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Increased Appetite

increased appetite gluten celiac symptomWhat Is Increased Appetite?

Increased appetite is the increased desire for food.

Q: What causes appetite.

A: Appetite is caused by hunger.

The brain monitors nutritional needs and employs a hunger mechanism to alert us when fresh food is needed. Hunger is mainly caused by the need for protein. Low blood sugar also triggers hunger.

The tempting sight, smell, taste and expectation of food stimulates involuntary sensory nerves. By reflex action, these sensory nerves cause muscle and sensory activity in various digestive organs. Salivary glands in the mouth begin to secrete saliva as stomach glands and muscles become active.1

What Is Increased Appetite In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Cleo Libonati. Recognizing Celiac Disease. Gluten Free Works Publishing, Fort Washington, PA 19034 USA [↩]

Lactose Intolerance

Lactose IntoleranceWhat Is Lactose Intolerance?

Lactose intolerance is a well known symptom of carbohydrate malabsorption characterized by inability to properly digest lactose, the sugar in milk, due to low lactase digesting activity in the small intestine.

Lactase is an enzyme produced by specialized cells in the tips of villi within the brush border of the small intestinal lining that digests lactose.

Lactose is a disaccharide, or double sugar, made up of a molecule of glucose and a molecule of galactose (simple sugars). Lactose cannot be absorbed as is into the body unless it is broken down by lactase into glucose and galactose.

Q: How does lactose cause diarrhea?

A: If lactose is not broken down, undigested lactose moves into the colon where it acts osmotically to draw water from the walls of the colon into the lumen, which causes diarrhea by the unnatural amount of water. How much water? Can be 2 liters! Meanwhile, the normal population of colonic bacteria ferment the undigested lactose, generating short-chain fatty acids and hydrogen gas, resulting in bloating pain and flatulence.

Testing for intolerance is based on the action of lactose to increase intestinal permeability.1 Positive response to a breath hydrogen test (BHT), involving 1 – 3 hours of time post ingestion of lactose test dose, signifies malabsorption in the small intestine and fermentation in the colon. If BHT is positive before 60 minutes, the result implies bacteria is abnormally present in the small intestine, causing fermentation there.

Endoscopy is used to measure activity of lactase in a tissue sample.

Treatment is avoidance of milk and dairy products that contain lactose. Nevertheless, milk treated with lactase enzyme can be safely consumed. Fermented milk products like yogurt or kefir are safe because the lactose has been digested by organisms. If there is also a problem with milk protein, then no milk is acceptable that comes from the cow or animal that is causing the allergy.

What Is Lactose Intolerance In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease. Journal of Gastroenterology and Hepatology. 2003;18:479-91. [↩]

Aphthous Ulcers (Canker Sores) 

Aphthous_ulcer[1]What Are Aphthous Ulcers?

Aphthous ulcers, also called canker sores, are a chronic disorder of soft mouth tissue characterized by small, painful purpuric, papular, or erosive lesions that are often surrounded by erythematous (red) margins.1

Q: What soft mouth tissues develop canker sores?

A: Canker sores can erupt on the mucosal surface of the inside lip, sides of mouth, under the tongue and along the side of the tongue. When they are forming, the area swells into a papule, or small bump. Later, the surface erodes and a crater forms with firm pus.

What Are Aphthous Ulcers In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Lahteenoja H, Toivanen A, Viander M, Maki M, Irjala K, Raiha I, Syrjanen S. Oral mucosal changes in coeliac patients on a gluten-free diet. European Journal of Oral Sciences. Oct 1998;106(5):899,8p. [↩]

Macrocytosis

Comparison of normoblast and megaloblastWhat Is Macrocytosis?

Macrocytosis is a blood cell disorder characterized by altered blood cell formation that results in abnormally large erythrocytes (red blood cells) circulating in the bloodstream.

The mean corpuscular volume (MCV), which is a measure of the size of red blood cells in the bloodstream, is greater than 100 fL as shown in a complete blood count (CBC) laboratory analysis report.

Macrocytosis produces macrocytic anemias that are classified as megaloblastic or non-megaloblastic:

  1. Megaloblastic anemias result from disorders of DNA synthesis of red blood cell precursors (megaloblasts) in bone marrow due to B vitamin deficiency demonstrated by macro-ovalocytes and hypersegmented neutrophils.1
  2. Non-megaloblastic anemias are or those caused primarily by alcoholism, liver disease and hypothyroidism.2

What Is Macrocytosis In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Kaferle J, Strzoda CE.Evaluation of macrocytosis. Am Fam Physician. 2009 Feb 1;79(3):203-8. [↩]
  2. Davenport J. Macrocytic anemia. Am Fam Physician. 1996 Jan;53(1):155-62. [↩]

Cheilosis (Cracks in corners of mouth)

cheilosisWhat Is Cheilosis?

Cheilosis is a painful feature of nutritional deficiencies, especially riboflavin and/or pyridoxine deficiency, and less frequently, from vitamin B12, folic acid, and iron. It is characterized by redness of the lips with cracking and weeping in the corner of the mouth.

Q: What is the consequence of weeping at the corners of the mouth?

A: The open sores that develop at the corners of the mouth invite infection by candida albicans, a yeast organism, and less commonly by bacteria normally present on the skin such as staphylococcus aureus.

These sores make opening the mouth very painful and so restrict eating, talking, socializing, and dental care.

What Is Cheilosis In Celiac Disease and/or Gluten Sensitivity?

Hypocalcemia (Low Blood Calcium)

hypocalcemia celiac disease gluten symptomWhat Is Hypocalcemia?

Hypocalcemia, or low plasma calcium, means the level of calcium in blood is too low to meet metabolic needs of the body for calcium.

Low blood calcium is characterized by bone and tooth demineralization (loss of calcium causing weak teeth and fragile bones), and these impaired functions: nerve conduction, muscle contraction, blood clotting, blood pressure regulation, glycogen to glucose conversion, many hormone actions, many enzyme activities, and acetylcholine production.

Q: Where is calcium found in the body?

A: Calcium is the most abundant mineral in the body, with 99% residing in bones and teeth where it constitutes 40% of skeletal bone weight along with 45% phosphorus. As a component of bone (hard tissue), calcium fulfills a structural role to maintain body size and act as attachments for musculoskeletal tissues. The remaining 1% of calcium is present in blood and soft tissues.

Calcium levels in the blood are maintained within very strict limits by dietary intake, hormonal regulation by the parathyroid gland and a rapidly exchangeable pool in bone tissue.

What Is Hypocalcemia In Celiac Disease and/or Gluten Sensitivity?

Bleeding / Swollen Gums

Vitamin C Deficiency: Clean Teeth with Swollen Gums.
Vitamin C Deficiency: Swollen Gums.

What Are Bleeding / Swollen Gums?

Bleeding and/or swollen gums is  an inflammatory disorder characterized by changes in gum integrity that may result in tooth loss.

Sponginess of the gum (swelling) indicates inflammation, called gingivitis. 

Q: What causes gingivitis?

A: Gingivitis that is caused by inadequate dental hygiene shows as pockets of swollen gum between or along the base of teeth where sticky plaque was allowed to build up. Plaque holds bacteria that inflames the gums where it occurs.

Gingivitis that is caused by vitamin C deficiency, pregnancy, certain drugs such as the anti-epileptic drug phenytoin, and leukemia affects the whole gum irrespective of mouth care.

What Are Bleeding / Swollen Gums In Celiac Disease and/or Gluten Sensitivity?

Hypocupremia (Low Blood Copper Level)

hypocupremia low copper and celiac disease gluten symptom
Paleness and Tendon Problem: Symptoms of Hypocupremia.

What Is Hypocupremia?

Hypocupremia, or low plasma copper, means the level of copper is too low to meet metabolic needs of the body for copper and is characterized by these many features:

  1. Impaired energy production causing weakness.
  2. Impaired ability as part of an enzyme to oxidize vitamin C which is required to breakdown histamine.
  3. Faulty blood cell formation and instability of blood cell membranes causing anemia, shortened life span of neutrophils causing susceptibility to infection, faulty platelet formation causing impaired blood clotting.
  4. Faulty elastin formation causing weak blood vessels.
  5. Poor collagen and connective tissue strength causing joint and tendon problems and weak bones causing deformities, faulty bone mineralization causing fragile bones.
  6. Loss of proprioception causing ataxia.
  7. Loss of pigmentation of hair and skin.
  8. Impaired thyroid function.
  9. Impaired adrenalin production.

Untreated, copper deficiency can advance to brain degeneration. Failure to make normal blood cells can result in death.

What Is Hypocupremia In Celiac Disease and/or Gluten Sensitivity?

Oral Mucosal Lesions, Chronic (Mouth Soreness)

Canker Sore Inside Mouth. Notice The White Spot on This Person's Nail Showing Zinc Deficiency.
Inflammation/Sore Inside Mouth. Notice White Spot on Fingernail Nail Showing Zinc Deficiency.

What Are Chronic Oral Mucosal Lesions?

Chronic lesions of the oral mucosa are disorders of the mouth that are characterized by soreness and sores of the soft mucosal lining of the mouth.

What Are Chronic Oral Mucosal Lesions In Celiac Disease and/or Gluten Sensitivity?

Hypoglycemia (Low Blood Sugar)

hypoglycemia symptom of celiac disease and glutenWhat Is Hypoglycemia?

Hypoglycemia means the level of glucose within cells is too low to meet metabolic needs of the body for this essential sugar.

Q: What are the metabolic needs for glucose?

A: Glucose is the most important simple sugar in human metabolism mainly because it is the primary source of energy for most cells of the body.

Energy contained in the glucose molecule is obtained by the body from its reaction with oxygen (oxidation). This oxidation reaction occurs in power producing mitochondria structures that are located within cells.1

Hypoglycemia is characterized by alterations in neurologic, metabolic and muscular functions:

  1. Neurologic function because brain tissue is particularly dependent on glucose for energy,
  2. Metabolic function of glucose-dependent tissues which include red blood cells, white blood cells, bone marrow, eye, inner heart of the kidney, and peripheral nerves because these tissues cannot metabolize fatty acids as an alternate source of energy, and
  3. Muscle function because muscle cells continually require glucose for energy production.

Glucose is made available to cells through the regulating action of insulin, a hormone produced by specialized cells located on the surface of the pancreas.

What Is Hypoglycemia In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. http://hyperphysics.phy-astr.gsu.edu/hbase/organic/sugar.html accessed 11 14 12 [↩]