Thursday, December 09, 2010

Gluten and how it may affect a developing Brain

A reader submitted a question that I wanted to answer here because it brings up two incredibly important issues. First is the question of gluten “challenges” and second is the effect gluten has on the brain.

Here is her question:
“I was diagnosed with Celiac Sprue at age 12 after having suffered my entire life. After that they had me do two challenges, one at age 13 and one at age 14. Both left me sick for months. I am a person that responds to eating gluten in both physical and mental ways. When I slip I get depressed, anxious, and have mood swings. My question is if eating gluten can affect the brain and actually cause lesions, what happens when a person has undiagnosed Celiac Sprue during the time that the brain is still maturing?”

You may think that because Catherine is likely an adult that her gluten “challenges” occurred more than 10+ years ago and such things wouldn’t happen today.  I wish that were true, and honestly little gets me more upset than hearing from someone that they were “made” to challenge gluten for several weeks in order to re-do a biopsy or other celiac testing procedure, only to get incredibly ill as a result.

As I’ve stated before I am not against celiac testing. But there are times when one needs to evaluate what is the greatest good. When a person has “suffered [her] entire life” prior to being diagnosed, only to remove gluten from her diet and feel vastly improved, what really is the point of doing a challenge?  And since the first challenge left her “sick for months”, what on earth could be the justification for doing another one?  It certainly wasn’t because her symptoms were subtle. She clearly states that she feels ill both physically and mentally when any gluten enters her diet.

Yet this happens often – too often.  I hear about it personally from our patients, not to mention those who write to me.  My biggest concern is that a gluten challenge will cause the body’s immune system to cross a threshold from which it cannot be brought back with the result being an autoimmune disease.  I have seen this all too often which is why you’ve heard me refer to gluten challenges and cheating as playing Russian roulette. It has been well established that untreated gluten intolerance shortens one’s life span.  It too has been well established that gluten is a frequent root cause of autoimmune disease.  I never see a good reason to do a gluten challenge in an individual who “knows” they are sensitive – it certainly violates the oath to “do no harm”.

Catherine goes on to ask a good question about how gluten may affect a developing brain. As I mentioned, the inflammatory and autoimmune effects of gluten upon the nervous system are well established.  The symptoms created are numerous and include depression, chronic headaches or migraines, ADD/ADHD, autism, developmental delay, poor memory, schizophrenia and more. The degree to which gluten affects the nervous system is likely dependent on several factors, specifically, the presence of a leaky gut, a genetic predisposition, the presence of gluten in the diet, and the health of the immune system.  Factors in utero are highly related to the health and diet of the mother, in addition to the genetics of both parents. All these variables likely go to answering the question of why some people seem to “come out of the womb” ill from gluten, while others can live many decades before it becomes a problem.

Dr David Perlmutter has and continues to do some excellent work in this area.  Just recently he was published on Huffington Post so you can read more there.

Is gluten, in its current state, truly good for anyone? With the recent research revealing that many develop celiac disease later in life, one really starts to wonder…

I hope this data is helpful.  If you'd like to improve your health, consider calling us for a free health analysis - call 408-733-0400.. We are a destination clinic and treat patients from across the country and internationally. You don't need to live local to us to receive help.

To your good health,

Dr Vikki Petersen, DC, CCN
Co-author of “The Gluten Effect”

Tuesday, December 07, 2010

Is Gluten Sensitivity the Cause of PMS?

A reader wrote the following comment to an earlier blog post entitled, “Gluten and PMS, What is the Association?” It was so compelling that I have decided to write a post about it.

Here is her question:

I've been getting terrible PMS for about 7 years. Sometimes it would last 2 weeks. Recently it changed to 3 weeks and I've developed a massive fibroid even though I am slim. I read about the gluten connection to estrogen dominance and cut-out all gluten a month ago, however my PMS has not improved, in fact I think it's worse. Any suggestions would be appreciated. Kitty

First of all I’d like to say that PMS is never normal.  Common it may be, but “normal”, no.  And it is absolutely ridiculous that Kitty has had to put up with PMS for 2 and 3 weeks per month!  That is between 50 and 75% of her life – truly unnecessary considering it’s able to be fixed, naturally. I underscore “naturally” because too often such women are put on the birth control pill to “control” their symptoms.  I am opposed to this as it doesn’t get to the root cause of the problem but merely masks the issue while in fact the real problem worsens.  Other doctors may recommend inducing a short term “menopause” with drugs to give the fibroid a chance to shrink.  I don’t recommend this approach either.

When making a dietary or lifestyle change that you hope will result in a favorable change in your hormones, you must be patient. It takes at least 3 months to alter hormonal balance.  There are some lucky individuals who notice changes sooner but typically you need to give it 3 months.

Kitty also tells us that she has a “massive fibroid”.  We don’t know her age but regardless, a large fibroid speaks strongly of hormonal imbalance. Typically symptoms such as PMS, anxiety, depression, heavy periods, migraines, fibroids and fibrocystic breasts all can be interpreted as a likely deficiency of progesterone in relationship to estrogen. Changing PMS with the profile of a concomitant large fibroid is definitely not something that will occur in a month.

Progesterone is a common deficiency seen in women in this country of all ages.  Progesterone, when normalized, can almost “magically” handle the above mentioned symptoms. An added bonus is that progesterone is a glucose tolerance factor.  When its levels are normalized, sugar cravings abate and unstable blood sugar is no longer an issue. This can be a huge relief to someone being “ruled” by sugar cravings and who is unable even to eat fruit or any complex grains without getting the cravings started.

The good news is that the solution to these symptoms is not difficult. We work with women frequently in this area with excellent success.  The “fix” is often a multi-pronged one, meaning that it entails more than one step.  Let’s look at the possible steps below:
  1. First is always food and Kitty has made a great start eliminating gluten.  Gluten is known to offset hormonal balance, whether it's from celiac disease or gluten sensitivity. Kitty doesn’t mention if after 30 days she has noticed any improvement in her general health from removing gluten, which is something I would very much like to know. Dairy products are also a big no-no when a woman is expressing estrogen dominant symptoms. Unfortunately our cows are fed a lot of hormones (as is our beef) and that can definitely contribute to estrogen dominance.  So in addition to diagnosing any food intolerances, all sources of exogenous [coming from the outside] hormones must be removed.
  2.  Adrenal gland balance.  We don’t know much about Kitty’s health history but it would be important to know about her stress load, both past and present, sleep habits, caffeine consumption, any drugs she takes, etc.  The adrenal gland is the stress gland and when it is overstressed it will make more stress hormones and less progesterone.  This is a major cause of hormonal imbalance in this country. A poor diet and food sensitivities will also stress the adrenal glands which is why step #1 is always done first. Fortunately normalizing adrenal function is not difficult nor does it involve any drugs or surgery.
  3. Natural, bio-identical hormones. Once again there are many questions about Kitty’s health that are unknown to us, but it would be important, considering her large fibroid, to have some blood tests for hormonal levels.  A woman who typically has a 28 day cycle would get a blood test on day 21 of her cycle.  Her progesterone, total estrogen, DHEA and testosterone would all be measured. With Kitty’s large fibroid and horrific PMS, would could likely make the assumption of a low progesterone level, but that doesn’t tell us the rest of the values, which are equally important to know.  Depending on the woman’s age, some bio-identical hormones could be prescribed.  There’s also a substance made from broccoli that has a strong estrogen lowering effect in women whose estrogen is excessive.  But without a lab test this is impossible to determine.
  4. Liver and digestive function. The top 3 points listed above are the major ones.  But it is important to ensure that the liver and digestive organs are functioning normally to ensure that hormones are being excreted effectively.  As an example, if you did all the points mentioned but the woman had constipation, you wouldn’t get the desired results.  The slow moving colon is allowing hormones that should be excreted to re conjugate and create disruption.
Personally I used to suffer from extreme PMS and migraines related to hormonal imbalance.  I also suffered from terrible menstrual cramps with my period.  When I added all those days together is was about 1/3 of my life.  Fortunately I handled the problem while still in my 20s and have had no issues since. So when I hear of such stories as Kitty’s my heart goes out to her.  But more importantly I know how to solve such problems so I am, of course, delighted to help anyone I can.

Please do know that such symptoms are never normal and truly do not need to be put up with.

I hope you find this helpful and let me know how I can be of any assistance.Our destination clinic treats patients from across the country and internationally. You don't need to live local to us to receive help. And if you would like to improve your health, consider calling us for a free health analysis - call 408-733-0400.

To your good health,

Dr Vikki Petersen
Co-author of the bestselling “The Gluten Effect”