For many that don’t know, May is Celiac Awareness Month. Over 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, irregular cycles to more specific symptoms like abdominal pain, bloating, diarrhea and rash. About 38% people are actually asymptomatic (3). People with other autoimmune disease are more likely to be have Celiac and it is known to run in families. The triggers for this disease include having the autoimmune susceptibility and consuming gluten. The treatment is easy, avoiding Gluten. 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, miscarriages, having small for gestation age babies, decreased sperm in men, early menopause in females, and increased risk of cancers. There is no pharmacological cure besides following a gluten free diet. It is much easier to be gluten free today than it was 20 years ago. There is easy labeling on everything and most restaurants are becoming aware and offering gluten free menus. More and more research is going into Celiac Disease.(1-3)
Here’s my journey.
All throughout medical school in the early 2000’s I had severe acne, and got on birth control to fix the “problem”. What did I know at 23?! It didn’t occur to me my acne could be a sign of something more. I started eating “healthier” incorporating more whole wheat grains in my diet; oatmeal for breakfast, whole wheat pasta, whole wheat sandwiches, before you know it, whole wheat everything! In fact, I was convincing everyone in my family to go “whole wheat!” I was determined everyone was going to eat “healthy” just like me!
I started residency and developed a rash above my upper lip that never went away. I saw the dermatologist who treated me with every known medication with no improvement. That’s when I knew something was not right. Everyone just brushed it off as you’re the hypochondriac doctor-patient. I even saw an allergist begging them to test me for allergies and autoimmune problems and he again brushed it off as nothing. It wasn’t until I started doing my integrative rotation when my symptoms started making more sense and I started to look deeper in my symptoms. Why was every symptom an individual one: headaches, irregular menstrual cycles, fatigue, abdominal pain, and rash? Everyone kept saying it’s residency you’re stressed. I refused to believe it. I put myself on a low gluten diet mainly for anti-inflammatory reasons and my symptoms improved. As a physician you think I would have gotten my answer. Well my rash flared up again because of course it’s hard to always eat well on the go when you’re working 80 hours/week. I finally got tested and behold my ferritin was super low and I was severely anemic which then triggered my brain to go off saying, “Bindiya you have Celiac and Gluten intolerance, you’ve been in denial.” My Antibody for gliadin came back positive as well as my food intolerance testing. I personally chose to avoid the biopsy since it is neither 100% sensitive or specific for Celiac Disease (3). I figured if I went on a strict gluten free diet, I’d have my answer and I did.
This whole time I’ve been following society’s “whole wheat” craze not realizing that plan wasn’t meant for me. Retrospectively, it all makes sense now. I’m barely 5’0, small petite frame with GI issues growing up, having irregular cycles, rashes, chronic anemia, chronic fatigue not related to residency/studying and no one took the time to look deeper and put it all together including myself. I wasn’t in tune with my body and symptoms earlier on in life. I figured every kid has abdominal pain; it wasn’t that big of a deal.
I always felt bad for Celiac patients, but never in a million years thought it could be me. Knowing this has changed my life and has allowed me to keep my symptoms at bay: my acne has decreased, cycles are better, headaches have gone, fatigue is better and overall I feel better and great. I refuse to fall into the trap of our society’s hoopla by just treating one symptom at a time, and this is why I am pursuing and integrative medicine Fellowship.
1. “National Foundation for Celiac Disease Awareness.” Celiac Disease Facts & Figures. National Foundation of Celiac Awarness, 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®.” Celiac Disease: 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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