Wednesday, July 02, 2014

Gluten Sensitivity Can Cause Belly Fat

Where did my flat tummy go?

Below is a case study from our book, “The Gluten Effect”. This patient had some very common complaints, but the common treatment she was receiving was having no effect. Did you used to have a flat stomach but can't seem to “find” it anymore? Gluten intolerance could very well be the underlying cause.

J.W had developed a big belly that she could not get rid of. She felt bloated all the time—and no matter how often she exercised or how closely she watched her caloric intake, her weight remained the same. She felt and looked four months pregnant.

A Successful 30-pound Weight Loss!

We diagnosed her with gluten sensitivity, and after being off gluten for several months, she went from a size 14 to a size 6, with a thirty-pound weight loss. She not only lost the weight, but it came off her problem areas first—her stomach and face.

She now had a flat belly, which she had never enjoyed before. J.W. also noted that her bloating was gone, and that she felt “clean” inside.

Lab tests revealed several infections, which were treated successfully, and that removed other chronic stressors from her system.

In J.W.'s case, the distribution of weight around the mid-region of the body was typical of excessive cortisol (a hormone) production with adrenal (your stress gland) exhaustion, secondary to a food sensitivity. Once gluten was removed, the stress on her body subsided, and a normal weight distribution returned.

Do You Have a “Spare Tire” or “Muffin Top”?

What we've discovered after working with patients for over 20 years is that much of that “tire” can be due to swelling of the small intestine from the inflammation caused by gluten and the adrenal fatigue ensues from malabsorption of nutrients.

You have about 23 feet of small intestine—with the surface area the size of a tennis court.

Look down at your abdomen. That's a lot of track to be laid down in a relatively small space.
Now imagine, that 23 feet is swollen, due to irritation created by a diet that doesn't suit your body, or an infection. Infections in the intestine are very common secondary to gluten intolerance. When it swells it has to go somewhere—welcome spare tire!

What's the Solution?

The solution is to discover the underlying cause of the swelling. Now I'm not against exercise, quite the contrary. But I can promise you that all the crunches in the world will not flatten a tummy that's swollen from a food intolerance or irritation from an untreated parasite or bacteria.

5 Things You Can Do

1. Discover if you're gluten intolerant for starters. There are tests available for this and remember we're talking about finding out if you're sensitive to gluten, not just if you have celiac disease.

2. If you already know that you're sensitive to gluten, then realize that you must be perfect about removing if from your diet. Being good “most of the time” is just not enough.

3. If you have not had a comprehensive stool analysis to check for the presence of infectious organisms, this really is something you should look into. It is rare that a gluten sensitive individual DOESN'T have some type of infection due to years of assault on the immune system from eating gluten.

4. The damage created by gluten in the intestines results in a condition known as a “leaky gut”. This is very common. Removing gluten from the diet is usually not enough to restore the integrity to the intestine. Such treatments as probiotics, herbs and other supplements may be needed to repair the lining of the gut to it's normal healthy state.

5. Get an idea of how your adrenal glands are functioning. Adrenal fatigue or exhaustion is quite common in our society. It is especially associated with malabsorption of nutrients and unstable blood sugar, which is definitely an effect created by gluten sensitivity.

The good news is that with some help from clinical nutrition, including dietary changes and lifestyle management, restoring that nice flat tummy is within reach—no surgery required!

Please let me know how I can assist you. Or call us to schedule a Free Health Analysis: (408) 733-0400.

Here at HealthNOW we are a Destination Clinic and we see patients from across the country as well as internationally. We are here to help!

I look forward to hearing from you.

To your good health,

Dr. Vikki Petersen, DC, CCN
IFM Certified Practitioner

Founder of HealthNOW Medical Center

Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”

Tuesday, June 24, 2014

Celiac Disease vs. Gluten Sensitivity—Are They Different?

70-80% of Medical Research is Funded by Pharmaceutical Companies

We live in a society where medical treatment efficacy is gauged by two major standards:

1) Make a diagnosis, then

2) Find the drug best suited to treat the symptoms associated with that diagnosis

Fully 70-80% of all medical research is funded by pharmaceutical companies. Where does celiac disease fit into this paradigm? Celiac disease is considered to be a rare disorder and there is no drug to treat it. You can imagine where that puts it on the hierarchy of most medical practitioners.

In addition, the “face” of celiac that most doctors are taught, is a patient presented with chronic diarrhea and severe weight loss. Is it any wonder that little emphasis is put on its diagnosis? Once the patient with severe weight loss has been ruled out for cancer and other serious diseases, then their doctor might consider celiac disease.

What’s the Difference Between Celiac Disease and Gluten Sensitivity?

In my opinion, very little. The problem we have encountered is that celiac disease is the only manifestation of gluten sensitivity that medicine has been able to diagnose. And not very well at that—considering it takes the average celiac patient as long as 10 years before they're even given the proper diagnosis.

So what is the problem?

Is it that something considered rare is not often looked for?  Partially.

Is it because there's no drug to treat it, so there's no “easy fix”?  Partially.

Is it the fact that the only treatment for it is a dietary change—and no one really wants to “condemn” a patient to never eating wheat, rye or barley again?  Definitely!

Is Celiac Disease Just a Subset of Gluten Sensitivity?

Celiac disease is just the tip of the iceberg of the greater issue called “gluten sensitivity”. 

In this case, the tip is 1/40 of the whole iceberg—because research has been telling us that while celiac disease affects 1% of the population, gluten sensitivity’s incidence is anywhere from 7% to up to 40%

Estimates vary widely. But even conservative estimates take it right our of the “rare” category with higher estimates putting it squarely in the category of obesity which is considered to be an epidemic!

The Problem with “Diagnosis”

The “gold standard” for diagnosing celiac disease has been a positive intestinal biopsy that reveals severe degradation of the surface of the small intestine. But damage has to occur for many years before such a test is positive, not to mention all the secondary problems that have likely arisen during that time. Yet we wait and wait for that positive test during which time it's considered “perfectly good medicine” to tell a patient to continue eating gluten if their test is negative!

Is It Malpractice?

I have been saying that, within the decade, the current protocols being used to diagnose and treat celiac disease will be looked upon as malpractice. Is that too strong a statement? I don't think so. 

Do we wait for a patient to have a heart attack before we assess risk factors for cardiovascular disease? Of course not!

So why is it acceptable to allow a patient to get to the point of severe atrophy of their intestine with concomitant malabsorption, inflammation, and risk of autoimmune disease before we make a diagnosis? It isn't!

Gluten Intolerance Puts You at Risk for Many Severe Diseases

I've been working with gluten sensitive patients for around 20 years and even co-authored a book on the subject, "The Gluten Effect". What I have come to find out through research and clinical experience has taught me that we have an obligation to our society to change our procedures and strategies.

We are creating many ill patients by missing the diagnosis of gluten sensitivity.

Such things as: obesity, depression, anxiety, fatigue, migraines, IBS, and autoimmune disease (such as arthritis, lupus, diabetes, thyroid disease, and osteoporosis) are all implicated with gluten sensitivity. The list is long and growing as we learn more.

Everyone Should Be Screened

I believe everyone should be screened for gluten intolerance, which includes both celiac disease and gluten sensitivity. It involves a simple lab test which should be evaluated by an experienced clinician. The reasoning behind this is that interpretation of these tests requires some experience and it's often not a simple “yes” or “no” proposition.

Most researchers and clinicians prefer also using a blood test, although the efficacy of saliva testing has been validated. Personally, I use blood and saliva testing both for my patients, with a stool test recommended for those living too far away to come into the office.

What if the test is equivocal? What if it’s in the gray “suspicious but not confirmed” area? The TRUE gold standard test is evaluating a dietary change—it's called elimination and provocation. Eliminate gluten completely from your diet for a minimum of 30 days and see how you feel. If you notice a change, that is considered a positive test.

We are committed to spreading the word about gluten and are here to help you, your family and friends. Patients come to see us from around the country and internationally.  

Our clinic is in Sunnyvale, California. Please let us know if you want to visit. Or call to schedule a FREE CONSULTATION: (408) 733-0400.
I look forward to hearing from you.

To your good health,
Dr. Vikki Petersen, DC, CCN
IFM Certified Practitioner

Founder of HealthNOW Medical Center

Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”

Wednesday, June 11, 2014

Gluten Intolerance and Vitamin D Go Hand-in-Hand

Vitamin D is a crucial component of not only healthy bones, but a protector against cancer, diabetes, and a strong immune system booster as well

Despite all these virtues, its common deficiency has gone largely unnoticed. Vitamin D deficiency is further exacerbated by malabsorption, which is very common among those who have gluten sensitivity and celiac disease.
A reader (who is gluten intolerant) wrote in that he has low Vitamin D levels despite supplementation for over six months. He wanted some information on why that might occur.

Vitamin D is a fat soluble vitamin.  Gluten intolerance, especially celiac disease, creates malabsorption of nutrients. But exactly what you'll malabsorb, and to what degree, is somewhat unique to individual patients depending where their intestine is most damaged.

The villi (the finger-like projections which line the small intestine) help to emulsify and absorb fat. These villi are frequently eroded with celiac disease—and fat absorption is thereby compromised. 

The inability to adequately absorb fat will not only affect absorption of vitamins D, E and A, but it will drastically affect hormones—creating a hormonal imbalance as well. (Hormones are made from cholesterol—fat.)

Why Does a Vitamin D Deficiency Continue Despite a Gluten-Free Diet?

In the case of this reader, he had been gluten-free for some time. Removal of gluten should, ideally, result in the healing of the villi and normalization of absorption. When that doesn't occur, then we know that something else is compromising healing. 

I wish I could say that this was an unusual scenario, but it isn't.  In fact, it is more the norm. 

Eliminating gluten, while an important and critical first step, is typically insufficient to restore normal function to the small intestine and thereby the total health of the body. But why? 

Frequently an individual has an intestinal infection, poor balance of good bacteria, or some other inflammatory factor that is preventing healing. That cause must be identified and treated quickly.

Another possibility is that the vitamin D being taken is not the best quality.

What Type of Vitamin D Supplementation is Best? And What Should Our Levels Be?

For my patients, I recommend vitamin D3 (cholecalciferol) in a liquid form. The base is olive oil so that's what it tastes like.

It is truly important for everyone to know their vitamin D level, so you need to get tested. And how much Vitamin D is ideal? For answers, read my blog, “Is Low Vitamin D Causing You a Leaky Gut?”.  This is especially critical if you're gluten intolerant. 

Follow up after a few months to ensure that the vitamin D you're taking is working to optimize your levels is also key.

Finally, work with a clinician who utilizes clinical nutrition or naturopathic medicine so that they have the tools to assess if the small intestine is healing properly. It is frustrating to work so hard to maintain a gluten-free diet or take supplements when damage is continuing to occur that prevents health restoration. Such a program is not difficult, but it must be done.

Please let me know how I can assist you. Or call us to schedule a Free Health Analysis: (408) 733-0400.

Here at HealthNOW we are a Destination Clinic and we see patients from across the country as well as internationally. We are here to help!

I look forward to hearing from you.

To your good health,
Dr. Vikki Petersen, DC, CCN
IFM Certified Practitioner

Founder of HealthNOW Medical Center

Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”

Tuesday, June 03, 2014

Eating Out with a Gluten Intolerance

When you have food sensitivities, whether it’s celiac disease, gluten intolerance, dairy intolerance or something else, going out to a restaurant can be difficult. 

Making a mistake on your diet can result in anything from mild discomfort to life-threatening consequences, depending on the degree of your sensitivity or allergy. 

While those with gluten intolerance can be affected acutely or seemingly silently, we know that a zero tolerance policy is the only way to go

5 Tips for Eating Out Successfully 

I would love to say that the following tips are foolproof, but we unfortunately do not live in a perfect world. Hopefully they will at least be helpful, and make going out to eat more enjoyable and safer. 

1. If you know that you’re going to a restaurant for dinner, call ahead (about 3 or 4 pm) and speak to the chef.  (Ideally it would be great to have pulled up their menu on-line so that you have an idea of what they offer beforehand.) 

A typical restaurant chef will be in “dinner prep” mode at this time, and therefore has more time to speak with you than when the restaurant is busy serving customers. 

Chefs love to nourish people, it’s the reason they became chefs. If you clearly state what foods you are intolerant to and what you do like to eat, it should be fairly easy to work out a dish that he/she can prepare for you. 

Get the chef’s name, and give him yours, as well as the time you will be arriving for dinner. 

Work out what the waiter should say to the kitchen staff when your order comes in so that the chef will know it’s you. This may be a little labor intensive on the front end, but imagine how nice it will be to simply place your order without having to “grill” the waiter about your food restrictions! 

Note: If a) you don’t have time to do the above, b) you end up going out unplanned, or c) it just didn’t work to speak to the chef or maitre ‘d, then you’ll have to be more aggressive in the defense of your health. 

2. Look at the menu from the perspective of what’s in the kitchen rather than how they have put the meals together. In other words, if you want the salmon, but it comes with polenta and you’re allergic to corn, ask for the salmon with rice, if you see rice somewhere on the menu. 

Or better yet, get it with some broccoli or spinach. Think of it more as selecting what you want from the available options on the menu as a whole, rather than how the chef is choosing to serve to pair the ingredients. 

3. When ordering, make the seriousness of your needs clear. If the waiter is standing far away from you, ask them to come closer. Let them know that the reason you have to ask questions is that you have severe allergies (yes it’s okay to say “severe”—it gets their attention). And if you mistakenly eat gluten (or whatever food is problematic) you will get very ill. 

If you say it in a serious tone, they will not treat your request lightly. It’s up to you to make your statement impactful enough for them to carry the information back to the chef accurately. 

4. When you are asking for special consideration, make sure they know that it’s due to food allergies. I usually say something like this: “While the pasta sounds delicious with the chicken, unfortunately I’m allergic to it. Can we substitute broccoli?” 

5. Order simple. Simple is best. Unless you are a decent cook yourself and you know how things are made, sauces and dishes that are “stuffed” or complex have a higher likelihood of getting you into trouble. The fewer components to the meal, the more likely you will have an enjoyable, healthy experience. 

Don’t Be Shy—Your Good Health is Worth It

Navigating through menus and others’ kitchens can definitely be anxiety-provoking, especially when you’ve had a bad experience. But if you do your homework and you’re not shy about communicating your needs, you should do well. 

The good news is that the awareness of food sensitivities, especially gluten intolerance and celiac disease is definitely increasing. Fortunately, more and more restaurants are providing gluten-free options on their menus.

I hope you found this article informative. If your health is not to the level you desire, consider contacting us for a FREE Health Analysis. Call 408-733-0400.

We are a Destination Clinic and treat patients from across the country and internationally. We are here to help!

I look forward to hearing from you.

To your good health,
Dr. Vikki Petersen, DC, CCN
IFM Certified Practitioner

Founder of HealthNOW Medical Center

Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”

Tuesday, May 27, 2014

New Research Argues There IS a Test for Gluten Sensitivity

Best Blood Test to Diagnose Gluten Sensitivity

Mainstream literature continues to state there is no blood test for gluten sensitivity. While it may not be perfect (but what tests are?) some researchers offer a differing opinion, and I wanted to share their results with you.

While there is no further argument of the existence of gluten sensitivity, having a blood test that everyone can agree on has not yet occurred. 

In a 2012 study published in Clinical Reviews in Allergy & Immunology entitled “Serological Tests in Gluten Sensitivity”, the authors set out to characterize a potential pattern in blood testing that would be helpful in diagnosing gluten sensitivity as compared with celiac disease.

They took 78 patients with gluten sensitivity and 80 patients with celiac disease, and retrospectively tested their blood for four standard tests, three of which are classically used for celiac disease, and one that is more commonly thought to be accurate for gluten sensitivity.

For those of you who like the specifics, the tests used were:

1) IgG DGP-AGA (deamidated gliadin peptide antibodies)

2) IgA tTGA (tissue transglutaminase antibodies)

3) IgA EmA (endomysial antibodies)

4) IgG/IgA AGA (anti-gliadin antibodies)

And the Winner Is…

Here are the findings:

The  IgG AGA test was the winner in detecting gluten sensitive patients—56.4% were positive. The test doesn’t rule out the presence of celiac disease however. 81.2% of celiac patients were also positive.

The IgA version of the same AGA test yielded vastly different, although not unexpected, results. The test was elevated in only 7% of gluten sensitive patients while 75% of those with celiac disease were positive. Why is that not a surprise? IgA is found on the mucous membranes of the body where it is exposed to outside foreign substances: nose, lungs, GI tract, ears, eyes, etc. Since celiac disease mostly affects the lining of the GI tract, it isn’t unexpected that the IgA part of the immune system might be most affected.

But when you compared the “classic” celiac tests against the gluten sensitive patients, the results were rather definitive—only one gluten sensitive patient was positive for DGP-AGA and zero gluten sensitive patients demonstrated a positivity for tTGA or EmA. But the celiacs showed a positivity rate of 88.7%, 98.7% and 95% respectively for these three tests.

What Do We Know From This?

A couple of things:

1) Ensure that when you are tested you receive a complete panel of tests, including all those mentioned above. Additionally both the IgA and IgG versions should be included, especially for the AGA test.

2) When interpreting the tests, remember that you are doing more than just ruling out celiac disease. For many doctors that is their goal. Despite international research knowledge to the contrary, many doctors still don’t appreciate the existence of gluten sensitivity. While no single test is perfect, if you’re suspecting celiac and you test positive for the classic celiac panel of tTGA, EmA and DGP-AGA, then you’ve likely identified your condition. 

If you know that you do poorly with gluten and test positive for AGA, especially the IgG version, and negative for the rest of the celiac panel, you can feel more assured of a gluten sensitive diagnosis.

Some other tell-tale signs of gluten sensitivity, according to the researchers, are a varied clinical picture, meaning many symptoms occurring at the same time. And while many of these symptoms are similar to another disease, IBS, the authors warn against considering gluten sensitivity as a subtype of IBS. 

The “extraintestinal” symptoms so common with gluten sensitivity are not typically seen in those patients suffering with IBS, making the distinction clear, in these researchers’ opinion.

The common complaints associated with gluten sensitivity include:
  • abdominal pain, bloating, diarrhea, constipation
  • foggy mind, tiredness
  • eczema/skin rash
  • headache
  • joint/muscle pain
  • numbness of legs/arms
  • depression
  • anemia
  • together with a normal or mildly abnormal lining of the small intestine
In conclusion, when you’re building a case for gluten sensitivity, you need to look at several factors: blood testing, symptoms, and reactions to eating and eliminating gluten.

New Information on Celiac Genes

In the past, the rule of thumb was that “you could never have celiac disease if you didn’t carry the genes for it”. That remains true, but these researchers cited findings from 2010 that demonstrated a full 40-50% of gluten sensitive patients possess the same genetic profile as those with celiac disease—HLA DQ2 or DQ8.

And with that we watch another stable datum bite the dust. This opens the door to a new interpretation of genetic testing that doctors should be aware of. Instead of being too quick to tell a patient that while they may have the genes for celiac disease, considering that their blood tests are negative for the disease, they’re fine to eat gluten; we now understand that such genes can be present in a case of gluten sensitivity as well. 

And as we now know, the classic celiac blood tests would be negative in such a case.

I believe we’ll be seeing a wide array of genes responsible for these diseases in the future. But knowing that almost half of those with gluten sensitivity demonstrate the exact same genetic profile as someone with celiac disease is important to know when a patient or their doctor is trying to make an accurate diagnosis.

Based on this common gene profile, it is then not surprising to learn that gluten sensitivity can be found in celiac disease family members. In this study almost 13% of the gluten sensitive patients were first degree relatives of celiac patients.

What Might the Future Hold?

As a clinical nutritionist, I have been speaking of celiac disease and claiming the existence of gluten sensitivity for over two decades now. We continue to discover more and more about these conditions. One day there will be a near perfect test and one day we will readily and easily diagnose most all of those suffering. And that my friends, will be a good day!

I hope you found this article informative. If your health is not to the level you desire, consider contacting us for a FREE Health Analysis. Call 408-733-0400.

We are a Destination Clinic and treat patients from across the country and internationally. We are here to help!

I look forward to hearing from you.

To your good health,
Dr. Vikki Petersen, DC, CCN
IFM Certified Practitioner

Founder of HealthNOW Medical Center

Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”

1. Clinical Reviews in Allergy & Immunology 2012
Serological Tests in Gluten Sensitivity (Nonceliac Gluten Intolerance)
Umberto Volta, MD, Francesco Tovoli, MD, Ronny Cicola, MD, Claudia Parisi, MD,
Angela Fabbri, MD, Maria Piscaglia, MD, Erica Fiorini, MD, and Giacomo Caio, MD

2. Clinical Reviews in Allergy & Immunology 2010
Cutting-edge issues in celiac disease and in gluten intolerance.
Bizzaro N, Tozzoli R, Villalta D, et al.