Tuesday, May 27, 2014

New Research Argues There IS a Test for Gluten Sensitivity


Best Blood Test to Diagnose Gluten Sensitivity

Mainstream literature continues to state there is no blood test for gluten sensitivity. While it may not be perfect (but what tests are?) some researchers offer a differing opinion, and I wanted to share their results with you.

While there is no further argument of the existence of gluten sensitivity, having a blood test that everyone can agree on has not yet occurred. 

In a 2012 study published in Clinical Reviews in Allergy & Immunology entitled “Serological Tests in Gluten Sensitivity”, the authors set out to characterize a potential pattern in blood testing that would be helpful in diagnosing gluten sensitivity as compared with celiac disease.

They took 78 patients with gluten sensitivity and 80 patients with celiac disease, and retrospectively tested their blood for four standard tests, three of which are classically used for celiac disease, and one that is more commonly thought to be accurate for gluten sensitivity.

For those of you who like the specifics, the tests used were:

1) IgG DGP-AGA (deamidated gliadin peptide antibodies)

2) IgA tTGA (tissue transglutaminase antibodies)

3) IgA EmA (endomysial antibodies)

4) IgG/IgA AGA (anti-gliadin antibodies)

And the Winner Is…

Here are the findings:

The  IgG AGA test was the winner in detecting gluten sensitive patients—56.4% were positive. The test doesn’t rule out the presence of celiac disease however. 81.2% of celiac patients were also positive.

The IgA version of the same AGA test yielded vastly different, although not unexpected, results. The test was elevated in only 7% of gluten sensitive patients while 75% of those with celiac disease were positive. Why is that not a surprise? IgA is found on the mucous membranes of the body where it is exposed to outside foreign substances: nose, lungs, GI tract, ears, eyes, etc. Since celiac disease mostly affects the lining of the GI tract, it isn’t unexpected that the IgA part of the immune system might be most affected.

But when you compared the “classic” celiac tests against the gluten sensitive patients, the results were rather definitive—only one gluten sensitive patient was positive for DGP-AGA and zero gluten sensitive patients demonstrated a positivity for tTGA or EmA. But the celiacs showed a positivity rate of 88.7%, 98.7% and 95% respectively for these three tests.

What Do We Know From This?

A couple of things:

1) Ensure that when you are tested you receive a complete panel of tests, including all those mentioned above. Additionally both the IgA and IgG versions should be included, especially for the AGA test.

2) When interpreting the tests, remember that you are doing more than just ruling out celiac disease. For many doctors that is their goal. Despite international research knowledge to the contrary, many doctors still don’t appreciate the existence of gluten sensitivity. While no single test is perfect, if you’re suspecting celiac and you test positive for the classic celiac panel of tTGA, EmA and DGP-AGA, then you’ve likely identified your condition. 

If you know that you do poorly with gluten and test positive for AGA, especially the IgG version, and negative for the rest of the celiac panel, you can feel more assured of a gluten sensitive diagnosis.

Some other tell-tale signs of gluten sensitivity, according to the researchers, are a varied clinical picture, meaning many symptoms occurring at the same time. And while many of these symptoms are similar to another disease, IBS, the authors warn against considering gluten sensitivity as a subtype of IBS. 

The “extraintestinal” symptoms so common with gluten sensitivity are not typically seen in those patients suffering with IBS, making the distinction clear, in these researchers’ opinion.

The common complaints associated with gluten sensitivity include:
  • abdominal pain, bloating, diarrhea, constipation
  • foggy mind, tiredness
  • eczema/skin rash
  • headache
  • joint/muscle pain
  • numbness of legs/arms
  • depression
  • anemia
  • together with a normal or mildly abnormal lining of the small intestine
In conclusion, when you’re building a case for gluten sensitivity, you need to look at several factors: blood testing, symptoms, and reactions to eating and eliminating gluten.

New Information on Celiac Genes

In the past, the rule of thumb was that “you could never have celiac disease if you didn’t carry the genes for it”. That remains true, but these researchers cited findings from 2010 that demonstrated a full 40-50% of gluten sensitive patients possess the same genetic profile as those with celiac disease—HLA DQ2 or DQ8.

And with that we watch another stable datum bite the dust. This opens the door to a new interpretation of genetic testing that doctors should be aware of. Instead of being too quick to tell a patient that while they may have the genes for celiac disease, considering that their blood tests are negative for the disease, they’re fine to eat gluten; we now understand that such genes can be present in a case of gluten sensitivity as well. 

And as we now know, the classic celiac blood tests would be negative in such a case.

I believe we’ll be seeing a wide array of genes responsible for these diseases in the future. But knowing that almost half of those with gluten sensitivity demonstrate the exact same genetic profile as someone with celiac disease is important to know when a patient or their doctor is trying to make an accurate diagnosis.

Based on this common gene profile, it is then not surprising to learn that gluten sensitivity can be found in celiac disease family members. In this study almost 13% of the gluten sensitive patients were first degree relatives of celiac patients.

What Might the Future Hold?

As a clinical nutritionist, I have been speaking of celiac disease and claiming the existence of gluten sensitivity for over two decades now. We continue to discover more and more about these conditions. One day there will be a near perfect test and one day we will readily and easily diagnose most all of those suffering. And that my friends, will be a good day!

I hope you found this article informative. If your health is not to the level you desire, consider contacting us for a FREE Health Analysis. Call 408-733-0400.

We are a Destination Clinic and treat patients from across the country and internationally. We are here to help!

I look forward to hearing from you.

To your good health,
Dr. Vikki Petersen, DC, CCN
IFM Certified Practitioner

Founder of HealthNOW Medical Center

Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”













Reference:
1. Clinical Reviews in Allergy & Immunology 2012
Serological Tests in Gluten Sensitivity (Nonceliac Gluten Intolerance)
Umberto Volta, MD, Francesco Tovoli, MD, Ronny Cicola, MD, Claudia Parisi, MD,
Angela Fabbri, MD, Maria Piscaglia, MD, Erica Fiorini, MD, and Giacomo Caio, MD

2. Clinical Reviews in Allergy & Immunology 2010
Cutting-edge issues in celiac disease and in gluten intolerance.
Bizzaro N, Tozzoli R, Villalta D, et al.

Wednesday, May 21, 2014

Going for Optimal Health? Following a GF Diet is Not Enough


I Have a Pet Peeve

When it comes to the area of celiac disease and gluten sensitivity, there's a pet peeve that I’ve had for a long time. And that is the recommendations associated with a celiac disease or gluten sensitivity diagnosis.

What are those recommendations? A gluten free diet. And that’s it.

There is nothing wrong, of course, with the recommendation of a gluten-free diet, but when that is all that is recommended, that is where I have a problem—a big problem.

Why? Solely instituting a gluten-free diet is never (at least 95% of the time) enough to cause a person to completely regain their health.

It’s hard enough to eliminate gluten from your diet without at least reaping the benefits of feeling great as a result. After all, the goal is to vastly improve a patient’s health.

It is for this reason we created the term “secondary effects of gluten”. It is what we use, after a diagnosis, to address everything else that needs to be taken care of after one has begun a gluten-free diet.

We have seen the value of addressing the secondary effects of gluten for the past two decades. Yet I continue to be surprised at the lack of awareness associated with only implementing a gluten-free diet with this group of individuals.

The Results of an Ongoing Study Reveals…

I was happy and vindicated to see the results of an ongoing clinical trial for celiac patients. The study followed 117 adults in the United States with a diagnosis of celiac disease. These individuals were adhering to a gluten-free diet as “best they could”.

On average, these were individuals who had received their diagnosis over six years prior. In other words, they were not new to following a gluten-free diet.

Despite their “veteran” status and their efforts at following a gluten-free diet, the researchers discovered the following:

95% (111 of the 117 participants) showed evidence of ongoing inflammation of the lining of their small intestine

• In 65% of those individuals, the inflammation was so extensive that is was consistent with patients whose celiac disease was untreated—meaning it looked as if the person wasn’t following a gluten-free diet at all, even though they were.

• Even in those whose blood tests were negative for antibodies (meaning their blood test for active celiac disease was negative), they still demonstrated significant inflammation of their small intestine similar to the damage seen before adopting a gluten-free diet.

What does this all mean? Exactly what I and my fellow clinicians here at HealthNOW have been stating for almost two decades: instituting a gluten-free diet cannot be the only action that a person diagnosed with celiac disease or gluten sensitivity takes.

More must be done—and that “more” is the implementation of the secondary effects of gluten, as follows:

1. Testing for the presence of infections in the intestinal tract

2. Isolating if other food sensitivities exist—common are dairy, corn, soy

3. Testing to see if there are any cross-reactive food reactions occurring

4. Ensuring that the probiotic population in the small intestine is healthy and robust

5. Ruling out any enzyme or nutritional deficiencies

6. Normalizing any adrenal or hormonal imbalance

7. Ruling out any other sources of toxins such as Lyme’s disease or heavy metal toxicity

8. Ensuring that the individual is on a healthy diet, not just a gluten-free diet. That’s saying a lot in our era of gluten-free junk food. You can be gluten-free and still not eat your 9 servings of fruits and veggies every day, as an example.

That’s the list. As you can see, it’s not terribly long, nor does it involve the use of any scary drugs or surgery. But if you don’t address the factors that are pertinent to the individual in front of you, you’ll end up like the participants of this study—with an inflamed gut and therefore at an increased risk of lymphoma (cancer), not to mention other serious health complications.

It’s Just Not Fair!

Recommending solely a gluten-free diet to these individuals is unacceptable. I realize that the reason for this problem lies squarely in the arena of pharmaceuticals. Doctors in this country really don’t know what to do for a disease that doesn’t have a drug to control it.

Because celiac disease has no medication to treat it, and is known to respond to a gluten-free diet, that’s what they recommend. And that’s all they recommend.

The secondary effects (as delineated above) are not typical actions in traditional medical environments—and I think that’s why we don’t see them occurring. But it is to the detriment of the patient and this research supports my view.

What Can You Do?

If you have celiac disease or gluten sensitivity, and ALL you do is follow a gluten-free diet, I recommend that you find a clinician who can assist you in determining what secondary effects should be identified to help ensure the FULL HEALING of your intestine and optimized health.

If you need assistance finding such a doctor, we’ll be happy to help you. And if you want our assistance, consider contacting us for a FREE Health Analysis. Call 408-733-0400. We are a Destination Clinic and treat patients from across the country and internationally.

Dr. Vikki Petersen, DC, CCN
IFM Certified Practitioner
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect”




Monday, May 12, 2014

Is Celiac Disease More Common in Children?




Is it True that Children are More Likely to Have Celiac Disease?

A research study out of Spain found that children were five times more likely to have celiac disease than adults.

That’s interesting. On one hand it would seem to make no sense, and on the other hand it is a fair warning that I believe we should all heed.

Is Celiac Disease Becoming More Common?

Here’s my interpretation:

First of all, there has never been any evidence that celiac disease is reversible. So extrapolating that the child with celiac somehow becomes an adult without the disease is definitely false, based on the knowledge we currently have.

So let’s look at another possibility: could it be that due to “something”, the rate of celiac is actually increasing? Recent research has shown that while we used to consider celiac as rare, the percentages currently being put forth by researchers are between one and four percent, putting the disease squarely in the “common” category.

Do Less Healthy Intestines Predispose Us to More Celiac?

Now what could that “something” be? Dr. Alessio Fasano from the University of Maryland’s Celiac Research Center tells us that our increased use of toxins, drugs and poor diet has created a milieu or environment in our intestine that makes us more and more susceptible to altering our genetic expression in a negative fashion.

He has stated that while a healthy small intestine can keep a celiac gene “turned off”, an unhealthy small intestine is fully capable of “turning on” that gene, which results in an intolerance to gluten.

It’s my opinion that this study is a red flag showing that the health of small intestines in Spain is no better than it is in the U.S.

What You Can Do:

Some steps we need to take are:

1)  Consume more organic fruits and vegetables that provide healthy antioxidants and fiber to heal and replenish good bacteria in the intestine. Women need 7 servings of fruits and vegetables each day, men need 9, and children need between 5 and 7 depending on their age and activity level. The percentage of us that accomplish this task is pitifully low.

2) Reduce our exposure to drugs, toxins and chemicals as much as possible. E.g., eliminating high fructose corn sweeteners and artificial sweeteners would be an easy first step.

3) Eliminate dairy products from your diet (organic butter is fine, it has little to no protein solids making it have a low sensitivity).

4) Stay hydrated. The body needs water to detoxify and many of us are dehydrated making the elimination of toxins more difficult.

5) See a clinician who can adequately evaluate for the presence of hidden infections. The intestine will never heal when an unhandled infectious organism is present.

The above list could be longer, but the point is clear. Our lifestyle is putting us at risk for increased disease—including heart disease, diabetes, cancer and autoimmune disease, including celiac disease.

I am convinced that if we take these steps, we would all enjoy greater health. I don’t know if we could get to the level of perfection such that all those with celiac disease could keep those genes “turned off” for life, but it does sound like a lofty goal to strive for—and it definitely couldn’t hurt.

Please email me should you have any questions or need any assistance.

We see patients from across the country as well as internationally. To schedule a free consultation, call (408) 733-0400.

To your good health,

Dr. Vikki Petersen, DC, CCN
IFM Certified Practitioner
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect”