{"id":4705,"date":"2013-04-23T14:22:05","date_gmt":"2013-04-23T14:22:05","guid":{"rendered":"http:\/\/www.mynutriguide.com\/?p=135"},"modified":"2019-12-26T12:48:27","modified_gmt":"2019-12-26T17:48:27","slug":"macrocytosis","status":"publish","type":"post","link":"https:\/\/glutenfreeworks.com\/health\/macrocytosis\/","title":{"rendered":"Macrocytosis"},"content":{"rendered":"<h2><a href=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/Comparison-of-normoblast-and-megaloblast2.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft  wp-image-6977\" style=\"margin-left: 5px;margin-right: 5px\" src=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/Comparison-of-normoblast-and-megaloblast2-300x244.png\" alt=\"Comparison of normoblast and megaloblast\" width=\"270\" height=\"220\" srcset=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/Comparison-of-normoblast-and-megaloblast2-300x244.png 300w, https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/Comparison-of-normoblast-and-megaloblast2.png 320w\" sizes=\"auto, (max-width: 270px) 100vw, 270px\" \/><\/a>What Is Macrocytosis?<\/h2>\n<p style=\"text-align: justify\"><span class=\"dropcap\">M<\/span>acrocytosis is a blood cell disorder characterized by altered blood cell formation that results in abnormally large\u00a0erythrocytes (red blood cells) circulating in the bloodstream.<\/p>\n<p style=\"text-align: justify\">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.<\/p>\n<p style=\"text-align: justify\">Macrocytosis produces macrocytic anemias that are classified as megaloblastic or non-megaloblastic:<\/p>\n<ol>\n<li style=\"text-align: justify\"><span style=\"text-align: justify\"><strong>Megaloblastic anemias<\/strong>\u00a0result 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.<a href=\"#footnote_1_4705\" id=\"identifier_1_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Kaferle J, Strzoda CE.Evaluation of macrocytosis. Am Fam Physician. 2009 Feb 1;79(3):203-8.\">1<\/a><\/span><\/li>\n<li style=\"text-align: justify\"><span style=\"text-align: justify\"><strong>Non-megaloblastic anemias<\/strong>\u00a0are or those caused primarily by alcoholism, liver disease and hypothyroidism.<a href=\"#footnote_2_4705\" id=\"identifier_2_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Davenport J. Macrocytic anemia. Am Fam Physician. 1996 Jan;53(1):155-62.\">2<\/a><\/span><\/li>\n<\/ol>\n<h2>What Is Macrocytosis In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p><!--more--><\/p>\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\"><strong>Relationship between macrocytosis and celiac disease.<\/strong> Macrocytosis is a classic sign of celiac disease.<\/li>\n<li style=\"text-align: justify\"><strong>Relationship between macrocytosis and vitamin deficiencies.\u00a0<\/strong>Macrocytosis in celiac disease results from chronic deficiencies of folate and\/or vitamin B12.\u00a0These B vitamins are required for normal red blood cell production in bone marrow.<\/li>\n<li style=\"text-align: justify\"><strong>Relationship between macrocytosis and symptoms.\u00a0<\/strong>Initial evaluation should include a carefully taken history and physical examination along with a complete hematologic (blood) profile, reticulocyte count, and peripheral blood smear.\u00a0Serum vitamin B12 and red cell folate determinations and other studies may then be undertaken as appropriate.<a href=\"#footnote_3_4705\" id=\"identifier_3_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Brigden ML. A systematic approach to macrocytosis. Sorting out the causes. Postgraduate Medicine. May 1995; 97(5):171-2,175-7,181-4 passim.\">3<\/a><\/li>\n<\/ul>\n<h2>How Prevalent Is Macrocytosis In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p style=\"text-align: justify\">Macrocytosis is a common serology (blood test) finding in untreated celiac disease patients.<a href=\"#footnote_4_4705\" id=\"identifier_4_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Murray JA, the widening spectrum of celiac disease. American Journal of Clinical Nutrition. Mar 1999; 69(3):354-365.\">4<\/a><\/p>\n<h2>What Are The Symptoms Of\u00a0Macrocytosis?<\/h2>\n<p style=\"text-align: justify\">Macrocytosis is marked by\u00a0anemia causing tissue hypoxia (not enough oxygen to the body) including:<\/p>\n<ul class=\"cp_bullet red\">\n<li>Fatigue.<\/li>\n<li>Weakness.<\/li>\n<li>Headache.<\/li>\n<li>Lightheadedness.<\/li>\n<li>Angina.<\/li>\n<li>Dyspnea.<\/li>\n<li>Pallor.<\/li>\n<li>Tachycardia (fast heart rate).<\/li>\n<li>Curly graying hair.<\/li>\n<li>Increased skin color (hyperpigmentation).<\/li>\n<li>Worsening of heart disease.<\/li>\n<\/ul>\n<h2>How Does Macrocytosis In Celiac Disease and\/or Gluten Sensitivity Develop?<\/h2>\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\">Macrocytosis results from folic acid and\/or vitamin B12 deficiencies induced by celiac disease.<a href=\"#footnote_4_4705\" id=\"identifier_5_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Murray JA, the widening spectrum of celiac disease. American Journal of Clinical Nutrition. Mar 1999; 69(3):354-365.\">4<\/a><\/li>\n<\/ul>\n<h2>Does \u00a0Macrocytosis Respond To Gluten-Free Diet?<\/h2>\n<p style=\"text-align: justify\">Yes. Celiac disease-related macrocytosis responds to gluten free diet.<a href=\"#footnote_5_4705\" id=\"identifier_6_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Murray JA, the widening spectrum of celiac disease. American Journal of Clinical Nutrition. Mar 1999; 69(3):354-365.\">5<\/a><\/p>\n<h2>6 Steps To Improve Macrocytosis In Celiac Disease and\/or Gluten Sensitivity:<\/h2>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>1<\/strong><\/span><\/span><strong><span style=\"color: #800000\">Remove the Trigger. Maintain a Strict, Nutritious Gluten Free Diet:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<b>Treatment<\/b>. This condition responds to the complete elimination of gluten, which is the required treatment that improves both macrocytosis and gut health.<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Gut health is the foundation to restore ALL health. Restored health will enable you to maintain a strict gluten free diet, just as other life tasks will be easier.<\/li>\n<li>A strict gluten free diet means removing 100% of wheat, barley, rye and oats from the diet.<\/li>\n<li>Cutting out bread and other obvious sources of gluten is not good enough for recovery. Even 1\/8th teaspoon of flour or bread crumb is enough to sustain the inflammation that is damaging your small intestine, causing increased permeability (leaky gut) and allowing undigested gluten to enter your body where it can damage structures and function, and instigate immune inflammatory responses.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Correct Your Individual Nutritional Needs.<\/strong><\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Eat foods that can replenish missing nutrients. Find them under\u00a0NUTRIENT DEFICIENCIES.<\/li>\n<li>Take nutritional supplements as needed.\u00a0Find them under\u00a0NUTRIENT DEFICIENCIES.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Recovery<\/strong>. You should begin to feel better within a week and notice more energy as inflammation subsides and the \u00a0absorbing cells that make up the surface lining of your small intestine are better able to function.<\/p>\n<ul class=\"cp_bullet green\">\n<li>Intestinal lining cells are replaced every 5 days. The healing process is like sunburn where the damaged surface layer of skin sloughs off and is replaced with new normal cells.<\/li>\n<li>Leaky gut normally resolves in two month after starting a gluten free diet and brings about a big improvement in health. Improvement in intestinal permeability precedes morphometric recovery (cell appearance and structure) of the small intestine in celiac disease.<a href=\"#footnote_6_4705\" id=\"identifier_7_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease.&nbsp;Clinical Science. Apr 2001;100(4):379-86.\">6<\/a><\/li>\n<li>The intestinal lining may take up to a year to heal.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul class=\"cp_check green\">\n<li><span style=\"color: #800000\"><em><span class=\"dropcap\"><strong>2<\/strong><\/span><strong>\u00a0Reduce Inflammation. Foods to Eat and Foods Not to Eat:<\/strong><\/em><\/span><\/li>\n<\/ul>\n<p>Because gluten is inflammatory, eliminate OTHER inflammatory foods from your diet to reduce an additive effect to gluten. At the same time, try to eat foods that reduce inflammation (anti-inflammatory).<\/p>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Here Are Major Inflammatory Food Types That Reduce Healing<\/strong>:<\/p>\n<ul class=\"cp_bullet red\">\n<li style=\"text-align: justify\"><strong>Damaging Foods<\/strong>. In susceptible persons, includes corn, dairy (cow), and soy. Lactose, the sugar in any animal milk disrupts intestinal permeability causing leaky gut.<a href=\"#footnote_7_4705\" id=\"identifier_8_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">7<\/a><\/li>\n<li style=\"text-align: justify\"><strong>Allergenic Foods<\/strong>. Includes foods that trigger the immune sytem to produce IgE antibodies. Allergy testing is the usual way to discover these offending foods.<\/li>\n<li style=\"text-align: justify\"><strong>Shelf Stable Processed Foods.\u00a0<\/strong>Includes any that contain additives and preservatives. Look for them on the nutrition label of the box or package. Additives and preservatives also disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_7_4705\" id=\"identifier_9_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">7<\/a><\/li>\n<li style=\"text-align: justify\"><strong>Fats.<\/strong>\u00a0Limit deep fried foods, trans-fats, saturated fats (animal fat\/butter), and EXCESSIVE omega-6 fatty acid oils like corn oil. Rancid fats, sodium caprate (a medium chain fat), and sucrose monester fatty acid (a food grade surfactant) induce significant disruption of the intestinal barrier that causes leaky gut.<a href=\"#footnote_7_4705\" id=\"identifier_10_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">7<\/a>.<\/li>\n<li style=\"text-align: justify\"><strong>Excessive Refined White Flours\u00a0<\/strong>(bran layer removed)<strong>.\u00a0<\/strong>Includes\u00a0products made from them such as cookies, bread, cakes, pies.\u00a0Bran contains the vitamins and minerals that metabolize grains and slows the otherwise rapid entry of sugar from their digestion into the bloodstream.\u00a0Also disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_7_4705\" id=\"identifier_11_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">7<\/a><\/li>\n<li style=\"text-align: justify\"><strong>Refined Sugars.\u00a0<\/strong>\u00a0Includes white sugar, corn fructose and high fructose corn syrup.<\/li>\n<li style=\"text-align: justify\"><strong>Certain Spices<\/strong>. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_7_4705\" id=\"identifier_12_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">7<\/a><\/li>\n<li style=\"text-align: justify\"><strong>Alcohol and Caffeine<\/strong>. Disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_7_4705\" id=\"identifier_13_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">7<\/a>\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Here Are Important Anti-Inflammatory Food Types to Promote Health<\/strong>:<\/p>\n<ul class=\"cp_bullet green\">\n<li style=\"text-align: justify\"><strong>Fruits<\/strong>.\u00a0Contain ample amounts of vitamins, minerals and phytochemicals which are\u00a0naturally occuring components in plants that detoxify toxins, carcinogens (reducing the risk by 50%) and mutagens.<\/li>\n<li style=\"text-align: justify\"><strong>Non-Starchy Vegetables.<\/strong>\u00a0Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes lettuce, kale, onion, broccoli, garlic, and others.<\/li>\n<li style=\"text-align: justify\"><strong>High Quality Complex Carbohydrates<\/strong>. Provide vitamins, minerals, and fiber while boosting serotonin levels to help you relax and feel calm. Includes whole grains, legumes, and root vegetables such as carrots, parsnips, sweet potatoes, turnips, red beets, and others.<\/li>\n<li style=\"text-align: justify\"><strong>Antioxidants<\/strong>. Protect the body from inflammatory oxidant molecules that continually occur and\u00a0help us handle stress and reduce irritability. Includes vitamin C-containing foods such as lemon, grapefruit, apricot, Brussels sprouts and strawberries, and others. Also, includes vitamin E-containing foods such as\u00a0nuts, seeds, avocado, olive oil, and others. Cocoa is good, too.<\/li>\n<li style=\"text-align: justify\"><strong>Omega-3 Fatty Acids<\/strong>. Balance opposing omega-6 fatty acids and bad fats. Fish sources includes tuna, salmon, cod, and others. Plants sources include flax, chia seeds, canola oil, and others.<\/li>\n<li style=\"text-align: justify\"><strong>Probiotics.\u00a0<\/strong>Supply normal microbes needed for colon health and health of the body such as these fermented foods: yogurt, kefir, and unpasteurized apple cider vinegar.<\/li>\n<li style=\"text-align: justify\"><strong>Prebiotics\/ High Fiber Foods<\/strong>. \u00a0Food with fiber keeps our population of colonic microbes healthy.<\/li>\n<li style=\"text-align: justify\"><strong>Protective Herbs and Spices<\/strong>. \u00a0See below #6 below for examples.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><strong><span class=\"dropcap\">3<\/span>\u00a0Information Sheet You Can Take to Your Doctor or Other Health Professional:<\/strong><\/span><\/em><\/li>\n<\/ul>\n<p>Click here.<\/p>\n<p>&nbsp;<\/p>\n<ul class=\"cp_check green\">\n<li><span style=\"color: #800000\"><strong><em><span class=\"dropcap\">4<\/span>\u00a0Manage Your Medications\u00a0Safely<\/em>:<\/strong><\/span><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<p>Certain prescription drugs can cause nutritional deficiencies that promote macrocytosis. Ask your doctor or pharmacist about this possible adverse effect.\u00a0<strong>Do not stop without supervision &#8211; this is mandatory<\/strong>:<\/p>\n<p><strong>FEMALE HORMONES<\/strong>\u00a0disrupt intestinal permeability.<\/p>\n<ul class=\"cp_bullet blue\">\n<li>Oral Contraceptives (Norinyl\u00ae, Ortho-Novum\u00ae, Triphasil\u00ae, and others) deplete Vitamin B12, Folic Acid.<\/li>\n<li>Oral Estrogen\/Hormone Replacement (Evista\u00ae, Prempro\u00ae, Premarin\u00ae, Estratab\u00ae and others) deplete Vitamin B12, Folic Acid.<\/li>\n<\/ul>\n<p><strong>DIURETICS<\/strong><\/p>\n<ul class=\"cp_bullet blue\">\n<li>Potassium Sparing Diuretics (Midamor\u00ae, Aldactone\u00ae, Dyrenium\u00ae and others) deplete\u00a0Folic Acid.<\/li>\n<\/ul>\n<p><strong>DIABETIC DRUGS\u00a0<\/strong><\/p>\n<ul class=\"cp_bullet blue\">\n<li>Metformin\u00ae depletes\u00a0Folic acid, Vitamin B12.<\/li>\n<\/ul>\n<p><strong>ANTI-INFLAMMATORIES<\/strong>\u00a0&#8211; Disrupt Intestinal permeability.<\/p>\n<ul class=\"cp_bullet blue\">\n<li>Corticosteroids (Prednisone, Medrol\u00ae, Aristocort\u00ae, Decadron) deplete Vitamin B12, Folic Acid.<\/li>\n<li>NSAIDS (Motrin\u00ae, Aleve\u00ae, Advil\u00ae, Anaprox\u00ae, Dolobid\u00ae, Feldene\u00ae, Naprosyn\u00ae and others) deplete\u00a0Folic acid.<\/li>\n<li>Aspirin and Salicylates deplete\u00a0Folic acid.<\/li>\n<\/ul>\n<p><strong>ANTICONVULSANTS<\/strong><\/p>\n<ul class=\"cp_bullet blue\">\n<li>Phenobarbital and Barbituates; and Dilantin\u00ae, Tegretol\u00ae, Mysoline\u00ae, Depakane\/Depacon\u00ae deplete\u00a0Folic Acid, Vitamin B12.<\/li>\n<\/ul>\n<p><strong>MAJOR TRA<\/strong><strong>QUILIZERS<\/strong>\u00a0<b>\u00a0<\/b><\/p>\n<ul class=\"cp_bullet blue\">\n<li>Thorazine\u00ae, Mellaril\u00ae, Prolixin\u00ae, Serentil\u00ae and others\u00a0deplete\u00a0Vitamin B12.<\/li>\n<\/ul>\n<p><strong>ANTIBIOTICS \u00a0<\/strong>disrupt intestinal permeability.<\/p>\n<ul class=\"cp_bullet blue\">\n<li>Gentomycin, Neomycin, Streptomycin, Cephalosporins, Penicillins\u00a0deplete\u00a0B Vitamins.<\/li>\n<\/ul>\n<p><strong>ANTACIDS \/ ULCER MEDICATIONS<\/strong><\/p>\n<ul class=\"cp_bullet blue\">\n<li>Pepcid\u00ae, Tagamet\u00ae, Zantac\u00ae deplete Folic Acid, Vitamin B12.<\/li>\n<li>Magnesium and Aluminum Antacid preparations (Gaviscon\u00ae, Maalox\u00ae, Mylanta\u00ae) deplete Folic Acid, Vitamin B12.<\/li>\n<li>Prevacid\u00ae, Prilosec\u00ae\u00a0depleteVitamin B12.<\/li>\n<li>Alka Seltzer\u00ae, Baking Soda deplete\u00a0Folic Acid.<\/li>\n<\/ul>\n<p><strong>CHOLESTEROL DRUGS<\/strong><\/p>\n<ul class=\"cp_bullet blue\">\n<li>Colestid\u00ae and Questran\u00ae Folic acid, Vitamin B12.<\/li>\n<\/ul>\n<p><strong>ANTIVIRAL AGENTS<\/strong><\/p>\n<ul class=\"cp_bullet blue\">\n<li>Zidovudine (Retrovir\u00ae, AZT and other related drugs) deplete Vitamin B12.<\/li>\n<\/ul>\n<p><strong>ANTI-DEPRESSANTS<\/strong><\/p>\n<ul class=\"cp_bullet blue\">\n<li>Adapin\u00ae, Aventyl\u00ae, Elavil\u00ae, Pamelor\u00ae, and others\u00a0deplete these nutrients: Vitamin B12.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><strong><span class=\"dropcap\">5<\/span>Nutritional Supplements To Help Correct Deficiencies:<\/strong><\/span><\/em><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<p style=\"text-align: justify\">The type and quantity of nutritional supplements that may be needed depend on which nutrients are deficient.<\/p>\n<ul class=\"cp_bullet orange\">\n<li style=\"text-align: justify\">Multivitamin\/mineral combination once a day is useful to improve overall nutrient levels. This is a safe dose, but always check with your doctor to avoid interactions with medications.<\/li>\n<li style=\"text-align: justify\">100% of the B vitamins, or as prescribed by a doctor. About\u00a0B Vitamin Complex supplements: \u00a0some labeling can be confusing, for example, &#8220;B 100&#8221; does not mean 100%. If the ingredient list shows\u00a0\u00a0an excessive amount like\u00a03000% or more, look for another brand because this excessive amount will cause the loss of mineral in the urine.<\/li>\n<li style=\"text-align: justify\">Vitamin B12 by mouth or if not absorbed by the intestines, sublingually or by injection as prescribed following blood test for status.<\/li>\n<\/ul>\n<p><strong>Storage Note<\/strong>:\u00a0<em>Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet &#8211; not in the bathroom or on the kitchen table<\/em>.\u00a0\n\t\t\t<\/div><\/div>\n<ul class=\"cp_check green\">\n<li><span style=\"color: #800000\"><em><strong><span class=\"dropcap\">6<\/span>Manage Natural Remedies:\u00a0<\/strong><\/em><\/span><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Hydration<\/strong>:<\/p>\n<ul class=\"cp_bullet green\">\n<li>Eight glasses of water are recommended per day unless there is a contraindication such as kidney or heart disease. The Institute of Medicine recommends approximately 2.7 liters (91 ounces) of total water, from all beverages and foods, each day for women and 3.7 liters (125 ounces) daily of total water for men.<\/li>\n<li>If you are thirsty, drink water. Add fresh, squeezed lemon to water. Lemon is anti-inflammatory, alkalizing and provides vitamin C.<\/li>\n<li>Hydration Test: Urine should be pale yellow. Fingertips should be plump, without pruning but this may not be reliable when fingers are swollen with edema. Lips should be plump, without puckering. The feeling of thirst can be unreliable.<\/li>\n<li>What is wrong with soda, coffee, tea, and alcohol? These drinks are dehydrating, increase acid, and deplete nutrients.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Carminatives.\u00a0<\/strong>The following \u00a0anti-inflammatory\u00a0plant sources called carminitives help heal the digestive tract. They also tone the digestive muscles which improves peristalsis, thus aiding in the expulsion of gas from the stomach and intestine to relieve digestive colic and gastric discomfort.<\/p>\n<p><strong>Carminative Food Remedies<\/strong>:<\/p>\n<ul class=\"cp_bullet green\">\n<li>Raspberry.<\/li>\n<li>Carrot is also a cleansing digestive tonic.<\/li>\n<li>Grape is also bile stimulating and a cleansing remedy for sluggish digestion and laxative.<\/li>\n<li>Redbeets also stimulate and improve digestion and are easily digested.<\/li>\n<li>Cabbage also stimulates and improves digestion and is also a liver decongestant.<\/li>\n<li>Lettuce also stimulates and improves digestion and is also an alterative, meaning it improves the function of organs involved with the digestion and excretion of waste products to bring about a gradual change.<\/li>\n<li>Potatoes are antispasmodic (due to atropine like properties) and a liver remedy.<\/li>\n<\/ul>\n<p><strong>Carminative Herb Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\">\n<li>Sage is also a digestive, astringent, bile stimulant and energy tonic that heals the mucosa. \u00a0Drink as tea or use in cooking.<\/li>\n<li>Chamomile, lemon balm, and fennel, (as a tea) also help relieve nervous tension.<\/li>\n<li>Parsley also relieves indigestion.<\/li>\n<li>Rosemary as a tea and in cooking also is a nervous system tonic for stress and fatigue, bile stimulant, and can relieve headaches and indigestion.<\/li>\n<li>Thyme is also soothing remedy useful for stimulating digestion of rich, fatty foods.<\/li>\n<\/ul>\n<p><strong>Carminative Spice Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\">\n<li>Cloves are also antispasmodic.<\/li>\n<li>Nutmeg is also useful for indigestion.<\/li>\n<li>Ginger.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Exercise Helps<\/strong>:<\/p>\n<p>Gentle exercise improves circulation and rids the body of toxins. Exercise only up to the point of pain to prevent tissue damage from lack of oxygen.<\/p>\n<ul class=\"cp_bullet green\">\n<li>Walking is aerobic exercise that reconditions the whole body to improve stamina.\u00a0Read more about<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">\u00a0Exercise and Fitness<\/a>.<\/li>\n<li>Weight training builds muscle.\u00a0Read more about\u00a0<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">Exercise and Fitness<\/a>.<\/li>\n<li>Stretching improves flexibilty.\u00a0Read more about\u00a0<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">Exercise and Fitness<\/a>.<\/li>\n<\/ul>\n<p><strong>Note<\/strong>: Exercise is important, but the amount and type of exercise undertaken depends on your health. Your first priority is to heal. \n\t\t\t<\/div><\/div>\n<p>&nbsp;<\/p>\n<h2>What Do Medical Research Studies Tell About\u00a0Macrocytosis In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<h4><strong>RESEARCH STUDY SUMMARIES<\/strong><\/h4>\n<p style=\"text-align: justify\"><strong>\u201cAnemia in celiac disease is multifactorial in etiology.\u201d<\/strong>\u00a0This study assessed the characteristics of anemia from a cohort of patients seen at a hospital care center for celiac disease. Hematological parameters measured less than 3 months of diagnosis and degree of villous atrophy from 405 patients diagnosed after 1995 was analyzed. Folate deficiency was seen in approximately 12% of the total sample. Macrocytic anemia with concurrent folate deficiency was 3%.<a href=\"#footnote_8_4705\" id=\"identifier_14_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Harper JW, Holleran SF, Ramakrishnan R, Bhagat G, Green PH. Anemia in celiac disease is multifactorial in etiology.&nbsp;Am J Hematol. 2007 Nov; 82(11):996-1000.\">8<\/a><\/p>\n<p style=\"text-align: justify\">\u201c<strong>Vitamin B12 deficiency in untreated celiac disease.\u201d<\/strong>\u00a0This study investigating the prevalence of vitamin B12 deficiency in patients with celiac disease demonstrated that vitamin B12 deficiency is common in patients with untreated celiac disease and concentration should be measured routinely before hematinic replacement.<a href=\"#footnote_9_4705\" id=\"identifier_15_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Dahele A, Ghosh S. Vitamin B12. deficiency in untreated celiac disease.&nbsp;American Journal of Gastroenterology. Mar 2001; 96(3):745-50.\">9<\/a><\/p>\n<p style=\"text-align: justify\"><strong>&#8220;Serum folates in man.&#8221;<\/strong>\u00a0This study investigating folate compounds and their breakdown compounds demonstrated that 5-ethyltetrahydrofolate is poorly absorbed by patients with celiac disease and the availability for biological utilization of the major dietary folate compounds will depend on the amount of gastric acidity and of the ascorbate in the intestinal chyme. Many folate compounds may be unavailable for metabolic utilization in the body.<a href=\"#footnote_10_4705\" id=\"identifier_16_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Thien KR, Blair JA, Leeming RJ, Cooke WT, Melikan V. Serum folates in man.&nbsp;Journal of Clinical Pathology. Mat 1977; 30(5):438-48.\">10<\/a><\/p>\n<h4 style=\"text-align: justify\"><strong>CASE REPORT SUMMARIES<\/strong><\/h4>\n<p style=\"text-align: justify\"><strong>\u201cCarpopedal spasm in an elderly man: an unusual presentation of celiac disease.\u201d<\/strong> This case report describes diagnosis of celiac disease in a 68-year-old single Caucasian man admitted to the hospital with a 24-hour history of carpopedal spasm of both hands. Apart from generalized weakness, he reported no other symptoms. Physical examination revealed carpopedal spasm, clubbing of fingers and cachexia (body mass index 14 kg\/m2). This patient was found to have several unusual features of celiac disease, including macrocytosis [low folate and vitamin B12 levels], severe hypocalcemia and electrolyte disturbances as the initial manifestations, minimal gastrointestinal symptoms, and negative tTG-antibodies.<\/p>\n<p style=\"text-align: justify\">Blood tests showed severe hypocalcemia, with a total serum calcium of 1.06 mmol\/L (normal range [NR] 2.05-2.55 mmol\/L). He also had low serum potassium (2.8 mmol\/L; NR 3.5-5.5 mmol\/L) and magnesium (0.36 mmol\/L; NR 0.65-1.05 mmol\/L). Other significant results included hemoglobin 10.6 g\/dL (NR 13-18 g\/dL), mean corpuscular volume 98.1 fl (NR 82-98 fl), vitamin B12 157 ng\/L (NR &gt; 165 ng\/L), folate 2.8 g\/L (NR 3.1-17.5 \u03bcg\/L), ferritin 252 \u03bcg\/L (NR 30-250 \u03bcg\/L), prothrombin time 20 s (NR 11-14 s), thyroid stimulating hormone 0.87 mu\/L (NR 0.35-4.5 mu\/L), phosphate 0.57 mmol\/L (NR 0.8-1.45 mmol\/L), albumin 32 g\/L (NR 34-48 g\/L) and alkaline phosphatase 313 IU\/L (NR 47-141 IU\/L). Subsequent results revealed vitamin D deficiency with a low serum 25-OH vitamin D of &lt; 7 \u03bcg\/L (NR 7-40 \u03bcg\/L), a low 24-hour urinary calcium excretion of 0.9 mmol (NR 2.5-7.5 mmol) and a raised serum parathyroid hormone of 22.7 pmol\/L (NR 1.6-6.9 pmol\/L). Serology for tissue transglutaminase (tTG) antibodies was negative, and a serum IgA level of 4.95 g\/L (NR 0.8-4.0 g\/L) excluded selective IgA deficiency. Electrocardiograph at admission showed prolonged QT interval.<\/p>\n<p style=\"text-align: justify\">In view of cachexia, clubbing and negative tTG-antibodies, he was further investigated for an occult malignancy. Barium meal and follow through showed dilated proximal bowel loops and absence of normal feathery pattern of the jejunum, features suggestive of a malabsorptive state. Upper gastroscopic examination was normal; however, the duodenal biopsy showed partial and subtotal villous atrophy with increased intra-epithelial lymphocyte infiltration, consistent with the diagnosis of coeliac disease.<a href=\"#footnote_11_4705\" id=\"identifier_17_4705\" class=\"footnote-link footnote-identifier-link\" title=\"Schmidt K, Powari M, Shirazi T, Vaidya B. Carpopedal spasm in an elderly man: an unusual presentation of coeliac disease. J R Soc Med. 2007 Nov;100(11):524-5.\">11<\/a><\/p>\n<ol class=\"footnotes\"><li id=\"footnote_1_4705\" class=\"footnote\">Kaferle J, Strzoda CE.Evaluation of macrocytosis. <\/span><em style=\"text-align: justify\">Am Fam Physician<\/em><span style=\"text-align: justify\">. 2009 Feb 1;79(3):203-8.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_1_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_2_4705\" class=\"footnote\">Davenport J. Macrocytic anemia. <\/span><em style=\"text-align: justify\">Am Fam Physician<\/em><span style=\"text-align: justify\">. 1996 Jan;53(1):155-62.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_2_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_3_4705\" class=\"footnote\">Brigden ML. A systematic approach to macrocytosis. Sorting out the causes.<em> Postgraduate Medicine<\/em>. May 1995; 97(5):171-2,175-7,181-4 passim.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_3_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_4_4705\" class=\"footnote\">Murray JA, the widening spectrum of celiac disease. <em>American Journal of Clinical Nutrition.<\/em> Mar 1999; 69(3):354-365.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_4_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_5_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_5_4705\" class=\"footnote\">Murray JA, the widening spectrum of celiac disease. <em>American Journal of Clinical Nutrition<\/em>. Mar 1999; 69(3):354-365.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_6_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_6_4705\" class=\"footnote\">Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease.\u00a0<em>Clinical Science<\/em>. Apr 2001;100(4):379-86.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_7_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_7_4705\" class=\"footnote\">Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.\u00a0<em>Journal of Gastroenterology and Hepatology<\/em>. 2003;18:479-91.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_8_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_9_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_10_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_11_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_12_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_13_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_8_4705\" class=\"footnote\">Harper JW, Holleran SF, Ramakrishnan R, Bhagat G, Green PH. Anemia in celiac disease is multifactorial in etiology.\u00a0<em>Am J Hematol<\/em>. 2007 Nov; 82(11):996-1000.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_14_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_9_4705\" class=\"footnote\">Dahele A, Ghosh S. Vitamin B12. deficiency in untreated celiac disease.\u00a0<em>American Journal of Gastroenterology<\/em>. Mar 2001; 96(3):745-50.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_15_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_10_4705\" class=\"footnote\">Thien KR, Blair JA, Leeming RJ, Cooke WT, Melikan V. Serum folates in man.\u00a0<em>Journal of Clinical Pathology<\/em>. Mat 1977; 30(5):438-48.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_16_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_11_4705\" class=\"footnote\">Schmidt K, Powari M, Shirazi T, Vaidya B. Carpopedal spasm in an elderly man: an unusual presentation of coeliac disease. <em>J R Soc Med.<\/em> 2007 Nov;100(11):524-5.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_17_4705\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><\/ol>","protected":false},"excerpt":{"rendered":"<p>What Is Macrocytosis? Macrocytosis is a blood cell disorder characterized by altered blood cell formation that results in abnormally large\u00a0erythrocytes (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 &#8230;<\/p>\n","protected":false},"author":29,"featured_media":7279,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[4,120,105,974,48,107],"tags":[1326,1915,1340,327,1904,452,776,1339,707,375,100,1886,546,1905,543],"class_list":["post-4705","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-conditions-2","category-blood-plasma-and-cells","category-folic-acid","category-symptoms","category-blood","category-vitamin-b12","tag-angina","tag-blood-plasma-and-cells","tag-curly-graying-hair","tag-fatigue","tag-folic-acid","tag-headache","tag-health-conditions","tag-hyperpigmentation-of-skin","tag-hypoxia","tag-macrocytosis","tag-symptom","tag-blood","tag-tachycardia","tag-vitamin-b12","tag-weakness"],"_links":{"self":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/4705","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/users\/29"}],"replies":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/comments?post=4705"}],"version-history":[{"count":22,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/4705\/revisions"}],"predecessor-version":[{"id":18883,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/4705\/revisions\/18883"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media\/7279"}],"wp:attachment":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media?parent=4705"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/categories?post=4705"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/tags?post=4705"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}