Nurse - by Laura James

Celiac Disease for Nurses EP056

Celiac disease is messy. It can develop at any age, in any ethnicity, in both men and women, with any symptom or no symptom at all. Every patient is different, and each one presents differently. There is nothing cut and dried about celiac disease, except that a 100% gluten-free diet is necessary for healing.

Nurses are in a unique position to make sense of this chaos and advocate for patients, recognizing possible celiac disease and non-celiac gluten sensitivity and recommending appropriate testing when necessary. Today, the Gluten Free RN covers the basics of celiac disease for nurses, explaining the frequency with which the disorder is misdiagnosed or goes undiagnosed for years.  She walks us through the testing required for a diagnosis of celiac disease proper, who should undergo testing, and why one negative test doesn’t rule out the disease.

Nadine speaks to the 300-plus signs of celiac disease, reviewing the most common symptoms and the overlap between celiac disease and autoimmune disorders like type 1 diabetes. She also shares the discouraging statistics around the impact of undiagnosed celiac disease on fetal development and maternal health. Listen in to understand why Nadine encourages fellow nurses include celiac disease as part of their differential diagnosis, providing gluten-sensitive patients with a safe, gluten-free environment and a higher quality of life!

What’s Discussed:

The frequency with which celiac disease is misdiagnosed or goes undiagnosed

  • 94% of people with celiac disease are undiagnosed
  • Current estimate is 3% of US population
  • Takes average of 9-15 years for diagnosis

The challenges around getting a diagnosis of celiac disease proper

  • Requires genetic test, celiac antibody test and documented villous atrophy
  • Celiac antibody test = 70% false negative in US

The chronic nature of celiac disease

  • Patients must go 100% gluten-free for life

The 300-plus signs and symptoms of celiac disease

  • Primarily a neurological disorder

Why celiac patients must be tested for potential nutritional deficiencies

  • May need B12, Mg RBC, D3, Zn or I supplements

The detrimental impact of undiagnosed celiac disease on fetal development, maternal health

  • 800-900% increase in miscarriage
  • Increased risk of stillbirth, premature birth and neural defects

Where gluten is hiding

  • Medications, personal care products and food items

Who should be tested for celiac disease

  • Patients with mental health issues, developmental delays
  • Anyone with an autoimmune disorder (e.g.: type 1 diabetes)
  • Family members of celiac patients

Why one negative test doesn’t rule out celiac disease

  • Can seroconvert at any time

How a gluten-free diet can benefit children with stunted growth

  • Growth resumes if diagnosed before epiphyseal plates seal

Resources:

Celiac Disease and Non-Celiac Gluten Sensitivity for Nurses

Recommended Labs

Recognizing Celiac Disease: Signs, Symptoms, Associated Disorders & Complications by Cleo J. Libonati

Gluten Free Works

PubMed

Cyrex Labs

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Books by Nadine:

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

exercising

Hopes and Wishes for Celiac Disease in 2018 EP055

As we ring in the New Year, many of us take the time to jot down our aspirations for the next twelve months. What are your hopes and dreams for 2018? Health and happiness? An opportunity to travel? Stronger relationships?

Whether you have big plans to hike the Grand Canyon this year, or you simply resolve to get a little more sleep, it’s likely that aspects of health and wellness are a big part of your vision for 2018. The Gluten Free RN wants you to be happy and healthy in the coming year, and today she is sharing her hopes and wishes around celiac disease for 2018.

Nadine offers insight on taking control of what you can, including the food you eat. She shares her wish for widespread access to high-quality food and nutritional information that is NOT influenced by corporations. She explains the need for universal healthcare, better comprehensive testing for celiac disease (performed annually), and appropriate follow-up care for patients with a celiac diagnosis. Listen in to understand why Nadine advocates for a global celiac education campaign and learn how to evaluate new information about the disease with a critical ear. Let’s get happy and healthy in 2018 so that we can pursue all of our hopes and dreams!

What’s Discussed:

Nadine’s wish for health, happiness and wellness

  • Reevaluate your choices and control what you can (sleep, food, activities)

Why Nadine advocates for universal healthcare

  • Everyone deserves access to high-quality healthcare without financial strain

The need for better comprehensive testing

  • Healthcare providers should be educated in ordering, interpreting labs

Nadine’s hope for worldwide knowledge of celiac disease

  • Patients in US not diagnosed correctly for 70 years
  • Consider mini-mass screening of patients/family

The importance of accurate media coverage

  • Stories not influenced by sponsors, pharmaceuticals, etc.

Why friends and family should be tested every year

  • Early diagnosis important
  • Can be ruled in, not ruled out

The value of nutritional information not influenced by food companies

  • Understand where food comes from, how processed

Nadine’s aspiration for universal access to high-quality food

  • Organic, whole foods with minimal processing
  • Provides fuel today, building blocks of healing

The need for appropriate follow-up care

  • Labs to address nutritional deficiencies, associated issues

Nadine’s insight around celiac education

  • Seek information, evaluate with critical ear

Resources:

Rotten Documentary Trailer

Whole30

Nadine’s Recommended Labs

Columbia University Celiac Disease Center

PALEOf(x)

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Books by Nadine:

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

wheat

Thoughts on Celiac Disease EP054

In 11 years as the Gluten Free RN, Nadine has done an incredible amount of research on celiac disease and delivered more than 2,000 lectures. No question she is frustrated to see misinformation continue to make its way onto celiac support sites and Facebook groups. How does the average person sift through all the material that’s out there—material that may be influenced by corporations and pharmaceutical companies with a vested interest in the way celiac disease is perceived—to get to the most accurate information?

Just in time for the holidays, the Gluten Free RN is sharing her wish list around the direction of celiac disease and non-celiac gluten sensitivity in the next ten years. She discusses the need for a global mass screening, explaining how celiac disease meets the World Health Organization’s criteria. She covers the reasons why pharmaceutical companies have no place in celiac research as well as the bad publicity the gluten-free community receives in the media.

Nadine speaks to the grievous lack of education about celiac disease among healthcare providers and shares her hope for a cultural shift to support people on a gluten-free diet, explaining the role nurses can play in ending the needless suffering. She talks about why a gluten-free diet is NOT dangerous and how to make the best food choices based on your lifestyle and current situation. Listen in and get empowered to accept responsibility for your health!

What’s Discussed: 

The need for a global mass screening

  • Celiac disease meets WHO criteria
  • 30-50% of population carries gene

Why pharmaceutical companies should not be involved in celiac research

  • Diet change resolves symptoms
  • Pharmaceutical involvement gives false hope for cure

The misinformation about celiac disease in the media

  • Misrepresentation in recent episode of Freakonomics Radio

The need to educate healthcare providers around celiac disease

Nadine’s call for support of people on a gluten-free diet

  • Don’t assume intentionally being difficult

The unique position of nurses to use their influence

  • Prevent needless suffering with understanding of celiac disease

Why you must accept responsibility for your own health

  • Take advantage of available resources
  • Find practitioners open to other modalities

How to avoid processed foods

  • Focus on raw, whole foods
  • Choose fresh fruits, vegetables
  • Don’t fall victim to convenience marketing
  • Use community, intuition to make decisions

Why a gluten-free diet is NOT dangerous

  • Nadine restored her health by eliminating grains
  • Unethical to suggest that celiac patient go off gluten-free diet

Resources:

Freakonomics Radio: The Demonization of Gluten

2004 NIH Consensus Statement on Celiac Disease

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Books by Nadine:

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

citrus fruits

Alex Michaels from LPI on Vitamin C EP053

You know that vitamin C is good for you. It is necessary for the growth, development and repair of all your body tissues, and it plays a role in the healthy functioning of your immune system. But evidence shows that the RDA—90mg for men and 75mg for women—may be woefully inadequate. And if you are suffering from certain types of cancer or sepsis, vitamin C may be the key to recovery.

The Gluten Free RN is joined by vitamin C researcher Alex Michaels from the Linus Pauling Institute at Oregon State University to discuss the latest developments in vitamin C, explaining how intravenous vitamin C works to kill certain cancer cells and reverses the organ failure associated with sepsis. He also covers the difference between vitamin C inadequacy and vitamin C deficiency and the debilitating symptoms of scurvy.

Nadine and Alex speak to the best food sources of vitamin C and how it impacts other vitamins and minerals like iron and copper. Alex offers his advice around how much vitamin C you should get on a daily basis and explains why synthetic and natural vitamin C are identical. Learn about the LPI mission to determine the optimal ranges of micronutrients and phytochemicals you should be getting on a daily basis and how you can benefit from their research!

What’s Discussed:

Micronutrients vs. macronutrients

  • Micronutrients are vitamins, essential minerals needed in small amounts (milligrams or micrograms/day)
  • Macronutrients include fats, carbs and proteins (grams/day)
  • Phytochemicals come from plants, affect health but not essential nutrients

The difference between intravenous and oral vitamin C

  • Intravenous bypasses GI system, high concentration in bloodstream (up to 100 grams)
  • Body can only absorb certain amount of oral vitamin C, inflammation may prevent absorption

Vitamin C’s resurgence as a cancer therapy

  • High levels of intravenous vitamin C can covert oxygen to hydrogen peroxide
  • Hydrogen peroxide floods and kills some cancer cells (e.g.: pancreatic tumors)

Vitamin C’s role in the treatment of sepsis

  • Reverses organ failure, decreases inflammation
  • May restore vitamin C to normal levels, protect from negative effects of iron

The availability of intravenous vitamin C

  • Difficult to obtain, naturopaths usually have dedicated supplier
  • More readily available in Australia, New Zealand

The fundamentals of scurvy

  • Defined as deficiency in vitamin C
  • Symptoms include bleeding gums, corkscrew hair growth, open wounds, malaise and low energy
  • Very rare in western world, would have to go without any fruits or vegetables for months
  • May have vitamin C inadequacy without any outward signs of problem

The best food sources of vitamin C

  • Chili peppers
  • Tropical fruits (papayas, Kakadu plum, camu camu)

Factors that are known to denigrate vitamin C

  • Heat, light and air
  • Mechanical disruption (i.e.: juicer)
  • Basic pH (anything above 7)
  • Enzymatic factors
  • Iron, copper

How vitamin C impacts other vitamins and minerals

  • Enhances iron absorption, some must be careful of iron overload
  • Synthetic vitamin C may deplete copper concentration

Alex’s take on the appropriate daily intake of vitamin C

  • 400 mg/day recommended
  • RDA much too low

Resources:

Linus Pauling Institute

Micronutrient Information Center

LPI on Facebook

LPI on Twitter

LPI on LinkedIn

LPI on Pinterest

Biochemical, Physiological, and Molecular Aspects of Human Nutrition by Martha H. Stipanuk PhD and Marie A. Caudill

Cancer and Vitamin C by Ewan Cameron and Linus Pauling

Dr. Paul Marik on NPR

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Books by Nadine:

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

fruits and vegetables

Go Gluten Free for Good EP052

How do you successfully transition to and maintain a 100% gluten-free diet for the rest of your life? The prospect of eliminating wheat, barley and rye from your diet may seem daunting, but it is possible to go gluten free for good—for the good of your family and your health!

The Gluten Free RN explains the addictive nature of gluten and what to expect during the detox process as you begin your gluten-free journey. She offers valuable advice around how to choose the best quality food products while avoiding potential sources of cross-contamination.

Nadine discusses the need for supplements that will help you heal faster and more completely, speaking to the vitamin levels you should monitor along the way. Listen and learn her best tips for navigating the grocery store and maintaining a positive attitude throughout the process of going gluten-free—for GOOD!

What’s Discussed:

The addictive nature of gluten

  • Gliadin, gluten proteins bind to opioid receptors
  • Wheat, barley and rye are cheap and readily available

What to expect during the detox process

  • Different for everyone
  • Consider elimination diet to reboot system
  • May feel worse before feel better
  • Headaches, low energy and feeling hungry are common

Why you shouldn’t cheat on a gluten-free diet

  • Same autoimmune response, even if symptom-free

Potential sources of cross-contamination

  • Processed foods
  • Unwashed fresh fruits, vegetables
  • Bulk bins
  • Restaurants
  • Own home (i.e.: cutting boards, hands, pets, utensils, appliances, etc.)

Nadine’s rules around choosing quality food products

  • Five ingredients or less
  • Picture every ingredient
  • Certified gluten-free
  • 100% grain-free

Why there is no such thing as cheap food

  • Pay for quick-fixes to treat symptoms

The necessity of additional vitamins, supplements

  • Helps heal faster, more completely
  • Use multivitamin, fish oil, pre- and probiotics
  • Check levels of D3, Zinc, B6 and B12
  • Liquid, chewables and capsules are easier to break down

Nadine’s advice around navigating the grocery store

  • Plan menus in advance
  • Bring list of safe foods
  • Read labels carefully
  • Consider local co-ops, natural grocers and farmers markets

Nadine’s best tips for going gluten-free

  • Concentrate on what you can eat
  • Accept more cooking, baking and meal planning
  • Find support group
  • Stay current on research, food labeling
  • Practice mindfulness, maintain positive attitude

Resources:

Whole30

Country Life Vitamins

Robb Wolf’s Paleo Food Matrix

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Books by Nadine:

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

healthy food

Nutrient Dense Foods EP051

‘When in doubt, go without.’

The problem with processed food is that you simply can’t be sure that it is gluten-free. The risk of cross-contamination is high, and no one at the big corporations is accountable for your health. Not to mention the fact that processed foods have been irradiated to make them shelf-stable, effectively killing any probiotics. Even certified gluten-free products are often low in nutrients, high in calories—and expensive!

So what should you eat? The Gluten Free RN is on the case with her best suggestions around finding organic, whole foods that contain the healthy fat you need to heal. She explains her revised, gluten-free version of the food pyramid and discusses how these nutrient-dense foods support the healing process.

Nadine provides a list of the best nutrient-dense foods, offering the benefits of each. She also speaks to the most appropriate vitamins and supplements available to solve your nutrient deficiencies. You are what you eat, so make sure you are filling your tank with nutrient-dense foods that will improve your health and quality of life!

What’s Discussed:

How nutrient dense foods support healing

  • Regenerate villi
  • Reduce inflammation of intestines
  • Heal immune system

Why Nadine recommends staying away from gluten-free junk foods

  • Low in nutrients, high in calories
  • Risk of cross-contamination (processed in facilities with wheat products)

The best sources of nutrient-dense foods

  • Whole foods, organic
  • Farmers market (few/no fertilizers)

Why shelf-stable products lack nutrients

  • Food dead from irradiation, no live probiotics

The risk of contamination in processed foods

  • No one accountable at big corporation
  • ‘When in doubt, go without’

Nadine’s revised food pyramid

  • Fruits and vegetables at base
  • Meat, fish and eggs
  • Nuts, seeds and berries

The importance of eating healthy fats

  • Heals intestines
  • Absorb fat-soluble vitamins (A, D, E and K)
  • Fix deficiencies
  • Healthy brain cells, nervous system
  • Balance hormones

Nadine’s recommendations around the best nutrient-dense foods

  • Sweet potatoes
  • Leafy greens (e.g.: kale, collard greens)
  • Berries
  • Coconuts
  • Black molasses
  • Avocados
  • Pumpkin, chia seeds
  • Meat and fish
  • High-quality eggs
  • Licorice root, peppermint tea
  • Cinnamon

Nadine’s vegetable challenge

  • Expand your vegetable repertoire
  • Try one new veggie per week

Nadine’s suggestions around additional vitamins, supplements

  • Good quality multivitamin
  • Fish oil (i.e.: Nordic Naturals)
  • Pre/probiotics
  • Vitamin D

How to avoid cross-contamination

  • Avoid bulk food bins
  • Wash produce

Resources:

Midway Farms on Facebook

Nordic Naturals

Country Life Vitamins

Bluebonnet Nutrition

Pure Encapsulations

National Nurses in Business Association

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Books by Nadine:

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

Christmas cookies

Managing the Holidays with Celiac Disease EP050

With the approach of the holidays, you may be nervous about navigating family and workplace gatherings—especially if you are newly diagnosed with celiac disease. How do you explain your dietary restrictions and keep yourself safe, eating well without getting ‘glutened’?

Today the Gluten Free RN shares her best advice around managing the holidays with celiac disease. She offers ten key tenants to help you enjoy the holiday season and mitigate stress, without feeling like you’re missing out. She shares some things you need to avoid, including unsafe situations, people who make you miserable, and cheating on your gluten-free diet! But she also discusses strategies you can implement to make the season bright, such as creating new traditions, getting creative in the kitchen, and finding your tribe—the people who will support you in your gluten-free journey.

Nadine also gives tips around where to go for gluten-free ingredients and holiday recipes, and how to develop a backup plan so you won’t go hungry if the food you encounter is questionable. You are likely to encounter well-intentioned friends and family members who have no idea how to feed you safely at holiday parties. Listen in and learn how to be clear about your dietary needs and take control of your health without isolating yourself from loved ones during this most wonderful time of the year!

What’s Discussed:

#1 Don’t eat anything contaminated with wheat

  • Cannot eat center of pie, any part of turkey with bread stuffing

#2 Beware of good-intentioned people

  • Don’t eat anything questionable
  • Bring a snack with you just in case

#3 Be prepared to establish new traditions

  • Get creative in kitchen

#4 Don’t isolate yourself

  • Find support group, create your own

#5 Gather recipes early

#6 Order ingredients in advance

  • Consider organic, free range turkey

#7 Don’t invite people who make you miserable

  • Set clear boundaries (no complaints, ridicule)

#8 Eat before you go or take your own plate

  • ‘Desperate people make desperate decisions’
  • Take a dish to share, take your portion first

#9 Don’t be a victim

  • Be clear about your needs

#10 Find your people

  • Those who truly love you don’t want you to be sick

Resources:

Nima Sensor

EZ Gluten Test Strips

Paleo Magazine

Paleo Principles: The Science Behind the Paleo Template, Step-by-Step Guides, Meal Plans, and 200+ Healthy & Delicious Recipes for Real Life by Sarah Ballantyne

Sarah Ballantyne on Instagram

Glutenpro

EnteroLab

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Books by Nadine:

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

lyme disease rash

Lyme Infection and Celiac Disease EP049

If you’ve been following a strict gluten-free diet, but continue to suffer from lingering neurological symptoms, you may need to explore the possibility that you have Lyme disease. In fact, there are many parallels between celiac disease and Lyme, and the Gluten Free RN has called in an expert to discuss the similarities between the two disorders and why a gluten-free diet is part of the proper treatment for both.

Dr. Usha Honeyman, a chiropractic and naturopathic physician out of Corvallis, Oregon, joins Nadine to explain the fundamentals of Lyme disease. She shares her best advice around prevention and treatment, exploring why it can be difficult to get an accurate diagnosis.

Nadine and Usha also cover the inflammation of the gut that plagues both celiac and Lyme patients, the neurological component of Lyme disease, and the relationship between Lyme and illnesses like MS, Parkinson’s and ALS. Listen in to understand what can happen when Lyme goes untreated and how antibiotics coupled with a gluten-free diet may restore your health!

What’s Discussed:

The fundamentals of Lyme disease

  • Most common insect-borne disease in US
  • Primarily carried by tics (disable immune system at bite site)
  • CDC estimates 300K new cases each year

How to prevent Lyme infection

How the political controversy in medicine has led to conflicting information around Lyme disease

The treatment for Lyme disease

  • Long-term antibiotics
  • T3 to raise body temperature, make white blood cells more efficient
  • Probiotics to support immune system

Why Dr. Honeyman advises Lyme patients to go gluten-free

  • Lyme causes inflammation of gut

The neurological component of Lyme disease

  • Spirochetes permeate blood-brain barrier
  • Cause brain fog, balance issues, sensory disorders, etc.

The alpha-gal reaction in Lyme patients in the Southeast US

The strange gait and lower-face movement in Lyme patients

  • Bell’s palsy is red flag for Lyme disease

The importance of having a Lyme-literate doctor

  • Skin scraping of rash for diagnosis available in research setting
  • ELISA and Western blot miss 80-90% of Lyme patients

The consequences of untreated Lyme disease

The three forms of Borrelia

  • Spirochete-form, intracellular and cystic

 Resources:

Dr. Honeyman’s Website

CDC Website

Picaridin

Natrapel

Insect Shield Clothing

Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar—Your Brain’s Silent Killers by David Perlmutter

Under Our Skin Film

International Lyme and Associated Diseases Society

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Books by Nadine:

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

Certified Gluten Free

Gluten Free Products EP048

The increasing number of gluten-free products on the market can be both a blessing and a curse. Yes, it gives us more options, but are those options truly safe and healthy?

Today the Gluten Free RN goes over the important questions to ask about the products you consume, explaining how the foods promoted by some gluten-free groups may be influenced by their corporate sponsors. She reminds us why we can’t simply trust the products labeled ‘gluten-free’ or ‘gluten removed,’ discussing the lack of oversight and standardization around classification and the cumulative effect of consuming a number of products that are just under the 20 ppm cutoff.

Nadine also shares a list of companies she trusts to consistently produce gluten-free products and offers suggestions around new food options we might explore. Listen in and learn to choose the nutrient-dense foods that will help your body heal!

What’s Discussed:

The importance of questioning the source of your information

  • Gluten-free groups take money from sponsors (corporations, pharmaceutical companies)

Why Nadine avoids the ‘gluten removed’ label

The questions to ask about gluten-free products

  • Is it manufactured in a designated facility?
  • From where do they source the ingredients?
  • Do they batch test those ingredients?

The cumulative effect of eating many products just under 20 ppm

Reliable companies that consistently produce truly gluten-free products

The challenges faced by newly diagnosed celiac patients

  • Feeling different
  • Loss of convenience

Why Nadine avoids gluten-free breads

New food options to explore as a celiac patient

Why Nadine recommends reevaluating the foods you consume

  • Ensure they are nutrient dense, don’t cause inflammation

Why you can’t trust product labels

  • Corporations given six months to update after ingredients change
  • Not required to test products labeled gluten-free (no oversight, standardization)

Nadine’s rules around choosing products

  • Five ingredients or less
  • Must be able to picture ingredients

Resources:

Canadian Celiac Association

The Gluten Dude on Facebook

Ground Breaker Brewing

The Gluten Intolerance Group of North America

Enjoy Life Foods

Glutino

Namaste Foods

Pamela’s Products

Jilz Crackers

Lundberg Family Farms

Mary’s Gone Crackers

Casabi Crackers & Flatbread

Jackson’s Honest

Kettle Brand

Nima Sensor

EZ Gluten Test Strips

Applegate

Beeler’s Pure Pork

Hempler’s

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Books by Nadine:

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