{"id":616,"date":"2015-03-19T21:55:19","date_gmt":"2015-03-20T01:55:19","guid":{"rendered":"http:\/\/www.mynutriguide.com\/?p=616"},"modified":"2020-07-11T10:39:31","modified_gmt":"2020-07-11T14:39:31","slug":"osteomalacic-myopathy-3","status":"publish","type":"post","link":"https:\/\/glutenfreeworks.com\/health\/osteomalacic-myopathy-3\/","title":{"rendered":"Osteomalacic Myopathy"},"content":{"rendered":"<h2><a href=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/iStock_000035302132Small.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-9460\" src=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/iStock_000035302132Small-200x300.jpg\" alt=\"osteomalacic myopathy in celiac disease\" width=\"200\" height=\"300\" srcset=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/iStock_000035302132Small-200x300.jpg 200w, https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/iStock_000035302132Small.jpg 566w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a>What Is Osteomalacic Myopathy?<\/h2>\n<p style=\"text-align: justify\"><span class=\"dropcap\">O<\/span>steomalacic myopathy is a major feature of osteomalacia that is characterized by painful muscle weakness involving the thighs and upper arms and hyperreflexia.<\/p>\n<p style=\"text-align: justify\"><strong>Q<\/strong>: What is hyperreflexia?<\/p>\n<p style=\"text-align: justify\"><strong>A<\/strong>: Hyperreflexia means the action of reflexes is increased. Reflex action is an involuntary, or automatic, response to a stimulus. A reflex action is complicated but essentially depends on \u00a0a normal responding muscle which is altered in osteomalacia.<\/p>\n<p style=\"text-align: justify\">Osteomalacic myopathy is diagnosed on bloodwork that shows deficient levels of vitamin D and\u00a0elevated levels of parathyroid hormone and alkaline phosphatase, a\u00a0bone enzyme.<\/p>\n<h2>What Is Osteomalacic Myopathy In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p><!--more--><\/p>\n<ul class=\"cp_check red\">\n<li><strong>Relationship between osteomalacic myopathy and celiac disease.<\/strong> Osteomalacic myopathy is a muscle disorder associated with vitamin D deficiency in celiac disease.<\/li>\n<li style=\"text-align: justify\"><strong>Relationship between osteomalacic myopathy and\u00a0muscle structure.<\/strong> Patients with osteomalacic myopathy associated with vitamin D deficiency show degenerative changes such as opaque fibers, ghost-like necrotic fibers, regenerating fibers, enlarged interfibrillar spaces, infiltration of fat, fibrosis, glycogen granules, and type II muscle fiber atrophy.<a href=\"#footnote_1_616\" id=\"identifier_1_616\" class=\"footnote-link footnote-identifier-link\" title=\"Wagatsuma A, Sakuma K. Vitamin D signaling in myogenesis: potential for treatment of sarcopenia. Biomed Res Int. 2014;2014:121254. doi: 10.1155\/2014\/121254.\">1<\/a><\/li>\n<\/ul>\n<h2>How Prevalent is Osteomalacic Myopathy In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p style=\"text-align: justify\">Prevalence of osteomalacic myopathy\u00a0is not established but is a recognized presentation of celiac disease.<a href=\"#footnote_2_616\" id=\"identifier_2_616\" class=\"footnote-link footnote-identifier-link\" title=\"Russell JA. Osteomalacic myopathy. Muscle and Nerve. Jun 1994;17(6):578-80.\">2<\/a><\/p>\n<h2>What Are The Symptoms Of Osteomalacic Myopathy?<\/h2>\n<p>Osteomalacic myopathy is marked by these symptoms:<\/p>\n<ul class=\"cp_bullet red\">\n<li style=\"text-align: justify\">Thigh pain followed within a year by proximal muscle weakness (thighs and upper arms).<\/li>\n<li style=\"text-align: justify\">Brisk reflexes.<\/li>\n<li style=\"text-align: justify\">Muscle atrophy (loss).<\/li>\n<li style=\"text-align: justify\">Physical disability due to muscle weakness that may advance to inability to get out of a chair and climb stairs.<\/li>\n<li style=\"text-align: justify\">Fatigue.<\/li>\n<li style=\"text-align: justify\">Increased risk of falls due to muscle weakness.<\/li>\n<\/ul>\n<h2>How Does Osteomalacic Myopathy Develop In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<ul class=\"cp_check red\">\n<li>Osteomalacic myopathy results from vitamin D and phosphorus malabsorption in celiac disease.<a href=\"#footnote_2_616\" id=\"identifier_3_616\" class=\"footnote-link footnote-identifier-link\" title=\"Russell JA. Osteomalacic myopathy. Muscle and Nerve. Jun 1994;17(6):578-80.\">2<\/a><\/li>\n<\/ul>\n<h2>Does Osteomalacic Myopathy Respond To Gluten-Free Diet?<\/h2>\n<p>Yes. Celiac disease-related osteomalacic myopathy responds to gluten free diet.<\/p>\n<h2>6 Steps To Improve Osteomalacic Myopathy\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 osteomalacic myopathy\u00a0and 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_3_616\" id=\"identifier_4_616\" 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.\">3<\/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_4_616\" id=\"identifier_5_616\" 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.\">4<\/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_4_616\" id=\"identifier_6_616\" 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.\">4<\/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_4_616\" id=\"identifier_7_616\" 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.\">4<\/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_4_616\" id=\"identifier_8_616\" 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.\">4<\/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_4_616\" id=\"identifier_9_616\" 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.\">4<\/a><\/li>\n<li><strong>Alcohol and Caffeine<\/strong>. Disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_4_616\" id=\"identifier_10_616\" 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.\">4<\/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 deplete vitamin D and phosphorus which cause osteomalacic myopathy. 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\">This is not a complete listing.<\/p>\n<p><strong>OSTEOPOROSIS DRUGS<\/strong><\/p>\n<ul class=\"cp_bullet blue\">\n<li>Bisphonates deplete Phosphorus.<\/li>\n<\/ul>\n<p><strong>CHOLESTEROL DRUGS<\/strong><\/p>\n<ul class=\"cp_bullet blue\">\n<li>Lipitor\u00ae, Crestor\u00ae, Zocor\u00ae, and others deplete Phosphorus.<\/li>\n<\/ul>\n<p><strong>DIURETICS<\/strong><\/p>\n<ul class=\"cp_bullet blue\">\n<li>Loop Diuretics (Lasix\u00ae, Bumex\u00ae, Edecrin\u00ae) deplete Phosphorus.<\/li>\n<li>Thiazide Diuretics (Hydrochlorothiazide, Enduron\u00ae, Diuril\u00ae, Lozol\u00ae, Zaroxolyn\u00ae, Hygroton\u00ae and others) deplete Phosphorus.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>ANTACIDS \/ ULCER MEDICATIONS<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Pepcid\u00ae, Tagamet\u00ae, Zantac\u00ae deplete Vitamin D.<\/li>\n<li>Magnesium and Aluminum Antacid preparations (Gaviscon\u00ae, Maalox\u00ae, Mylanta\u00ae) bind and deplete\u00a0Vitamin D, phosphorus.<\/li>\n<\/ul>\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 (Prednisone, Medrol\u00ae, Aristocort\u00ae, Decadron) deplete\u00a0Vitamin D, Phosphorus.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>ANTICONVULSANTS<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Phenobarbital and Barbituates; and Dilantin\u00ae, Tegretol\u00ae, Mysoline\u00ae, Depakane\/Depacon\u00ae deplete\u00a0Vitamin D.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>CHOLESTEROL DRUGS<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Colestid\u00ae and Questran\u00ae deplete\u00a0Vitamin D.<\/li>\n<\/ul>\n<p><strong>WEIGHT LOSS DRUGS THAT BIND FAT\u00a0<\/strong>also interfere with absorption of some nutrients.<\/p>\n<ul class=\"cp_bullet blue\">\n<li>Zenicol (Orlistat\u00ae) depletes Vitamin D.<\/li>\n<\/ul>\n<p><span style=\"text-align: justify\">\u00a0\n\t\t\t<\/div><\/div><\/span><\/p>\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 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>Vitamin D3 as prescribed following blood test for status.<\/li>\n<li>Phosphorus as prescribed following blood test for status is available in tablet and liquid form and as part of most multivitamin\/mineral supplements.<\/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 Osteomalacic Myopathy In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<h4>CASE REPORT SUMMARIES<\/h4>\n<p style=\"text-align: justify\"><strong>&#8220;Bone pain and extremely low bone mineral density due to severe vitamin D deficiency in celiac disease<\/strong>.&#8221;\u00a0This case report describes finding a non-detectible vitamin D blood level in a 29-year-old wheelchair-bound woman who had lived in the Netherlands all her life and was born of Moroccan parents. Her medical history revealed iron deficiency, growth retardation, and celiac disease, for which she was put on a gluten-free diet but did not follow.<\/p>\n<p style=\"text-align: justify\">She had progressive bone pain for 2 years, difficulty with walking, and about 15 kg weight loss. She had a short stature, scoliosis (curvature), and pronounced kyphosis of the spine with thoracic and lumbar percussion pain (pain on tapping). Pelvis and shoulders also were painful on touching. There was muscle atrophy and symmetrical loss of proximal muscle strength. She was short of breath during normal daily activities and poor condition of her teeth. She had a regular menstrual cycle, and her menarche was at 17 years of age. She had neither abdominal complaints nor diarrhea. On physical examination, she was pale. Her body height was 148 cm (previously 156 cm) and her weight, 38 kg.<\/p>\n<p style=\"text-align: justify\">Laboratory results showed hypocalcemia, an immeasurable serum 25-hydroxyvitamin D level, and elevated parathyroid hormone and alkaline phosphatase levels. Spinal x-rays showed unsharp, low contrast vertebrae. Bone mineral density (bone scan) measurement at the lumbar spine and hip showed a T-score of -6.0 and -6.5, respectively. A bone scintigraphy showed multiple hotspots in ribs, sternum, mandible, and long bones. A bone biopsy showed severe osteomalacia but normal bone volume. A duodenal biopsy revealed villous atrophy (Marsh 3C) and positive antibodies against endomysium, transglutaminase, and gliadin, compatible with active celiac disease She was treated with calcium intravenously and later orally. Furthermore, she was treated with high oral doses of vitamin D and a gluten-free diet. After a few weeks of treatment, her bone pain decreased, and her muscle strength improved.<a href=\"#footnote_5_616\" id=\"identifier_11_616\" class=\"footnote-link footnote-identifier-link\" title=\"Rabelink NM, Westgeest HM, Bravenboer N, Jacobs MA, Lips P. Bone pain and extremely low bone mineral density due to severe vitamin D deficiency in celiac disease.&nbsp;Arch Osteoporos. 2011 Dec;6(1-2):209-13. doi: 10.1007\/s11657-011-0059-7.\">5<\/a><\/p>\n<p style=\"text-align: justify\"><strong>&#8220;Celiac disease causing symptomatic hypocalcaemia, osteomalacia and coagulapathy.&#8221;<\/strong> This case report describes diagnosing celiac disease in a 36-year-old gentleman who presented with 6 months of poor energy, tingling in fingers and weight loss with a change in bowel habit. He appeared cachectic and had clubbing, demineralisation of teeth, pectus carinatus, kyphosis, spinal tenderness, proximal muscle weakness and generalised muscle wasting (atrophy).<\/p>\n<p style=\"text-align: justify\">Chvostek&#8217;s and Trosseau&#8217;s signs were positive. His hemoglobin (Hb) was 8.7 g\/dl, MCV 64.7 fl with low iron. Calcium corrected was 1.30 nmol\/l, parathyroid hormone 440.4 ng\/l, vitamin D &lt;12.5 nmol\/l; INR was 2.7 with coagulation inhibitor studies negative. Radiographs of spine and pelvis commented on osteopenia with thoracic kyphosis and mild anterior wedging of thoracic vertebrae. Antitissue transglutaminase was 145 U\/ml, and antiendomysial antibodies were positive. An esophagogastroduodenoscopy was consistent with celiac disease. A diagnosis of osteomalacia and coagulopathy secondary to celiac disease was made.<\/p>\n<p style=\"text-align: justify\">The hypocalcaemia was treated with calcium gluconate infusions with symptomatic relief. Coagulopathy was treated with vitamin K intravenously with normalization of INR (international normalised ratio), a lab measurement to determine coagulation.<a href=\"#footnote_6_616\" id=\"identifier_12_616\" class=\"footnote-link footnote-identifier-link\" title=\"McNicholas BA, Bell M. Coeliac disease causing symptomatic hypocalcaemia, osteomalacia and coagulapathy. BMJ Case Rep. 2010 Dec 1;2010. pii: bcr0920092262. doi: 10.1136\/bcr.09.2009.2262.\">6<\/a><\/p>\n<p style=\"text-align: justify\"><strong>&#8220;Disabling osteomalacic myopathy as the only presenting feature of coeliac disease.&#8221;<\/strong>\u00a0This case report describes diagnosing celiac disease in a 59-year-old woman who presented with a 3-month history of bilateral, proximal lower-limb weakness associated with disabling pain that rendered her wheelchair-bound. There were no gastrointestinal symptoms. Clinical examination showed evidence of bilateral, proximal muscle atrophy and weakness in the lower limbs. Low serum calcium and raised serum alkaline phosphatase, coupled with radiological findings, led to the diagnosis of osteomalacia. Subsequent gastroscopy and duodenal biopsy confirmed a diagnosis of coeliac disease. With adherence to a gluten-free diet, the patient&#8217;s condition remarkably improved within 3 months and she could walk pain-free using a stick. Osteomalacia and myopathy may rarely be the initial and primary presentations of coeliac disease. There are very few reports of osteomalacia as the only presentation of coeliac disease and no reports that describe such a dramatic recovery 3 months after commencing a gluten-free diet. A review of the literature regarding osteomalacia and myopathy in coeliac disease is presented.<a href=\"#footnote_7_616\" id=\"identifier_13_616\" class=\"footnote-link footnote-identifier-link\" title=\"Byrne MF, Razak AR, Leader MB, Sheehan KM, Patchett SE. Disabling osteomalacic myopathy as the only presenting feature of coeliac disease. Eur J Gastroenterol Hepatol. 2002 Nov;14(11):1271-4.\">7<\/a><\/p>\n<p style=\"text-align: justify\"><strong>&#8220;Osteomalacic myopathy.&#8221;<\/strong>\u00a0This case report describes how recognition of increased level of serum alkaline phosphatase and hypophosphatemia led to diagnosis of osteomalacia. Identification of iron deficiency anemia and hypocholesterolemia implicated previously unrecognized Celiac Disease with associated vitamin D malabsorption as the cause of osteomalacia.<a href=\"#footnote_2_616\" id=\"identifier_14_616\" class=\"footnote-link footnote-identifier-link\" title=\"Russell JA. Osteomalacic myopathy. Muscle and Nerve. Jun 1994;17(6):578-80.\">2<\/a><\/p>\n<ol class=\"footnotes\"><li id=\"footnote_1_616\" class=\"footnote\">Wagatsuma A, Sakuma K. Vitamin D signaling in myogenesis: potential for treatment of sarcopenia. <em>Biomed Res Int<\/em>. 2014;2014:121254. doi: 10.1155\/2014\/121254.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_1_616\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_2_616\" class=\"footnote\">Russell JA. Osteomalacic myopathy. <em>Muscle and Nerve<\/em>. Jun 1994;17(6):578-80.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_2_616\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_3_616\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_14_616\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_3_616\" 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_4_616\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_4_616\" 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_5_616\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_6_616\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_7_616\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_8_616\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_9_616\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_10_616\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_5_616\" class=\"footnote\">Rabelink NM, Westgeest HM, Bravenboer N, Jacobs MA, Lips P. Bone pain and extremely low bone mineral density due to severe vitamin D deficiency in celiac disease.\u00a0<em>Arch Osteoporos<\/em>. 2011 Dec;6(1-2):209-13. doi: 10.1007\/s11657-011-0059-7.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_11_616\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_6_616\" class=\"footnote\">McNicholas BA, Bell M. Coeliac disease causing symptomatic hypocalcaemia, osteomalacia and coagulapathy. <em>BMJ Case Rep<\/em>. 2010 Dec 1;2010. pii: bcr0920092262. doi: 10.1136\/bcr.09.2009.2262.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_12_616\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_7_616\" class=\"footnote\">Byrne MF, Razak AR, Leader MB, Sheehan KM, Patchett SE. Disabling osteomalacic myopathy as the only presenting feature of coeliac disease. <em>Eur J Gastroenterol Hepatol<\/em>. 2002 Nov;14(11):1271-4.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_13_616\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><\/ol>","protected":false},"excerpt":{"rendered":"<p>What Is Osteomalacic Myopathy? Osteomalacic myopathy is a major feature of osteomalacia that is characterized by painful muscle weakness involving the thighs and upper arms and hyperreflexia. Q: What is hyperreflexia? A: Hyperreflexia means the action of reflexes is increased. Reflex action is an involuntary, or automatic, response to a stimulus. A reflex action is &#8230;<\/p>\n","protected":false},"author":29,"featured_media":9460,"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":[4,779,1682,191,118,111],"tags":[101,1660,327,776,1661,1956,326,686,1913,1662,1908],"class_list":["post-616","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-conditions-2","category-associated-disorder","category-malabsorption-disorders","category-muscles","category-phosphorus","category-vitamin-d","tag-associated-disorders","tag-brisk-reflexes","tag-fatigue","tag-health-conditions","tag-muscle-atropy-loss","tag-muscles","tag-muscle-weakness","tag-osteomalacic-myopathy","tag-phosphorus","tag-thigh-pain","tag-vitamin-d"],"_links":{"self":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/616","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=616"}],"version-history":[{"count":19,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/616\/revisions"}],"predecessor-version":[{"id":15295,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/616\/revisions\/15295"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media\/9460"}],"wp:attachment":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media?parent=616"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/categories?post=616"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/tags?post=616"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}