Friday, January 02, 2009

Where did my flat tummy go?

Below is a case study from our upcoming book, The Gluten Effect. J.W. had some very common complaints, but the "common treatment" she was receiving was having no effect. I think she speaks for many.

No, I’m Not Pregnant!

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

We diagnosed her with gluten sensitivity, and after being off gluten for several months, she went from a size fourteen to a size six, with a thirty-pound weight loss. She not only lost the weight, but it came off her “problem areas” first—her stomach and her face. She now had a flat belly, which she had never enjoyed before. J.W. also noted that her bloating was gone, and that she felt “clean” inside.

We diagnosed several infections, which were treated successfully as well, which also removed other chronic stressors from her system. In J.W.’s case, the distribution of weight around the mid-region of the body was typical of excessive cortisol production with adrenal exhaustion. Once gluten was removed, the stress on her body subsided, and a normal weight distribution returned.

Does this sound like you? Have you developed a “spare tire” (or, I’m told the more politically correct description is “muffin top”)?

What we’ve discovered after working with patients for over 20 years is that much of that “tire” can be due to swelling of the small intestine and the resulting adrenal fatigue from malabsorption of nutrients. You have about 23 feet of small intestine. Look down - that’s a lot of track to be laid down in a relatively small space.

Now imagine that 23 feet is swollen due to irritation created by a diet that doesn’t suit your body, or an infection. When it swells it has to go somewhere – welcome spare tire!

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

What do you need to do?

1. Discover if you’re gluten intolerant for starters. There are tests available for this and remember we’re talking about finding out if you're sensitive to gluten, not just if you have celiac disease.
Enterolab has a test you can order yourself ( ) or you can work with your doctor providing they understand the difference between gluten sensitivity and celiac disease.
2. If you already know that you’re sensitive to gluten then realize that you must be perfect about removing it from your diet. Being good “most of the time” is just not enough.
3. If you have not had a comprehensive stool analysis to check for the presence of infectious organisms this really is something you should look into. As was mentioned in an earlier post, it is rare that a gluten sensitive individual DOESN’T have some type of infection due to years and years of assault on the immune system from eating gluten.
4. Get an idea of how your adrenal glands are functioning. We're not talking about adrenal gland disease which is very serious, but rather adrenal fatigue or exhaustion which is quite common. There will be an upcoming post specifically on the adrenal glands soon but suffice to say adrenal fatigue is very associated with malabsorption of nutrients which as you know is definitely an effect of being gluten sensitive. The good news is that with some natural nutrition and lifestyle management, adrenal function is not difficult to restore.
5. Lastly if you’ve already done all of the above and still don’t have the flat tummy you desire, you most likely are suffering from a “leaky gut” which needs some extra support to get completely healed. This support could come in the form of strong probiotics, the amino acid glutamine (not to be taken until you’re assured of not having an infection, however) or a medication called ketotifen which has a local effect to reduce irritation in the gut. This last medication would only be used for a short period of time.

I hope this is helpful.

Happy 2009! Our book “The Gluten Effect” will be out next month and it is one of our new year’s resolutions to have gluten sensitivity "come out of the closet” this year and be recognized for how common and hazardous it is to millions of people's health.

To your good health,

Dr Vikki Petersen


Anne said...

No matter what weight I was, I always had a big tummy. Gas and bloating was a problem for me until I stopped eating gluten. I lost about 10 lbs and still did not have a waist.

About 6 months ago I started eating based on my 1 and 2 hour glucose readings with a glucometer. I stopped eating the foods that spiked my blood sugar. About 20 lbs disappeared and I now have a waist. I went from size 12 to size 6. My waist is 30 - still too big, but better than what it was. How do carbs affect the adrenals?

I look forward to getting your book.

Anonymous said...

Dr. Petersen,
I could not agree with you more this answer- I have a 7 year old daughter that was just diagnosed by blood work for celiac disease. I was reluctant to get the biopsy due to other health issues she has- and was told that it had to be done- I got a second opinion from another PED GI Dr. and he stated that he did not think it was necessary to biopsy my daughter at this time- due to the positive blood results. I was very relieved to hear this- we have been doing the gluten free diet since she tested positive- She had already suffered so much over the past (4) years- as a result of not being diagnosed- I was the one that insisted on the blood work and I am glad that I did- otherwise the Specialists would still be treating her symptoms and the affects of the gluten damaging her body. P.S.-

I had an allergist say that she did not need to be tested- she does not have celiacs- you have to follow your instincts. Thanks for your work in this area.

Susan Hobbs

Skye said...

I am a diagnosed celiac through bloodwork and biopsy, I BLOAT like you would not BELIEVE! I am EXTREMELY careful with my diet and have been GF for a year and a half. My problem is that if someone cross contaminates my food, or I shake hands with lotion on their hands that contains wheat and I forget and touch my face I INSTANTLY bloat and look 4-6 months pregnant. I will gain 5-8 lbs with one such small mis-step. That takes 2 weeks to come off!

I can handle most of my symptoms but this all over body bloating is impossible to deal with. I will go to a friends house or to work and come back having my pants unbuttoned because I CAN NOT GET THEM CLOSED! It happens with in 30 minutes of getting Glutened...

Is there ANYTHING I can do to decrease the bloating or stop it all together when accidents outside of my control happen?

The HealthNOW Doctors said...

Dr Vikki here. I'd like to respond to Skye's comment on her bloating. She has been endeavoring to be gluten free for over a year, which in my experience, normally results in a person being LESS sensitive, not more. The fact that her sensitivity to minute portions of gluten creates such a dramatic response means that her intestine is not healing properly. She still has what we call a "leaky gut".
The reasons behind this are multiple but the top three that I'd like to rule out are:
1. pathogenic organisms - in other words an intestinal infection. Don't be deceived, as bad as they sound, you can be harboring a parasite, amoeba or bacteria and not know it.
2. a lack of healing due to malabsorption. We have definitely run into some patients who needed some extra help in getting their intestinal lining to heal. There are certain substances that help in this regard.
3. there may be another food sensitivity or toxicity that is preventing her immune system from settling down. At the moment it's very hypersensitive.

I hope this helps Skye and anyone else who is still suffering. Getting gluten-free is a critical first step, but it's not unusual to have some follow-up work that's needed as I've outlined above.

To your good health,
Dr Vikki Petersen