Arthritis, Gout & Gluten; The Connection


Genetic and metabolic processes found in arthritis and gout are common in both Celiac Disease (CD) and Gluten Sensitivity (GS). I am a sufferer and was thrilled to see a recent article in Simply Gluten Free Magazine written by Dr Alexander Shikhman; it was all about arthritis, gout and gluten. These conditions definitely run in my family and I am lucky to have been cursed with this for most of my life.  I wanted to share this information with all of you because I meet so many customers with the same issues and I get so many questions about this. If you are like me and suffer from Celiac Disease, arthritis and/or gout; this is for you.  If you don’t, you will become aware of the symptoms and understand why arthritis/gout can be a problem for those with CD or GS. Below; I will not only tell you about each; but also the causes, prevention methods and treatments.

The most common forms of arthritis that are seen in people with CD/GS are Calcium Pyrophosphate Depositon Disease (CPPD also known as pseudogout), Gout, Psoriatic Arthritis and Rheumatoid Arthritis. I also will share with you how the above conditions have affected me.

I have had severe issues with most of the above for most of my life; suffering from uric acid stones (jagged crystal stones) and calcium stones (they look very different when you pass them). Often, I had jagged crystals which would get stuck in my ureter when I was trying to pass them.  Sometimes a calcium stone would follow and get stuck on the jagged crystal stone lodged in my ureter.  A few times the urologist or nephrologist would have to go in and remove all of them for me (blessed relief).  I also had arthritis so bad in my shoulder that it took a 5 hour plus surgery to clean/free up my shoulder joint! I had constant gall stones and “gravel” (sand like crystals) until they finally took my gall bladder out back in the early 90’s. While reading the article, it reminded me of the explanation of why I have kidney stones (see post on this). Thankfully, I am now on a combination of diuretics to help flush calcium and uric acid from my system; which reduces the amount of stones and crystals that I get.  If I miss a dose of my diuretics, I brace myself for the oncoming storm of stones and/or severe stabbing pain in my toe joints, knees and some finger joints!

So, lets examine each:

CPPD; Calcium Pyrophosphate Deposition Disease (pseudogout)– most common form associated with GS/CD; characterized by deposition of calcium pryrophosphate crystals in the joints that will trigger acute inflammation.  When untreated the crystals are like abrasive materials and can cause cartilage degeneration and joint and tendon ruptures as well as joint degeneration.

-Caused by: Malabsorption of Vit D and Magnesium, excessive use of proton pump inhibitors (acid reflux meds) and complications of bisphosphonate therapy (drugs to prevent loss of bone mass) in those with osteopenia/osteoporosis, excessive production of parathyroid hormone, advanced hypothyroidism and iron metabolism diseases.  Prevention: methods include Vit D and Magnesium supplementation, address and correct hormonal imbalances, avoidance of proton pump inhibitors & bisphosphonates, physical therapy, anti inflammatory probiotics, and bromelain consumption. Bromelain are enzymes found in pineapples that digest protein. *The trick here is to control flare ups by keeping blood levels of calcium, magnesium, viatmin D and parathyroid hormones consistently in normal limits.  Having a good internal medicine doc who helps manage all of your medical conditions is key..the internist looks at the big picture and how everything interacts! (I was able to get off my Proton Pump Inhibitor because I only get acid reflux if I consume gluten and that is not an issue for me any longer. My first symptom of ingesting gluten is acid reflux! I also went undiagnosed with Hashimoto’s Disease (advanced hypothyroidism) for a long time as well.)

Gout- Gout often shows up in joints; red, tender, hot and swollen, accompanied by pain. The body is overproducing uric acid that form crystals at high concentrations which forms crystals that are then deposited in the joints causing inflammation. It can affect any joint and is most often found in joints of of toes, elbows, knees, ankles and index finger. Often the attacks occur at night when the body temperature is lower. Uric acid forms when purines (natural substances found in foods and our body) are broken down. Foods that are high in purines should be avoided: meat and meat products, seafood, alcoholic beverages, asparagus, cauliflower, spinach, mushrooms, green peas, lentils and beans.

-Causes of Gout: unbalanced diet with high purine foods, disturbances in gastro-intestinal tract such as the gut microflora resulting in decreased breakdown of uric acid in the gut. This causes re-absorption into the bloodstream. Another cause is non-alcoholic fatty liver disease because the liver enzyme, xantine oxidase is not adequate and it is the main regulator of uric acid. Lastly, imbalances in our sex hormones (low estrogen & testosterone and elevated progesterone) that are frequently seen in people with CD/GS. –Prevention of Gout: Treatment Options: non-steroidal anti-inflammatory drugs (NSAIDS), bromelain, fish oil, alpha lipoic acid, folic acid, baking soda, probiotics, prebiotics, etc. (Vitamin C is not recommended because it increases intestinal permeability and can make leaky gut syndrome worse).  The goal is to keep the blood uric acid level below 5.0mg/dl and incorporate Allopurinol and Febuxostat. (I take probiotics daily, Hydrochlorothiazide and Allopurinol. When they finally added the Allopurinol into my regimine back in 2006; that combination finally worked for me… as long as I don’t miss any doses! I can’t take NSAIDS due to previous ulcer. PS: I got a lot better when I took spinach and red wine out of my diet too.)

Psoriatic Arthritis – This is just a type of arthritis that shows up in people who have a skin rash known as psoriasis. The symptoms vary and can affect any joint and the spine. If left untreated it can cause joint deformities and disability. Often those with psoriatic arthritis have increased prevalence of carrying gene HLA-DQ8 (gene associated with CD).      Prevention: GF Diet normalizes absorption of drugs and supplements used for psoriasis and psoriatic arthritis and normalizes our gut microflora that could halt the progression. Also, the GF diet reduces intestinal inflammation which can delay the systemic inflammation. (I don’t have this! My rash was Dermatitis Herpetiformis or DH which is the skin manifestation of Celiac Disease. It flares up when I am exposed to gluten.  When I was younger, I was sent to a dermatologist who perscribed steroids and I also used steroid creams for years to try to clear this up. After my Celiac diagnosis and consistent GF Diet; the rash cleared on it’s own. DH is most often mis-diagnosed as eczema.)

Rheumatoid Arthritis- an autoimmune and systemic disease in which the body’s immune system – which normally protects its health by attacking foreign substances like bacteria and viruses – mistakenly attacks the joints. This creates inflammation that causes the tissue (sinovium) that lines the inside of joints to thicken, resulting in swelling and pain in and around the joints. The synovium makes a fluid that lubricates joints and helps them move smoothly. RA can also affect the other body systems like the heart and lungs and that is why it is an autoimmune disease and a systemic disease and it is hereditary.

If inflammation goes unchecked, it can damage cartilage and the bones themselves. Over time, there is loss of cartilage, and the joint spacing between bones can become smaller. Joints can become loose, unstable, painful and lose their mobility. Joint deformity also can occur and joint damage cannot be reversed sometimes surgery can help. RA can occur at a young age and doctors recommend early diagnosis and aggressive treatment to control RA. Rheumatoid arthritis most commonly affects the joints of the hands, feet, wrists, elbows, knees and ankles. The joint effect is usually symmetrical. That means if one knee or hand if affected, usually the other one is, too.  Diagnosis is through x rays and blood tests and symptoms. There is not one test for is a combination of tests, symptoms and family history.

My father’s aunt was crippled by RA when she was very young.  Many years ago, a Rheumatologist told me that he thought I had RA and I would have to come back for blood work when I was having a flare up. So, I tried that; I called but had to wait several weeks to get back in. By the time I got back in, the flare up had passed.  I decided that I would rather be a hypochondriac and did not attempt to go back the next time I had a flare up. So,  I don’t know..but I can say that once I had the Celiac diagnosis and adhered to my GF diet, the disabling joint pain subsided and my fingers and toes stopped curving.

The key is to know the signs and symptoms of these conditions and know your family history. I can’t stress enough the importance of a primary care physician who is also an internist. He or she manages and understands all of your conditions and how they affect other body systems and will actively work with your other doctors/specialists to keep you healthy. Many customers have asked me about this very issue. I will do a blog post very soon about my internist and why I am so glad I finally made the switch to an internist who also has Celiac Disease!

For more information on arthritis visit the arthritis foundation by clicking here!

As always, talk with your doctor before starting any treatment.




Nima Sensor, Sunflower Cafe to Close, New Day GF Hopes to Re-open


This week I tell you all about the new Nima Sensor and how it works.  Three weeks in a row I am having to tell you about gluten-free places closing; The Sunflower Cafe/Bakery in Williampsport, PA will close on October 30, 2016. Lastly, I will share some news about New Day GF hoping to open in a new location!

The Sunflower Cafe/Bakery in Williamsport, PA will close it’s doors. I was informed by one of my facebook followers last week and I immediately went to Sunflower Cafe’s facebook page. I  went to her page and read back about one year; I started crying.  She was very open about her struggles; talking about selling furniture to pay her business loan and trying to do it all by herself because she could not afford to pay help. Wow; she had 5 star ratings.  Let’s look at this situation by looking at the numbers:

Population of Williamsport, PA: 29,349 x 1.3% = 381 Celiacs

-This means every Celiac and their friends/family would need to eat there at least once a week. I know from experience that this did not happen.  Looking at this population statistic, I know it could not work because there are no large cities nearby. I am thankful to Sunflower Cafe & Bakery for being a safe haven for those with Celiac Disease.

Everyone is talking about the new Nima Sensor: Dining out in restaurants full of gluten is a calculated risk that many take way too often and pay the price later. Now you can test your food before you eat it! This is great news if you have Celiac Disease or a Wheat Allergy. Nima Sensor is a portable sensor that tests liquid and solid foods for the presence of gluten (wheat, rye and barley) in about two minutes. Nima hopes to be able to test for top 8 allergens in the future! My thoughts are:

  1. If you eat out a lot, you can make sure your food is safe before you eat it.
  2. If people detect gluten in their meals it will drive them back to the completely GF places who are doing it right!
  3. Cost for the device is $279.00
  4. Refill test capsules cost $60.00 for 12 capsules or $5.00 per test.
  5. Pretty pricey; add $5.00 to the price of your meal.
  6. Your meal is probably cheaper at the dedicated GF place; you don’t need to test it.
  7. If you must eat at a regular restaurant; a  $5 test is cheaper than taking days off work.
  8. If it detects gluten, the restaurant probably won’t refund your meal; especially if they have a disclaimer on their menu!
  9. Level of detection is to 20 ppm (parts per million).
  10. I won’t be getting one right now because I am always at One Dish Cuisine!

Click Here to learn more

Go Fund Me Page for New Day GF:  As I told you two weeks ago; this 5 star rated Gluten Free and Peanut Free cafe  was in a small town, too far out from St Louis, MO and had several competitors that had opened up in St Louis.  Last Friday they posted that they identified a new location just outside of St Louis and were awaiting “capital” or financing. It looks like they were not able to obtain financing. A “Go Fund Me” page was posted to their facebook page. They need to raise $300,000 in order to re-open. I hope that they can raise the funds, re-0pen and prosper in the new location.



Closed: Ali’s Marketplace; GF Store/Cafe Closes in Pittsburgh, PA


Two weeks in a row I find myself having to tell you about Gluten Free (GF)/Allergy Free or Friendly (AF) places closing. Here, at ODC, we just celebrated the 4th year of our Cafe, Deli and Bakery and 6.5 years for our frozen line of food and I feel so blessed and fortunate to be able to do what I love for the communities that I am a part of. It is so upsetting to have to share this news with you. Another one bit the dust on 9/30/16. What is even sadder to me is that I am the only one talking about it closing!

I wish there was a social media blitz when these places close so we could have a wake up call for the GF/AF community.  Occasionally, we may hear about a dedicated GF/AF place opening up; unfortunately, we mainly hear about mainstream places that get customers sick; that news travels around social media like a virus!  I wish this type of intense social media attention would be given when a place opens up so that our community would/could support them so they stay open.

Here is an example:  My Facebook/blog post on Sept 13, 2016 about “Cheeri-Oh-Nos” making people sick had 120 reactions, reached 24,441 people and had 117 shares. How many shares will this post about this closing have?  Whoever emails me by Sat 10/8/16 and guesses closest in the above categories, will win a ODC  t-shirt. I will wait a week to see what the response rate is!

Well, I am here to give it to you straight.  Ali’s Market Place by Gluten Free Zone, in Murrysville, PA (outside of Pittsburgh) closed after 4.5 years. This was a completely GF (gluten-free) cafe and the store carried all GF/AF products. I referred so many people there. What a shame; this store was awesome and they had a cafe too. Here is what they had to say:

Ali’s Marketplace by Gluten Free Zone

It is with great sadness that we announce the closing of Ali’s Marketplace by Gluten Free Zone. Your patronage of Ali’s Marketplace by Gluten Free Zone the past 4 ½ years has allowed us to provide to the gluten free community education, specialty products, a certified GF deli and an award winning gluten free bakery. We thank you for the many friendships gained and appreciate the support we provided each other dealing with the somewhat complex health conditions associated with gluten. As we prepare to close our doors, we will be offering 30% off your entire purchase (excluding bakery).
In good health,
Ali, Paul, Melanie

After lasts week’s bad news, many customers asked me to get more specific in my analysis by giving some hard numbers, so I will do this for you. Being a member of the Celiac/Food Allergy communities and owning a GF/AF Cafe, Deli and Bakery makes me qualified to explain the problem to you. It takes courage to say it and I believe that you all want to hear the truth. We hear of people complaining about lack of options while the ones offering the options complain about the lack of customers. Something is not adding up here!

Let’s take an educated guess about what might have caused Ali’s to close. From my research; their prices were higher and they could just not compete with lower prices in Wegman’s, Wal-Mart, Giant, 2 specialty food stores, 2 other dedicated GF Bakeries and all of the gluten filled restaurants that are offering “gf” meals (hopefully safe when you eat the food).

Again, the problem is too much competition and the supply/availability of GF goods outpaced the demand! How can this be?  Well, the population of Pittsburgh; 300k, Murrysville; 20k and Monroeville; 28k plus some more sparsely populated areas southeast of Pittsburgh .  Their you have it folks..350,000 people = 3,500 Celiacs. They just could not support and keep all of these specialty places afloat. (for ease of illustration I am only using Celiac numbers) Again, distance needed to drive, higher pricing, and not enough customers are probably all factors. If they experienced what we experience….only 3.5% of the Celiac, Food Allergy and Gluten Sensitive community actually supporting them on a regular basis, I can understand it.  I have no way to speculate as to what the numbers were for their grocery segment.

Specifics: Here, in Howard County (and Catonsville in Baltimore County), we have approximately 4,101 Celiacs (1.5%); 16,404 Gluten Sensitive (6%) and 32,809 with Food Allergies (12%).

*53,314 local people who need us; only 450 support us each week (this number will increase a bit in winter).

*The average family eats out between 4.2 and 5 times per week and that keeps the mainstream places busy.

*The average local person with Celiac/Food Allergies eats in our establishment less than 1 time per year! This is a dismal statistic for the communities that often complain there is no safe place to eat. I am sure that other specialty establishments have the same problem. Please keep this in mind the next time you have the choice of a completely GF/AF establishment or a mainstream establishment, wherever you are, and support them.

We see the average GF/AF customer about 1 time per year (actually the number works out to be under 1 time per year). In the past month a customer with Celiac told us 2 horror stories of being “glutened” at chains offering GF Meals. Dave and I thank God for our regulars every day, you keep us holding on and we can’t thank you enough for your ongoing support! We are not unique folks; we have the same problems as the others have. Sadly, many close and a few try to re-group and move to a more populated area.

The problem is that when completely GF businesses open, they over estimate the percentage of those who will support their business on a regular basis. I bet you all are shocked that only 3.5 % (of the 19.5%) of those that need us actually supports us on a regular basis.  The other 96.5% are not coming out. I must admit, I thought it would be a bit higher; at about 9% or worst case scenario 4.5%. However, the sad reality is that only 3.5% of the population “in need” shows up. I will use this percentage in my next business plan if/when we open up another location.

Now you know why businesses open up to serve the needs of our close knit community and end up closing their doors. Sadly, it will keep happening unless all of us who are “in need” of safe meals step up to the plate by showing up and spreading the word about the ones doing it right. Thanks Ali, Paul and Melanie for a job well done on behalf of the GF/FA community in Pittsburgh, PA!

Another GF/AF Cafe Closes It’s Doors; Wake Up Call!


Last year I told you about a gluten-free (GF) cafe/bakery closing in Harrisburg, PA and a GF burger place closing north of Philadelphia, PA. Here we go again folks, another one bit the dust last week and second one is no longer 100% GF. This is so upsetting to me and I share this type of information with all of you because I want you to think about this sad reality and hope it sinks in and you will support those who are doing it right! I did my own mini investigation. Below, I tell you what I believe happened with the latest casualties in the completely GF/AF arena. (AF=Allergen Free)

New Day Gluten Free & Peanut Free in Ellisville, MO closed their doors after 5.5 years. They served breakfast, lunch and dinner and enjoyed 4.5 and 5 star ratings.  They were about 23 miles outside of St Louis. This is the post from their Facebook page on 9/16/16 and it is also on their website:

“It is with great sadness that we write to you tonight to inform you all that the doors at New Day Gluten Free Ellisville will be closing effective immediately. It has been a true labor of love to serve this community for the last 5 and a half years, yet with our current staffing issues and lack of sales we have to cease operations. We are still working toward and are hopeful for a new central location, but are unable to make a move at this time. …”

I know they had great products based on their reviews and how long they lasted in a sparsely populated area. They want to re-open but will have to re-invent the wheel in some way to get more customers. Lets look at what most likely happened to them.

First; the population of Ellisville is only about 10,000 people; St Louis’ population is a little over 300,000 and we can add in sparser suburb populations. The glaring problem that I see is that another GF Cafe opened up in St Louis and a mini chain with 2 locations (dedicated GF prep space; Find Me GF App allows them to list as dedicated GF). That is a lot of competition! When the competitors arrived closer in to St Louis, less people were driving out to Ellisville.  I can see from the above that they were struggling due to lack of customers/sales and when 3 competitors popped up, this is what took away quite a few of their customers and they could not survive.

Maybe a move into downtown St Louis (3,0o0 Celiacs = 1% of population) will help. If each person with Celiac Disease was eating in Ellisville twice a month..they could probably have survived. However, I know from experience that this was not the case and I don’t believe that 4 establishments can survive given the limited number of people who actually need to eat at these establishments. A move closer in may work for them and they may put the other GF place out of business. The place that has 2 locations and also serves mainstream meals will survive because 99% of their customers don’t eat GF!

Moo Cluck Moo no longer GF:  (outside of Detroit with a population of 688,701)  Last month, folks around Dearborn Heights, MI (population 95,000) and Canton, MI (population 90,000) were freaking out because Moo Cluck Moo (chicken place) announced on their Facebook page that they were moving from only serving GF buns to introducing regular buns and just offering a GF Bun option. Reviewers on the Find Me Gluten Free app went crazy, giving them 1 star ratings (after many five star ratings previously) and people were ranting and raving about how awful it was and saying that they would lose the support of the GF community. I understand that this is upsetting to the GF community; maybe they should have supported them more to begin with! There are also 4 other facilities showing as dedicated GF in the vicinity of Detroit; I can see why they had this problem. Supply and demand is the problem.

I have to give you all the REALITY; neither of these places had the full support of the GF community; that is why they were forced to make the decisions that they are making!  

Moo Cluck Moo was not making enough sales to stay in business while being completely GF. The owner clearly stated this in an interview by saying that they were not making a profit doing what they were doing and he was paying himself less than he paid his employees!  A popular GF Blogger wrote about it too. My thought bubble after reading all of the comments on one blog (many of them were nonsense) was:  “What do you expect them to do? It appears that many of you would rather have them go out of business instead of changing their business model to one in which they can survive and stay in business?”

 It is clear that not enough GF people (GF & Peanut Free in New Day’s case) chose to do this and to make matters worse and what pushed them over the edge was the competition; it spread the customer base so thin that it will be hard for more than one to survive staying completely GF. Moo Cluck Moo just decided it is not worth the headache because they can’t make a living. Think about it gang… is it worth doing it if you can’t take a paycheck or make a profit?

This is a another wake up call for the GF/FA Community.  These were very highly rated restaurants who responded to the pleas for safe GF/AF meals and were doing it right! What a restaurant cannot overcome is the lack of sales; which is due to the lack of support (people showing up) from the communities they serve. Many customers do support these establishments but not frequently enough and there are many reasons for this. Some reasons are the distance needed to travel, preferring to eat at mainstream restaurants who offer GF items (complain when they get sick) and finally there are those who just assume everyone else is supporting the GF/AF place.

I am sure there was a small group of regulars who were supporting them. However; if most of the GF customers only show up once every 6 months, these businesses can’t survive and it is even worse when several completely GF places open up; supply and demand rears it’s ugly head and there just are not enough customers to sustain them all or sometimes even just one of them!

*If they were in NY City, with a population of 8.4 million, not to mention tourists, there is plenty of room for competition!

We are so thankful for our customers (6.5 years for our frozen food line and 4 years for our cafe, deli and bakery). You might be wondering what the population of Ellicott City, MD is…65,834 & close by Columbia is 100,000. We are not immune; we also suffer from the same common problem; lack of customers. All I can do is tell you what is going on; I can’t make you all support those doing it right; that is completely up to each one of you. These places will only stay in business by you showing up and creating the demand at the places who are doing it right.

Thank you to New Day Gluten Free and Moo Cluck Moo for making a valiant effort on behalf of the GF & FA communities. I feel your pain and can truly say, “I get it”. Thank you for your efforts.




Neurological/Pshyciatric Manifestations of Celiac/Gluten Sensitivity


What do Depression, Mood Disorders, ADHD, Gluten Ataxia, Autism, Neurological Issues, Migraine Headaches, Epilepsy, Seizures, White Matter on Brain and Schizophrenia; have in common? According to NIH (National Institute of Health), all of the above are also symptoms of Celiac Disease and Gluten Sensitivity which can affect adults and children!

I get asked about this so often by customers, at least once or twice a week, that I thought I would write about this in depth. Some are having multiple neurological complications from their Celiac or Gluten Sensitivity or their child is exhibiting ADHD Symptoms and stomach aches but has not been tested for Celiac Disease. (I am Celiac and also have Ataxia (Neurological symptoms; loss of balance & coordination, fumbled speech and I exhibit signs of ADHD-can’t concentrate when exposed to gluten). The shocking thing is that many in the medical community are not investigating the gluten connection by testing for Celiac Disease first! Often a child or adult are just put on ADHD medications or anti depressants and just sent on their way. Often the medicines are just addressing some of the symptoms; not the actual cause! The result is ongoing pain and suffering because the true condition is NEVER addressed. The good news is that NIH (National Institute of Health) has put solid information out there for our physicians and us to see!

First we need to understand the difference between Celiac Disease and Gluten Sensitivity. Then we will learn that psychological and neurological issues can be preset in either condition. NIH has some great information about this and will clear up any question that you or your medical provider have about the validity of these symptoms. Finally, I give you a link to these neurological and psychological symptoms; which are sometimes the only symptoms that an adult or child actually presents with. (Yes, many don’t even have any gastrointestinal symptoms or stomach aches!)

First, read this, all of it. Second, if any of this applies to you or you child, get yourself or your child tested for Celiac Disease (while still eating gluten) by a gastroenterologist who is well versed in Celiac Disease.

Celiac Disease (CD) affects about 1% of the population (about 1 in 130) and gluten sensitivity affects about 6% of the population. Even with all of the knowledge that we have now, it is believed that as many as 85% of cases of CD go undiagnosed. CD is dependent on an autoimmune reaction to gluten (the protein found in wheat, rye and barley) and is usually characterized by intestinal symptoms. Those with gluten sensitivity (GS) don’t have intestinal damage (villous atrophy) or antibodies for CD but can test positive for antibodies to gliadin. Those with CD and GS can present with many neurological and psychiatric symptoms. However, gluten sensitivity remains under-treated and under-recognized as a contributing factor to psychiatric and neurological manifestations.

In CD, the classic symptoms typically include abdominal bloating, steatorrhea (excretion of abnormal quantities of fat due to malabsorption) and weight loss. Some just present with a rash that looks like eczema, but is really the skin manifestation of Celiac Disease known as Dermatitis Herpeterormis (DH). However, there are too many symptoms to list here; so a link will follow. Diagnosis is confirmed by testing for a number of different antibodies including anti-endomysial antibodies (EMA), anti-tissue transglutaminase antibodies (tTG), and anti-gliadin antibodies (AGA).  We understand what causes the intestinal damage and the genetics related to CD.  Those genes are HLA-DQ2 or HLA-DQ8 and their other versions.

There are more than 300 signs and symptoms of CD. Click Here for List. This list is great because it describes symptoms as they affect different body systems and there is also a list of how children may present with Celiac Disease (that list is at the bottom of the link). Not everyone presents with the same symptoms..some just have bloating and constipation and stomach aches. Some just are fatigued, irritable and are moody or present with Autism or ADHD like symptoms. The intestinal biopsy used to be the gold standard.  Now there are 5 criteria for a Celiac diagnosis. Those with GS often have the same symptoms as those with CD.

Five Criteria for Diagnosing Celiac Disease and someone only has to have 4 of the 5!

  1. The presence of signs and symptoms compatible with celiac disease.
  2. Positive serology screening (high serum levels of anti-TTG and/or EMA).
  3. Presence of the predisposing genes HLA-DQ2 and/or –DQ8.
  4. Histological evidence of auto-insult of jejunal mucosa typical of celiac disease.
  5. Resolution of the symptoms and normalization of serology test following the implementation of a gluten-free diet.

Click Here for More     Click Here for 4 of 5 Rule

People with GS would not fit into less than 4 of the 5 categories. GS is a diagnosis of exclusion; this diagnosis is given once CD and wheat, rye or barley allergies are ruled out. This means all of the above testing was done while the patient is still consuming gluten and did not meet 4 of the 5 criteria for CD. Then the patient is put on a Gluten-Free diet.  If symptoms resolve; you are given a diagnosis of gluten sensitivity!  (There is some evidence that GS is just an early form of CD.)

Neurological/Psychiatric complications of CD have been known to the medical community for over 40 years. Meanwhile, GS sensitive patients also have many neurological and psychiatric complications. However, based on the lack of intestinal involvement, the neurological and psychiatric complications may be the prime presentation in patients suffering from GS! Therefore gluten sensitivity may easily go unrecognized and untreated.

Studies have shown that about 22% of  patients with CD develop neurological or psychiatric dysfunction and as many as 57% of people with neurological dysfunction of unknown origin test positive for anti-gliadin antibodies. Neurological and psychiatric complications observed with gluten-mediated immune responses include a variety of disorders.

From 1953 to 2011 a PubMed literature search located 162 original articles associating psychiatric and neurologic complications to celiac disease or gluten sensitivity!  36 articles for seizure disorders, 20 for ataxia and cerebellar degeneration, 26 for neuropathy, 20 for schizophrenia, 14 for depression, 12 for migraine. There were up to 10 articles each for anxiety disorders, attention deficit and hyperactivity disorder (ADHD), autism, multiple sclerosis, myasthenia gravis, myopathy, and white matter lesions.

However, the  vast majority of research to date has not looked at CD and GS independently, so the true prevalence of the neurological/psychiatric complications with each is hard to pin down. It does call attention to the fact that GS and CD are different gluten-mediated immune responses that may be the cause of patients presenting with a host of psychiatric and neurological complications.

For more information on the symptoms listed at the top of the article (NIH) please use this link. It goes into detail about each neurological and psychological manifestation, just click on link and scroll down, good stuff in here..! Click Here for NIH Info



10 Healthy Gut Supplements; What They Do for You!

Concept image of a lost and confused signpost against a blue cloudy sky.

In the latest issue of Simply Gluten Free Magazine, Dr.Alexander Shikhman shares some great information about the top 10 healthy gut supplements.  If you are like me, you are probably familiar with some of these but don’t really understand what they actually do for your digestive health. This will definitely be an eye opener for you; it definitely was for me. So, I decided to paraphrase it for all of you.

  1. Probiotics: live microorganisms that will improve our microbial balance and suppress pathogenic microorganisms in our intestines (sometimes referred to as our microbiom).  We can get them directly from live fermented foods like sauerkraut, pickled vegetables, buttermilk, GF soy sauce, kimchi and yogurts or we can get them though supplements. If we go the supplement route, we need to understand how they are measured..which is by CFU’s or colony forming units. For gut maintenance use 20-25 million CFU’s daily. During antibiotic treatment we should increase that dose to 100 billion CFU’s daily. If you have Candida (chronic yeast infection), colitis or leaky gut; you should take 100-500 billion CFU’s daily. (I buy True Nature Probiotic at Costco and it is in a blue box and is gluten-free, dairy-free and soy-free)
  2. Prebiotics: non-digestible food ingredients (carbohydrate based) and they stimulate the growth of beneficial bacteria in our intestinal tract. They are not live microorganisms; actually they are heat resistant fiber like substances! Basically, they increase production of short-chain fatty acids by stimulated bacteria that will feed normal gut microbiota; they provide energy supply to the cells that form the intestinal lining. They are found naturally in foods like leeks, onions garlic, asparagus, artichokes and gluten-free brewer’s yeast. They also facilitate absorption of calcium, magnesium and vitamin D and stimulate mucosal immune responses, reduce inflammation, prevent colon cancer and normalize our bowel movements! (Who knew? Yup, I gotta get some of these.) But wait, there is more…they should include mannan-oligisaccharides (MOS) and galacto-olifosaccharides (GOS). Daily dose varies between 1,000 to 5,000 milligrams.
  3. Digestive Enzymes: proteins that break down large food molecules into smaller fragments in order to aide in their absorption by our bodies.  They are found naturally in our saliva, stomach and pancreatic juices and in secretions in the small and large intestines.  However, how well we produce these proteins is really age dependent. As we age, our production of these enzymes gets sluggish so as we age we  will require external digestive enzymes in the form of micronutrients which are available from animal or plant based sources. Most people don’t know this part: If you eat a high protein diet, you should use an enzyme with a high protease concentration. For high fat diets; you should consume one with a high lipase concentration. The amount should be proportional to the meal that you are consuming.
  4. Betaine HCL: naturally occurring and found in lots of foods such as beets and spinach. Betaine HCL acts as a gastric juice acidifier (it lowers our gastric pH). It activates gastric protein that degrades enzymes and will stimulate the entire digestive process. Production of this acid declines as we age and makes it difficult to digest protein rich foods. It is recommended for those on high protein diets and is take before meals in amount of 400 to 600 milligrams per meal. (cannot be taken together with anti-inflammatory drugs)
  5. Magnesium: controls gastric acid production, gastric emptying, intestinal motility and bile secretion along with our digestive enzyme production. Deficiency symptoms might include constipation, bloating, indigestion and muscle cramps.  It is found in unrefined grains, seeds, cocoa, nuts, almonds and green leafy veggies. We only absorb about 2/3 of what we consume! Dosage would be 250 to 500mg per day.
  6. Bioflavanoids: stimulate bile production, improve circulation in intestines, optimize mucosal immune response, inhibit histamine, suppress yeast overgrowth, enhance toxin elimination as well as prevent inflammation. They are usually citrus or quercetin with dosage of 500 mg to 2 grams.
  7. Turmeric: comes from curcumin and it stimulates the gall bladder to make bile and breakdown large fat globs and improves digestion. It also reduces inflammation in our digestive tracts and is often used to treat colitis. Daily dose can range from 1 to 5 grams. (I don’t have a gall bladder, not sure if this would help me)
  8. Glutamine: acts like a fuel and is an important source of nitrogen for the lining of our small intestine and is key in maintaining our mucosal cell integrity and the function of our gut barrier. It stabilizes intestinal permeability  and is used for prevention of leaky gut syndrome. Dosage is 500 mg to 10 g, depending on current gut health.
  9. Butyrate: (Butyric Acid) is a short chain fatty acid whose salts are know as butyrates which are produced by fermentation of dietary fibers in the GI tract. They control intestinal and colon permeability and aid in controlling inflammation. This deficiency is often associated with leaky gut syndrome. Daily requirements vary based on health of the diet and health of the digestive system. Dosages can range from several hundred to several thousand milligrams. (magnesium and calcium salts are more slowly absorbed than the sodium and potassium forms. Sodium and potassium are taken during the day when the gut cycle is much more active…calcium and magnesium salts are taken at night.
  10. Triphala: acts like a digestive cleanser that promotes contractions that will move the food through the digestive tract and will aid in bowel functions.  It will also improve circulation and liver function, normalizes stress response and improve adrenal function as well as reduce our cholesterol. It also has anti-microbial, anti-inflammatory and cancer preventing characteristics. Consumption is 500-1000 mg before each meal and 1000-2000 mg before bed.  

As always, contact your physician before starting any supplement; I know I will be talking to my physician about this. For more information about Dr. Alexander Shikhman (Board Certified in Internal Medicine and Rheumatology) and founder of The Institute for Specialized Medicine and Gluten-Free Remedies. All of his supplements are certified GF to 5ppm by the Celiac Support Association (CSA).

Click Here for IFSMed                             Click Here for Gluten Free Remedies


Cheeri-Oh-Nos, Not GF Says Canadian Celiac Association!


In the summer and fall of 2015, I spent a lot of time blogging about the sloppy processing and testing of General Mills “Gluten Free” (GF) Cheerios. Not only are they not using certified GF Oats, they are using sub-par testing methods to make their”GF” claim! Hence the nickname that I gave them; “Cheeri-Oh-Nos”! The Canadian Celiac Association has just advised those with Celiac Disease or Gluten Sensitivity not to eat them.

What happened and why have I been perpetually banging my head against the proverbial brick wall for over a year? How can this be so?  You just won’t believe it, so here is the re-cap and update.

Basically, the problem is that General Mills (GM) is using contaminated oats and “shaking” them in order to get off the offending wheat, rye and barley. Then they are using a testing method known as “means testing” to get their final ppm. A product must test below 20ppm to be called Gluten Free. So, if they make a batch of cheerios, they will  take out several samples…if one sample is 21pm, one is 80ppm and one is 5ppm..they would combine those to get the actual parts per million. Then they would keep adding in batches at lower ppm to get their 20ppm score. That is dangerous because in the end, you can mix them together over and over but there is still a high likelihood that some or many boxes will test higher than 20ppm.  The big problem is that they were not testing the final batch or boxes.

This practice resulted in many Celiacs getting sick and complaints to the FDA. Eventually GM had to recall 1.8 million boxes of GF Cheerios.  How can this be? Well, it is simple folks, the FDA does not mandate testing or a particular method for testing..they suggest that each company regulate themselves.  Yup, GM is NOT looking out for those with Celiac Disease or allergies to wheat, rye and barley!

A regular (celiac) customer came in last month and told me that his blood levels were elevated and he was having stomach problems and could not figure out why because everything he is eating is GF. He told me he would be going in for new endoscopy and biopsy in the next few weeks. I asked him, to tell me what he was eating for breakfast and he said “GF Cheerios”.   I asked when his issues started…he said around that time. He was shocked when I filled him in on the happenings. I directed him to my blog articles from last year and suggested he also do a google search and read what Gluten Free Watchdog has been saying and also suggested he remove the “GF” Cheerios and see how he does.

If you are a Celiac, Gluten Sensitive, or have an allergy to wheat, rye or barley; you are playing a game of Russian Roulette if you are eating GM’s GF Cereals.

Many of us have been outraged that the Celiac Associations in the US have not been more vocal about this. Last month the Canadian Celiac Association recommended that those with Celiac Disease or Gluten Sensitivity not eat them.  Gluten Free Living Magazine just wrote an article about this. Click Here to Read Article

bang head here