{"id":508,"date":"2015-08-25T14:38:36","date_gmt":"2015-08-25T18:38:36","guid":{"rendered":"http:\/\/www.mynutriguide.com\/?p=508"},"modified":"2020-07-11T10:38:41","modified_gmt":"2020-07-11T14:38:41","slug":"dermatomyositis-3","status":"publish","type":"post","link":"https:\/\/glutenfreeworks.com\/health\/dermatomyositis-3\/","title":{"rendered":"Dermatomyositis"},"content":{"rendered":"<h2><a href=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/dermatomyositis.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft  wp-image-7265\" style=\"margin-left: 5px;margin-right: 5px\" src=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/dermatomyositis-225x300.jpg\" alt=\"dermatomyositis\" width=\"225\" height=\"300\" srcset=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/dermatomyositis-225x300.jpg 225w, https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/dermatomyositis.jpg 250w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a>What Is Dermatomyositis?<\/h2>\n<p style=\"text-align: justify\"><span class=\"dropcap\">D<\/span>ermatomyositis is a rare autoimmune systemic disease of the connective tissue that is characterized by inflammatory and\u00a0<span style=\"font-size: 14px;line-height: 1.5em\">debilitating<\/span><span style=\"font-size: 14px;line-height: 1.5em\">\u00a0<\/span><span style=\"font-size: 14px;line-height: 1.5em\">degenerative changes in the muscles and in the skin.\u00a0<\/span><\/p>\n<p style=\"text-align: justify\"><span style=\"font-size: 14px;line-height: 1.5em\">Dermatomyositis results in symmetric, proximal muscle weakness of limbs (upper arms and legs), and skin manifestations.\u00a050-70% of patients have circulating myositis-specific auto-antibodies. <\/span><\/p>\n<p style=\"text-align: justify\"><span style=\"font-size: 14px;line-height: 1.5em\">The course of dermatomyositis is unpredictable being marked by spontaneous flare-ups and remissions. It can begin slowly or abruptly according to the factor that is triggering the onset such as infection, medications like phenytoin, and autoimmune disease.<\/span><\/p>\n<p style=\"text-align: justify\"><strong>Q<\/strong>: What are the skin manifestations of dermatomyositis?<\/p>\n<p style=\"text-align: justify\"><strong>A<\/strong>: Classic skin manifestations of dermatomyositis include these features:<\/p>\n<ul class=\"cp_bullet black\">\n<li>The heliotrope rash (lilac color) on upper eyelids.<\/li>\n<li>Rash on\u00a0face, neck, shoulders, upper chest, elbows, knees, knuckles, and back.<\/li>\n<li>Gottron&#8217;s papules (scaly, red eruptions or \u00a0patches over the knuckles, elbows, and knees).<\/li>\n<li>The V-sign (rash front of neck and chest).<\/li>\n<li>The shawl sign\u00a0<span style=\"font-size: 14px;line-height: 1.5em\">(rash distribution on shoulders and back).<a href=\"#footnote_1_508\" id=\"identifier_1_508\" class=\"footnote-link footnote-identifier-link\" title=\"Marvi U, Chung L, Fiorentino DF. Clinical presentation and evaluation of dermatomyositis. Indian J Dermatol. 2012 Sep;57(5):375-81. doi: 10.4103\/0019-5154.100486.\">1<\/a><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><span style=\"font-size: 14px;line-height: 1.5em\">Additional cutaneous manifestations are described below under symptoms.<\/span><\/p>\n<p style=\"text-align: justify\">Dermatomyositis is\u00a0<span style=\"font-size: 14px;line-height: 1.5em\">associated with an increased risk of \u00a0cancer, other autoimmune diseases, such as lupus and psoriasis, and it\u00a0<\/span><span style=\"font-size: 14px;line-height: 1.5em\">can be a\u00a0<\/span><span style=\"font-size: 14px;line-height: 1.5em\">complication of interferon-\u03b1 therapy.<\/span><span style=\"font-size: 14px;line-height: 1.5em\">\u00a0<\/span>About 1 person in 100,000 are affected according to various studies. While it affects all ages, w<span style=\"font-size: 14px;line-height: 1.5em\">omen have twice the occurence of men.<\/span><\/p>\n<p style=\"text-align: justify\">There is no cure for dermatomyositis, but the symptoms can be treated. \u00a0Options include medication, physical therapy, exercise, heat therapy (including microwave and ultrasound), orthotics and assistive devices, and rest. \u00a0The standard treatment for dermatomyositis is a corticosteroid drug, given either in pill form or intravenously. \u00a0Immunosuppressant drugs, such as azathioprine and methotrexate, may reduce inflammation in people who do not respond well to prednisone.<a href=\"#footnote_2_508\" id=\"identifier_2_508\" class=\"footnote-link footnote-identifier-link\" title=\"National Institute of Neurological Disorders and Stroke.\">2<\/a><\/p>\n<h2>What Is Dermatomyositis 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 dermatomyositis and celiac disease.\u00a0<\/strong>Dermatomyositis is an auotimmune disorder associated with celiac disease.<\/li>\n<li style=\"text-align: justify\"><strong>Relationship between dermatomyositis and gluten.\u00a0<\/strong>The association between deliac disease and other immune disorders may be due to the sharing of a common genetic background, such as HLA antigens.\u00a0However, in a very large study, involving 909 patients with celiac disease, Ventura and his associates found that the development of immune disorders in celiac disease was clearly related to the duration of exposure to gluten.<a href=\"#footnote_3_508\" id=\"identifier_3_508\" class=\"footnote-link footnote-identifier-link\" title=\"La Villa G, Pantaleo P, Tarquini R, Cirami L, Perfetto F, Mancuso F, Laffi G. Multiple immune disorders in unrecognized celiac disease: a case report. World J Gastroenterol. 2003;9(6):1377-1380.\">3<\/a><\/li>\n<\/ul>\n<h2>How Prevalent Is Dermatomyositis In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p style=\"text-align: justify\">The association between dermatomyositis and celiac disease in children has been well documented. In the adult population, however, the association has not been clearly established,<a href=\"#footnote_4_508\" id=\"identifier_4_508\" class=\"footnote-link footnote-identifier-link\" title=\"Song MS, Farber D, Bitton A, Jass J, Singer M, Karpati G. Dermatomyositis associated with celiac disease: response to a gluten-free diet. Can J Gastroenterol. 2006 Jun;20(6):433-5.\">4<\/a> except by case reports documenting the co-existence in individual patients.<a href=\"#footnote_5_508\" id=\"identifier_5_508\" class=\"footnote-link footnote-identifier-link\" title=\"Marie I, Lecomte F, Hachulla E, et al. An uncommon association: celiac disease and dermatomyositis in adults. Clinical and Experimental Rheumatology. Mar-Apr 2001;19(2):201-3.\">5<\/a><\/p>\n<p style=\"text-align: justify\">A study investigating the presence of celiac disease and antibodies associated with celiac disease in 51 adult patients with inflammatory myopathies and their relationship found that celiac disease is more prevalent in patients with inflammatory myopathies than in the general population.<a href=\"#footnote_6_508\" id=\"identifier_6_508\" class=\"footnote-link footnote-identifier-link\" title=\"Selva-O&rsquo;Callaghan A, Casellas F, de Torres I, Palou E, Grau-Junyent JM, Vilardell-Tarr&eacute;s M. Celiac disease and antibodies associated with celiac disease in patients with inflammatory myopathy. Muscle Nerve. 2007 Jan;35(1):49-54.\">6<\/a><\/p>\n<h2>What Are The Symptoms Of Dermatomyositis?<\/h2>\n<p>Dermatomyositis is marked by these symptoms:<\/p>\n<ul class=\"cp_bullet red\">\n<li style=\"text-align: justify\">Gottron rash. Reddish patches, sometimes raised, smooth or scaly, that forms defined areas over bony prominences like the elbow.<\/li>\n<li style=\"text-align: justify\">Heliotope rash. A purplish lilac discoloration that affects the eyelids.<\/li>\n<li style=\"text-align: justify\">Poikiloderma. A chronic reddish-brown rash on the cheeks and neck.<\/li>\n<li style=\"text-align: justify\">An itchy rash. A flat red eruption on the face. forehead, and chest that can be triggered by sunlight and may cover much of the body.<\/li>\n<li style=\"text-align: justify\">Nail involvement called\u00a0periungual telangiectasias (rash around nails (see photo upper left).<\/li>\n<li style=\"text-align: justify\">Nail cuticle overgrowth.<\/li>\n<li style=\"text-align: justify\">&#8220;Mechanic&#8217;s hands&#8221; (dry, cracked, rough looking).<\/li>\n<li style=\"text-align: justify\"><span style=\"font-size: 14px;line-height: 1.5em\">Wasting of skeletal muscles, especially of the shoulder and pelvic girdles causing w<\/span><span style=\"font-size: 14px;line-height: 1.5em\">eakness with difficulty climbing stairs, rising from sqatting position, and reaching overhead.<\/span><\/li>\n<li style=\"text-align: justify\">Muscle ache and tenderness.<\/li>\n<li style=\"text-align: justify\">Difficulty breathing from lung involvement.<\/li>\n<li style=\"text-align: justify\">Alopecia, thin hair.<\/li>\n<li style=\"text-align: justify\">Calcinosis (calcium deposits in skin). Calcium deposits\u00a0appear as hard bumps under the skin or in the muscle. Calcinosis most often occurs 1-3 years after the disease begins and \u00a0is associated with damaged, inflamed, or necrotic skin.<\/li>\n<\/ul>\n<h2>How Does Dermatomyositis Develop In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<ul class=\"cp_check red\">\n<li>Dermatomyositis results from an immune mechanism not well understood.<\/li>\n<\/ul>\n<h2>Does Dermatomyositis Respond To Gluten-Free Diet?<\/h2>\n<p style=\"text-align: justify\">Yes. After a patient was put on a strict gluten-free diet, both nutritional deficiencies and the dermatomyositis resolved.<a href=\"#footnote_7_508\" id=\"identifier_7_508\" class=\"footnote-link footnote-identifier-link\" title=\"Song MS, Farber D, Bitton A, Jass J, Singer M, Karpati G. Dermatomyositis associated with celiac disease: response to a gluten-free diet. Can J Gastroenterol. 2006 Jun;20(6):433-5.\">7<\/a><\/p>\n<h2>6 Steps To Improve\u00a0Dermatomyositis\u00a0In 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 dermatomyositis 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\" style=\"text-align: justify\">\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_8_508\" id=\"identifier_8_508\" 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.\">8<\/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<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>2<\/strong><\/span><\/span><strong><span style=\"color: #800000\">\u00a0Reduce Inflammation. Foods to Eat and Foods Not to Eat:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\">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\" style=\"text-align: justify\">\n<li><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_9_508\" id=\"identifier_9_508\" 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.\">9<\/a><\/li>\n<li><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><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_9_508\" id=\"identifier_10_508\" 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.\">9<\/a><\/li>\n<li><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_9_508\" id=\"identifier_11_508\" 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.\">9<\/a>.<\/li>\n<li><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_9_508\" id=\"identifier_12_508\" 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.\">9<\/a><\/li>\n<li><strong>Refined Sugars.\u00a0<\/strong>\u00a0Includes white sugar, corn fructose and high fructose corn syrup.<\/li>\n<li><strong>Certain Spices<\/strong>. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_9_508\" id=\"identifier_13_508\" 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.\">9<\/a><\/li>\n<li><strong>Alcohol and Caffeine<\/strong>. Disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_9_508\" id=\"identifier_14_508\" 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.\">9<\/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\" style=\"text-align: justify\">\n<li><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><strong>Non-Starchy Vegetables.<\/strong>\u00a0Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes green leafy vegetables such as lettuce and kale, also onion, broccoli, garlic, and others.<\/li>\n<li><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><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><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><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><strong>Prebiotics\/ High Fiber Foods<\/strong>. \u00a0Food with fiber keeps our population of colonic microbes healthy.<\/li>\n<li><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\" style=\"text-align: justify\">\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 style=\"text-align: justify\">Click here.<\/p>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><span style=\"color: #800000\"><strong><em><span class=\"dropcap\">4<\/span>\u00a0Manage Your Medications\u00a0Safely<\/em>:<\/strong><\/span><\/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\n<p style=\"text-align: justify\">Certain medications used to treat dermatomyositis cause nutritional deficiencies that can promote complications in celiac disease. Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below.\u00a0<strong>Do not stop prescribed medications without supervision.<\/strong><\/p>\n<p style=\"text-align: justify\">\u00a0This is not a complete listing.<\/p>\n<p style=\"text-align: justify\"><strong>ANTI-INFLAMMATORIES<\/strong>\u00a0disrupt intestinal permeability which complicates celiac disease.<\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Corticosteroids for inflammation (Prednisone, Medrol\u00ae, Aristocort\u00ae, Decadron) deplete Calcium, Vitamin D, Magnesium, Zinc, Vitamin C, Vitamin B6, Vitamin B12, Folic Acid, Selenium, Chromium, Phosphorus.<\/li>\n<li>NSAIDS for pain (Motrin\u00ae, Aleve\u00ae, Advil\u00ae, Anaprox\u00ae, Dolobid\u00ae, Feldene\u00ae, Naprosyn\u00ae and others) deplete\u00a0Folic acid. \n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\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<p style=\"text-align: justify\"><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\" style=\"text-align: justify\">\n<li>Multivitamin\/mineral combination that provides 100% 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>B-Complex with 100% to 300% or as\u00a0as prescribed.<\/li>\n<li>Calcium citrate is the best absorbed of calcium supplements. Calcium carbonate is a poor choice.<\/li>\n<li>Vitamin D3 as prescribed following blood test for status.<\/li>\n<li>Chelated magnesium\u00a0\u00a0as prescribed but do not take at same time as calcium because they compete for absorption.<\/li>\n<li>Zinc\u00a0as prescribed following blood test for status.<\/li>\n<li>Selenium\u00a0as prescribed following blood test for status.<\/li>\n<li>Chromium\u00a0as prescribed following blood test for status.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><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>.\n\t\t\t<\/div><\/div>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><span style=\"color: #800000\"><em><strong><span class=\"dropcap\">6<\/span>Manage Natural Remedies:\u00a0<\/strong><\/em><\/span><\/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>Hydration<\/strong>:<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\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<p style=\"text-align: justify\"><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 style=\"text-align: justify\"><strong>Carminative Food Remedies<\/strong>:<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\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 style=\"text-align: justify\"><strong>Carminative Herb Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\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 style=\"text-align: justify\"><strong>Carminative Spice Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\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<p style=\"text-align: justify\"><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 style=\"text-align: justify\">Exercise improves circulation and rids the body of toxins.<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\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 style=\"text-align: justify\"><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<h2 style=\"text-align: justify\">What Do Medical Research Studies Tell About Dermatomyositis In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<h4><strong>CASE REPORT SUMMARIES<\/strong><\/h4>\n<p style=\"text-align: justify\"><strong>\u201cCalcinosis cutis: A rare feature of adult dermatomyositis.\u201d<\/strong> This case report describes calcinosis in a 55-year-old woman with dermatomyositis who presented with dystrophic calcinosis resistant to medical treatment. Calcinosis cutis is the deposition of insoluble calcium salts in the skin. In connective tissue diseases, calcinosis is mostly of the dystrophic type and it seems to be a localized process rather than an imbalance of calcium homeostasis. Calcium deposits may be intracutaneous, subcutaneous, fascial, or intramuscular.<\/p>\n<p style=\"text-align: justify\">The woman was referred for evaluation because of multiple, firm nodules of the lateral hips since 1994. At that time, dermatomyositis was diagnosed based on cutaneous, muscular and pulmonary involvement. The nodules, gradually enlarging since 1999, have begun to cause incapacitation pain and many exude a yellowish material suggestive of calcium. She denied an inciting traumatic event. Combinations of oral prednisone, hydroxychloroquine, or chloroquine, have been able to control the heliotrope rash, Gottron papules, and myositis, but have not prevented progression of nodule formation.<a href=\"#footnote_10_508\" id=\"identifier_15_508\" class=\"footnote-link footnote-identifier-link\" title=\"Lobo IM, Machado S, Teixeira M, Selores M. Calcinosis cutis: A rare feature of adult dermatomyositis. Dermatology Online Journal&nbsp;2008;14 (1): 10.\">10<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cCeliac disease and antibodies associated with celiac disease in patients with inflammatory myopathy.\u201d<\/strong> This study investigating the presence of celiac disease and antibodies associated with celiac disease in patients with inflammatory myopathies and their relationship found that celiac disease is more prevalent in patients with inflammatory myopathies than in the general population.<\/p>\n<p style=\"text-align: justify\">Serum antigliadin, anti-tissue transglutaminase, and antiendomysial antibodies were determined in 51 patients with inflammatory myopathies. HLA-DQ2 and -DQ8 alleles were studied to assess their complementary diagnostic value. Jejunal biopsy was performed in patients with moderate to high levels of antigliadin antibodies. Patients with jejunal histology consistent with celiac disease initiated a gluten-free diet. Seventeen patients (31%) were positive for antigliadin antibodies, which were significantly more frequent in patients with inclusion-body myositis than dermatomyositis. Positive status to HLA-DQ2 and\/or -DQ8 did not differ between antigliadin-positive (75% and 12.5%) or -negative (60% and 15%) patients. Three of five jejunal biopsies were diagnostic for celiac disease with histological normalization after a gluten-free diet.<\/p>\n<p style=\"text-align: justify\">The diagnostic value of HLA-DQ2 or -DQ8 haplotypes to detect celiac disease in patients with inflammatory myopathy is limited.<a href=\"#footnote_6_508\" id=\"identifier_16_508\" class=\"footnote-link footnote-identifier-link\" title=\"Selva-O&rsquo;Callaghan A, Casellas F, de Torres I, Palou E, Grau-Junyent JM, Vilardell-Tarr&eacute;s M. Celiac disease and antibodies associated with celiac disease in patients with inflammatory myopathy. Muscle Nerve. 2007 Jan;35(1):49-54.\">6<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cDermatomyositis associated with celiac disease: response to a gluten-free diet.\u201d<\/strong> This case report describes concomitant dermatomyositis and celiac disease in a 40-year-old woman. After having been diagnosed with dermatomyositis and iron deficiency anemia, this patient was referred to the gastroenterology clinic to exclude a gastrointestinal malignancy. Blood tests revealed various vitamin deficiencies consistent with malabsorption. The results of gastroscopy with duodenal biopsy were consistent with celiac disease. After she was put on a strict gluten-free diet, both nutritional deficiencies and the dermatomyositis resolved. The patient&#8217;s human leukocyte antigen haplotype study was positive for DR3 and DQ2 genotypes, which have been shown to be associated with both juvenile dermatomyositis and celiac disease. It is suggested that patients with newly diagnosed dermatomyositis be investigated for concomitant celiac disease even in the absence of gastrointestinal symptoms.<a href=\"#footnote_4_508\" id=\"identifier_17_508\" class=\"footnote-link footnote-identifier-link\" title=\"Song MS, Farber D, Bitton A, Jass J, Singer M, Karpati G. Dermatomyositis associated with celiac disease: response to a gluten-free diet. Can J Gastroenterol. 2006 Jun;20(6):433-5.\">4<\/a><\/p>\n<p style=\"text-align: justify\">\u201d<strong>An uncommon association: celiac disease and dermatomyositis in adults<\/strong>.\u201d This case report of a patient with malabsorption after a 2 year history of dermatomyositis describes subsequent diagnosis of celiac disease. Celiac disease should be suspected in patients with dermatomyositis who exhibit a malabsorption syndrome. Evaluation for celiac disease, including anti-gliadin antibodies, anti-endomysium antibodies, and tissue transglutaminase antibodies should be considered in dermatomyositis patients presenting with unusual and unexplained gastrointestinal \u00a0features.<a href=\"#footnote_5_508\" id=\"identifier_18_508\" class=\"footnote-link footnote-identifier-link\" title=\"Marie I, Lecomte F, Hachulla E, et al. An uncommon association: celiac disease and dermatomyositis in adults. Clinical and Experimental Rheumatology. Mar-Apr 2001;19(2):201-3.\">5<\/a><\/p>\n<ol class=\"footnotes\"><li id=\"footnote_1_508\" class=\"footnote\"><\/span><span style=\"font-size: 14px;line-height: 1.5em\">Marvi U, Chung L, Fiorentino DF. Clinical presentation and evaluation of dermatomyositis. <em>Indian J Dermatol<\/em>. 2012 Sep;57(5):375-81. doi: 10.4103\/0019-5154.100486.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_1_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_2_508\" class=\"footnote\">National Institute of Neurological Disorders and Stroke.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_2_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_3_508\" class=\"footnote\">La Villa G, Pantaleo P, Tarquini R, Cirami L, Perfetto F, Mancuso F, Laffi G. Multiple immune disorders in unrecognized celiac disease: a case report. <em>World J Gastroenterol.<\/em> 2003;9(6):1377-1380.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_3_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_4_508\" class=\"footnote\">Song MS, Farber D, Bitton A, Jass J, Singer M, Karpati G. Dermatomyositis associated with celiac disease: response to a gluten-free diet. <em>Can J Gastroenterol<\/em>. 2006 Jun;20(6):433-5.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_4_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_17_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_5_508\" class=\"footnote\">Marie I, Lecomte F, Hachulla E, et al. An uncommon association: celiac disease and dermatomyositis in adults. <em>Clinical and Experimental Rheumatology<\/em>. Mar-Apr 2001;19(2):201-3.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_5_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_18_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_6_508\" class=\"footnote\">Selva-O&#8217;Callaghan A, Casellas F, de Torres I, Palou E, Grau-Junyent JM, Vilardell-Tarr\u00e9s M. Celiac disease and antibodies associated with celiac disease in patients with inflammatory myopathy. <em>Muscle Nerve<\/em>. 2007 Jan;35(1):49-54.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_6_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_16_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_7_508\" class=\"footnote\">Song MS, Farber D, Bitton A, Jass J, Singer M, Karpati G. Dermatomyositis associated with celiac disease: response to a gluten-free diet. <em>Can J Gastroentero<\/em>l. 2006 Jun;20(6):433-5.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_7_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_8_508\" 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_8_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_9_508\" 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_9_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_10_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_11_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_12_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_13_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_14_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_10_508\" class=\"footnote\">Lobo IM, Machado S, Teixeira M, Selores M. Calcinosis cutis: A rare feature of adult dermatomyositis. <em>Dermatology Online Journal<\/em>\u00a02008;14 (1): 10.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_15_508\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><\/ol>","protected":false},"excerpt":{"rendered":"<p>What Is Dermatomyositis? Dermatomyositis is a rare autoimmune systemic disease of the connective tissue that is characterized by inflammatory and\u00a0debilitating\u00a0degenerative changes in the muscles and in the skin.\u00a0 Dermatomyositis results in symmetric, proximal muscle weakness of limbs (upper arms and legs), and skin manifestations.\u00a050-70% of patients have circulating myositis-specific auto-antibodies. The course of dermatomyositis is &#8230;<\/p>\n","protected":false},"author":29,"featured_media":7265,"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":[4,779,408,191,183,56],"tags":[1027,101,1493,1601,1362,685,1600,776,1595,1008,1365,1599,1096,1598,1596,1597,1126,1951,1893,1364,543],"class_list":["post-508","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-conditions-2","category-associated-disorder","category-autoimmune","category-muscles","category-skin","category-integumentary-2","tag-alopecia","tag-associated-disorders","tag-autoimmune-disease","tag-calcinosis","tag-debilitating","tag-dermatomyositis","tag-gottrons-papules","tag-health-conditions","tag-heliotope-rash","tag-itchy-rash","tag-lilac-skin-rash","tag-mechanics-hands","tag-muscle-pain","tag-nail-cuticle-overgrowth","tag-poikiloderma","tag-rash-around-nails","tag-red-rash","tag-skin","tag-integumentary-2","tag-wasting-of-muscles","tag-weakness"],"_links":{"self":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/508","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=508"}],"version-history":[{"count":28,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/508\/revisions"}],"predecessor-version":[{"id":16068,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/508\/revisions\/16068"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media\/7265"}],"wp:attachment":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media?parent=508"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/categories?post=508"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/tags?post=508"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}