Wednesday, November 27, 2013

Is Your Nervous System Being Traumatized by Your Gut?



We have long known that gluten intolerance, both celiacdisease and gluten sensitivity, are highly associated with neurologic symptoms. Migraines, ataxia (unstable gait), seizures, schizophrenia – the list is long. But a  research study sheds new light on what the mechanism may be. 

Understanding why such debilitating symptoms occur as a result of a gluten intolerance will hopefully go a long way to increase awareness in the lay public and amongst clinicians alike. It is certainly true millions of Americans suffer the effects of a gluten intolerance that creates nervous system problems unknowingly. Such individuals don't feel unhealthy but they have no idea that gluten is the culprit.


The digestive tract is sometimes called the second brain. Some say that is because it is second in importance to the brain. After all, if the food that is consumed doesn’t turn into fuel that can effectively feed the 10 trillion cells in the body, those cells will be unable to perform their job and keep the body healthy. In fact, poor digestion is absolutely linked to poor health and increased onset of degenerative disease, including autoimmune disease and cancer.

The article in Current Pain and Headache Reports looks at another possibility for naming the digestive tract the second brain, and it simply stems from anatomy. The digestive tract actually has a ‘mind of its own’, more correctly a nervous system of its own, called the enteric nervous system. ‘Enteric’ simply means having to do with the intestine. This nervous system, according to research, is very similar to the brain housed in the head in that it is bathed in similar chemicals (called neurotransmitters – which, interestingly enough, are mostly produced in the gut!), it sends and receives impulses and records experiences and is influenced by emotions. Some proof of the latter: Have you ever been nervous and had diarrhea?

This particular study cited that experiencing ‘adverse events’ created a state of hypervigilance (a state of being overly responsive - not a good thing) in the nervous system which was associated with migraines and IBS. Such  ‘hypervigilance’ was previously only associated with the central nervous system – the one attached to the brain in the head. This group of researchers feels that the initiation of hypervigilance may very likely lie in the enteric nervous system also.

What this means is that if the small intestine is genetically sensitive to gluten and gluten is ingested, it could set off a nervous system response that could create disabling diseases, such as migraines and IBS, but likely others as well. 

The take-away is that it is truly critical to diagnose gluten intolerance as soon as possible. Once that hurdle is surmounted it then needs to be followed with a program of nutrition, lifestyle and diet that will ensure healing of the small intestine and a ‘calming’ of the hypervigilant nervous system. You may sometimes hear this referred to as healing a leaky gut..

Here at HealthNOW we often see this clinically in patients who seem intolerant to many different foods and can’t seem to enjoy stable improvement of their symptoms, despite eliminating gluten from their diet. The reason for this insufficient improvement is that a comprehensive follow-up program is missing – a program that addresses what we call the Secondary Effects of Gluten. This entails evaluating for any other food sensitivities, cross reactive foods, a tendency towards autoimmune disease, the presence of any infectious organisms, healing the leaky gut, balancing the probiotic population, and more.

While increasing awareness of the presence of gluten intolerance is absolutely critical, neglecting the secondary effects, as mentioned above, can result in long-term ill health that is truly preventable.

Have you experienced such symptoms? Have you removed gluten but are only partially healthier? I’d love to hear from you.

If your health is not where you desire it to be, consider contacting us for a free health analysis – call  408-733-0400. Our destination clinic treats patients from across the country and internationally. We are here to help!

To your good health,

Dr Vikki Petersen, DC, CCN
Author of the e-Book: “Gluten Intolerance: What you don’t know may be killing you!”
Awarded Gluten Free Doctor of the Year 2013-2014

Reference: “The Bowel and Migraine: Update on Celiac Disease and Irritable Bowel Syndrome”, R.K. Cady, K. Farmer, J.K. Dexter, J. Hall, Current Pain and Headache Reports, Mar 2012.

Thursday, November 14, 2013

What's Your Celiac and Gluten IQ?



Are You a Well Educated Celiac?

 
The hazards to health created by celiac disease and gluten sensitivity are well understood. From nutritional deficiencies to osteoporosis, from depression to autoimmune disease, and from psoriasis to thyroid disease, there are few areas of the human body that gluten doesn’t impact in a negative way. 

There is so much emphasis on our inadequate abilities to diagnose celiac disease and gluten sensitivity, that when we do finally make the diagnosis I believe we are guilty of another problem – Lack of adequate education to those affected patients.

Removing Gluten Is NOT Enough to Heal the Gut

A research study released by the American Journal of Gastroenterology, (2010) . The article was entitled “Mucosal recovery and mortality in adults with celiac disease after treatment with a gluten-free diet”. The research team hailed from the Division of Gastroenterology and Hepatology at Mayo Clinic College of Medicine.

They stated that while most adults with celiac disease feel better after treatment with a gluten-free diet, the rate of small intestine recovery is less certain. Their aims were to estimate the rate of intestinal recovery after a gluten free diet in a cohort [a group of people with statistical similarities] of adults with celiac disease, and to assess the implications upon health of persistent intestinal damage after a gluten-free diet.

There was a pool of 381 adults with biopsy-proven celiac disease, 241 had both a diagnostic and follow-up biopsy. Among these 241, the confirmed mucosal recovery at 2 years following diagnosis was 34% and at 5 years was 66%. Most patients (82%) had some positive clinical response (they felt better) to the gluten-free diet, but it did not prove a reliable marker of intestinal recovery. 

Poor compliance to the gluten-free diet, severe celiac disease as defined by diarrhea and weight loss, and total villous atrophy at diagnosis were strongly associated with persistent intestinal damage. 

More Healing = Less Future Risk of Disease

There was a trend toward an association between mucosal recovery and a reduced rate of all-causes of death, adjusted for gender and age. 

The conclusions were that intestinal recovery was absent in a substantial portion of adults with celiac disease despite treatment with a gluten-free diet, and that there was an association between confirmed intestinal recovery (vs. persistent damage) and reduced mortality independent of age and gender. 

So what can we learn from this?
1.      Eating gluten-free when you are sensitive will cause you to feel better.
2.      Going on a gluten-free diet is not enough to ensure that your intestines will heal.
3.      Failing to heal your intestines puts you at increased risk for disease and death.
4.      Successfully healing your intestines reduces your incidence of death from disease.

While you likely knew the first point, 2 through 4 are perhaps less well known. 

Where I see that we are failing the gluten intolerant population is in the narrow focus of  eliminating gluten as the only needed treatment.  What the above research proves is that, unfortunately, for over 30% of those diagnosed, simply eliminating gluten is insufficient to ensure intestinal healing and thereby prevention of future disease states.

If patients were educated that healing their intestine would make the difference between contracting serious disease or not, and extending their life expectancy or not, I think they’d be more interested in ensuring that it occurs.

I am not a researcher but my clinic sees hundreds of patients who conform with the results of this study completely.  Patients come to see us who have been told that they shouldn’t consume gluten and for the most part they follow that recommendation.  They know that they feel better when they are gluten-free so that is an impetus to not cheat.  When they do cheat they know that they’ll “pay” for it but they still do so with some regularity.

Cheaters Beware!

Why do they cheat?  Because they believe that the diarrhea, headache, bloating, etc is temporary and that when it goes away they are “fine” again.  Their thought process is not unreasonable, it’s just wrong!

If each patient was educated that cheating created intestinal destruction that in turn put them on a fast track towards disease and early death, I believe that cheating would take on a whole new perspective.

Patients need this education and they need it often. Our book “The Gluten Effect” was written with this intention – our patients actually requested it.   They asked for a written reminder of why they should maintain their gluten-free lifestyle. Later I began taping Youtube videos because other patients preferred a reminder in a video form.

I personally am attempting to educate in a few different because it is terribly upsetting to meet individuals, as I so often do, who have been diagnosed celiac or gluten sensitive and do not follow their diet solely due to ignorance.

After almost 25 years of clinical experience I also know that some people “hear what they want to hear” and doctors with the best of intentions cannot get through to everyone.  But I strongly believe that we could be doing a much better job of education and enlightenment.

Further, we need to educate patients of the secondary effects associated with gluten. When the immune system of the intestine is suppressed, as is the case of a gluten intolerant patient, inhospitable and pathogenic organisms can gain entry into the intestine and remain there.  These organisms may be in the form of bacteria, parasites, amoebas or worms, and if they are not identified and eradicated, complete healing of the intestines is all but impossible. 

The good bacteria that are housed in the gut, known as the microbiome or probiotics, make-up  much of the intestinal immune system. In gluten intolerant patients this important population of organisms is often insufficient due to the onslaught from gluten and pathogenic organisms that have weakened it.  If the population of these probiotics is not restored to a healthy, robust balance, any attempt to achieve a healthy intestine will too be unsuccessful.

Diagnosing any cross-reactive foods, other food sensitivities or allergies, any other sources of toxins, and hormonal imbalance should also be on the checklist to rule out.

Lastly, it is an interesting catch-22 that in order to digest our food we need enzymes and enzymes are made from the nutrients we digest.  This circular pattern is dramatically interrupted in the gluten intolerant patient.  Celiacs in particular suffer from very poor absorption.  It shouldn’t then come as a surprise that augmenting with proper enzymes may be critical for “priming the pump” until proper digestion of nutrients is restored.

Unfortunately I find that few, if any, of these points are made clear to patients who are gluten intolerant.  Most feel that they are doing all that they need to simply by maintaining a mostly gluten-free diet.  Nothing could be further from the truth.

Find a Clinician Who Treats the Secondary Effects of Gluten

To review we need to do the following, something we call the Secondary Effects of Gluten:
-          Maintain a “perfect” avoidance of gluten
-          Test for the presence of pathogenic organisms
-          Test for any imbalance of the probiotic organisms
-          Evaluate the need for enzymes
-          Evaluate for the presence of any other food sensitivities or allergies, e.g. dairy
-     Evaluate for any toxins or hormonal imblance
-          Educate the patient until they have a full understanding of the above
-          Test to ensure that the intestine is healed

I hope this proves informative.  If your health is not at the level you desire and you suspect that your small intestine may not be fully healed, consider contacting us for a free health analysis - call 408-733-0400. We are a destination clinic and we treat patients from across the country and internationally at our destination clinic. We are here to help!

To your good health,

Dr Vikki Petersen, DC, CCN
Co-author of "The Gluten Effect"
Awarded Gluten-Free Doctor of the Year 2013-2014

Reference:
American Journal of Gastroenterology, (2010) Jun; 105(6):1412-20. “Mucosal recovery and mortality in adults with celiac disease after treatment with a gluten-free diet”. Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine.

Wednesday, November 13, 2013

Is Gluten Causing Your Hormonal Imbalance?



What Do Fatigue, Overweight, PMS, etc All Have in Common?


Fatigue is the most common symptom plaguing most patients. Trouble sleeping, weight issues, PMS, headaches, fertility or libido issues, and achy joints are also very common and can all be affected by hormonal imbalance that continues after gluten has been removed from the diet in the gluten intolerant individual.  The trouble with trying to resolve such symptoms is that the root cause can vary. If every patient with fatigue had a thyroid problem, it would be easy to correct because we would know exactly where to look.

If you’re gluten intolerant you may have suffered from some of the complaints listed above prior to discovering your celiac disease or gluten sensitivity. But perhaps now, despite your gluten-free diet, some of these same symptoms continue to plague you.  If so, read on.

Do You Have Any of These Symptoms?
  • Fatigue
  • Trouble sleeping
  • Weight trouble
  • PMS
  • Migraines
  • Infertility or miscarriage
  • Achy joints or muscles
  • Allergies
  • Light headedness
  • Frequent illness, weak immune system
  • Asthma


While the list is long, believe it or not, there is a common cause to all of them.  I’m not saying it’s the only cause, but I want to discusswhy someone can be found gluten intolerant, successfully institute a gluten-free diet, and yet continue to suffer from many of the above symptoms.

The Problem May Be Your Stress Gland

There is a gland in your body, of which you have two, called the adrenal glands. They sit atop each of your kidneys and they are the master of multi-tasking! If I asked you if one part of your body was responsible for:


  • Providing you with strong energy
  • Maintaining a healthy weight, 
  • Keeping your immune system strong,
  • Decreasing inflammation
  • Maintaining stable mood, 
  • Anti-aging, 
  • Controlling sleep quality, 
  • Balancing hormones, 
  • Handling allergies, and more… 

 What would you say?

You might think to yourself that if there was one body part responsible for all those things then you better start treating it well! You’d be very right in your analysis.

As you’ve probably guessed the aforementioned adrenal glands are responsible for handling that very long job list and, unfortunately, those very same adrenal glands tend to be quite stressed in the gluten intolerant individual.

Gluten Intolerance Can Damage Your Stress Glands

Why? Because adrenal glands are sensitive to, and get very stressed with, unstable blood sugar. Stable blood sugar comes from eating healthy food that your body finds nourishing. As you well know if you’re gluten intolerant, gluten, for you, is a poison. Therefore years of eating gluten created unstable blood sugar and thereby put a tremendous strain on your adrenal glands.

Due to the many, many jobs that the adrenal glands are responsible for, simply removing gluten as a stressor is typically insufficient to restore them to normal function. They need to be ‘re-set’ with a nutritional and dietary program, to restore their good health. This explains why many who are gluten intolerant continue to suffer with the symptoms mentioned above.

Therefore, even if your gluten intolerance has been diagnosed and you’ve instituted a strict gluten-free diet, if you haven’t also found a clinician who understands and specializes in restoring health and function to the adrenal glands, you may very well continue to suffer with the symptoms associated with adrenal stress.

Treatment is Easy and Drug-Free

The good news is that the treatment to normalize adrenal function is not at all difficult.Here at the Clinical Nutrition department of HealthNOW we utilize a natural program that involves no dangerous drugs or surgery. There are lab tests to determine the level of adrenal malfunction occurring, and these are called functional specialized lab tests. They differ from traditional adrenal lab tests that only look for disease, not malfunction. I mention this because I want to ensure that there is no confusion created when I mention adrenal function lab testing. We are measuring 'function' and therefore are looking for signs of malfunction rather than only looking for disease, which in the case of adrenal glands is quite rare, although dangerous.

If you ask your traditional medical doctor to test for adrenal malfunction he or she will test for adrenal disease – once again a rare occurrence – and will likely pronounce your adrenal glands ‘fine’ because they are not diseased. While adrenal gland disease is rare, adrenal gland malfunction is extremely common. It is this latter condition that we are speaking of here.

This is an important distinction because I want to make sure that if you are suffering from adrenal fatigue that you aren’t given a ‘clean bill of health’ incorrectly. Unfortunately this happens often. If it took you a while to receive a diagnosis of gluten intolerance then you understand this phenomenon. Sadly this area of health is fraught with misunderstanding and it is the patient who ultimately suffers, unnecessarily.

We Can Help!

If you need any help finding a clinician to help you, feel free to contact me. Normalizing adrenal function is one of our areas of expertise and patients visit us from across the country as well as internationally at our destination clinic to receive this treatment. If we cannot find a clinician close to you that specializes in this then we are more than happy to see you here. The good news is that the treatment is natural and inexpensive.

Should you be interested in receiving assistance, consider contacting us for a free health analysis - call 408-733-0400. We are here to help!

I look forward to hearing from you.

To your good health,

Dr Vikki Petersen, DC, CCN
Co-author of “The Gluten Effect”
Awarded Gluten-Free Doctor of the Year 2013

Monday, November 11, 2013

Gluten Sensitive – When is an Egg NOT Gluten-Free?



Eggs Are Totally Safe, Right?

Eggs are a nice source of protein, they are available pretty much everywhere and can be prepared a number of different ways, making them a pretty safe go-to when traveling. I always believed that if one wasn’t allergic to them, eggs were a very safe option for those on a gluten-free or dairy-free diet.

I don’t tend to eat many when I’m at home, but when traveling, some form of egg has been a common breakfast solution. After all, we’re not going to order the cereal, waffles or pancakes! Does this sound like you? Have you ever eaten eggs in a restaurant and felt like you had a reaction? If so, you’re not alone.

Just the Eggs, No Pancake Batter

Let’s review why eggs might ‘get you in trouble’.

       1.   It’s all in the preparation. If you’ve ever been to a breakfast buffet where they offered ‘made to order’ omelettes, you may have noticed that the individual making the omelette isn’t breaking eggs for you. Instead he or she is pouring from a pre-mixed contained of ‘eggs’ that may or may not contain dairy and gluten. 

You may be wondering where the gluten might come from. I too was surprised when I learned this. When it comes to ‘secret’ egg ingredients, I’ll have to admit that before becoming dairy-free the ‘secret’ ingredient in my scrambled eggs was some milk or, better yet, cream. (I’m sure a non-dairy milk, especially coconut milk would yield as good a result.) But what about gluten? Where does that come into the picutre?

It turns out that some restaurants (IHOP for one) add pancake batter to their eggs - that’s their ‘secret’ ingredient. That one I never would have guessed!

Rule #1 –make sure the eggs are broken fresh for you when you order any kind of egg dish. Don’t accept any pre-made egg ‘batters’.

     2. Where was the egg cooked? Much like anyone who is gluten-free knows to ask that pasta be prepared in its own water, rather than sharing water with previously cooked wheat-based pasta, so too one must be careful of where one’s eggs are prepared. While you may prepare your own eggs in a fry pan, many restaurants prepare scrambled eggs, fried eggs and omelettes on their griddle. That same griddle that they just cooked pancakes or French toast on.

Rule #2 – ensure that you ask for a clean pan for your eggs to be cooked in to prevent any cross-contamination. And remember that holds true for pasta water and French fry oil.

     3.  Have you ever been to a salad bar and noticed that the contents of one container had migrated to another adjacent one. In other words, there were pieces of red cabbage mixed with the lettuce? Well, the same thing can happen in a kitchen that is preparing egg dishes that contain a variety of ingredients. If the cook that just was grabbing some croutons next grabs some mushrooms to put in your omelette, cross-contamination is likely to occur.

Rule #3 – If you are ordering breakfast in a restaurant, consider getting an egg dish that just contains eggs. Ensure the waitperson appreciates your ‘allergies’ (you don’t actually have an allergy if you’re celiac or gluten sensitive, but it’s a word that people can readily understand) and the need for a clean pan, designated clean utensils and freshly broken eggs.

       4.  Eggs themselves are, as mentioned earlier, a common allergy. If you suspect that you are reacting to eggs, consider getting tested for a blood IgE  or delayed IgG test. Either, if positive would show that you are reacting to them. Scratch tests are not particularly accurate for food, therefore no need to put yourself through that procedure.

5. Eggs are a potential cross-reactive food. This means that the compromised immune system of a celiacor gluten sensitive person mistakes the protein of the egg for gluten and therefore reacts as if it WAS gluten. There is a blood test to determine if such a reaction is occurring in your case. Fortunately this is a temporary situation and once the eggs are removed for a period of time while building the immune system and healing the gut, these individuals can typically return to eggs safely.

What Did You Feed That Chicken? 

        6/  Finally, there was an interesting study in Bioscience, Biotechnology and Biochemistry (2001)  entitled, “Transfer of soy isoflavone into the egg yolk of chickens” where the researchers proved that feeding chickens a great deal of soy was transferred into their egg yolks. This study has been seen as foundational research that may explain why certain highly reactive celiac and gluten sensitive patients can be found to react to eggs, despite having no egg allergy.

 The particular eggs that these individuals react to are those from hens whose diets are very high in glutinous grains. In the past we wouldn’t have ever thought that the feed of an animal would affect eating said animal, but these are eggs, not the animal’s flesh, and as mentioned above, the soy study gave credence to the fact that such a transference is very possible.

Now, I must caution you that the quantity of gluten that could be found in such a case is likely so small as to make the egg still pass a ‘gluten-free’ test – meaning it’s well below the 20 parts per million that would designate a level of gluten warranting a gluten label. We are only mentioning this in the case of those rare individuals we are so sensitive that literally ANY gluten is enough to cause their immune systems to react.

Don't Be Shy, Speak Up and You Won't Get Sick.... hopefully

I hope you found this helpful. I think some diligence when eating out should allow most of us to safely enjoy eggs without too much trouble. But if you don’t speak up and let the restaurant know what you need, you very well might have an exposure that really sets your healing and health status back. Not necessary, I assure you.

If your health is not to level you desire, consider contacting me for a free health analysis – call 408-733-0400. Our destinationclinic treats patients from across the country and internationally so you don’t need to live locally to us to receive care. We are here to help!

To your good health,

Dr Vikki Petersen, DC, CCN
Co-author of “The Gluten Effect”
Awarded Gluten-Free Doctor of the Year 2013