Celiac & Gluten Intolerance, Part One
Celiac Disease (CD) is a permanent, autoimmune digestive disorder that affects the small intestine. (The word "celiac" comes from the Greek word for abdomen.) When people with CD ingest gluten (proteins in wheat, rye, barley and gluten-contaminated foods) their immune systems attack the small intestine thereby inhibiting absorption of nutrients. If undiagnosed or untreated, CD can cause damage to the small intestine and may pave the way to other autoimmune disorders as well as many other serious conditions including, but not limited to, osteoporosis, infertility and miscarriage, neurological conditions and intestinal lymphoma.
According to the National Institutes of Health, 1 in 133 people have celiac disease (also called celiac sprue or non-tropical sprue). That's 3 million Americans! For people with first-degree relatives (parent, child, sibling) who have CD, it's 1 in 22 and 1 in 39 for those with second-degree relatives (grandparent, aunt, uncle, cousin) who have celiac disease. This inherited trait is more common in those of northwest European ancestry, and is especially high among Celts and Finns, although not limited to those populations. Also, people with autoimmune diseases are hugely at risk for celiac disease. If someone in your family has celiac disease or an autoimmune disorder it is a good idea to get yourself tested since most people with CD have no symptoms.
Classic Celiac Disease symptoms involve the gut: diarrhea, flatulence/bloating, fatty stools (they float), malabsorption/anemia, weight loss/wasting, failure to thrive and damaged intestinal villi. Dermatitis herpetiformis is a skin manifestation of celiac disease. CD is very common in infants and young children ó in fact it was once mistakenly thought to be a childhood illness that would be outgrown. Some people diagnosed with irritable bowel syndrome may actually have CD. It takes, on average, 4 years for a symptomatic person to be given the diagnoses of celiac disease. In the meantime, they suffer ill health and are at increased risk. In the United States we have mostly Atypical Celiac Disease, usually diagnosed in middle age and often as a result of an existing autoimmune condition. Those with atypical celiac frequently have no digestive symptoms (so it may be called gluten intolerance or gluten sensitivity). They may be overweight, constipated or anemic. They may have diabetes, thyroid disease, high cholesterol and/or triglycerides, dental enamel defects or chronic mouth ulcers. They may be suffering from osteoporosis, chronic fatigue, skin problems or liver disease or experiencing peripheral neuropathy, ataxia or seizures. Some are struggling with depression or schizophrenia.
There are literally dozens of conditions (too numerous to list here) that are related to gluten intolerance and they are often unresponsive to conventional medical treatment. Because of the absence of gastrointestinal damage or gut symptoms those with atypical celiac may not be told that gluten is the source of their troubles. In addition, the amazing variety of symptoms associated with gluten intolerance can impede diagnosis.
It is especially important to get an early diagnosis for children who are gluten intolerant. Their growing bodies require nutrients they may not be absorbing. In addition to the classic celiac symptoms, gluten sensitive children are more likely to have learning disabilities and behavior issues, early bone loss, late onset of puberty and they often are short in stature. If diagnosed early and put on a gluten-free diet these children usually resume normal growth and development.
If you think you are at risk for celiac/gluten intolerance consult with your doctor who may order a blood test for gluten antibodies (or perhaps another screening procedure). It is vitally important that you DO continue consuming gluten before a diagnosis is made, otherwise the test will be inaccurate and you may be misdiagnosed.
Celiacs may experience a variety of nutrient deficiencies because they may feel too sick to eat as well as from malabsorption due to intestinal damage. Strict adherence to a gluten-free diet can heal the gut so absorption is increased, however some people with celiac never completely heal, especially if diagnosed late in life, so they may continue to have nutrient deficiencies.
- Unexplained, unresponsive IRON deficiency anemia may be caused by celiac disease. It will persist until the gut is healed and iron requirements are met.
- FOLATE deficiency due to severe malabsorption is of great concern to women with CD who are or may become pregnant.
- Osteopenia and osteoporosis are common in both men and women with celiac disease due to malabsorption of CALCIUM.
- VITAMIN D and VITAMIN K deficiencies, which are common in people with CD, also contribute to bone loss.
- Celiac disease can increase the risk of deficiencies of several other nutrients including B VITAMINS, VITAMIN E and VITAMIN A, and the minerals SELENIUM and COPPER.
- LACTOSE INTOLERANCE may result from decreased lactase production due to damaged villi. A strict gluten-free diet for 6 to 24 months should heal the gut enough for lactase production to resume.
The only "cure" for celiac disease and gluten sensitivity is a lifelong, completely gluten-free diet. Although the majority of those who react to gluten have no overt symptoms when they ingest it, even small amounts of gluten can damage the small intestine increasing the risk of serious complications.
Early diagnosis is crucial since untreated gluten intolerance can cause life-threatening complications. The prognosis is excellent (if there is no permanent damage) if you absolutely and always follow the gluten-free diet. Eliminate foods, beverages, supplements, medications and even cosmetics/body care products that contain wheat, barley, rye, contaminated oats and their derivatives. Read all labels carefully to look for hidden sources of gluten. A nutritionist can assist you with a well-balanced, gluten-free diet and their are a number of support groups to help you transition to the gluten-free lifestyle.
Evergreen Nutrition can help in a number of ways. To begin with, we have several lines of gluten-free supplements including our own Evergreen brand, Country Life, Whole Earth & Sea, New Chapter, MegaFood, Garden of Life, Nature's Plus, Carlson and others. Enzymedica makes a variety of digestive enzymes including Gluten-Ease. In addition, we have gluten-free cosmetics and body care products. By the way, distilled spirits used in herbal extracts do not contain gluten ó the gluten molecule is too big to pass through the distillation process.
We also have a Certified Clinical Nutritionist, Terri Williams, BS, CCN, who is available for private consultations. She can show you how to meet your specific nutritional requirements.
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