Friday, May 24, 2013

Autoimmune Disease & Celiac – What You Need to Know


Autoimmune disease is an odd phenomenon. The body’s immune system is designed to attack foreign invaders such as bacteria and cancer cells. But in autoimmune disease the immune system ‘decides’ to attack the body itself.

What types of diseases fall under the autoimmune umbrella? Type I diabetes, rheumatoid arthritis, autoimmune thyroid and liver disease, Sjogren’s, M.S., Parkinson’s, Alzheimer’s, psoriasis, celiac disease, DH (the skin condition associated with celiac disease), fibromyalgia and many more, totaling about 100 diseases in all.

Their frequency, once thought to be uncommon, has risen to a degree that autoimmune diseases, taken as a whole, are the third leading cause of death in the U.S. Their incidence has doubled every 15 years for the past 75 years, with no signs of slowing down.

The genetic component associated with autoimmune disease does not explain its increased frequency, so experts are looking to the environment as a source of the sudden rise. One area that has shown promise is the health of the small intestine. As the gateway to the body, a healthy small intestine should prevent any inhospitable substances or organisms from entering the bloodstream.

Early work by Dr Fasano on type I diabetic rats and small intestine integrity, revealed that a full 2/3 of rats inbred to develop type I diabetes did not do so when their small intestines were optimized in function.
Subsequently more research has supported this premise and the ill health of the small intestine is acknowledged to be a likely culprit in the development of at least some autoimmune diseases.

When does gluten enter the picture? Gluten, in intolerant individuals, is known to create the irritation to the lining of the small intestine that in turn creates easy passageway for toxins and organisms to gain access to the bloodstream. This phenomenon is known as a leaky gut. Also, a gluten intolerance is known to weaken the ‘good’ organisms of the gut, the probiotics, that are responsible for keeping bad genes turned off. They provide this function quite well when they themselves are robust and healthy, but once their numbers and strength become compromised, so too does their ability to keep bad genes from expressing disease. The result? The gene flips ‘on’ and the body develops the disease.

Is gluten intolerance or celiac disease the cause of EVERY autoimmune disease? Not likely. But it does seem to be a contributing factor in some. Other autoimmune diseases have an infectious component, but when you think of why the immune system didn't or couldn't handle the initial infection, you are brought back to WHY it was weakened. That reason could lie in a history of medications, a poor diet, toxic overload or a food intolerance. These are the issues we address when trying to normalize an overburdened immune system and the reason we feel that we see the success rate that we do.

A study just released several days ago from Current Allergy and Asthma Reports reviewed the association between celiac and other autoimmune diseases as well as the impact of a gluten-free diet. The diseases most closely associated with celiac are autoimmune thyroid disease, autoimmune liver disease, type I diabetes, DH, Sjogren's and psoriasis.

Correlation between a gluten-free diet and autoimmune disease was cited in a study of celiac patients who also suffered from either type I diabetes or autoimmune thyroid disease. After 2 years on a gluten-free diet all antibodies for the diseases abated. Antibodies, you may remember, measure autoimmune activity and in this study they were no longer found to be active once these patients eliminated gluten from their diet!
Another study of over 900 celiac patients found that those compliant on their gluten-free diet had much lower incidence of autoimmune disease than their non-compliant counterparts.

Finally, a study evaluating autoimmune liver disease in celiacs saw complete reversal of the liver disease in both adults and children who followed a gluten-free diet.

So, there definitely seems to be some correlation between eliminating gluten in those with gluten intolerance and reversal of specific autoimmune diseases.

Does everyone who is diagnosed with those autoimmune diseases receive advice to be checked for gluten intolerance? I would bet the answer is no, but it should be a resounding ‘yes’.

Please spread the word. It’s been fairly well established that the increased incidence of autoimmune disease does have an environmental component. And at least for some, that component is diet-related, specifically gluten. It certainly does no harm to check if gluten is a contributing factor, and as you can see in the research findings above, it could provide a great deal of help.

If you know of someone suffering with autoimmune disease or you yourself suffer or have family members that do, consider calling us for a free health analysis. (call 408-733-0400) We are here to help!
Our destination clinic treats patients from across the country and internationally. You don’t need to live locally to receive assistance.


To your good health,
Dr Vikki Petersen, DC, CCN
Co-Author of “The Gluten Effect”
Gluten Doctor of the Year 2013

References:
J. Denham, I. Hill, Celiac Disease and Autoimmunity: Review and Controversies, Current Allergy and Asthma Reports , 17 May 2013
Cosnes J et al. Incidence of autoimmune diseases in celiac disease: protective effect of the gluten-free diet. Clinical Journal of Gastroenterology and Hepatology. 2008;6(7):753–8.

Ventura A et al. Gluten-dependent diabetes-related and thyroid-related autoantibodies in patients with celiac disease. Journal of Pediatrics. 2000;137(2):263–5. 

Monday, May 20, 2013

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”

Friday, May 10, 2013

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
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.

Wednesday, May 01, 2013

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