Thursday, December 31, 2009

Gluten Sensitivity Diagnosis is Accepted

It is December 31st so a little reflection is in order. 2009 was a big year for us personally as it was the year that the dream of publishing our book reached fruition.

“The Gluten Effect” was a combined labor of love and passionate mission. As clinicians we literally stumbled upon gluten 15 years ago as we analyzed patients for food reactions. As more and more patients were discovered to be sensitive we were literally amazed at the panoply of reactions associated with these supposed “innocent” and “healthy” grains.

We were initially taken aback that no one else seemed to be discussing this. Our gluten sensitive patients, for the most part, were not celiac sufferers. But they were certainly reacting to gluten and it was affecting them from their digestive tract to their nervous system to their hormonal balance to their joints. Were we hallucinating these reactions? Was there some placebo affect occurring?

I still remember so clearly discussing gluten with a mentor of mine about 8 years ago. He is a highly respected individual in the field of functional medicine and positively brilliant. I somewhat shyly proposed that he investigate gluten and gave a brief overview what I and my team were experiencing clinically. Ever the gracious gentleman, he was polite and attentive but I could tell from his reaction that he didn’t consider gluten to be a legitimate health issue.

Yet barely three years after that meeting he spoke for the first time about gluten at a national conference. Not that I needed his blessing, but if felt good to have someone I so respected begin to see what I was seeing.

About 2 ½ years ago while in the throes of writing “The Gluten Effect” with my co-author, we began to feel like renegades as we came to the realization that despite all the scientific research that we had to hand that supported our work, most of our fellow clinicians were completely unaware of it.

We braced ourselves for some disbelief and opposition.

About that same time I spoke to a leader of a national celiac group. This individual is absolutely passionate about educating Americans about celiac disease and decreasing the amount of time that it takes to receive a diagnosis. But when I discussed gluten sensitivity with her, she really had absolutely no information about it.

A mere year later she was completely on board due to some personal experiences she had with people close to her. They were ill, not celiac, but removing gluten from their diet completely resolved their health issues. She was convinced but what ensued was some infighting with traditional MDs who worked within her organization. She even had her grant money threatened for a period of time.

The happy ending is that, fortunately, scientific research caught up with the clinical observations we were witnessing in our patients and gluten sensitivity was validated this year from many previously skeptical experts including Dr Peter Green and Dr Alessio Fasano.

So while that “war” is over there are many battles ahead. We still have a traditional medical community that thinks celiac disease is impossible unless a patient has unrelenting diarrhea and is severely underweight. These clinicians believe that an intestinal biopsy is still the gold standard for diagnosis and that without complete obliteration of the intestinal villi, gluten can’t possibly be a problem for a patient.

On the other hand, research just came out in the British Journal of Nutrition whereupon they analyzed a group of non-gluten sensitive individuals who expressed a much healthier balance of microflora (good bugs) in their intestines after a 30 day gluten-free diet than was present prior to going gluten-free.

Does this mean that gluten isn’t good for anyone? Is there something truly pro-inflammatory in these grains such that they spell ill health for all who consume them?

Or, if a truly healthy small intestine could be achieved would tolerance to gluten rise, as some researchers postulate? And is dairy the underlying culprit that causes the initial irritation thus “allowing” gluten to create its inflammatory effects?

And will all these questions be answered in the New Year?

I for one (and my team) are already diligently working on these issues and if the timing continues to occur as it has been, just about the time we feel confident in stating our findings, there will be ample scientific research to corroborate them.

I am very excited for 2010. I am anticipating meeting more of my readers as many have already come to visit our Destination Clinic from around the world this past year. We are expanding our clinic quite dramatically this year to better educate and treat all who seek better health.

As always, please let me know your thoughts and how I may help you.

To your good health in 2010!

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Monday, December 28, 2009

Avoid High Fructose Corn Syrup in a Gluten Free Diet

We have spoken before about healthy diets. There has been mention of what to include and what to avoid but there is a substance I neglected to mention in earlier posts and it deserves your attention.

High fructose corn syrup (HFCS) is not only unhealthy due to its ill effects on blood sugar and insulin resistance, but during its production mercury residues occur within. It’s estimated that the average U.S. person intakes about 50 gm of HFCS per day. This would equal about 28 mcg/day of ingested mercury!

Thimerasol in injections such as vaccinations and flu shots contain about 25 mcg of mercury per injection. Thimerasol has been removed from many injections due to the concern of mercury and its neurotoxicity. To think that the average American is potentially consuming that amount daily through HFCS is frightening.

What new research points to is that the bioaccumulation of toxins is what is creating much of the toxic load from which we are suffering. Many diseases such as Alzheimer’s, Parkinson’s, M.S., ADD and autism, to name a few, have an association with heavy metal toxicity. So while 28 mcg in and of itself doesn’t sound like a lot, when you add that to all the other toxins coming from our environment, the accumulation is overwhelming the tissues of our body,in particular our nervous systems.

I will be speaking more on this topic and other sources of avoidable toxins but in the meantime I encourage you to make this easy and healthy choice – avoid all high fructose corn syrup for you, your children and family.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Tuesday, December 01, 2009

Lifestyle and Diet - the Miracles of Functional Medicine

Imagine if you will that people were aware of the fact that food was their best medicine and much in the way of prevention would occur from a healthful diet and lifestyle. Imagine too that drugs were reserved for very serious conditions and even then used with the purpose of acting as a temporary measure until the true root cause was identified and treated.

What would this world be like? I have a dream. This dream involves everyone being aware of the option of sane health care. I’m not so idealistic as to dream that everyone would utilize such a product, but that they knew that it was available and the benefits of it, would be a dream come true for me and it is that dream that drives me to do what I do each and every day.

A friend of mine just visited Tokyo, Japan. He loved his visit and one of the aspects that struck him most was how incredibly clean the city was. He commented: “I’d have eaten off the subway floor!” No doubt a bit of an exaggeration but he makes his point. Add this almost unbelievable cleanliness to the fact that this city positively teems with citizens and you begin to ponder how it happens. I asked him if he saw a lot of people who were responsible for keeping the city clean. (I was thinking of Disneyland where one constantly sees an employee sweeping and cleaning.) His response was no, but rather it seemed an ingrained habit of the people to maintain cleanliness. It’s a bit amazing when you think of it.

My friend continued to say that when he returned to his home in San Francisco he was almost sickened by the dirt of the city in comparison to Tokyo.

Of course this conversation had me quickly leaping to my favorite topic of healthcare and I began to dream my favorite dream – what would happen if we could alter our culture of health along the lines of Japanese cleanliness. While it’s overwhelming to think of “cleaning up” downtown San Francisco, what if everyone suddenly got the idea of keeping their surroundings clean? How long would it take to have a clean city?

Similarly if everyone got the idea of natural healthcare and the importance of lifestyle changes such as diet and exercise, how long would it take to have a healthier society? Fortunately this is not a rhetorical question. Some of my personal heroes from the field of Functional Medicine have some very exciting statistics to support my “dream”.

Listen to this from the following clinicians who posted this article a few months ago:

Rescuing Health Reform: Why Doctors Should Practice Lifestyle Medicine
September 15, 2009
Mark Hyman, MD, Dean Ornish, MD, and Mike Roizen, MD


Mark Hyman is Vice Chair of The Institute for Functional Medicine, Dean Ornish is Clinical Professor of Medicine at the University of California, San Francisco, and Mike Roizen is Chief Wellness Officer and Chair of the Wellness Institute at Cleveland Clinic

Recently, at a small gathering in Martha’s Vineyard, the economist Larry Summers spoke about the nation’s narrow escape from economic depression. Dr. Summers addressed the even larger impending risks to our economy if the costs of health care are not successfully addressed now.
He was asked how we could control these costs without tackling the root causes of the problem. The chronic diseases that affect 160 million Americans account for 78% of our $2.1 trillion in annual health care costs. Lifestyle and environmental factors –our diet, sedentary lifestyle, smoking, and chronic stress—are the most important underlying causes of these diseases.
But most believe that doctors don’t “do” lifestyle. Dr. Summers dismissed “lifestyle” as a community and public health issue that was already included in the current plan. He didn’t understand that physicians can and must do lifestyle medicine to effectively treat disease and dramatically reduce health care costs. Lifestyle factors leading to chronic diseases such as heart disease, diabetes, obesity and cancer are the domain of doctors and not merely a “public health problem.”

Lifestyle medicine is not just about preventing chronic diseases but also about treating them, often more effectively and less expensively than relying only on drugs and surgery. Nearly all the major medical societies recently joined in publishing a review of the scientific evidence for lifestyle medicine both for the prevention and TREATMENT of chronic disease. http://www.acpm.org/LifestyleMedicine.htm. There is strong evidence that this approach works and saves money. Unfortunately, insurance doesn’t usually pay for it. No one profits from lifestyle medicine, so it is not part of medical education or practice. It should be the foundation of our health care system.

For example, the recent “EPIC” study published in the Archives of Internal Medicine studied 23,000 people’s adherence to 4 simple behaviors (not smoking, exercising 3.5 hours a week, eating a healthy diet [fruits, vegetables, beans, whole grains, nuts, seeds, and low meat consumption], and keeping a healthy weight [BMI <30]). In those adhering, 93% of diabetes, 81% of heart attacks, 50% of strokes and 36% of all cancers were prevented.

“Prevention” therapies as written into current health care bills are public health and community based wellness initiatives, or payment for early detection of disease with mammograms, colonoscopies and other screening tests. As the Congressional Budget Office recently indicated, early detection without treating the major underlying causes of chronic diseases—our lifestyle choices—may actually add to costs.

While health insurance reform is important, it is insufficient. We must not only change who is covered but also what is covered to include personalized lifestyle medicine if we are to make current treatments more effective and less costly.

When the underlying lifestyle causes are not addressed, medications to treat chronic diseases usually have to be taken for a lifetime. If the causes are addressed, patients are usually able to reduce or stop taking these medications and often avoid surgery (under their doctor’s supervision).


Personalized lifestyle medicine is a high-science, high-touch, low-tech, low-cost treatment that is more effective for the top five chronic diseases than our current approaches. If lifestyle treatments were applied to all patients with cardiovascular disease, diabetes, metabolic syndrome (obesity), prostate cancer, and breast cancer, then net health care expenditures could be reduced by $930 billion over 5 years, according to analysts from the Cleveland Clinic. This will result in dramatically better health and quality of life.

On August 6, 2009, Senator Ron Wyden [D-OR] introduced new legislation, the “Take Back Your Health” Act (S. 1640) that includes payment for intensive lifestyle medicine as treatments, not just prevention. This legislation has bipartisan co-sponsorship by Senator John Cornyn (R-TX) and Senator Tom Harkin (D-IA).



So as you can see, not only is this dream shared by others, but it’s a dream that’s validity is already substantiated by research.

Please show your support for this in any way that you see fit, and as always, let me know how I can assist you in any way.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Monday, November 30, 2009

It Takes Time to Heal from Gluten Damage

I’ve always been a believer in simplicity. I’ve found that most things that seem overly complicated usually have something inherently wrong with them.

But is “simple” the same as “fast”? No. And the reason I bring this up is that we are currently living in a “one pill” for “one symptom” society. Take a pill and feel better. It’s one of the many reasons so many continue to suffer a multitude of health problems due to gluten – the concept of changing their diet seems unconfrontable to them. They’re waiting for that “pill” that they can swallow which will allow them to continue to eat gluten. Not that I’m adverse to the advancement of science, but what about in the meantime? How many are suffering needlessly because they are swept up in the mentality?

Over the Thanksgiving holiday a friend was speaking to me of her teenage daughter. Her daughter is a very talented young lady who is not in the best of health. She has a skin condition, amongst other issues, that sounded like hives as her mother described it to me. Despite having spent a little time under my care, her mother asked me what her daughter could “take” for the problem.

In my mind this translates as follows: “What chemical can I put into my daughter’s body such that the outward symptomatic manifestation is masked while absolutely nothing is benefited as regards the root cause of the problem?”

I’m not trying to be harsh, nor am I trying to say that there is never a place for a palliative “band-aid”. But at least while you’re applying the band-aid it would be great if you appreciated the temporary nature of it and simultaneously strived to truly unravel why your body was expressing that particular symptom. Because know this, there’s always a reason underlying the body’s symptoms.

Does this make sense?

Is it a surprise to learn that drugs don’t correct, but rather, mask symptoms?

Here are the facts: The human body is an amazing machine capable of an incredible amount of self-healing when given the correct raw materials to do so. When you realize that gene expression can be altered depending on the nutrients present in your body, you should be very impressed with the body’s ability to heal itself.

Is getting to the root cause of a symptom a complicated issue? No, not at all. Is it fast? Sorry but the answer is again “No”. Now when you take a patient who has been suffering for decades and in several months turn their health around, that may very well be considered “fast” in some people’s minds. So that’s not what I’m referring to. What I’m trying to address is the “take a pill” and feel different in a few hours mentality. That, in my opinion, is what’s getting us into trouble and creating the tremendous numbers of degenerative diseases we have in this country.

It has been estimated that we could save 78% of what we pay for health care if we could just start making healthy lifestyle changes. Is it “complex” to change your diet? No. There are some simple rules and you simply need to follow them. Is it “fast”? No again. It’s something you need to embrace as a lifestyle choice and do every day.

We are always amazed here at the clinic at the number of patients who are simply astounded to discover that what they eat can make them feel so much better. And they usually exclaim: “This is so simple. I never would have believed it!”

So whether you are removing gluten and dairy from your diet (a great start!) or simply beginning to eat “real” food like whole grains (start with the gluten-free ones please), fruit, vegetables, and shunning the artificial sweeteners, colors, refined starches and sugar – give it some time. Three weeks is the minimum amount of time required to change you taste buds and the cells lining your intestine.

So be patient and remember – big health changes can come in easy, uncomplicated (but not fast) packages. And if you’re a parent it’s not too soon to start teaching these lessons to your children. Such lifestyle changes can impact our future generation’s health in a very positive way.

Please let met know if I can answer any further questions.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Monday, November 23, 2009

Gluten Sensitivity and the Flu

(and why I don’t recommend the use of antibacterial soaps and hand sanitizers)

If you’ve been off gluten for a while, your vitamin D status is optimum (>50) and your small intestine is well healed, you’re probably going to sail through the flu season with no problems. A healthy immune system (and remember 70% of your immune system is housed in your intestines) should stand you in good stead despite the presence of inhospitable viruses.

However if you have been recently diagnosed (less than 1 to 2 years ago) or are just beginning to make changes in your diet due to a suspicion of gluten sensitivity then there are some important steps to take to optimize your immune system as quickly as possible.

First, do get your vitamin D status evaluated and begin supplementing with vitamin D3. As mentioned previously, vitamin D3 is superior to vitamin D2 for normalizing D status so ensure that you use the correct form when supplementing.

Second, begin taking a good probiotic. Probiotics help support the immune system, are best taken with meals and are quite safe. Rarely, patients feel worse on a probiotic and in those cases we perform a stool analysis to evaluate for the presence of pathogenic organisms. A good probiotic will provide billions of organisms per capsule and be a blend of such species as Lactobacillus, Bifidobacterium and Saccharomyces boulardii.

Third, I like to recommend that you don’t stock up on antibacterial soaps and hand sanitizers. The major ingredient in such items is a chemical called triclosan which has been accused of creating antibiotic-resistant germs. Not only that but recent research (Environmental Science and Technology 2006) shows it to be responsible for speeding the transition of tadpoles into adult frogs. I understand that you may be thinking, that’s nice but I’m not a frog… Read on please.

Triclosan has the ability to disrupt the balance of hormones in animals as well as humans. In addition is has been found to contaminate mothers’ breast milk.

Some researchers postulate that triclosan causes thyroid hormones to be more potent as it appears that it requires the presence of thyroid hormones to cause its negative actions. Others are stating that it’s acting as a xenoestrogen, a proposed cause of such conditions as thyroid disease, endometriosis, early onset of the menstrual cycle in young girls, breast cancer and infertility to name a few.

While it’s definitely important to wash your hands and keep good hygiene to prevent the spread of disease, antibacterials are likely posing more problems than benefits and I’m very concerned about the increasing numbers of xenoestrogens in our environment.

Lastly, especially with the holiday season upon us, ensure that you get adequate rest, be vigilant on your diet, take a good vitamin C, A and zinc, and stay hydrated.

Please let me know if I can be of any assistance.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Wednesday, November 11, 2009

Gluten Intolerance and Probiotics

A very exciting new discovery has been made regarding the population of probiotics (also known as the microbiome) in your intestine and how it affects your risk of gluten sensitivity and leaky gut.

Just as an aside, I’ve had a few people ask me if “leaky gut” is a real phenomena. Also known as “increased intestinal permeability”, leaky gut is not only real but a quick internet search will show that such respected journals as the Journal of Hepatology, Gastroenterology, the British Medical Journal, the Journal of Allergy and Clinical Immunology, Digestive and Liver Disease and the Journal of Pediatrics, to name a few, have multiple scientific studies focusing on the importance and effects of a leaky gut on health. There are literally hundreds of articles that focus on this issue. Okay, sorry for the digression.

What are probiotics? A major constituent of the intestinal immune system consisting of 100s of trillions of organisms. You have more (at least you should have) of these organisms in your gut than you have cells in your body!

It’s estimated that 70 - 80% of your immune system is housed in your gut. This is why we spend as much time as we do ensuring that our patients’ digestive systems are working optimally. More and more research is supporting the premise that without a healthy digestive tract, good health is all but impossible.

Not only do these good bacteria help defend you against infection but the new research that was just released shows that they have an ability to modify gene expression.

What does this mean? The researcher was evaluating why certain people “turn on” celiac disease and gluten sensitivity at different ages. If it’s genetic, as we know it to be, then why doesn’t that first teething biscuit or gold fish cracker begin the symptoms of gluten sensitivity? It does in some of course but for many the symptoms begin in later decades of life.

Dr Alessio Fasano believes that it’s not enough to have the gene and have the presence of gluten, but there must be a third factor, an initiator, that creates an insult to the gut enough for gluten to then be able to cause its inflammation and subsequent damage.

It’s like the spark that begins the forest fire. You can have a windy day and dry tinder but you need the spark to begin the decimation.

Dr Fasano believes that the “spark” is an unhealthy balance of good and bad probiotics in the gut. The good ones are protectors, but the bad ones are initiators. The make-up of probiotic populations actually have the ability to turn on and off genes at will.

This is terribly exciting and at the very least should have you interested in “who” is being housed in your intestines! There is a simple lab test that provides the data and treatment is similarly easy but very beneficial.

I hope this helps.

p.s. New Discovery - Appendix Provides an Important Function!

Did you think it was unlikely that you possessed a body part that had no function? I know I did. Well after a very long wait the reason why we have an appendix has been discovered.

It turns out that the appendix houses probiotics. Don’t worry if your appendix was removed. You can still restore health to your intestines.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Monday, November 02, 2009

Gluten Sensitivity & Vitamin D, an Update on Supplementation

As I’ve said before, if you don’t like change then the field of clinical nutrition will not be a happy place for you. Fortunately I love the evolution that my field goes through and I am happy to share the changes with you.

So here’s the latest update on vitamin D supplementation.

A deficiency of vitamin D is a serious condition that affects not only those with gluten sensitivity but as well the general population. Bone density and increased cancer risk are just two of the dangers posed by a deficiency of this important nutrient.

Due to the damage suffered by the small intestine in those sensitive to gluten, absorption of fat soluble vitamins such as D is inhibited.

The “normal” that we should strive for in the blood has consistently risen as the importance of vitamin D has been revealed. Currently it is thought that a level of 60 ng/mL is optimal. Just several months ago I believe we were citing that a value of 40 was adequate with 50 being the target when there was a prior history of cancer.

The treatment options have similarly been refined with the publishing of an article in a French medical journal specializing in internal medicine. While it was previously thought that severely deficient levels of vitamin D would respond beneficially to high doses of vitamin D2 (50,000 IU) taken once per week for about 3 months, that protocol was dismissed with this research. The scientists revealed that D2 is much less effective than D3 due to its shorter half-life and lowered affinity for the vitamin D receptor, making vitamin D3 the recommended form for supplementation.

Here at the clinic we use a liquid form of D3 that’s more bio-available for enhanced absorption. Typically a dose of 5,000 IU in a deficient patient will improve their profile over the course of several months.

Needless to say adherence to a gluten-free (and likely dairy-free) diet is also needed to ensure absorption occurs.

I heartily recommend a blood test to discover your serum vitamin D levels. It’s simple but extremely important.

Please let me know if I can answer any questions in this area.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Tuesday, October 20, 2009

Depression & Gluten, A reader's success story

I received this uplifting email from a reader today. I thought it might brighten your day and encourage you to share the data with anyone you know suffering from nervous system problems such as depression, anxiety, autism and the like.

The devastation such symptoms cause to not only the patient but their family is difficult to measure. Yet the dramatic results when the correct solution is implemented are a joy to behold!

Enjoy this success story:

Hi there,

I have been gluten-free for two weeks.

Within the first few days, I no longer suffered from depression, panic attacks, anxiety and obsessive compulsive disorder.

In the past my thoughts raced constantly and I found it impossible to withstand noise of any kind - even a radio.

Now my mind is clear, I can tolerate noise more easily, my spots are decreasing. (I cut out both sugar and milk from my diet last year, but the spots still stayed).
I had no abdominal pains or issues - only mental health issues.

To go from deeply unhappy to very well within a matter of days is truly remarkable.

My friend's son has autism and she has him on a gluten-free diet. Within two weeks, his headbanging stopped completely and his emotional outbursts decreased.

You probably hear anecdotal evidence on a regular basis, but I wanted to share with you, just how remarkable 'the freedom of being gluten-free' truly is.


I am excited about your blog - because it articulates the problem with gluten so well, which makes it easier for me to understand and to describe to others.
I would love to find ways of encouraging and promoting the awareness of the link between gluten and depression - if you have any ideas, please let me know.

In deepest appreciation for the work you do, with your words of confidence, passion and hope in your articles.
Thank you for your common sense!


Best wishes,
M.R.


To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of "The Gluten Effect"

Friday, October 16, 2009

Dairy Creates Intestinal Damage

A reader wrote the following:
I would like to learn more about dairy causing a leaky intestine.
Is it all dairy? Just cow’s milk? Goat’s milk? What about fermented dairy, yogurt and cheeses? Does pasteurization matter? Age of introduction? What about cream and butter?

If it hasn't apparently caused a problem for an adult, does it continue to be safe or is it a ticking time bomb?

The mechanism behind dairy causing the damage it does lies in several areas:

1. It stops the formation of glucosamine in the gut lining, thereby creating a leaky gut. (Glucosamine is known to help repair the mucosal-lining defensive barrier in our small intestine.)
2. It impairs immune system development in the gut and the maturation of important immune cells known as T helper cells – this can lead to autoimmune disease, asthma, allergies.
3. The milk from other mammals is too high in protein and phosphorus and the protein damages the gut lining.
4. Dairy products are highly chemically laden, the highest per gram of all food, and are thereby toxic to the gut lining.
5. Dairy creates a mucous “slime” in the lining of the gut that prevents the absorption of some nutrients as well as causing gut inflammation.

As a former dairy-lover, I understand the hopeful questions about yogurt, cheese, pasteurization, goat, sheep, etc. Unfortunately if it’s made from the milk of another mammal it’s not beneficial for us. Humans are able to digest their mother’s milk for the first few years of life only. After that they should no longer have it or anyone else’s milk.


I do have one piece of good news – Butter!

Butter is mostly fat and has very few milk solids. Therefore it is fine to consume for most people and the negative effects of the dairy protein are all but absent.

I would caution you to purchase organic butter because hormones are made from fat and we really want to avoid as many exogenous estrogens as possible.

Enjoy some butter!

Until next time, I wish you good health.

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

A Healthy Organic Gluten-free Diet

There is a “dirty dozen” currently amongst are fruits and vegetables. One receives this moniker by being one of the top twelve fruits or vegetables with the highest pesticide load.

We’ve been speaking lately about what a healthy diet entails and the importance of eating organic as much as possible. But what if you can only mostly eat organic? Is there a “Must” category?

Yes. When it comes to the “dirty dozen”, they are so bad that it would be better to forego eating them altogether if you can’t get the organic variety. Here they are:

1. Peach (worst)
2. Apple
3. Sweet Bell Pepper
4. Celery
5. Nectarine
6. Strawberries
7. Cherries
8. Kale
9. Lettuce
10. Grapes – imported
11. Carrot
12. Pear

Some of these are true staples of the American diet. Sorry to be the bearer of bad news, but better you know the truth than eat the “innocent” apple in ignorance.

If you enjoy fruit like peaches and strawberries, I might suggest the frozen organic variety when they’re not in season fresh. The frozen variety are great for smoothies and available pretty much year round.

Until next time, I wish you good health.

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Wednesday, October 14, 2009

Autoimmune Disease Relates to Gluten Induced Leaky Gut

We have spoken about increased intestinal permeability also known as a “leaky gut” before. We have also discussed autoimmune disease and its link to gluten. But considering that all autoimmune diseases when taken as a whole comprise the third leading cause of death, I would like to take this opportunity to delve into this further.

Celiac is an autoimmune disease. It’s the only one thus far that can be definitively “turned off” with an environmental change – namely eliminating gluten from the diet.

The root cause beneath gluten’s autoimmune trigger begins with a predisposed individual who eats gluten with the resulting damage being a leaky gut. The leaky gut then allows partially digested gliadin access to the blood stream where the immune system reacts and “self” is damaged, hence the correct label of autoimmune disease.

New research out of the University of Maryland states that the increased intestinal permeability doesn’t only result in celiac disease, but that type 1 diabetes, multiple sclerosis, rheumatoid arthritis and inflammatory bowel disease all have leaky guts as a factor in common.

This is very exciting and certainly corroborates the clinical findings we see here at our clinic. We observe other autoimmune diseases improving once a patient gets on a gluten-free diet and starts to heal up their intestine.

Is gluten the underlying cause of all these autoimmune diseases and upon its removal healing occurs and the immune system stops being activated? Or is the leaky gut the underlying common factor and the causative agent of that loss of integrity is gluten for some but something else for others?

I don’t have an answer for you but researchers are working diligently on this issue. Speaking of research, while I love to stay up to date on the latest results, I must confess that an impatient streak would make me a terrible researcher. A study I just read about zonulin, the protein responsible for increased permeability in not only the intestine but other organs as well, revealed that it took 5 years between hypothesizing the presence of zonulin and its confirmed discovery! If you're interested these studies can be found in "The Journal Of Immunology" 2006, 176 and "Nature Clinical Practice Gastroenterology and Hepatology in 2005 Vol 2 No 9. Let’s all give a moment of thanks to these wonderfully patient men and women who dedicate their lives to the endeavor of scientific research.

Back to being a clinician, what this data does support is something we strive to do with our patients and that is to repair the integrity of the small intestine via whatever means possible.
Typically this involves:
1. removing allergens/sensitive foods
2. diagnosing and eradicating pathogenic organisms
3. recolonizing the good bacteria in the gut
4. healing the lining through the use of nutrients.

So whether it’s gluten, dairy, a pathogenic organism and/or an imbalance of good flora, the key to reversing an autoimmune tendency seems to lie in fully restoring function to that 23 feet of pipe we call a small intestine.

I’ll keep you posted as this story continues to unfold, but what you can do right now is investigate the four points I’ve delineated above and eat “real” food. Trust me, your small intestine doesn’t like chemicals and overprocessed junk food.

Please let me know if I can be of any assistance.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Tuesday, October 13, 2009

Decreasing Gluten Sensitivity for Future Generations

Scientific American, August 2009 had a nice article by Alessio Fasano, MD called “Surprises from Celiac”. In it he discussed the “Trio” of causes that create gluten sensitivity:
1. the trigger: gluten
2. genetic predisposition: nothing we can do about that one.
3. leaky small intestine

In # 1 and 3 we have some hope. It is suggested that in those infants with a suspicious genetic predisposition that restricting all gluten for the first year of life may empower the immune system sufficiently to lessen its responsiveness to gluten and tolerate it better. The research is currently occurring but preliminary findings suggest that such a delay in initiating gluten exposure may reduce fourfold that incidence of celiac.

If I was about to have a child I would definitely consider avoiding all gluten in the diet and after a good year plus had expired do a small challenge of gluten followed by an antibody test to see how the child’s immune system responded.

In the third point: trying to keep the small intestine intact and less “leaky” is something we work very hard on with our patients. It involves many steps and usually removing gluten and dairy are on the top of the list. What follows is the isolation and eradication of any unfriendly organisms, recolonization with beneficial probiotics and healing with amino acid L-glutamine and other nutrients as needed.

There is some evidence that dairy products are responsible for damaging the small intestine and creating a leaky gut. Dairy is also responsible, it is thought, for weakening the immune system. We know that Rotavirus is a culprit as an initiator of small intestine damage. Could a stronger immune system lessen the number of these infections?

All good food for thought. I believe the isolation of the underlying cause(s) of leaky gut is going to be a very important factor in restoring and maintaining good health.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Thursday, October 08, 2009

Components of a Healthy Diet When Gluten Sensitive

Once you realize gluten is not your friend and you eliminate it from your diet you are likely to feel much improved. That improvement may “flatten” after a time and you’re left feeling not quite as good as you’d hoped.

What to do?

I’ve posted before on the secondary effects of gluten and gone into the need to diagnose the presence of pathogenic organisms, adrenal fatigue, malabsorption, etc. But today I’d simply like to talk about a healthy diet.

All too often once we remove gluten, finding substitutes for all of our most favorite gluten containing foods becomes the highest priority. So you buy the gluten-free pizza crust, brownie mix, crackers, etc. In moderation that’s fine, but we still haven’t answered the question as to what a healthy diet truly is.

Obviously for you it’s not going to contain whole wheat, rye or barley. But what must it contain?

Vegetables and fruits are critical to maintaining good health and something we typical Americans tend to minimize in our diets. Every meal should contain a good amount of these, preferably fresh and organic whenever possible. Organic produce does provide a much higher amount of nutrition than its pesticide-laden counterpart. If you buy seasonal produce from a local grower it will be more affordable than trying to purchase strawberries in December!

The best fruits and vegetables are the ones that are very brightly colored as they provide the highest amounts of anti-oxidants that are protective against heart disease and cancer. Such things as blueberries, raspberries, pomegranate, blackberries, and citrus are very healthy. Vegetables such as peppers, broccoli, cauliflower, artichoke, spinach, kale, brussel sprouts, onions and garlic are very beneficial.

Oils are also important for their anti-inflammatory, hormone-producing qualities, not to mention being a good source of fat. Olive oil, coconut oil, avocado oil and some organic butter or ghee are all recommended. Coconut oil is nice for high heat cooking as it isn’t altered by the temperature. Olive oil is better when used on a medium heat. Fresh, raw nuts are another good source of fat. Good fat must be consumed in adequate amounts to prevent sugar or simple carbohydrate cravings and to stabilize blood sugar.

Protein is an interesting issue. We consume 6 – 8x more protein than any other country in the world. While protein is critical for growth and repair we could likely decrease our intake somewhat while increasing the quality of what we do eat.

With the chemicals and hormones being fed to our animals (3 million pounds of antibiotics/hormones given to livestock), it’s becoming increasingly difficult to find a “clean” source of animal protein.

Fish that are wild or farm raised on good quality feed are available. Eggs from organic farms that enhance the chicken’s feed with fish oil creates an egg that is higher in omega-3 fatty acids.

Of course there’s always the vegetarian option of whole grains (gluten-free of course!), legumes, beans, raw nuts, etc. I must admit to being quite leery of soy. I know it’s a “go-to” protein source but I find many of our patients to react poorly to it. I don’t know if it’s the genetic modification of the bean or what exactly, but I would caution moderation if you do seem to tolerate it. Another note, Dr Gonzalez, from New York who specializes in cancer treatment and gets outstanding results through use of diet, enzyme therapy and more, cautions his patients to “cross the street” if they see a soybean!

Dairy products, based on my most recent research, may very well not be a good idea for any of us. The enzymes that we have available to digest milk (and that’s human milk) stop getting produced after about the age of 3. It is thought that the proteins in cow’s milk are actually damaging to our gut lining, while creating a mucous buildup that prevents the absorption of some vital nutrients.

This theory segues very nicely with some recent research that makes the supposition that in order for gluten to initially create damage in the small intestine, there has to be an initial insult to the gut. Could this initial insult come from dairy? More on that in a future blog.

The toxic burden on our bodies from living in the US is huge as compared to other countries. Our FDA has approved 3,200 food additives to be used in our food while the European union only allows 6 different food additives.

My recommendation is to consume moderate amounts of protein from as clean a source as possible, meaning organic, grass-fed, hormone and antibiotic-free, etc.

I know that it’s extra work but remember than you can control what you put into your mouth. The other sources of toxins coming our way from air pollution and chemical exposures from industry are more difficult, if not impossible, to avoid. So if you control toxic exposure as much as possible in your food it will help a great deal.

I realize that I am promoting cooking and mostly eating from home. And I also realize that this isn’t the American way. But may I point out that the “American way” is not really working? Witness the statistic of dropping form 11th in the world for life expectancy down to our current ranking of 42nd.

To summarize, clean and pure sources of all food products is what you should be striving for as much as possible. This would entail also eating food that is in its natural state. E.g. a piece of organic fruit vs a fruit roll-up!

Increasing one’s consumption of fruits and vegetables is something we commonly see as needed in our patients. Balancing carbohydrates with good protein and fat in a meal is another good recommendation. If all you ate for a snack was a banana, you’re likely to find yourself “craving” in a couple of hours. Had you balanced that out by eating only half the banana with some raw nuts you likely would have felt much better.

Don’t forget to stay hydrated. Other than some green or white tea, your beverage of choice should be good clean water in the quantity of eight to ten or more 8 oz glasses per day, depending on your weight. (Hint: take you weight, divide it in half and you’ll have the number of ounces of water you should consume each day.)

While we’re all thrilled that Betty Crocker has come out with a line of gluten-free bakery mixes and that other companies have perfected that perfect brownie or cake, don’t fool yourself into thinking they’re good for you. Enjoy them in moderation on special occasions, but don’t make them a daily habit.

I think I could write another book on this topic alone, but until then I hope this helps.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of The Gluten Effect

Monday, September 28, 2009

Vitamin D3 deficiencies, the Flu & Gluten

I’ve written on this topic before but I have some new, updated information that I think warrants some attention. Since this post “jumps off” from the data presented in the last one, you may want to read that one first. Here’s the link:http://glutendoctors.blogspot.com/2008/05/are-you-deficient-in-vitamin-d-odds-are.html

While this blog is dedicated to gluten sensitivity and celiac disease predominantly, this post truly is for everyone so please feel free to share it with friends and family.

There certainly has been a buzz about the importance of Vitamin D3 and getting your levels tested. But what happens once you do? You may remember the chart below where the cut-off for concern seems to be at <30 .="" be="" has="" level="" new="" research="" that="" to="" upped="" well="">60, with 60-100 being the target, especially if there’s any risk of cancer.

Normal or Suboptimal Levels of 25 hydroxy vitamin D
<10 br="" deficiency="" ml="severe" ng="">10-20 ng/ml = deficient
20-30 ng/ml =insufficiency
30-40 ng/ml = possibly insufficiency
>36 ng/ml = decreased incidence of heart disease
>40 ng/ml = decreased incidence of MS
40-50 ng/ml = probably sufficient levels
>50 ng/ml = sufficient or optimum levels
>50 ng/ml = decreased incidence of cancer
80-100 ng/ml = goal for most cancer patients
>125 ng/ml = potentially toxic

So please be pro-active. Realize that many doctors follow the guidelines given to them by the lab. If they're not on the cutting edge of Vitamin D research they may give you the "green light" that your status is fine even if it's only 32! You now know that's not sufficient. It's fine and safe to sensibly take a good quality Vitamin D3 on your own. Just make sure to recheck the level.

The exciting cancer news is that Vitamin D3 is considered the only substance that can reduce 78% of all cancers. Vitamin D affects over 200 genes in our body and is involved in the transcription of genes (how the genes are “read” or “expressed”).

As mentioned in an earlier post, a deficiency in Vitamin D3 is causally related to MS and current research estimates that a patient with MS may need 14,000 IU/day.

What’s too high? A daily dose of 50,000 IU can be immunosuppressive.

With the flu season almost upon us, finding out your Vitamin D3 status and supplementing properly could well assist in avoiding that nasty viral infection. The lower your level the more aggressive you want to be in supplementing. Take between 1,000 - 5,000 IU/day for 1 month and then recheck your level. If it's coming up nicely continue. If the change is very slow, consider doubling the dose you’re taking and recheck again in another month. Barring any other reason for malabsorption (undiagnosed celiac or gluten sensitivity as an example!) you should see a nice change with adequate supplementation.

This is such an easy solution to a deficiency that is affecting us in so many ways.

I hope you find this helpful.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect”

Friday, September 25, 2009

Chronic Fatigue, Chronic Fatigue Syndrome/ME and Gluten Intolerance

My last post on Chronic Fatigue caused some nomenclature discussion to arise that I want to clear up.

The topic of the blog was chronic fatigue and how it can be affected by a gluten sensitivity. It was not meant to include a complex known as chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). “Chronic Fatigue Syndrome” is used in the US while the term "Myalgic Encephalomyelopathy" (ME) is used predominantly outside the US.

CFS/ME is a chronic, inflammatory disease primarily affecting the nervous system. It is multisystemic, affecting the central nervous system, immune system cardiovascular system, endocrine system and musculoskeletal system. The disease process can cause a wide variety of symptoms, including changes in sensation, vision, muscle weakness, coordination and speech difficulties, severe fatigue, cognitive impairment, problems with balance, and severe pain. ME will cause some degree of impaired mobility and disability in all cases. The degree of impairment depends upon the amount of brain injury and end organ involvement.

Needless to say this is a very serious debilitating condition and not the one I was referring to in my previous blog. At this writing I have not had any experience with CFS/ME but will pass along any positive treatment options as I come across them.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of "The Gluten Effect"

Wednesday, September 23, 2009

Chronic Fatigue and Gluten Sensitivity

Chronic Fatigue, now known as Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS), affects between 400,000 and 900,000 adults, and is characterized by unexplained fatigue that lasts for at least six months, fails to get better with rest, and interferes with daily activities. It is also accompanied by at least some of the following additional symptoms: extreme fatigue after exertion, memory and concentration problems, poor sleep, headaches, muscle and joint pain, sore throat, or tender lymph nodes.

Chronic fatigue is unfortunately one of those syndromes that seems to “fall through the cracks” of our traditional medical system. Why? Likely because it doesn’t fit into the symptom-drug model. No drug has been created that successfully treats the myriad symptoms associated with CFIDS.

Not being a particular fan of masking symptoms with drugs, I don’t find the lack of “effective” drug treatment a negative. But what I would like to address is the success we’ve had here treating Chronic Fatigue and the interrelated causative factors.

Research studies have associated the development of chronic fatigue with patients exposed to traumatic events and chronic stress, with stress increasing an individual’s risk by 500%!

If you evaluate the symptoms associated with adrenal gland exhaustion and compare them to those of chronic fatigue, you will see a common thread between the two.

The adrenal glands are your stress gland and when they aren’t functioning adequately you can expect to experience such symptoms as fatigue, immune system weakness, joint pains, muscle aches, depression, anxiety, insomnia and headaches. Basically the symptoms of adrenal fatigue are identical to those of chronic fatigue.

Our philosophy is to address the underlying root cause and upon evaluating a chronic fatigue patient it is most common to find the following:
Weakened adrenal glands
Food sensitivities
Digestive malfunction
Infections of the digestive tract
Hormonal imbalance.

While the list may seem a bit extensive, a program can embrace most all of those issues simultaneously resulting in a patient feeling substantially better in 2 or 3 months.

Many researchers are putting chronic fatigue and fibromyalgia in the same category and I too see similar features in both disorders.

But more important than the label is to truly normalize body function such that the unrelenting fatigue and other debilitating symptoms are no longer an issue. When addressing root cause one needs to get to that undercut of malfunction that, when resolved, results in regained health. While this can prove challenging it truly isn’t difficult when one understands how the body functions.

We reviewed that adrenal malfunction and chronic fatigue have similar symptoms. So the next question is, how do we resolve adrenal fatigue? It’s a natural therapy but it doesn’t tend to be the bottom line root cause. Rather it’s often a secondary effect of the root cause. The primary problem is often digestive in nature and involves food sensitivities (think gluten and dairy as the biggest culprits), infections in the small intestine and a resultant weakened immune system.

Diagnosing and treating the above is not difficult and it’s completely natural (excepting an occasional antibiotic to treat a particularly stubborn infection). But the program must be done as an orchestrated whole utilizing strong enough remedies to affect the necessary change. Simply going to your local health food store and picking up some vitamins or probiotics is likely not going to be sufficient.

We have treated many patients with chronic fatigue successfully. The worst of which was a woman in her 30s that was disabled because of it. I’ll never forget speaking to her on the phone and her relating to me that she would lift her forearm off the bed just to see if she still could. That was the extent of effort she could perform. We not only got her back to work but it has been over a decade and she continues to do well and has a very productive life.

If you know someone suffering please forward this to them and let me know how I may be of further assistance. I truly believe that the treatment protocol that I’ve laid out above can be successful for most.

Until next time, I wish you good health.

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Wednesday, September 09, 2009

Depression and Gluten; Is a Dietary Change Just Too Easy?

FUNCTIONAL MEDICINE UPDATE
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If you ever watch TV you’ve probably seen ads for a new drug called Abilify. I found several aspects of the commercial interesting, not the least of which was the opening statement that: “2 out of 3 patients taking antidepressants were still depressed”. The commercial goes on to “explain” that the reason for this is that a patient needs more drugs. Abilify is an add-on to an anti-depressant, supposedly making it more effective.

Really? Could it be that the actual problem is that antidepressants don’t work and are factually very dangerous? There have certainly been enough studies to validate my opinion.

But no, this ad campaign asks you to suspend such logical thinking. Well keep it suspended so that you won’t hear all the side effects they then list out. Such things as suicidal thoughts, large weight gain, diabetes symptoms, restlessness or jitteriness and last but not least, abnormal muscle movements (these movements can become permanent if Abilify is not stopped quickly)!!

Wow, sounds terrific! (Sorry, I’m becoming sarcastic).

What about this approach? Why don’t we get to the underlying root cause of the depressive symptoms and address that? And in 25 years that root cause has never been a deficiency of an antidepressant drug?

But there has certainly been a strong cause and effect association between gluten and depression. Am I suggesting that all depression is caused by a reaction to gluten? Of course not. However it is definitely an issue that should be ruled out.

Can I support these statements? You bet!
The American Journal of Medicine in 2004 studied how well brains of celiacs were perfused with blood. They found a strong association between celiacs eating gluten and brains starved for bloodflow. And the area of the brain most affected was the frontal lobe, most associated with depression.

The Journal of Neurology, Neurosurgery and Psychiatry in 1997 stated:
“The immune response triggered by sensitivity to gluten may find expression in organs other than the gut; and the central and peripheral nervous systems are particularly susceptible.”
Digestive Disorders in 2008 had an article entitled: “Affective and Psychiatric Disorders in Celiac Disease” where the association was clearly delineated.

And lastly, Practical Neurology in 2004 stated: “Neurological manifestations of gluten sensitivity are a scientific fact, not a theological issue. Whilst the debate continues, we owe it to our patients to screen them effectively for gluten sensitivity with the simple, widely available antigliadin antibody test so that we do not in the meantime deprive them of a harmless but potentially effective treatment in the form of a gluten-free diet.”

I couldn’t say it better myself!

To your good health,

Dr Vikki Petersen
Co-author of “The Gluten Effect

Friday, September 04, 2009

Gluten, The Cold, Hard Facts

Recently I’ve been hearing the expression “soft science” and a possible relationship to gluten sensitivity. These same individuals conclude that the only “hard science” applies to celiac disease. They maintain that suggesting a benefit may be achieved from a gluten-free diet for anyone who is not diagnosed as a celiac is not only dangerous, but misleading and downright cruel!

So let’s take a look at these claims and accusations and see if they have any merit.

I believe that new ideas and new findings, be they in the field of health or anywhere else, are frequently not embraced. We are critical and cautious of change. Is the “soft science” of today the “hard science” of tomorrow? I think we have seen this on many occasions. It brings to mind the bacterium Helicobacter pylori. This bacterium can infect the stomach and cause not only ulcers but cancer. My clinic has been looking for and addressing H. pylori infections for many years. But we, and other clinics like us, were accused of treating a “normal constituent” of the stomach and it was claimed that the bacterium was definitely not a danger. Fast forward about 5 years from that point and “every” GI doc is currently testing for it. Why? Because it can be dangerous.

Getting back to gluten sensitivity vs celiac disease, if the information regarding celiac is so clear cut, why do we as a nation only diagnose 5% of those suffering? And why does it take about a decade to get properly diagnosed?

The presence of “hard science” does not equate to efficient diagnosis nor effective treatment.

I try to stay abreast of all the most current research as regards celiac and gluten sensitivity. Dr Harris out of the University of Maryland Medical School works with Dr Fassano, a long time researcher in the area.

Dr Harris stated that gluten sensitivity was a condition where the combination of genes for it and celiac disease may very well be the same but other insults hit the celiac creating that disease and autoimmunity.

She feels that gluten is initiating an innate immune response but that it somehow gets regulated such that the intestinal epithelium remains more intact than in the celiac. But she continued to say that they did see infiltration of lymphocytes in the epithelium. (Note: some researchers states that infiltration of the epithelium by lymphocytes is the precursor to villous atrophy.)

Dr. Harris has already published several articles about her work. Specifically a 2008 article published in The Journal of Immunology was co-authored by Dr. Fasano. Shall we accuse Dr Harris, one of the leading researchers in the field, of practicing “soft science” because she believes that gluten sensitivity is a real thing?

One of the problems we encounter with celiac is diagnosis. While intestinal biopsy has long stood as the gold standard of diagnosis, it currently is considered antiquated. Why? It’s too gross a measurement of such a large and complex structure. In a biopsy one is taking a few snips of small intestine that has the surface area of a tennis court. What is the likelihood of missing an affected area and giving a false negative diagnosis? Quite high obviously since we only effectively diagnose 5% of those affected with the disease.

Everything happens on a continuum. Does villous atrophy happen suddenly or slowly? It’s a slow erosion as inflammatory factors affect the small intestine. Is it correct or “kind” to wait until someone’s intestinal lining is completely eroded before diagnosing them? Talk about cruel and unusual!

What’s wrong with an early diagnosis? What’s wrong with trying to prevent autoimmune disease, the third leading cause of death? I say nothing.

While I appreciate the role of a researcher needing “proof” and hard evidence before going forward with a statement of fact, as a clinician I have a duty to help my patients to enjoy better health. Should I put all my patients “on hold” because there is still some discrepancy in the research? Should I ignore the miraculous results patients have experienced going gluten-free because they don’t have a definitive celiac diagnosis?

What’s right? I think if you’re a researcher waiting for more support of your hypothesis is acceptable. But if you’re a clinician and the benefits so vastly outweigh the liabilities (there is absolutely no proof that a gluten-free diet can in any way be dangerous) then I think the answer is obvious.

I’m a clinician and I will continue to utilize gluten-free diets for those patients whom have positive laboratory tests identifying an immune system reaction to gluten and those patients who, upon elimination and provocation, have a positive reaction to gluten. And if you want to call that “soft science” so be it.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Monday, August 31, 2009

The Best Gluten-free Bagel

They say rules are made to be broken and August has been such a month for me. I no sooner mention that I never make product endorsements only to find myself doing just that – twice! A few weeks ago I endorsed Udi’s bread and now I find myself on a bagel bandwagon –specifically Joan’s GF Great Bakes (www.gfgreatbakes.com).

Last spring my husband and I were part of the NFCA (National Foundation for Celiac Awareness) Cook-off in D.C. We were there for a book signing and presentation of our book “The Gluten Effect”. There were many wonderful vendors and chefs who participated in the event and at the end of the evening my husband mentioned tasting a truly wonderful bagel. I scurried over to taste for myself only to find that they had run out.

As a New Yorker who grew up on bagels as a Sunday morning ritual, it has definitely been something I’ve missed…a lot. While I hadn’t personally tasted Joan’s bagels my husband’s recommendation was so strong that I just had to try them.

Joan is a New Yorker as well (no wonder she knows how to make bagels!) and the only unfortunate part was negotiating a shipment to California. A good portion of my staff went in on a large enough order to defray what turned out to be rather expensive shipping and I waited with bated breath for my order.

What I didn’t know is that the bagels arrive not only frozen but raw. The pale bagel looked a little sad in the package until I read the directions and discovered the need for a little baking. Part of my childhood memory was warm bagels fresh from the oven as the bakery was close to our home. Therefore the prospect of baking individual bagels and enjoying them fresh from the over was an even better option as far as I was concerned.

Joan’s did not disappoint – quite the contrary. They were truly delicious and undetectable as being gluten-free. Following a dairy-free diet as well, I was thrilled that she also provided that option and a multiple of flavors.

Those of you living on the east coast are fortunate. You can simply place an order and enjoy. For those west of the Rockies a little more thought and collaboration is involved, but it’s truly worth it if you’re a bagel fan.

Joan’s also makes English muffins, pizza crust and cookies. I haven’t tried them yet but I’m sure they’re all delicious.

As a side note, the shipping company was a little rough on our boxes and the bagel bags were a little worse for wear. When I called customer service I spoke to Joan herself and she was wonderful to deal with. As a business owner who prides myself on excellent service it was great to meet someone who shared similar values.

And now the cautionary tale: don’t eat these daily as simple carbohydrates are not as nutritious as all those fruits and vegetables I prefer that you eat. But there’s nothing wrong with a bagel meal as a weekly indulgence – enjoy!

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Wednesday, August 26, 2009

Gluten Dangers: The Truth Is Here To Stay

If you’re gluten sensitive or have celiac disease you may have heard the comment that gluten is a "fad" from a curious friend or family member. Granted one would have to be quite “out of the loop” these days to not have heard of gluten, but more and more those who haven’t been diagnosed are asking: Why now? Why is it suddenly so large a problem?

These are good questions and I’d like to provide some possible answers.

Recently I had the good fortune to listen to Dr Harris, a celiac and gluten researcher out of the University of Maryland who works with Dr Fassano, a long time researcher in the field. Dr Harris felt that increased awareness and better detection of celiac disease has definitely gone a long way towards diagnosing more of those afflicted. (Considering there are over 90% of celiacs who remain undiagnosed, we obviously still have a long way to go but any improvement is appreciated.)

Dr Harris additionally noted that viruses and vaccines can perhaps cause an increased reaction to gluten in susceptible individuals. Viruses have been identified that trigger an immune response that cross reacts with gluten through molecular mimicry. Rotavirus is such an example. Rotavirus typically strikes children causing them to suffer with diarrhea for several days and is the most common cause of childhood diarrhea. The virus works by attacking the lining of the small intestine, causing often copious loss of fluids and electrolytes. Antibodies in celiac patients are known to cross react with rotavirus.

What does this all mean? We review this mechanism in our book The Gluten Effect. Remember that gluten is a protein (actually an array of proteins but we’ll discuss that later). It is known that certain fragments of the gluten proteins are quite similar to structures within our body as well as that of viruses. The rotavirus has such a structure. When the body has been exposed to rotavirus the immune system remembers it. Due to gluten’s similar structure, gluten ingestion occurring after the viral infection causes the body’s immune system to attack the gluten molecule “thinking” it’s the rotavirus again. In sum, this infection causes the immune system in the gluten susceptible individual to be primed to react.

My research revealed that rotavirus affects 3 million people in the US each year, 5 every minute.

What about the vaccine comment? The number of vaccines that our children are exposed to has increased dramatically over the past several decades. Based on the above mechanism of molecular mimicry a susceptible GI tract can begin reacting to gluten after receiving a vaccine.

How does one explain the genetically susceptible individual who seems to eat gluten with impunity? Dr Harris’ research is looking at a co-variable concept that I believe, based on my clinical experience, makes a lot of sense. It is thought that while an individual can possess the genes that make him or her susceptible to reacting to gluten, the reason not everyone does and the age of onset is so variable is dependent upon the presence of other factors. Dr Harris thinks that without some underlying inflammation already present in the gut, a healthy individual might go on consuming gluten with no negative effects.

It is an interesting theory. What we see here in the clinic is a varying time of onset of symptoms. While someone has been consuming gluten their whole life, they may have been “fine” until their 30s, 40s or 50s. And then there are the infants whose first exposure causes dramatic results. The time of expression may very well be dependent upon the underlying health and stability of the immune system. A stable, healthy, uncompromised immune system and small intestine could well sustain a gluten-containing diet with no apparent negative results. It’s not unusual for a patient to have suffered a severe infection of some sort or a stressful life period, after which they began to react to gluten.

And finally the structure of our grains was discussed as it relates to different cultivars containing different protein fragments. Some fragments of proteins are inflammatory and some are not. Witness the Americans who travel to Italy and eat older cultivars of wheat with seeming impunity. Don’t book a flight just yet…

There is a lot more to learn and that’s a tremendous understatement. But as a clinician I do find that the health of the small intestine and immune system plays a large role in how quickly a patient will see a resolution of their symptoms. And it also give credence to the protocol we follow that goes beyond simply removing gluten from the diet. Concurrent with a gluten-free diet one must heal the gut, remove pathogens, recolonize with healthy probiotic bacteria and follow a healthy diet – otherwise the result will be unsatisfactory.

There is much more to come on this topic and to answer the question: No, gluten sensitivity is not a fad!

Until next time,
I wish you good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of The Gluten Effect

Wednesday, August 12, 2009

Is All Gluten Bad?

The good news is that awareness of gluten has increased dramatically the past several years. This has resulted in improved health for many people and the food industry has noticed the interest and responded in kind with more and more gluten-free offerings.

“Gluten” is no longer a strange word with even fast food restaurants and candy companies becoming savvy to its ill effects on health.

But we do have a problem in nomenclature because “gluten” is actually a protein found in many grains that are not problematic for what we call the gluten sensitive patient. A more correct term would be “gliadin sensitive” vs “gluten sensitive”.

Don’t groan; I’ll explain. The word we should be using is “gliadin” because that is the component in the protein portion that celiacs and gluten sensitive patients react to in the offending grains wheat, rye and barley. Gliadin is a specific fragment or sequence of amino acids in these offending grains.

“Gluten” is the storage protein found in wheat but other proteins that are similar are also called gluten despite being found in such innocuous grains as rice, oats, corn, millet, etc.

The reason for this blog post is that a patient recently saw corn gluten on a label and got confused. She knew that she was fine with corn but the “gluten” word confused her.

I’m not trying to start a movement to change our vernacular from “gluten” to “gliadin” – personally I’m just glad that the awareness has increased so well. But I did want to clarify the point to allay any confusion.

Here’s a little information about the grain families that might help:

Within the family of Grasses are two subtypes: Monocots and Dicots.

Monocots have 3 subgroups:
1. Wheat, Rye, Barley
2. Rice, Oats
3. Corn, Sorghum, Millet

Dictots also have 3 subgroups:
1. Buckwheat, Rhubarb (fruits)
2. Quinoa, Spinach
3. Amaranth


So to sum up – wheat, rye, barley, spelt, kamut, bulgur, etc are gliadin containing grains for which an individual suffering with celiac or gluten sensitivity cannot ingest safely. (Please go to: http://www.healthnowmedical.com/info/gluten_foods.html to get a complete list of allowed and disallowed foods)

The gluten found in rice, oats, corn, sorghum, millet, quinoa, amaranth and buckwheat is just fine.


I hope this helps!

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Gluten Sensitive Patients Rejoice: The Best Gluten-free Bread Ever Made!

If you’ve been following this blog at all you know that it is not commercial in any way. I don’t push products or sell anything. But sometimes you just need to give credit where credit is due.

My family and I just got back from a beautiful 5 day vacation (who can get away for longer!) in Jackson Hole, WY. We rode horses, hiked, enjoyed white water rafting and the amateur photographer in me had a field day!

Being a diligent mother I checked out gluten-free options in Jackson Hole and found a great health food store. Upon arrival I asked for help finding gluten-free breads and a knowledgeable sales person directed me to the freezer and mentioned that a new bread was selling very well and getting rave reviews.

I’m adventurous and I already recognized the rest of the breads they offered so I happily purchased two varieties of Udi’s gluten-free bread. They offer a whole grain and sandwich bread.

As many of you know, even the best gluten-free bread usually requires toasting. But Udi’s defrosted and was instantly soft. Before we even tasted it, it was obvious that we were dealing with a “new breed” of gluten-free bread. Then came the tasting and we were smitten. It was unanimous that if you didn’t know it was gluten-free you’d never know by tasting it. I’ve said this before about certain dessert items (like brownies) and I defy anyone to figure my lasagna for being gluten-free, but bread had never remotely fit into that category. The best we could hope for was that it wasn’t too bad – as in dry and crumbly…

That was until Udi’s came along. For those of you living in the Rocky Mountain area of the U.S. you’re in luck. Udi’s is produced out of Denver, CO and they are well represented there. For the rest of us, there’s going to be a waiting period. I recommend you go online and order from there: www.udisfood.com. The gluten-free portion of their website is being worked on currently so you may need to call- 303-657-1600.

But believe me any trouble you have to go through is well worth it. You’ll be a happy little bread eater! And did I mention that it’s not only gluten-free but dairy, soy and nut-free?

I won’t ruin this good news by encouraging you to keep such simple carbohydrate consumption to a minimum… I’ll save that for a later blog!

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Monday, July 27, 2009

Living Gluten-free – But What Should I Eat?




Those of us following a gluten-free diet can get very focused on what we cannot eat. We can’t eat gluten, obviously, and we exert a lot of time and energy identifying those hidden gluten sources that can make us feel ill. Sometimes we spend so much time being “gluten-meters” that we forget to focus on what we should eat.

When I was speaking to one of my children last week we were discussing the mental checklist that I go through each afternoon to make sure that I’m on track for getting all my necessary nutrients each day. If you wait until the evening to review, the day is basically done and it’s too late. So instead, I do it each afternoon while there’s still time to make needed corrections.

To make this easy I came up with six major points (all beginning with the letter “F”).

Follow the 6 Fs

1.Flush your system of toxins. Drink a minimum of 8 glasses of clean, pure water each day. A recent study showed that those who exercised a lot needed 3 to 4 more glasses and those exercising moderately needed 1 to 2 more. Ramp up to it by adding another glass each day until you get to the desired amount. Staying well hydrated will help to keep your weight down and it will flush toxins from your body – a strong key to good health.

2.Fresh – we could add to that: Organic, Unprocessed and Real – everything you eat should fall into this category. Organic unprocessed, fresh food has an incredibly higher amount of health promoting nutrients as compared with pesticide laden processed food. There is absolutely no comparison. Is organic more expensive? Somewhat, but remember to buy seasonal food and take advantage of your local farmer’s market. This will keep costs down. Plus, not buying all the processed foods such as soda, chips, candy, etc should help to save money in the long run.

3.Free – you want to eat food that’s free of hormones, antibiotics, pesticides and heavy metals. Ideally it should be grass-fed, wild or farm-raised with a high quality diet. Our local fish market offers very high quality farm-raised fish that is fed krill, a small fish high in omega-3 fatty acids. Most farm-raised fish is of a lower quality than wild so I encourage you to speak to your fish market and find out the difference and what they specifically offer.

4.Fiber - helps to keep bowel movements regular and stabilize blood sugar. Flax seeds, fruits, veggies when consumed in adequate quantities are usually sufficient to provide adequate fiber. But if not, adding a fiber powder (use mostly soluble fiber) is a good idea. It’s very important to have 1 to 2 easy, large bowel movements every day. If not, toxicity in the body increases, leading to health problems.

5.Fat – It’s important to consume good fat. Omega-3 fatty acids found in cold-water fish, eggs and flax seeds tend to be underconsumed by the average American. Omega-3 fatty acids can protect against stroke, obesity, osteoporosis, depression, they raise good cholesterol, lower triglycerides and are anti-inflammatory. Inflammation is considered the trigger for most of the major diseases killing Americans such as heart disease, cancer and diabetes. Extra virgin olive oil and coconut oil are good oils for cooking.

6.Flush (again, but different) – Otherwise known as that nice “glow” one gets after exercise. It’s important to exercise 30 minutes per day, 5 days per week. Remember to combine stretching, strengthening and aerobics to get the most benefit from your exercise regime.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of The Gluten Effect

Monday, July 20, 2009

Gluten Containing Foods

I was doing an analysis of my website and was surprised that the “gluten containing foods” page was the most commonly read. Having seen some of the other websites and blogs on the internet I realized that there remains a lot of confusion about what does and does not contain gluten.

While from one perspective it could be quite easy (all fruit, vegetables, nuts, seeds, oils, beans and animal protein is gluten-free), our pre-prepared, pre-packaged foods add a great deal of complexity.

My daughter was away for a few days and called me from the airport today informing me that she didn’t feel well and suspects she was exposed to gluten. She went on to explain that she was very careful but in hindsight suspects a salad dressing was the root of the problem.

So let’s address the two most common pitfalls I see patients fall into:

1. They don’t speak up and ask enough questions. My daughter is a perfect example of this. Maybe she didn’t even consider that a salad dressing COULD have gluten in it. But remember that gluten is a great thickener so unless that salad dressing is oil and vinegar that you personally pour from a bottle – ask about the ingredients.

When you’re outside your own kitchen ask questions about ingredients. If it’s not easy to find out, don’t chance it, eat something else. While some people think they’re “being difficult” asking questions at a restaurant, think of it this way instead: you may be very well saving the health of the waitperson or a member of their family by enlightening them about gluten. That exact situation has happened to me on several occasions in restaurants. Similarly, your dining partners may very well learn something about their health.

Americans are not particularly healthy and gluten is playing a role in that a large percentage of the time. So asking questions and being vocal about gluten is not only good for you but likely also for someone who’s within earshot!

2. Patients haven’t committed to memory what the glutinous grains are. I was amazed this past week when a longtime patient was about to start eating barley. She and her entire family are gluten sensitive and they know it. Yet she didn’t know that barley was a no-no.

Please visit my website at: www.healthnowmedical.com for the most comprehensive list of grains and other foods that contain gluten. I am updating the list constantly to keep it as current as possible.

I hope this helps.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Thursday, July 16, 2009

Gluten Attacks the Health of a Family



Below is an email I received from a reader. I post it here as an example and hopefully an inspiration. It can be difficult to do the right thing for your health and the health of your family when those around you are not supportive or in fact downright insulting. That's why we wrote our book and that's why we have this blog - to support and improve the health of Americans by providing the truth about gluten sensitivity and celiac disease.

There is plenty of scientific research out there to support the effects gluten has on the health of sensitive individuals. We are way beyond "theory".

Please help to spread the word. There are too many families like the one below - suffering with a multitude of symptoms needlessly.

Thank you for your support.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of The Gluten Effect


"Wow! Finally a website/blog and a medical practice that gets it!!! Our entire family of 4 was diagnosed with Celiac/gluten sensitivity in 2005 by Enterolab after our daughter testing positive blood with Prometheus and my husband testing negative blood with Prometheus. We have no health insurance and therefore no primary care doctor. We went about our testing utilizing friends who have health insurance and Celiac and their recommendations. Going Gluten Free initially cured us of pretty much every single symptom. My brother is an MD working at NIH in Maryland. He no longer speaks to my family because we did not do the "gold standard" testing route. He has accused us of feeling better gluten free psychosomatically and does not believe we truly have Celiac. My husband and I are the ONLY family member on both sides of our family who will or have done testing. EVERYONE else thinks we are crazy----doing a "Diet Du Jour" and trying to eat this new 'popular' way. This is absolutely sickening as there is severe osteporosis, aneurysms, arthritis, reflux, obesity, lymphoma, and a whole host of other gluten related illnesses ongoing in pretty much every other family member. Our daughter showed symptoms from the time I started feeding her food: mystery skin rashes, extreme clinginess, crankiness. At about 5 she had headaches, gas, constipation, stomachaches, very low immunity, 'wavy' eyes, joint and bone pain and then started getting horrible bloody noses. Our son started getting bloody noses at about 18 months. My husband and I had horrid reflux, joint pains, mystery joint injuries that took months to heal. anxiety, depression, weight gain, bloating, gas etc. I guess we were all 'asymptomatic'!"

Monday, July 06, 2009

Diagnosing Celiac Disease - Intestinal Biopsy with villous atrophy no longer the “gold standard”



If you’ve been through an intestinal biopsy to determine if you have celiac disease you were likely told one of two things: “your villi are very damaged, you have celiac disease” or “your villi appear normal, you don’t have celiac disease.”

The focus of a biopsy is the health or damage of your villi – the finger-like projections responsible for absorbing nutrients and giving your small intestine its large surface area (the size of a tennis court!).

While diagnosing celiac disease is important, here at the clinic we are also very concerned with correctly diagnosing the larger share of gluten sensitive patients, or those with non-celiac gluten sensitivity. But with that said, it’s not unusual for patients with severe digestive symptoms, secondary to gluten consumption to come to us confused with their negative celiac diagnosis. They have proven to themselves time and time again that gluten is no “friend” and the digestive symptoms gluten causes them to suffer are clearly no coincidence.

If they have such a severe reaction why didn’t their biopsy show it? Here’s a possible answer.

First I’d like to give credit to a dear friend, Dr Thomas O’Bryan, who has dedicated himself to educating doctors about gluten sensitivity. I’ve known Tom for many, many years and it was interesting to discover that our paths had taken such a similar turn after years of not seeing one another. Dr O’Bryan has his finger on the pulse of the research done in this area and he has pulled together several articles supporting the point I’d like to make.

First, villous atrophy should no longer be considered the “gold standard” when diagnosing celiac disease.

Second, if a patient chooses to receive a biopsy they must ensure that it includes an IEL (intraepithelial lymphocytosis – don’t worry I explain below) count so as not to miss the earlier manifestations of celiac disease.

Wow, that’s a mouthful. Don’t worry about pronunciation, let’s just stick with “IEL” and explain what it means.

When you think about it, it makes sense that the first thing that happens in celiac disease is not complete annihilation of the villi. Considering the small intestine is 23 feet long and the surface area is so large, something must happen before the destruction of the villi. Everything happens on a gradient, right? Exactly. So it should be no surprise to learn that before the villi atrophy they inflame or get irritated. That’s what the IEL count measures – the amount of inflammation. So if a biopsy is not taking an IEL count, it could very well be missing the early stages of celiac disease.

Now please understand I’m not a great fan of biopsies. But if you plan to get one you should at least get the most accurate and comprehensive data on the health of your small intestine.

If your doctor is not comfortable with the IEL count or it’s not part of his or her “typical” study, find a new practitioner – that doctor is out of step with current research.

Keep in mind also that those suffering from gluten sensitivity often show no sign of intestinal inflammation because gluten is affecting them predominantly at a system distant from the GI tract. Our book, The Gluten Effect addresses that point and explains how it occurs. So if you already know that gluten has a negative effect on you there is no need for you to reintroduce it into your diet in order to put yourself through a biopsy. Remember, reintroducing gluten can create negative effects the likes of which you may never successfully reverse. It’s a gamble I wouldn’t advise you to take.

Below is a list of journals that presented articles that all basically stated the same thing: villous atrophy should no longer be considered the “gold standard” of celiac diagnosis and IEL count is a specific marker that must be included with every intestinal biopsy to prevent missing early celiac disease. You will note that the earliest articles were written in 2002 – 7 years ago. I always say that the medical profession is about 10 years behind scientific research. So by that estimate this should be more common knowledge within the next few years. But let’s not wait that long – spread the word today!

With a little research, your doctor can find these articles: Modern Pathology (2005), Journal of Clinical Pathology (2004), European Journal of Endocrinology (2002).

Until next time, to your good health!

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of The Gluten Effect