Tuesday, December 09, 2008

My Daughter Began My Gluten Journey

Today is my daughter’s 16th birthday. You may wonder the appropriateness of bringing that up on a gluten blog but it actually is completely germane. You see it is because of her that gluten sensitivity got on my radar in the first place. I had two children prior to my daughter and they were both quite healthy. I breastfed all three children so it was with some concern that I viewed my third child’s weight and overall health. She was “skinny” as compared to my previous “chubby” babies, tended towards rashes and liked to projectile vomit. Yes it was definitely that last trait which got my attention. It’s one thing reading about projectile vomiting and quite another thing witnessing it!

So like any good mother and doctor, I tried to discover what was bothering my daughter. Simultaneously I was trying to help my mother who had never enjoyed good health and was almost 70 when my daughter was born. Coincidentally I discovered they were both sensitive to gluten about the same time. And, much to my own dismay, I realized I was the sole genetic link between them!

And while my response of - “Why Me?” - was very similar to many who are diagnosed with gluten sensitivity, it soon became a blessing as all three of us started to exhibit excellent health.

My mother is now 85 and says that she’s enjoyed the past 15 years much more than the first 70 due to her improved health and vitality. She is spry, healthy and takes no medications (exclusive of bio-identical hormones).

My daughter fortunately never knew the poor health that both my mother and I suffered from and I am very happy about that.

Earlier today I had a conversation with a patient whom I haven’t seen in many years. She suffered from many digestive problems when she originally came to see us and we diagnosed her with gluten sensitivity. She definitely noticed an improvement being off gluten but never really stuck with it. She would “limit” consumption but that was as good as it got. She called to tell me that she was recently diagnosed with an autoimmune disease. It was so frustrating to realize that the odds of that autoimmune disease being prevented by a strict adherence to a gluten-free diet all those years ago were great. We discussed, once again, the importance of being completely gluten-free but unfortunately I don’t think she is yet ready to hear it.

It is so wonderful to have the opportunity to help patients each day at the clinic. But I want to do so much more. I want all the millions of people who are being affected by gluten to know it before they suffer any longer.

I am convinced that what we know to be true about gluten and its ability to ruin people’s health will be common knowledge within the decade. But in the meantime we can only continue to communicate about it – a message I hope that our book does well. Speaking of which, The Gluten Effect is finally about to go to print. Getting this book completed has felt like a fourth child - very exciting and a lot of work! January is the expected release and I’ll fill you all in on the specifics as they’re available to me.

So the takeaway from this message is this: Don’t rule gluten out as a causative factor in your health problems or those of the ones you love. Take a lab test but better yet change your diet. Go gluten-free for several weeks and see how you feel. If you have questions write me; I truly want to help!

To you good health!

Dr Vikki Petersen
drvikki@healthnowmedical.com

Tuesday, November 25, 2008

It’s Frustrating!

It can be very frustrating knowing what we know and not being able to get that information to everyone who needs it. I keep reminding myself that our book, The Gluten Effect – How “Innocent” Wheat is Ruining Your Health, is being publishing in January 2009. Only 2 months away but sometimes it seems like an eternity. It took us 5 years to write. Okay, we seriously started last January 2008 but I personally made some feeble attempts over the previous 4 years.

Back to my frustration – a patient came in 9 months ago very overweight and walking with the help of a cane. She hadn’t been suffering silently. She was a bright, proactive woman who was diligently searching for an answer to her problems. She received diagnoses and drugs but no particular improvement of her condition.

We see many patients and while we delight in every success story, sometimes we don’t remember how bad a patient’s symptoms were when they first arrived. When this patient came in last week she had to remind us of her cane. It had disappeared several months ago so it had become a bit “out of sight, out of mind” for us. But for her it was a miracle. She has lost 40 lb and at last week’s visit was proud to announce that she had just completed a half-marathon walk. Yes folks, that’s 13 miles of walking and not a cane in sight!

What changed? She found out that she was sensitive to gluten. Utilizing the HealthNOW Method we restored strength to her immune system and her adrenal glands as well, but the biggest missing ingredient was a life-long gluten sensitivity which had remained undiagnosed.

Do you see what’s so frustrating? I want to shout it from the rooftops. I want to enter every gastroenterologist’s office on the planet and do a lecture about gluten sensitivity to all the patients and staff.

Another patient, one who knows she is gluten sensitive came into the office the other day to receive some chiropractic care along with physical therapy. She told me that she recently went to her general practitioner for her annual physical and informed him that she was avoiding gluten and how much her health had improved as a result. (She had been on the verge of a heart attack about 2 years prior.) Despite relating her tremendous health improvements to her M.D, he insisted that if she didn’t have unrelenting diarrhea it was ridiculous for her to avoid gluten.

Do you see why I’m frustrated?

The number of M.D.s in this country who equate gluten sensitivity with celiac disease is phenomenal. Waiting for a positive celiac diagnosis is akin to waiting for a heart attack to occur before you tell a patient they have high cholesterol. It’s barbaric. And mark my words, within the decade gluten sensitivity WILL be known, understood and the idea of waiting for a positive intestinal biopsy before diagnosing it will be considered malpractice.

To Your Good Health,

Dr Vikki Petersen

Friday, November 14, 2008

Foods Posing the Biggest Hidden Dangers to the Gluten Sensitive

Now that you know you’re sensitive to gluten you’re very carefully avoiding all the wheat bread, bagels, cookies and cakes. You’ve stopped eating oatmeal for breakfast (you know about the contamination of oats) and you watch those protein bars for all signs of glutinous grains. You’re aware that fried chicken and breaded anything is also a problem and you’ve realized the hidden danger of sauces and things like meat loaf.

So where might you get tripped up? The biggest problem we run into with patients is with certain ethnic foods that cook with soy sauce. It’s just not “obvious” that soy sauce has wheat in it. When you cook at home you can definitely enjoy cooking with wheat-free soy sauce (usually known as Tamari) but Chinese and Japanese food very often contains soy sauce and if the sauce is brown you probably just got a nice hit from gluten.

The cautionary tale here is keep learning about food and how it’s prepared. As someone who enjoys cooking I know how many things are prepared so I rarely get fooled.

It you’re sensitive to gluten ANY is too much – way too much!

I hope this helps!

To your good health,

Dr Vikki Petersen

Monday, November 03, 2008

Case Study

Here is another amazing case study about missing gluten sensitivity in a young woman who's been suffering needlessly. A simple screening for gluten would have prevented a lot of unecessary pain. This case exemplifies why we wrote our book. Hopefully increasing awareness will diminish these types of cases. “The Gluten Effect” is being published early January 2009. Stay tuned!

Recently a young lady age 19 came to see us, referred from a local celiac website. Her story epitomizes why we wrote our book and the medical community’s shameful lack of understanding of gluten and how it can affect the human body.

This patient, at the tender age of 16, began experiencing rather severe neurological problems. She had tremors in her hands and trouble walking due to pain and weakness. She suffered from brain fog and very poor concentration. When her joint pains got too severe she had to get a wheelchair. She also developed hearing problems.

While visiting a neurologist the patient’s mother asked the doctor if gluten or celiac disease could be a possible component in her daughter’s condition. Being a good mother she had done some research and wanted the doctor’s opinion. She had concurrently brought her daughter to a gastroenterologist and had requested a test for celiac disease but at the time of the conversation with the neurologist she had not yet received the results. The neurologist assured her that there was absolutely no way her symptoms could possibly be associated with gluten and proceeded to discuss multiple sclerosis and other possible neurological problems as the likely diagnosis.

Two days later her celiac test came back… positive. Upon removing gluten from her diet her symptoms improved considerably. But, as is often the case, simply removing gluten and doing nothing else is not sufficient.

What are our plans to restore her health? Glad you asked!

First we’re going to rule out any hidden infections lurking in her intestines. Remove gluten was a great first start to improving her health and she did notice some improvement. But what an infectious organism will do is prevent the intestine from healing to a large degree. This lack of healing and inflammation will cause a malabsorption of nutrients to persist which can in turn prevent healing in addition to compromising one’s immune system.

Second it is critical to heal the intestines so that they can effectively provide the function for which they are designed – namely turning food into fuel which then nourishes all the cells of the body. This young lady had very severe symptoms at quite a young age which tells us that her body’s recuperative abilities are very stressed and compromised and she likely suffers from a “leaky gut”. Therefore evaluating the status and integrity of the intestine and using nutrients, probiotics, etc to heal it will be very important.

Next we need to evaluate the status of her adrenal glands. This is the stress gland which is responsible for making many hormones, maintaining joint integrity, controlling inflammation and pain plus much, much more. Her chronic pain for many years has created a great strain on her adrenal glands so their function must be evaluated and supported.

And lastly there may very well be some genetic factors which have predisposed her to developing these various symptoms. Genetics can create the predisposition but targeted nutrition can offset that predisposition such that the patient can regain their good health.

In summary, there are still many avenues to address to restore this young lady’s health and I thought it might be interesting to talk you through our procedures which are producing excellent results in our patients.

The frustration of so few people being properly diagnosed who have gluten sensitivity is compounded by the fact that even when they are diagnosed the necessary follow-up and supportive care is not done.

The good news is that help is available.

To your good health,
Dr Vikki Petersen

Thursday, October 09, 2008

Tired? Sleepless Nights?


Is exhaustion disrupting your work and life?


Come get
the answers to these questions:

  • How much sleep do you actually need?
  • Is less sleep associated with disease and aging?
  • How can you handle poor sleep naturally.
  • How is sleep associated with weight gain?
  • Why do you wake up in the middle of the night?
  • How what and when you eat affect sleep quality?

Join us Wednesday, October 22nd at 7 p.m.
HealthNOW Medical Center
Call 408-733-0400 to reserve your seat.
It is FREE!
Bring your family and friends!


Tuesday, August 26, 2008

Enterolab

A reader writes: “Anne mentions Enterolab helping her confirm her gluten sensitivity. Can you please comment on the different gluten sensitivity related tests (e.g. stool test) that are offered by Enterolab (www.enterolab.com)? How much more accurate are they compared to the saliva test and the modified elimination diet that your clinic uses? Why does your clinic not use any of these tests to determine gluten sensitivity?”

Actually, here at HealthNOW we utilize many different testing methods to help a patient determine if they are sensitive to gluten. Please see below for further data:

Common Tests to Diagnose Gluten Sensitivity

Blood Testing

Genetic Blood Tests - Genetic blood studies assess an individual’s capacity to carry one of the HLA genes that is associated with gluten sensitivity. Studies support that 90 percent of patients with gluten sensitivity carry the HLA DQ2 gene, and others may carry the HLA DQ8 gene commonly.

These tests are not performed as commonly now as other antibody tests which are more accurate and have thus replaced them. However, genetic screens can be helpful in individuals who are at risk of having gluten sensitivity. For example, in relatives and children of gluten sensitive individuals with negative blood antibody tests, HLA patterns can indicate future risk. If both HLA DQ2 and HLA DQ8 are absent, the risk of being gluten intolerant is minimal and it would negate the need for future testing for the individual. If positive, continued periodic screening and a gluten-free diet would be indicated.

The other area of benefit in genetic testing is for children. The ease of testing by simply swabbing the inside of the mouth makes this less invasive for a small child. This may be a reasonable screening test in children at risk for gluten sensitivity.

Anti-Gliadin Antibodies - Gliadin is the protein component of gluten that triggers the immune reactions in sensitive people, and therefore many people with gluten sensitivity have antibodies to this protein. Testing for anti-gliadin antibodies (AGA) is a simple blood test, but studies have shown that it is less sensitive for detecting Celiac disease compared to other antibodies which will be discussed later. The confusion, as stated earlier, is that the ability of AGA to detect gluten intolerance has been defined in conjunction with a positive intestinal biopsy. While this may be a standard for Celiac disease, we now know that this is an inaccurate standard for gluten sensitivity. In fact, AGA may be the best current diagnostic test when considering all gluten related disorders.

In testing for AGA, antibodies of both the IgG and IgA classes are checked since low total levels of IgA may be present. If a person has low total IgA levels, antibody tests for IgA may be falsely negative.

Anti-Endomysial Antibodies - Unlike Anti-Gliadin Antibodies, Anti-Endomysial Antibodies (EM antibodies) are auto-antibodies. What do we mean by this? Gliadin is a gluten protein so therefore when the immune system attacks it, is not attacking “self” tissues but instead a foreign food protein. In contrast, as gliadin is absorbed through the intestinal lining, it attaches to the smooth muscle cells of the intestinal wall. EM antibodies are directed against proteins of these smooth muscle cells, and therefore EM antibodies are directed against “self” tissue. This defines them as auto-antibodies.

Because EM antibodies attack the smooth muscle of the small intestine, these antibodies correlate better with damage to the intestine wall. Studies have supported an accuracy rate of approximately 90 percent for Celiac disease. Actually in one study, EM antibodies were present in 100 percent of individuals when total villous atrophy was present. However, EM antibodies are ineffective in detecting individuals with silent or subclinical gluten sensitivity. If minor involvement of the intestinal lining occurs or if no intestinal involvement is present, EM antibodies are much less accurate.

As with Anti-Gliadin Antibodies, EM antibody testing should evaluate IgG and IgA forms of antibodies for the same reason as described above. If a gluten sensitive patient is IgA deficient, IgA EM antibodies may be falsely negative even for Celiac disease.

Anti-tissue Transglutaminase Antibodies - Similar to Anti-Endomysial Antibodies, Anti-tissue Transglutaminase Antibodies (tTG antibodies) are also auto-antibodies directed against “self” tissue. After gliadin crosses the intestinal lining, a special enzyme called tissue transglutaminase binds to gliadin and takes off a portion of the protein. This portion is called glutamine. tTG antibodies are antibodies that are directed against the complex of gliadin attached to tissue transglutaminase. Because tissue transglutaminase is a “self” enzyme, tTG antibodies are also auto-antibodies.

Also like Anti-Endomysial Antibodies, tTG antibodies are 90 percent accurate in Celiac disease 5 because they represent immune system attack at the level of the intestinal lining. Gluten sensitivity that involves minor intestinal injury or no villous atrophy will be less likely detected by tTG antibodies. Therefore, tTG antibodies correlate best with villous atrophy as several studies have supported, and a negative tTG antibody test (or EM antibody test for that matter) does not rule out gluten sensitivity when intestinal involvement is minimal or absent.

While some researchers support tTG antibodies as being a sensitive test for identifying Celiac disease, it is less sensitive for gluten sensitivity in a broader sense. This makes logical sense given the location of where this enzyme acts on gliadin. Disorders related to gluten sensitivity that do not involve the intestinal tract would be unlikely to trigger tTG antibody response from the immune system.

Deaminated Gliadin Antibodies - After tissue transglutaminase detaches the glutamine protein from gliadin, the remaining gliadin protein is termed a “deaminated” gliadin. The immune system can make specific antibodies against several different parts of the gliadin protein, and a deaminated gliadin can provoke different antibodies to be produced compared to an intact gliadin protein. As a result, newer antibody tests detect antibodies made against deaminated gliadin selectively. In studies looking again at Celiac disease patients only, deaminated gliadin antibodies had an accuracy rate of approximately 85 percent making it comparable to EMA and tTG antibody tests.

The ability of deaminated gliadin antibodies to detect gluten sensitivity outside of Celiac disease is not known. In Celiac disease patients with IgA deficiency, the IgG test for deaminated gliadin antibodies was as effective as tTG tests. Because testing for deaminated gliadin antibodies offers little advantage over tTG and EMA antibody tests, it is usually not commonly ordered. It may be an effective tool in screening for gluten sensitivity but to date these studies have not been performed.

Total Serum IgA Level - Low total levels of IgA antibodies are rarely found in the normal population with one out of every six hundred people having this condition, but in gluten sensitivity, low IgA levels are more common. This reflects the increased IgA antibody production in the intestine to fight off gluten as it attempts to enter our bodies. If a low level of IgA is present, then certainly IgG varieties of the antibody tests described above will be more accurate in diagnosing gluten related conditions. In general, total IgA levels are not ordered often since IgG antibody tests are usually ordered concurrently. Therefore, defining a low IgA level adds little information in making a diagnosis. There is a general theory however that a lower IgA level suggests greater inflammation of the intestinal lining and greater chronicity of disease. A low IgA level may provide some insight into duration of disease.

Saliva testing
Saliva Antibody Testing - While serum antibody testing has been shown in some studies to be more accurate than saliva testing in gluten sensitive patients, IgM and IgA antibodies are also made in the saliva allowing a less invasive way of screening for gluten sensitivity. The difficulty is that these saliva tests have yet to be tested against patient’s response to a gluten free diet in large populations. The saliva tests are therefore not as widely accepted in the medical community. However, our clinical experience shows the tests to be very accurate when correlated with clinical changes that occur with a gluten-free diet. There are research projects currently underway to show the validity of saliva testing, and it is our belief that saliva testing in the future may become one of the best screening tests because of its ease and low cost.

Fecal Testing
Fecal Anti-Gliadin Antibodies - As you may recall, the immune system begins its line of defense against gluten in sensitive individuals at the intestinal lining by producing IgA antibodies. In keeping with this information, it is predicted that IgA levels against gliadin in the stool may be a more sensitive reflection of gluten intolerance compared to blood testing. One researcher has conducted extensive research in this area and reports statistics that 100 percent of Celiac disease patients have fecal Anti-Gliadin Antibodies (fAGA) and over 70 percent of those with gluten sensitivity have fAGA. This research has yet to be independently duplicated by other research studies but if the current research holds true, then someday fecal testing may prove to be one of the best and most reliable methods for testing for gluten sensitivity.



Scopes and Biopsies
Upper Esophagogastroduodenoscopy (EGD) - Despite the advent of less invasive blood, saliva and fecal tests, there are several clinicians that feel a small intestinal biopsy is required before instituting a gluten free diet. These clinicians may not have distinguished between Celiac disease and the bigger category of disease that falls under gluten sensitivity, or they may not be aware of the broad effects that gluten can have on our health. As research supports, Celiac disease represents a fraction of all gluten related health disorders. Additionally, there exists a misconception by a few that a gluten free diet is a major inconvenience as a treatment. This lends some clinicians to support biopsies for “proof” before committing one to what they feel is a very restrictive diet. In actuality, being gluten free is quite easy and very healthy. Better understanding of this among clinicians may also change an insistence on small intestinal biopsies.

EGD is administered to a person while they are in a lightly sedated state. A flexible tube with a light and a tiny camera at the end of the scope is slowly inserted through the mouth and navigated through the esophagus, the stomach, and into the upper portion of the small intestine. The small intestine is vast, and EGD only assesses the first five feet or so of the small intestine. This causes some significant limitation in terms of finding pathology in many cases.

In addition to directly visualizing the intestinal lining, EGD can biopsy portions of the intestinal wall for evaluation. Small “pinchers” take little pieces of tissue that can be examined later under a microscope. Specifically in gluten disorders, findings sought include villous atrophy and inflammation of the intestinal wall. Unfortunately, contrary to some people’s beliefs, a negative biopsy does not rule out gluten sensitivity. In fact, it does not even rule out Celiac disease 100 percent of the time. Because EGD samples only a portion of the small intestine, and because the area of intestinal lining chosen for biopsy may not be involved with inflammation, a biopsy can be falsely negative even when Celiac disease is present. The small intestine is 21 feet long with the surface area the size of a tennis court. With that picture in mind one can appreciate that a biopsy even in Celiac disease may fail to make an accurate diagnosis.


Secondary Tests
We do want to stress that having gluten sensitivity for a prolonged time can cause secondary health problems. Chronic stimulation and attack of the immune system makes the body vulnerable to other infections which we see commonly. Evaluating for the presence of parasites, amoebas, bacteria, etc is critical for not only regaining one’s health but for the successful healing of a damaged small intestine. Also nutritional deficiencies as a result of intestinal inflammation are significant problems for many with gluten sensitivity. Calcium, magnesium, Vitamin B12 and Iron are just a few of these commonly seen. Concurrent food allergies, such as lactose intolerance, can also develop secondary to being sensitive to gluten. Lastly, adrenal exhaustion must be considered in many patients with longstanding gluten related disorders as we discussed in the chapter on adrenal disorders.

The most common scenario we see involves a patient suffering many years with gluten sensitivity. We are able to make the diagnosis and proceed to eliminate gluten from the diet. Improvements occur, but all symptoms are not completely resolved. Secondary testing then reveals one or more of these other health problems that require further attention until complete restoration of health can be achieved.

Our Approach is to Identify the Root Cause

We have helped numerous people who have suffered for years with gluten sensitivity but had not been accurately diagnosed previously. Many of our success stories utilizing the HealthNOW Method are included in our upcoming book. The bottom line is that there is no perfect blood test or biopsy protocol to define 100 percent of those with gluten sensitivity. At least not yet. Therefore, you have to consider the limitations of these tests as you undergo evaluation.

Our approach to a person in poor health is first to identify the symptoms and to which bodily system these symptoms are related. The next step is to find what stressor may be affecting this bodily system and remove it. Stressors can include toxins, foods, infections, malnutrition, physical stress, emotional stress, and others. Because our bodies are so resilient, once we eliminate the stressor our bodies have an amazing ability to heal over time.

Our algorithm for diagnostic testing in gluten sensitivity is to screen everyone. It is our belief that gluten sensitivity testing should be part of an annual health examination. Given the impact this dietary substance can have on multiple areas of the body, why shouldn’t we screen for gluten sensitivity? As a means of prevention of further illnesses and a lower quality of life, the benefits in costs alone would outweigh the costs of screening.

How do we test everyone? Generally, everyone is tested with a saliva and blood evaluation of Anti-Gliadin Antibodies (IgG and IgA) as well as Anti-tissue Transglutaminase Antibodies (IgG and IgA). In small children we will consider an oral swab for genetic screening for HLA patterns. At the same time, we place all patients on a Modified Elimination Diet (MED) for 10 days that eliminates gluten and other common food allergies such as cow’s milk, corn and soy products, while invoking a good balance of healthy foods such as lean protein, vegetables and fruits. By assessing the response to the MED and the results of the diagnostic tests, we will receive a highly accurate assessment of gluten intolerance.

For us, the gold standard for diagnosing gluten sensitivity is not an intestinal biopsy or a blood test. It is a beneficial response to elimination of gluten in the diet. We have hundreds of patients that have benefited from this diagnostic approach of getting to the root cause.

To Your Good Health,

Dr Vikki Petersen

Thursday, August 21, 2008

How Gluten Creates Problems in the Nervous System

A Reader named Anne writes: "I discovered my gluten sensitivity while trying to figure out something to help or reverse my small fiber peripheral neuropathy. My PN was progressing up my arms and legs. My feet were extremely painful - I had to sleep with them dangling off the side of the bed so nothing would touch them. I was also slightly off-balance, but the doctor said I was not ataxic."

"After going GF [gluten-free], I have seen regression in my PN. My arms and legs no longer tingle. I can sleep with my feet under the covers. I no longer limp and my balance is better. I doubt my feet will ever feel normal - too much damage. But they are so much better."

"Interesting, my son started complaining of foot pain when he was 20. He is now GF and says he no longer has any foot pain. Was that the start of PN? I wonder that as my foot pain began when I was 20. PN was not diagnosed until I was in my 50's. I was told it was planter fasciitis. Is there a connection between gluten and PF [peripheral neuropathy]?"

"I used Enterolab to confirm my gluten sensitivity. I have been gluten free for 5 years and the change in my health has been absolutely amazing. No more fatigue and depression. Improvement in peripheral neuropathy. Eyes and mouth are no longer dry. The list of improvements is very long."

"I stumbled across your blog this morning - nice find, will bookmark it. It is refreshing to find more doctors who are looking at the whole spectrum of gluten sensitivity and not just celiac disease. When will your book become available?"

I love Anne’s question and comment on her Peripheral Neuropathy (PN) because it brought Chapter 5 of my book to life. In Chapter 5 we discuss the various symptoms associated with gluten’s affect on a person’s nervous system. There are many such symptoms including clumsiness, imbalance, numbness, pain, memory and attention difficulty and mood disturbances. Two of these are exactly what Anne and her son experienced – pain of their extremities and imbalance.

In an effort to clarify why she noticed the benefits she did from removing gluten from her diet, please enjoy another snippet from our upcoming book:

Clumsiness and Imbalance

While this may not be the most common symptom of the nervous system related to gluten intolerance, it certainly is the most researched area. In medical circles, the term “ataxia” is used to describe poor coordination and balance. It can affect your walking, your ability to stand, or even your arms or legs in isolation. While many systems contribute to your balance (your inner ear, your vision, your sensations of your feet on the ground, etc.), your brain is the location that organizes all of this information and navigates your movements precisely. More specifically, the cerebellum, which is a part in the back of your brain, is the “balance control center.”
Some examiners claim that ataxia is one of the most common disorders produced by gluten in relationship to our nervous system. Poor coordination and clumsiness does occur with gluten intolerance and affects children as well as adults. But how does gluten cause our brains to function improperly and cause this imbalance? Evidence suggests that it is all due to the immune system’s reaction to gluten itself.
In your cerebellum (a part of the brain that plays an important role in the integration of sensation and control of movement), there are special cells called Purkinje cells. These cells are found in your cerebellum and are the main components of the “balancing center.” In patients with gluten sensitivity, it has been shown that these individuals have antibodies against these Purkinje cells. The antibodies made against gluten (anti-gliadin antibodies) cross-react against these Purkinje cells. What this means is that in a person who is genetically at-risk for gluten sensitivity, gluten induces an immune attack against the protein gliadin, and this antibody not only attacks gliadin, but also attacks tissues far away from the intestines. In this case, through the bloodstream, these antibodies travel to the cerebellum and attack the Purkinje cells. As these cells become inflamed from the immune attack, the ability to coordinate all the “balance information” is impaired. Symptoms of poor balance and coordination then result.
To further demonstrate this point, another study out of Britain examined 224 people with ataxia disorders. Some had an inherited disorder of ataxia, some had ataxia combined with other neurologic symptoms, and some simply had ataxia without known cause. Of those that were without known cause, 41 percent were found to have anti-gliadin antibodies supporting gluten sensitivity as a cause. Also, when looking at all the patients in these groups that were positive for these antibodies, 79 percent had “small” cerebellums on MRI testing. The gluten antibodies that had been generated from the immune system’s reaction were not only directed against gluten proteins, but also against the cerebellum and its Purkinje cells. Over time, the size of the cerebellum had decreased.
But the proof is always in the pudding. What happens if someone with poor balance is taken off gluten? In another study, ten patients with headaches and/or clumsiness were placed on a gluten-free diet. Over time, nine of the ten showed a beneficial response in all symptoms. The evidence is overwhelming. The presence of gluten antibodies, shrinkage of the cerebellum and the dramatic response to dietary change all support gluten as the cause. Yet despite these obvious factors indicating gluten (a dietary component) as the root cause, the majority of the time no digestive symptoms exist. In more than one study in patients with ataxia, other changes in the brain by MRI testing demonstrate inflammation and small areas of tissue damage. These changes occur silently without us even knowing it until they grow large enough to create symptoms. But by the time symptoms occur, the inflammation has been evolving over a long time for most people. For example, in individuals with small silent strokes to the brain where symptoms are absent, eventually enough tissue can be damaged to cause memory problems and dementia. By the time this is diagnosed, often more than 20 percent of brain is already damaged!


Think of your nervous system as an electrical circuit where information flows to and from the brain and spinal cord. Thousands of nerves traverse your body telling your muscles to move a certain way, and several sensors send information about touch, movement, pressure, temperature and pain back to your brain as well. When these nerves are unable to function well, “false” information can be sent back to the brain and cause many perceived symptoms. Of these, numbness, tingling and pain are the most common. If you have ever slept on your arm incorrectly, you know how uncomfortable the symptoms of numbness and tingling can be. Imagine having this all the time! If you slept in a poor position, as soon as you adjust and move, the compression on the nerve is released and the numbness fades away. In cases where the nerves are being damaged, however, changing your position does not help. This is called “neuropathy.”
Neuropathy can be due to many causes, and diabetes is the most common known cause. Unfortunately, the majority of neuropathies are without a known cause. In addition to ataxia, neuropathy is fairly well studied in relationship to gluten and is a common neurologic manifestation of gluten intolerance. The mechanism is related to the immune system. Antibodies directed against gliadin or gluten can result in cross-reactions against proteins or fibers of the nerves causing damage. Research supports that these antibodies have specific cross-reactivity with myelin (insulating layer around nerves composed of protein and fat) and neurofilaments (fibers that make up the nerve cell). Both of these are key components of nerves that relate to sensation and movement.
Depending on which portion and which set of nerves are affected will determine your symptoms. For instance, if nerves that sense temperature changes are attacked by gluten-related immune antibodies, then odd sensations of hot, cold or pain may develop. Or if nerves that sense pressure and touch are involved, unusual pressure sensations or deep pain can result. While it may seem that something which is hot, cold, or painful is affecting an area of your body, there is really nothing there. But your brain’s perception is purely based on what the nerves tell it. So, if they are signaling “bad” information because they are inflamed or injured, you still feel the pain even though nothing painful is there. In this way, it is like a short circuit in a faulty monitor. The monitor’s alarm is going off signaling a problem, everyone is hurrying to fix a problem, but no problem with the system is present. The problem is in the monitor, or in this case, the nerve itself.
How commonly does gluten cause these “neuropathy” problems? More often than you might think. In a study of 27 children with Celiac disease, 11 percent had some form of neurologic disorder. Neuropathy was the most common. Another examined nine patients with confirmed Celiac disease, and several different types of neuropathies were documented in this group affecting many different sorts of nerves. When you consider how few patients with neuropathy carry a documented cause to their complaints, gluten may well account for a high number.

Friday, August 15, 2008

A reader asked where I got the following data which I referred to in a prior post:
"Celiac is suffered by approximately 1% of our population. Research estimates that gluten sensitivity is conservatively present in approximately 40% of our population –big discrepancy there."

I was told that celiac disease = gluten intolerance/sensitivity; i.e., you either have it or you don't.

Nice question and thanks for asking it!

Let's start with the comment equating celiac disease to gluten intolerance/sensitivity. First of all you are correct - you DO either have it or you don't. Gluten sensitivity is genetic and the sooner it gets diagnosed the better your health will be.

While it is true that every celiac is gluten sensitive, the reverse doesn't hold up. In other words, not every gluten sensitive patient has celiac disease. The problem really arises from the incorrect equating that has been going on for so long in the medical community. It has been thought, for a very long time, that if a patient did not have celiac disease then they weren't gluten sensitive. And because celiac disease is relatively rare, looking for it as the root cause of a patient's symptoms was definitely no where near the top of this list for most M.D.s. It is this very misconception and the resultant patients who continue to suffer due to not being properly diagnosed, that was the driving force behind writing my book. What we kept seeing in the practice was patients who clearly couldn't tolerate gluten but who did not fit the classic narrow diagnostic criteria for celiac disease - which is villous atrophy (just think degradation of the small intestine).

Insisting that a patient is fine unless they have villous atrophy is akin to saying a person with very high cholesterol is fine unless they have a heart attack.

Add the above misconception to the fact that only 1 in 8 of those people suffering from celiac disease are diagnosed and you begin to see not only the magnitude of the problem but why it is that the average celiac patient takes 10 to 15 years to be diagnosed.

Gluten sensitivity is truly "the elephant in the room" that no one has been seeing!

In response to the first part of the question from the reader I'm going to include a little snippet from Chapter 8 of my upcoming book on gluten sensitivity.

For every one Celiac disease patient, there are eight who have asymptomatic gluten sensitivity.[9] It is estimated that between 35-50 percent of our population have some form of gluten sensitivity.[10] We understand more about our immune system now, and also we have many blood tests and other procedures that help us “see” how gluten affects some people. But we are just scratching the surface. It is not a surprise that a protein in our diets that has been causing bone, dental and nutritional changes for centuries still is not fully understood in its full scope of effects. Gluten has stealthily hidden itself from obvious view and continues to do so for much of the traditional medical community (a mistake we hope to correct with this book).

[9]. The Iceberg Cometh: Establishing the Prevalence of Celiac Disease in the United States and Finland,Gastroenterology Vol.126, No.1, Jan. 2004, 359-361.

[10]. EnteroLab. “Early Diagnosis of Gluten Sensitivity: Before the Villi are Gone,” June 2003. Kenneth Fine, M.D.

According to a New England Journal of Medicine in 2007, a gluten-free diet is a valid means for diagnosis of gluten intolerance. This is a very respected medical journal and this statement will hopefully be getting the attention it deserves.

Wednesday, August 13, 2008

If you have Celiac disease or are gluten sensitive?

If you have Celiac disease or are gluten sensitive, you're probably used to this question. "How would I know if I had a problem with gluten?" "What would I feel?"

Whether it's asked by a concerned friend or a curious waitperson at a restaurant, once someone knows that you're gluten sensitive, the question mentioned above usually comes into the conversation.

Most people assume that if you were having trouble with a food you'd have a digestive complaint. While that is often true with gluten sensitivity, 2/3 of the time it isn't. Next to the digestive tract, the next most afflicted system from gluten sensitivity is the immune system. Why? What health problems might that cause? Glad you asked! Read on...

When gluten comes into the body of a gluten sensitive person, the body is unable to digest the protein. Instead it invokes a response similar to when a toxin enters the body and the immune system launches that response.

If you consider the frequency with which we consume gluten-containing grains in this country you start to get the idea of how often the immune system would get called into action. After years and years of several times per day responses, the immune system starts to get worn down in the intestine.

Considering it is estimated that the intestines are confronted with a pathogenic organism every 10 minutes in a normal person, the now weakened immune system of a gluten sensitive person is often unable to adequately defend itself and an infection can occur.

These intestinal infections can cause a myriad of problems but not always the one you'd assume, which is diarrhea. Countless times patients who suspected infections were told by their doctor that since they didn't complain of diarrhea there was no reason to test them. After two decades of experience I can tell you that is not the case.

The presence of gluten not only weakens the immune system of the intestine but it also degrades the very structure of the intestine itself. This compromises the intestine's ability to do its job of absorbing the nutrients you consume. Once again your intuitive thought might be that if you were malaborbing your nutrients you'd probably be losing weight. That is usually not the case. When you malabsorb your cells go into starvation mode, your metabolism decreases, and often the body starts to gain weight!

Therefore obesity is a sign of malabsorption. Most physicians in this country equate gluten sensitivity with Celiac disease. Celiac is suffered by approximately 1% of our population. Research estimates that gluten sensitivity is conservatively present in approximately 40% of our population – big discrepancy there. So not only does it take the average person suffering from Celiac disease a decade to receive their diagnosis, another 40% of the population is suffering with the same problem, gluten sensitivity, and never being diagnosed.

That is why this blog came into existence. And that’s why I just finished writing my book on gluten. (Hold for publish date, it’s only just arrived in the editing department.)

So, let’s get back to the immune system and why 2/3 of the time patients have non-digestive complaints.

We talked about the fact that the small intestine begins to structurally degrade and how that can cause malabsorption. Obviously if you are not absorbing adequate nutrition from your food, your cells will not get properly nourished and that can create multiple problems. But the loss of structural integrity also creates an interesting problem. Imagine that your intestine is a very sieve with microscopic holes. The holes are so small to ensure that food gets properly digested before it enters the bloodstream. But when the integrity is lost it affects the size of the holes as well. The microscopic holes actually get enlarged. This is knows as increased intestinal permeability, or “leaky gut”.

The significance behind “leaky gut” when it comes to a person suffering gluten sensitivity is that partially digested gluten proteins make their way out into the bloodstream via these enlarged “holes”. The immune system of the bloodstream marks this protein as an invader and mounts a response to destroy it. Unfortunately, the make-up of the gluten protein is very similar to the structural make-up of some of the parts of our body. After seeing this protein and attacking it as a foreign invader the immune system starts to see other extremely similar proteins in the body and mistakes them for gluten. This is known as “molecular mimicry” and it is at the root of why gluten sensitivity is associated with various auto-immune diseases such as cancer, diabetes, thyroid disease, arthritis, osteoporosis and more.

Simply speaking your own immune system confuses your body parts for gluten and starts destroying them.

It is exciting to work with such patients who have been given no hope for their condition other than dangerous drugs which suppress their immune system. The immune system doesn’t need suppressing it simply needs to stop reacting gluten and confusing other body parts for gluten. That is done by removing gluten from the diet and building up the immune system – not beating it down with drugs.

So when someone asks what symptoms are associated with gluten sensitivity, let them know that while the list is long, it’s also very treatable. It includes such things as:
Autism
ADD
Arthritis
Cancer
Depression
Diabetes
Fatigue
Fibromyalgia
IBS
Memory problems
Obesity
Osteoporosis
Skin problems
Thyroid Disease

To your good health,
Dr Vikki Petersen

Wednesday, July 09, 2008

Yesterday I posted part of the Introduction to our upcoming book about Gluten Sensitivity. As someone commented on its need for editing I want to address that by letting you know that you are viewing the "pre-edited" version. We're doctors, not editors, so please excuse the rawness of this material. I promise you it will be formally edited prior to publishing!

We look forward to hearing your comments and plan to post some more "snippets" soon.

Tuesday, July 08, 2008

I have to admit that I've been a bit of a "bad blogger" these past few months. I'm hoping the fact that I, along with another Gluten Doctor, have been writing a 350 page book on gluten is an adequate excuse!

We're very excited about this book because we believe that not only will it be a reference book for many suffering from gluten related health issues but it is literally the first of its kind. There are several books about celiac disease as well as several books about gluten-free cooking. But to the best of our knowledge there isn't a book which makes the distinction between celiac disease and gluten sensitivity while providing an abundance of scientific references to support the cause and effect relationship between gluten and such conditions as arthritis, thyroid disease, diabetes, IBS, etc.

I have included a bit of the book's introduction here and I would appreciate feedback about it.

Introduction

If you’re picking up this book in the hopes of finding an answer to your health problems, you have the right frame of mind. This book is about gluten sensitivity and its under-appreciated ability to have far reaching negative effects upon your health. The decision to write a book about gluten came as a result of an amazing phenomenon that occurred repeatedly throughout many years of practicing a method of medicine that focuses on identifying the root cause of a patient’s health problem which we call The HealthNOW Method. Again and again we had patients describing to us how significantly their lives had changed as a result of discovering that they were gluten sensitive. We write this book to inspire you to seek out the root cause of your health problem and to help you discover if the root cause of your illness is gluten sensitivity.
It has now been more than fifteen years since we became interested in the effects of gluten on our the health of our patients. At that time, even the most commonly known form of gluten sensitivity, Celiac Disease, was a rare diagnosis. What is even more startling is the fact that Celiac Disease is diagnosed in only a small fraction of affected individuals even today. Why is this? The biggest reason is lies in how standard medicine approaches health in general. Patients with gluten sensitivity, we have found, demonstrate many different symptoms. Likewise, the symptoms are usually nonspecific which means they could result manifest from many different health conditions. As a result, more common conditions are investigated first and sometimes the under-appreciated disorders such as gluten sensitivity go unnoticed.
Vikki’s mother was such an example. In addition to having many medical problems including an adrenal gland dysfunction, she had long suffered from constipation, chronic headaches, fatigue, low blood sugar, constipation and a host of gastrointestinal other complaints. She had undergone many tests and examinations, but none of these had given her an answer. Medicines were prescribed, treatments recommended, but in the end, the symptoms stayed the same. We had just begun investigating gluten sensitivity in our office, and when we tested Vikki’s mother for anti-gliadin antibodies. This is a test to see if the body’s immune system is reacting to gluten in a negative way. Well, to our surprise, she had elevated levels of these antibodies. Even more intriguing was the fact that she responded dramatically well to a gluten-free diet. Her headaches, low blood sugar symptoms and constipation resolved after having suffered for well over 50 years. Today she is a vibrant, healthy 85 year-old that takes no medication and by her own statement considers that she is in “the best health of her entire life”.
To drive home the point even further, 15 years ago our newly born daughter had been having persistent problems with projectile vomiting. When this is an ongoing problem, believe us that when we say you try to find an answer as quickly as possible. Not only is it painful to see your child suffer, but the mess is not much fun either. After Vikki’s mother was found to react poorly to gluten, and knowing that this can run in families, we tested our daughter as well. Sure enough, she likewise demonstrated gluten sensitivity and responded very nicely to the elimination of gluten in her diet. This started our crusade to evaluate the effects of gluten on people’s health.
But what is gluten? You have maybe heard of it in recent years with gluten-free foods being sold at health stores, and the rash of gluten-free recipe books in the bookstores now. But what is it? And what is gluten sensitivity? Gluten is essentially the major protein component of wheat, rye, and barley and to a lesser extent oats As it is metabolized or broken down, it can give some people tremendous problems particularly along their digestive tract . In short, the body’s immune system can see it as an infectious a toxic protein and can launch an attack against it (as if it were a virus) which can it also damages you’re the body’s tissues that harbors it (for instance the intestinal lining). Secondarily, you can develop a multitude of symptoms depending on what is organ system is affected, how severely it is, and what other problems occur later as a result of the prolonged damage. In short, the body’s immune system can see it as a toxin and therefore launches an attack against it. Varied and multiple symptoms are created depending on what tissues of the body are attacked.
Are you ready to consider a fresh approach to your health? Are you interested in finding what the underlying cause is rather than what is currently happening to your body merely masking your symptoms? So are we. If you suffer from cramping, nausea, chronic bowel problems, or stomach pains, the information in this book about gluten could be what you have been seeking. If you have chronic fatigue, sleep difficulties, depression, memory difficulty, or anxiety, you will want to hear about how gluten affects the nervous system. If you have joint pains, rashes, chronic pain, weight issues, or menstrual problems, don’t rule gluten out as a potential base cause to your symptoms. If you are constantly getting infections or have other immune or autoimmune disorders, gluten certainly is worth your time. While all of these complaints are varied in nature, their appearance occurrence reflects how gluten may “stress” your health individually.
It wasn’t until the 1970’s that we clinicians even appreciated how “bad” cholesterol and fats in our diet caused heart disease and stroke. But since that time, attention to these dietary components has significantly decreased these diseases. Likewise, we are just now understanding the effects that simple sugars have on our body’s ability to produce insulin and regulate glucose in relationship to diabetes and glucose intolerance. Diet has always been a major influence on our health, and truly we are what we eat. New vitamins, minerals and herbal nutrients continue to be discovered decade after decade. This is such a virgin field in this modern era of medicine, even though it would seem to be so basic. It is no wonder then that we are only now embracing how gluten can affect our bodies. This wheat protein in wheat, rye and barley has been around for thousands of years. But its evolution, and its growing appearance in our diets, has finally caught our attention. For many of you, it indeed may be the root cause to your symptoms. As we have stated earlier, the reason we have written this book is because of experiences with our patients. We love helping people get healthier so that they can live life to it fullest without having any attention on their body. Illness and symptoms keep a person from fully experiencing and fully participating in life. We believe life is meant to be lived, full-out with no stops.

Wednesday, July 02, 2008

Lose Weight for the Summer!

Come get information on the following:
  • What are the 5 secrets to Permanent Weight Loss?
  • What foods tend to make us store fat-Hint: It's not what you think!
  • Did you know that where you carry your weight tells you much about what diseases you'll be prone to get?
  • Learn what causes you to crave certain foods.
Make your desire to lose weight a reality!



Join us Wednesday, July 23rd 2008 at 7 p.m.
HealthNOW Medical Center
Call 408-733-0400 to reserve your seat.
It is FREE!!

Wednesday, June 04, 2008

Gluten Sensitivity Lecture

Back by Popular Demand and on a NEW Night!

This lecture contains new information and is unlike previous lectures we've given before.
You won't want to miss it. Included is the most current research on gluten and its effects on:

· Diabetes
· Neurological disorders
· Obesity
· Anxiety/Depression
· Autoimmune Diseases
· Muscle/Joint Pain
· Asthma
· Eczema
· Thyroid Disease
· Liver Disease

· Diabetes
· Neurological disorders
· Obesity
· Anxiety/Depression
· Autoimmune Diseases
· Muscle/Joint Pain
· Asthma
· Eczema
· Thyroid Disease
· Liver Disease

· Diabetes
· Neurological disorders
· Obesity
· Anxiety/Depression
· Autoimmune Diseases
· Muscle/Joint Pain
· Asthma
· Eczema
· Thyroid Disease
· Liver Disease

· Diabetes
· Neurological disorders
· Obesity
· Anxiety/Depression
· Autoimmune Diseases
· Muscle/Joint Pain
· Asthma
· Eczema
· Thyroid Disease
· Liver Disease

· Diabetes
· Neurological disorders
· Obesity
· Anxiety/Depression
· Autoimmune Diseases
· Muscle/Joint Pain
· Asthma
· Eczema
· Thyroid Disease
· Liver Disease

· Diabetes
· Neurological disorders
· Obesity
· Anxiety/Depression
· Autoimmune Diseases
· Muscle/Joint Pain
· Asthma
· Eczema
· Thyroid Disease
· Liver Disease

· Diabetes
· Neurological disorders
· Obesity
· Anxiety/Depression
· Autoimmune Diseases
· Muscle/Joint Pain
· Asthma
· Eczema
· Thyroid Disease
· Liver Disease

· Diabetes
· Neurological disorders
· Obesity
· Anxiety/Depression
· Autoimmune Diseases
· Muscle/Joint Pain
· Asthma
· Eczema
· Thyroid Disease
· Liver Disease

· Diabetes
· Neurological disorders
· Obesity
· Anxiety/Depression
· Autoimmune Diseases
· Muscle/Joint Pain
· Asthma
· Eczema
· Thyroid Disease
· Liver Disease

      • Diabetes
      • Obesity
      • Autoimmune Diseases
      • Asthma
      • Thyroid Disease
      • Neurological disorders
      • Anxiety/Depression
      • Muscle/Joint Pain
      • Eczema
      • Liver Disease
When: TUESDAY, June 24th 2008 at 7 p.m.
Where: HealthNOW Medical Center
How: Call 408-733-0400 to reserve your seat.
Cost: It’s FREE!
Please bring family and friends who are having health problems