Lab Test Interpretation for Celiac and Gluten Sensitivity

What do you do when your doctor is uninformed?

The question below came from a listener of my recent virtual book tour. It was a bit horrifying to read, I must tell you. Unfortunately I see this type of poor advice given often, but it doesn’t make it any less palatable.

Here’s the question:
“I had positive deamidated gliadin antibodies but did not have any celiac-specific antibodies... my doctor did not recommend I go gluten-free. What does this mean and where do I go from there?”

The deamidated gliadin antibody test IS a celiac-specific test. It is believed to be more sensitive than the traditional tTG test and that is why it is being used more broadly. As you may know, one of our biggest concerns is to have those suffering from celiac and gluten sensitivity diagnosed as soon as possible. Early diagnosis will help to prevent a tremendous amount of suffering, ill health and secondary autoimmune diseases.

Unfortunately this person’s doctor didn’t seem to know what the purpose of the test was and as a result didn’t recommend that a celiac patient remove gluten from their diet! What a tragedy…

On the bright side, I was happy that this individual attended the virtual book tour and shared her question. Now she knows what the test means and will remove gluten from her diet. This will not only improve her current health status but will also hopefully protect her from developing future problems such as autoimmune disease.

Situations just as this occur all too frequently. While such ignorance may not be intentional on the part of the doctor, it is ignorance none the less and the effects it creates can be devastating. We see it here at our clinic, unfortunately, all too often. A patient came in just last week with undiagnosed dermatitis herpetiformis (a skin condition related to celiac disease) who was told that the reason her skin looked the way it did was because she had a psychological problem and she was prescribed antidepressants. Fortunately a friend helper her to find us and we KNOW that her problem is not a mental one.

The bottom line is that it is critical to find a clinician who is really informed about celiac and gluten sensitivity. Here’s a test question for your doctor: Ask him or her if they would recommend removing gluten from the diet due to suspected gluten sensitivity even without the presence of celiac. If the doctor states there is no reason to eliminate gluten from the diet if celiac isn’t present, then find a new clinician. This may sound harsh but I want you to be healthy. There is too much needless ill health from undiagnosed gluten intolerance

I know that I’m located in California and not all of you are. But I do want you to know that I am more than happy to help you locate someone to help you if you are unable to visit us here.

Visit us at www.RootCauseMedicalClinic.com. If you have questions or need any help, I’m here for you! Call 408-733-0400.

I look forward to hearing from you.

To your good health,

Dr Vikki Petersen, DC, CCN, CFMP


IFM Certified Practitioner

Founder of Root Cause Medical Clinic
Co-author of “The Gluten Effect”

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

How Long Does it Take to Heal After Removing Gluten?

A reader asks: “How long does it take for the small intestine to heal once gluten is out of the diet..for a person in their 50's?”

While we tend to think of the small intestine as a long smooth tube or pipe, I’d like to paint a more accurate picture for you. The small intestine is about 23 feet long but because it is folded into many finger-like projections it is anything but smooth (imagine shag carpeting), and its surface area is that of a tennis court. That’s a tremendously large area that is responsible for converting one’s food into available fuel that is then delivered to the trillion cells that you own.

In order the answer the above question completely accurately it would require knowing how much damage the small intestine had sustained. If this individual has celiac disease and was only just diagnosed in her 50s, the likelihood is that it could take several years to heal the intestine. If the individual is gluten sensitive then the healing time is less, maybe 1 ½ to 2 years, as less damage was sustained. While this may sound like a long time, do realize that most people start feeling better in a matter of weeks. And considering how many years the intestine was likely under attack from gluten, it’s only a fraction of that time that is needed to heal it. And when you recall that we’re talking about something the size of a “tennis court”, it makes sense that it takes some time.

What further plays into this equation, is what the person is doing to ensure that healing occurs. Obviously completely removing gluten is most important. But supplementing any nutritional deficiencies such as vitamin D, B12, iron, calcium, etc are also needed to give the body the raw materials it needs to heal itself. Further, identifying and removing any inhospitable organisms such as parasites, amoeba, bacteria or yeast is also necessary to regain health and proper healing of the small intestine. You can’t re-grow the grass on your lawn if every night an animal is digging it up!

In fact, the above paragraph addresses the largest hole we see in addressing gluten intolerance. The prescribed treatment is to remove gluten, but not much else. Neglecting to similarly remove any infectious organism can prevent regaining one’s health. Adding nutrients in which one has become deficient or those specifically designed to assist healing plus probiotics that help restore strength to the intestine’s immune system, are all factors that need to be employed for a truly successful program.

I hope you find this helpful and please let me know if I can be of further assistance.

Visit us at www.RootCauseMedicalClinic.com. If you have questions or need any help, I’m here for you! Call 408-733-0400.

I look forward to hearing from you.

To your good health,

Dr Vikki Petersen, DC, CCN, CFMP


IFM Certified Practitioner

Founder of Root Cause Medical Clinic
Co-author of “The Gluten Effect”

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

“The Gluten Effect” Virtual Book Tour an Amazing Success!

I was delighted to participate in my first virtual book tour this week. Several hundred people signed up for the event and it was truly an international affair with listeners from Canada, Mexico and Australia.

If you missed the event you can listen to the replay at www.askaboutgluten.com/replay.

Many wonderful, insightful questions were asked during the event but for those who didn’t get their questions answered at the event I thought this blog would be a good place where I could continue to address all the important issues that were raised.

Imagine my surprise when barely 24 hours later there are 210 questions awaiting me! There is an incredible diversity in the questions and I will truly try to answer as many of them as possible.

So stay tuned. I will also be answering some of the shorter responses in a video format on my YouTube channel: http://www.youtube.com/healthnowmedical.

Okay, so let’s get started.

Question: If I eliminate gluten from my diet but then begin to eat it again will I be more sensitive to it than I was before I eliminated it?

When you eliminate gluten from your diet your body will begin to heal. Whether you’re gluten sensitive or have celiac disease positive changes will begin to develop in your digestive tract, your immune system as a whole, and other affected systems will also begin to improve.

You must realize that because gluten has the ability to affect so many systems of the body, the changes that you see upon removing it will be different for different people. One person may see their migraines disappear, while another may see an increase of energy and less anxiety. One person may stop experiencing joint pain while another’s skin will begin to clear up. The list of symptoms associated with celiac and gluten sensitivity is truly huge! I will post them below:


Signs & Symptoms of Celiac Disease

Alopecia
Anemias, especially iron and folic
Anorexia
Autism
Autoimmune arthritis
Autoimmune connective tissue diseases
Autoimmune thyroiditis
Cerebellar ataxia
Cerebral and cerebellar atrophy
Cerebral calcifications
Chromosome aberrations
Chronic fatigue
Chronic liver disease
Colitis
Constipation
Delayed puberty
Dental enamel defects
Depression
Down’s syndrome
Early menopause
Febrile seizures
Gallbladder dysfunction
Gallstones
IgA deficiency
IgA nephropathy
infertility
Insulin-dependent diabetes mellitus
Intestinal Cancers
Kidney Stones
Low Calcium
Low Iron
Low Magnesium
Low Vitamin A
Low Vitamin D
Low Vitamin K
Low Zinc
Mild ataxia
Monoarthritis
Muscular hypotonia
Neurological disorders
Obesity
Obstructive pulmonary disease
Osteomalacia
Osteoporosis
Pancreatic insufficiency
Pica
Pulmonary bleeding
Retarded motor development
Rickets
Sacroileitis
Schizophrenia
Short stature
Single generalized seizures
Spontaneous, low-impact fractures
Systemic lupus erythematosus
White-matter brain lesions


Symptoms and Conditions Associated with Gluten Sensitivity

Craving for wheat/gluten or inability to stop eating it
Obesity
Allergies, asthma
Sinus congestion, post-nasal drip
Arthritis
Joint and muscle aches
Diarrhea and/or constipation
Gas, bloating, abdominal pain
IBS, colitis, gastritis
Psoriasis, eczema or unexplained rash
Depression, anxiety or mood-swings
Hormonal imbalance
Neurological disorders
Memory loss
Unexplained Chronic Fatigue
Fibromyalgia
Increased liver enzymes
Frequent canker sores
Iron-deficiency anemia
Headaches / Migraines
Hyperactivity
Osteoporosis
Dental problems
Short stature


The beautiful thing about the human body is that the healthier it is the better it communicates to you how it feels. So the answer is yes, when you introduce gluten into your body after you have eliminated it for at least a month, your body will most likely react in a more sensitive fashion than it did when you were eating gluten all the time. You were always sensitive, it’s just that the reaction is easier to detect when you have eliminated it for a while.

Please note however that the response can be delayed. Your reaction to gluten can occur anywhere from immediately upon its ingestion to up to 3 or 4 days later. It depends on which systems are affected most in your particular situation.

I have some patients experience migraines within a few hours. Others have soreness and swelling the next day and still others notice symptoms several days later. These are all legitimate reactions to gluten.

I hope this helps. Please feel free to contact me if I can be of further assistance.

Visit us at www.RootCauseMedicalClinic.com. If you have questions or need any help, I’m here for you! Call 408-733-0400.

I look forward to hearing from you.

To your good health,

Dr Vikki Petersen, DC, CCN, CFMP


IFM Certified Practitioner

Founder of Root Cause Medical Clinic
Co-author of “The Gluten Effect”

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

Why Vitamin D Levels Won't Rise Despite Supplementation

It’s estimated that nearly one billion people around the world are deficient in vitamin D and need to be supplemented. We’ve discussed the important functions that vitamin D performs in earlier posts (see post of May 4, 2008) but let’s summate the highlights of its function.

Benefits of Vitamin D:
1. It strengthens your immune system, reducing your risk of cancer as well as colds and flu.

2. It affects the development and maintenance of bone health. In people who are vitamin D deficient, you will see a wide variety of bone disorders, such as osteoporosis, osteopenia and osteomalacia - the inability to mineralize bone, causing pain and weakness.

3. It has been shown to improve hypertension and drastically reduce the risk of heart disease.

4. It can help with diabetes, psoriasis and there are even some studies that link Alzheimer's disease, depression and multiple sclerosis to low vitamin D levels.

5. Deficiency is associated with musculoskeletal pain and fibromyalgia.

6. It is commonly malabsorbed in patients with celiac disease and gluten intolerance. Note: vitamin D deficiency subsequent to celiac disease and intestinal damage has been discussed previously and is not the focus of this post.

All too often patients are supplemented with vitamin D only to find in subsequent testing that they are still deficient. Knowing the importance of normalizing these levels for optimal health, the patient is left frustrated as they have followed their clinician’s instructions accurately.

What is the reason? There appear to be two major reasons vitamin D supplementation does not work adequately. The good news is that there IS a solution.

1. It has been a protocol for some time to use vitamin D2 as a supplement when D levels are found to be very low. Prescribing 50,000 IU for several weeks to a patient very deficient in vitamin D has been a standard accepted protocol.

Research reveals flaws in this protocol. The vitamin D2 potency is less than one third that of vitamin D3. Vitamin D2 has a shorter half-life in the blood and a lower affinity for the vitamin D binding protein. What this means is that according to a recent study in the French Internal Medicine Review, “vitamin D2 should not be regarded anymore as suitable for supplementation or fortification.”

So if you’ve been supplementing with vitamin D2 switch to D3 and recheck your levels in a few months. You should also feel much better with this preferred form.

2. Very recent research brings another very important issue to light. Retinol, a form of vitamin A, competes with vitamin D (even the preferred vitamin D3) and prevents its absorption. When you supplement vitamin A you can do it in two forms. Beta carotene, or pre-vitamin A derived from vegetables (or a supplement) which, in your intestines, is converted into the correct amount of retinol needed by your body. Your body will not convert beta carotene into excessive levels of vitamin A. Retinol, the other means of supplementing vitamin A, when given directly as a supplement, bypasses the natural controls of the body as seen above when beta carotene is the source. One could, therefore, get too much vitamin A in the form of retinol.

In an ideal world, all the vitamin A you require would come from vegetables you ate and all the vitamin D you need would come from sunlight. Unfortunately, we don’t live in such a place and many of us are deficient. And as discussed previously, we are not a culture that excels in consuming adequate quantities of vegetables.

Cancer, heart disease and diabetes are leading killers of Americans. As an example, a study by Dr. William Grant, Ph.D., a research scientist, found that about 30 percent of cancer deaths could be prevented each year with higher levels of vitamin D. That’s truly fantastic!

Since proper vitamin D status is known to lessen the incidence of these diseases, it is critical that you maintain an optimal status.

But what if another supplement interfered?


In the recent British Medical Journal 2010; 340:b5500, an article entitled:
“Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations: a nested case-control study” was published. In this article the researchers confirmed that low vitamin D levels are a risk for colon cancer and those with the highest levels are half as likely to develop the disease as compared to those with the lowest levels.

However, what they almost missed was that vitamin D levels are almost entirely negated in those with the highest vitamin A intake. Ingesting vitamin A, in the form of retinol could negate the effect of supplementing with vitamin D, even with levels as low as 3,000 IU/day. That is not a high dose.

Many people are completely losing the benefits they could receive from adequate vitamin D due to taking vitamin A (retinol), either in the form of multi-vitamins or cod liver oil.

Many people take cod liver oil based on the fact that it DOES contain vitamin D, A and omega-3 fatty acids. Now it appears that it should be avoided. Vitamin A and D do work together but the form of vitamin A (beta carotene vs retinol) and the ratio between the two must be balanced. On the other side of the coin consider this: being deficient in vitamin A precludes the proper function of vitamin D.

Like most things in nutrition (and life), neither too much nor too little is beneficial.

While it’s unclear what the exact correct ratio is, we do know this: vitamin A should be ingested in the beta carotene form, not retinol. Based on this research it seems unlikely that the amount of beta carotene gotten in a multiple vitamin would create any imbalance to vitamin D absorption.

Help me spread the word about this. In our clinic we see an abundance of patients deficient in vitamin D. Optimizing those levels create wonderful health benefits.

Please let me know if I can be of any assistance. If you would like to improve your health consider calling 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. You don't need to live locally to receive help.

To your good health,

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

Steps to Deal with a Gluten Intolerance

If you’ve recently been diagnosed with celiac disease or gluten sensitivity you’re probably feeling a bit disoriented and confused. It’s not easy to discover that a mainstay in your diet has been creating major health problems. It’s also not easy to change your diet overnight. I’ve been helping patients in this arena for 20 years and I’ve laid out a stepwise program that I hope will assist you to feel less overwhelmed and start feeling better as quickly as possible.

1. Go through your home and eliminate all gluten-containing foods. If you live with others who are not gluten-free then simply give yourself a generous section of the kitchen’s real estate, both in the pantry and the refrigerator, that all family members understand is a gluten-free zone.

2. If you like to use a toaster either buy yourself one that’s exclusively yours or purchase bags that you can place your gluten-free bread in that are toaster and contamination safe, reusable, and will allow you to utilize the family toaster. I don’t have the exact source but these bags work well – you should be able to find them online. You can also get yourself your own cutting board if sandwich preparation is a frequent activity in your home.

3. Go on-line and acquaint yourself with the list of grains you can consume, sources of “hidden” gluten (much less than it’s ever been due to improved labeling laws) and manufacturers that cater to the gluten-free lifestyle. I have written several blogs on this topic and my website: http://www.healthnowmedical.com/ is also a good resource that is updated often.

4. Realize that your small intestine needs to heal itself and that takes time. Don’t expect your symptoms to resolve overnight. Patience is key.

5. While successfully eliminating all gluten from your diet I would also strongly encourage you to eliminate all dairy products as well. I’ve spoken about why before but suffice to say that dairy is a source of irritation to the intestine and anything creating inflammation will hinder the healing process. (Organic butter is fine to eat – it is virtually free of the problematic milk proteins as it is a fat predominantly.)

6. Ensure that your diet consists of a good number of servings (5 is ideal) of organic vegetables and fruits. These are very healing and anti-inflammatory. Also work at staying well hydrated (8-10 glasses of purified water/day) as it will assist your body in detoxifying.

7. Exercise several times per week at a level of intensity that you can tolerate. What I mean by that is that you should feel energized by the exercise and not “wiped out” the following day. Exercising earlier in the day is also beneficial vs. at night to allow a more regenerative sleep.

8. Try to get a blood test as soon as possible to evaluate some frequently compromised vitamins and minerals associated with the malabsorption secondary to gluten intolerance. Vitamin D, vitamin K, calcium, magnesium, folic acid, zinc, essential fatty acids and iron are nutrients that should be checked. If found to be deficient ensure that you supplement with a high quality product and retest to ensure that your levels are normalizing.

9. Elimination of any inhospitable organisms from your gut is also critical to healing. Performing a stool test that evaluates for the presence of any bacteria, parasites, amoeba, yeast as well as one that looks at the balance of the good bacteria, or probiotics, is essential. Receive treatment for any pathogenic organisms and then recolonize with healthy bacteria. Taking 1 capsule per day of probiotics is likely something you should consider doing for life.

10. Get a hormone balance test that evaluates the sex hormones (estrogen, progesterone and DHEA – testosterone for men) as well as the adrenal hormone cortisol. The adrenal function is best tested through saliva and the hormones are best measured through blood. Menstruating women should take this test approximately 1week before their period for the best accuracy. You will need to find a practitioner excelling in this area but it is important for regaining your energy, metabolism and optimal brain function.

Please let me know if I can be of any assistance in this area of if you have any questions.

To your good health,

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