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Vitamin C Deficiency

vitamin c gluten celiac disease symptomWhat Is Vitamin C?

[dropcap]V[/dropcap]itamin C, also called ascorbic acid or ascorbate, is an essential water soluble vitamin.

Fresh supplies of vitamin C are required every day to perform vital roles throughout the body among which are the production of connective tissue such as skin, blood vessels and bone, anti-inflammatory responses and anti-oxidant performance. See below for all roles.

Vitamin C fights for us! It has an anti-cancer effect stemming from its role as a potent anti-oxidant in blood plasma and within cells. It also protects nucleic acids (DNA) from oxidative damage and inhibits the formation of nitrosamines (carcinogenic compounds formed in the digestive tract).

Importantly, vitamin C can regenerate vitamin E from an oxidized state after vitamin E performs its own anti-oxidant role against free radicals and vitamin C works together with other anti-oxidants, such as beta-carotene and glutathione, to increase their overall anti-oxidant effect.

A study investigating the specific anti-inflammatory and anti-oxidant micronutrients that reduce oxidative stress found that in adolescents with metabolic syndrome (MetS) the lower the vitamin C level in blood the worse the MetS status and blood uric acid level.  MetS prevalence was estimated at 7% among boys and 3% among girls.1

Vitamin C reverses osteoporosis by reducing or preventing oxidative stress that destroys living bone tissue. Osteoporosis is a disorder of bone inflammation that results in thin, weak bones that may easily fracture. In normal bone structure, vitamin C is required to form collagen, which is living bone tissue.

In humans, vitamin C reduces the duration of common cold symptoms, even if its effect is not clear.2

Vitamin C must be obtained from food daily because our bodies, unlike monkeys and other animals, cannot produce it.

Urinary excretion of vitamin C cannot be detected when vitamin intake is below the required levels. On the other hand, when intake exceeds saturation in the body, the vitamin and/or its metabolites are actively excreted into urine to prevent excessive toxicity of the vitamins.3

What Is Vitamin C Deficiency In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. TGBeydoun MA, Canas JA, Beydoun HA, Chen X, Shroff MR, Zonderman AB. Serum antioxidant concentrations and metabolic syndrome are associated among U.S. adolescents in recent national surveys. J Nutr. 2012 Sep;142(9):1693-704. doi: 10.3945/jn.112.160416. [↩]
  2. Shaik-Dasthagirisaheb YB, Varvara G, Murmura G, Saggini A, Caraffa A, Antinolfi P, Tete’ S, Tripodi D, Conti F, Cianchetti E, Toniato E, Rosati M, Speranza L,Pantalone A, Saggini R, Tei M, Speziali A, Conti P, Theoharides TC, Pandolfi F. Role of vitamins D, E and C in immunity and inflammation. J Biol Regul Homeost Agents. 2013 Apr-Jun;27(2):291-5. [↩]
  3. Shibata K, Hirose J, Fukuwatari T. Relationship Between Urinary Concentrations of Nine Water-soluble Vitamins and their Vitamin Intakes in Japanese Adult Males. Nutr Metab Insights. 2014 Aug 5;7:61-75. doi: 10.4137/NMI.S17245. eCollection 2014. [↩]

Arthritis, Juvenile Idiopathic

Rheumatoid_arthritis_joint[1]What Is Juvenile Idiopathic Arthritis?

[dropcap]J[/dropcap]uvenile idiopathic arthritis (JIA) is a rheumatic disorder characterized by chronic, inflammatory disease of large and small synovial joints and other organs in children under age 16 years. Growth and development may be impaired in these children.1

Q: Which joints are affected in juvenile idiopathic arthritis?

A: In juvenile idiopathic arthritis the joints that are affected are variable and so are the manifestations.

According to the International League of Associations for Rheumatology (ILAR) classification system, there are seven different subtypes of  juvenile idiopathic arthritis. 

The main treatment to reduce inflammation and relieve pain is with non-steroidal inflammatories such as Ibuprofen.

What Is Juvenile Idiopathic Arthritis In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Stagi S, Giani T, Simonini G, Falcini F. Thyroid function, autoimmune thyroiditis and coeliac disease in juvenile idiopathic arthritis. Rheumatology. Apr 2005;44(4):517-20. [↩]

Recurrent Monoarthritis

monoarthritis gluten celiac disease symptomWhat Is Recurrent Monoarthritis?

[dropcap]R[/dropcap]ecurrent monoarthritis is a joint disorder characterized by pain and inflammation involving just one peripheral joint (elbow, hand, knee, ankle, foot, or hip).

What Is Recurrent Monoarthritis In Celiac Disease and/or Gluten Sensitivity?

Arthritis, Enteropathic

DSCN4748aWhat Is Enteropathic Arthritis?

[dropcap]E[/dropcap]nteropathic arthritis is a form of inflammatory arthritis characterized by peripheral joint disease that also involves the attachments sites for tendons at joints, called entheses, and is characterized by joint stiffness, swelling and loss of motion.

Q: How is enteropathic arthritis classified?

A: Enteropathic arthritis is a form of arthritis classified as one of the group of seronegative spondyloarthropathies, which also includes psoriatic arthritis, reactive arthritis, and idiopathic ankylosing spondylitis.

Enteropathic arthritis is associated with the chronic inflammatory bowel diseases, ulcerative colitis, and Crohn’s disease.  Joint involvement also occurs with other gastrointestinal diseases such as Whipple’s disease, celiac disease, and following intestinal bypass surgery for morbid obesity.1

What Is Enteropathic Arthritis In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Holden W, Orchard T, Wordsworth P. Enteropathic arthritis. Rheumatic Diseases Clinics of North America. Aug 2003;29(3):513-30,viii. [↩]

Psoriatic Arthritis

Bone scintigraphy showing left elbow affected by psoriatic arthritis. Photo by P Kitsoulis et. al. Courtesy BioMed Central.
Bone scintigraphy rear view showing left elbow with psoriatic arthritis. Photo P. Kitsoulis et. al. Courtesy BioMed Central.

What Is Psoriatic Arthritis?

[dropcap]P[/dropcap]soriatic arthritis is a joint manifestation of psoriasis, a systemic autoimmune disease, characterized by asymmetric involvement in one or more joints, especially affecting the distal phalangeal joints of fingers and toes (joints nearest nails).

In some patients, psoriatic arthritis can occur only with peripheral enthesitis which is inflammation where tendons insert into bone, particularly Achilles tendinitis and plantar fascitis, and/or dactylitis. Dactylitis is inflammation of the entire toe, also called “sausage toe.”1

Early treatment is crucial to symptom control. Even a 6-month delay from symptom onset to the first visit with a rheumatologist contributes to the development of peripheral joint erosions and worse long-term physical function.2

Q: Does psoriatic arthritis get worse when skin symptoms get worse?

A: Joint symptoms may coincide with exacerbations and remissions of skin symptoms.

What Is Psoriatic Arthritis In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Salvarani C, Cantini F, Olivieri I, Macchioni P, Niccoli L, Padula A, Ferri S, Portioli I. Isolated peripheral enthesitis and/or dactylitis: a subset of psoriatic arthritis. J Rheumatol. 1997 Jun;24(6):1106-10. [↩]
  2. Haroon M, Gallagher P, Fitzgerald O. Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis. Ann Rheum Dis. 2014 Feb 13. doi: 10.1136/annrheumdis-2013-204858. [↩]