For many that don’t know, May is Celiac Awareness Month. Over 3 million Americans have Celiac Disease, that’s 1% of the population, affecting 1/133 people including both men and women of every race. (1)
Celiac Disease is an autoimmune disease that affects the intestinal villa of your gut. Every time a person with Celiac consumes gluten, their body is attacking the absorption of their gut. Symptoms of Celiac can be very vague like fatigue, headaches, acne, irregular cycles to more specific symptoms like abdominal pain, bloating, diarrhea and a rash. About 38% people are actually asymptomatic (3). People with other autoimmune disease are more likely to have Celiac and it is known to run in families. The triggers for this disease include having the autoimmune susceptibly and consuming gluten. The treatment is easy; avoiding Gluten!
So what is gluten?
Gluten is a protein found in barely, wheat, rye, oat and spelt to name a few. Unfortunately, gluten is in everything from breads pasta, hidden additives, alcohol, soy sauce to makeup and lotion. There are many complications to this if one continues gluten, including miscarriages, having small for gestation age babies, decreased sperm in men, early menopause in females, and an increased risk of cancers. There is no pharmacological cure besides going on a gluten free diet. It’s much easier to be gluten free today than it was 20 years ago. More and more research is going into Celiac Disease.(1-3)
Non-Celiac Gluten Intolerance
There is also Non Celiac Gluten Intolerance in which patients don’t have Celiac Disease but are not able to digest gluten normally. Many people have gluten sensitivities which can manifest in GI issues, dermatitis like eczema, fatigue, and depression. I advise my autoimmune patients, severe allergy patients, abnormal thyroid patients and patients suffering from digestive problems to go on a gluten free diet. Gluten causes a lot of inflammation and causes intestinal permeability and leaky gut all which are precursors to many autoimmune conditions. I also encourage my patients who have wheat allergies to go on a strict gluten free diet. I have had many success with my patients who suffer from thyroid, autoimmune conditions and Inflammatory Bowel Disease who’s symptoms and autoimmune antibodies dramatically improve by removing this protein!
How do you know if you have Celiac of Gluten sensitivity?
Your primary care physician can run some basic antibody testing for you like your endomysial, gliadin and transglutaminase antibodies. The definitive test is an invasive upper endoscopy (EGD) biopsy, which is neither 100% sensitive or specific for Celiac Disease (3). However if you have been on a gluten-free diet and then get an EGD, it may not pick it up. I encourage my patients try an elimination diet regardless of their antibody and EGD results. The best test is experience! If and when you eliminate gluten and your symptoms improve, then you’re on to something. When you re-introduce gluten after being off of it for a while and observe stomach issues, rashes, fatigue, headaches then you have your answer to having a gluten sensitivity.
Where can you find Gluten-Free foods?
Patients always ask me where they can shop and find groceries. We are fortunate you can go to many grocery stores these days and they have gluten free sections. You will also find many products in the organic food isle. There is easy labeling on everything and most restaurants are becoming aware and offer gluten free menus. The biggest thing to be aware of is cross reaction to gluten and avoiding products have have been processed around gluten. Some people think going on a gluten free diet will help them lose weight, and they can if they do it right. Be sure to not substitute gluten products with high sugar, Glycemic index gluten free carbohydrates which will affect your insulin and blood sugar levels. Instead of substituting regular pasta for gluten free pasta, switch it out and adjust your palate to enjoy zucchini pasta. (Be sure to look out for my recipe blog including what gluten free meals and snacks you can eat)
Elimination Diet Challenge!
I challenge everyone to become more educated about Celiac and Gluten sensitivity this month and take the Gluten Free challenge with my patients and staff and go on gluten free diet for at least 5 days in June! Elimination diets are one of the best ways to know if you have a gluten sensitivity. Ideally, 21 days would be better, but after seeing dramatic results the first week I’m convinced you’ll want to stick to it. Pay attention to how you feel if and when you introduce gluten into your diet to correlate your symptoms. I have been doing it for almost 3 years and I have never felt more energized and healthier than I have before.
1. “National Foundation for Celiac Disease Awareness.” Celiac Disease Facts & Figures. National Foundation of CeliacAwarness, n.d. Web. 29 Apr. 2014. <http://www.celiaccentral.org/celiac-disease/facts-and-figures/>.
2. PELKOWSKI, TIMOTHY D., MD. MS, and ANTHONY J. VIERA, MD. MPH. “American Family Physician®.” CeliacDisease: Diagnosis and Management 2nd ser. 15.89 (2014): 99-105.
3. Bast, Alice., Pietzak, Michelle MD., Defining, Diagnosing, and Managing Celiac Disease in Primary Care. Celiac CME Newsletter. Vol 1. Dec 1 2010.
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