ARE YOU THE ONE in 133 People Who Have Celiac Disease?

As more research is coming out in the news people have asked “Why is ‘gluten free’ becoming so popular?” or “Why is celiac disease being talked about?”  

Celiac disease is a lot more common than originally thought back when many of today’s health care practitioners and especially gastroenterologists were educated in school. Just a few years ago it was thought to be 1 in 10,000. The Celiac Disease Foundation is doing a great job educating the public through press releases, articles in medical journals, their annual convention, website and publications; so the word is getting out. In our health care system, unfortunately we are treating many autoimmune diseases symptomatically, without questioning where they are coming from, and why autoimmune diseases are on the rise. Although an epidemic of vitamin D deficiency is one part of the problem with the rise in autoimmune illnesses, this blog will address the celiac factor. ( Vitamin D3, acts as a hormone, and in addition to being important in building healthy bones, it regulates the immune system; in fact helping our bodies to recognize “self” from “other”,  so that our white blood cells do not attack our own tissues.)  

Undiagnosed celiac disease and gluten sensitivity spectrum disorder ( which does not have the same genetic underpinnings) are linked to the up-regulation of the immune system which can lead to many autoimmune illnesses. When irritated or “confused” the immune system can fail to distinguish “self” from “other” and attack one’s own body. Gut barrier integrity; that is, keeping the junctures between cells in the intestines tight and secure, is the issue. If the junctures become disturbed and widen, then larger (dalton) food particles can slip through and key the lymph tissue around the intestines to start developing antibodies to similarly structured proteins. This leads to dysregulation of the immune system. What destroys the junctures is the constant irritation from inflammation of the intestines if there is a gut “dysbiosis” or some imbalance. A wheat allergy, gluten intolerance, or gluten sensitivity all can cause chronic inflammation. There are other things that can cause gut issues, such as a bacterial pathogen, or a “bug”, like a protozoan infection, or a yeast imbalance, but many of the IBS, Crohn’s or other diagnoses may actually be misnomers for untreated celiac. 

The following is from the Celiac Disease Foundation’s website, in regard to getting a diagnosis.

(A chiropractor, naturopath, or MD can sign the lab requisition slip. You can check with the lab and/or your insurance company to see if all the tests will be covered.)

A person seeking diagnosis MUST be following a daily diet that contains gluten for at least 4 weeks in order for test results to be accurate. 

Specific antibody blood tests are the initial step in screening for CD. Patients should always consult with a physician to ensure proper diagnosis.

Recommended Blood Tests:

• Anti-tissue transglutaminase antibody (tTG – IgA and IgG)
commonly used whether or not symptoms are present and the most sensitive test available

• Anti-endomysial antibody (EMA-IgA) – highly specific marker for celiac disease

• Anti-deaminated gliadin peptide (DGP – IgA and IgG)
used when tTG or EMA is negative and in cases where patient is IgA deficient

• Total serum IgA – used to check levels to exclude selective IgA deficiency that results in a false negative test

• Anti-gliadin antibody (AgA – IgG and IgA) not considered sensitive or specific enough for adults, but used for children under 2 because tTG and EMA antibodies may be absent. The anti-DGP test is sensitive in this group.

A patient with positive antibody tests and a patient with selective IgA deficiency are strongly advised to consult with their physician regarding a small bowel biopsy (which is performed endoscopically). A positive small bowel biopsy is required to confirm the diagnosis and assess the degree of damage to the villi in the intestinal lining.

Antibody test results can only suggest the presence of Celiac Disease but cannot confirm it. When antibody results and biopsy are inconclusive, or when the patient is on a gluten-free diet, genetic testing of the HLA (human leukocyte antigen) DQ2/DQ8 genes may be helpful. 

The specific genes DQ2 and/or DQ8 are considered necessary for Celiac Disease to develop. Since one-third of the population also has these genes, the presence of DQ2 or DQ8 does not imply that the person will necessarily develop CD, rather, that they have a genetic predisposition to CD.

Genetic testing does not diagnose Celiac Disease - its largest benefit is that the absence of DQ2 and DQ8 essentially excludes CD.

The onset of Celiac Disease can occur at any time in a person’s life. Once a person is diagnosed, family members should be urged to get tested as well.

In a sense there is a “perfect storm” that triggers the onset of the disease. It’s a combination of diet, stress, how dysregulated your immune system is, etc. It can show up in newborns, but for many people it’s as they age that the multiple factors come into play and they become symptomatic.

Contact www.celiac.org for more information, and to read about the upcoming annual convention in Los Angeles on April 28th 2012. 

For more information, to get tested and treated feel free to call me for a free consultation to see if I can be of help to you or your family. 

Step Into 2012 in a Whole New Way

It’s New Year’s Eve and everyone is either poised to create a new and better self, and new and better life this year, or they are resisting the social pressure to make New Year’s resolutions. I, myself, am weary of all the hot tips on health, weight loss research, exercise and nutrition. I hear confusion from my patients in my practice every day, because the media presents sensationalistic reports, often pulling out “nuggets” from some poorly designed research, which stands us on our heads; such as: “Vitamins Kill”, or something like that. Reports conflict such that one day coffee is “good for you” and another it’s not. Same with chocolate, or zinc, or vitamin D. I’m going to offer something for your New Year that is so simple and fundamental as to be obvious, but then it doesn’t “sell soap.” 

When it comes to making change, I find it helps to check in with yourself, and come down to the nitty gritty of what makes you tick. What “calls” to you, has you getting all excited, or passionate and happy? What draws you forward, out of your bad habits? What makes you try something new and has you feeling exhilarated and glad you stepped out?  What’s so much fun, like an activity, that you practically can’t tear yourself away from it to get to work, or mowing the lawn...the chores and practical things you know you have to attend to? What are your aspirations that are so important to you, you’re willing to sacrifice your “deliciously” bad habits, and curb those desires, in order to stay true to your ideals, and make sure your health becomes a support for achieving those goals?; doing things like eating better and going to bed earlier so you have energy for your special journey. 

I have a very sage chiropractic colleague who teaches a course on “Adjusting the Mind” for chiropractors,  who put it this way, “Ask yourself, ‘what are my principles and virtues?’, is this activity/choice in line with what makes me ME, that has me being congruent with what I stand for? The lack of being in alignment with your principles, creates a kind of friction, or in-authenticity that costs us feeling genuine and true. Being in an inquiry about your goals and principles, checking in with yourself in your daily travels, or having a game plan for this year, that looks more like a treasure map than a laundry list, might make all the difference.

One of my favorite games as a kid, was Candyland. I loved rolling the dice, advancing a few blocks on the roadmap, and seeing where it got me. That treasure map of the things I want to do in life, makes me question whether staying up ‘til the wee hours, is really going to forward the action tomorrow, or whether I’ll be sullen and dull instead, unable to fulfill my promises to family, friends and myself. 

So, don’t get stuck in the Choclolate Swamp.  Check in, is this consistent with who I  am? what I stand for? where I’m going? and what I want?  If not, change that choice quickly in “present time” and practice consistently. You’d be amazed at the results. You’ll still trip, and have set backs, but gradually you can move from point A to point B, and be able to make new milestones. 

Don’t know who you are, or what you want or where you’re going? That’s a whole ‘nother post. 

Have a save and Happy New Year’s celebration, and an exciting new year!