Gluten Sensitivity Research Findings – What Went Wrong?

Every once in a while a study is released that just makes no sense. Certainly researchers know the liability of a study that goes wrong or a hypothesis that just doesn't add up once the results are tallied. That’s just part of being a researcher. But other times a study is just poorly designed and executed.

Misleading results can become a problem when it gives people the wrong idea about their condition, in this case gluten sensitivity.

The Columbia University Celiac Disease Center, headed by Dr Peter Green, presented their research at the American College of Gastroenterology meeting. Their intention was to discover the percentage of the population suffering from gluten sensitivity. Their ‘findings’ were that 0.55% of the population suffered from this condition. That would mean that about half of the number who suffer from celiac disease, have gluten sensitivity. This goes in the face of research by Dr Alessio Fasano and his team from the Maryland Center for Celiac Research, who placed that estimate at 7% - fourteen times higher than the Columbia researchers.

That’s a rather large discrepancy. Who’s right? Well, let’s look at the design of this study and see what you think.

The study was performed by having people answer questions about whether or not they had ever been diagnosed with celiac disease. If they:

1.      Had been tested for celiac disease and the test was negative, and

2.      If they chose to follow a gluten-free diet despite that negative test, then

3.      They were labeled as ‘gluten sensitive’ by this study.

Of the almost 8,000 people who participated, 49 fit the criteria and from this was derived the 0.55% prevalence estimate.

Does that sound comprehensive to you?

Do you think there are people who have determined they are gluten sensitive who never received a celiac test?

Do you think that there are likely many people who are gluten sensitive and have no idea that they are, and therefore have never been tested for anything relating to gluten?

Does it seem wrong that absolutely zero diagnostic tests were performed on these people? I would wager that many hundreds of those 8,000 individuals likely fit the gluten sensitivity diagnosis. But, once again, they remain undiagnosed.

Knowing that we are TERRIBLE at diagnosing celiac disease and that a full 95 to 97% of those suffering with the disease remain undiagnosed, does it make sense to predicate a study on only those who HAVE been tested and are found negative?

If you think the study is poor, you’re in most excellent company. Dr Alessio Fasano stated that the study was “extremely biased” and “not informative”.

Why do I bring this up? Because it concerns me that anyone hearing this study result and wondering if they are truly gluten sensitive, might abandon the idea because the condition seems so rare. It does often happen that I meet people who ‘know’ they react to gluten but go back to eating it because they have received no formal confirmation and it’s ‘easier’ to just eat it again.

It might ‘seem’ easier, but living with poor health and avoidable disease is anything BUT easy!

Don’t listen to the results of this study. Gluten sensitivity research is in its infancy. We have much to learn. But I can guarantee you this – the incidence of gluten sensitivity is NOT less than the incidence of celiac disease. And, it’s likely 10x or more. Time will tell, but I’ve been working with patients for a long time and I know how often I find it and how often it creates miraculous changes in a patient’s health status.

Do you or someone you know suffer from poor health? Would you like to find out if gluten is playing a role in your health problems? If so, consider calling us for a free health analysis (408-733-0400) – we’re here to help!

Our destination clinic treats patients from across the country and internationally. You don’t need to live locally to receive assistance.

I look forward to hearing from you.

To your good health,

Dr Vikki Petersen, DC, CCN

Gluten Free Doctor of the Year 2013

Co-author of “The Gluten Effect”

Why do you Stay Sick on a Gluten-Free Diet

Too often, patients with celiac disease or gluten sensitivity remain ill despite all intentions to remain on a gluten-free diet. Why is this? There are several reasons, but a new one was recently revealed that you do need to know about.

It turns out that inherently gluten-free foods can be contaminated with gluten. Specifically a study looked at single item flours, seeds and grains of gluten-free foods. If you bought a sealed bag of millet, for example, you shouldn't need to be concerned that it contained gluten, right? It turns out that that premise is quite wrong – to the tune of 32% of the time!

Specifically researchers who published in the Journal of the America Dietetics Association, were interested in discovering if a proposed law under the Food Allergen and Consume Protection Act which stated the  Food and Drug Administration must issue a ruling for the voluntary labeling of foods as being gluten-free. The ruling states that inherently gluten-free grains be actually be considered ‘misbranded’ if they carry a gluten-free label and do not also state that all foods of the same type are gluten-free.

In other words, since buckwheat is inherently gluten-free, if a bag of buckwheat stated on the label that it was gluten-free, it would also need to include on that label that ALL buckwheat is gluten-free.

That’s true in a perfect world, but is it true in reality. Not so much, as it turns out. The researchers discovered, after sending twenty-two unopened products to a highly respected company  specializing in gluten analysis, that a fully 32% of them were in fact contaminated. And not just a little, their contamination put them above the 20 parts per million threshold, squarely identifying them as a gluten-containing food. The fact that they were all foods that naturally were gluten-free was, unfortunately, beside the point. Through some form of contamination, 32% of them were tainted and would create devastating health effects to a person with celiac disease or gluten sensitivity.

It is worth noting that none of these products labeled themselves as ‘gluten-free’. According to the proposed law, they shouldn't have to due to their inherent gluten-free nature. That might ‘make sense’ on the face of it, but practically it obviously has huge flaws. Contamination is obviously quite rampant. While any number of contaminated products would be too many, over 30% is downright frightening.

What can you do?

1.      Avoid any grains, seeds or flours that don’t specifically state they are gluten-free. If they state that they are, you know the company is testing their product.

2.      If possible, try to deal with companies who are a dedicated gluten-free facility. The likelihood of cross-contamination is minimized in such a company.

3.      If you continue to have symptoms or feel ‘glutened’ after eating foods that ‘should’ be safe, and are following 1 and 2 above, consider getting evaluated for cross-reactive foods. There is a blood test to determine if your body is reacting to non-gluten foods in a fashion similar to gluten. In other words, your immune system can mistake a non-gluten food for gluten. This is usually not permanent, but the foods need to be identified so that you can avoid them for a period of time.

4.      According to the researchers, rice was safe across the board, so feel free to enjoy it.

5.      If you are having issues with your health and don’t seem to be getting better, please consider calling us for a free health analysis (call 408-733-0400). We know what to do  -it is, in fact, our specialty.

Our destination clinic treats patients from across the country and internationally, so you don’t need to live locally to receive help.

I posted a blog on my website recently entitled, “A Serious Form of Celiac Disease is ‘Cured’ by Diet Alone”. If you haven’t yet read it, I urge you to take a look at it here (http://www.healthnowmedical.com/blog/2013/04/30/a-serious-form-of-celiac-disease-is-%E2%80%98cured%E2%80%99-by-diet-alone/). It reviews a diet free from contamination that can make a difference in those continuing to suffer symptoms, as well as those diagnosed with refractory celiac disease (RCD) or non-responsive celiac disease (NRCD), both serious manifestations of celiac disease.

Lastly, if you have a ‘political bent’, I urge you to bring this discrepancy to the awareness of legislators and congressman. This loophole in our law opens the door to dangerous gluten contamination that can affect health in a serious manner.

Consider sharing this with those whom you believe would benefit.

To your good health,

Dr Vikki Petersen, DC, CCN

Founder of HealthNOW Medical Center

Co-author of The Gluten Effect

Source:  Journal of the American Dietetic Association. 2010 Jun;110(6):937-40. doi: 10.1016/j.jada.2010.03.014. “Gluten contamination of grains, seeds, and flours in the United States: a pilot study.” Thompson T, Lee AR, Grace T.

Are Gluten-Free Grains Contaminated?

Personally I hate doom and gloom titles to blogs. I think it’s overdone and truly I like to take the high road if I can. But this one, we’ve just got to look at. Ok? Here we go:

New research from Dr Fasano and a team of others was recently published in BMC Gastroenterology. The title of the article is “Trace gluten contamination may play a role in mucosal and clinical recovery in a subgroup of diet-adherent non-responsive celiac disease patients”. The title is a mouthful, but basically the researchers were curious about a subgroup of celiac that fall into the category of non-responsive celiacs. These patients continue to have symptoms despite a strict gluten-free diet and some continue to show villous atrophy as well.

Within the group of non-responsive celiac disease is a smaller, though more serious condition, called refractory celiac disease. This condition involves such a lack of healing that patients are put on immunosuppressive drugs to try to suppress the damage the immune system is creating. These drugs are quite dangerous, increasing one’s risk of life-threatening infections while increasing cancer risk. Obviously these are conditions we all want to avoid. And what if avoiding them was pretty simple?

As a side note, I’d like to say that I’m grateful to these researchers for the work they've done. I've long thought that both non-responsive and refractory celiac disease were likely quite treatable, without the use of dangerous medications. Here at HealthNOW we have found that to be true. We have rarely had a patient whose ‘seemingly’ refractory or non-responsive celiac disease was not improved with our program. So while we've had suspicions, there was no research to had to support what we have seen clinically – until now that is!

But, back to the research… This group took 17 patients with diagnosed non-responsive celiac disease, 6 of whom had the dangerous refractory type. All patients met with a dietitian who confirmed that they were strictly avoiding gluten in their diet.

The hypothesis was that gluten contamination was potentially to blame for their continued symptoms and, for some, lack of healing of their small intestine. The researchers created a gluten contamination elimination diet. (See table below for the specifics.)

The diet, that excludes all grains other than rice, came about in part from a startling discovery that 32% of all single ingredient gluten-free grains, flours and seeds were contaminated with gluten! Not good. It is thought that the contamination likely occurred during the course of milling, processing and/or transport. The exact ‘how’ remains unknown, but the facts are that it did occur, and that’s a problem.

Is it a problem for everyone? Hard to know. The researchers claim that most celiacs can safely tolerate about 10 mg of gluten cross-contamination daily.  This is about 500 grams of food containing 20 ppm of gluten, the legal limit whereby a food can be labeled gluten-free. While the immune system’s of some patients can sustain that amount of gluten, others clearly cannot. And certainly there are many patients who are unable to tolerate even low gluten exposure without negative ramifications.


The gluten contamination elimination diet, removed grains understandable, but it also removed processed food. The thought is that the more highly processed a food, the more likely contamination occurs. Their hypothesis must have been correct, because here are the results:
Of the 17 total patients evaluated, 14 ‘responded’ to the diet, which was an 82% success rate. The definition of ‘responded’ was a strict one – it meant that the patient had no further symptoms and was no longer suffering from villous atrophy (if the test was performed). Excellent result!
But even more impressive was this fact. At the beginning of the study, 6 patients were diagnosed and met the criteria for refractory celiac disease. After following the diet, 5 of these 6 patients were completely symptom-free and no longer met the criteria for that serious condition. Therefore, out of 6 dangerously ill patients, only 1 did not respond. That means that a mere 17% of the initial 100% diagnosed with the disease actually had it after following the diet. It also means that 83% of those patients were needlessly being given immunosuppressive drugs.
What was also exciting was the finding that 79% of the entire group evaluated was, after a 3 to 6 month period following the diet, were able to return to their ‘regular’, non-restricted gluten-free diet and maintain their lack of symptoms. The researchers felt that the 3 to 6 month period was enough time to ‘heal’ the immune system such that its ability to tolerate some cross-contamination improved.

I would like to add that evaluating these patients for the secondary effects of gluten, including infections, probiotic insufficiency, cross-reactive foods, toxins, nutritional deficiencies and hormonal imbalance, would also be a good idea. I’m curious how many of these patients may have regressed again after a passage of several months back on their processed food diet. This is a time frame we find that our patients, who have done well gluten-free, but who have not been evaluated for the secondary effects, tend to again become symptomatic.
Do you know anyone who seems ‘ultra’ sensitive to gluten contamination? Do you know anyone who seems to react to foods that are ‘gluten-free’? Perhaps you know someone who has been diagnosed with non-responsive celiac or refractory celiac disease. If so, please do pass this information along to them. You could truly make an impact on their health.
If your health, or that of a friend or loved one, is not at the level you desire, consider contacting us for a free health analysis. Just give us a call at 408-733-0400. Our destination clinic treats patients from across the country and internationally, so you don’t need to live locally to receive assistance. We are here to help!

To your good health,

Dr Vikki Petersen, DC, CCN

Founder of HealthNOW Medical Center

Co-author of “The Gluten Effect”

Author of the e-Book: “Gluten Intolerance: What you don’t know may be killing you!”

Are Migraines a Predictor of Celiac Disease?

According to a research study published in Headache: The Journal of Head and Face Pain, if you have celiac disease, you’re more than twice as likely to have migraines than the normal population. If you have gluten sensitivity, you’re more than four times likely to suffer with debilitating migraines. The researchers also looked at those suffering with IBD, inflammatory bowel disease, and found them a little over one and half times more likely to suffer migraines.

Migraine intensity seemed to also be positively associated with gluten intolerance. Seventy-two percent of celiac stated that they suffered from migraines that were severe in impact, as did sixty percent of those suffering from gluten sensitivity. Of those suffering with IBD, only thirty percent ranked their migraines in the severe category.

When we consider that ninety-five percent of all celiacs remain undiagnosed and likely ninety-nine percents of all those suffering from gluten sensitivity, any assistance in improving those abysmal percentages is data well worth knowing.

What this study reveals is that the symptom of migraine could very well be a red-flag for celiac disease or gluten sensitivity. Imagine if doctors whose patients complained of migraines were regularly screened for gluten intolerance? Would our percentage of diagnosis improve? It seems likely that it would.

One thing that did concern me was the researchers found that the number of years on a gluten-free diet had no influence on the severity of the migraines suffered. For me that is unacceptable. It is rare in my clinic that we don’t resolve migraines. I agree, that a food sensitivity, frequently gluten, is a trigger. But more must be done and this study clearly demonstrates that.

We once again find ourselves in the arena of Secondary Effects. If not addressed, these Secondary Effects of gluten will perpetuate a weakened immune system, leaky gut, nutritional deficiencies and hormonal imbalance – to name a few. When these factors persist, so will the migraines, in the majority of cases.

The take away from this study was two-fold for me. One facet being positive, while the other was decidedly negative.

1.      Patients suffering from migraines should be evaluated for gluten intolerance as they suffer from the symptom, vastly more often than does the general population of sufferers.

2.      One the negative side, those removing gluten from their diet, continued to suffer from migraines. Based on my clinical experience, this is due to improper treatment of the Secondary Effects of gluten. The facts are that we see many very serious migraine cases and our success rate is quite excellent. We attribute that to diagnosing not only any food sensitivities, but also proper evaluation of the Secondary Effects as mentioned above.

Many individuals suffer from debilitating migraines. I was one, actually and so was my mother. When I developed migraines in my teenage years I was told that I had them because my mother did. Not a very encouraging statement! After all, I couldn't change my genes… or could I? In fact, I found that what my mother and I both shared was a gluten intolerance. And yes, secondary to that intolerance were some infections, nutritional deficiencies and hormonal imbalance. And guess what? When I fixed those things I NEVER had another migraine – never. And when I fixed them in my mother, she NEVER had another migraine.

I understand migraines, therefore, personally as well as professionally. They are definitely no fun and I urge you to pass this post along to anyone you know who suffers.

We are always here to answer questions and assist where needed. Anyone interested can call us for a free health analysis as well – call 408-733-0400.

Our destination clinic treats patients from across the country and internationally. You don’t need to live locally to receive help.

To your good health,

Dr Vikki Petersen, DC, CCN

Founder of HealthNOW Medical Center

Co-author of “The Gluten Effect”

Author of the e-Book: “Gluten Intolerance: What you don’t know may be killing you!”

Reference:

Headache: The Journal of Head and Face Pain. 5 Nov 2012, Prevalence of Migraine in Patients With Celiac Disease and Inflammatory Bowel Disease Volume 53, Issue 2, Pages 227–425 Alexandra K. Dimitrova MD, Peter H. Green MD, et al

A “Green” Solution to Leaky Gut for Celiacs

If you’re new to the world of celiac disease and gluten sensitivity, you may not have heard the term ‘leaky gut’. It simply refers to the increased permeability of the small intestine that occurs as a result of damage caused by gluten. While the concept is simple to understand, the ramifications of a leaky gut are complex and devastating to health.

The small intestine very intelligently allows the passage of digested food to leave the confined of its interior and via the bloodstream such foodstuffs are delivered to all the cells of the body so that they can be nourished. Putting food in your mouth is one thing, ensuring it adequately gets delivered to the 10 trillion cells making up your body is quite another.

But while the small intestine acts as a conduit for food to leave via small openings, it too prevents the movement of anything it considers to be a ‘bad guy’, be it bacteria, parasites or other toxic substances. This scenario occurs quite beautifully in the normally functioning ‘unleaky’ small intestine.

In the damaged small intestine, a very different picture presents itself. Due to enlarged openings, partially digested food passes into the bloodstream before full digestion has occurred, bad organisms too gain access to the bloodstream. This is the picture of a leaky gut and it’s not a pretty one.

What we know very clearly, is that once a diagnosis of gluten intolerance has occurred and a gluten-free diet has been initiated, the next critical step is to ensure that the health of the small intestine is restored. This has far reaching effects that not only would influence digestive health, but also the health of the rest of the body including development of autoimmune disease, inflammation leading to degenerative disease and neurological problems, to name just a few.

Therefore I was delighted to run across some recent research that not only was extremely revealing as to how best to keep the small intestine healthy, but a major breakthrough in leaky gut.

The researchers out of Australia discovered specialized immune cells calls ILCs (innate lymphoid cells) are generated from a gene called the T-bet gene. These cells are responsible for killing bad bacteria in the small intestine, keeping the good bacteria happy, healing small abrasions on the lining of the intestine and preventing intestinal cancers. These are some amazing cells.

They are activated when the T-bet gene is turned on. What turns on the gene? Green leafy cruciferous vegetables! Now that’s an easy solution. Not only are greens loaded with antioxidants, they keep the ILCs functioning at a good level.

Which vegetables fall into this category? Glad you asked – here’s the list:

Kale	collard greens	Chinese broccoli
cabbage	brussels sprouts	kohlrabi
broccoli	broccoflower	cauliflower
wild broccoli	bok choy	mizuna
broccoli rabe	turnip root, turnip greens	rutabaga
arugula (rocket)	maca	garden cress
watercress	radish	daikon
wasabi

In summary it is believed that ILCs play a critical role in controlling:

Food allergies

Inflammatory diseases – this category basically includes all the degenerative diseases killing most people. E.g heart disease, cancer, diabetes, etc.

            Obesity           

            Development of bowel cancers – the ILCs are thought to prevent these cancers.

This is exciting. Imagine being able to turn on these important genes and activate these immune cells, all with a decision of eating more green veggies. And, as you can see above, you have quite a selection to choose from.

While I wish this was the ONLY step you had to take to heal a leaky gut, it certainly is a very important step that is easily achieved – no lab test, no doctor visit – just eat those healthy greens.

I hope this was informative for you. For more information on this study go here.

If your health is not as you desire, please consider contacting us for a free health analysis – we’re here to help! Just give us a call at 408-733-0400. Our destination clinic treats patients from across the country and internationally.

To your good health,

Dr Vikki Petersen, DC, CCN

Founder of HealthNOW Medical Center

Co-author of “The Gluten Effect”

Author of the e-Book: “Gluten Intolerance – What you don’t know may be killing you!”

Are Other Countries ‘Better Off’ When it Comes to Gluten?

The grass often seems greener on the other side of the fence, but in this case I think it’s no exaggeration when referring to ‘Down Under’. I don’t cite this example to depress anyone, but rather to empower you and all of us who are gluten intolerant to continue to fight, to continue to push and to continue to enlighten and educate.

Here’s the story:

About 12 years ago, a patient traveled to Australia on her honeymoon. She arrived at the hotel after a very long flight from California and was hungry. She called room service and when the very kind voice at the other end of the phone asked her “What would you like to eat” she responded, albeit a bit crankily, “What I would like and what you can give me are two different things. I’d really love a sandwich but I am gluten intolerant.” To which the lovely voice replied, “Would you like your gluten–free bread with raisins or without.”

Needless to say my patient was very happy during her stay in Australia. Apparently there was a delicious bakery across the street that baked the bread and several other goodies. When she returned home to California, however, her comment to me was: “We live in the wrong country!” Twelve years ago there was ‘slim pickings’ when it came to bread and I too was impressed with her Australian experience.

Fast forward to present time and I just heard from a family who had recently moved to Australia (near Perth). They happily reported that eating gluten-free is truly a ‘breeze’ in Australia. Apparently regular grocery stores have a lot to offer and better yet, they have found the school system and day-care facilities to be extremely understanding and supportive of their gluten-free diet.

So, once again, I don’t write this to be depressing, but rather to show that it is well worth it to keep being vigilant and continue to share how important it is to have gluten-free options for all those who need it, while educating broadly so that those suffering with gluten intolerance can receive a diagnosis.

It starts small but it will grow. Work with your schools, work with your day care, work with your company’s cafeteria. If you need help, let me know. That’s why I’m here.

Vow to speak to one person or one organization each day about gluten. Even if it’s just for a minute or two, all those small conversations can add up to big change!

If you or someone whom you care about is not enjoying good health, please consider calling us for a free health analysis – call 408-733-0400. Our destination clinic treats patients from across the country and internationally so you do not need to live locally to receive help.

I look forward to hearing from you.

To your good health,

Dr Vikki Petersen, DC, CCN

Founder of HealthNOW Medical Center

Co-author of “The Gluten Effect”

Author of the e-Book: “Gluten Intolerance – What you don’t know may be killing you!”

Why You Can’t Stop with Just a Gluten-free Diet

The two major issues we have regarding gluten in this country are:

1.      We are terrible at diagnosing celiac disease and gluten sensitivity. Over 95-97% of those with celiac disease continue to suffer, with the number likely being much higher for gluten sensitivity.

2.      When we finally DO diagnose either condition, the only treatment we offer is a gluten-free diet.

Now, don’t get me wrong, the only place to START is definitely with a strict gluten-free diet. What I take issue with is that being the ONLY recommendation.

Witness this comment from the mother of a child with celiac disease:
My 19 month old son was diagnosed with celiac in September 2012 at 13 months.  I nursed him until 16 months when he self-weaned (too busy chasing his big brothers.)  At the time of his diagnosis, his AST and ALT were quite high [these are liver enzymes].  We immediately went gluten free and his symptoms were better within 36 hours.  He's been happily gluten free since Sept 2012.  He has no real health issues since going gluten free, other than dry skin and mild rashes that a lot of celiacs experience even when off gluten.

Fast forward six months when we had his enzyme levels checked again this month.  His ALT and AST were worse.  The pediatric gastro had him tested for multiple things.  Thus far, everything has come back negative, except the HLA molecular test for Celiac and lymphoma [a genetic test]. 

Let’s analyze this. Here we have a small child barely 2 years old with celiac disease. His mom says that ‘all’ his symptoms disappeared when beginning a gluten-free diet, except his dry skin and rashes, which she states that “a lot of celiacs experience”. What is concerning is elevated liver enzymes, showing some liver damage that is actually worsening despite a gluten-free diet.
Here’s my take on it:

1.      It’s great that most symptoms improved but one cannot ignore the skin issues. Why? Because the skin is a reflection of colon health and his continuing skin issues mean that his gut isn’t healed – yes, he likely has a leaky gut.

2.      What’s showing on the outside (his skin), is likely also being demonstrated on the inside (his liver). When a leaky gut persists, any autoimmune type reaction that occurred while the person was eating gluten can persist despite no gluten being ingested. Why? Because the immune system is on an ‘auto-destruct’, which is what autoimmune disease is.

3.      What needs to be done is to heal the gut and normalize the immune system. This child could have infections in his gut that are migrating out through the leaky gut into the bloodstream and affecting his liver. Or, the immune system could just be continuing the liver ‘auto-destruct’ message that is originally received from gluten, but is now continuing because the leaky gut continues.

4.      Another option is that the child is eating foods that are cross-reactive to gluten and that is continuing the autoimmune tendency. Finally, the child could also have a sensitivity to dairy products which is known to be highly anti-inflammatory.

The great news is that the child has been testing extensively and all the ‘scary’ diseases have been ruled out. Now we could just move forward with the above, very easy treatment, to truly reverse the situation before it becomes permanent and the child is left with a malfunctioning liver.

I hope this makes sense. It frustrates me no end that the secondary effects of gluten are not addressed more routinely. It could definitely save patients from many chronic diseases.

If you know someone who is gluten-free but is still not enjoying good health, please share this with them. We would also be happy to offer them a free health analysis – call 408-733-0400.

Our destination clinic treats patients from across the country and internationally, we are here to help!

To your good health,

Dr Vikki Petersen, DC, CCN

Founder of HealthNOW Medical Center

Co-author of “The Gluten Effect”

Author of the e-Book: “Gluten Intolerance: What you don’t know could be killing you!”