www.mindbodygreen.com/articles/7-chakras-for-beginners) What is the Dark NIght of the Soul? (https://www.youtube.com/watch?v=4DrR6rSJhN0) About Redlining and Its Legacy (https://www.npr.org/2017/05/03/526655831/a-forgotten-history-of-how-the-u-s-government-segregated-america) About Juneteenth (https://nmaahc.si.edu/explore/stories/historical-legacy-juneteenth) What is NLP? (https://en.wikipedia.org/wiki/Neuro-linguistic_programming) Ayurveda Daily Routine (https://www.youtube.com/watch?v=pJtEJa2qskU) About the Gut Microbiome (https://www.healthline.com/nutrition/gut-microbiome-and-health) Special Guest: Kabiatou Sibi.

Meg Talks with LGBT+ and Mental Health Influencer and digital content creator Heather Moradeyo. This week peeps we are getting into a totally new discussion topic. I know you guys are going to want a part 2,  we needed more time lol. This episode has a trigger warning attached for anyone sensitive to topics concerning: mental health sectioning, psychiatric wards, self harm & suicide. Heather and I get into a captivating  conversation, unpacking the true story behind the creative mind and social media mogul.  We uncover the synergy between Heather's life experiences and the dope work she is doing supporting the LGBT+ community in Nigeria. We talk about Heathers reality living with schizophrenia and what life is truly like on a psych ward.  Heather opens up about life in Lagos, searching for love in heterosexuality and being outed within her community back home

More about our guests:John BeardFacebookPort Arthur CanDr. Larysa Dyrszka and Dr. Sandra SteingraberConcerned Health Professionals of NYDr. Steingraber's Twitter

Hosted by Andrew Keen, Keen On features conversations with some of the world's leading thinkers and writers about the economic, political, and technological issues being discussed in the news, right now. In this episode, Andrew is joined by Phyllis Vine, author of Fighting for Recovery: An Activists' History of Mental Health Reform. Phyllis Vine‘s book Families in Pain was the first to discuss family relationships of people with mental illness. As a tenured professor of American history at Sarah Lawrence College, she taught courses on the history of healthcare. Vine was a founding member of NAMI-New York State. Presently she is the president of the board of directors of Gould Farm, the oldest farm-based residential treatment program for people with mental illness in the US. Learn more about your ad choices. Visit megaphone.fm/adchoices

As a child, Soleil Moon Frye became famous for her breakout role in the eighties show Punky Brewster – then in 2021, she released a critically acclaimed documentary called Kid90. Now, the mom of four, who has been an activist her whole life, is a spokesperson for the public health awareness campaign around the Meningitis B vaccine for children and young adults. In this episode, Liz talks to Soleil about why she's always felt a responsibility to make the world a better place, why she always wanted to have a big family, and the questions parents should ask their doctor about the Meningitis B vaccine. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

You've probably heard of a mental health advocate, but what about a mental health activist?! Today we're chatting with Liv, a young adult on a mission to continue healing her community by being a proactive activist with mental health. She shares her own story, why this topic is important, in addition to encouraging others listening to join the charge towards breaking stigmas. |MENTIONED| ⋒ Bridges of Hope ⋒ The Umbrella Project ⋒ The Ripple Effect Education ⋒ Jack.org ⋒ Conflict Style ⋒ Restorative Justice |FIND LIV| ⋒ Instagram |FIND AMANDA| ⋒ Instagram ⋒ Website ⋒ Sunshine + Rainbows Insta ⋒ "Jumo the Unicorn" Children's Book Series ----------------------------------------- If you'd like to share your own story with our audience about how you've overcome something in your life or maybe want to start an important conversation that needs to be heard, please send us an email at hello@thatmandagirl.com - until next week besties!

It was so great to have a conversation with Ben West this week on the podcast, where we talk all things mental health! After tragically losing his younger brother to suicide, Ben began campaign for increasing awareness, promoting positive change, influencing the government, and altering laws within the mental health space. Mental health is universal in its impact and effects everyone, however there is still a very clear lack of funding and education in order to tackle the huge struggles being faced by thousands.We discuss the consistent tendency to separate mental and physical health issues, when in fact they so often exist as intertwined, and need to be treated with equal importance. At present Ben is focusing particularly on universities and schools as social spaces in which mental health care is needed more than ever, with the largest killer of teenagers horrifically remaining to be suicide. Conscious to not simply call for change but offer suggestions, Ben and I highlight the specific solutions he is hoping to take to government in order to produce active change and save lives. We additionally explore the power of therapy as preventative medicine (but simultaneously the serious need for increased support in this area), dropping out of university, how Ben used positive campaigning to heal from his grief, the positive and negative aspects of social media, and an in-depth discussion surrounding diet culture, eating disorders, and the fitness industry. There are a lot of heavy topics in this podcast episode, so I advise you to note these trigger warnings before listening: *We speak about suicide/depression/anxiety/eating disorders/body weight and image in this episode. This is to caution anyone who may find this triggering or upsetting. Remember you are not alone, and sending you tons of loving vibes. Websites for support:https://www.mind.org.uk/https://www.beateatingdisorders.org.uk*This episode is recorded remotely so apologies for any audio issues! Follow me: https://www.instagram.com/healingwithtorzi/Follow Ben: https://www.instagram.com/iambenwest/MENTIONED: Ben's Petition (Save our Students: Make Mental Health First Aid a Compulsory Part of Teacher Training): https://www.change.org/p/saveourstudentsMatt Haig: https://www.instagram.com/mattzhaig/James Middleton: https://www.instagram.com/james.middleton_/Support this show http://supporter.acast.com/that-healing-feeling. See acast.com/privacy for privacy and opt-out information.

Do you think you know everything you need to know about living gluten-free? Think again! You may learn some new things in this episode. Also, If you need to eat gluten-free, how important is it to make sure you live 100% gluten-free? In this episode, Lee welcomes Nadine Grzeskowiak, RN, BSN, CEN, who almost died before she learned she has Celiac disease. Nadine has over sixteen years of experience working as a trauma nurse in the emergency departments as a staff and agency nurse. Additionally, she owns and operates three businesses; RN On Call, Inc., Gluten-Free RN, and Celiac Nurse Consulting. Her background in critical care benefits her private patients as they strive to maintain health and navigate the health care system. Nadine is an international expert consultant, author, researcher, and professional speaker who has presented over 1,800 lectures. Her first book was released in 2015: DOUGH NATION: A Nurse's Memoir of Celiac Disease, From Missed Diagnosis to Food and Health Activism.

In this segment, Sean and Jacquie are joined by Dr. Johanna Fernandez, Associate Professor of history at Baruch College of the City University, author of the book The Young Lords: A Radical History to discuss the anniversary of the historic occupation of Lincoln Hospital in NYC by The Young Lords in 1970, the issues of lack of access to decent housing, food, and healthcare that they confronted, the connection to workers' rights and wages that they also connected, and the lessons we can learn in the ongoing struggle surrounding these issues today.

We are beyond thrilled to share this episode with you where we sit down with Claire Snyder, a local activist and good friend to us here at the PUSH Podcast.In this episode we discuss:Claire's lived experiences as a Black women in different fitness environments and in her community;How mental health is so crucial to overall healthHer evolution toward becoming an activist;Her relationship with her body growing up and how it has changed throughout the years;And more. Such much more!Laugh, cry and learn with us as we talk with Claire during our latest podcast episode.Resources discussed in this episode:Sit in SalemBlack Joy OregonSEKNA Community GardenSalem Keizer Interfaith Network

Brian & Marion speak at UNC’s 42nd Minority Health Conference Body & Soul: The Past, Present, and Future of Health Activism, hosted by the Gillings School of Public Health’s Minority Health Caucus. They get into it with public health students about what the last year of COVID-19 and quarantine has revealed to us about our sense of collective responsibility, and how we can redefine public health as an essential public good and health access as a right. (This episode was recorded on February 26, 2021). Don't forget to nominate At The Intersection for Best Local Podcast here: https://vote.indyweek.com/out-and-about/best-local-podcast --- Support this podcast: https://anchor.fm/at-the-intersection/support

In Episode 16 Piers and author and activist Robert Whitaker discuss Psychiatry, Big Pharma, and Mental Health Activism. Recorded on November 30, 2020.Robert Whitaker is an American journalist and author who has won numerous awards as a journalist covering medicine and science, including the George Polk Award for Medical Writing and a National Association for Science Writers' Award for best magazine article. In 1998, he co-wrote a series on psychiatric research for the Boston Globe that was a finalist for the Pulitzer Prize for Public Service. His first book, Mad in America, was named by Discover magazine as one of the best science books of 2002. Anatomy of an Epidemic won the 2010 Investigative Reporters and Editors book award for best investigative journalism. He is the founder of madinamerica.com and the co-author, with Lisa Cosgrove, of Psychiatry Under the Influence.Resistance Recovery (RR) is reimagining addiction, recovery, and community in the 21st century. Piers Kaniuka, MTS, MS has worked with thousands of addicts and alcoholics in his 25+ years in the field. Discover RR's new paradigm of addiction recovery by visiting http://resistancerecovery.com.Visit the RR YouTube channel: https://www.youtube.com/c/RESISTANCERECOVERYSign-up for Long Threads and get Resistance Recovery news: https://mailchi.mp/ddc8023bec67/welcometoresistancerecoverySupport this podcast at — https://redcircle.com/resistance-recovery/donations

In this episode we take a journey into the world of art and HIV activism through a lively conversation between host James Watson and performance and video artist, and self-described “harm reductionista,” Mikiki. Art has a long-standing presence in the HIV/AIDS movement, evoking strong reactions and delivering powerful messages, and the work of Mikiki is no different. Over the course of this episode they reflect on their work in the HIV response and the impact that living with HIV has had on their art making, and define what it means to be a “body autonomy activist” and a “cheerful nihilist.” From drag to blood draws, Mikiki's work is never timid—it's political and it's personal. Do we need to be in pain to create meaningful or beautiful art? Let's find out.For full episode details and more about Mikiki, visit the episode page on The Positive Effect website. Subscribe to pozcast on your favourite podcast streaming service to ensure you're notified when new episodes are released each month. Also check out our recent blog post, ‘Art, activism and HIV: triggering emotions, imagination and action' where we explore some of the origins and ideas surrounding gay culture, art movements and activism.Click here for the full audio transcript.

Host Jason Schreurs has a lively conversation with Sascha Altman DuBrul, a mental health activist with a punk background. Sasha runs a private practice in Oakland, CA providing transformative mental health services. He was also a member of New York ska-punk band Choking Victim in the '90s, and part of the band's reunion shows in the mid '00s. http://saschadubrul.com http://chokingvictim.bandcamp.com Featured songs: Choking Victim - "Infested: Lindane Conspiracy, Pt.1" from Squatta's Paradise (1996) Suicidal Tendencies - "Institutionalized" from Suicidal Tendencies (Frontier Records, 1983) Buzzcocks - "Breakdown" (live at Lesser Free Trade Hall, Manchester, 1976) Choking Victim - "500 Channels" from No Gods / No Managers (Hellcat/Epitaph Records, 1999) Photo: Walter Hergt About this podcast: Scream Therapy explores the link between punk rock and mental health. My guests are members of the underground music scene who are living with mental health challenges, like myself. Intro/background music: Submission Hold - "Cranium Ache" Render Useless - "The Second Flight of Icarus" Artwork: Luke Ramsey - http://lukeramseystudio.com Contact host Jason Schreurs - jasonschreurs@telus.net

Mental health is such an intersectional subject especially when blackness is factored into it. My guest @thebrettina and I discuss her journey to becoming a mental health activist and the role it has played in her blackness, and how she advocates for people of color.

Join me as my special guest Anika J. McDonald, LCSW., the #CreativeSocialWorker and I discuss activism, domestic violence, and healing during COVID-19. Anika can be reached on Instagram @ak4ra_divine

Join me for a rich conversation with Sage Liskey.  Sage is an activist and author. In 2010 he founded the Rad Cat Press, dedicated to creating accessible literature that uplifts lives and reimagines society. His latest book, You Are A Great And Powerful Wizard, explores how to empower your life and change the world through the fun lens of magic and wizardry. He currently resides in Eugene, Oregon, and can be found online at www.sageliskey.com as well as Instagram and Facebook by searching Rad Cat Press.

Associate professor Jochen Mierau’s background is in economics, but as a founding member of the Aletta Jacobs School of Public Health, he is applying his expertise to a new discipline. Health outcomes vary from one nation to the next, but zooming in on the level of neighbourhoods can shed light on best practices that can be applied on a city or regional level. Mierau says that public health is not a spectator sport, and in our conversation about the increasingly interdisciplinary nature of this academic field, in honour of the school’s namesake, he talks about how health care interventions effectively amount to a form of activism.

Welcome to Next Gen sound studies! In the month of November, you will be treated to the future. . . today! In this series, we will share excellent work from undergraduates, along with the pedagogy that inspired them. You’ll read voice biographies (Kaitlyn Liu’s “My Voice, or On Not Staying Quiet,”) check out blog assignments (David […]

In conjunction with this podcast, Blackfishing the IUD is a collaboratively-written memoir by novelist, Caren Beilin, about reproductive health and the IUD, gendered illness, medical gaslighting, and activism in the chronic illness community.Head to http://wolfmanhomerepair.com/blackfishing to get more info about the book and project, and to order a copy!SHOW NOTES:Flor’s trailer for “When Bodies Talk”Copper IUD Detox Yahoo GroupDr. Wilson and Copper ToxicityMothering Magazine Copper IUD ForumAbuse of Time by VVD WNDWS (Intro Song)Matt CarneyAccessibility Transcript

“We cannot be generative if we are afraid.” We are so hype for you to hear and learn from the wisdom and electric energy of Dr. Monica McLemore, Assistant Professor of Family Health Care Nursing at UCSF. Together, we talk about health injustices faced by Black mothers and the amazing work of the Black Mamas Matter Alliance. In addition, we talk about the importance of Reproductive Justice frameworks and the brilliant work that Dr. McLemore has done and continues to imagine with love for the health and well-being of Black mothers. We hope that by the end of this episode, listeners are encouraged to create change within their institutions and communities for Black mothers, children, and families. #ThisCouldAllBeDifferent and it will be. Bio: At the University of California, San Francisco, Dr. Monica McLemore is an assistant professor in the Family Health Care Nursing Department, an affiliated scientist with Advancing New Standards in Reproductive Health, and a member of the Bixby Center for Global Reproductive Health. She maintains clinical practice as a public health and staff nurse at San Francisco General Hospital in the Women's Options Center. McLemore's research is geared toward understanding women's health and wellness across the lifespan. She is an elected member of the governing council for Population Reproductive and Sexual Health section of the American Public Health Association and a recipient of the 2015 teaching award from the American College of Nurse Midwives. She received the 2018 Person of the Year Award from the Abortion Care Network. Her work embraces complex and intersectional problems associated with sexual and reproductive health, including health disparities, stigma, incarceration, unintended pregnancy, and difficulty accessing services.

Is the new public health activism different from the old one? I address this question because we are in 2018 and that 50 years ago, 1968 remains the symbolic year of a transformative decade, the sixties, from which public health emerged profoundly transformed. Today there is a new public health activism challenges which challenges injustices. How different is the new activism from the older one? My guests are Prof Nick Freudenberg, from CUNY, and Prof Jeanne Stellman, from Columbia, both public health scientists who were student activists in the sixties, and Kelsey Schertz, who is currently a MPH student.

To pierogi or not to pierogi… If you have celiac disease, there is no question that you should avoid anything made with flour or grains, no matter how delicious the dish may be. Although the Gluten Free RN has fond memories of her Polish grandmothers making traditional pastries, she contends that you don’t have to eat customary Polish food to celebrate your Polish heritage. In preparation for her upcoming trip to Warsaw in July, Nadine is taking a closer look at celiac disease in Poland. She discusses a 2009 study assessing the prevalence of celiac disease in Polish children, highlighting the asymptomatic and oligosymptomatic nature of the disease and explaining her own false negative test. Listen in for the Gluten Free RN’s insight around preparing for a trip to Poland, including research on the available gluten-free food and adult beverages! What’s Discussed: Why Nadine is concerned about her upcoming trip to Poland Flour, grains used in cooking and baking Nadine’s Polish heritage Fond memories of grandmothers making pierogi, pastries The 2009 study of celiac disease in Poland Assessed prevalence in children, only screened for IgA EmA, IgG EmA 3,235 children in Bydgoszcz tested, 25 identified (seven with Marsh III) Predominantly asymptomatic or oligosymptomatic Nadine’s genetic predisposition for celiac disease HLA-DQ2.5 homozygous How Nadine is preparing for travel in Poland Aware of Polish translations for gluten-free, celiac (bezglutenowe, trzewny) Take ‘rescue food’ for emergencies The prevalence of celiac disease in Poland 1:100 (matches worldwide estimate) The gluten-free alcoholic beverages available in Poland Potato vodka, honey mead Nadine’s caution against eating bread in Europe Wheat, grain causes damage regardless of location The overlap between autoimmune and celiac disease CD is grossly unrecognized, underdiagnosed Nadine’s suggested diet for celiac patients Meat, fish and eggs Nuts and seeds Fruits and vegetables  Resources: NIH Consensus Development Conference on Celiac Disease ‘Screening for Celiac Disease in Poland’ in the Medical Science Monitor Gluten-Free Globetrotter Blog on Poland Gluten-Free Travel in Poland—Coeliac Youth of Europe Poland Travel Guide—Coeliac UK ‘Graves’ Disease, Celiac Disease and Liver Function Abnormalities in a Patient—Clinical Manifestation and Diagnostic Difficulties’ in ACTA Biochimica Polonica ‘Neuropsychiatric Symptoms and Celiac Disease’ in Neuropsychiatric Disease and Treatment ‘Evaluation of HLA-DQ2/DQ8 Genotype in Patients with Celiac Disease Hospitalised in 2012 at the Department of Paediatrics’ in Przeglad Gastroenterologiczny For Visitors with Coeliac Disease—Polskie Stowarzyszenie Osob z Celiakia i na Diecie Bezglutenowej Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

The Irish are known for being lucky… But does that luck hold out when it comes to celiac disease? The prevalence of celiac disease among the Iris is 1:100, about the same as the rest of the world. And if you are a redhead of Irish descent, there is a good chance that you are an HLA-DQ2 or HLA-DQ8 gene carrier. Today, the Gluten Free RN explores Irish ancestry and celiac disease, discussing how the Potato Famine led to a change in diet for much of the surviving population. She walks us through a paper published by Irish College of General Practitioners explaining the clinical presentations and complications of celiac disease. Nadine shares her experience running the Dublin marathon and the health consequences she suffered after touring the Guinness brewery. Listen in to understand the work of the Coeliac Society of Ireland and learn about the trends in celiac disease among the Irish. What’s Discussed:  Why red hair is associated with celiac disease Tend to be HLA-DQ2 and/or HLA-DQ8 gene carriers The prevalence of celiac disease in Irish Setters Do much better on a gluten-free/Paleo diet The Irish Potato Famine Potato-based diet, little access to grains Famine from 1845-1849 One million died, many emigrated The myth that celiac disease is more prevalent in Europe than the US 30-50% of the population carries HLA-DQ2, HLA-DQ8 gene The myth that women are more susceptible to celiac disease Statistics don’t support this belief The Irish College of General Practitioners paper on celiac disease Clinical presentations, complications of celiac disease Conditions associated with increased prevalence The prevalence of celiac disease in Ireland 1:100 (matches rest of world) The appropriate testing for celiac disease and NCGS Blood test for total IgA/IgG, DGP and AGA Nadine’s experience running the Dublin marathon in 1998 Extreme edema in lower extremities The information provided by the Coeliac Society of Ireland Health ramifications of undiagnosed CD Average duration from symptoms to diagnosis (nine months) Resources: ‘Gluten-Sensitive Enteropathy in a Family of Irish Setters’ in The Canadian Veterinary Journal ‘Diagnosis and Management of Adult Coeliac Disease’ in ICGP Coeliac Society of Ireland ‘Prevalence and Incidence of Celiac Disease in Edinburgh and the Lothian Region of Scotland’ in Gastroenterology ‘Prevalence and Diagnosis’ by the Coeliac Society of Ireland ‘Coeliac Disease in Europe’ in Alimentary Pharmacology & Therapeutics ‘Escalation in the Amount of Adults Diagnosed with Coeliac Disease’ in Lifestyle Health ‘Gluten-Free Foods’ by the Food Safety Authority of Ireland ‘How Irish Diets of the Past Affect the Present’ in The Irish Times ‘Changes in Presentation of Celiac Disease in Ireland from the 1960s to 2015’ in Clinical Gastroenterology and Hepatology ‘Coeliac Disease: A Personal Perspective’ in Irish Health ‘Coeliac Disease: More Common Than You Think in Irish Health ‘Pathology and Management of Coeliac Disease’ by the Dublin Academic Medical Centre & UCD Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

It goes without saying that anyone who serves in the military needs to be healthy and strong—and that military leaders have an obligation to keep enlisted servicemen and women as safe and healthy as possible. So, it makes sense that people with food allergies (including celiac patients) are disqualified from military service, but it is less clear why celiac testing is not a part of the medical exam to qualify for enlistment. Today, the Gluten Free RN addresses the issue of celiac disease in the military. She explains the challenges of preparing gluten-free food in a mess hall setting and describes the consequences for an active duty soldier who is found to have celiac disease. Nadine shares a research study exploring celiac trends among active duty military as well as a case study around veterans and celiac disease. Listen in for insight on what’s behind the increased prevalence of celiac disease among military personnel and the confirmed association between celiac disease and other complex health issues. What’s Discussed:  Why celiac patients are disqualified from enlisting in any branch of service Unable to provide safe food What happens to military personnel who are found to have celiac disease Will receive medical discharge The US military policy around food allergies and intolerances No accommodations made Countries that allow celiac patients to serve Israel, Finland and Scandinavia The Mayo Clinic study of celiac trends among active duty military Healthy worker population with medical diagnostic coding Incidence of celiac disease increased five-fold from 1999-2008 Combination of increased suspicion and environmental factors The challenge of preparing gluten-free food in a military setting High risk of cross-contamination A case study involving military veterans and celiac disease Confirmed association between CD and other complex issues The benefits of a gluten-free diet Preventative for autoimmune disorders, nutritional deficiencies and cancer Nadine’s argument for celiac testing prior to enlistment Obligation to safety of servicemen/women   Resources: Military Standards of Medical Fitness ‘The Incidence and Risk of Celiac Disease in a Healthy US Adult Population’ in the American Journal of Gastroenterology ‘Celiac Sprue Among US Military Veterans: Associated Disorders and Clinical Manifestations’  in Digestive Diseases and Sciences ‘Gluten-Free Soldier in Afghanistan’ in Gluten-Free Living ‘Medical Mix-Up Sidelines Army Sergeant’s Career’ in Military Times Celiac Disease-Related Veterans Affairs Case Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

We get vaccinated to protect ourselves, to gain an immunity to a particular disease. But in the case of hepatitis B, celiac patients may come to find out that we are NOT immune—despite having done the right thing in getting a hepatitis B vaccination.  Today, the Gluten Free RN is walking us through the latest research around vaccination and celiac disease. She explores the fact that celiac patients are more likely to be non-responsive to HBV than the general population, explaining the fundamentals of hepatitis B and the two main theories as to why the vaccine doesn’t work for some celiac patients.  Nadine shares her take on immunizations, explaining why she is a proponent of an alternate vaccination schedule for infants who may be immunocompromised. Listen in and learn how to determine whether you are truly immune to hepatitis B and protect yourself from potentially life-threatening disease! What’s Discussed:  The basics of hepatitis B (HBV) Viral infection that attacks liver Transmitted through blood, body fluids The prevalence of hepatitis B 257M people infected 887K deaths in 2015 The 2013 Italian study around celiac disease and the hepatitis B vaccine Number of non-responders to vaccine higher in CD patients May be genetic OR caused by gluten intake during vaccination Nadine’s experience with vaccination as a child Contracted mumps despite MMR Nadine’s take on vaccination Advocates for immunization to prevent disease Giving babies multiple vaccines at once may not be best The conclusion of a 2017 Italian study Administer booster shots of hepatitis B vaccine as needed Evaluate response to vaccine in newly diagnosed celiac patients Revaccinate one year after adoption of gluten-free diet The value of a hepatitis B titer Confirms whether really immune If not, test for celiac disease Resources: ‘Hepatitis B Vaccine in Celiac Disease: Yesterday, Today and Tomorrow in the World Journal of Gastroenterology ‘Vaccinations in Celiac Disease’ in the Journal of Pediatric Gastroenterology and Nutrition ‘Immune Response to Vaccines in Children with Celiac Disease’ in the World Journal of Gastroenterology ‘Immune Response to Hepatitis B Vaccine in Patients with Celiac Disease: A Systematic Review and Met-Analysis’ in Human Vaccines and Immunotherapeutics ‘Early Vaccinations are Not Risk Factors for Celiac Disease’ in Pediatrics ‘Gluten Intake Interferes with the Humoral Immune Response to Recombinant Hepatitis B Vaccine in Patients with Celiac Disease’ in Pediatrics ‘Effect of Pentavac and Measles-Mumps-Rubella (MMR) Vaccination on the Intestine’ in Gut ‘Normal of Defective Immune Response to Hepatitis B Vaccine in Patients with Diabetes and Celiac Disease’ in Human Vaccines and Immunotherapeutics Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

When the Gluten Free RN went on a gluten-free diet 11 years ago, her thyroid settled down and the associated symptoms and disorders—Graves’ disease, weight gain and hair loss—resolved. But when Nadine was inadvertently hit with gluten two years ago, several of those symptoms returned, along with a few new ones. She was losing hair and gaining water weight again. On top of that, her sinuses were congested. She developed asthma, a rash on her lower right leg and a scary case of pulmonary edema (excess fluid in the lungs). Hindsight being 20/20, Nadine realizes that her recent diagnosis of hypothyroidism is associated with that accidental gluten ingestion. Further study made it clear that there is a potential connection between her thyroid problems and pulmonary edema, as the leaky gut that comes with celiac disease can cause fluid shifts into body tissues. Today the Gluten Free RN explores the links among celiac disease, thyroid disorders and pulmonary edema. She explains the function of the endocrine system, the symptoms associated with hypothyroidism, and the diet she recommends for patients with thyroid issues. Listen in for Nadine’s insight around how gluten affects the thyroid gland and why the resulting low sodium levels might trigger edema in celiac patients. What’s Discussed:  The function of the endocrine system Glands in body that make hormones The connection between celiac disease and thyroid disorders Thyroid especially vulnerable to gluten protein in wheat, barley, rye and oats Nadine’s symptoms of hypothyroidism Lower extremity edema Congested sinuses Hair falling out Pulmonary edema Asthma Rash on leg How damp rash lotion resolved Nadine’s symptoms Prescribed by acupuncturist in Chiang Mai Rash cleared, could breathe easy Symptoms returned within four weeks of return to US Nadine’s thyroid-stimulating hormone (TSH) levels Within normal limits despite thyroid issues Practitioner declined to order thyroid panel The relationship between thyroid issues and edema Sodium = major electrolyte, maintains body’s pH Hypothyroidism means low sodium levels Leaky gut of celiac disease leads to fluid shifts (edema) The research around thyroid disorders and celiac disease in Current Allergy and Asthma Reports Association between CD and thyroid disorders well documented Increased prevalence of autoimmune thyroiditis and Graves’ disease in celiac populations The diet Nadine recommends for celiac patients with potential thyroid issues Gluten-free, dairy-free Whole food, Paleo Why patients with unexplained pulmonary edema should be tested for celiac disease AND thyroid disorders Potential connection among all three The symptoms associated with hypothyroidism Puffy face, constipation, fatigue Muscle weakness, aches and pains Irregular, delayed menstrual periods Hair loss, thinning hair Slower heartrate, hypothermia Depression, memory problems Resources:   ‘Pregnancy Complicated with Pulmonary Edema Due to Hyperthyroidism’ in the Journal of the Chinese Medical Association ‘Sleep Apnea, Hypothyroidism and Pulmonary Edema’ in CHEST Journal Letters to the Editor ‘Thyroid and Fluid Retention’ on the Wilson’s Syndrome Site ‘Acute Pulmonary Edema as a First Manifestation of Hyperthyroidism in a Pregnant Woman’ in Revista Medica de Chile ‘Hypothyroidism and Non-Cardiogenic Pulmonary Edema: Are We Missing Something Here?’ in Endocrinology, Diabetes & Metabolism Case Reports ‘Celiac Disease and Autoimmune Thyroid Disease’ in Clinical Medicine & Research ‘Celiac Disease and Autoimmunity: Review and Controversies’ in Current Allergy and Asthma Reports ‘An Unusual Cause of Flash Pulmonary Oedema’ in BMJ Case Reports ‘Challenges in the Management of a Patient with Myxoedema Coma in Ghana: A Case Report’ in Ghana Medical Journal ‘Hyponatremia and the Thyroid: Causality or Association?’ in the Journal of Clinical Medicine ‘Interactions Between Thyroid Disorders and Kidney Disease’ in the Indian Journal of Endocrinology and Metabolism Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

An estimated 50% of Americans are on some type of psychotropic drug. Half of the US population! What is causing such widespread prevalence of mental health disorders? Prescription anti-depressants and sedatives don’t solve the underlying problem…  So how do we get to the bottom of this?  The Gluten Free RN contends that there may be a connection between mental health and undiagnosed celiac disease. Today she explains how several disorders (anxiety, depression and paranoia, among others) have been linked to gluten, discussing how a leaky blood-brain barrier can lead to hypoxia, an inflammation of the brain. Nadine walks us through the best research in mental health disorders and gluten sensitivity, sharing two landmark studies that emphasize the gut/brain connection and characterize celiac disease as primarily a neurological disorder. Nadine offers her insight around working with schizophrenic patients and the increasing number of children suffering from anxiety. Listen in to understand how gluten impacts your mental health, and learn how to eliminate brain fog, get off prescription meds, and enjoy a higher quality of life! What’s Discussed:  The connection between gluten and hypoxia Leaky blood-brain barrier leads to inflammation of brain, decreased oxygen flow The shocking statistics around Americans and psychotropic drugs Estimated 50% of US population on psychotropic medication The potential relationship between mental health disorders and undiagnosed celiac disease High instance of depression, anxiety, fatigue and paranoia May have difficulty sleeping, headaches or seizure disorder Nearly all experience brain fog The health consequences of undiagnosed celiac disease Malabsorption of nutrients Damaged immune system Neurological symptoms Hormonal imbalance Neurotransmitter disruption The findings of the landmark Cooke study in 1966 Ten of 16 patients with celiac disease had severe progressive neuropathy All 16 had severe malabsorption The conclusion of an editorial published in Neurology, Neurosurgery & Psychiatry Celiac disease, NCGS is primarily neurological How a gluten-free diet can resolve gastrointestinal and psychiatric symptoms Celiac disease can manifest as depression, anxiety or psychosis Research published in International Journal of Celiac Disease demonstrates gut/brain connection Nadine’s experience with schizophrenia patients Majority are gene positive for HLA-DQ2, HLA-DQ8 The increasing number of children diagnosed with anxiety disorder May be caused by undiagnosed sensitivity to gluten The concept of food as medicine Body may read gluten as toxic, must remove from diet Resources: ‘Gluten Sensitivity as a Neurological Illness’ in the Journal of Neurology, Neurosurgery & Psychiatry ‘Psychiatric Complications of Celiac Disease’ in the International Journal of Celiac Disease ‘Genetic Hypothesis of Idiopathic Schizophrenia: Its Exorphin Connection’ in Schizophrenia Bulletin ‘Markers of Gluten Sensitivity and Celiac Disease in Bipolar Disorder’ in Bipolar Disorders ‘Neurologic and Psychiatric Manifestations of Celiac Disease and Gluten Sensitivity’ in Psychiatric Quarterly ‘Neuropsychiatric Symptoms and Celiac Disease’ in Neuropsychiatric Disease and Treatment Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Two and a half years ago, Nadine was inadvertently hit with gluten—three times in a row. In the past, it had taken about ten weeks for her symptoms to resolve after an accidental exposure, but this time they stuck around. It started with feeling cold. Then she began experiencing abdominal distention and pain.  Her dermatitis herpetiformis returned, she was plagued with sinus congestion, and she was gaining weight. Most concerning of all, she developed pulmonary edema, a condition caused by excess fluid in the lungs.  Today, the Gluten Free RN is getting real, revealing the health struggles she has been dealing with since 2015. She explains the circumstances that led to her accidental gluten exposure and recounts the ten scary nights she spent in a recliner, forced to sit up in order to breathe.  Nadine takes us along on her global search for the answers that began with a practitioner in Thailand and a tiny container of damp rash lotion, and ended with a diagnosis of myxedema from a naturopath here in the States. Nadine discusses how those three consecutive hits of gluten targeted her thyroid gland and how T3 is working to resolve her symptoms. Listen in and learn how the Gluten Free RN is reclaiming her Superwoman status and how you, too, can reach your full potential with good health and wellbeing!   What’s Discussed:  Maslow’s hierarchy of needs Physiological, safety needs must be taken care of first Difficult to achieve self-actualization with poor health  Nadine’s health struggle the past 30 months Inadvertently hit with gluten three times in a row Symptoms persisted past usual ten weeks Sinus congestion, DH, pulmonary edema and weight gain  Nadine’s search for the underlying cause Saw practitioner in Chiang Mai, damp rash lotion resolved symptoms Naturopath in Oregon diagnosed myxedema (hypothyroidism)  How Nadine is reclaiming her health Taking T3 to resolve symptoms  How a damaged thyroid gland impacted Nadine Affected sleep, ability to do challenging physical activity  The importance of support in getting your health back Need relationships to support choices Resources: Whole30 Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Celiac disease is messy. It can develop at any age, in any ethnicity, in both men and women, with any symptom or no symptom at all. Every patient is different, and each one presents differently. There is nothing cut and dried about celiac disease, except that a 100% gluten-free diet is necessary for healing. Nurses are in a unique position to make sense of this chaos and advocate for patients, recognizing possible celiac disease and non-celiac gluten sensitivity and recommending appropriate testing when necessary. Today, the Gluten Free RN covers the basics of celiac disease for nurses, explaining the frequency with which the disorder is misdiagnosed or goes undiagnosed for years.  She walks us through the testing required for a diagnosis of celiac disease proper, who should undergo testing, and why one negative test doesn’t rule out the disease. Nadine speaks to the 300-plus signs of celiac disease, reviewing the most common symptoms and the overlap between celiac disease and autoimmune disorders like type 1 diabetes. She also shares the discouraging statistics around the impact of undiagnosed celiac disease on fetal development and maternal health. Listen in to understand why Nadine encourages fellow nurses include celiac disease as part of their differential diagnosis, providing gluten-sensitive patients with a safe, gluten-free environment and a higher quality of life! What’s Discussed:  The frequency with which celiac disease is misdiagnosed or goes undiagnosed 94% of people with celiac disease are undiagnosed Current estimate is 3% of US population Takes average of 9-15 years for diagnosis  The challenges around getting a diagnosis of celiac disease proper Requires genetic test, celiac antibody test and documented villous atrophy Celiac antibody test = 70% false negative in US  The chronic nature of celiac disease Patients must go 100% gluten-free for life  The 300-plus signs and symptoms of celiac disease Primarily a neurological disorder  Why celiac patients must be tested for potential nutritional deficiencies May need B12, Mg RBC, D3, Zn or I supplements  The detrimental impact of undiagnosed celiac disease on fetal development, maternal health 800-900% increase in miscarriage Increased risk of stillbirth, premature birth and neural defects  Where gluten is hiding Medications, personal care products and food items  Who should be tested for celiac disease Patients with mental health issues, developmental delays Anyone with an autoimmune disorder (e.g.: type 1 diabetes) Family members of celiac patients  Why one negative test doesn’t rule out celiac disease Can seroconvert at any time  How a gluten-free diet can benefit children with stunted growth Growth resumes if diagnosed before epiphyseal plates seal Resources: Celiac Disease and Non-Celiac Gluten Sensitivity for Nurses Recommended Labs Recognizing Celiac Disease: Signs, Symptoms, Associated Disorders & Complications by Cleo J. Libonati Gluten Free Works PubMed Cyrex Labs Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

As we ring in the New Year, many of us take the time to jot down our aspirations for the next twelve months. What are your hopes and dreams for 2018? Health and happiness? An opportunity to travel? Stronger relationships?  Whether you have big plans to hike the Grand Canyon this year, or you simply resolve to get a little more sleep, it’s likely that aspects of health and wellness are a big part of your vision for 2018. The Gluten Free RN wants you to be happy and healthy in the coming year, and today she is sharing her hopes and wishes around celiac disease for 2018.  Nadine offers insight on taking control of what you can, including the food you eat. She shares her wish for widespread access to high-quality food and nutritional information that is NOT influenced by corporations. She explains the need for universal healthcare, better comprehensive testing for celiac disease (performed annually), and appropriate follow-up care for patients with a celiac diagnosis. Listen in to understand why Nadine advocates for a global celiac education campaign and learn how to evaluate new information about the disease with a critical ear. Let’s get happy and healthy in 2018 so that we can pursue all of our hopes and dreams! What’s Discussed:  Nadine’s wish for health, happiness and wellness Reevaluate your choices and control what you can (sleep, food, activities)  Why Nadine advocates for universal healthcare Everyone deserves access to high-quality healthcare without financial strain  The need for better comprehensive testing Healthcare providers should be educated in ordering, interpreting labs  Nadine’s hope for worldwide knowledge of celiac disease Patients in US not diagnosed correctly for 70 years Consider mini-mass screening of patients/family  The importance of accurate media coverage Stories not influenced by sponsors, pharmaceuticals, etc.  Why friends and family should be tested every year Early diagnosis important Can be ruled in, not ruled out  The value of nutritional information not influenced by food companies Understand where food comes from, how processed  Nadine’s aspiration for universal access to high-quality food Organic, whole foods with minimal processing Provides fuel today, building blocks of healing  The need for appropriate follow-up care Labs to address nutritional deficiencies, associated issues  Nadine’s insight around celiac education Seek information, evaluate with critical ear   Resources: Rotten Documentary Trailer Whole30 Nadine’s Recommended Labs Columbia University Celiac Disease Center PALEOf(x) Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

In 11 years as the Gluten Free RN, Nadine has done an incredible amount of research on celiac disease and delivered more than 2,000 lectures. No question she is frustrated to see misinformation continue to make its way onto celiac support sites and Facebook groups. How does the average person sift through all the material that’s out there—material that may be influenced by corporations and pharmaceutical companies with a vested interest in the way celiac disease is perceived—to get to the most accurate information? Just in time for the holidays, the Gluten Free RN is sharing her wish list around the direction of celiac disease and non-celiac gluten sensitivity in the next ten years. She discusses the need for a global mass screening, explaining how celiac disease meets the World Health Organization’s criteria. She covers the reasons why pharmaceutical companies have no place in celiac research as well as the bad publicity the gluten-free community receives in the media. Nadine speaks to the grievous lack of education about celiac disease among healthcare providers and shares her hope for a cultural shift to support people on a gluten-free diet, explaining the role nurses can play in ending the needless suffering. She talks about why a gluten-free diet is NOT dangerous and how to make the best food choices based on your lifestyle and current situation. Listen in and get empowered to accept responsibility for your health! What’s Discussed:  The need for a global mass screening Celiac disease meets WHO criteria 30-50% of population carries gene Why pharmaceutical companies should not be involved in celiac research Diet change resolves symptoms Pharmaceutical involvement gives false hope for cure The misinformation about celiac disease in the media Misrepresentation in recent episode of Freakonomics Radio The need to educate healthcare providers around celiac disease Recommended in 2004 NIH Consensus Statement Never happened in standardized form Nadine’s call for support of people on a gluten-free diet Don’t assume intentionally being difficult The unique position of nurses to use their influence Prevent needless suffering with understanding of celiac disease Why you must accept responsibility for your own health Take advantage of available resources Find practitioners open to other modalities How to avoid processed foods Focus on raw, whole foods Choose fresh fruits, vegetables Don’t fall victim to convenience marketing Use community, intuition to make decisions Why a gluten-free diet is NOT dangerous Nadine restored her health by eliminating grains Unethical to suggest that celiac patient go off gluten-free diet Resources: Freakonomics Radio: The Demonization of Gluten 2004 NIH Consensus Statement on Celiac Disease Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

You know that vitamin C is good for you. It is necessary for the growth, development and repair of all your body tissues, and it plays a role in the healthy functioning of your immune system. But evidence shows that the RDA—90mg for men and 75mg for women—may be woefully inadequate. And if you are suffering from certain types of cancer or sepsis, vitamin C may be the key to recovery.  The Gluten Free RN is joined by vitamin C researcher Alex Michaels from the Linus Pauling Institute at Oregon State University to discuss the latest developments in vitamin C, explaining how intravenous vitamin C works to kill certain cancer cells and reverses the organ failure associated with sepsis. He also covers the difference between vitamin C inadequacy and vitamin C deficiency and the debilitating symptoms of scurvy.  Nadine and Alex speak to the best food sources of vitamin C and how it impacts other vitamins and minerals like iron and copper. Alex offers his advice around how much vitamin C you should get on a daily basis and explains why synthetic and natural vitamin C are identical. Learn about the LPI mission to determine the optimal ranges of micronutrients and phytochemicals you should be getting on a daily basis and how you can benefit from their research! What’s Discussed: Micronutrients vs. macronutrients Micronutrients are vitamins, essential minerals needed in small amounts (milligrams or micrograms/day) Macronutrients include fats, carbs and proteins (grams/day) Phytochemicals come from plants, affect health but not essential nutrients  The difference between intravenous and oral vitamin C Intravenous bypasses GI system, high concentration in bloodstream (up to 100 grams) Body can only absorb certain amount of oral vitamin C, inflammation may prevent absorption  Vitamin C’s resurgence as a cancer therapy High levels of intravenous vitamin C can covert oxygen to hydrogen peroxide Hydrogen peroxide floods and kills some cancer cells (e.g.: pancreatic tumors)  Vitamin C’s role in the treatment of sepsis Reverses organ failure, decreases inflammation May restore vitamin C to normal levels, protect from negative effects of iron  The availability of intravenous vitamin C Difficult to obtain, naturopaths usually have dedicated supplier More readily available in Australia, New Zealand  The fundamentals of scurvy Defined as deficiency in vitamin C Symptoms include bleeding gums, corkscrew hair growth, open wounds, malaise and low energy Very rare in western world, would have to go without any fruits or vegetables for months May have vitamin C inadequacy without any outward signs of problem  The best food sources of vitamin C Chili peppers Tropical fruits (papayas, Kakadu plum, camu camu)  Factors that are known to denigrate vitamin C Heat, light and air Mechanical disruption (i.e.: juicer) Basic pH (anything above 7) Enzymatic factors Iron, copper  How vitamin C impacts other vitamins and minerals Enhances iron absorption, some must be careful of iron overload Synthetic vitamin C may deplete copper concentration  Alex’s take on the appropriate daily intake of vitamin C 400 mg/day recommended RDA much too low Resources: Linus Pauling Institute Micronutrient Information Center LPI on Facebook LPI on Twitter LPI on LinkedIn LPI on Pinterest Biochemical, Physiological, and Molecular Aspects of Human Nutrition by Martha H. Stipanuk PhD and Marie A. Caudill Cancer and Vitamin C by Ewan Cameron and Linus Pauling Dr. Paul Marik on NPR Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

How do you successfully transition to and maintain a 100% gluten-free diet for the rest of your life? The prospect of eliminating wheat, barley and rye from your diet may seem daunting, but it is possible to go gluten free for good—for the good of your family and your health! The Gluten Free RN explains the addictive nature of gluten and what to expect during the detox process as you begin your gluten-free journey. She offers valuable advice around how to choose the best quality food products while avoiding potential sources of cross-contamination. Nadine discusses the need for supplements that will help you heal faster and more completely, speaking to the vitamin levels you should monitor along the way. Listen and learn her best tips for navigating the grocery store and maintaining a positive attitude throughout the process of going gluten-free—for GOOD! What’s Discussed:  The addictive nature of gluten Gliadin, gluten proteins bind to opioid receptors Wheat, barley and rye are cheap and readily available  What to expect during the detox process Different for everyone Consider elimination diet to reboot system May feel worse before feel better Headaches, low energy and feeling hungry are common  Why you shouldn’t cheat on a gluten-free diet Same autoimmune response, even if symptom-free  Potential sources of cross-contamination Processed foods Unwashed fresh fruits, vegetables Bulk bins Restaurants Own home (i.e.: cutting boards, hands, pets, utensils, appliances, etc.)  Nadine’s rules around choosing quality food products Five ingredients or less Picture every ingredient Certified gluten-free 100% grain-free  Why there is no such thing as cheap food Pay for quick-fixes to treat symptoms  The necessity of additional vitamins, supplements Helps heal faster, more completely Use multivitamin, fish oil, pre- and probiotics Check levels of D3, Zinc, B6 and B12 Liquid, chewables and capsules are easier to break down  Nadine’s advice around navigating the grocery store Plan menus in advance Bring list of safe foods Read labels carefully Consider local co-ops, natural grocers and farmers markets  Nadine’s best tips for going gluten-free Concentrate on what you can eat Accept more cooking, baking and meal planning Find support group Stay current on research, food labeling Practice mindfulness, maintain positive attitude  Resources:   Whole30 Country Life Vitamins Robb Wolf’s Paleo Food Matrix Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

‘When in doubt, go without.’ The problem with processed food is that you simply can’t be sure that it is gluten-free. The risk of cross-contamination is high, and no one at the big corporations is accountable for your health. Not to mention the fact that processed foods have been irradiated to make them shelf-stable, effectively killing any probiotics. Even certified gluten-free products are often low in nutrients, high in calories—and expensive! So what should you eat? The Gluten Free RN is on the case with her best suggestions around finding organic, whole foods that contain the healthy fat you need to heal. She explains her revised, gluten-free version of the food pyramid and discusses how these nutrient-dense foods support the healing process. Nadine provides a list of the best nutrient-dense foods, offering the benefits of each. She also speaks to the most appropriate vitamins and supplements available to solve your nutrient deficiencies. You are what you eat, so make sure you are filling your tank with nutrient-dense foods that will improve your health and quality of life! What’s Discussed:  How nutrient dense foods support healing Regenerate villi Reduce inflammation of intestines Heal immune system Why Nadine recommends staying away from gluten-free junk foods Low in nutrients, high in calories Risk of cross-contamination (processed in facilities with wheat products) The best sources of nutrient-dense foods Whole foods, organic Farmers market (few/no fertilizers) Why shelf-stable products lack nutrients Food dead from irradiation, no live probiotics The risk of contamination in processed foods No one accountable at big corporation ‘When in doubt, go without’ Nadine’s revised food pyramid Fruits and vegetables at base Meat, fish and eggs Nuts, seeds and berries The importance of eating healthy fats Heals intestines Absorb fat-soluble vitamins (A, D, E and K) Fix deficiencies Healthy brain cells, nervous system Balance hormones Nadine’s recommendations around the best nutrient-dense foods Sweet potatoes Leafy greens (e.g.: kale, collard greens) Berries Coconuts Black molasses Avocados Pumpkin, chia seeds Meat and fish High-quality eggs Licorice root, peppermint tea Cinnamon Nadine’s vegetable challenge Expand your vegetable repertoire Try one new veggie per week Nadine’s suggestions around additional vitamins, supplements Good quality multivitamin Fish oil (i.e.: Nordic Naturals) Pre/probiotics Vitamin D How to avoid cross-contamination Avoid bulk food bins Wash produce Resources: Midway Farms on Facebook Nordic Naturals Country Life Vitamins Bluebonnet Nutrition Pure Encapsulations National Nurses in Business Association Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

With the approach of the holidays, you may be nervous about navigating family and workplace gatherings—especially if you are newly diagnosed with celiac disease. How do you explain your dietary restrictions and keep yourself safe, eating well without getting ‘glutened’? Today the Gluten Free RN shares her best advice around managing the holidays with celiac disease. She offers ten key tenants to help you enjoy the holiday season and mitigate stress, without feeling like you’re missing out. She shares some things you need to avoid, including unsafe situations, people who make you miserable, and cheating on your gluten-free diet! But she also discusses strategies you can implement to make the season bright, such as creating new traditions, getting creative in the kitchen, and finding your tribe—the people who will support you in your gluten-free journey. Nadine also gives tips around where to go for gluten-free ingredients and holiday recipes, and how to develop a backup plan so you won’t go hungry if the food you encounter is questionable. You are likely to encounter well-intentioned friends and family members who have no idea how to feed you safely at holiday parties. Listen in and learn how to be clear about your dietary needs and take control of your health without isolating yourself from loved ones during this most wonderful time of the year! What’s Discussed:  #1 Don’t eat anything contaminated with wheat Cannot eat center of pie, any part of turkey with bread stuffing #2 Beware of good-intentioned people Don’t eat anything questionable Bring a snack with you just in case #3 Be prepared to establish new traditions Get creative in kitchen #4 Don’t isolate yourself Find support group, create your own #5 Gather recipes early Reference Paleo Magazine, gluten-free cookbooks Follow Sara Ballantyne #6 Order ingredients in advance Consider organic, free range turkey #7 Don’t invite people who make you miserable Set clear boundaries (no complaints, ridicule) #8 Eat before you go or take your own plate ‘Desperate people make desperate decisions’ Take a dish to share, take your portion first #9 Don’t be a victim Be clear about your needs #10 Find your people Those who truly love you don’t want you to be sick Resources: Nima Sensor EZ Gluten Test Strips Paleo Magazine Paleo Principles: The Science Behind the Paleo Template, Step-by-Step Guides, Meal Plans, and 200+ Healthy & Delicious Recipes for Real Life by Sarah Ballantyne Sarah Ballantyne on Instagram Glutenpro EnteroLab Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

If you’ve been following a strict gluten-free diet, but continue to suffer from lingering neurological symptoms, you may need to explore the possibility that you have Lyme disease. In fact, there are many parallels between celiac disease and Lyme, and the Gluten Free RN has called in an expert to discuss the similarities between the two disorders and why a gluten-free diet is part of the proper treatment for both. Dr. Usha Honeyman, a chiropractic and naturopathic physician out of Corvallis, Oregon, joins Nadine to explain the fundamentals of Lyme disease. She shares her best advice around prevention and treatment, exploring why it can be difficult to get an accurate diagnosis. Nadine and Usha also cover the inflammation of the gut that plagues both celiac and Lyme patients, the neurological component of Lyme disease, and the relationship between Lyme and illnesses like MS, Parkinson’s and ALS. Listen in to understand what can happen when Lyme goes untreated and how antibiotics coupled with a gluten-free diet may restore your health! What’s Discussed:  The fundamentals of Lyme disease Most common insect-borne disease in US Primarily carried by tics (disable immune system at bite site) CDC estimates 300K new cases each year How to prevent Lyme infection Repellants, Insect Shield clothing  How the political controversy in medicine has led to conflicting information around Lyme disease The treatment for Lyme disease Long-term antibiotics T3 to raise body temperature, make white blood cells more efficient Probiotics to support immune system Why Dr. Honeyman advises Lyme patients to go gluten-free Lyme causes inflammation of gut  The neurological component of Lyme disease Spirochetes permeate blood-brain barrier Cause brain fog, balance issues, sensory disorders, etc. The alpha-gal reaction in Lyme patients in the Southeast US The strange gait and lower-face movement in Lyme patients Bell’s palsy is red flag for Lyme disease The importance of having a Lyme-literate doctor Skin scraping of rash for diagnosis available in research setting ELISA and Western blot miss 80-90% of Lyme patients The consequences of untreated Lyme disease  The three forms of Borrelia Spirochete-form, intracellular and cystic Resources: Dr. Honeyman’s Website CDC Website Picaridin Natrapel Insect Shield Clothing Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar—Your Brain’s Silent Killers by David Perlmutter Under Our Skin Film International Lyme and Associated Diseases Society Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

The increasing number of gluten-free products on the market can be both a blessing and a curse. Yes, it gives us more options, but are those options truly safe and healthy? Today the Gluten Free RN goes over the important questions to ask about the products you consume, explaining how the foods promoted by some gluten-free groups may be influenced by their corporate sponsors. She reminds us why we can’t simply trust the products labeled ‘gluten-free’ or ‘gluten removed,’ discussing the lack of oversight and standardization around classification and the cumulative effect of consuming a number of products that are just under the 20 ppm cutoff. Nadine also shares a list of companies she trusts to consistently produce gluten-free products and offers suggestions around new food options we might explore. Listen in and learn to choose the nutrient-dense foods that will help your body heal! What’s Discussed: The importance of questioning the source of your information Gluten-free groups take money from sponsors (corporations, pharmaceutical companies)  Why Nadine avoids the ‘gluten removed’ label  The questions to ask about gluten-free products Is it manufactured in a designated facility? From where do they source the ingredients? Do they batch test those ingredients?  The cumulative effect of eating many products just under 20 ppm  Reliable companies that consistently produce truly gluten-free products  The challenges faced by newly diagnosed celiac patients Feeling different Loss of convenience  Why Nadine avoids gluten-free breads  New food options to explore as a celiac patient  Why Nadine recommends reevaluating the foods you consume Ensure they are nutrient dense, don’t cause inflammation  Why you can’t trust product labels Corporations given six months to update after ingredients change Not required to test products labeled gluten-free (no oversight, standardization)  Nadine’s rules around choosing products Five ingredients or less Must be able to picture ingredients Resources:   Canadian Celiac Association The Gluten Dude on Facebook Ground Breaker Brewing The Gluten Intolerance Group of North America Enjoy Life Foods Glutino Namaste Foods Pamela’s Products Jilz Crackers Lundberg Family Farms Mary’s Gone Crackers Casabi Crackers & Flatbread Jackson’s Honest Kettle Brand Nima Sensor EZ Gluten Test Strips Applegate Beeler’s Pure Pork Hempler’s Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

How do I get over feeling sad about giving up the foods I love? Don’t celiac patients look a certain way? Can I eat wheat when I travel to Europe? Today the Gluten Free RN is answering your frequently asked questions about celiac disease, clearing up misconceptions around the safety of wheat in Europe, the appearance of a celiac patient, and the percentage of the population that suffers from gluten sensitivity. She speaks to the challenges of getting your healthcare provider to do appropriate testing for celiac disease and the learning curve associated with changing your diet. Nadine also explains the risks of embarking on a gluten challenge and the benefits of a super-good high fat diet. She discusses why a single breadcrumb can trigger an autoimmune response and how she uses tools like a Nima Sensor when she eats out. Listen in and learn why one negative test doesn’t rule you out for celiac disease, especially if you suffer from type 1 diabetes. Having celiac disease doesn’t mean you have to live in a bubble. The Gluten Free RN wants to give you the answers you need to navigate the world—happy, healthy and gluten-free! What’s Discussed:  ‘My sister has celiac disease, but I tested negative. I do have type 1 diabetes… What should I do?’ Get genetic test for HLA-DQ2, HLA-DQ8 Virtually every type 1 diabetic is gene carrier One test doesn’t rule you out  ‘Why do you use a Nima Sensor or EZ Gluten test strips? Doesn’t it give you a false sense of security?’ Have to trust others to prepare food when out Not foolproof, but does give decent idea  ‘A single breadcrumb or dusting of flour can trigger an autoimmune response? Really?’  ‘I am overweight, I have dark hair, and I’m not of European descent. Don’t celiac patients look a certain way?’ Can’t see genes, celiac disease can affect any population worldwide Overweight patients tend to be malnourished (unable to absorb nutrients) Never rule out based on appearance, may not show physical symptoms ‘Why do you recommend a super-good high-fat diet?’ ‘I’m already on a gluten-free diet. Do I need to go back to gluten to prove I have celiac disease?’ ‘My cousin was just diagnosed with celiac disease, and she is very sad about giving up the food she grew up with. How can she get started on a gluten-free diet?’ Steep learning curve goes with process Okay to feel sad, angry Remember you will get better without surgery, medication Try to see as an adventure  ‘Why won’t my doctor order tests for celiac disease?’ Countries with for-profit healthcare tend to do poor job of testing, follow-up care Fragmented, inaccurate education around celiac disease Be own best advocate  ‘Can I eat wheat in Europe?’  ‘Is it true that celiac disease affects 1% of the population?’ 1% translates to 3M people 3% is more accurate statistic Won’t know for sure until conduct mass screening Resources: Gluten Free RN EP027: Type 1 Diabetes and Celiac Disease Nima Sensor EZ Gluten Test Strips Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism  

Never assume. It makes an ass of u and me! Not only do assumptions make you feel foolish, they can be dangerous. If you suffer from celiac disease or non-celiac gluten sensitivity, assuming that a product is safe and gluten-free can be hazardous to your health! Gluten is hiding is some surprising places, from cashews to PlayDoh, and it is in your best interest to remember that anything processed in the same facility with wheat is at risk for contamination. Today the Gluten Free RN shares the many places she has discovered gluten ‘hiding in plain sight,’ including personal care products, olive oil and communion wafers. She offers advice around supporting companies that are 100% gluten-free, alternatives to gluten-containing products, and choosing nutrient-dense foods that will help you heal. Nadine also covers labels, discussing why you can’t necessarily trust the information you find there, the many different names for wheat to look out for, and why you should take a look even when the product should be naturally gluten-free. She reveals some of her favorite gluten-free products as well as several companies that are committed to maintaining gluten-zero production facilities. Listen in and learn how to make good choices—without giving up the activities you love. Eating gluten-free doesn’t have to be a punishment, and the Gluten Free RN can’t wait to share! What’s Discussed:  Why Nadine sticks with clearly marked gluten-free products Some of the surprising places gluten hides Olive oil, kombucha, hard ciders, smoothies and other drinks Alcohol and malted beverages Lipsticks, lip balms and gloss Communion wafers Supplements and medications Play-Doh Why you can never assume a product is naturally gluten-free Anything processed in same facility with wheat is at-risk for contamination Why Nadine encourages the support of companies striving to be 100% gluten-free Don’t have to worry about safety Sends message to companies with unclear labels The many different names for wheat to watch out for on labels Alternatives to gluten-containing products like bread, crackers and chocolate Why you can’t trust labels Companies have six months to change a label after ingredients, info has changed Must read label every time buy product, refill prescription medication The cumulative effect of consuming products that contain just under 20 ppm of gluten Why Nadine urges you to be picky Don’t settle for cheap filler foods Only nutrient-dense foods will help you heal Resources: Desert Essence Savonnerie Schmidt’s Naturals Mary’s Gone Crackers Jilz Crackers eatingEVOLVED PASCHA Chocolate Enjoy Life Foods Ground Breaker Brewing Red Apple Lipstick Connect with Nadine: Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Imagine being admitted to a psychiatric hospital and accused of being a pathological liar because no matter how carefully you follow the high-carb diet prescribed by your physicians, you continue to lose weight. In the introduction to his book, How Doctors Think, Dr. Jerome Groopman shares the story of a woman who was misdiagnosed with anorexia nervosa. The patient was ready to give up when one last doctor discovered villous atrophy and determined that it was celiac disease—not an eating disorder—that was causing her malnourishment. Today the Gluten Free RN explores the reasons why celiac disease and gluten sensitivity are often mistaken for anorexia nervosa. She shares the limited research in the field, as well as the symptoms related to malnourishment that may be caused by gluten, including several mental health disorders. Listen in as Nadine covers the use of PWAG (people who avoid gluten) as a derogatory term and shares her frustration with labels like ‘orthorexia nervosa’ which imply that gluten-sensitive patients are obsessed with healthy food: ‘I avoid gluten like the plague because it is, in fact, the plague for those of us who have celiac disease.’     What’s Discussed:  The use of PWAG as a derogatory term ‘People who avoid gluten’ Half of people in US Implies food crazed/obsessed  The new term orthorexia nervosa Refers to obsessive behavior in pursuit of healthy diet Not clinical term/official diagnosis  The concept of food as medicine  Anecdotal evidence of celiac disease misdiagnosed as anorexia Introduction of Dr. Jerome Groopman’s book, How Doctors Think Woman admitted to psychiatric hospital (thought to be pathological liar) Continued to lose weight despite prescribed high-carb diet Biopsy revealed Marsh 4 damage Gluten-free diet resolved symptoms  Why celiac disease and gluten sensitivity are misdiagnosed as eating disorders Inability to absorb nutrients results in severe weight loss, malnutrition Become picky eaters because food causes suffering Practice food avoidance  The prevalence of celiac disease 3% of the US population Millions undiagnosed  How gluten affects a celiac patient Gluten protein as neurotoxin Damages intestines Impairs immune system Causes inflammation Heart attack Stroke Joint, muscle pain Any -itis  Nadine’s recommended variation of a Paleo diet Local, organic, whole foods 100% grass-fed beef (no antibiotics/hormones) Nutrient dense  The study of celiac disease and eating disorders Very few research studies in last 11 years Handful of case studies in literature  The issues associated with malnourishment Little body fat Cachectic Hormonal disruption Thyroid issues  The anger and contempt Nadine has experienced as the Gluten Free RN Gluten, dairy associated with comfort food People resistant to give up  The mental health issues associated with malnourishment Significant cognitive impairment Hypoxia Brain atrophy (shrinking)  The effect of gluten on epithelial tissue Leaky skin, lungs, blood vessels, blood-brain barrier Causes increased/decreased blood pressure, POTS  The consequences of gluten getting through the blood-brain barrier Causes hypoxia Brain needs oxygen to work appropriately Brain fog (irritability, anger) Early onset dementia  The shocking statistics around psychotropic medication in the US Up to 50% of population on anti-depressants, mood-altering drugs Gluten-free diet could help ‘get brain back’  Nadine’s advice for parents of children who miss multiple days of school Could be undiagnosed celiac disease No downside to clinical trial of gluten-, dairy-free diet Consider Whole30 Diet (eliminate sugar, grains, legumes)  The process of a gluten detox Gluten has narcotic-like effect on brain May feel worse before you feel better One day to two months  The benefits of maintaining a gluten-free diet Anxiety goes away Mood improves Able to sleep Pain resolves Heal intestines, epithelial tissue Reduce inflammation Heal immune system Brain receives necessary oxygen  The foods Nadine recommends as part of a super-good, high fat diet Avocados Olive oil Coconut oil Coconut milk Hemp milk  Why Nadine chooses not to eat if there is any risk of gluten contamination in her food  The places where gluten hides Single bread crumb Dusting of flour Oil French fries cooked in Personal care products Resources: How Doctors Think by Jerome Groopman, MD Dr. Groopman’s NPR Interview “The Interaction Between Eating Disorders and Celiac Disease: An Exploration of 10 Cases” in the European Journal of Gastroenterology & Hepatology “Orthorexia and Anorexia Nervosa: Two Distinct Phenomena? A Cross-Cultural Comparison of Orthorexic Behaviours in BMC Psychiatry “Predictors of Orthorexic Behaviours in Patients with Eating Disorders: A Preliminary Study” in BMC Psychiatry “Eating Disorders and Celiac Disease: A Case Report” in The International Journal of Eating Disorders Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

In his opening talk at the 2017 International Celiac Disease Symposium, celiac expert Dr. Abul Abbas of UC San Francisco said, “We are drowning in data, but thirsting for information.” Though there is still much debate around celiac disease and non-celiac gluten sensitivity (even among global experts), the featured ICDS speakers sifted through the numbers to help practitioners interpret what the latest studies can tell us about the negative effects of gluten and how celiac disease presents in populations all over the world.  Today the globetrotting Gluten Free RN is coming to us from Thailand, after attending the International Celiac Disease Symposium in New Delhi, India. Armed with the latest information from the ICDS clinical forum, Nadine covers talks given by Dr. Abbas on gluten and the immunological system, and Dr. Alessio Fasano on the spectrum of gluten-related disorders. She relays information regarding the barriers researchers face in studying autoimmune disease as well as gluten’s negative impact on body tissue, including that of our brain.  Nadine also shares the most up-to-date statistics around the big business that is celiac disease and the increasing prevalence of gluten intolerance in the US and Asia. She discusses the importance of celiac testing in patients with other autoimmune and neurological disorders and the need for a global education campaign. Listen as Nadine educates you about what gluten is, where it hides, what you can do to avoid it, and how to undo the damage and get healthy again! What’s Discussed: The challenge of eating gluten-free in India Conference food wasn’t entirely gluten-free Nima sensor helped identify unsafe meals Travel with stash of safe food Carry Gluten Free Passport Allergy Cards to communicate dietary needs The highlights of Dr. Abul Abbas’ talk on the immunological system Celiac disease as autoimmune issue ‘Drowning in data, but thirsting for info’ The importance of the thymus gland T cells manufactured there Why the ‘mouse model’ doesn’t work well in the study of celiac disease The impossibility of in vivo experiments for celiac research The significance of epithelial barriers in a functioning immune system First line of defense against microorganisms Produce local antibodies The difficulty of studying the dendritic cells Inside tissues How the immune system recognizes double-stranded RNA (viruses) Can’t escape autoimmune response Should not recognize own single-stranded as ‘invader’ Dr. Terry Wahls’ work around the mitochondria Cured MS with Paleo diet Dr. Alessio Fasano’s presentation ‘Spectrum of Gluten-Related Disorders’ Controversy re: who should go gluten-free Gluten affects every tissue in body (even brain) Celiac cases double every 15 years in US 1:2 in US will try gluten-free diet this year The big business of celiac disease $17.6B industry at end of 2017 Largest untapped market in world Who is affected by the gluten protein Gluten can’t be digested by human body (long chain amino acid) Triggers autoimmune response, especially in HLA-DQ2/HLA-DQ8 gene carriers Patients without genetic predisposition can present with villous atrophy In absence of celiac diagnosis, may still have non-celiac gluten sensitivity AGA-positive patients at risk for developing neurological issues How infants exposed to gluten are at an increased risk for developing celiac disease Includes exposure in utero, breast milk No downside to eliminating gluten from baby’s diet The value of avoiding gluten exposure for infants Emotionally stable Grow, develop appropriately The latest statistics regarding the prevalence of celiac disease Increased to 3% in US (not 1% consistently reported) 30-50% of world population has genetic predisposition Global prevalence of 1.37% Celiac disease in the Asian population Used to say could not develop celiac disease At increased risk of developing neurological disorders 6-8M people in east, south Asia 50 countries make up 60% of world population 35B people in China have celiac disease 22B people in India have celiac disease 19% of Chinese 16-25 tested positive for celiac disease in study How the Chinese diet has evolved over time Older Chinese ate much less wheat Fast food has become common in recent years Despite rice-based diet, many products contain wheat (soy sauce, cashews) Other disorders that may indicate undiagnosed celiac disease Anemia Osteoporosis Elevated liver enzymes Eating disorders Type 1 diabetes Autoimmune thyroiditis Why patients should be tested for celiac disease annually Can seroconvert at anytime Develops at any age with any/no symptoms The new information about a potential connection between Wilson’s and celiac disease 3% of Wilson’s patients tested positive What celiac experts agreed on at ICDS 2017 Poor support, understanding of celiac disease Need to increase knowledge base (general practitioners, food manufacturers, public) Important to find where gluten hides Must take education campaign to non-traditional settings Resources: Nima Sensor Gluten Free RN Travel Podcast EP036 Gluten Free Passport Allergy Cards Dr. Terry Wahls’ Website ICDS 2017 Program Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Perhaps the most intriguing thing about the history of celiac disease in the US is its absence—from medical textbooks, the vast majority of research studies, and the news—from 1952 through the 1990’s. Why did celiac disease disappear from the healthcare consciousness as well as the public eye? Today the Gluten Free RN takes a closer look at the story of celiac disease, starting with the first doctor to understand it as a dietary issue back in 1888. She highlights the important progress made by pediatricians Willem Dicke who is credited with identifying gluten as the issue and Sidney Haas who honed the gluten-free diet to exclude specific carbohydrates. Nadine explores the period of time when celiac disease seemingly ‘went dark’ in the United States, discussing the handful of renegade authors and researchers who continued to study the disease despite its absence from health education. Nadine also explains the resurgence of gluten sensitivity to the public consciousness in the 1990’s, when medical professionals from abroad questioned the claim that there was no celiac disease in the US. She covers our evolving understanding of the symptoms of celiac disease and the woefully inadequate training around gluten in medical and nursing schools. Listen in to find out why the mass screening proposed by the National Institute of Health never materialized and how the for-profit healthcare system impacts celiac patients. Let’s honor the practitioners who dedicated their careers to understanding celiac disease and write our own history through celiac advocacy! What’s Discussed:  The first doctor to identify celiac disease Samuel Gee, 1888 Established dietary approach to treatment The role of Dr. Sidney V. Haas in advancing celiac treatment All carbs and fats had been eliminated from celiac diet Haas discovered that kind of carbs made difference Experimented with fats, learned that could be absorbed 370 celiac cases studied at Bellevue, only 2.2% not cured The conclusions of a New York Times article from May of 1950 Late 1800’s, celiac disease ‘incurable and often fatal’ By 1950, 90% cured and deaths rare Cause still unknown The grains that contain gluten Wheat Barley Rye Oats (cross-contamination) How Dr. Willem Dicke developed the gluten-free diet Dutch pediatrician during WWII No access to grains during famine, previously sick children improved Mothers realized that when grains returned to diet, sickness returned Dicke credited with determining that gluten causes damage The myth that celiac is a childhood disease Patients do not ‘grow out of it’ When gluten is reintroduced, disease returns (along with other disorders) Elaine Gottschall’s work in developing the Specific Carbohydrate Diet Grains containing proteins other than gluten have negative effect on digestive tract Gottschall’s model removes all grains Paleo/whole food diet considered ideal The elimination of celiac disease from medical training Stopped teaching in 1952 Debate over carbs vs. proteins Same paragraph appears in medical textbooks from 1952-2008 Still taught incorrectly (if at all) in medical, nursing schools Should be part of every differential diagnosis The Paleo diet Nadine suggests for celiac and gluten-sensitive patients Gluten-, dairy-free Whole food Low carb, super-good high fat Appropriate supplements to remedy deficiencies Hilda Cherry Hill’s 1976 book Good Food, Gluten Free Hill cured invalid husband with gluten-free diet Whole food, no grain derivatives The classical symptoms of celiac disease Fatty stool Malabsorption Short stature Low energy Infirm The expanded picture of how celiac disease may present Osteoporosis Short stature Delayed puberty Iron deficiency anemia Hepatitis Recurrent canker sores Elevated liver enzymes Dental enamel defects Peripheral neuropathy Celiac cerebellar ataxia Seizure disorders Migraine headaches The genes that indicate a predisposition to celiac disease HLA-DQ2 HLA-DQ8 Occur in 30-50% of the population How recognition of celiac disease resurfaced in the 1990’s Gastroenterologists from abroad asking questions The 2004 NIH Consensus Statement on Celiac Disease Determined that celiac disease grossly underdiagnosed in US Proposed mass screening, healthcare education program Mass screening never materialized (‘too cost-prohibitive’) How the US for-profit healthcare system impacts celiac patients System profits from incorrect diagnoses Celiac tends to be last thing we test for Patients often spend hundreds of thousands of dollars out-of-pocket Nadine’s advice for celiac patients around choosing healthcare providers Many still don’t know how to manage celiac disease Look for practitioner of functional/integrated medicine What has changed since the NIH Consensus Statement in 2004 Little real change More media attention, some doctors testing Medical professionals still not educated in testing, follow-up Little support, assistance for patients in adopting gluten-free diet Dr. Rodney Ford’s role in celiac advocacy Pediatrician, gastroenterologist and allergist Promotes ‘gluten zero world’ Gut-brain-skin connection Nadine’s guidance for vegetarians and vegans Work with nutritionist to be sure not malnourished Consider changing diet for optimal health The vulnerable populations particularly at risk for celiac disease and non-celiac gluten sensitivity Children Williams, Turner or Down syndrome Developmentally delayed, cystic fibrosis communities Autoimmune patients Resources: “Celiac Disease: Most Children are Now Cured but Cause is Still Unknown”  in The New York Times Management of Celiac Disease by Sidney Valentine Haas and Merrill Patterson Haas “Whatever Happened to the Cure for Coeliac Disease?  in Nutritional Therapy Today “The Erie Country Survey of Long-Term Childhood Illness” in the American Journal of Public Health Good Food, Gluten Free by Hilda Cherry Hills Dr. Alessio Fasano’s 2003 Celiac Study 2004 NIH Consensus Statement on Celiac Disease Books by Dr. Rodney Ford Gluten: ZERO Global by Dr. Rodney Ford International Celiac Disease Symposium “Small Intestinal Mucosal Abnormalities in Relatives of Patients with Dermatitis Herpetiformis” in Gut “Adult Coeliac Disease and Other Disorders Associated with Steatorrhoea” in the British Medical Journal The University of Chicago: Celiac Disease Facts and Figures “A History of Coeliac Disease” in Digestive Diseases “Dermatitis Herpetiformis in Two Patients with Idiopathic Steatorrhoea” in the British Medical Journal Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

According to the University of Chicago Celiac Disease Center, 10% of MS patients also suffer from celiac disease. Studies conducted in Italy and Spain uncovered a significant increased prevalence of celiac disease in first-degree relatives of MS patients, 18% and 32% respectively. Additional research has identified situations in which celiac disease mimicked other neurological disorders such as MS and ALS.  With evidence like that, it is definitely worth it to further explore the relationship between MS and celiac disease. Today, the Gluten Free RN investigates whether MS and celiac disease are similar, related, or perhaps the same thing, as she shares case studies from the literature and her own experience. Nadine discusses the story of Dr. Terry Wahls, explaining how she was able to resolve her symptoms of MS with a variation of a Paleo diet. She outlines the analogous symptoms of MS and celiac cerebellar ataxia, the neurological damage caused by gluten, and how malabsorption of nutrients caused by intestinal damage can extend to medication. Listen and learn how Nadine and others have resolved symptoms of MS and other neurological disorders on a gluten-free diet! What’s Discussed:  Nadine’s MS scare Bouts with falling, dragging feet Numbness, tingling (neuropathy) Symptoms disappeared after adopting gluten-free diet Takes two to three years to resolve neurological symptoms Dr. Terry Wahls’ story Diagnosed with MS, confined to wheelchair Continued to research condition Adopted version of Paleo diet Now walks without cane, rides bike again Conducts seminars to share how healed mitochondria The commonalities between celiac disease and MS Both autoimmune issues Studies necessary to determine if conditions are similar, related, or the same How celiac disease affects the body Triggered by ingestion of gluten Causes villous atrophy, cryptic hyperplasia in small intestines, damage to immune system Primarily neurological disorder The symptoms of celiac cerebellar ataxia Poor balance Hard to distinguish where body is in space Trip, stumble or fall Related to vision The multi-organ manifestations of celiac disease in the central nervous system White matter lesions Inflammatory cerebral spinal fluid syndrome Sinus venous thrombosis Epilepsy, seizure disorders Cerebellar pontine atrophy Encephalopathy Myelopathy Dementia Gluten ataxia Migraines, headaches Depression, anxiety Cerebellar ataxia Nadine’s patient who wasn’t responding to MS medication Nadine recommended celiac testing Panel negative, but gene carrier Already adopted gluten-free diet Fewer medications necessary Hope to decrease, discontinue meds Malabsorption issues extend to medications, could stem from undiagnosed celiac disease The 2014 study in Vienna regarding celiac disease and MS Concluded that celiac disease may mimic MS Celiac disease may be present despite absence of anti-gliadin antibodies If patient history indicates gastrointestinal issues, celiac disease should be considered even if CSF and MRI findings suggest MS The new evidence around seronegativity in celiac disease Most labs only test for tissue transglutaminase 2 Transglutaminase 6 is specific for neurological damage caused by gluten The 2014 Italian study of the genetic overlap between celiac disease and MS Sites significant increased prevalence of celiac disease in MS first-degree relatives (18%) Recommends celiac testing in MS patients who aren’t responding to MS treatment or present with ataxia The association between MS and celiac disease as reported by the University of Chicago Celiac Disease Center Approximately 10% of those who have MS also have celiac disease The genes that indicate a predisposition to celiac disease HLA-DQ2 HLA-DQ8 The 2013 Iranian case study of a celiac patient diagnosed with MS 37-year-old woman with history of chronic abdominal pain Diagnosed with celiac disease, adopted gluten-free diet Became ataxic, met with neurologist MRI indicated multiple sclerosis Nadine argues that patient likely re-exposed to gluten How gluten acts as a neurotoxin Pastor exposed to gluten in cookies had acute neurological event Shaking, tremors (similar to stroke) The 2007 Oxford case study of celiac disease mimicking ALS 44-year-old man with progressive right-sided spastic hemiparesis (muscle wasting) Remote family history of celiac disease Strict gluten-free diet resolved most symptoms Why patients with neurological symptoms should be tested for celiac disease The anti-gliadin antibody is excellent biomarker for gluten sensitivity Why it is acceptable to adopt a gluten-free diet if your antibody test is negative for celiac disease The Paleo diet Nadine suggests for celiac and gluten-sensitive patients Gluten-, dairy-free Whole food Low carb, super-good high fat The increased prevalence of celiac disease in MS patients revealed in a 2011 study Increased prevalence found in eight of 72 MS patients (11.1%) Also in first-degree relatives (13/126 or 32%) Advises increased efforts aimed at early detection and dietary treatment The fundamentals of MS Chronic disease of unknown etiology T-cell mediated antibody response Leads to demyelination of central nervous system Associated with autoimmunity (body attacking itself) Damage to enteric nervous system can lead to constipation How to conduct your own research around celiac disease and neurological disorders Celiac researcher Dr. Marios Hadjivassiliou How long it takes to heal on a gluten-free diet Villous atrophy heals in six months to one year Neurological damage takes two to four years The nutrients a celiac patient is missing that contribute to neurological issues B vitamins Trace amounts of copper Magnesium Zinc The autoimmune symptoms Nadine resolved/reversed with a gluten-free diet MS symptoms Graves’ disease Positive ANA panel Why it’s important for celiac patients to work with educated practitioners who understand functional medicine Resources: Dr. Terry Wahls’ TED Talk The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principle by Terry Wahls MD “Celiac Disease with Cerebral and Peripheral Nerve Involvement Mimicking Multiple Sclerosis” in the Journal of Medicine and Life “Celiac Disease in Multiple Sclerosis: A Controversial Issue” in the International Journal of Neurology and Neurotherapy University of Chicago Celiac Disease Center MS Info “Multiple Sclerosis or Neurological Manifestations of Celiac Disease” in Advanced Biomedical Research “A Case of Celiac Disease Mimicking Amyotrophic Lateral Sclerosis” in Nature Clinical Practice Neurology “Prevalence of Celiac Disease in Multiple Sclerosis” in BMC Neurology “A Case of Concurrent Multiple Sclerosis and Celiac Disease” in Govaresh “Neurological Disorders in Adult Celiac Disease” in the Canadian Journal of Gastroenterology “A Case of Multiple Sclerosis and Celiac Disease” in Case Reports in Neurological Medicine  Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Did you know that it is possible to diagnose celiac disease with a smile? Damage from gluten starts in the mouth, and today the Gluten Free RN explores the important role dentists can play in identifying undiagnosed celiac disease. She outlines the symptoms of celiac disease that present in the mouth, the follow-up questions dentists should ask when they notice dental enamel defects or aphthous ulcers, and the nature of the tongue as an indicator of overall health. This episode covers how the plastics in orthodontic retainers might contain gluten and what to do if you are accidentally exposed. Nadine also explains the relationship between fat-soluble vitamins and celiac disease, as well as the nutrient deficiencies a potential celiac patient should test for. You’re never fully dressed without a smile, so listen in to understand how to keep your mouth healthy—and prevent the accumulation of complications from celiac disease with a whole food, gluten-free diet! What’s Discussed:  How the GI tract functions Starts at mouth, ends at rectum Allows us to consume food, liquid Only extract what body needs Expel the rest How damage from gluten presents Malabsorption of nutrients Inflammation Autoimmune issues Type 1 diabetes ALS Lupus MS Sjögren’s Leaky gut How dentists can play an important role in identifying undiagnosed celiac disease The symptoms of celiac disease that present in the mouth Dental enamel defects Aphthous ulcers (canker sores) Cheilosis (cracks, open sores where upper and lower lip join) Dry, cracked lips TMJ—temporal mandibular joint disorder Pain where jaws meet Inflammation of the jaw Clicking Lock jaw Mouth pain, burning Oral lesions Tongue pain, tingling Redness, swelling of the tongue Tongue sores Changes in taste, smell Diminished sensory input Dry mouth Sore throat Difficulty swallowing Increased thirst Bleeding gums Delayed eruption of teeth Pyrosis Oral lichen planus Glossitis (inflammation of tongue) Clearing throat Sinus infections Redness, swelling of the uvula How Nadine treats gluten exposure Activated charcoal Drink water The grains to look for in personal care products (e.g.: lip balm) Wheat Barley Rye Oats The relationship between fat soluble vitamins and celiac disease Gluten causes malabsorption Vitamins A, D, E and K are fat soluble Under 40 in vitamin D may indicate deficiency in all How we tested for celiac disease in children in the early 20th century Fecal fat score Pale stool that floats suggests malabsorption of A, D, E and K Why parents should be tested for celiac disease prior to pregnancy The fetal development issues that may present if an expectant mother is unable to absorb nutrients Dental enamel defects Smaller jaw formation Smaller airway passages Why Nadine advocates for a mass screening How gluten in plastics, personal care products can prevent celiac patients from healing The questions dentists should ask when they notice dental enamel defects, aphthous ulcers Other clinical celiac symptoms (abdominal pain, diarrhea, weight loss, anemia, fatigue) Associated disorders (type 1 diabetes, thyroiditis, etc.) Family history of celiac disease Why we need to get much better at recognizing celiac signs and symptoms Even in Canada, diagnosis takes 11.7 years Why Eastern medicine examines the tongue as an indicator of overall health The genes that indicate a predisposition to celiac disease HLA-DQ2 HLA-DQ8 Why it is acceptable to adopt a gluten-free diet if your antibody test is negative for celiac disease The deficiencies a potential celiac patient should test for Calcium Magnesium RBC Vitamin D Zinc Folic acid Why thrush may be an indicator of celiac disease or gluten sensitivity Why one negative test for celiac disease doesn’t rule anyone out The importance of early diagnosis Symptoms accumulate over the years The Paleo diet Nadine suggests for celiac and gluten-sensitive patients Whole food Focus on local, fresh 100% grass-fed meat (no antibiotic, no hormone) Fish and eggs Nuts and seeds 100% organic fruits and vegetables Resources:  “An Orthodontic Retainer Preventing Remission in Celiac Disease”  in Clinical Pediatrics “Oral Manifestations of Celiac Disease: A Clinical Guide for Dentists” in the Journal of the Canadian Dental Association Gluten Free RN Podcast EP027: Type 1 Diabetes and Celiac Disease “The Association Between Celiac Disease, Dental Enamel Defects, and Aphthous Ulcers in a United States Cohort” in the Journal of Clinical Gastroenterology “Small-Bowel Changes in Recurrent Ulceration of the Mouth” in Hepatogastroenterology “Oral Signs and HLA-DQB1*02 Haploytypes in the Celiac Paediatric Patient: A Preliminary Study” in Autoimmune Diseases “The Oral Manifestations of Celiac Disease: Information for the Pediatric Dentist” in Pediatric Dentistry “Oral Aphthous Ulcers and Dental Enamel Defects in Children with Coeliac Disease” in Acta Paediatrica “Oral and Dental Manifestations of Celiac Disease” in the New York State Dental Journal “Jejunal Mucosal Abnormalities in Patients with Recurrent Aphthous Ulceration” in The British Medical Journal “Dental Enamel Defects in Adult Coeliac Disease” in the European Journal of Internal Medicine “Screening for Celiac Disease in Children with Dental Enamel Defects”  in ISRN Pediatrics “Celiac Disease Associated with Recurrent Aphthae” in Gut “Importance of Oral Signs in the Diagnosis of Atypical Forms of Celiac Disease” in Recenti Progressi in Medicina Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

People are suffering. From a feeling of hopelessness. From depression and anxiety. Add to that a despair that no one supports them, and you have a desperate individual at an increased risk of committing suicide. This topic hits close to home for Nadine, as she lost a nephew to suicide in 2007. Ian struggled with addiction issues, and he took his life at the age of 19. Because her family is predisposed to celiac disease, Nadine wonders if undiagnosed celiac disease may have been partially to blame for her nephew’s issues. Today she explores the mental health disorders that are associated with gluten getting through the blood-brain barrier. She also explains how undiagnosed celiac disease puts patients at an increased risk for morbidity, and stresses the fact that celiac disease can—and will—kill you if it goes untreated. Listen in as the Gluten Free RN tells her own story of improved mental health on a gluten-free diet. She also covers the types of cancers that might be prevented by going gluten-free, the connection between AFib and celiac disease, and how dermatitis herpetiformis affects patients. Listen and learn the best diet to help you get better, faster, and why medical professionals need to pay more attention to the intestines! What’s Discussed:  How to define morbidity and mortality Morbidity = sickness Mortality = death People with undiagnosed celiac disease have increased risk for morbidity How morbidity presents itself in undiagnosed celiac patients Chronic anemia Fatigue Osteoporosis Failure to thrive, grow Infertility Thyroid issues Autoimmune disorders Type 1 diabetes Lupus MS Sjögren’s Information from the World Health Organization (WHO) Diarrheal diseases are #1 killer of children Only funded one celiac study 1:19 rate in pediatric patients of Sahrawi descent The prominent mental health issues associated with celiac disease Depression Anxiety Anti-social behavior Suicide How removing gluten from her diet improved Nadine’s mental health Brain fog went away ‘Got brain back’ Embrace all life has to offer Freeing to know cause of symptoms The grains that contain gluten Wheat Barley Rye Oats (cross-contamination) The Paleo diet Nadine suggests for celiac and gluten-sensitive patients Whole food Focus on local, fresh 100% grass-fed meat (no antibiotic, no hormone) Fish and eggs Nuts and seeds 100% organic fruits and vegetables Nadine’s experience with celiac disease Multi-system organ failure, seven auto-immune disorders Dermatitis herpetiformis Diagnosed by dermatologist Tests negative, but HLA-DQ2.5 gene carrier (both parents) The connection between AFib and celiac disease AFib puts patient at risk for stroke, sudden death Check for magnesium RBC deficiency Can be corrected with gluten-free diet Resolve without pharmaceuticals How dermatitis herpetiformis affects patients Extremely painful, itchy skin Manifestation of celiac disease Suicide rate higher in patients with DH Dapsone alone will not heal Must also go gluten-free Prolonged use of Dapsone is toxic to liver (bowel cancer, lymphoma) The cancers that are potentially preventable on a gluten-free diet Lymphoma Small intestinal adenocarcinoma Esophageal cancer Oral pharyngeal The genes that indicate a predisposition to celiac disease HLA-DQ2 HLA-DQ8 Other disorders that could be mitigated by a gluten-free diet Chronic anemia Osteoporosis Osteomalacia Thyroid disorder Dementia Alzheimer’s MS Type 1 diabetes How long it takes to receive celiac diagnosis in US 9-15 years The risks for patients diagnosed with celiac disease in childhood Threefold increased risk of death (suicide, accidental death, violence) Nadine’s research around celiac testing in autopsy Couldn’t get straight answer from medical examiner (state of Oregon) Study conducted in 1974 concluded that despite systematically positive response to gluten-free diet, some patients ended up with lymphoma How Nadine periodically gives her system a detox Limited fast (three to seven days) Give organs, immune system a rest Why medical professionals should give more attention to the intestines Vast majority of signs, symptoms originate in intestines 70-90% of immune system in intestines Homocysteine levels higher in newly diagnosed celiac patients, related to other health issues The issues that can result from undiagnosed celiac disease Heart attack Stroke Appendix removed Gall bladder removed The definition of refractory celiac disease Intestines don’t heal even on gluten-free diet Sometimes caused by continued exposure to trace amounts of gluten Some patients past point of being able to heal Why it’s crucial to remove all gluten from the environment Celiac patients should feel safe where live, work and go to school Even trace amounts cause continued symptoms, early death Takes an emotional toll to be hypervigilant, mocked by loved ones The connection between undiagnosed celiac disease the despair that leads to suicide No hope of getting better Don’t feel supported, believed (celiac is real disease) Depression, anxiety and other mental health disorders More vulnerable if undiagnosed and enduring abusive relationship What happens when gluten gets through a leaky blood-brain barrier Inflammation of the brain Hypoxia (decreased oxygen flow) Low end—brain fog, anxiety, depression, fatigue High end—bipolar disease, antisocial behavior, learning disabilities, schizophrenia The risks associated with eating traditionally grown fruits and vegetables Glyphosate in Roundup causes leaky gut The goals of the first six months on a gluten-free diet Remove all gluten Allow villi to grow back Heal inflammation Repair immune system Resources:   Celiac Disease and Gluten Sensitivity in Down, Turner and Williams Syndrome WHO Celiac Disease Study “Necropsy Studies on Adult Coeliac Disease” in the Journal of Clinical Pathology “Mortality in Celiac Disease” in Gastroenterology “The Global Burden of Celiac Disease” in PLoSONE “The Unknown Burden and Cost of Celiac Disease in the US”  in Expert Review of Pharmacoeconomics and Outcomes Research “Long-Term Mortality in People with Celiac Disease Diagnosed in Childhood Compared with Adulthood” in the American Journal of Gastroenterology “Increased Risk of Atrial Fibrillation in Patients with Coeliac Disease: A Nationwide Cohort Study” in the European Heart Journal “Increased Suicide Risk in Coeliac Disease—A Swedish Nationwide Cohort Study” in Digestive and Liver Disease “The Burden of Celiac Disease and the Value of Having It Diagnosed” by Fredrik Norström of UMEA University “Complications of Coeliac Disease: Are All Patients at Risk?” “Evidence-Informed Expert Recommendations for the Management of Celiac Disease in Children” in Pediatrics Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Nadine spent 17 years working as a nurse in the ER. She holds a membership in the Emergency Nurses Association, as well as a Certified Emergency Nurse certification. During the course of her career, Nadine obtained ACLS, PALS, NALS, ENPC and TNCC certifications, honing her skills in advanced cardiac life support, neonatal advanced life support, pediatric advanced life support, and trauma. Despite this impressive background and experience, she had never been educated about celiac disease, and didn’t know what to look for until she was diagnosed herself. Nurses are in a unique position to recognize potential celiac patients and act appropriately. Though most nurses don’t have the authority to diagnose, they do have an obligation to act as patient advocates. Because celiac disease is the most underdiagnosed and misdiagnosed autoimmune disease in the world, it is important that nurses get educated about the fundamentals of celiac disease, the wide array of symptoms an undiagnosed patient may present, and how to keep celiac patients safe in and out of the hospital. Today on the podcast, the Gluten Free RN addresses nurses, explaining how celiac disease damages the GI tract, the consequences of a ravaged immune system, and the neurological nature of the disease. She also reviews the genes that indicate a predisposition to celiac disease, the best available tests for gluten sensitivity, and the need for a worldwide mass screening. This is a must-listen for medical professionals, offering an overview of the most current celiac studies and an explanation of how to approach doing research on your own. Celiac disease is on the rise and it doesn’t discriminate, so it is crucial that the nursing community get educated – STAT. What’s Discussed:  Why nurses need to employ a high index of suspicion regarding celiac disease Most undiagnosed and misdiagnosed autoimmune disease in world  The lack of training around celiac disease in the medical community Nadine was nurse for 17 years Didn’t know symptoms of celiac disease Diagnosed ‘by accident’  The celiac symptoms Nadine thought to be ‘normal’ Canker sores Intermittent constipation, diarrhea Eczema on hands Difficult time gaining weight Whole family had gas  What nurses need to know about celiac disease What it is, what it entails Symptoms may present with How to keep patients safe (in and out of hospital) How to request testing How to interpret lab results  How long it takes to receive celiac diagnosis in US 9-15 years  The restrictions of being a nurse Can’t diagnose (can recognize, treat appropriately) Can’t perform surgery Can’t prescribe meds, take patient off medication  Nadine’s experience leading up to her celiac diagnosis  Nadine’s celiac diagnosis Dermatologist diagnosed Blood test, skin biopsy negative HLA-DQ2.5 gene carrier (super-celiac category)  Why a negative blood test, skin biopsy doesn’t rule out celiac disease  Nadine’s current health  Why Nadine stopped working as an ER nurse Celiac diagnosis was life-changing Started own businesses RN On Call, Inc The Gluten Free RN Celiac Nurse Consulting  The increased prevalence of mortality in undiagnosed celiac patients Undiagnosed celiac disease associated with 4-fold increased risk of death (45 years of follow-up) Prevalence of undiagnosed celiac disease has increased dramatically in US over last 50 years  The grains that contain gluten Wheat Barley Rye Oats (cross-contamination)  The products that may contain gluten Medication Food Personal care products  The search terms to use when doing celiac research Gluten-related disorders Both spellings (celiac, coeliac)  Why celiac disease is primarily a neurological disorder Involves enteric nervous system (in intestines) Vagus nerve (superhighway of information from intestines to brain)  Why celiac disease is not an allergy Allergy is IgE-mediated antibody response Celiac tends to be IgA, IgG-mediated antibody responses  The genes that indicate a predisposition to celiac disease HLA-DQ2 HLA-DQ8  Why Nadine advocates for a world-wide mass celiac screening  The relationship between celiac disease and infertility People with infertility issues, difficulty maintaining pregnancy should be tested  The chronic nature of celiac disease Never goes away Gluten is neurotoxin Must be 100% gluten-free for life  How gluten exposure presents for Nadine Blisters in mouth within 10 minutes  How gluten can cause damage along entire length of GI tract 28 to 32 feet in length Person-to-person variability  How damage to GI tract presents Canker sores Difficulty swallowing, dysphasia GERD Eosinophilic esophagitis Gas, bloating Diarrhea constipation Crohn’s disease Atypical diseases Idiopathic diseases Ulcerative colitis Diverticulitis Diverticulosis Rectal cancer Bowel cancer Hemorrhoids  How constipation can be a neurological issue Gluten as neurotoxin can paralyze nervous system, intestines Stool cannot get pushed through Can result in colon cancer, megacolon  Disorders that may be caused by undiagnosed celiac disease Diabetes Heart problems Sudden cardiac deaths Strokes Bowel, rectal cancer (recent increase in young people)  Why a biopsy is no longer considered the gold standard of celiac testing Positive anti-tissue transglutaminase and positive EMA indicates damage to intestines Endoscopist should take six to 15 samples in duodenum, jejunum (damage can be patchy)  The stages of intestinal damage caused by celiac disease Marsh 1 – microvilli destroyed Marsh 2, 3 – villi themselves fall over, blunt or atrophy Marsh 4 – looks like hot, inflamed sponge and immune system compromised  The consequences of a damaged immune system Hypo-responsive (doesn’t respond) Hyper-responsive (reacts to everything)  The importance of including a total IgA and IgG in the celiac antibody panel Ensure patient is not IgA deficient  How the US has gone backwards in the last 70 years Times article from 1950 declares ‘cures certain in 90% of cases’ and ‘deaths rare’ Celiac disease has gone unrecognized since then  The testing for celiac disease Celiac antibody test (baseline) Small intestinal biopsy Nutritional panel (D3, B6, B12, magnesium RBC, zinc, ferritin) Follow-up to track healing, ability to absorb nutrients  The difficulty with the celiac antibody test 70% false negative  The best available celiac testing EnteroLab Gluten Sensitivity Stool Test Cyrex Laboratories Array 3  Factors that might interfere with accurate celiac testing IgA deficiency Benicar (blood pressure med) known to cause villous atrophy in absence of celiac disease Lab-to-lab variability Only tests for anti-tissue transglutaminase 2  How to carry out a clinical trial for celiac disease or gluten sensitivity Adopt gluten-, dairy-free diet for at least three months It takes six months to a year for intestines to heal Recommended for patients with genetic predisposition, regardless of negative blood test  The Paleo diet Nadine suggests for celiac and gluten-sensitive patients Whole food Meat, fish and eggs Nuts and seeds Fruits and vegetables  The findings of a celiac study published in the Journal of Insurance Medicine Atypical, non-diarrheal presentations now most frequent Celiac disease is grossly underdiagnosed in US Average delay in diagnosis for adult patients ranges from four to 11 years Diagnosis and treatment with gluten-free diet leads to improved quality of life Medical costs in celiac cohort were 31% lower over three-year period  Why celiac disease should be on every primary care physician’s differential diagnosis  The rise of celiac disease 1:501 in 1974 1:219 in 1989 1:100 is current estimate Doubles every 15 years (according to Mayo Clinic)  Why Celiac disease is a worldwide issue Affects every ethnicity Frequency of tTGA in Mexico City study was 1:37 Increasing diagnoses in North Africa, Middle East and Northern India  How celiac disease can lead to obesity Patient cannot absorb nutrients (malnourished) Body responds by storing fat for cheap energy  How the risk of cancer increases exponentially in undiagnosed celiac patients  Why nurses must be patient advocates  Nadine’s advice around research and celiac disease for nurses Not taught in nursing programs Do your own research to keep up with current info Resources: Snarky Nurses  on Instagram National Nurses in Business Association “Increased Prevalence and Mortality in Undiagnosed Celiac Disease” in Gastroenterology PubMed Cyrex Laboratories EnteroLab New York Times Article, May 1950 “Economic Benefits of Increased Diagnosis of Celiac Disease in a National Managed Care Population in the United States” in the Journal of Insurance Medicine “Celiac Disease Could be a Frequent Disease in Mexico: Prevalence of Tissue Transglutaminase Antibody in Healthy Blood Donors” in the Journal of Clinical Gastroenterology “Celiac Disease in African-Americans” in Digestive Diseases and Sciences “Coeliac Disease” in The Lancet Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Wanderlust. It is human nature to want to explore, to experience a geography and culture different from our own. Travel can truly enrich our lives. Yet if you have celiac disease or non-celiac gluten sensitivity, the prospect of being away from the familiar for an extended period can be intimidating. Will I be able to find a grocery store? How do I locate a gluten-free restaurant that I can trust? What do I need to bring with me to ensure that I am avoiding gluten? And what if, despite my best efforts, I am accidentally exposed to the gluten protein? No one wants their trip ruined by an unexpected illness, but you shouldn’t let the fear of gluten exposure keep you from going on an important business trip or taking that vacation you’ve always dreamed of. The Gluten Free RN has ten years of experience helping people discover that they can travel safely on a gluten-free or Paleo diet, and today she shares her recent travel experiences with you. Road trip with Nadine and learn how she locates safe restaurants, what she takes along to avoid inadvertent gluten exposure, and which apps and online resources offer the best advice for gluten-free travel! What’s Discussed:  The danger of living in a bubble Leads to isolation No way to live  Nadine’s mission to teach people how to travel safely on gluten-free/Paleo diet Follow her travels on social Posts include pics of locations, food Various travel tips  How Nadine packed her cooler for a summer road trip to Boston Applegate deli meat Kite Hill cheese Fresh fruits and vegetables Mary’s crackers Jilz Crackerz EPIC bars  The challenge of eating out on the road Lucky to live in Pacific Northwest 37 100% gluten-free restaurants in Portland Accommodating to food intolerance More difficult other places Stressful when unfamiliar with establishment  The fundamentals of a food desert Little/no access to fresh fruits, vegetables Most available food is highly processed  Nadine’s advice around locating grocery stores, fresh foods when traveling Research local Whole Foods, Natural Grocers locations Look up local Farmer’s Markets and Co-ops  Nadine’s tips for locating safe restaurants Employ the Find Me Gluten Free app Read Yelp reviews, though can be deceptive Avoid restaurants that make pizza Flour stays in air for up to 72 hours Enormous risk of cross-contamination  The myth that heat breaks down the gluten protein Gluten protein is heat stable Very difficult to denature (even at temperatures of 1200°) Applies to woks, fryers and grills  How Nadine is able to go without a meal when necessary Nutrient ‘gas tank’ is full High levels of vitamin D, B6, B12 and magnesium Better to skip than be sick for days, weeks or months  Who to talk to when you are eating out Start with wait staff, chef Speak with manager, if necessary  Nadine’s experience at a highly-rated restaurant in Boston Selected for positive Yelp reviews Friend used Nima sensor, daughter’s meal contained gluten Notified wait staff, spoke to chef and manager Though establishment caters to gluten-free community, next four meals also tested positive for gluten Learned that pizza was also made in kitchen Stopped by grocery store on way back to hotel Made great, quick and easy dinner in room  Nadine’s gluten-free travel supply packing list Bamboo utensils Pans Nima sensor or EZ Gluten strips Gluten Free Passport allergy cards Activated charcoal (to take with water after accidental exposure) Sense of humor  The best gluten-free online travel resources Gluten-Free Globetrotter Gluten Free Passport  Why you should avoid fast food/restaurant chains that claim to have gluten-free offerings Risk of cross-contamination too high May not truly understand what it means to be gluten-free Using gluten-free label as marketing tool  Nadine’s upcoming River Cruise on the Danube Opportunity for safe travel Responsible, attentive chefs Nadine on hand to confirm food is gluten-free, Paleo  The food options available to the gluten-free population Meat, fish and eggs Nuts and seeds Fruits and vegetables Resources: International Celiac Disease Symposium Applegate Kite Hill Mary’s Gone Crackers Jilz Crackerz EPIC bars Gluten Free Portland Restaurant List Amy Fothergill of the Warm Kitchen Ground Breaker Brewing Whole Foods Natural Grocers Find Me Gluten Free Nima Sensor EZ Gluten Test Strips Gluten-Free Globetrotter Gluten Free Passport Melodies of the Danube Brochure Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

When boys are hurt, we tell them to ‘rub some dirt on it’ and get back in the game. So it comes as no surprise that men have a tough time admitting weakness, especially to something as innocuous as a slice of bread. Perhaps this explains why celiac disease is considered a women’s issue, when in reality the male-to-female ratio is closer to 1:1. Today the Gluten Free RN discusses the large numbers of men in the US who go undiagnosed or misdiagnosed, sharing several anecdotes of patients whose symptoms resolved on a gluten-free diet. She covers the particular social challenges for men with celiac disease, the laundry list of symptoms men may encounter, and the specifics of nutrition she recommends for gluten-sensitive patients. Through it may be difficult to give up pizza and beer with the guys, it is worth the effort to go from sick and struggling to happy and healthy. Listen in and learn how to make going gluten-free simple and easy, even for men with limited culinary skills. Add bacon fat to your greens AND regain your abs with advice from the Gluten Free RN! What’s Discussed:  The myth that men are less likely to suffer from celiac disease 3 women diagnosed for every man Actual ratio of men to women is 1:1 Huge numbers of undiagnosed celiac patients in US The addictive nature of gluten Morphine-like effect Difficult to give up pizza, beer Case study of man diagnosed with pancreatitis Athletic entrepreneur in 40’s Tested positive for celiac disease Adopted gluten-free diet Pancreatitis resolved Fatigue and throat-clearing went away Common symptoms of celiac disease in men Fatigue Thyroid issues Anemia Osteoporosis Bowel issues Difficulty swallowing Chronic cough GERD Gastritis Hemorrhoids Gas Bloating Diarrhea Constipation Irritability IBS Urinary incontinence IBH Erectile dysfunction Prostatitis Prostate cancer Facial ticks Why men with osteoporosis and anemia together should assume they have celiac disease Review labs for red blood cell count Check for hemoglobin and hematocrit in right range Nadine’s patient with a climbing PSA (lab indicator of prostate cancer) Patient had difficulty sleeping, snoring issues Had to eat bread or cereal before coffee to avoid abdominal pain Suffered from chronic belching, brittle nails Adopted variation of Paleo diet, symptoms resolved How Nadine’s doctor had a change of heart around celiac disease Nicknamed her ‘Gluten Insufficiency Nurse’ Called to request consultation Endoscopy report indicated he had celiac disease Symptoms resolved on gluten-free diet No longer needed Cialis The lack of celiac understanding exhibited by healthcare practitioners in the US Doug’s story PA diagnosed with atypical Crohn’s Three trips to ER with GI bleeding Endured surgery to resect bowels Followed Nadine’s instructions for gluten-free diet No longer has Crohn’s, rectal bleeding Feels significantly better How gluten causes excessive gas, explosive diarrhea and constipation Gluten can trigger paralysis of intestines Normal BM with diet change Nadine’s advice around nutrition for gluten sensitive patients Super-good, high fat diet Paleo, whole food diet is ideal Incorporate meat, fish, eggs, fruits, vegetables, nuts and seeds Eliminate all grains, legumes and processed foods Replace starches with potatoes, rice Make choices based on preference and nutritional value Select fewer processed, more fresh foods Don’t just replace gluten-containing foods with gluten-free version (processed = nutrient deficient) The benefits of bacon Can use bacon fat to sauté greens Body uses fat to heal, keep brain and nervous system healthy, prevent neurological disorders Why men may be more resistant to diet change Nadine’s advice for men on eating fresh, gluten-free food Find a few easy-to-prepare recipes you like Use a Crock-Pot Incorporate fruits and vegetables ‘If it’s hard, you’re doing it wrong’ Why subsidized ingredients are found in countless products Government pays food manufactures to incorporate Wheat, corn, soy and peanuts in surprising foodstuffs like catsup, tuna The social challenges for men with celiac disease Don’t want to be perceived as needy, weak Others may be unkind if express special dietary needs Especially difficult if others cooking for you, at special events (e.g.: wedding) How switching from vegan or vegetarian to Paleo has affected Nadine’s male patients Realize healthy weight Able to gain muscle mass Pain issues resolve Improved mood Resources: The Whole 30: The 30-Day Guide to Total Health and Food Freedom by Melissa and Dallas Hartwig Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Few things are as painful as losing a loved one to an overdose. Addiction is such a powerful demon, and most of us have friends or family who are facing it right now. It is easy to feel helpless, believing that there is little you can do to ease their pain. But what if a diet change could resolve the physical and psychological pain at the root of the dependency? You might be surprised to learn that gluten binds with the opioid receptors in the brain, functioning as a ‘gateway drug’ to other addictions. Today the Gluten Free RN shares her experiences with addiction and overdose during her 17-year career in the ER, explaining how she made the connection between undiagnosed celiac disease and addiction issues. She discusses the US opioid epidemic and how a mass screening for celiac disease could prevent such widespread substance abuse. Listen as she describes the morphine-like effects of gluten on your brain, the role of the microbiome in dictating cravings, and why gluten may be at the root of the pain that leads patients to self-medicate with dangerous recreational drugs. The sad truth is that 91 Americans die every day from an opioid overdose. Because undiagnosed celiac disease goes hand in hand with addiction, is it past time to get our loved ones tested. Suggest it today -- it could save a life. What’s Discussed: The recent flood of headlines regarding the US opioid epidemic How exorphins affect the brain Endorphins release chemical to make person feel good (i.e.: runner’s high) Ingest exorphins, make feel differently (e.g.: good, tired, sedate) Includes food, alcohol, pharmaceuticals and recreation medications (marijuana, cocaine, heroin, methamphetamines) How Narcan reverses a heroin overdose Binds with opioid receptors The potential connection between gluten and opioid addiction Gluten binds with same receptors in brain Addiction to gluten, dairy may be precursor to other addictions Many self-medicate with ‘comfort food’ containing wheat and dairy (i.e.: pizza, mac and cheese) The morphine-like effects of gluten and dairy on your brain Very similar to narcotics Elimination diet causes uncomfortable detox process Can take a few days, several weeks May experience fatigue, depression, abdominal pain, headaches Feel better once body clear of damaging proteins The substances patients abuse to treat pain Prescription drugs Over-the-counter drugs Alcohol Cigarettes Recreational drugs (e.g.: methamphetamine, marijuana) The symptoms of pain patients may experience due to gluten Autoimmune issues Intractable headaches Psychological, emotional anguish The data around opioid overdose in the US 91 Americans die every day 32,000 people die annually Numbers likely much higher How gluten sensitivity may lead to pain med addiction Opioid receptors may be damaged, destroyed by gluten Patient cannot absorb pain meds due to villous atrophy Need stronger meds, higher dose Common prescription meds for pain Vicodin Percocet Morphine Dilaudid Why patients turn to heroin for pain relief Less expensive to acquire Easily accessible How food can act as a ‘gateway drug’ to other addictions Celiac disease causes nutrient deficiencies Magnesium Folic acid B vitamins D3 Addictions to alcohol, cigarettes, shopping, etc. seek to fill void Eliminate gluten and heal intestines, addictions resolve Why Nadine advocates a mass screening for celiac disease HLA-DQ2, HLA-DQ8 gene carriers more susceptible to addiction issues Identification can prevent opioid addiction How ER departments treat alcoholics Banana bag (liter of saline + multivitamin, thiamin, folic acid and magnesium sulfate) Addresses nutrient deficiencies Prevent the shakes, help patient detox gradually Celiac disease may be underlying issue The power of the microbiome Tiny bacteria live in intestine Dictate what we eat, drink through cravings Communicate with brain (e.g.: yeast signals need for sugar) The mental health issues caused by untreated celiac disease that may lead patients to self-medicate Depression Anxiety Hallucinations Schizophrenia Bipolar disorder Resources: “Here’s How a Key Part of the Opioid Legislation is Not Working” in the Boston Globe “Gluten Sensitivity May Be a Misnomer for Distinct Illnesses to Various Wheat Proteins” in Scientific American “John F. Kennedy’s Pain Story: From Autoimmune Disease to Centralized Pain” in Practical Pain Management “Malabsorption of Opioid Medications” in Practical Pain Management “The Opioid Effects of Gluten Exorphins: Asymptomatic Celiac Disease” in the Journal of Health, Population and Nutrition Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

There are a number of misconceptions about celiac disease, even within the medical community! Despite a growing body of research to the contrary, many practitioners still believe celiac disease to be strictly a gastrointestinal issue with a just a few tell-tale symptoms. It’s time to get the facts, and today the Gluten Free RN shares 21 important truths about celiac disease that you need to know.  Nadine shares her take on the list compiled by Gluten Free Works, covering the truth about who is at risk, the wide variety of neurological symptoms a celiac patient might present, and the components of an optimal treatment plan. As the most common genetic autoimmune disease in the world, it is incredibly important that we understand how gluten exposure can damage the intestines and cause debilitating nutrient deficiencies.  Nadine also explains why celiac disease often goes undiagnosed and how an astute practitioner is able to accurately interpret biopsies, antibody screenings and lab work. Get familiar with these 21 important facts about celiac disease, and become your own advocate!  What’s Discussed:  Celiac disease is the most common genetic autoimmune disease in the world Powerful as consumer group, ‘vote with dollars’ Purchasing fewer grains More and more gluten-free products available Choose grass-fed, no antibiotic/hormone meat Look for local, organic, non-GMO produce Celiac disease is the most commonly misdiagnosed disease in the world Patients often diagnosed with other disorders Gluten-free diet necessary for symptoms to resolve Celiac disease blood tests are not pass/fail Measure antibody levels Suggest how likely intestinal biopsy will discover damage 70% false negative Anti-TG2 or IgA EMA antibodies indicate gut damage Celiac disease can affect any genetically predisposed person of every race of gender and can first present symptoms at any age No one can be ruled out HLA-DQ2, HLA-DQ8 indicate genetic predisposition 30% of those diagnosed over age 60 Optimal treatment of celiac disease includes a 100% strict gluten-free diet, nutrient deficiency identification and replenishment, and education and support that meet the physical and emotional needs of the patient May need to eliminate dairy, soy, grains and legumes as well (anything that causes inflammation) ‘Find your people’ Most cases of unresponsive celiac disease are due to inadvertent gluten exposure, where the person is consuming gluten without realizing it May not exhibit symptoms when exposed to gluten (airborne, via cross-contamination) Have expert examine home environment to ferret out potential sources The average person with celiac disease has a normal body mass index Traditionally thought to be underweight Roughly 33% of celiac patients are overweight Obesity indicates malnourishment (body’s attempt to store cheap energy) Silent celiac disease refers to a person who tests positive on blood test and villous atrophy on intestinal biopsy, but exhibits no overt symptoms Roughly 50% of those diagnosed on screening exam would claim to have no symptoms Astute practitioner recognizes warning signs Celiac disease presents submicroscopic damage causing nutrient deficiencies before villous atrophy Damage can occur before endoscopy finds it Marsh 1 damage is first stage, caused by gluten Don’t wait for total villous atrophy (Marsh 4 damage) to adopt gluten-free diet Ask knowledgeable practitioner to review biopsies, antibody screenings and lab work 50% of people diagnosed with celiac disease exhibit neurological symptoms at the time of diagnosis Neuropathy (numbness or tingling in hands and feet) Seizure disorders Ticks (especially facial) Bell’s palsy Fasciculation of muscles ‘Pins and needles’ in feet Gastroparesis Constipation (paralysis of intestines) Doctors consider celiac disease to be a gastrointestinal disease Symptoms can be neurological Medical professionals must be astute, recognize all 300 symptoms Anxiety can be the only symptom of celiac disease Due to nutrient deficiencies Irritability can be sign of gluten sensitivity Celiac disease tests are not pass/fail Follow up testing should be performed if symptoms don’t resolve ‘Seroconversion’ means can test negative one day, then positive two weeks later Patient education is the most important predictor of good clinical outcome in celiac disease Find a practitioner to help develop diet for health/lifestyle Pursue body work to repair damage, strengthen body Celiac disease symptoms can be completely different among family members Celiac symptoms number over 300, affecting every system and any organ Widely varied in nature Listed in Recognizing Celiac Disease: Signs, Symptoms, Associated Disorders and Complications by Cleo J. Libonati Symptoms in celiac disease are due to inflammation and/or nutrient deficiencies from chronic intestinal damage Gluten-free diet will heal intestines, eliminate inflammation Requires time, energy and investment in best possible food Celiac disease diagnosis can take ten years or more from the time symptoms first present Frequently last disease considered by doctors (in for-profit healthcare systems) Countries with universal health care diagnose much more quickly Celiac disease affects over three million people in the US, yet the vast majority are not diagnosed Symptoms considered definitive diagnoses, treated superficially Type 1 diabetes MS ALS Lupus Sjögren’s syndrome Anemia Osteoporosis Failure to thrive Eating disorders Underlying cause (celiac disease) left untreated Exposure to gluten is the most important environmental factor in celiac disease Sooner gluten is removed, more likely to achieve full remission If gluten is never introduced, celiac disease will never develop Although celiac disease is now known to cause over 300 symptoms, the medical community has traditionally instructed doctors that celiac disease affects children, presenting symptoms of diarrhea, wasting muscles, anemia, and abdominal distention Be your own advocate    Resources: Recognizing Celiac Disease: Signs, Symptoms, Associated Disorders and Complications by Cleo J. Libonati 21 Important Celiac Disease Facts You Need to Know… Gluten Free Works Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

You don’t have to prove to anyone that you have celiac disease proper. Because food functions as both medicine and poison, it is important to have all the facts before you get talked into a gluten challenge … and the fact is, going back on gluten after you have adopted a gluten-free diet will cause organ damage. The Gluten Free RN speaks to the motivation behind doing a gluten challenge, the consequences for celiac and gluten sensitive patients, and her work as a patient advocate to discourage people from being talked into a gluten challenge. She offers a detailed risk versus reward analysis of braving a gluten challenge, explaining how the maintenance of a gluten-free diet prevents the development of celiac disease and other autoimmune disorders. Nadine also covers the unreliable nature of celiac testing in the US, where the medical community lacks savvy in interpreting results, and explains why biopsy results are no longer considered the gold standard of celiac testing. Listen in to understand the recommended diet for those who have adopted a gluten-free lifestyle and why it requires a long-term commitment. Get armed with information and protect yourself and your family from the dangerous, irreversible consequences of a gluten challenge! What’s Discussed:  The gluten free lifestyle Involves long-term change Can’t take days off  Why you should be cautious of restaurants with a gluten-free menu Very few actually deliver gluten-free meal Employees may not understand contamination, cross-contamination  The advantages of living in the Northwest US Almost 50 designated gluten-free/Paleo restaurants in Portland Farmer’s markets Whole Foods, Natural Grocers Local food Co-ops (First Alternative, LifeSource)  Nadine’s recommendations re: food options Organic produce Grass-fed meat Whole foods produced locally  The misguided reason why people do a gluten challenge Want to prove presence of celiac disease You don’t have to prove to anyone, especially if HLA-DQ2 or HLA-DQ8 gene carrier 30-50% of population has genetic predisposition to celiac disease  The value of a gluten-free diet in preventative medicine Averts celiac disease and associated issues Prevents other autoimmune disorders Type 1 diabetes Lupus Sjögren’s Rheumatoid arthritis MS ALS  What it means to do a gluten challenge Targets patients who have adopted a gluten-free diet Requires they consume gluten (2-6 slices of bread/day)  The consequences of a gluten challenge on celiac and gluten sensitive patients Seizures GI bleeds Appearance of bowel cancer, bone cancer Inability to get out of bed Organ damage  The risks vs. rewards of enduring a gluten challenge No benefit other than proving presence of celiac disease Can be thrown into refractory celiac disease (permanent, irreversible damage to intestines)  Why Nadine would never do a gluten challenge  Why biopsy results are no longer considered the gold standard of celiac testing Often misinterpreted, read incorrectly Damage can be patchy  Why an antibody panel can be unreliable in identifying celiac disease Takes time for body to mount autoimmune response 70% false negative nationwide  How long it takes to obtain celiac diagnosis Two to three weeks in countries where medical community is savvy about celiac disease Nine to 15 years in US  Nadine’s advice around celiac testing Seek practitioner with experience reading results Request total IgA, IgG Consider Cyrex Laboratories, LabCorp or EnteroLab  The enduring nature of celiac disease Doesn’t go away Children don’t grow out of it  Nadine’s nutrition guidelines for celiac patients Gluten- and dairy-free Ideally Paleo Nutrient dense foods  Nadine’s work as a patient advocate Seeks to help people stay healthy, avoid illness/disease Patients get lives back, active and thriving Resources: Whole Foods Natural Grocers First Alternative Co-op LifeSource Co-op Cyrex Laboratories LabCorp EnteroLab Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Celiac disease is grossly underdiagnosed in the United States in large part because the medical community is operating on outdated information about the condition. And despite the recommendations of the National Institute of Health back in 2004, we have yet to implement a mass screening for celiac disease, and health care providers remain alarmingly uninformed. The Gluten Free RN is taking steps to remedy the situation by sharing the basics for medical professionals. Today she covers the WHO’s definition of celiac disease, how our understanding of the condition has change over time, and some common misconceptions about celiac disease. She also explains the top symptoms, recommended testing for celiac disease and gluten sensitivity, and the neurological nature of the disorder. Listen in to learn what health care providers need to know about this undiagnosed epidemic, the complex web of health issues that may result from undiagnosed celiac disease, and why it is important to have a high index of suspicion and include celiac testing on every differential diagnosis. Help your patients go gluten-free and collect something other than autoimmune disorders!  What’s Discussed:  The standard of care in the US Providers should have diagnosed at least 1% of patients with celiac disease Undiagnosed for 70 years, must overcome to prevent further pain and suffering The goals of Nadine’s consulting business Works with facilities to protect celiac patients Ensure compliance with ADA How the media portrays the gluten-free lifestyle Dissuades people from adopting diet (program sponsors influence messaging) Negative headlines How our understanding of celiac disease has changed over time The recommendations of the 2004 NIH consensus meeting regarding celiac disease Mass screening (meets WHO criteria) Education for health care providers The World Health Organization criteria for mass screening Early clinical detection essential Condition is common Screening tests highly sensitive and specific Effective treatment available Untreated condition leads to complications The autoimmune disorders associated with undiagnosed celiac disease MS Type 1 diabetes Lupus Rheumatoid arthritis Sjögren’s Vitiligo The WHO definition of celiac disease Characterized by hypersensitivity to gluten Prevalence currently estimated at 1:1,000 worldwide Screening trials suggest prevalence of 1:100 Results in weight loss, diarrhea, nutritional deficiencies Caused by villous atrophy May present as extraintestinal manifestations or remain clinically silent Why celiac disease can’t be ruled out with a single test Can be triggered at any point HLA-DQ2 and HLA-DQ8 genes indicate genetic predisposition Misconceptions about celiac disease in the US medical community Thought to be digestive disorder, but really neurological Can present with seizures, numbness, constipation, balance issues, celiac cerebellar ataxia How skin issues are a reflection of what is going on internally Epithelial skin is same tissue as inside How damage to the small intestine leads to multiple health issues Increased permeability of intestinal wall Leaky blood brain barrier Leaky blood vessels Leaky lungs and skin The classic symptoms of celiac disease Chronic diarrhea Malabsorption Extreme weight loss Malnutrition What celiac disease looks like in children Diarrhea, constipation General abdominal pain Failure to thrive Falling off growth chart Short stature Learning disabilities ADD, ADHD, ODD Autism Skin issues (eczema, cirrhosis, acne) Delayed puberty Dental problems Anorexia, obesity Bed wetting The prevalence of celiac disease in older adults 30% of people diagnosed with celiac disease are over 60 Potential signs of celiac disease in the aging population Dementia Alzheimer’s Vision, hearing loss Urinary problems Cancer diagnosis (especially bowel cancer) Ataxia Arthritis Hair loss Fatigue Osteoporosis Anemia The elements that get into your blood stream as a result of villous atrophy Toxins Heavy metals Undigested food particles Yeast, fungus Parasites, other harmful bacteria Top symptoms of celiac disease Chronic anemia Fatigue Muscle, joint pain Depression, irritability Thyroid disorders Infertility issues GI problems (from mouth to rectum) Migraine headaches Psychiatric disorders Seizures Dermatitis herpetiformis Down, Turner or Williams syndrome Cardiomyopathy The effects of gluten on the brain Anger Depression, anxiety Learning disabilities Lethargy Insomnia Brain fog Schizophrenia Dyslexia Populations affected by celiac disease Any age, race, gender 3 million people all over the world Study of healthy blood donors in Mexico found unexpectedly high prevalence of tTGA positivity Now recognized as common disease among Middle Eastern and North African populations 1:7 Americans suffer from non-celiac gluten sensitivity (43 million people) The findings of an economic study by Columbia University Non-diarrheal presentations now most frequent Celiac disease grossly underdiagnosed in US Average delay in diagnosis is 4-11 years for adults in North America Significant improvement in quality of life when patients diagnosed and treated appropriately The importance of ensuring that medications are gluten-free Nadine’s recommendations around nutrition for celiac patients Gluten- and dairy-free Ideally Paleo Super-good high fat Things to consider re: the results of a celiac panel A positive test guarantees intestinal damage Include total IgA and IgG 70% produce a false negative Additional tests that offer valuable information Fecal fat score (ask for #, over 300 indicates malabsorption) Complete blood count Comprehensive metabolic panel Vitamin D3 level (below 40 ng/ml is critically low) Vitamins A, E & K levels Vitamin B6 & B12 levels MTHFR gene test Magnesium RBC test Zinc level Iodine level B9/Folate level Ferritin level Iron level Thyroid panel Bone density test Lipid panel ANA test (autoimmune issues) ESR test CRP test Surprising facts around celiac disease contrary to conventional wisdom Only 15% of celiac patients have chronic diarrhea 39% of celiac patients are overweight Shampoos, cosmetics and airborne gluten affect patients with gluten intolerance and celiac disease Super-good high fat diet is essential for celiac patients   Resources: NIH Consensus Statement “Where Have All the American Celiacs Gone?” in Acta Pediatrica Montana Gluten Free “Economic Benefits of Increased Diagnosis of Celiac Disease in a National Managed Care Population in the United States” in the Journal of Insurance Medicine “Celiac Disease Could be a Frequent Disease in Mexico: Prevalence of Tissue Transglutaminase Antibody in Healthy Blood Donors” in the Journal of Clinical Gastroenterology “Celiac Disease in Middle Eastern and North African Countries: A New Burden? in the World Journal of Gastroenterology Recommended Labs CDC 2013 Report Antibiotic Resistance Threats Cyrex Laboratories LabCorps Glutenpro EnteroLab Primal Docs Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism  

Nobody wants bad bacteria, parasites, yeast or food particles hanging around their small intestine! There are a number of causes of small intestinal bacterial overgrowth (SIBO), and undiagnosed celiac disease just happens to be one of them. The Gluten Free RN is prepared to discuss the complexity of health issues celiac patients must resolve after going on a gluten free diet, one of which may be SIBO. She shares the symptoms of small intestinal bacterial overgrowth, how we test for SIBO, and potential treatments for the condition. Listen in to learn how foods and medication affect the microbiome and alter the environment of your intestines. What’s Discussed: The complexity of healing once a celiac patient goes gluten free Very rarely does diet change heal all associated disorders Other issues like SIBO must be treated once intestines heal The causes of irritable bowel syndrome Thought to be caused by stress Studies now show food poisoning may be trigger How food, drink and medication affect your intestines Certain food/drink can move in bad bacteria, push out good Antibiotics change pH of stomach acid Bacteria, parasites, yeast and food particles get into small intestine The consequences of damaged villi due to undiagnosed celiac disease Compromised immune system Inflammation Body can’t absorb nutrients The process of healing your intestines Takes six months to a year Must eliminate all foods that cause inflammation (gluten, dairy, soy, etc.) After villi heal, deal with additional health issues (i.e.: SIBO) Villi MUST grow back before good bacteria can return The symptoms of SIBO Gas, bloating Abdominal pain Diarrhea Constipation How to test for SIBO Consume sugary drink, then breathe into tube Hydrogen sulfate associated with diarrhea Methane connected to constipation Gives snapshot of what is happening in intestines How SIBO is treated Antibiotics (rifaximin) Herbs (i.e.: oregano oil, berberine, neem) Fecal microbial transplant Risk factors for SIBO Any course of antibiotics Diabetes Bowel surgery Crohn’s disease Undiagnosed celiac disease Resources: Primal Docs SIBO Info Website “Small Intestinal Bacterial Overgrowth: A Comprehensive Review” in Gastroenterology and Hepatology Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism  

Did you know that the spleen plays a leading role in a properly functioning immune system? As the largest organ in your lymphatic system, the spleen spends its time fighting infection and keeping you healthy. Unfortunately, research points to a connection between disorders of the spleen and celiac disease. And if your immune system is already compromised because of gluten damage to your intestines, a spleen issue leaves you at heightened risk for a variety of infections and autoimmune diseases. Today the Gluten Free RN shares her personal connection to genetic spherocytosis and how spleen damage affected her family. She also covers several studies that document the correlation between spleen issues and celiac disease. Listen in to understand how your spleen functions, the symptoms of spleen disorder, and the autoimmune diseases you may develop if your spleen is damaged or removed. What’s Discussed: How your spleen works to keep you healthy Filters used/damaged red blood cells Harvests iron to recycle Produces antibodies, white blood cells Fights infection Vital to immune system Conditions you may acquire if spleen is damaged (increased risk) Pneumonia UTI Overwhelming sepsis Instances in which spleen may be enlarged Mononucleosis Some bacterial infections, metabolic disorders Liver diseases Some blood cancers, lymphoma Blood clots in veins of liver, spleen Symptoms of spleen issues Pain in upper left quadrant Fatigue Anemia Bruise easily Bloated The correlation between genetic spherocytosis and celiac disease As high as 88% in some studies How the ratio of spleen diameter to RDW can indicate celiac disease Two-thirds of celiac patients in study had elevated red blood cell distribution width Small spleen in 80% of celiac patients Spleen diameter to RDW ratio under 6 had 88.5% specificity in predicting celiac disease Why patients with hyposplenism should get tested for celiac disease 25-75% of celiac patients have hyposplenism Look for red blood cell abnormality HLA-DQ2 and HLA-DQ8 genes indicate predisposition for celiac disease Antibody test available from EnteroLab or Cyrex Laboratories Ask for total IgA, IgG Other autoimmune diseases patients with hyposplenism may develop (increased risk) Type 1 diabetes Lupus Sjögren’s syndrome Vitiligo Raynaud’s Autoimmune thyroiditis ALS, MS, any demyelination of nervous system Idiopathic thrombocytopenia Autoimmune hepatitis Nadine’s recommendations around nutrition Local, organic Nutrient dense Gluten-free, Paleo The link between hyposplenism and autoimmune manifestations of celiac disease Autoimmune disorders may cause splenic hypofunction or vice versa Study hypothesizes that higher risk for splenic function in celiac patients may be related to celiac disease rather than autoimmunity Prevalence of celiac disease-associated hyposplenism increased from 19% in uncomplicated patients to 59% in those with autoimmune disorders Why celiac patients may not benefit from iron supplements, infusions Damaged intestines cannot absorb iron Damaged spleen destroys healthy red blood cells  Resources: “Ratio of Spleen Diameter to Red Blood Cell Distributions Width” in Medicine (Baltimore) EnteroLab Cyrex Laboratories “Is it Worth Investigating Splenic Function in Patients with Celiac Disease?” in the World Journal of Gastroenterology “Hyposplenism in Gastrointestinal Disease” in Gut BMJ “Hyposplenism, Adult Coeliac Disease, and Autoimmunity” in Gut BMJ “Splenic Volume Differentiates Complicated and Non-Complicated Celiac Disease” in UEG Journal Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

The average human takes between 14 and 20 breaths per minute. But if you are conscious of those breaths, that’s a problem. Perhaps you’re experiencing chest tightness, clogged sinuses or a nagging cough that make you very aware of every breath you take. If so, the ingestion of gluten may be a contributing factor to these respiratory issues. Today Nadine explores the relationship between the lungs and celiac disease, offering anecdotal evidence as well as explaining the way that inflammation can lead to a number of respiratory problems. Because 70-90% of your immune system is housed in your intestines, it is no surprise that a leaky gut could make you more vulnerable to respiratory tract infections. Despite the fact that current literature considers respiratory challenges to be an atypical presentation of celiac disease, the Gluten Free RN argues that there is enough anecdotal evidence to merit further study. Listen in to understand the vitamin deficiencies that likely contribute to respiratory issues, how those health concerns might be corrected by going gluten-free, and why your body heals more quickly on a high fat, whole food diet. It’s time to go gluten-free and breathe easy again! What’s Discussed:  How gluten ingestion likely affects the respiratory system Body keeps fluids separate unless tissues leaky Gluten alters epithelial tissue, including that of lungs Nadine’s anecdotal evidence of a connection between gluten and respiratory issues Fellow nurse had lung removed as child Always needed inhalers Went gluten-free with Nadine Inflammation in lungs cleared, asthma gone No longer needed inhalers Respiratory issues that may be corrected on a gluten-free diet Anemia (lack of red blood cells to carry oxygen causes shortness of breath with minimal exertion) Recurrent respiratory infections Cystic fibrosis COPD IPH (bleeding lung) Pulmonary edema Vitamin deficiencies caused by gluten ingestion that lead to respiratory problems Vitamin K deficiencies initiate easy bruising, nose bleeds and bleeding lung Why going gluten-free eliminates many respiratory issues Gluten causes inflammation (-itis = inflammation) Removing the cause heals intestines, repairs immune system Patients operate on a higher level Common symptoms of respiratory issues Difficulty breathing Chest tightness Nagging cough Clogged sinuses Post-nasal drip Nadine’s recommendations around diet and nutrition Gluten- and dairy-free at a minimum Ideally variation of Paleo diet Whole foods (meat, fish, eggs, fruits, vegetables, nuts and seeds) High fat (body needs to absorb fat-soluble nutrients – A, D, E & K) Maintain Gluten Zero (takes six months to a year for intestinal villi to heal) Why your body heals more quickly on a high fat, whole food diet Body knows how to break down, utilize nutrients Fat-soluble vitamins repair connective tissue, leaky gut The genes that indicate a predisposition for celiac disease HLA-DQ2 HLA-DQ8 Resources:   “Hemoptysis in Patients of Celiac Disease with Disproportionately Severe Anemia” in Multidisciplinary Respiratory Medicine “A Case of Cough, Lymphocytic Bronchoalveolitis and Coeliac Disease with Improvement Following a Gluten Free Diet” in Thorax “Respiratory Symptoms as Atypical Manifestation of Celiac Disease” in the Pediatric Oncall Journal “Recurrent Rhinitis and Pulmonary Infections Revealing Celiac Disease” in Revue de Pneumologie Clinique “Pneumococcal Septic Shock in the Setting of Hyposplenic Celiac Disease” in Hospital Physician Coeliac Australia: Associated Conditions Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Struggling to maintain control of your blood sugar? A gluten-free diet may be the answer! If you have one autoimmune disorder, you have a 30-50% greater risk of developing another, and both type 1 diabetes and celiac disease fall into that category. As more and more research points to an enormous overlap between type 1 diabetes and celiac disease, it is in our best interests to mitigate additional risk by getting screened and/or adopting a gluten-free or Paleo diet to mitigate further risk. Today Nadine discusses the prevalence of diabetes, several research studies that explore the connection between type 1 diabetes and celiac disease, and the potential risks for type 1 diabetics who are undiagnosed celiac patients. Listen and learn how your diet may be affecting your blood sugar and why going gluten-free could improve your health and quality of life! What’s Discussed:  The prevalence of diabetes By 2050, half the population will have diabetes According to CDC, 29.1 million have diabetes One out of four don’t know they are diabetic 18,000 young people diagnosed from 2008-2009 The difference between type 1 and type 2 diabetes Minimize risk for type 2 through diet and exercise Type 1 is autoimmune disorder, don’t produce enough insulin to break down sugar Symptoms of type 1 diabetes Extreme thirst Urgency to urinate frequently Fatigue Weakness The enormous genetic overlap between type 1 diabetes and celiac disease Scottish study found 94% of type 1 diabetics were HLA-DQ2 or HLA-DQ8 gene carriers 100% overlap if include HLA-DQ2.2 Prevalence of celiac disease among type 1 diabetics is 20% higher than general population The importance of testing all type 1 diabetics for celiac disease annually Can develop celiac disease at any age The consequences of undiagnosed celiac disease in children with type 1 diabetes Short stature Failure to thrive Early onset osteopenia, osteoporosis Easily broken or rubbery bones Difficulty maintaining glycemic control (low blood sugar, spikes) Anemia The decreased quality of life for type 1 diabetics who are undiagnosed celiac Development of infections Difficulty with blood sugar maintenance Research studies re: the percentages of type 1 diabetics who also have celiac disease Iraq – 11.2% Mexican participants – 5.9% Denmark – 12.3% Nadine’s anecdotal evidence of the overlap Volunteers at community outreach clinic Young man struggling to control blood sugar Nadine recommended gluten-free diet Improved health and quality of life Health risks associated with an inability to control blood sugar Blindness Kidney failure Amputation of extremities Difficulty healing wounds Heart attacks Strokes Why carb counting doesn’t control blood sugar Carbs with little/no nutrient value cause spikes in blood sugar The diet Nadine recommends for type 1 diabetics Variation of Paleo diet Nutrient dense foods Meat and fish Eggs Fruits and vegetables Nuts and seeds The benefits of a gluten-free diet for type 1 diabetics Weight easier to control Immune system works better Tighter control on blood sugar The lack of uniformity in screening guidelines Additional autoimmune diseases that may be avoided with a gluten-free diet Multiple sclerosis Lupus Sjögren’s Scleroderma Autoimmune thyroiditis Graves’ disease Hashimoto’s Vitiligo Raynaud’s Potential triggers for autoimmune disorders Gluten Change in microbiome Stress to body (i.e.: cold, food poisoning, travel)  Treatments for small intestinal bacterial overgrowth Low FODMAPs or specific carb diet Rifaximin (antibiotic) The dangers of maintaining high blood sugar Damage to kidneys, eyes, capillaries, fingers and toes Neuropathy Gastroparesis The long history of a connection between type 1 diabetes and celiac disease The need for information re: the connection in diabetic education services Resources: “Type 1 Diabetes and Celiac Disease: The Effects of Gluten Free Diet on Metabolic Control” in the World Journal of Diabetes “Co-occurrence of Type 1 Diabetes Mellitus and Celiac Disease” in the World Journal of Diabetes “Screening for Coeliac Disease in Adult Patients with Type 1 Diabetes Mellitus: Myths, Facts and Controversy in Diabetology & Metabolic Syndrome “The Prevalence of Coeliac Disease in Libyan Children with Type 1 Diabetes Mellitus” in Diabetes Metabolism Research and Reviews “Type 1 and Type 2 Diabetes in Celiac Disease: Prevalence and Effect on Clinical and Histological Presentation” in BMC Gastroenterology “Coexistence of Coeliac Disease and Type 1 Diabetes” in Przeglad Gastroenterologiczny “Screening for Celiac Disease in Type 1 Diabetes: A Systematic Review” in AAP News and Journals Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

The gluten-free movement is often dismissed in the media as a fad. Even so-called experts actively discredit the gluten-free diet and apply a negative connotation to terms like PWAG. Have you ever wondered why there is so much misinformation about celiac disease and non-celiac gluten sensitivity in the media? And who sponsors the coverage that dissuades people from going gluten-free?  Today, Nadine explains how the big business of wheat affects which voices we hear in media treatment of the gluten-free movement. In addition, she covers how the for-profit healthcare system in the US affects the timely diagnosis of celiac disease and non-celiac gluten sensitivity.  Celiac disease is a medical, social and economic issue with political implications. Listen and learn how to choose high quality, nutrient dense foods, and leverage your power as a gluten-free consumer! What’s Discussed:  Misinformation in the media Some coverage dissuades from adopting a gluten-free diet Program/print sponsors may be corporations that depend on people eating wheat Wheat/grain industry threatened by rise of gluten-free diet (33% of people in US and Canada on variation of gluten free diet) The illusion of options in the area of food production 8-10 corporations own nearly every food company Nadine patronizes farmer’s markets, co-ops and local companies Nadine’s rules for buying food products Label must be clear, easy to read Five or fewer ingredients Must be able to picture each ingredient The importance of reading labels May be gluten in products that are typically gluten-free (i.e.: pesto, kombucha) Companies are given six months to update labels after making changes Barley and rye are not on list of allergens Nadine’s story Multi-system organ failure Negative test for celiac disease despite being homozygous gene carrier Healed quickly on a Paleo diet Why countries with universal healthcare take celiac disease seriously Early diagnosis saves money Finland: 70% of people w/ celiac disease have been diagnosed Italy, UK and Canada: 30-40% have been diagnosed US: Less than 1% of those with celiac disease have been diagnosed How long it takes to be diagnosed with celiac disease (for-profit vs. universal systems) US: 9-15 years Italy: 2-3 weeks How doctors/experts discredit gluten-free as a fad Use PWAG as derogatory term Placebo effect Nocebo effect (expect to feel poorly) The inaccuracy of blood tests for celiac disease 70% false negative How companies profit from undiagnosed celiac patients Products geared toward people with health issues (i.e.: compression socks, hypoallergenic sheets) The prominence of wheat as a publicly traded commodity Top export of US/Canada The health risk associated with genetically modified wheat The benefits of a gluten-free diet Symptoms resolve No longer need medicine, surgery Nadine’s advice re: selecting gluten-free products Avoid nutrient deficient gluten-free options (cheap fillers, empty carbs) Focus on high quality, nutrient dense foods How to leverage your power as a gluten-free consumer Hold food producers accountable (standards, production methods) ‘Vote carefully with your dollar’ Speak up when you see inaccurate media coverage Why you cannot assume that gluten-free menu items are truly free of gluten Uneducated restaurant staff Possibility of contamination, cross-contamination What a ‘gluten free’ designation means in labeling GIG certification indicates less than ten parts per million Standard in US/Europe is less than 20 parts per million The Gluten Free RN mission Educate people globally about celiac disease and non-celiac gluten sensitivity Empower people to improve their health and quality of life with food Resources: Food Company Infographic Gluten Intolerance Group Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

We typically associate liver disease with alcoholism. But the liver functions as a filter, and over time it can be damaged by certain pharmaceuticals and even food. In fact, research suggests a strong correlation between undiagnosed celiac disease and non-alcoholic steatohepatitis (NASH). The Gluten Free RN shares a number of case studies in which a diet change reversed liver damage and prevented the need for an organ transplant. She also takes us through the alarming statistics regarding NASH in children and discusses her approach to treating NASH patients.  Listen to understand the obesity trends in the US and how a sedentary lifestyle plays a part in liver disease. Join Nadine’s campaign to educate the population about the benefits of a gluten- and dairy-free, whole food diet – and prevent NASH! What’s Discussed:  Nadine’s introduction to NASH in children Videoconference of pediatricians Discovered NASH on autopsies Few had signs/symptoms The fundamentals of NASH Liver failure caused by changing environmental factors Dietary culprits (e.g.: sodas, fast food, processed foods, alcohol, high fructose corn syrup, nutrient-deficient carbs) Up to 90% of patients undergoing bariatric surgery have fatty liver disease Only diagnostic tool is liver biopsy Obesity trends in the United States 60% of people in 13 states will be obese by 2030 Link between poverty and obesity Why starving people are obese Lack of nutrient-dense food results in low nutrient levels Body compensates for deficiencies by storing fat as cheap energy The correlation between undiagnosed celiac disease and NASH Celiac disease found in 10% of patients with unexplained abnormal liver panels and 3.5% of patients with NASH Anyone with bump in liver enzymes should be screened for celiac disease and given gluten-free diet option The 2015 Canadian study re: liver transplant NASH as most common indication for liver transplant in North America NASH projected to be leading cause by 2025 Identified obesity, sedentary lifestyle, highly processed foods, undiagnosed celiac disease, MS and type 2 diabetes as causes The basics of non-alcoholic fatty liver disease (NAFL) Buildup of fat in liver cells Largely asymptomatic until have profound liver/organ failure Which populations are at increased risk for NASH Obese Hispanic Native American Pediatric Liver transplant statistics 16,000 people on waiting list for liver transplant Only 6,000 liver transplants performed each year Case study demonstrating the reversal of liver damage on gluten-free diet 19-year-old woman referred for emergency liver transplantation Recovered quickly on gluten-free diet, normal liver and small intestines after 20 months No surgery required The correlation between celiac disease and liver disease Celiac patients at increased risk of NAFLD compared to general population Most common cause of chronic liver disease in children and adolescents in western nations How Nadine approaches a patient with NASH Examine diet (food as medicine/poison) Replace highly processed fats Leverage minimally processed foods How to combat obesity Educate people about the value of nutrient-dense food Provide medical and social support The liver as a detoxing organ Functions as a filter Can be damaged over time by foods, acetaminophen, alcohol What a good, whole food diet looks like Gluten- and dairy-free (ideally Paleo) Includes meat and fish, nuts and seeds, organic fruits and vegetables The need for access to accurate nutritional information Not influenced by politics, food corporations, agribusiness or pharmaceutical companies Resources: PubMed “Sonographic Diagnosis of Coeliac Disease in a Case with Suspected Acute Liver Failure” in the European Journal of Gastroenterology and Hepatology “Non-Invasive Diagnostic Biomarkers” by Dr. Rohit Loomba of UC San Diego “Acute Cryptogenic Liver Failure in an Untreated Coeliac Patient” in the European Journal of Gastroenterology and Hepatology “Increased Risk of Non-Alcoholic Fatty Liver Disease After Diagnosis of Celiac Disease” from the Journal of Hepatology Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

‘With our technology, every time a woman dies, it’s a medical error.’  Recent reports have uncovered some alarming statistics regarding maternal mortality rates in the United States. While these numbers are on the decline in every other developed nation, pregnant women in the US are at greater risk of dying than they were in recent years. We know that undiagnosed celiac disease has a significant impact on maternal health and fetal development, and we must identify expectant mothers (and fathers) who have the potential to reap remarkable benefits from a simple diet change. This issue is especially important to the Gluten Free RN as a mother herself – as well as an emergency ER nurse certified in PALS, NLS and pediatric emergency nursing. She shares the stories of women who had difficulty getting pregnant or maintaining pregnancies as a result of undiagnosed celiac disease and gluten sensitivity, and explains how a mass screening could work to prevent such intense suffering. Listen to learn how adopting a gluten-free or Paleo diet can help women carry their babies to full-term and deliver healthy, thriving children! What’s Discussed:  Nadine’s mission to get women tested for celiac disease prior to pregnancy Allows to absorb nutrients during pregnancy (including prenatal vitamins) Can deliver healthy, thriving child  The story of Alice Bast Suffered miscarriage and still births Multiple doctors couldn’t provide answers Vet gave idea to test for celiac disease Founded the National Foundation for Celiac Awareness  The necessity for a mass screening of men and women Identify HLA-DQ2 and HLA-DQ8 gene carriers Genes of both parents affect fetal health Ratio of women to men with celiac disease is 1:1 Ratio of women to men diagnosed with celiac disease is 3:1  The increased risks for pregnant women with undiagnosed celiac disease Miscarriage Still birth Low birth weight Failure to thrive in children Pre-eclampsia/eclampsia (dangerously high blood pressure)  The role men play in infertility ED, low sperm count and low libido may be attributed to undiagnosed celiac disease Symptoms include deficiencies in zinc, magnesium and B vitamins as well as anemia and osteoporosis  The argument that a mass screening for celiac disease is too expensive The cost associated with undiagnosed celiac disease is much higher Consists of medical costs from complications Also includes decreased productivity and morbidity/mortality Study published in Science Digest found that 42,000 children may die annually due to undiagnosed celiac disease  Conditions that indicate high risk for celiac disease Chronic GI issues Irritable bowel syndrome Weight loss/gain Iron deficiency anemia Vitamin/mineral deficiencies Secondary hyperparathyroidism Unexplained elevations in liver function Down, Turner or Williams syndrome Type 1 diabetes Lupus Autoimmune thyroid disease  Sam’s story Delayed puberty (didn’t get period until 17-years-old) Diagnosed with celiac disease at 19 Doctors warned she would probably never have children Raising two healthy boys  Why Nadine is concerned about the current generation of children Higher rates of autoimmune diseases, cancer and learning disabilities  The appropriate diet to promote maternal health and proper fetal development Gluten- and dairy-free Paleo is best Humans have enzymes to break down meat proteins Humans do not have enzymes to break down grain proteins Avoid wheat, barley, rye and oats Embrace meat, fish, eggs, fruits, vegetables, nuts and seeds  Deficiencies that can be corrected to promote healthy pregnancy B6 and B12 A, D, E and K (the fat-soluble vitamins) Magnesium RBC Zinc  The US maternal mortality rate compared to other developed nations Rising in the US, declining in other developed nations 28 deaths for every 100,000 births in 2013, up from 23 in 2005 Resources: “Maternal Mortality Rate in US Rises, Defying Global Trend, Study Finds” in The New York Times “Focus on Infants During Childbirth Leaves US Moms in Danger” on NPR Beyond Celiac: Alice Bast “Reproductive Changes Associated with Celiac Disease” from the World Journal of Gastroenterology “Celiac Disease and Reproductive Health” from Celiac Disease: A Comprehensive Review and Update Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Given the choice between a heart transplant and a gluten-free diet, the vast majority – if not all – of us would quickly opt for the diet! Yet the medical community continues to ignore celiac disease as a potential cause of cardiac complications, despite documented connections between the two conditions. The Gluten Free RN is sharing her experience with heart attack and stroke victims in the ER, and discussing the necessity of screening cardiac patients for celiac disease. She gets into the nitty gritty of how intestinal damage leads to nutrient deficiencies that affect the cardiac system, and reveals the cardiac symptoms that may resolve on a gluten-free diet. Listen in and learn about the actual cause of heart attack and stroke (spoiler alert – it’s not high cholesterol) and how Nadine has achieved a lipid panel akin to that of a ‘23-year-old marathon runner’! What’s Discussed:  The connection between cardiac issues and celiac disease Study linked celiac disease to almost doubled risk of CAD Documented connection between gluten and cardiomyopathy The real cause of heart attack and stroke Thought to be high cholesterol Actual cause is inflammation/malabsorption How a gluten-free diet can resolve cardiomyopathy Medical community claims cardiomyopathy can be treated with meds, but not cured Patient eventually needs heart transplant Anecdotal evidence proves that removing gluten may cure profound heart failure Nadine’s experience in treating cardiac patients as a critical care nurse in the ER ER staff does not take a magnesium panel Deficiencies in magnesium or calcium can cause arrhythmias (irregular heartbeat) Even when patient tested for ‘everything,’ celiac disease and nutritional panels often omitted How to correct a magnesium deficiency Food (pumpkin seeds, molasses, etc.) Magnesium supplements (including calcium, zinc and vitamin D) How intestinal damage leads to nutrient deficiencies that affect the cardiac system Thiamine deficiency may lead to wet beriberi or acute pernicious beriberi Low electrolytes may lead to arrhythmia Low iron, B vitamin may lead to anemia (less oxygen in blood) Low vitamin K levels affects protein S and protein C levels (involved in clotting) Cardiac symptoms that may resolve on a gluten-free or Paleo diet Arrhythmias Chest pain Difficulty breathing The myth that fat is bad for us Nadine consumes a super-good high fat diet Her lipid panel ‘looks like a 23-year-old marathon runners’ Cardiac risk factor very low Nadine’s call for a worldwide mass screening for celiac disease Find undiagnosed Prevent cardiac disease, stroke Resources: “Celiac Disease Linked to Almost Doubled Risk of CAD” by Marlene Busko PubMed Gluten Toxicity: The Mysterious Symptoms of Celiac Disease, Dermatitis Herpetiformis, and Non-Celiac Gluten Intolerance by Shelly L. Stuart Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Guest host Laura Howe RN interviews Nadine Grzeskowiak, RN, BSN, CEN. Nadine began her nursing career in 1992 working in emergency, trauma and critical care at hospitals throughout Oregon. In 2006, a the age of 40, she was diagnosed with celiac disease, a disease she had never heard of before, even as a nurse. A gluten-free diet changed her life and saved her life. Nadine founded three nursing businesses shortly thereafter: RN On Call, Inc. in February 2007, Gluten Free RN in March 2007 followed by Celiac Nurse Consulting. Nadine is an international expert, author and professional speaker on all aspects of gluten intolerance, celiac disease, the Paleo lifestyle and surrounding topics. She has presented over 1,600 lectures to a wide variety of audiences. Nadine's first book, DOUGH NATION: A Nurse's Memoir of Celiac Disease From Missed Diagnosis to Food and Health Activism was officially released September 2015. Work has begun on her second book to be released next year. Dough Nation can be found here: http://amzn.to/2pxABiE Her website is : http://glutenfreern.com And she can also be found on Youtube under Gluten Free RN For bonus material to help you follow some of Nadine's guidelines, go to http://www.kataniataylor.com/toolkit/

We all know how it feels to struggle through the day when you didn’t get enough sleep the night before. Your brain feels fuzzy, it’s tough to focus, and you simply aren’t the best version of yourself! The good news is, there may be a simple explanation for your sleep disorder – and there are steps you can take to eliminate the potential celiac symptoms that are keeping you up at night. Today the Gluten Free RN shares her struggle with sleep deprivation as an undiagnosed celiac patient who also worked the night shift in the ER. Find out how she leveraged a Paleo diet and went from having a contentious relationship with sleep to becoming a champion ‘Olympic Sleeper’ who enjoys at least eight hours of rest every night! She also covers the components of an ideal sleep space, suggestions for implementing an evening routine, and the benefits of a good night’s rest. Listen and learn about the connection between sleep disorders and undiagnosed celiac disease or non-celiac gluten sensitivity. What’s Discussed:  Nadine’s struggle with sleep working the night shift 10 years as ER nurse working 12-hour night shifts Difficult to shift into normal sleep pattern on days off Circadian rhythm thrown off, felt fuzzy-brained Needed extra sleep Struggle to block out distractions The correlation between undiagnosed celiac disease and sleep disorders Celiac symptoms can keep you awake at night May experience joint pain, muscle pain, DH, eczema, headaches, muscle twitches, restless leg syndrome How a Paleo lifestyle can alleviate symptoms preventing sleep How many hours of sleep you should be getting each night Nadine recommends 8-10 hours of good quality sleep Provides the energy for your body to carry out the tasks of daily living The components of an ideal sleep space Comfortable mattress Quality sheets Plenty of supportive pillows Appropriate temperature Fresh air, if possible No electronic equipment in the room (i.e.: phones, televisions, computers) Source of white noise (e.g.: fan, music) The model evening routine Limit screen time in the hours before bed Try relaxing activities like reading or knitting instead Take a warm bath with Epsom salt (muscle relaxer, source of magnesium) Consider magnesium supplements Celiac symptoms that can cause sleep apnea How your body heals neurological damage in the absence of gluten The repercussions of vitamin C deficiency Signs of sleep disorders in children that may be caused by undiagnosed celiac disease Can’t or don’t want to go to sleep, crying Cranky and fatigued during the day Decreased productivity Learning disabilities Difficulty with focus Signs of celiac disease in children Short stature Anemia Falling off growth chart Learning disabilities Seizure disorders Why anyone with sleep disorders should get tested for celiac disease How Nadine’s sleep issues went away on a gluten-free diet Eliminated back pain, joint pain, skin discomfort, muscle pain, muscle spasms and leg cramps Now she qualifies as an ‘Olympic Sleeper’ The unhealthy approach to compensating for lack of sleep Take in stimulants to make it through the day (e.g.: coffee, sugar) Take depressants at night to help fall asleep (e.g.: alcohol, prescription meds) Everything you consume impacts your health and ability to sleep A healthy option that functions as a sleep aid The benefits of a good night’s rest When to take multivitamins In the morning with food At night before bed (absorbed differently) The risks associated with prescription medications Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism  

A diagnosis of Parkinson’s disease is devastating, and the associated symptoms – difficulty walking, tremors, memory issues – are debilitating. But what if those symptoms aren’t necessarily indicative of Parkinson’s after all? What if a simple diet change could improve or even eliminate those symptoms?  Today Nadine explores anecdotal evidence suggesting that the symptoms of Parkinson’s and other demyelination syndromes might be actually be caused by celiac disease or non-celiac gluten sensitivity. She argues that as Parkinson’s diagnoses become more and more common, it is imperative that we explore the potential connection between Parkinson’s and celiac disease.  Listen in to understand how gluten can affect the neurological system, why Parkinson’s patients should be tested for celiac disease, and how a gluten-free diet can heal neurological damage.  What’s Discussed:  Nadine’s Parkinson’s patient Diagnosed with celiac disease as a child in the 1940’s Recently diagnosed with Parkinson’s Symptoms included difficulty walking, falling, stooped gait, masked appearance, tremors, memory issues and confusion Discovered unintentional gluten exposure in the home Moved to adult foster home to ensure gluten-free diet Many symptoms went away Working with neurologist to wean off Parkinson’s meds Why patients diagnosed with Parkinson’s, ALS and MS should get test for celiac disease and gluten sensitivity Every nerve in the body is insulated with myelin Myelin is made of fat Gluten prevents the absorption of fats Parkinson’s, ALS and MS are all demyelination syndromes The need for research regarding the potential connection between Parkinson’s and celiac disease The University of Chicago asserts there is ‘no published evidence of a connection between Parkinson’s and celiac disease’ Nadine argues that enough anecdotal evidence exists to suggest that a connection should be investigated Nadine’s recommendation for a comprehensive celiac lab test Cyrex Labs tests for 25 of the gluten intolerant antibodies, including tTG-2, tTG-3 and tTG-6 Ask for a total IgA and IgG in addition to the Cyrex Array 3 Insurance should cover the tests Can be ordered by any practitioner Celiac diagnoses in patients over 60 30% of newly diagnosed celiac patients are over 60 Many have neurological issues Neuropathy Headaches Migraines Seizure disorders Difficulty walking Falling Balance issues MS Nadine’s patients improve on a Paleo diet The Stanford idiopathic familial narcolepsy study Entire family diagnosed with narcolepsy Found that family members had celiac disease Adopting a gluten-free diet eliminated the narcolepsy Family now runs organic farm The increasing number of Parkinson’s diagnoses More and more common UK neurological expert routinely tests for celiac disease and non-celiac gluten sensitivity How your body heals neurological damage in the absence of gluten Heal intestines Eliminate inflammation Repair immune system Replete nutrient deficiencies Vitamin D Cancer preventative Level should be between 60-80 Indicator of all fat-soluble vitamins (A, D, E and K) ‘Sunshine’ vitamin synthesized through skin Must also be taken in dietarily Little chance of overdosing on D3 What your nails can tell you about your health Look for white spots, cracked nails, hangnails May indicate lack of zinc, D3, or B vitamins Dr. Terry Wahls’ MS misdiagnosis Diagnosed with MS and required wheelchair Healed with a gluten-free diet Can ride her bike and walk without a cane Nadine’s story At 40, her symptoms suggested MS Issues with clumsiness (falling, dragging feet, dropping things, difficulty with balance) Problems went away on a gluten-free diet Nutrient deficiencies were causing neurological issues Celiac cerebellar ataxia Caused by lesions on or inflammation of the brain Results in inability to walk straight Tissue can be healed on a gluten free diet  Resources: Cyrex Laboratories Midway Farms La Mancha Ranch and Orchard Dr. Wahls’ TED Talk Dr. Wahls’ YouTube Channel The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles - by Terry Wahls, MD and Eve Adamson  Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Forget everything you thought you knew about obesity. 68% of the population of the US is overweight, and we know that there are a number of health risks associated with the issue. But did you know that people are overweight because their bodies are actually starving?  Today the Gluten Free RN is challenging your assumptions about weight gain and celiac disease, revealing the surprising way your body compensates for malnourishment, the necessity of fat in nutrient absorption, and the healing power of a whole food gluten-free diet. Listen and learn why more people are overweight when diagnosed with celiac disease than underweight, more have constipation than diarrhea, and more have neurological disorders than gastrointestinal issues. Nadine is prepared to shake up your idea of what it means to have celiac disease and offer guidance regarding the food we should be eating in order to heal, and lose – or gain – weight in the process! What’s Discussed:  The classic symptoms of celiac disease Used to be identified by weight loss and chronic diarrhea We now know there are well over 300 signs and symptoms The obesity epidemic in the US 68% of the population is overweight Obesity increases morbidity and mortality The majority of celiac patients are overweight Why celiac patients are overweight Damage to intestines prevents absorption of nutrients Body is starving, so it compensates by storing fat as cheap energy The health risks associated with obesity The failings of fast food Little to no nutritional value ‘Bad’ fat Little use as energy The whole food diet Nadine recommends for celiac and gluten sensitive patients  The rapid weight loss of overweight celiac patients once they adopt a gluten-free diet Why wounds may not heal appropriately in celiac patients Body is malnourished and cannot absorb nutrients Nutrients are necessary to heal tissue How to heal your body with food Choose fermented foods Regenerate villi in intestines Build diverse microbiome Nadine’s patient with tunneling wound in sacral area Wound would not heal, required daily dressing changes Patient was HLA-DQ2 gene carrier Wound healed after 10 days on a gluten-free diet How a gluten-free diet affects underweight celiac patients Muscle and tissue build appropriately Weight increases as nutrients are absorbed The necessity of a high-fat diet for celiac patients Vitamins A, D, E and K are fat-soluble The brain is made of fat ‘Good’ fats that Nadine recommends incorporating into your diet Listen in for the full list!! Connect with Nadine:  Instagram Facebook Contact via Email Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

In Italy, it takes only two to three weeks to get diagnosed with celiac disease. In the United States, however, it typically takes nine to 15 years. Why is there such a huge discrepancy? And what are the legal ramifications for practitioners who overlook celiac disease and non-celiac gluten sensitivity, causing patients unnecessary pain and suffering?  On this episode, Nadine explores the legal issues surrounding celiac disease as well as the potential reasons for delayed diagnosis in the US. She also explains the differences between universal healthcare and the for-profit system and how each appears to influence celiac diagnosis.  Listen and learn what medical practitioners need to know about celiac disease and gluten sensitivity in order to avoid being sued for malpractice, the value of standardization in celiac testing and follow-up care, and how you can get involved in advocating for universal coverage. What’s Discussed:  How the US health insurance system works Usually purchased through employer Loss of job often means loss of coverage ACA provides coverage for many who were uninsured For-profit system  Why Nadine is an advocate for a single-payer system People treated in ER with or without insurance (we pay regardless) US healthcare is very expensive, yet outcomes poor  Celiac disease diagnoses around the world Italy: 2-3 weeks; standardized follow-up care US: 9-15 years; patients endure numerous other tests, misdiagnoses, unnecessary medications Canada: effective early diagnosis, but follow-up care lacking  The excuses practitioners use to avoid diagnosing celiac disease Don’t believe in it, despite research and documentation Don’t want to learn about another illness Gluten-free diet is too difficult for patients  Symptoms Nadine encountered as an ER nurse that may have signaled celiac disease Migraine headaches Abdominal pain Neurological disorders (headaches, difficulty with balance) Fever  Why practitioners should be concerned about malpractice suits if celiac disease goes undiagnosed Ignorance is not a defense Michael Marsh contends that failure to do appropriate screening signals liability Avoid by learning the basics of celiac disease, how to diagnose and follow-up  Why celiac disease needs to be part of differential diagnosis for every patient  Indicators of celiac disease and non-celiac gluten sensitivity HLA-DQ2 or HLA-DQ8 gene denotes predisposition for celiac proper AGA antibody suggests gluten sensitivity  Maladies suffered by patients whose celiac disease went undiagnosed Mental health issues Neurological disorders Seizures Balance issues Abdominal pain Incorrect diagnosis of Crohn’s or colitis Hemorrhoids GERD High blood pressure Heart attack Stroke Cancer  Why standardization of testing and follow-up care is a necessity Screenings are often misinterpreted Celiac patients who follow a gluten-free diet are often told that they have been cured or that the initial test was a false positive when follow-up shows antibodies in normal range  The story of Nadine’s 70-year-old celiac patient Diagnosed with celiac disease by biopsy, but received no follow-up care Suffered from significant neurological issues (e.g.: gluten ataxia, falling) Nadine recommended standard lab tests Primary care doctor refused Patient returned to Nadine in distress Doctor culpable for patient’s neurological damage  Why celiac patients should consider advocating for universal coverage  The differences between celiac diagnoses under universal vs. for-profit insurance systems Financial benefit to early diagnosis under universal system (i.e.: UK, Canada, Italy) No benefit to early diagnosis for insurers under for-profit structure Resources Mentioned:  Physicians for a National Health Program  Health Care for All Oregon  Mid-Valley Health Care Advocates Additional Resources:  “Economic Benefits of Increased Diagnosis of Celiac Disease in a National Managed Care Population in the United States” from the Journal of Insurance Medicine Connect with Nadine:  Instagram Facebook Contact via Email Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

The medical community has an obligation to protect vulnerable populations, speaking up for any group that may not be able to advocate for themselves, and patients with Down, Turner, and Williams syndrome certainly fall into this category. Yet one facet of their health – one that could vastly improve quality of life – often goes overlooked. There is a high prevalence of celiac disease among individuals with Down, Turner, and Williams syndrome, and it is recommended that these patients get tested annually. Unfortunately, many of the symptoms of celiac disease are attributed to the syndrome instead, and gluten sensitivity goes undiagnosed. Today Nadine shares several case studies as well as her own experience working with patients with developmental delays. She covers the high incidence of celiac disease and non-celiac gluten sensitivity in Down, Turner, and Williams syndrome patients, the signs and symptoms of gluten damage, and the importance of annual screening in this population. What’s Discussed:  The prevalence of celiac disease and non-celiac gluten sensitivity in individuals with Down, Tuner and Williams syndrome Annual testing is recommended Signs and symptoms can be eliminated with a gluten-free diet Tiffany’s story Williams syndrome patient Suffered from stage 4 liver failure and diabetes Endured cracked, bleeding skin and fluid in the abdomen Tested positive for celiac disease Gluten-free diet resolved most of her symptoms Alternatives to the standard blood test that could reveal non-celiac gluten sensitivity in Down syndrome patients The anti-gliadin antibody (AGA) is an excellent biomarker In a study published in the World Journal of Gastroenterology, 41% of Down syndrome patients had AGA antibodies  The importance of testing family members A mother who is malnourished during pregnancy may have a child with Down, Turner or Williams syndrome Celiac disease may disrupt fetal development The overlap of celiac disease and Down syndrome Study found that 18 of 284 subjects ages two to 15 tested positive for celiac disease In another study, 11 of 47 had positive blood tests Symptoms of celiac disease and non-celiac gluten sensitivity Diarrhea Abdominal pain Gas Bloating Constipation Short stature Brittle bones Osteoporosis Osteopenia Thyroid issues Anemia Type 1 diabetes Skin rash Decreased appetite Yeast overgrowth Lichen planus Difficulty swallowing Nadine’s story of an autistic patient Sweet gentleman who lived in group home Suffered from diabetes, repeated infections and self-harm Paleo diet made him calmer, didn’t irritate his throat He enjoyed an improved quality of life Cases of asymptomatic celiac disease in children with Down syndrome Study published in the International Journal of Pediatrics Toddlers screened at around 24 months Biopsy proven celiac disease identified in 3-9% of children with Down syndrome Not all patients with positive screens receive a biopsy if asymptomatic One child in the study gained weight and energy on a gluten-free diet A second child had less constipation and diarrhea Follow-up study reported that 66% had health improvement Resources Mentioned: “Screening for Celiac Disease in Down’s Syndrome Patients Revealed Cases of Subtotal Villous Atrophy Without Typical for Celiac Disease HLA-DQ and Tissue Transglutaminase Antibodies” from the World Journal of Gastroenterology “Prevalence of Celiac Disease in Down’s Syndrome” from the European Journal of Gastroenterology and Hepatology “Asymptomatic Celiac Disease in Children with Trisomy 21 at 26 Months of Age or Less” from the International Journal of Pediatrics Other Resources: “Celiac Disease” from the Pediatric Gastroenterology Board Review Manual “The Coexistence of Down Syndrome and a Triad Consisting of: Coeliac Disease, Insulin Dependent Diabetes Mellitus and Congenital Hypothyroidism” from Down Syndrome Research and Practice “Coeliac Disease in Williams Syndrome” from the Journal of Medical Genetics “Turner Syndrome and Celiac Disease: A Case-Control Study” from Pediatrics Connect with Nadine:  Instagram Facebook Contact via Email Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

“Cheap food is an illusion. There is no such thing as cheap food. The real cost of the food is paid somewhere. And if it isn’t paid at the cash register, it’s charged to the environment or to the public purse in the form of subsidies. And it’s charged to your health.” –Michael Pollan Adopting a gluten-free lifestyle can be incredibly overwhelming, and many are resistant to the idea. Maybe you don’t want to give up the foods you love, or you don’t think you can do without pizza and beer. But the truth is that in order to heal, coping is your only option.  Nadine is here to tell you that going gluten-free is not as difficult as you think. In fact, if it’s hard – you’re doing it wrong! She recommends a number of healthy gluten-free and Paleo-friendly food options, explains how your taste buds will change as you rid your body of addictive proteins, and discusses how to approach your grocer to request gluten-free alternatives. It’s time to stop eating for convenience and begin eating to enjoy high-quality food!  What’s Discussed:  Why going gluten-free can be challenging Emotional attachment to food Function as reward/comfort  How to change your mindset to embrace the gluten-free lifestyle Remember that there is plenty of other food to eat Create a new ‘country’  Why celiac patients should avoid eating meat from cattle fed on grass treated with glyphosate Celiac patients are trying to heal increased permeability of the intestinal wall Chemical in Roundup can cause ‘leaky gut’  Nadine’s tips for realizing a healthy gluten-free diet Don’t simply replace gluten-containing with gluten-free products Focus on nutrient dense, whole foods high in good fat Choose organic fruits and vegetables Select 100% grass-fed, antibiotic free meat Avoid dairy (proteins are molecularly similar to gluten) Use almond, coconut or hemp milk and Kite Hill cheese/yogurt Satisfy your sweet tooth with molasses, honey and occasionally maple syrup Pick foods that have been processed very little or not at all Explore new vegetables Try bars when you are on the go (e.g.: Lärabar, EPIC, KIND) Freeze fruits and vegetables to savor year round Consider going Paleo (fruits, vegetables, nuts, seeds, meat, fish and eggs)  The benefits of turning your lawn into a garden ‘Growing food is like planting money’ Allows you to enjoy kale, tomatoes, beans, peas, peppers, squash, etc.  How to tailgate on a gluten-free diet Explore gluten-free alcohol options (i.e.: Ground Breaker, 2 Towns, honey mead) Try gluten free snack foods like Kettle Brand or Jackson’s Honest chips and Jilz Crackers Enjoy guacamole, salsa, hummus and pesto dips Sample desserts like Hail Merry Miracle Tarts  Nadine’s guidelines for selecting healthy foods No more than five ingredients Should be able to picture each ingredient  Quality sources of fat Bacon Pumpkin seed and nut butters Olive oil Avocados Eggs  Resources Mentioned:  Kite Hill  Ground Breaker Brewing  2 Towns Ciderhouse  Kettle Brand Chips  Jackson’s Honest Chips  Jilz Crackers  Hail Merry Miracle Tarts  Lärabar  EPIC Bar  KIND Snacks Connect with Nadine:  Instagram Facebook Contact via Email Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism