Symptoms of Gluten Intolerance

Is Subclinical Gluten Intolerance/Celiac Disease Sabotaging Your Health? The Celiac Disease/Autoimmune/Thyroid Connection

Gluten intolerance -- also known as celiac disease, celiac sprue, and sprue -- is a genetic autoimmune condition that makes it difficult for the body to properly absorb nutrients from foods. It affects an estimated 1.5 million Americans. What happens in gluten intolerance is: The body lacks a particular digestive enzyme, intestinal glutaminase, that can digest gluten products Gliadin antibodies are produced as the body's reaction to the presence of the gluten the villi in the bowels become flattened, making them less able to sweep along waste products and filter out toxins The bowel, in a state of irritation, becomes more permeable, allowing larger proteins to pass through, which further aggravates the "allergic" response The body responds by producing more histamine, seratonin, kinins, prostaglandins, and interleukins -- which can trigger or aggravate autoimmune and inflammatory conditions The incidence of full-scale gluten intolerance has been found to be substantially higher in people with autoimmune thyroid disease. A study reported on in the February 2000 issue of Digestive Diseases and Sciences found that undiagnosed celiac disease may be part of the process that triggers an underlying autoimmune disease. In their findings they wrote: ""We believe that undiagnosed celiac disease can cause other disorders by switching on some as yet unknown immunological mechanism. Untreated celiac patients produce organ-specific autoantibodies." Of perhaps greatest importance to thyroid patients, those researchers found that the various antibodies that indicate celiac disease - organ-specific autoantibodies (i.e., thyroid antibodies) -- disappear after 3 to 6 months of a gluten-free diet. The researchers suggested that patients with autoimmune thyroiditis "may benefit from a screening for celiac disease so as to eliminate symptoms and limit the risk of developing other autoimmune disorders." Celiac antibodies blood testing can help diagnose the full-scale version of the condition, but formal diagnosis requires biopsy. Because the full-scale diagnosis of the condition is not that common, many doctors and patients do not realize that a milder version of the condition -- subclinical gluten intolerance/celiac disease -- may be the cause of chronic symptoms in millions more thyroid patients. Diagnosing the subclinical, reversible version requires newer "intestinal permeability" or "mucosal barrier" tests, along with clinical observation of symptoms made by an experienced practitioner. What are the symptoms of subclinical gluten intolerance and celiac disease? Recurring abdominal pain and bloating Gas, intestinal difficulties Aggravated allergies Difficulty losing weight Muscle aching Joint stiffness and pain, especially in hands, with swelling Fatigue Burning sensations in the arms and legs Numbness and tingling in hands, arms and legs Brain fog, memory problems, disorganized thinking Sores inside the mouth Painful skin rash on elbows, knees, and buttocks Hives Once diagnosed, the next step is a gluten-free diet. The Gluten Free Diet (Featuring information from the federal government's NIDKK site) The only treatment for celiac disease is to follow a gluten-free diet--that is, to avoid all foods that contain gluten. For most people, following this diet will stop symptoms, heal existing intestinal damage, and prevent further damage. Improvements begin within days of starting the diet, and the small intestine is usually completely healed--meaning the villi are intact and working--in 3 to 6 months. (It may take up to 2 years for older adults.) The gluten-free diet is a lifetime requirement. Eating any gluten, no matter how small an amount, can damage the intestine. This is true for anyone with the disease, including people who do not have noticeable symptoms. Depending on a person's age at diagnosis, some problems, such as delayed growth and tooth discoloration, may not improve. A small percentage of people with celiac disease do not improve on the gluten-free diet. These people often have severely damaged intestines that cannot heal even after they eliminate gluten from their diets. Because their intestines are not absorbing enough nutrients, they may need to receive intravenous nutrition supplements. Drug treatments are being evaluated for unresponsive celiac disease. These patients may need to be evaluated for complications of the disease. If a person responds to the gluten-free diet, the physician will know for certain that the diagnosis of celiac disease is correct. A gluten-free diet means avoiding all foods that contain wheat (including spelt, triticale, and kamut), rye, barley, and possibly oats--in other words, most grain, pasta, cereal, and many processed foods. Despite these restrictions, people with celiac disease can eat a well-balanced diet with a variety of foods, including bread and pasta. For example, instead of wheat flour, people can use potato, rice, soy, or bean flour. Or, they can buy gluten-free bread, pasta, and other products from special food companies. Whether people with celiac disease should avoid oats is controversial because some people have been able to eat oats without having a reaction. Scientists are doing studies to find out whether people with celiac disease can tolerate oats. Until the studies are complete, people with celiac disease should follow their physician or dietitian's advice about eating oats. Plain meat, fish, rice, fruits, and vegetables do not contain gluten, so people with celiac disease can eat as much of these foods as they like. Examples of foods that are safe to eat and those that are not are provided below. The gluten-free diet is complicated. It requires a completely new approach to eating that affects a person's entire life. People with celiac disease have to be extremely careful about what they buy for lunch at school or work, eat at cocktail parties, or grab from the refrigerator for a midnight snack. Eating out can be a challenge as the person with celiac disease learns to scrutinize the menu for foods with gluten and question the waiter or chef about possible hidden sources of gluten. However, with practice, screening for gluten becomes second nature and people learn to recognize which foods are safe and which are off limits. A dietitian, a health care professional who specializes in food and nutrition, can help people learn about their new diet. Also, support groups are particularly helpful for newly diagnosed people and their families as they learn to adjust to a new way of life.

ADDers Are More Likely to Have Fatty Acid Deficiencies

Omegas and ADD A Purdue University study showed that kids low in Omega-3 essential fatty acids are significantly more likely to be hyperactive, have learning disorders, and to display behavioral problems. Omega-3 deficiencies have also been tied to dyslexia, violence, depression, memory problems, weight gain, cancer, heart disease, eczema, allergies, inflammatory diseases, arthritis, diabetes, and many other conditions. Over 2,000 scientific studies have demonstrated the wide range of problems associated with Omega-3 deficiencies. The American diet is almost devoid of Omega 3's except for certain types of fish. In fact, researchers believe that about 60% of Americans are deficient in Omega-3 fatty acids, and about 20% have so little that test methods cannot even detect any in their blood. Your brain is more than 60% structural fat, just as your muscles are made of protein and your bones are made of calcium. But it's not just any fat that our brains are made of. It has to be certain types of fats, and we no longer eat these types of fats like we used to. Worse, we eat man-made trans-fats and excessive amounts of saturated fats and vegetable oils high in Omega-6 fatty acids, all of which interfere which our body's attempt to utilize the tiny amount of Omega-3 fats that it gets. Other parts of our bodies also need Omega-3 fatty acids. Symptoms of fatty acid deficiency include a variety of skin problems such as eczema, thick patches of skin, and cracked heels. In the fall of 1998, after reading about the Purdue study which associated fatty-acid deficiencies with learning disorders and hyperactivity, I began to give my six-year son a tablespoon of Barlean's Flax Oil each day, and I took the same amount myself (mixed with yogurt). Flax oil is extremely high in Omega-3's. I also reduced our consumption of trans-fats and increase the amount of olive and canola oil in our diet. After one month, the incurable eczema located on the back of my son's legs vanished, and it is still gone as of this writing (5/99). That eczema had not responded to diet changes, cremes, or allergy medication, and he'd had it for years, so bad that he would scratch it until it bled and caused him to lose sleep. Then, during the next three months my cracked heels slowly improved until they too were cured. Like my son's rashes, my cracked heels had not responded to any type of treatment for several years, even though I tried lotions and pumice stones to thin the skin. Today, they are fine. I can only imagine what the fatty-acid deficiency we clearly both had had was doing to me and my son neurologically, and I am grateful to have learned about it. My son has been doing great in Kindergarten with very few behavior problems, and is ahead of his peers in reading, so I can't help but wonder if the increase in Omega-3 fatty acids is a factor in that. While I'll never know for sure, I suspect that it was. Signs of Fatty Acid Imbalance (from the book "Smart Fats") Dry skin Dandruff Frequent urination Irritability Attention deficit Soft nails Alligator skin Allergies Lowered immunity Weakness Fatigue Dry, unmanageable hair Excessive thirst Brittle, easily frayed nails Hyperactivity "Chicken skin" on backs of arms Dry eyes Learning problems Poor wound healing Frequent infections Patches of pale skin on cheeks Cracked skin on heels or fingertips Imagine your brain conducting some routine maintenance on your dopamine and serotonin receptors (implicated in both ADD and mood disorders). These receptors are composed of an Omega-3 fatty acid called DHA. If you don't have much DHA in your blood, man-made trans-fat molecules may be used as a construction material instead. But trans-fats (hydrogenated oils) are shaped differently than DHA: they are straight while DHA is curved. The dopamine receptor becomes deformed and doesn't work very well. Repeat this scenario day after day, year after year, and you could wind up with problems like depression and problems concentrating. This problem is most severe for a child whose brain is still developing. "A lack of highly unsaturated fats is particularly noticeable in connection with brain and nerve functioning. An adjustment in diet to one with oil and protein contents high in unsaturated fats brings the best results in children. I have often observed this when called in to treat cancer patients. In general, I recommend that the whole family adjust their food intake so that they use the optimal, natural fats. As for children whose scholastic performance is often below standard -- and it's usually the case in families where the parents don't eat correctly -- the results of an optimal fat intake normally begin to show themselves in school marks being bettered by not only one, but two levels." - from "Flax Oil as a True Aid..." by Dr. Johanna Budwig, a seven time nobel prize nominee and considered by many to be the foremost authority on fats & healing, 1959. Now imagine a child in school learning math. The act of learning requires the brain to form new neural pathways. DHA is needed, especially for the delicate neural synapses which are composed entirely of DHA. This child, like the vast majority of U.S. children, eats almost no Omega-3 fatty acids. What does the brain do? Again, it struggles and finally uses other types of fats, which are the wrong shape. The neural network develops slowly and is defective. The child has learning and memory problems as well as behavior problems. "The Link Between Omega-3 Fatty Acids and Learning (from "The Omega Plan") "In a study of learning ability, rats were raised on either a diet that was deficient in Omega-3 fatty acids or one that was nutritionally complete. Initially, both groups of rats had similar numbers of synaptic vesicles. After a month-long learning program, however, the Omega-3 enriched rats had considerably more vesicles in their nerve endings and also performed markedly better on the tests. This study suggests there may be a direct connection between the amount Omega-3 fatty acids in your diet, the number of synaptic vesicles in your neurons, and your ability to learn." I believe that within the next 5 or 10 years the population at large will become familiar with the issue of fatty acid deficiency and the harm causes by transfats, and there will be significant changes in the way food is formulated and marketed. In 1994 the Center For Science in the Public Interest petitioned the FDA to require labeling of transfats. In 1998 Consumer Reports called for similar labeling (Nov. 98 issue). In response to growing pulic pressure and the rising number of studies implicating transfats, the FDA has announced a new rule that will require the transfat content of foods, but it won't become effective for a few years. Companies are beginning to market omega-3 foods, like tuna and eggs from chickens fed with high-omega 3 foods. Babyfood companies like Gerber are talking about adding DHA to foods (meanwhile the same food still contains transfats). In Japan parents have been giving their kids DHA supplements for years to improve their grades. "Struggling With Jamie" From "Smart Fats" by Michael Schmidt "Jamie was a ten-year-old boy who seemed to struggle with behavioral problems almost from the beginning. He was inattentive, aggressive, and had difficulty with coordination. Sports were hard for him and learning was no better... Jamie also had patches of dry skin and coarse, unruly hair -- clues to fatty acid imbalance. Jamie began taking a balanced fatty acid supplement that contained DHA, GLA, and ALA from DHA oil, primrose oil, and flax seed oil respectively. It took roughly six months, but Jamie became "a different child" according to his mother. His balance and motor problems improved along with his behavioral problems." Research has shown that the diets of hunter/gatherers were rich in Omega-3's. They ate a mix of meat, fruits and vegetables, with little or no grains. Green leafy vegetables, certain seeds and nuts, and wild game are rich in Omega-3's. It turns out that cows, chickens and other animals have much higher levels of Omega-3s when they are fed by "free-range" methods because they eat lots of green leafy vegetables. On the other hand, if they are fed grain, their Omega-3 levels crash. Wild game is much healthier to eat and it is much leaner than farm-raised animals. Hunter/gatherers ate greens with lots of Omega-3's. We know this because scientists have actually tested many of the plants and animals eaten by existing and past hunter/gatherer groups. These have been replaced primarily with grains, which contain the wrong kinds of fats. More Detail Than You May Want to Know: EPA, DHA, and the Omega-3 family of Eicosanoids are important types of Omega-3 fatty acids. Normally our body can manufacture all of these products if it has plenty of the parent Omega-3 fatty acid called Alpha-Linolenic Acid (ALA) found naturally in green leafy vegetables, flax, flaxseed and canola oil, walnuts and Brazil nuts. (Note: DHA is not to be confused with DHEA, a popular hormonal supplement). Our bodies convert ALA to EPA; EPA to DHA; and DHA to Omega-3 Eichosanoids. There are many things that can interfere with this process, especially vegetable oils in the diet. Note that it is possible to acquire EPA and DHA directly by eating fish oil, certain eggs, or by taking supplements. Fatty fish contain plenty of both substances. Plenty of studies have shown that fish-eating cultures have much better health, including mental health. DHA is particularly important for brain functions. Scientists have discovered that severely depressed people are lower in DHA, and the more depressed they are, the less DHA they have. One ancient remedy for depression was to feed the patient animal brains, now known to be extremely high in DHA and Omega-3 fatty acids. Incidentally, alcohol is known to deplete DHA stores extremely rapidly. While the body can theoretically manufacture its own DHA out of the parent ALA fatty acid, things can interfere with this conversion. The most important problem is an excess of Omega-6 fatty acids in the bloodstream, which use the same enzymes for a similar type of conversion. This is why it is extremely important not to have too many Omega-6 fats in your diet (the vegetable oils like sunflower and soybean oil). Other problems might inhibit the conversion process, such as a deficiency in certain vitamins and minerals. Infants who are fed formula in the United States receive almost no Omega-3's, while infants who are breast fed thrive on milk rich in DHA (the amount depends on the mother's diet). Researchers have found that infants who are fed formulas enriched with Omega-3's or who are breast fed do better visually and intellectually. Incidentally, pregnant women experience a major loss in DHA as their DHA is rerouted to the fetus. This may be one reason depression is so common after child birth.

Physical Symptoms Associated with EFA Deficiencies

Omega-3 and omega-6 fatty acids are absolutely essential for human life and health, but they must be provided by our diet. They play particularly key roles in brain development and function. Various physical signs are associated with deficiencies in these essential fatty acids. These include excessive thirst, frequent urination, rough, dry or scaly skin, dry, dull or ‘lifeless’ hair, dandruff, and soft or brittle nails. Raised bumps on the skin are particularly characteristic. (This is called ‘follicular keratosis’ as it results from a build-up of hard, dry skin around the hair follicles). Research has shown that these fatty acid deficiency signs are unusually common in people with ADHD, dyslexia and autistic spectrum disorders.(1-7) They have also been linked with behaviour, learning and health problems in boys with and without an ADHD diagnosis,(4) with the severity of reading, spelling and related difficulties in dyslexic children(5) and with visual, auditory and other features of dyslexia in adults.(6) This and other evidence has led to treatment trials to find out if supplementing the diet with fatty acids may help in these conditions. A simple checklist rating scale used in many of these studies to assess fatty acid deficiency signs is available as a separate document.(8) This can easily be used as an informal measure by parents, teachers, health professionals or researchers who may be interested. Across groups, scores have been shown to correlate with blood levels of fatty acids. However, results from this scale should never be interpreted in isolation, and any reliable diagnosis of fatty acid deficiency would require other information and professional advice. (Blood fatty acid analyses or other measures may be useful if available and properly conducted, but the response to dietary supplementation with fatty acids – if appropriate - would usually be a fairly definitive indicator). Many other features or clinical signs can sometimes reflect deficiencies or imbalances of omega-3 or omega-6 fatty acids. These include: * Allergic or ‘atopic’ tendencies (such as eczema, asthma, hayfever etc.) * Visual symptoms (such as poor night vision, sensitivity to bright light, or visual disturbances when reading - e.g. letters and words may appear to move, swim or blur on the page) * Attentional problems (distractibility, poor concentration and difficulties in working memory) * Emotional sensitivity (such as depression, excessive mood swings or undue anxiety) * Sleep problems (especially difficulties in settling at night and waking in the morning) IMPORTANT: Any of these signs can have other causes, so it should never be assumed that fatty acid deficiencies are responsible. Always seek medical attention for any such symptoms, and before taking food supplements or making any other major dietary changes. References 1. Colquhoun, I. and Bunday, S. A lack of essential fatty acids as a possible cause of hyperactivity in children. Medical Hypotheses, 1981; 7: 673-9. 2. Baker SM. A biochemical approach to the problem of dyslexia. Journal of Learning Disabilities 1985; 18(10): 581 584. 3. Stevens LJ, Zentall SS. Deck JL, Abate ML, Watkins BA, Lipp SR, Burgess JR. Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder. American Journal of Clinical Nutrition 1995; 62: 761-8. 4. Stevens LJ, Zentall SS. Abate ML, Kuczek T, Burgess JR. Omega-3 fatty acids in boys with behaviour, learning, and health problems. Physiol. Behav. 1996; 59(4/5): 915-920. 5. Richardson AJ, Calvin CM, Clisby C, Schoenheimer DR, Montgomery P, Hall JA, Hebb G, Westwood E, Talcott JB, Stein JF. Fatty acid deficiency signs predict the severity of reading and related difficulties in dyslexic children. Prostaglandins Leukotr Essent Fatty Acids, 2000; 63:69-74. 6. Taylor KET, Higgins CJ, Calvin CM, Hall JA, Easton T, McDaid AM, Richardson AJ. Dyslexia in adults is associated with clinical signs of fatty acid deficiency. Prostaglandins Leukotr Essent Fatty Acids, 2000; 63:75-78. 7. Bell JG, Dick JR, MacKinlay EE, Glen ACA, MacDonald DJ, Ross MA, Riordan V, Sargent JR. Apparent fatty acid deficiency in autistic spectrum disorders. Prostaglandins Leukotrienes and Essential Fatty Acids (In Press). 8. FAB Research. Factsheet 003/PFADS-CRS: Physical Fatty Acid Deficiency Signs – Clinical Rating Scale. Food and Behaviour Research, November 2003.