Archive for the ‘Celiac disease’ Category

 

John Libonati

Shared Genes in Type 1 Diabetes and Celiac Disease

December 16th, 2008 by John Libonati


A 2008 study provides more evidence that there is a link between celiac disease and gluten. This article in Scientific American reviews the study.

Diabetes and celiac disease: A Genetic Connection
Patients with type 1 diabetes have been known to be more prone to another autoimmune disorder, celiac disease, in which gluten in wheat, rye and barley triggers an immune response that damages the small intestine or gut. Now there’s evidence that the two diseases have a genetic link: they share at least seven chromosome regions.

The discovery, published in this week’s New England Journal of Medicine, indicates that both diseases may be triggered by similar genetic and environmental mechanisms, such as certain foods, that cause patients’ immune systems to become overactive and destroy healthy instead of infected tissue. Previous research has found that celiac disease is five to 10 times more common in people with type 1 diabetes than in the general population, an editorial accompanying the study notes.

“These findings suggest common mechanisms causing both celiac and type 1 diabetes – we did not expect to see this very high degree of shared genetic risk factors,” said study co-author David van Heel, a gastrointestinal geneticist at Barts and the London School of Medicine and Dentistry.

Van Heel and his colleagues studied genetic material or DNA from about 20,000 people, half of them healthy, nearly half with type 1 diabetes, and 2,000 with celiac disease. The overlapping genetic variants occurred on regions of chromosomes (parts of cells that carry genetic code) that are believed to regulate the gut’s immune system, the BBC notes.

Type 1 diabetes occurs when a person’s immune system mistakenly attacks healthy beta cells in the pancreas that produce the hormone insulin, which is needed to convert glucose into energy. In celiac disease, a similar attack occurs on the small intestine when sufferers eat gluten-rich grains, causing inflammation in the gut that can lead to bloating, abdominal pain, nausea, constipation, diarrhea, fatigue, anemia, headaches, weight loss and failure to thrive in children. Whereas diabetes 1 patients must inject insulin daily to make up for their deficiency, people with celiac disease can avoid damage and symptoms by sticking to a gluten-free diet.

“The finding raises the question of whether eating cereal and other gluten products might trigger type 1 diabetes by altering the function of the gut and its interaction with the pancreas, the authors write. But Robert Goldstein, chief scientific officer of the Juvenile Diabetes Research Foundation, which helped fund the study, says it would be premature to assume from this study that gluten is also a diabetes trigger.

“I fear the newspaper headlines in the popular press will read like, ‘Eating wheat will cause type 1 diabetes,’” Goldstein tells us. “The presence or absence of these associations has to be linked to some biological consequence” for a person’s health.

Article Source: http://www.sciam.com/blog/60-second-science/post.cfm?id=diabetes-and-celiac-disease-a-genet-2008-12-11

*UK Study Source: Shared and Distinct Genetic Variants in Type 1 Diabetes and Celiac Disease, New England Journal of Medicine. http://content.nejm.org/cgi/content/full/NEJMoa0807917


by John Libonati

Here are six important facts about celiac disease in the United States:

1. Doctors do not understand celiac disease. 97% of celiacs are not diagnosed. Diagnosis takes over 10 years on average and follow up treatment is poor.

2. Doctors do not understand nutrition. Medical schools do not teach it, so doctors generally do not look for nutrient deficiencies unless you are emaciated.

3. Most of the 300 health problems stemming from celiac disease are due to nutrient deficiencies.

4. Comparing symptoms with one another does not work in celiac disease because symptoms change over time and everyone absorbs or malabsorbs nutrients differently. You may absorb everything but vitamin B12. Another person will not absorb calcium or vitamin D. Even siblings sometimes have totally different symptoms.

5. Symptoms from nutrient deficiencies show up before intestinal damage occurs, but also after starting the gluten-free diet depending on the degree of damage and quality of diet.

6. Most celiacs do not realize how sick they really are. They think, “This is me. I’ve always been this way.” They end up spending thousands of dollars on lotions, salves, medications and surgeries when the root of their problem has been a missing nutrient or nutrients all along.

You need to understand gluten and how celiac disease affects your body if you want to be healthy.

You must be able to identify health problems and the nutritional deficiencies that cause them so you can add the missing nutrients to your diet and inform your doctor to help him treat you.

You need the book, Recognizing Celiac Disease.

Recognizing Celiac Disease teaches you everything about gluten, celiac disease, the health problems it causes and what you need to fix them.

Thousands of celiacs around the world are using Recognizing Celiac Disease…because it works.

“Having been dx with CD for one year, I reached saturation – almost overload point a few months ago. Then I read the summary of “Recognizing Celiac Disease” and felt it might encompass everything I had referenced across numerous articles and books – and more. I love being able to look in the index and go to detailed information in my struggle to ensure my nutritional requirements and deficiencies are being met and addressed.” – Reta McCallum, TX

Read how this one of a kind book is helping others at www.recognizingceliacdisease.com.

Order your copy of Recognizing Celiac Disease today. Review it and bring it with you to your next doctor visit. This way you can work with your doctor to make sure you get the best treatment possible.

Visit www.recognizingceliacdisease.com for more information and to see what others are saying.

 

PRESS RELEASE
Milestone Marks the First Time a European Patient with Active Celiac Disease has Enrolled in a Clinical Trial for an Investigational Medication from Alba Therapeutics
Last update: 8:22 p.m. EST Nov. 11, 2008
BALTIMORE, Nov 11, 2008 /PRNewswire via COMTEX/ –

Alba Therapeutics Corporation announced today that for the first time, a European patient with active celiac disease has been enrolled in its clinical trial to investigate a treatment for the disease. Alba has enrolled and randomized the newly diagnosed patient from Spain in an eight-week Phase IIb trial with oral larazotide acetate, a tight junction regulator, for the treatment of patients with active celiac disease (CD). The global multi-center, randomized, double-blind, placebo-controlled study will evaluate the clinical and histological efficacy, safety and tolerability of larazotide acetate in 106 active CD subjects adhering to a gluten-free diet, while assessing improvement in the clinical signs and symptoms of celiac disease.

“These are decisive times for our desire to one day be able to offer our celiac patients a treatment that allows them to live more normal lives,” said Dr. Gemma Castillejo, MD, a pediatric gastroenterologist and principal investigator in the study. Dr. Castillejo, a leading European celiac expert from the Sant Joan de Reus University Hospital in Reus, Spain added, “I believe this clinical trial has the potential to be a turning point in the search for treatments for celiac disease.”
“This is a major milestone for the celiac community in Europe,” stated Francisco Leon, MD, PhD, Vice President, Clinical Development and Medical Affairs of Alba. “This is Alba’s sixth human trial with larazotide acetate, and we are excited to be advancing our investigational program for larazotide acetate in this important region of the world.”
About Celiac Disease
Celiac disease is an inherited autoimmune disorder where gluten has been identified as the environmental trigger of the disease. Gluten is an ingested protein found in wheat, barley and rye. Gluten is broken down into gliadin which can pass through the intestinal epithelial barrier during times of increased intestinal permeability. The ingestion of gluten causes an immune response which triggers an inflammatory reaction in the small intestine. This then causes damage to the villi in the small intestine and can lead to total villous atrophy in celiac disease. This results in varying symptoms such as fatigue, skin rash, anemia, fertility issues, joint pain, weight loss, pale sores inside the mouth, tooth discoloration or loss of enamel, depression, chronic diarrhea or constipation, gas and abdominal pain. The immunology and nutritional abnormalities in celiac disease can potentially result in long- term complications such as osteoporosis, refractory sprue, small intestinal cancer, and lymphoma.
Celiac disease is a growing public health concern, affecting approximately 3 million people in the United States and over 6.5 million people worldwide. The only current management of celiac disease is complete elimination of gluten from the diet, which can be very difficult to implement in practice. Additionally, the response to the gluten-free diet is poor in up to 30% of patients, and dietary nonadherence is the chief cause of persistent or recurrent symptoms.(1)
(1) Green, P, and Cellier, C, Review Article,
 Medical Progress, Celiac Disease, N ENGL J MED
 2007;357:1731-43
About “Larazotide Acetate”
Larazotide acetate is an experimental medicine and a tight junction regulator that acts locally by inhibiting the opening of tight junctions in epithelial cells lining the small intestine. In celiac disease, gluten crosses the epithelial barrier and stimulates the immune system, leading to cytokine release, gut inflammation, and opening of tight junctions. This leads to increased paracellular permeability, increased entry of gluten and the establishment of an intestinal permeability-inflammation loop. Larazotide acetate inhibits tight junction opening triggered by both gluten and inflammatory cytokines, thus reducing uptake of gluten. Larazotide acetate disrupts the intestinal permeability-inflammation loop, and reduces symptoms associated with celiac disease. Larazotide acetate is orally formulated, has been granted “Fast Track” designation by the U.S. Food and Drug Administration for the treatment of celiac disease, and is also being evaluated for the treatment of Crohn’s Disease.

For more information about Alba’s clinical trials, please visit the www.clinicaltrials.gov web site and search for Alba Therapeutics.

About Alba
Alba Therapeutics Corporation is a privately held, clinical-stage biopharmaceutical company focused on the discovery, development, and commercialization of therapies to treat autoimmune and inflammatory diseases and is located in Baltimore, Maryland. Alba’s technology platform is based upon a key pathway that regulates the assembly and disassembly of tight junctions in cell barriers throughout the body. As a result of its unique technology platform, Alba is a leader in mucosal biology and has developed a pipeline of innovative therapeutic candidates that has the potential to modify the course of disease and significantly improve upon existing treatments for a wide range of diseases such as celiac disease, Crohn’s disease, and Asthma/COPD or acute lung injury.
    Media: Mariesa Kemble
    Sam Brown Communications
    608-850-4745
    kemblem@aol.com 

    Corporate: Wendy Perrow, MBA
    Alba Therapeutics Corporation
    410-878-9850
    info@albatherapeutics.com
    http://www.albatherapeutics.com
----------------------
Author Information: John Libonati, Philadelphia, PA
Publisher, Glutenfreeworks.com.
Editor & Publisher, Recognizing Celiac Disease.
John can be reached by e-mail here.
John Libonati

Dentists Can Help to Recognize Celiac Disease

July 21st, 2008 by John Libonati

gluten free dentist
Photo © ADAM

Dentistry Blog

By Tammy Davenport, About.com Guide to Dentistry since 2005

Celiac disease causes the body’s immune system to damage and attack the small intestine upon consumption of proteins in barley, rye, wheat and possibly oats. Since there are no specific blood tests to determine if someone has Celiac disease, doctors use blood tests to look for certain autoantibodies and biopsy the small intestine to look for traits of Celiac disease.Nancy Lapid, our Guide to Celiac Disease, points out that certain dental conditions are more common in people with this disease, which puts dentists in a good position to help notice when a patient might have Celiac disease.

Some examples of dental related problems in a patient with Celiac disease are tooth enamel defects, canker sores and delayed eruption in the teeth.

Source: http://dentistry.about.com/b/2008/05/14/dentists-can-help-to-recognize-celiac-disease.htm

The news release below is timely because anti-gliadin antibody blood tests are losing ground while the reality of gluten sensitivity looms far larger than is now appreciated by many doctors!  These blood tests are absolutely necessary to investigate health problems caused by gluten itself, yet they are being dismissed by doctors who look only to diagnosing celiac disease.

Positive anti-gliadin antibody tests show undigested gluten peptides in the bloodstream.  This abnormal finding tells the story that gluten has passed through the tight barrier defenses of the small intestinal lining into the body where it can wreak havoc, with or without celiac disease.  Gluten is a food protein in wheat, barley, rye and oats.

In screening for celiac disease, an inherited immune response to gluten entering the small intestinal lining, doctors rely on the celiac specific antibody tests, anti-endomysium and anti-tissue transglutaminase.  However, the investigation to find these auto-antibodies must not exclude the anti-gliadin antibodies. 

Doctors Slow To Recognise Gluten Harm.” Dr. Rodney Ford, Leading New Zealand Paediatrician And Allergist Challenges Medical Stalwarts With Revolutionary Gluten Thinking

There is more to gluten problems than just coeliac disease. Gluten sensitivity is ten times more prevalent than celiac disease in New Zealand and mostly undiagnosed. This is the message that Christchurch-based paediatrician, allergist and author, Doctor Rodney Ford wants to get across to the public and the ever conservative medical fraternity.

The practice of medicine is restricted to the knowledge, experience, attitudes and politics of the society it functions in. Medicine is an inexact but evolving science, thus current standard medical practices are often disproved. The validity of medical opinion, long held to be the gold standard of diagnosis and treatment, are constantly challenged. This is a healthy dynamic, one that enables the pursuit of excellence and the evolution of better forms of practice, resulting in better outcomes for patients. Why, then asks Dr Ford, is there such resistance to his new Gluten Syndrome hypothesis recently published in a book and supported by years of clinical experience and research.

In the absence of coeliac disease, his latest research shows that the simple gluten test (IgG-gliadin antibody) is a sensitive indicator to detect those people who get sick eating gluten but who have tested negative to Celiac Disease. However, this test is rarely ordered by general practitioners or specialists. He says “This is because of an illogical rejection of gluten sensitivity as a valid diagnosis. Ignoring gluten flies in the face of all of the evidence and is also alienating doctors from their patients.”

Picture this, if you will: a six year old girl, Elizabeth, small for her age, a distended stomach, gas and suffering from gastric reflux. Her teachers reported a lack of attention at school and early learning problems. Elizabeth had been thoroughly investigated by the medical profession: blood tests, bowel biopsies, colonoscopy, endoscopy. Celiac Disease had been ruled out, various medications had been tried and doctors had started to question her mother’s parenting skills. Elizabeth’s parents had gone beyond frustration and fear for their child, they were at the point of desperation.

This is a common story in Dr Ford’s practice. It is also one of the many success stories he has to share. After seeing Dr Ford, a positive IgG-gliadin antibody test and being put on a gluten free diet, Elizabeth improved within a few days. Within weeks she made a remarkable recovery and was in essence cured. Gluten was no longer a choice for her and accidental intake still causes her a reoccurrence of symptoms. Adhering to a gluten free diet has enabled Elizabeth to grow into the healthy, happy and successful young woman that she is today.

Common stories such as this, along with the increasing research and evidence of gluten based harm, should be enough to spur the medical profession into action in an effort to save the current generation of children from the long term health, social and financial consequences of what is an easily diagnosed and treatable condition.

The shocking truth is that this terrible scourge of gluten is being ignored by most medical practitioners. Even worse, the blood tests that can diagnose it are being abandoned by many medical laboratories. For instance, Medlab Diagnostics in Auckland no longer offers gliadin antibody tests.

The medical professions reluctance to act on the gluten problem is costing New Zealand billions of dollars each year with long term and far reaching consequences. From a dollars and cents point of view it makes no economic sense. From a patient care point of view it is bordering on negligence.

Source: Scoop Independent News, New Zealand, Thursday, 19 June 2008, 9:49 am
You can find this news release at http://www.scoop.co.nz/stories/GE0806/S00059.htm

Cleo Libonati, RN, BSN

Making the Connection – in Celiac Disease

May 19th, 2008 by Cleo Libonati, RN, BSN

Advance For Nurses Magazine
Vol. 9 •Issue 11 • Page 21

Making the Connection

Underdiagnosed in the U.S., celiac disease can be identified and treated if the condition is understood

By Cleo Libonati, RN, BSN

Celiac disease is a common food sensitivity that can be the underlying source of hundreds of health problems mistakenly attributed to other causes. This insidious disorder has the potential to disfigure, disable and destroy lives at any age. Yet, of the 3 million affected Americans, only 3 percent are diagnosed and treated.1 Prevalence rates are higher in certain populations, such as blood relatives of a person with celiac disease and those with autoimmune disorders.

Unfortunately, people in the U.S. with this condition actively seeking help for their symptoms can go a lifetime without diagnosis and proper treatment. Typically, worldwide diagnosis is faster.
Genetic Susceptibility & Gluten

Celiac disease is also called celiac sprue, nontropical sprue, gluten-sensitive enteropathy or simply celiac by the public.

This immune-mediated disorder stems from an inherited lifelong intolerance to the gluten protein found in wheat, barley, rye and oats. When ingested, gluten resists the breakdown action of normal digestive enzymes into harmless amino acids. Undigested peptides precipitate hyperpermeability of the small intestinal lining (so-called “leaky gut”) to breach the intestinal barrier defense system. In this way, gluten unnaturally gains entrance to the lamina propria.

Within the lamina propria, gluten peptides encounter the enzyme transglutaminase and the local immune system. Transglutaminase deamidates, or breaks off, the rich glutamine residues in gluten. This deamidation creates the toxic molecular compounds, or epitopes, the immune system identifies as foreign.

These epitopes trigger autoimmune antibodies in genetically susceptible individuals. Ensuing inflammation swells affected portions of the small intestinal lining and damages its delicate structures, interfering with its function to finish digestion and absorb nutrients.

While gluten itself is the environmental cause for antibody development, some stressors that can trigger active disease include gluten overload, pregnancy, viral gastrointestinal infection, surgery and severe stress.
Recognizing Celiac Disease

Despite dramatic advancements in knowledge and testing procedures, recognition of this multifaceted disorder is lacking.1Celiac disease often is undiagnosed due to ignorance of the following:

Pathophysiology — The traditional description of celiac disease as an intestinal disorder with malabsorption as the primary defect is a shadow of the real condition.

Prevalence — In contrast to the historic belief celiac disease affected just one in 5,000 individuals, antibody testing demonstrated prevalence of one in 100.

Diagnostic tests — Healthcare providers are unfamiliar with new and improved testing methods.

Manifestations — Many patients do not have diarrhea and wasting symptoms of classic celiac disease. Extraintestinal symptoms predominate in people with atypical symptoms.
How It’s Diagnosed

Diagnosis of celiac disease is made by a positive serologic antibody study and confirmed by histological findings of small-bowel biopsy specimens obtained by endoscopy and improved clinical response following a gluten-free diet.

The single most important step in diagnosing celiac disease is to recognize its myriad clinical features. No single test can definitively diagnose or exclude celiac disease in every individual; there also is a continuum of laboratory and histopathologic results.1

Positive anti-endomysium antibodies and positive anti-tissue transglutaminase antibodies show celiac disease. Positive antigliadin antibodies demonstrate sensitivity to gliadin itself, the gluten in wheat.

Not all patients have positive antibodies at presentation. When symptoms are present but test results are negative, further testing is warranted, including selective immunoglobin A deficiency. In the event the patient started a gluten-free diet prior to testing, suggest a gluten challenge of 3 months or longer in the expectation of antibody development.

Positive small intestinal biopsy shows the degree of villous atrophy, yet this is not foolproof either. The gastroenterologist must be skilled in taking accurate specimens from multiple sites, and the pathologist must be skilled in examining them properly. In addition, damage may be submicroscopic, returning a level not yet detectable by histological examination.

Additional studies include sonogram and genetic testing. Sonogram shows edema and abnormal appearance of the bowel wall. This is especially helpful for children or those who cannot undergo an endoscopy.

More than 97 percent of people with celiac disease share the same genetic human leukocyte antigen (HLA) haplotype markers, HLA-DQ2 and HLA-DQ8. While HLA genotyping is not specific for celiac disease, it has a very high negative predictive value. If the markers are not present, genetic testing essentially rules out the disease.

Annual follow-up testing is warranted for patients with negative test results who continue to show symptoms.
Recognizing Symptoms

There are no typical symptoms of celiac disease, although the most common clinical presentation is unexplained iron-deficiency anemia with or without gastrointestinal symptoms.

Celiac disease, by way of malnutrition, immunity or the direct toxic effect of gluten on cellular structures, has the potential to produce a broad range of symptoms, associated disorders and complications that may affect any organ or body system. Manifestations vary and may appear at any age.

Nutrient deficits are responsible for many seemingly unrelated conditions, such as depression, inability to concentrate, anxiety, insomnia, defective tooth enamel, coagulopathies, hypertension, obesity, anorexia and excessive thirst.

Associated autoimmune disorders may affect any body tissue, including type I diabetes mellitus, hypothyroidism and Grave’s disease, to name a few. Further, severe complications include various cancers such as B-cell non-Hodgkin lymphoma, cryptic intestinal T cell lymphoma and enteropathy-associated T cell lymphoma.

Chronic diarrhea in childhood should provoke screening. Pediatric presentation for celiac disease could involve hypotonia, failure to thrive, growth retardation, short stature, convulsions, poor bone and tooth development, thymic atrophy and delayed puberty.
Treatment

Treatment is a gluten-free diet. Excluding gluten usually results in rapid healing of the small intestinal mucosa, resolution or improvement of nutritional deficiencies, and disappearance of many manifestations of celiac disease.

The gluten-free diet is challenging due to the plethora of gluten-containing foods in the standard American diet. To succeed, patients need detailed diet instruction, including how to read food labels and identify hidden sources of gluten, such as in medications and supplements. Refer patients to a qualified dietitian if possible; otherwise, nurses can teach appropriate information.

Inform patients about community help such as celiac support groups, which offer practical advice on how to shop and cook, and where to dine. Many support groups hold their meetings at local hospitals.
Prognosis

Clinical outcome depends on duration of exposure to gluten. The longer gluten is consumed, the more the body is damaged, and the greater the likelihood of health disorders and complications developing.

Intestinal permeability improves within 2 months of starting a gluten-free diet. Despite a good clinical response, abnormal endoscopic and histologic appearances persist in the majority of patients.2Patients who receive adequate education about celiac disease and treatment with the gluten-free diet are better able to prevent intestinal damage and improve their health by dietary self-management. Clearly, nursing intervention that uncovers hidden celiac disease, provides nutritional education and promotes regular follow-up will considerably improve prognosis. n
References for this article can be accessed at www.advanceweb.com/nurses. Click on Education, then References.
Cleo Libonati is author of Recognizing Celiac Disease, and co-founder, president and CEO of Gluten Free Works Inc., Ambler, PA.
This article copyrighted to Advance For Nurses and can be accessed online at their website at http://nursing.advanceweb.com/Editorial/Search/AViewer.aspx?AN=NW_08may12_n4p21.html&AD=05-12-2008

John Libonati

Everyone on a Gluten Free Diet?

May 15th, 2008 by John Libonati

The below article by Nadine Grzeskowiak is a good explanation of why the gluten-free diet can work for anyone and everyone and pitfalls of the celiac tests.  Medical experts speak of the gluten-free diet as if it is something strange, yet most unprocessed foods you cook yourself are naturally gluten free.  All meats, seafood, fruits, vegetables, nuts, legumes, dairy (unless gluten was added to them), corn, rice and other grains,(besides wheat, barley, rye or oats), naturally do not contain harmful gluten.  Wheat, barley, rye and oats don’t contain any nutrients you cannot get in other foods, so what is the big deal with not eating them?Nadine’s article is excellent.  The only thing I would add is if you do eliminate the gluten grains of wheat, barley, rye and oats and feel better within two weeks, get yourself tested for celiac disease.  A positive diagnosis makes dealing with healthcare providers much easier.  That said, if it comes back negative but you feel better being gluten-free then eliminate gluten from your diet and be healthy.You can find Nadine’s blog article at http://glutenfreern.com:80/everyone-on-a-gluten-free-diet/-John Libonati, Editor Glutenfreeworks.com
john.libonati@glutenfreeworks.com

Discussion | | Nadine Grzeskowiak | May 13, 2008

I have thought for a long time about this very question.  Who would suggest such a thing?  I would.  The main reason I would dare to make such a statement is because we have been so negligent in recognizing and treating people with celiac disease.  Not a day goes by that I don’t hear about or speak to someone directly who has suffered needlessly for years.  The other main point I want to make is that NONE of the currently available testing is 100%.  The blood tests and endoscopic biopsies are great tools if they are positive.  If they are negative, I have heard of too many people tell me ‘I don’t have celiac disease, my blood test/biopsy was negative’.  This is a major cause for concern to me.  Both of these tests do not confirm you don’t have, or will never develop celiac disease.  First, neither test is 100% reliable.  Second, both tests are simply a snapshot of right now.  I have also seen test results that are clearly positive for celiac disease, but read as negative by a medical provider that does not understand what the results mean.  The genetic testing is great and it is my first choice when testing people.  The test is a cheek swab, I get results in one week and it is covered by most insurances.  I utilize Kimball Genetics in Denver, Colorado,  www.kimballgenetics.com.  I have run into this scenerio in the past week: a 12 year old on a gluten free diet for several months, a remarkable recovery from many symptoms while on the gluten free diet, and yet, she tests negative for DQ2 and DQ8.  Is she at risk for celiac disease if she eats gluten?  Are there other genes that could be looked at?  I am gathering more data on this because nothing is black and white with gluten intolerance, there are many grey areas.  Other than, of course, the need to be on a strict gluten free diet for the rest of your life if you have celiac disease.  Not much grey there. 

So, this leads me back to the original question: everyone on a gluten free diet?  In my perfect world, the answer would be a resounding YES!  If people would simply try the gluten free diet for a month, most, if not all of those people will feel better.  It remains simply a diet change.  Change your diet and feel better, doesn’t that sound appealing.  To some yes, and to others, not really. Not without the proof that they need to change their long held diet and lifestyle habits.  It also sounds quite un-American to say ‘I can’t eat wheat, barley, rye and oats’, by extension, bread, pies, cakes, beer and pizza.  My most recent convert to a gluten free diet, said to me, “You know I don’t even miss the bread anymore, it doesn’t even appeal to me, I feel so much better on the gluten free food”.  This is a woman who has had symptoms for most of her 76 years and I had a hard time convincing her to try the gluten free diet for a month.  She is convinced now.  I can tell many stories with the same happy ending.  I can also tell you that most men have a harder time changing anything, let alone their diet, than women.  Trust me, I am a nurse and I have no reason to lie to you.  Try it.  Go gluten free for a month and contact me with your results.  GO!

We have some very important information to share with you today.

While we were at Columbia University’s Topics in Gastroenterology, Dr. Steven Lobritto talked about cirrhosis of the liver and how he has actually seen people who were on the liver transplant list heal enough to be taken off once they started a gluten-free diet.

According to our new book, “Recognizing Celiac Disease”, 3.4% of people with non-alcoholic fatty liver disease have SILENT Celiac Disease. Most patients DO NOT have gastrointestinal symptoms.

Non-alcoholic fatty liver is a non-inflammatory hepatic (liver) disorder characterized by degenerative changes in the liver secondary to excessive accumulation of lipid in hepatocytes.

The good news is that studies showed liver enzymes normalize after 6 months on a gluten-free diet.

If you have patients or family members with non-alcoholic fatty liver (cirrhosis), who are not diagnosed with celiac disease, give them this information so they can get tested.

Related medical studies are referenced in “Recognizing Celiac Disease.” www.recognizingceliacdisease.com.

Celiac disease is a multi-system, hereditary, chronic, auto-immune disease estimated to affect 1% of the human population (3 million in the US) that is caused by the ingestion of wheat, barley, rye and oats. It is treated by removing these items from the diet. Signs, symptoms, associated disorders and complications can affect any part of the body and removal of the offending foods can result in complete recovery.  

Health Alert - Microbes Matter - Probiotics a.k.a. Good Bacteria in Your Gut

Strange as it seems, our well-being is uniquely tied to the condition of our colon, which is commonly unhealthy at diagnosis of celiac disease. To keep our colon healthy, we need to understand what happens there on a microscopic level.  Hundreds of varieties of intestinal microbe populations called “flora” live there, numbering in the billions.  To put these numbers into focus, dead bacteria make up about a third of each bowel movement.  Our resident microbes, whether beneficial or harmful, play a decisive role in nourishing or damaging the cells that form the intestinal lining.  Probiotic and prebiotic foods and supplements restore and feed our friendly microbes.


Probiotic flora inhibit colonization of pathogens by physically preventing them from adhering to the gut lining.  Other important functions are:

  • Produce short chain fatty acids (SCFA)s.  SCFAs are important and necessary energy byproducts formed during fermentation of undigested carbohydrates in the colon by flora.  SCFAs nourish the colonocytes, the cells that line the colon. They also help absorb salts and water from stool.

  • Produce a form of vitamin K and appreciable amounts of biotin.
  • Reduce the presence of putrefactive enzymes.

  • Protect against toxic substances.

  • Contribute to normal bowel movements.

For these reasons, we need to use probiotics and prebiotics every day to improve our overall health and specifically our intestinal health.  This is especially important if fatigue, weakness, achiness, depression, foggy thinking and digestive problems continue while maintaining a gluten-free diet. 


(This Health Alert was taken from information found in
Issue #9 – Microbes Matter of the Gluten Free Gazette.)  Celiac disease is a hereditary, auto-immune disorder estimated to affect 1% of the human population (3 million in the

US). Less than 3 % are estimated to be medically diagnosed, but numbers are expected to rapidly increase as diagnosis improves. Celiac disease is caused by the ingestion of wheat, barley, rye and oats and treated by removing these items from the diet. Signs, symptoms, associated disorders and complications can affect any part of the body and removal of the offending foods can result in complete recovery.  Visit Glutenfreeworks.com for more information.

John Libonati

Psoriasis and Celiac Disease – Genetic Link

April 4th, 2008 by John Libonati

The research below further supports the links demonstrated between celiac disease and psoriasis as noted in the book “Recognizing Celiac Disease.” (www.recognizingceliacdisease.com) Although not the focus of this study, the link could be a genetic sensitivity to gluten itself, considering the resolution of symptoms seen by people with psoriasis who go on a gluten-free diet. In addition, the other disorders, diabetes type 1 and arthritis have been linked to celiac disease/gluten sensitivity reactions. – John Libonati, Glutenfreeworks.com

Psoriasis: 7 New Genetic Clues

Newly Discovered Genetic Variations May Make Psoriasis More Likely, Study Shows
By Miranda Hitti

WebMD Medical NewsReviewed by Louise Chang, MDApril 3, 2008 — Scientists have discovered seven genetic variations linked to psoriasis.

If confirmed in other studies, those gene variants may make good targets for new psoriasis drugs, note the researchers, who included Anne Bowcock, PhD, genetics professor at Washington University School of Medicine in St. Louis.

“Common diseases like psoriasis are incredibly complex at the genetic level,” Bowcock says in a news release. “Our research shows that small but common DNA differences are important in the development of psoriasis. Although each variation makes only a small contribution to the disease, patients usually have a number of different genetic variations that increases their risk of psoriasis and psoriatic arthritis.”

Bowcock’s team compared DNA from 223 psoriasis patients (including 91 with psoriatic arthritis) and 519 people without psoriasis, and also from two other large groups of people with and without psoriasis.

Through those comparisons, the researchers identified seven genetic variations linked to psoriasis and psoriatic arthritis and confirmed other variations already linked to psoriasis.

One of the newly discovered variants is in a genetic region tied to four other autoimmune diseases: celiac disease, type 1 diabetes, Grave’s disease, and rheumatoid arthritis.

Further studies are needed to confirm the findings, Bowcock and colleagues note in the April 4 online edition of Public Library of Science Genetics.

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SOURCES:

Liu, Y. Public Library of Science Genetics, April 4, 2008; online edition.

News release, Public Library of Science.

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http://www.webmd.com:80/skin-problems-and-treatments/psoriasis/news/20080403/psoriasis-7-new-genetic-clues