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The US Military and Celiac Disease EP061

It goes without saying that anyone who serves in the military needs to be healthy and strong—and that military leaders have an obligation to keep enlisted servicemen and women as safe and healthy as possible. So, it makes sense that people with food allergies (including celiac patients) are disqualified from military service, but it is less clear why celiac testing is not a part of the medical exam to qualify for enlistment.

Today, the Gluten Free RN addresses the issue of celiac disease in the military. She explains the challenges of preparing gluten-free food in a mess hall setting and describes the consequences for an active duty soldier who is found to have celiac disease.

Nadine shares a research study exploring celiac trends among active duty military as well as a case study around veterans and celiac disease. Listen in for insight on what’s behind the increased prevalence of celiac disease among military personnel and the confirmed association between celiac disease and other complex health issues.

What’s Discussed: 

Why celiac patients are disqualified from enlisting in any branch of service

  • Unable to provide safe food

What happens to military personnel who are found to have celiac disease

  • Will receive medical discharge

The US military policy around food allergies and intolerances

  • No accommodations made

Countries that allow celiac patients to serve

  • Israel, Finland and Scandinavia

The Mayo Clinic study of celiac trends among active duty military

  • Healthy worker population with medical diagnostic coding
  • Incidence of celiac disease increased five-fold from 1999-2008
  • Combination of increased suspicion and environmental factors

The challenge of preparing gluten-free food in a military setting

  • High risk of cross-contamination

A case study involving military veterans and celiac disease

  • Confirmed association between CD and other complex issues

The benefits of a gluten-free diet

  • Preventative for autoimmune disorders, nutritional deficiencies and cancer

Nadine’s argument for celiac testing prior to enlistment

  • Obligation to safety of servicemen/women

Resources:

Military Standards of Medical Fitness

‘The Incidence and Risk of Celiac Disease in a Healthy US Adult Population’ in the American Journal of Gastroenterology

‘Celiac Sprue Among US Military Veterans: Associated Disorders and Clinical Manifestations’  in Digestive Diseases and Sciences

‘Gluten-Free Soldier in Afghanistan’ in Gluten-Free Living

‘Medical Mix-Up Sidelines Army Sergeant’s Career’ in Military Times

Celiac Disease-Related Veterans Affairs Case

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse’s Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

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Hepatitis B Vaccine and Celiac Disease EP060

We get vaccinated to protect ourselves, to gain an immunity to a particular disease. But in the case of hepatitis B, celiac patients may come to find out that we are NOT immune—despite having done the right thing in getting a hepatitis B vaccination.

Today, the Gluten Free RN is walking us through the latest research around vaccination and celiac disease. She explores the fact that celiac patients are more likely to be non-responsive to HBV than the general population, explaining the fundamentals of hepatitis B and the two main theories as to why the vaccine doesn’t work for some celiac patients.

Nadine shares her take on immunizations, explaining why she is a proponent of an alternate vaccination schedule for infants who may be immunocompromised. Listen in and learn how to determine whether you are truly immune to hepatitis B and protect yourself from potentially life-threatening disease!

What’s Discussed: 

The basics of hepatitis B (HBV)

  • Viral infection that attacks liver
  • Transmitted through blood, body fluids

The prevalence of hepatitis B

  • 257M people infected
  • 887K deaths in 2015

The 2013 Italian study around celiac disease and the hepatitis B vaccine

  • Number of non-responders to vaccine higher in CD patients
  • May be genetic OR caused by gluten intake during vaccination

Nadine’s experience with vaccination as a child

  • Contracted mumps despite MMR

Nadine’s take on vaccination

  • Advocates for immunization to prevent disease
  • Giving babies multiple vaccines at once may not be best

The conclusion of a 2017 Italian study

  • Administer booster shots of hepatitis B vaccine as needed
  • Evaluate response to vaccine in newly diagnosed celiac patients
  • Revaccinate one year after adoption of gluten-free diet

The value of a hepatitis B titer

  • Confirms whether really immune
  • If not, test for celiac disease

Resources:

‘Hepatitis B Vaccine in Celiac Disease: Yesterday, Today and Tomorrow in the World Journal of Gastroenterology

‘Vaccinations in Celiac Disease’ in the Journal of Pediatric Gastroenterology and Nutrition

‘Immune Response to Vaccines in Children with Celiac Disease’ in the World Journal of Gastroenterology

‘Immune Response to Hepatitis B Vaccine in Patients with Celiac Disease: A Systematic Review and Met-Analysis’ in Human Vaccines and Immunotherapeutics

‘Early Vaccinations are Not Risk Factors for Celiac Disease’ in Pediatrics

‘Gluten Intake Interferes with the Humoral Immune Response to Recombinant Hepatitis B Vaccine in Patients with Celiac Disease’ in Pediatrics

‘Effect of Pentavac and Measles-Mumps-Rubella (MMR) Vaccination on the Intestine’ in Gut

‘Normal of Defective Immune Response to Hepatitis B Vaccine in Patients with Diabetes and Celiac Disease’ in Human Vaccines and Immunotherapeutics

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse’s Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

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Hypothyroid, Pulmonary Edema and Celiac Disease EP059


When the Gluten Free RN went on a gluten-free diet 11 years ago, her thyroid settled down and the associated symptoms and disorders—Graves’ disease, weight gain and hair loss—resolved.

But when Nadine was inadvertently hit with gluten two years ago, several of those symptoms returned, along with a few new ones. She was losing hair and gaining water weight again. On top of that, her sinuses were congested. She developed asthma, a rash on her lower right leg and a scary case of pulmonary edema (excess fluid in the lungs).

Hindsight being 20/20, Nadine realizes that her recent diagnosis of hypothyroidism is associated with that accidental gluten ingestion. Further study made it clear that there is a potential connection between her thyroid problems and pulmonary edema, as the leaky gut that comes with celiac disease can cause fluid shifts into body tissues.

Today the Gluten Free RN explores the links among celiac disease, thyroid disorders and pulmonary edema. She explains the function of the endocrine system, the symptoms associated with hypothyroidism, and the diet she recommends for patients with thyroid issues. Listen in for Nadine’s insight around how gluten affects the thyroid gland and why the resulting low sodium levels might trigger edema in celiac patients.

What’s Discussed: 

The function of the endocrine system

  • Glands in body that make hormones

The connection between celiac disease and thyroid disorders

  • Thyroid especially vulnerable to gluten protein in wheat, barley, rye and oats

Nadine’s symptoms of hypothyroidism

  • Lower extremity edema
  • Congested sinuses
  • Hair falling out
  • Pulmonary edema
  • Asthma
  • Rash on leg

How damp rash lotion resolved Nadine’s symptoms

  • Prescribed by acupuncturist in Chiang Mai
  • Rash cleared, could breathe easy
  • Symptoms returned within four weeks of return to US

Nadine’s thyroid-stimulating hormone (TSH) levels

  • Within normal limits despite thyroid issues
  • Practitioner declined to order thyroid panel

The relationship between thyroid issues and edema

  • Sodium = major electrolyte, maintains body’s pH
  • Hypothyroidism means low sodium levels
  • Leaky gut of celiac disease leads to fluid shifts (edema)

The research around thyroid disorders and celiac disease in Current Allergy and Asthma Reports

  • Association between CD and thyroid disorders well documented
  • Increased prevalence of autoimmune thyroiditis and Graves’ disease in celiac populations

The diet Nadine recommends for celiac patients with potential thyroid issues

  • Gluten-free, dairy-free
  • Whole food, Paleo

Why patients with unexplained pulmonary edema should be tested for celiac disease AND thyroid disorders

  • Potential connection among all three

The symptoms associated with hypothyroidism

  • Puffy face, constipation, fatigue
  • Muscle weakness, aches and pains
  • Irregular, delayed menstrual periods
  • Hair loss, thinning hair
  • Slower heartrate, hypothermia
  • Depression, memory problems

Resources:

‘Pregnancy Complicated with Pulmonary Edema Due to Hyperthyroidism’ in the Journal of the Chinese Medical Association

‘Sleep Apnea, Hypothyroidism and Pulmonary Edema’ in CHEST Journal Letters to the Editor

‘Thyroid and Fluid Retention’ on the Wilson’s Syndrome Site

‘Acute Pulmonary Edema as a First Manifestation of Hyperthyroidism in a Pregnant Woman’ in Revista Medica de Chile

‘Hypothyroidism and Non-Cardiogenic Pulmonary Edema: Are We Missing Something Here?’ in Endocrinology, Diabetes & Metabolism Case Reports

‘Celiac Disease and Autoimmune Thyroid Disease’ in Clinical Medicine & Research

‘Celiac Disease and Autoimmunity: Review and Controversies’ in Current Allergy and Asthma Reports

‘An Unusual Cause of Flash Pulmonary Oedema’ in BMJ Case Reports

‘Challenges in the Management of a Patient with Myxoedema Coma in Ghana: A Case Report’ in Ghana Medical Journal

‘Hyponatremia and the Thyroid: Causality or Association?’ in the Journal of Clinical Medicine

‘Interactions Between Thyroid Disorders and Kidney Disease’ in the Indian Journal of Endocrinology and Metabolism

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse’s Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism