Podcasts about hla dq2

Send us a textDid you know that coeliac disease affects 1 in 100 people worldwide, yet only 30% are properly diagnosed? In this episode, I'll explain what coeliac disease is, who is at risk, and why thorough testing and diagnosis are so important.In this episode, I discuss:Common signs and symptoms and why many are not related to the gut; The prevalence of coeliac disease; Three important tests for coeliac disease;Why an accurate diagnosis is crucial; Why symptoms in children are different from adults;The link between autoimmune conditions and coeliac disease;Why testing in children under 3 is not recommended;If you or someone you know is experiencing any of the symptoms discussed in this episode, it might be time to get tested for coeliac disease. And if you found this episode helpful, please share it with others who might benefit!Episode Links: Download our free Kids Gut Health e-bookBook an appointment with one of our Naturopaths This episode is proudly sponsored by my membership, the Natural Super Kids Klub. If you would like to become a member of the Klub to get more helpful resources to help you raise a happy and healthy family click here and pop your name on the waitlist. If you loved this episode, leave me a review! I would super appreciate it. Also, let me know your biggest takeaway from this episode by sending me a direct message on Instagram @naturalsuperkids or shoot me an email at jessica@naturalsuperkids.com.

Immunic Inc (NASDAQ:IMUX) chief scientific officer Hella Kohlhof joined Proactive's Stephen Gunnion on International Celiac Day, in the middle of Celiac Disease Awareness Month, to discuss the disease and the company's developments in treating it. Kohlhof explained that celiac disease is a severe autoimmune disorder affecting around 1% of the global population, predominantly females. Unlike gluten intolerance, celiac disease involves an immune reaction to gluten, leading to gut inflammation and destruction. The only current treatment is a gluten-free diet, which is not effective for all patients. Kohlhof elaborated on the disease's scientific background, highlighting its genetic association with specific HLA genotypes (HLA-DQ2 and HLA-DQ8). She explained that celiac disease is triggered by the immune system's reaction to deaminated gluten peptides, causing inflammation and damage to the gut lining. Immunic is developing IMU-856, an epigenetic modulator, to treat gastrointestinal diseases like celiac disease. IMU-856 enhances gut regeneration and strengthens the gut barrier, improving patients' conditions. Kohlhof detailed the successful completion of a Phase 1b study in celiac patients, which demonstrated the drug's safety, good pharmacokinetic properties, and positive effects on symptoms, biomarkers, gut histology, and nutrient uptake during a gluten challenge. The study confirmed the potential of IMU-856 in treating celiac disease, and further exploration of its mode of action is ongoing. #ImmunicInc, #CeliacDisease, #AutoimmuneDisorder, #GlutenFree, #HellaKohlhof, #ScientificResearch, #EpigeneticModulator, #IMU856, #GutHealth, #Phase1bStudy, #GlutenChallenge, #GastrointestinalDiseases, #Biotechnology, #MedicalResearch, #HealthInnovation, #Pharmacokinetics, #GeneticResearch, #ImmuneSystem, #Healthcare, #ProactiveInvestors #invest #investing #investment #investor #stockmarket #stocks #stock #stockmarketnews

Have  you ever wondered if you have celiac disease? Tune in to hear how you can know and get feeling your best!   Blood Work: TTG is the abbreviation for tissue transglutaminase, an enzyme that is present in the intestines, as well as in other parts of the body. ... There are 2 main types of anti-TTG antibodies, or immunoglobulins, that can be measured when one is tested for celiac disease: TTG IgA and TTG IgG  *Must be eating gluten to show positive* Endoscopic Biopsy: The only true way to get a diagnosis  *Must be eating gluten to show positive* Carry the gene: HLA-DQ2 or HLA-DQ8 You have to carry one of these genes to have celiac disease. This does not necessarily mean that you have or will ever have celiac disease. It means that you have the ability and an increased risk of developing CD.   I'm aware at home test Enhanced biomarker screening The preferred screening method currently tests for tTG-IgA. imaware™ tests for tTG-IgA along with 3 additional biomarkers to provide a more comprehensive result. I'mAware 10% off Code: Coral10 ------------------------- To find out more about my 12 week Transformation Coaching Program message me at coral@servingceliacs.com For our Ultimate Gluten Free Product Guide with over 140 safe and healthier choice items and brands click HERE Instagram Facebook Private FaceBook Group Pinterest

There has been a steady rise in autoimmune disease throughout industrialised societies over the last 30 years. Almost 4.5% of the world's population is affected by one of more than 80 different autoimmune diseases.To add to these already alarming statistics, recent studies have revealed that the incidence of autoimmune diseases worldwide is increasing at a rate of 19% per year.While we know that numerous predisposing genetic risk factors have been identified, these only account for a fraction of the overall incidence of autoimmune diseases.There are studies pointing to a strong influence of environmental and lifestyle factors, but translating this into a meaningful therapeutic model is a challenge, especially under the current, prevailing medical paradigm.Nevertheless, there are those who have pioneered this field of research and, through their personal and professional endeavours, have made it all but impossible to ignore how profound an impact diet, lifestyle and mindset can have when faced with seemingly intractable conditions.Dr Terry Wahls is a clinical professor of medicine at the University of Iowa. In 2000, she was diagnosed with relapsing remitting multiple sclerosis and from that point, began to steadily decline. Because of her academic medical training, Terry began a research journey that eventually led her to investigate these under-explored factors and from this she developed a treatment plan that would help restore her health. Today, Dr Terry Wahls is a teacher and mentor to millions of people around the world who are seeking more effective ways to treat multiple sclerosis and other progressive health problems.Her story is truly inspirational and we are so fortunate to have Terry share this on the IMH Patient Journeys podcast. References:Jamka M, et.al. The Effect of the Paleolithic Diet vs. Healthy Diets on Glucose and Insulin Homeostasis. J Clin Med. 2020;9(2):296. Challa HJ, Bandlamudi M, Uppaluri KR. Paleolithic Diet. [Updated 2022 May 2]. Abbott RD, et.al. Efficacy of the Autoimmune Protocol Diet as Part of a Multi-disciplinary, Supported Lifestyle Intervention for Hashimoto's Thyroiditis. Cureus. 2019;11(4)Gauree G. et.al. Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease, Inflammatory Bowel Diseases, Volume 23, Issue 11, 1 November 2017, Pages 2054–2060Cecilio LA, et.al. The prevalence of HLA DQ2 and DQ8 in patients with celiac disease, in family and in general population. Arq Bras Cir Dig. 2015 Jul-Sep;28(3):183-5.Mangalam, Ashutosh et.al. (2009). HLA-DQ8 (DQB1*0302)-restricted Th17 cells exacerbate experimental autoimmune encephalomyelitis in HLA-DR3-transgenic mice. Journal of immunology.Santoro L, et.al. Looking for celiac disease in Italian women with endometriosis: a case control study. Biomed Res Int. 2014;2014 Małgorzata Królik, et.al. Possible effect of the HLA-DQ2/DQ8 polymorphism on autoimmune parameters and lymphocyte subpopulation in recurrent pregnancy losses, Journal of Reproductive Immunology, Volume 149, 2022,Garcia J, et.al. Social isolation and connectedness as determinants of well-being: Global evidence mapping focused on LGBTQ youth. Glob Public Health. 2020 Apr;15(4):497-519. doi: 10.1080/17441692.2019.1682028. Epub 2019 Oct 28. Rothman, Emily F.et.al. "The Prevalence of Sexual Assault Against People Who Identify as Gay, Lesbian, or Bisexual in the United States: A Systematic Review". Trauma, Violence, & Abuse. 12 (2): 55–66. Brenton JN, et al. Phase II study of ketogenic diets in relapsing multiple sclerosis: safety, tolerability and potential clinical benefits. J Neurol Neurosurg Psychiatry. 2022;93(6):637-644.

In deze aflevering is prof. dr. Frits Koning te gast, werkzaam bij het Leids Universitair Medisch Centrum, afdeling immunologie. “Coeliakie is een ziekte die veroorzaakt wordt door een verkeerde reactie van het afweersysteem. Als immunologen zijn wij erg geïnteresseerd in hoe en waarom dit gebeurt en wat je eraan zou kunnen doen.” Frits Koning doet al sinds 1988 onderzoek naar coeliakie en geeft in deze podcast uitleg over de werking van het immuunsysteem. Bij coeliakiepatiënten denkt het immuunsysteem om een of andere reden dat gluten gevaarlijk is. Hij legt uit wat de rol is van HLA-DQ2 en beantwoordt vragen van luisteraars. Kan een parasiet, bacterie of een virus een trigger zijn voor coeliakie? Hoe kan het dat de een met meer klachten reageert op een onbedoelde gluteninname dan de ander? Wat weten we over refractaire coeliakie en wat is de stand van zaken in onderzoek? Kort samengevat; een boeiend gesprek over o.a. triggers van coeliakie, de werking van het immuunsysteem en dat er tegenwoordig veel aandacht is voor onderzoek naar coeliakie wereldwijd! Handig om te weten: * Alles over de Nederlandse Coeliakie Vereniging: www.ncv.nl * Alles over glutenvrij eten: www.glutenvrij.nl/ * Alles over coeliakie: www.glutenvrij.nl/ziek-van-gluten/coeliakie/coeliakie * Een dietist gespecialiseerd in het glutenvrij dieet vinden? www.ncv.nl/vind-een-dietist

I asked what you wanted to know about Hashimoto’s and the questions came flying in! In this episode, I’m going to tackle half of them and tune in next week as well because I’ll answer the rest there! Hashimoto’s disease is an autoimmune disease that affects the thyroid. Like other autoimmune diseases, what happens is that the immune system gets confused and starts to see the thyroid as a threat. In other autoimmune diseases, the system attacks a different part of the body (the myelin sheath with MS, joints with rheumatoid arthritis, connective tissue with lupus). Under this attack, the thyroid can’t perform optimally and the result is often hypothyroidism.  Conventional medicine treats Hashimoto’s by only addressing the  hypothyroidism if present or waiting for hypothyroidism to begin or suppressing the immune system with medication. The functional medicine approach is to find the root cause of the Hashimoto’s and fix it. I support the functional medicine approach and it starts by understanding what’s going on first. Which is why, I’m so happy to answer your questions!   Autoimmune Triggers  There are four main triggers that can get the immune system in a tizzy. Here are the key triggers for autoimmune diseases: Food Individuals may have food sensitivities, or lack the proper enzymes or stomach bile to properly digest food. If the food we eat doesn't work for our body its a huge trigger for autoimmunity. Infection There are a variety of infections that can become chronic causing the immune system to malfunction. Toxins Environmental toxins (like those found in some cleaning products and beauty products) as well as heavy metals can serve as a trigger. Stress The immune system handles stress by shutting down other non-essential systems. Over time (especially if it’s chronic), this can be a trigger for autoimmune disease.    Question #1: What is the relationship between heavy metals and the root cause of Hashimoto's? Heavy metals are things like aluminum, mercury, arsenic, lead and they can really do a number on our system. Our bodies can handle a little bit of heavy metals but when they build up, they become a toxin (which is one of the triggers). Even copper can become a toxin if it gets out of control (usually due to a zinc deficiency). Mercury has an affinity for the thyroid, so this heavy metal (in particular) should be monitored to ensure it hasn’t reached toxic levels in the body.  There are lab tests that will determine if heavy metals might be the root cause for you. A standard hair analysis is one test but it doesn’t show both types of mercury. My go-to tests for heavy metal are the Quicksilver Scientific Tests because it includes a full heavy metal panel and looks for mercury levels in the blood, urine, and hair.  If heavy metal is a problem, then a detox using binders and herbs like Milk Thistle are often used. However, you’d want to consult with a functional medicine practitioner to make sure you’re doing the right kind of cleanse.   Question #2: What is the connection between Hashimoto’s and the adrenal glands? Stress is one of the four triggers. The adrenal glands deal with stress by producing the hormone cortisol. When too much is produced, the immune system takes that to mean that it’s an emergency putting things like thyroid production on the backburner.  Cortisol also has a relationship with TSH. When cortisol is off, TSH can be off as well and directly affect thyroid function. There is one other potential connection. The symptoms of hypothyroidism are very similar to the symptoms of adrenal fatigue (weight gain, fatigue, depression, hair loss) and so the symptoms may be misinterpreted.    Question #3: What is the true connection to EBV (Epstein-Barr Virus)?  This question sparked a secondary question involving the Medical Medium and the things he’s said about EBV being connected to everything, including attacking the thyroid before causing Hashimoto’s.  I get asked about this a lot but remember the four triggers - one of them is infection which is exactly what EBV is. There is some research that EBV can get into the thyroid gland (as well as other organs) but I wouldn’t say it’s conclusively linked. However, it is an infection which is a trigger. It’s worth noting that once someone gets EBV it’s always in the system and it can flare up due to stress, toxins, and other infections - it has the same triggers as autoimmune.    Question #4: Can you Address Food Sensitivities with Hashimoto’s? Another listener also asked about her experiences with cutting out gluten and dairy and subsequently developed other food sensitivities. (Be sure to check out the episode I did on food sensitivities for more on this)  Food is one of our four triggers, so we know there is a connection. Food sensitivities are not  typically things are born with, they develop over time. So, I  always recommend that you get tested  to see what your sensitivities are using a test that will look comprehensively at antibodies and genetics (not just the general antibody test). But also we want to look at where the sensitivities come from (before eliminating more and more foods) because if there’s inflammation in the body, you're more prone to sensitivities.  Another thing to consider is if you might have gut issues, dysbiosis, candida, parasites or bacteria. This could create a lot of inflammation in the intestines, causing leaky gut. And, if you are lacking the right enzymes or your bile is off, you may not be digesting your food which could result in food getting into your bloodstream. So, sensitivities can definitely be a trigger but you also want to make sure that it’s not your gut health (and infections) causing the issue.    Question #5: Hashimoto’s tends to run in families, especially daughters and females. Is there anything I can do to keep my daughters from getting it down the line? I love this question because there’s so much we can do to protect our children’s health. Prevention is the key when you’re dealing with any disease - especially autoimmunity. Start by considering the four main triggers.  Testing for food sensitivities early can be helpful as can genetic testing - specifically the HLA-DQ2 and HLA-DQ8 which is related to gluten which has a big connection to autoimmunity (not just Hashimoto’s).  Keep an eye on their gut healthy - especially with regards to antibiotics that can disrupt the microbiome and cause dysbiosis (which introduces another trigger - infection).  Consider a good probiotic for kids and doing a regular stool test to get a sense of their microbiome.  Toxins can be minimized by control chemicals in the home (including cleaning products and beauty products). And finally, try to help them learn how to deal with stress. I like the book The Goodnight Caterpillar: A Children's Relaxation Story to Improve Sleep, Manage Stress, Anxiety, Anger by Lori Lite and Emily Fletcher (who appeared on episode 005) has a new meditation program for kids. And, remember that kids learn from watching us, so make sure you model good stress-management skills too.    Next Episode You had more questions about Hashimoto’s disease than I could answer in this one episode! So, tune in next week for more questions and answers about Hashimoto’s and your thyroid health.  Eliminating Health Mysteries Do you know someone struggling with autoimmunity or Hashimoto’s? Share this episode with them. It could help regain their health and give them hope because the answers are out there!   Links: Resources mentioned: Enter the contest by submitting a review then letting me know on Instagram Review Health Mysteries Solved Here  My Instagram Page The Goodnight Caterpillar: A Children's Relaxation Story to Improve Sleep, Manage Stress, Anxiety, Anger by Lori Lite Ziva Meditation for Kids (Emily Fletcher)   Suggested Products Mercury Tri Test Push Catch Detox Related Podcast Episodes: The Case of Exercise Zapping Energy w/ Dr. Kasia Kines Everything You Need to Know to Interpret Epstein Barr (EBV) Results Demystifying Food Sensitivities (and What You Can do About Them) Solving the Autoimmunity Mystery w/ Inna Topiler The Case of the Soul-Crushing Insomnia w/ Emily Fletcher   Thanks for ListeningIf you like what you heard, please rate and review this podcast. Every piece of feedback not only helps me create better shows, it helps more people find this important information. Never miss an episode -  Subscribe NOW to Health Mysteries Solved with host, Inna Topiler on Apple Podcasts, Spotify, Stitcher or Google Podcasts and remember to rate and review the show! Find out more at http://healthmysteriessolved.com   PLEASE NOTE All information, content, and material on this podcast is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Some of the links provided are affiliate links. This means we may make a very small amount of money should you choose to buy after clicking on them. This will in no way affect the price of the product but it helps us a tiny bit in covering our expenses.

The Investigation Chances are you know someone with a gluten sensitivity despite reports that only 6-7% of the population suffer from it. That’s because testing is tricky and false negatives can make people think their health issues are caused by something else. In this episode, I want to break down what’s going on and help you determine if a gluten sensitivity might be at the root of your health mystery.    Understanding Gluten Intolerance Gluten is a protein found in wheat, rye, barley and oats. A person with gluten intolerance cannot digest the protein portion of these grains which triggers an immune response to what the body deems a foreign substance. This immune reaction causes inflammation in the digestive system and damages the lining tissue which, in turn, can cause symptoms like fatigue, bloating, diarrhea, constipation, gas, and cramping. The compromised lining can leave the person more susceptible to bacteria, parasites, and funguses.  Overtime, if a person who has a gluten intolerance continues to eat gluten, their small intestine may also become damaged which leads to malabsorption of nutrients. This can cause fatigue and weight gain. And, the person will be at an increased risk of insomnia, osteoporosis, hormone imbalances, inability to deal with stress, and mood swings. Over time, additional issues may arise like lactose intolerance, depression, leaky gut syndrome (leading to higher susceptibility to infections and other illnesses.) Gluten Intolerance is the Root Cause of Many Health Issues Symptoms of Gluten Intolerance There are many symptoms that could be the result of a gluten intolerance. How many from this list can you check off?    Weight gain Unexplained fatigue Difficulty relaxing, feel tense frequently Unexplained digestive problems Female hormone imbalances, (PMS, menopausal symptoms) Muscle or joint pain or stiffness of unknown cause  Migraine like headaches Food allergies/sensitivities Difficulty digesting dairy products Tendency to over consume alcohol Overly sensitive to physical and emotional pain, cry easily Cravings for sweets, bread, carbohydrates Tendency to overeat sweets, bread, carbohydrates Abdominal pain or cramping Abdominal bloating or distention Intestinal gas “Love” specific foods Eat when upset, eat to relax Constipation or diarrhea of no known cause Unexplained skin problems/rashes Difficulty gaining weight Anorexia Bulimia Rosacea Diabetes Osteoporosis/bone loss Iron deficiency/anemia hronic fatigue Candida Hypoglycemia If you checked off 4 or less it is very unlikely that you have a gluten sensitivity. If you scored between 5 and 8 there may be a reason to suspect it. If you scored 9 or higher there can be a good chance that you are gluten sensitive.   What is a Gluten-Free Diet? Gluten-free means avoiding all foods containing gluten, including wheat, rye, spelt, bulgar, semolina, couscous, kamut and some oats. Gluten can be hidden in processed foods and thickened products such as sauces and soups so read labels carefully. While this can be an adjustment at first, eating gluten free if you are sensitive will make a huge difference in your health.     What’s the Difference between Celiac and Gluten Sensitivity? Celiac disease is an extreme intolerance to gluten where eating gluten will actually damage the lining of your intestines and cause mal-absorption along with many other symptoms such as all types of GI issues, skin issues, headaches, arthritis, depression and the list goes on and on. A gluten sensitivity is when you do not have full-blown celiac and your intestines are not completely damaged but eating gluten makes you feel worse and can often cause very similar if not the same symptoms of those with celiac disease.   What are the Problems with Celiac Testing (and Why is it so Hard to Get a True Answer)? Testing for this is very tricky because the occurrence of false negatives is often likely. The only way to get a true celiac test is to go to the GI doctor and have a biopsy. Your intestines are lined with hair like structures called villi and in healthy intestines; they stand straight up like a shaggy rug. When a person has celiac disease, gluten causes damage to the intestines and the villi lose their integrity and become flattened. The biopsy looks at the state of the villi and only if they are flattened can there be a true celiac diagnosis. Once gluten is removed from their diet, the villi can be revived fairly quickly and thus the intestines will heal.  Patients who already started a gluten free diet prior to their biopsy can often get a false negative because of this. To get a proper diagnosis, the patient should eat gluten (equivalent to at least 1 slice of wheat bread) every day for 30 consecutive days before the biopsy There is also a blood test that can identify the antibodies the body produces against gluten. Some GI doctors use this as a celiac test. The problem here is that the gluten antibodies are produced in significant numbers only if the person has a good functioning immune. With a weak immune system, antibody production will be low and lead to a false negative result. Furthermore, there are several types of antibodies that can be tested such and some of the main ones include IgE, IgG and IgA. IgE shows an immediate response and this often comes out negative unless someone has an anaphylactic shock type reaction to the food which is far less common. IgG and IgA are the delayed antibodies and are more likely to be found through testing because gluten-containing foods take several hours to several days to show symptoms and inflame the immune system.    Testing for Gluten Sensitivity When a celiac test is negative but someone feels worse after consuming gluten (this can happen from 1-72 hours post consumption) they most likely have a sensitivity to gluten. The reason the other tests are negative is because gluten reactions vary in strength. The easiest way to describe this is if you think of a spectrum from 0 to 100 with 0 being no sensitivity and 100 being extremely sensitive. If someone is all the way at 100 it would equate to celiac disease and/or extreme intolerance and often result in a positive biopsy but anything below that would not show up on those tests. So the problem is what if you are at 95? or 85? These cases would show up negative for celiac but as you can see from the example, 95 is still very high on the spectrum and the person would have a pretty severe sensitivity to gluten with all the same symptoms. Testing for sensitivities is also tricky because people can react to gluten through various allergenic pathways and being able to find a possible reactive pathway is the way to see a true result. The major proven pathways include antibody pathways and inflammatory cell mediated pathways. Antibodies can also be tested in blood, but only the IgA and IgG should be used (not IgE) as those are the delayed ones. IgA and IgG antibodies can also be tested in stool and saliva. There are different opinions on what is best (some say gluten is in contact with stool more than blood or saliva thus stool may be more accurate) but most likely testing in all 3, (blood, saliva and stool) is probably better. A positive result in any one of these means there is a sensitivity.    A Negative Gluten Sensitivity Test Does Not Rule Out Gluten Sensitivity It is possible that all 3 antibodies tested in all 3 body fluids can turn out negative but a reaction can still be occurring. This is possible because the body can react to gluten on a cellular level without necessarily producing antibodies, or if the antibody response is weakened due to immune weakness and other diseases. Another way to look at gluten sensitivity is through the inflammatory pathway of the white blood cells. The ALCAT technology has made their name in this area and they test by collecting blood, separating out the while blood cells and then introducing gluten to the white blood cells to look for information. If the while blood cell changes shape, the result is positive. The severity of the change in the white blood cell indicates the severity of the sensitivity. If there is no change to the white blood cell, there is no sensitivity. Persistent Gluten-Sensitivity Symptom Despite Negative Tests Another big piece of the gluten puzzle is a gluten intolerance due to the slight genetic change of the seeds of wheat. In Dr. William Davis's book Wheat Belly, he explains how a geneticist (about 50 years ago) was able to slightly modify the wheat seed to allow the wheat plant to grow faster and be harvested more often. This was lauded as a great help in the fight against world hunger but the genetic modification in the seed created a plant that now has a higher gluten content. Plants can naturally mutate from strain to strain over time but this process takes hundreds of years and this was done overnight. The human DNA is not familiar with this new strain of wheat and thus there are many people who are intolerant to this new wheat strain. Dr. Davis uses a wonderful analogy in his book to describe it. The new wheat is 99.9% genetically the same as the old wheat which doesn’t seem like it would be that harmful, but apes are also 99.9% genetically the same as humans and yet we are quite different. Intolerance to this genetically modified strain of wheat is not a blanket intolerance to gluten which is why eating it causes symptoms but a gluten sensitivity is not detectable in tests.   The Role of Genetics in Gluten Sensitivity and Gluten Intolerance Genetics are often ignored in the gluten intolerance discussion. Genes are something that you are born with and are carried down from generation to generation. There are a set of genes recognized as celiac genes and they are called HLA DQ2 and DQ8. We now know that the DQ2 gene has 2 pieces each with 2 alleles for a total of 4 and the DQ8 has 1 allele for a grand total of 5 different alleles. We need to see all of them. Studies show that if you have a specific number of these gene segments, your body is not designed to process certain gluten proteins and therefore you may have celiac disease already or will be likely to become gluten intolerant/sensitive. Gluten sensitivity is not a disease like celiac disease but can be looked at as a state of genetics. If a person is not designed to process gluten properly based on their genetics but eat it anyways, the end result is a constant attack on the immune system which can subsequently lead to autoimmune disease. But, if we knew a person’s propensity was to be gluten sensitive, we can stop the disease before it happens.   Testing for the Gluten Genes Most labs only do 2 of the gene pieces, but it is essential to have a complete profile of all of them. I have been searching for labs and found a panel that does all the pieces. They are a subsidiary of Labcorp so there is a good chance the test may even be covered by insurance which is a huge plus!   Best Test to Determine Gluten Intolerance The only way to know for sure if gluten is an issue for you is to look at all the pathways through various tests and if any are positive then you have an issue with gluten. Please don’t just take one negative result as an absolute - especially if you do not feel well when you eat gluten or if you have an autoimmune disease. After a lot of research, I believe that looking at genetics holds the biggest key in the gluten puzzle. All the other tests measure only a fraction of how a person’s immune system can react to gluten but genetics can actually tell us what the immune system is going to do in the future. You cannot control what genes you are born with, but you can identify them and change your diet and lifestyle to accommodate them to both heal a health issue as well as prevent a potential future health issue.     Eliminating Health Mysteries Could gluten be the root cause of your health mystery or that of someone in your life?  If you find that you don’t feel well when eating wheat at restaurants, this may be your issue. Eating organic wheat would be helpful for you as well as avoiding wheat when going out as most restaurants do not use organic wheat.    Links: Resources mentioned - tests for gluten sensitivity Alcat  Stool Test  Vibrant America Testing Genetic DQ2/DQ8 Testing   Related Podcast Episodes: #60 Demystifying Food Sensitivities (and What You Can do About Them)   Thanks for Listening If you like what you heard, please rate and review this podcast. Every piece of feedback not only helps me create better shows, it helps more people find this important information. Never miss an episode -  Subscribe NOW to Health Mysteries Solved with host, Inna Topiler on Apple Podcasts, Spotify, Stitcher or Google Podcasts and remember to rate and review the show! Find out more at http://healthmysteriessolved.com   PLEASE NOTE All information, content, and material on this podcast is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Some of the links provided are affiliate links. This means we may make a very small amount of money should you choose to buy after clicking on them. This will in no way affect the price of the product but it helps us a tiny bit in covering our expenses.

The Case: Diana is 36 and suffers from irregular bowel movements and stomach upset. Endoscopies, colonoscopies and genetic testing for celiac disease provided no answers She tried adjusting her diet but nothing has helped and her doctor was stumped. My first suspicion was that her Celiac test was a false negative or that she had some underlying gluten-sensitivity. Gluten is found in wheat, rye, barley and oats and many people may have the sensitivity. It’s estimated that 30 – 40% of people are genetically positive for gluten-sensitivity. Many go undiagnosed. Dr. Peter Osborne is world renown in the field of gluten and grain sensitivity. He is the author   of the highly acclaimed bestseller, ‘No Grain, No Pain’ and is a Doctor of Chiropractic and board certified in clinical nutrition and pastoral medicine. He is the clinical director of Origins Healthcare in Sugarland, Texas and is also an advisor for Functional Medicine University. He joins me in the discussion of this case to share his significant expertise in this field. Confusion Around Gluten Terminology Many people mislabel conditions relating to gluten and mistakenly use gluten-sensitive, gluten-intolerant, gluten allergy, and celiac interchangeably. So, what is the difference between gluten sensitivity and gluten allergy? What’s the difference between gluten intolerance and celiac disease? Dr. Osborne explains that gluten sensitivity is a state of genetics which is not a disease. However, this sensitivity can lead to the development of celiac disease which is an autoimmune disease. Gluten intolerance is a reaction to gluten without the genetic disposition. The body cannot digest gluten properly because it is not producing the necessary enzyme. This can result in irritable bowel, gas, bloating and other intestinal discomforts. An allergy to gluten it very rare. Classically, this would show up as an acute response similar to other food allergies which often have symptoms like hives, swollen lips, and throat constriction. It’s potentially life-threatening. Traditional Testing for Celiac is Insufficient Most doctors will test two genetic markers for celiac disease but there are 5 antibodies that should be tested. Some people, like Diane, are told they don’t have Celiac disease and can eat gluten when that is not the case. Comprehensive tests that specifically include HLA DQ2 and DQ8 as well as the wheat zoomer (see below for links to these tests) are needed to completely rule out gluten issues. These tests are a simple cheek swab and a blood test. Gluten Sensitivity due to Genetics is Permanent While some people may feel better after giving up gluten for a period of time, this does not mean they can return to eating gluten. Dr. Osborne says that it can’t be reversed and his best advice is to stay away from it if they want to maintain their health. Eating gluten (for those that have the gluten genes) is unhealthy for them so if they go back to it, they’ll soon feel the repercussions of their unhealthy ways. Consider the Quality of Grains People who do not have the genetic markers for gluten sensitivity, antibodies to gluten, or the presence of autoimmune disease do not need to follow a gluten-free diet. However, it’s important to look at the quality of the food they’re eating. Grains can have mold or mycotoxins (see episode 006). They may also have trace amounts of pesticides that could include glyphosate which has been linked to cancer, neurodegeneration and fertility issues. In addition to that, many grains have been genetically modified. You Can’t Just Take a Pill There are enzymes available in supplement form that will help the body digest gluten. While this might seem like a ‘get out of jail free’ card, it’s not. If you have a gluten sensitivity or Celiac disease these are meant only to protect you against unwitting exposure (often through cross contamination in non-gluten-free restaurants or homes). It’s not a magic pill that you can take and then go devour a pizza. Sorry, guys. Eliminating Health Mysteries For Diana we were able to get to the real root of the problem and help her regain her health. Could a gluten sensitivity be the missing clue for you or someone in your life? Please share this episode with them so that they can feel better too. Links: Resources mentioned Thanks to my guest Dr. Peter Osborne. You can connect with him through his website: https://drpeterosborne.com/ You can get a copy of his book No Grain, No Pain here: www.glutenfreesociety.com   Thanks for Listening If you like what you heard, please rate and review this podcast. Every piece of feedback not only helps me create better shows, it helps more people find this important information. Never miss an episode –  Subscribe NOW to Health Mysteries Solved with host, Inna Topiler on Apple Podcasts, Spotify, Stitcher or Google Podcasts. Find out more at http://healthmysteriessolved.com   Overcoming Hashimoto’s Summit Claim your free spot to this 7-day virtual summit featuring the top experts in Hashimoto’s and Hypothyroidism so that you can overcome this diagnosis and feel better. https://bit.ly/2KigemW    PLEASE NOTE All information, content, and material on this podcast is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Some of the links provided are affiliate links. This means we may make a very small amount of money should you choose to buy after clicking on them. 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La Enfermedad Celiaca (EC) es una enfermedad sistémica inmunomediada, provocada por el gluten y prolaminas relacionadas, en individuos genéticamente susceptibles, y se caracteriza por la presencia de una combinación variable de: manifestaciones clínicas dependientes del gluten, anticuerpos específicos de EC, haplotipos HLA DQ2 o DQ8 y enteropatía. Esta definición fue actualizada por la ESPGHAN, Sociedad Europea de Gastroenterología Pediátrica, Hepatología y Nutrición en 2012.Hay diferentes tipos de EC: - Síntomática: Los síntomas son muy diversos pero todos los pacientes mostrarán una serología, histología y test genéticos compatibles con la EC.- Subclínica: En este caso no existirán síntomas ni signos, aunque sí serán positivas el resto de las pruebas diagnósticas.- Latente: Son pacientes que en un momento determinado, consumiendo gluten, no tienen síntomas y la mucosa intestinal es normal. Existen dos variantes:--Tipo A: Fueron diagnosticados de EC en la infancia y se recuperaron por completo tras el inicio de la dieta sin gluten, permaneciendo en estado subclínico con dieta normal.--Tipo B: En este caso, con motivo de un estudio previo, se comprobó que la mucosa intestinal era normal, pero posteriormente desarrollarán la enfermedad.-Potencial: Estas personas nunca han presentado una biopsia compatible con la EC pero, del mismo modo que los grupos anteriores, poseen una predisposición genética determinada por la positividad del HLA-DQ2/DQ8.Sintomatología de la Enfermedad CeliacaLos síntomas más frecuentes son: pérdida de peso, pérdida de apetito, fatiga, náuseas, vómitos, diarrea, distensión abdominal, pérdida de masa muscular, retraso del crecimiento, alteraciones del carácter (irritabilidad, apatía, introversión, tristeza), dolores abdominales, meteorismo, anemia por déficit de hierro resistentes a tratamiento. Sin embargo, tanto en el niño como en el adulto, los síntomas pueden ser atípicos o estar ausentes, dificultando el diagnóstico. La sensibilidad al gluten no celiaca es una nueva patología que sufren personas a las que se les ha descartado padecer la enfermedad celiaca y/o alergia al trigo, y que podrían sufrir entre un 5 y un 10 por ciento de la población. Pese a incluir el término gluten en el nombre de la nueva enfermedad, se desconoce si este componente del trigo, otras proteínas o los hidratos de carbono son los que desencadenan la sintomatología.Desde el punto de vista clínico, los afectados por esta nueva patología experimentan síntomas gastrointestinales como diarrea, dolor o hinchazón abdominal, aunque también predominan las manifestaciones extradigestivas como cansancio, dificultad para concentrarse y dolores musculares o articulares.Los anticuerpos antitransglutaminasa tisular son negativos y la mucosa intestinal muestra, en algunos casos, lesiones del tipo Marsh 1, aunque pueden no presentar ningún tipo de lesión.Los alérgicos al trigo, no lo son al gluten, solo al trigo y por ese motivo solo tendrán que retirar de su dieta este alimento.

La Enfermedad Celiaca (EC) es una enfermedad sistémica inmunomediada, provocada por el gluten y prolaminas relacionadas, en individuos genéticamente susceptibles, y se caracteriza por la presencia de una combinación variable de: manifestaciones clínicas dependientes del gluten, anticuerpos específicos de EC, haplotipos HLA DQ2 o DQ8 y enteropatía. Esta definición fue actualizada por la ESPGHAN, Sociedad Europea de Gastroenterología Pediátrica, Hepatología y Nutrición en 2012.Hay diferentes tipos de EC: - Síntomática: Los síntomas son muy diversos pero todos los pacientes mostrarán una serología, histología y test genéticos compatibles con la EC.- Subclínica: En este caso no existirán síntomas ni signos, aunque sí serán positivas el resto de las pruebas diagnósticas.- Latente: Son pacientes que en un momento determinado, consumiendo gluten, no tienen síntomas y la mucosa intestinal es normal. Existen dos variantes:--Tipo A: Fueron diagnosticados de EC en la infancia y se recuperaron por completo tras el inicio de la dieta sin gluten, permaneciendo en estado subclínico con dieta normal.--Tipo B: En este caso, con motivo de un estudio previo, se comprobó que la mucosa intestinal era normal, pero posteriormente desarrollarán la enfermedad.-Potencial: Estas personas nunca han presentado una biopsia compatible con la EC pero, del mismo modo que los grupos anteriores, poseen una predisposición genética determinada por la positividad del HLA-DQ2/DQ8.Sintomatología de la Enfermedad CeliacaLos síntomas más frecuentes son: pérdida de peso, pérdida de apetito, fatiga, náuseas, vómitos, diarrea, distensión abdominal, pérdida de masa muscular, retraso del crecimiento, alteraciones del carácter (irritabilidad, apatía, introversión, tristeza), dolores abdominales, meteorismo, anemia por déficit de hierro resistentes a tratamiento. Sin embargo, tanto en el niño como en el adulto, los síntomas pueden ser atípicos o estar ausentes, dificultando el diagnóstico. La sensibilidad al gluten no celiaca es una nueva patología que sufren personas a las que se les ha descartado padecer la enfermedad celiaca y/o alergia al trigo, y que podrían sufrir entre un 5 y un 10 por ciento de la población. Pese a incluir el término gluten en el nombre de la nueva enfermedad, se desconoce si este componente del trigo, otras proteínas o los hidratos de carbono son los que desencadenan la sintomatología.Desde el punto de vista clínico, los afectados por esta nueva patología experimentan síntomas gastrointestinales como diarrea, dolor o hinchazón abdominal, aunque también predominan las manifestaciones extradigestivas como cansancio, dificultad para concentrarse y dolores musculares o articulares.Los anticuerpos antitransglutaminasa tisular son negativos y la mucosa intestinal muestra, en algunos casos, lesiones del tipo Marsh 1, aunque pueden no presentar ningún tipo de lesión.Los alérgicos al trigo, no lo son al gluten, solo al trigo y por ese motivo solo tendrán que retirar de su dieta este alimento.

Much existing propaganda claims that African Americans do not suffer from celiac disease. Even the Gluten Free RN was surprised to find out that her adopted daughter had a genetic predisposition to the disease back in 2006, as research available at the time regarded the HLA-DQ2 and HLA-DQ8 genes to be primarily Caucasian traits. And until we take steps to conduct a mass screening, we simply don’t know how common celiac disease is among people of African descent. Today, the Gluten Free RN is exploring celiac disease in the African American population. She covers a 2006 study out of Columbia University that assessed African American celiac patients, discussing the variety of ways the subjects presented with celiac disease and the potential reasons for their poor compliance with the prescribed gluten-free diet. Nadine also considers the prevalence of celiac disease on the continent of Africa, explaining why she believes the number of celiac patients will explode with the population’s growing exposure to wheat. Listen in for the Gluten Free RN’s insight on other health issues that may point to undiagnosed celiac disease and learn how we can prevent celiac disease among the African American population with access to testing, social support and gluten-free food! What’s Discussed: The 2006 Columbia University study of celiac disease in African Americans Identified nine patients with biopsy-proven celiac disease Presented with diarrhea, iron deficiency anemia and autoimmune disorders Why patients in the Columbia study demonstrated poor dietary compliance Expense, availability and palatability of gluten-free food Lack of symptoms at diagnosis, inaccurate dietary information Nadine’s prediction around the number of celiac patients in Africa Increasing exposure to wheat will cause explosion The statistics regarding the mortality burden of celiac disease Science Daily reported estimates of 42K child deaths every year in 2011 Majority from Africa and Asia The overlap between diabetes and celiac disease Every type 1 diabetic is HLA-DQ2/8 gene carrier The health issues that may indicate undiagnosed celiac disease Type 1 diabetes, cardiac issues, stroke and heart attack Obesity (stems from lack of nutrient absorption) How to prevent celiac disease among the African American population Access to testing, social support and gluten-free food Resources: Celiac Disease and How Gluten Affects Your Skin EP011 ‘Your Skin on Gluten’ on YouTube ‘Celiac Disease in African-Americans’ in Digestive Diseases and Sciences ‘First Global Estimates of Coeliac Disease and Its Mortality Burden’ in Science Daily Neurological Disorders Associated with Celiac Disease EP012 ‘Celiac Disease in the Developing Countries: A New and Challenging Public Health Problem’ in the World Journal of Gastroenterology ‘Systematic Review: Worldwide Variation in the Frequency of Coeliac Disease and Changes Over Time’ in Alimentary Pharmacology and Therapeutics ‘HLA Typing and Celiac Disease in Moroccans’ in Medical Sciences ‘A Historical Assessment of Sources and Uses of Wheat Varietal Innovations in South Africa’ in the South African Journal of Science University of Chicago: Celiac Disease Facts and Figures ‘Adult Coeliac Disease in South Africa: An Analysis of 20 Cases Emphasizing Atypical Presentations’ in the South African Medical Journal   ‘Epidemiological and Clinical Features in Immigrant Children with Coeliac Disease: An Italian Multicentre Study’ in Digestive and Liver Disease ‘Prevalence of Positive Coeliac Serology in a Cohort of South African Children with Type 1 Diabetes Mellitus’ in the South African Journal of Child Health ESPGHAN Goes Africa Course 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 Heal

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

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

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  

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

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  

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

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

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

Wherever there is wheat, there is susceptibility to celiac disease and non-celiac gluten sensitivity. Gluten is a growing global problem, exacerbated by the popularity of the western diet around the world. This issue has personal, social and political implications as it places a significant economic burden on individuals, communities, and even entire nations.  The Gluten Free RN brings us a ‘big picture’ perspective of the celiac and gluten sensitive population around the world, as we learn about how other countries support these individuals. She also covers the industries that have begun to recognize the power of the gluten free population as a consumer group.  Nadine will be doing some globe-trotting herself come September for the International Celiac Disease Symposium in New Delhi, and she is currently soliciting advice regarding where and how to eat safely during her travels in India and Thailand. Feel free to message her with recommendations!   What’s Discussed:  When and where wheat originated Fertile Crescent (Northern Africa and the Middle East) 10,000 years ago High prevalence of celiac disease in these regions now  The International Celiac Disease Symposium September 2017 in New Delhi Held every two years Scientists, medical professionals and other interested parties Share latest research  Where celiac disease is common Anywhere people are eating grains More widespread as other regions adopt a western diet Increased risk in Punjab population of India  The basics of celiac disease and non-celiac gluten sensitivity Can present in many ways (300+ signs and symptoms) #1 autoimmune disease in the world More likely to recover the sooner identified 30-50% of the population carry the genes (HLA-DQ2 and HLA-DQ8) that indicate predisposition Body doesn’t have enzymes to break down gluten proteins Gluten damages intestines Nadine recommends adopting a Paleo diet in order to heal  The World Health Organization’s “burden of disease” Measures the impact of celiac disease Based on financial cost, mortality, morbidity, etc.  How Italy supports celiac patients Provide extra days off work for doctor’s appointments, shopping Ship gluten free food  Potential symptoms of celiac disease affecting every ethnicity Odd gait (gluten ataxia) Skin rash (dermatitis herpetiformis)  The power of celiac and gluten-sensitive patients as a group Largest untapped market in the world Some industries taking notice (pharmaceutical, food) Use influence to heal selves and educate others  Why some people are so resistant to eliminating grains Sometimes crave what is bad for you Nutritional deficiencies may cause addiction  Resources Mentioned:  Guns, Germs, and Steel: The Fates of Human Societies -  by Jared M. Diamond 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

This time on the ‘Gluten Free RN’ podcast, Nadine explores the connection between gluten intolerance and antibiotic-resistant threats. Because damaged intestines compromise the immune system, undiagnosed celiac patients are more likely to develop infections that necessitate antibiotics.  Nadine summarizes the 2013 CDC report, Antibiotic Resistance Threats in the United States, explaining the three microorganisms identified in the report with a Threat Level of Urgent. Listen and learn how to protect yourself and your family from the public health threat posed by these bacteria!  What’s Discussed:  The prevalence of undiagnosed celiac disease and gluten intolerance 30-50% of the population carry the HLA-DQ2 and/or DQ8 genes The importance of healthy intestinal tissue 70-90% of the immune system is in your intestines The soldier analogy Healthy villi are like rested soldiers with loaded weapons on a clear day who can easily take out antigens that don’t belong Damaged villi are like soldiers on a bender with inadequate weaponry, operating in smoke and fire – they either don’t work at all or fire randomly at antigens The need for a more judicious approach to prescribing antibiotics Overuse of antibiotics wipes out good microbiome along with bad How to rebuild microbiome Kombucha High-quality probiotics Fermented foods Apple cider vinegar The need for IgA and IgG testing to complement a celiac panel The public health threat posed by antibiotic-resistant bacteria The 2013 CDC report details 2 million illnesses and 23,000 deaths yearly The connection between damaged intestines and a higher risk of bacterial infection requiring antibiotics The three microorganisms with a Threat Level of Urgent Clostridium difficile (causes profuse diarrhea, 14,000 deaths/year) Carbapenem-resistant Enterobacteriaceae (50% fatal, 600 deaths/year) Neisseria gonorrhoeae The causes of inflammation in your intestines Gluten Dairy Sugar Why Nadine has concerns about the potential pandemic and huge loss of life presented by large numbers of undiagnosed celiac patients who are susceptible to bacterial infections  Resources Mentioned:   CDC Report: Antibiotic Resistance Threats in the United States, 2013 Enterolab Website Cyrex Laboratories Website PubMed 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

This time on ‘Gluten Free RN,’ Nadine continues to cover the basics of celiac disease and gluten intolerance, reviewing the consequences of intestinal damage and gluten in the bloodstream and discussing what you can and cannot eat as part of a gluten-free diet. A registered nurse certified in emergency care and a celiac patient herself, Nadine is well-versed in the health complications and symptoms you might experience with undiagnosed celiac disease or gluten intolerance, including neurological disorders, dermatologic difficulties and even mental health issues. Join the Gluten Free RN on this podcast to learn the signs of undiagnosed celiac disease and gluten intolerance so that we can all be healthy and vital for years to come! What’s Discussed:  The definition of celiac disease and its chronic nature Diagnosis requires HLA-DQ2 and/or DQ8 genes and documented villous atrophy The importance of healthy intestinal tissue 70-90% of the immune system is in your intestines Grains to avoid that contain gluten Wheat Barley Rye Oats (due to cross-contamination) Places where gluten may be hiding Gluten-free, nutrient dense foods Complications caused by gluten in patients with celiac disease or gluten intolerance Chronic inflammation (suffering from an -itus of any kind) Autoimmune disorders Damaged immune system Malnutrition/deficiencies The increased risk of cancer in patients with undiagnosed celiac disease Symptoms doctors look for before testing for celiac disease Chronic diarrhea Malabsorption Extreme weight loss or malnutrition Components of the test for celiac disease Blood test (celiac panel) Biopsy of the small intestines The amount of time it takes to regenerate damaged villi in the absence of gluten Nadine recommends you continue the clinical trial of a gluten-free diet for at least six to 12 months Additional signs of a possible gluten intolerance or celiac disease Additional symptoms Nadine has encountered in undiagnosed patients Indicators of gluten intolerance in children and elders Resources Mentioned:  Montana Gluten Free Website Kite Hill Non-Dairy Foods Gluten: Zero Global by Rodney Ford 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

Prepare the tea and bring out that fancy gluten-free dessert while you listen to Hamed and Andy talk about the basics of Coeliac disease! **Error during podcast**- HLA DQ2, DQ8 are responsible to create recognition sites for MHC class II.