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Eosinophilic Esophagitis and Celiac Disease EP069


Your gastrointestinal tract is approximately 30 feet long, and it runs from your mouth all the way to the anus! We know that celiac disease can impact any part of the digestive tract. But there is another disease that wreaks havoc on the GI tract as well, a condition called eosinophilic esophagitis or EoE.

The Gluten Free RN is explaining the fundamentals of eosinophilic esophagitis, from its characteristic inflammation of the esophagus and elevated eosinophils in the blood to the common symptoms of vomiting and upper abdominal pain. She walks us through the treatment for EoE, an elimination diet or steroid therapy.

Nadine speaks to the research exploring a possible connection between eosinophilic esophagitis and celiac disease, citing a paper that found a higher prevalence of EoE in children with celiac disease than the general population as well as the case study of a woman with both celiac disease and elevated eosinophils in her blood. Listen in for the Gluten Free RN’s insight on the best EoE clinics and physicians in the country and learn why further study is needed around EoE and celiac disease!

What’s Discussed:

The fundamentals of eosinophilic esophagitis

  • Allergic response to dietary antigens
  • Causes inflammation of esophagus, increased eosinophils in blood

The benefits of unsedated transnasal endoscopy for children with EoE

  • Monitors esophageal mucosa without sedation
  • Safer, faster and less costly

Some common symptoms of eosinophilic esophagitis

  • Vomiting, difficulty swallowing, food stuck in throat
  • Chest pain, heartburn, upper abdominal pain

The condition of achalasia

  • Muscles of esophagus don’t work appropriately
  • Causes spasms or constriction

The treatment for EoE

  • Elimination diet (remove wheat, eggs, milk, soy, shellfish and seafood, peanuts and tree nuts)
  • Topical or systemic steroids

The potential increased prevalence of EoE in children with celiac disease

  • 2015 paper found prevalence of 10.7% (much higher than general population)
  • Other research articles argue no increased prevalence of EoE in CD

The case study of a 30-year-old woman with celiac disease and elevated eosinophils

  • Presented with abdominal pain and distension, vomiting and frequent bowel movement
  • Treated with IV hydrocortisone, but developed steroid induced psychosis

Nadine’s insight on the best specialty clinics for EoE in the US

  • University of Colorado (Denver School of Medicine)
  • Pennsylvania

Dr. Glenn Furuta’s insight on the difficulty of diagnosing EoE

  • Relatively new disease, tendency to diagnose based on pathology report alone
  • Elevated eosinophils also found in GERD, inflammatory bowel disease and celiac disease

Special considerations for pediatric patients with EoE

  1. Consultation with dietician
  2. Limited exposure to corticosteroids
  3. Attention to development of feeding skills
  4. Potential psychosocial, behavioral problems

Resources:

‘Unsedated Transnasal Esophagoscopy for Monitoring Therapy in Pediatric Eosinophilic Esophagitis’ in Gastrointestinal Endoscopy

‘Eosinophilic Esophagitis Associated with Celiac Disease in Children’ in BMC Research Notes

‘Eosinophilic Gastrointestinal Disorder in Coeliac Disease: A Case Report and Review’ in Case Reports in Gastrointestinal Medicine

‘Eosinophilic Esophagitis in Children and Adults’ in Gastroenterology and Hepatology

‘The Association Between Celiac Disease and Eosinophilic Esophagitis in Children and Adults’ in BMC Gastroenterology

‘Eosinophils in Gastrointestinal Disorders’ in Immunology and Allergy Clinics of North America

‘2013 Update on Celiac Disease and Eosinophilic Esophagitis’ in Nutrients

‘Eosinophilic Esophagitis: New Insights in Pathogenesis and Therapy’  in the World Journal of Gastrointestinal Pharmacology and Therapeutics

‘Incidence and Prevalence of Eosinophilic Esophagitis in Children’ in the Journal of Pediatric Gastroenterology and Nutrition

‘Management of Eosinophilic Esophagitis and Celiac Disease’ in Current Opinion in Pharmacology

‘Increased Risk of Esophageal Eosinophilia and Eosinophilic Esophagitis in Patients with Active Celiac Disease on Biopsy’ in Clinical Gastroenterology and Hepatology

‘Individuals Affected by Eosinophilic Gastrointestinal Disorders Have Complex Unmet Needs and Frequently Experience Unique Barriers to Care’ in Clinics and Research in Hepatology and Gastroenterology

‘Eosinophilic Esophagitis and Celiac Disease: A True Association or Coincidence?’ in the Journal of Pediatric Gastroenterology and Nutrition

Connect with Nadine:

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‘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 Heal

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Indigenous Populations, Celiac Disease and NCGS EP067

‘Globally, indigenous peoples suffer from poorer health, are more likely to experience disability and reduced quality of life, and ultimately die younger than their non-indigenous counterparts.’

A UN Report on the health of indigenous peoples points to a significant problem, but the question is WHY? Why are native populations more prone to autoimmune disorders and type 1 diabetes? Why do they have a higher incidence of alcoholism and drug addiction? And why the lower life expectancy?

The Gluten Free RN is exploring the role of food in health outcomes for indigenous populations around the world. She begins with an explanation of the dietary differences between hunter-gatherer and agricultural societies, discussing how native populations were exposed to the gluten in grains only when European conquerors came to occupy their lands.

Nadine shares her challenge in finding information about indigenous populations and celiac disease, explaining why further study is necessary. She speaks to the highly processed nature of the commodity foods provided to Native Americans in the US and the shortcomings of Canada’s Food Guide when it comes to the health of First Nations people. Listen in and learn the significance of educating indigenous populations around celiac disease and non-celiac gluten sensitivity, empowering those groups to make choices that will improve their health and quality of life!

What’s Discussed:

The global indigenous population

  • 370M in 70-plus countries
  • Rich diversity of cultures

The health status of indigenous populations

  • Higher incidence of autoimmune disorders, T1D
  • Higher prevalence of addictive disorders, cardiovascular disease
  • Lower life expectancy, increased morbidity/mortality

Why indigenous populations have more health issues

  • Access to health care, isolation and lifestyle
  • Food (hunter-gatherer vs. agricultural society)

The lack of information around indigenous populations and celiac disease

  • Very few studies available

The impact of grains on the native population

  • Significant change in health care outcomes, quality of life

The prevalence of celiac disease in indigenous populations

  • At least 1%, likely 3% or higher
  • No way to know without mass screening

Why eating healthy is a challenge for the indigenous population

  • Food scarcity, desserts
  • Reliance on commodity foods provided by government

The conclusions of the Prairie Nymph blog on Canada’s Food Guide

  • Based on diet of European origins, doesn’t mention celiac disease
  • Ignores health benefits of traditional diet for First Nations people

Why it’s important to educate indigenous people around celiac disease

  • Empower to make food choices with better health outcomes

Resources:

Guns, Germs, and Steel: The Fates of Human Societies by Jaren M. Diamond

Dough Nation by Nadine Grzeskowiak

USDA Commodity Supplemental Food Program

‘Canada’s Food Guide and Native Women’ by Prairie Nymph

The Sioux Chef’s Indigenous Kitchen by Sean Sherman

American Indian and Alaska Native Health

‘Celiac Disease: A Disorder Emerging from Antiquity, Its Evolving Classification and Risk, and Potential New Treatment Paradigms’ in Gut Liver

‘Celiac Disease: A Life-Changing Diagnosis’ in Indian Country Today

‘Government Food Boxes? It’s Nothing New for Native Americans’ on WDET

UN Indigenous Peoples Fact Sheet

‘Many Native Americans Lack Access to Healthy Food, But There’s a Growing Movement to Change That’ in Grist

‘Characteristics and Factors Related to Quality of Life in Mexican Mestizo Patients with Celiac Disease’ in BMC Gastroenterology

Summary of Aboriginal and Torres Strait Islander Health

WHO Health of Indigenous Peoples

WHO Indigenous Peoples and Substance Abuse

Connect with Nadine:

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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 Heal

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Russia and Celiac Disease EP065

As stories about Russia continue to dominate the news cycle, you are probably familiar with the recent sanctions against the country, Vladimir Putin’s reelection, and even the expulsion of Russian diplomats from the EU and US. But what do you know about celiac disease in Russia?

The Gluten Free RN is taking a closer look at the limited information about celiac disease in Russia, giving us an overview of the country’s size and population and the likely number of celiac cases based on the global tendency. She discusses the thriving wheat production industry in Russia as well as the gluten-containing traditional Russian diet.

Nadine walks us through a presentation created by Dr. Elena Roslavtseva at the Scientific Center for Children’s Health in Moscow, sharing how the diagnoses of celiac disease changed from the 1970’s through the 2000’s, the inconsistencies with testing for celiac disease around the nation, and the challenges of maintaining a gluten-free diet in Russia. Listen in as the Gluten Free RN covers the Journal of Immunology Research’s overview of celiac disease in Russia, explaining why the reported frequency probably doesn’t reflect the true prevalence and the necessity of a mass screening.

What’s Discussed: 

General information about the country of Russia

  • Population of 144.3M
  • Dual nation state, 185 ethnic groups
  • Largest country by land mass

Russia’s thriving wheat production industry

  • Very high, exported to Middle East and Africa
  • Ban on genetically modified wheat

The first diagnoses of celiac disease in Russia

  • Late 1970’s—1980’s
  • Cases of severe malabsorption
  • No gluten-free foods available

How celiac diagnoses changed in the 2000’s

  • Diagnosed more often, well-known in most regions
  • Research done in many universities, med centers

The Eastern European countries that have done mass screenings

  • Romania, Slovakia, Slovenia, Estonia

Why the data around celiac disease in Russia is unreliable

  • Variation in how practitioners test for celiac disease
  • Belarus—HLA-typing not available in most cases
  • Latvia—mandatory screening for patients with IDDM and AIT

The problems associated with celiac disease in Russia

  • Unreliable data in absence of mass screening
  • Gluten-containing traditional Russian food

The overview presented in the Journal of Immunology Research

  • Diagnostic tools for celiac disease in Russia vary significantly
  • Reported frequency of 0.2-0.6%, but real rate unknown

Resources:

‘Coeliac Disease and Gluten Related Disorders in Russia and Former Soviet Republics’ by Dr. Elena Roslavtseva

‘Overview of Celiac Disease in Russia: Regional Data and Estimated Prevalence’ in the Journal of Immunology Research

‘Russia, Argentina and Canada Displace US, Europe in Global Wheat Trade’ in agriCENSUS

‘Russian Wheat Sales Expand Global Reach with Surge in Sudan’ in Bloomberg

‘Russia’s Wheat Industry: Implications for Australia’ from the Australian Export Grains Innovation Centre

‘Growing Importance of Russian Milling Wheat Worldwide’ from Solaris Commodities

‘How an Oil Giant (Russia) Came to Dominate Wheat’ in Bloomberg

‘Celiac Disease in Russia and the Former Soviet Republics’ in The Celiac Scene

Connect with Nadine:

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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 Heal

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Review of Colombia University Celiac Disease Conference 2018 EP064

When faced with new information, it’s important to consider the source. Stop for a moment and examine whether the material is coming from someone with YOUR best interests at heart. The Gluten Free RN has just returned from the Colombia University Celiac Disease Conference, and she is breaking down the information presented to determine what’s useful—and what might be tainted by the pharmaceutical or food industry agenda.

Nadine begins with a workshop led by General Mills that offered some questionable information about how grains are processed at their factories and a talk led by University of Chicago faculty on the topic of a gluten challenge. She also speaks to the differences between celiac management in the US and countries with universal healthcare like Italy and Australia.

Nadine covers new testing that detects gluten exposure in stool or urine and what that reveals about the systemic nature of gluten damage as well as her take on practitioners who perpetuate the myth that grains are necessary and nutritious. Listen in for the Gluten Free RN’s insight around pharmaceutical treatments for celiac disease and the danger in volunteering for studies backed by drug companies.

What’s Discussed:

The two programs available at Colombia’s 2018 conference

  • Clinical (nurses, RDs and laypeople)
  • International (doctors, scientists, industry and VC)

How celiac disease is managed in Italy

  • Presentation by Dr. Carolina Ciacci
  • Law mandates gluten-free options

Nadine’s frustration with the General Mills presentation

  • Major sponsor of conference
  • Claim to separate grains at factory

Nadine’s take on gluten-free Cheerios

  • Should be avoided, not truly gluten-free

Nadine’s confusion around Dr. Bana Jabri’s comments

  • Wouldn’t put ‘potential celiac patient’ on gluten-containing diet
  • Did not include patients with positive antibody test but negative biopsy

Why the biopsy for celiac disease is problematic

  • Only tests one foot into duodenum
  • GI tract is 30 feet in length

Nadine’s insight on a gluten-free challenge

  • No possible benefit for patient
  • Unnecessary, unethical

The systemic nature of gluten damage

  • New tests detect gluten exposure in stool, urine
  • Urine test indicates passage through every system

Nadine’s stance on pharmaceutical treatments for celiac disease

  • No pill or vaccine will treat or cure CD
  • Harmful to people in studies

The myth that grains are necessary and nutritious

  • Practitioners who perpetuate are ‘toeing company line’

Why it’s important to understand the source of your information

  • Should be untainted by pharmaceutical money, agenda

Australia’s requirements for gluten-free food

  • Standard of less than 3 ppm

Resources:

Celiac Symposium Program

Connect with Nadine:

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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 Heal

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Poland and Celiac Disease EP063

To pierogi or not to pierogi…

If you have celiac disease, there is no question that you should avoid anything made with flour or grains, no matter how delicious the dish may be. Although the Gluten Free RN has fond memories of her Polish grandmothers making traditional pastries, she contends that you don’t have to eat customary Polish food to celebrate your Polish heritage.

In preparation for her upcoming trip to Warsaw in July, Nadine is taking a closer look at celiac disease in Poland. She discusses a 2009 study assessing the prevalence of celiac disease in Polish children, highlighting the asymptomatic and oligosymptomatic nature of the disease and explaining her own false negative test. Listen in for the Gluten Free RN’s insight around preparing for a trip to Poland, including research on the available gluten-free food and adult beverages!

What’s Discussed:

Why Nadine is concerned about her upcoming trip to Poland

  • Flour, grains used in cooking and baking

Nadine’s Polish heritage

  • Fond memories of grandmothers making pierogi, pastries

The 2009 study of celiac disease in Poland

  • Assessed prevalence in children, only screened for IgA EmA, IgG EmA
  • 3,235 children in Bydgoszcz tested, 25 identified (seven with Marsh III)
  • Predominantly asymptomatic or oligosymptomatic

Nadine’s genetic predisposition for celiac disease

  • HLA-DQ2.5 homozygous

How Nadine is preparing for travel in Poland

  • Aware of Polish translations for gluten-free, celiac (bezglutenowe, trzewny)
  • Take ‘rescue food’ for emergencies

The prevalence of celiac disease in Poland

  • 1:100 (matches worldwide estimate)

The gluten-free alcoholic beverages available in Poland

  • Potato vodka, honey mead

Nadine’s caution against eating bread in Europe

  • Wheat, grain causes damage regardless of location

The overlap between autoimmune and celiac disease

  • CD is grossly unrecognized, underdiagnosed

Nadine’s suggested diet for celiac patients

  • Meat, fish and eggs
  • Nuts and seeds
  • Fruits and vegetables

Resources:

NIH Consensus Development Conference on Celiac Disease

‘Screening for Celiac Disease in Poland’ in the Medical Science Monitor

Gluten-Free Globetrotter Blog on Poland

Gluten-Free Travel in Poland—Coeliac Youth of Europe

Poland Travel Guide—Coeliac UK

‘Graves’ Disease, Celiac Disease and Liver Function Abnormalities in a Patient—Clinical Manifestation and Diagnostic Difficulties’ in ACTA Biochimica Polonica

‘Neuropsychiatric Symptoms and Celiac Disease’ in Neuropsychiatric Disease and Treatment

‘Evaluation of HLA-DQ2/DQ8 Genotype in Patients with Celiac Disease Hospitalised in 2012 at the Department of Paediatrics’ in Przeglad Gastroenterologiczny

For Visitors with Coeliac Disease—Polskie Stowarzyszenie Osob z Celiakia i na Diecie Bezglutenowej

Connect with Nadine:

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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:

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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:

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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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Mental Health Disorders and Celiac Disease EP058


An estimated 50% of Americans are on some type of psychotropic drug. Half of the US population!

What is causing such widespread prevalence of mental health disorders? Prescription anti-depressants and sedatives don’t solve the underlying problem…  So how do we get to the bottom of this? 

The Gluten Free RN contends that there may be a connection between mental health and undiagnosed celiac disease. Today she explains how several disorders (anxiety, depression and paranoia, among others) have been linked to gluten, discussing how a leaky blood-brain barrier can lead to hypoxia, an inflammation of the brain.

Nadine walks us through the best research in mental health disorders and gluten sensitivity, sharing two landmark studies that emphasize the gut/brain connection and characterize celiac disease as primarily a neurological disorder. Nadine offers her insight around working with schizophrenic patients and the increasing number of children suffering from anxiety. Listen in to understand how gluten impacts your mental health, and learn how to eliminate brain fog, get off prescription meds, and enjoy a higher quality of life!

What’s Discussed: 

The connection between gluten and hypoxia

  • Leaky blood-brain barrier leads to inflammation of brain, decreased oxygen flow

The shocking statistics around Americans and psychotropic drugs

  • Estimated 50% of US population on psychotropic medication

The potential relationship between mental health disorders and undiagnosed celiac disease

  • High instance of depression, anxiety, fatigue and paranoia
  • May have difficulty sleeping, headaches or seizure disorder
  • Nearly all experience brain fog

The health consequences of undiagnosed celiac disease

  • Malabsorption of nutrients
  • Damaged immune system
  • Neurological symptoms
  • Hormonal imbalance
  • Neurotransmitter disruption

The findings of the landmark Cooke study in 1966

  • Ten of 16 patients with celiac disease had severe progressive neuropathy
  • All 16 had severe malabsorption

The conclusion of an editorial published in Neurology, Neurosurgery & Psychiatry

  • Celiac disease, NCGS is primarily neurological

How a gluten-free diet can resolve gastrointestinal and psychiatric symptoms

  • Celiac disease can manifest as depression, anxiety or psychosis
  • Research published in International Journal of Celiac Disease demonstrates gut/brain connection

Nadine’s experience with schizophrenia patients

  • Majority are gene positive for HLA-DQ2, HLA-DQ8

The increasing number of children diagnosed with anxiety disorder

  • May be caused by undiagnosed sensitivity to gluten

The concept of food as medicine

  • Body may read gluten as toxic, must remove from diet

Resources:

‘Gluten Sensitivity as a Neurological Illness’ in the Journal of Neurology, Neurosurgery & Psychiatry

‘Psychiatric Complications of Celiac Disease’ in the International Journal of Celiac Disease

‘Genetic Hypothesis of Idiopathic Schizophrenia: Its Exorphin Connection’ in Schizophrenia Bulletin

‘Markers of Gluten Sensitivity and Celiac Disease in Bipolar Disorder’ in Bipolar Disorders

‘Neurologic and Psychiatric Manifestations of Celiac Disease and Gluten Sensitivity’ in Psychiatric Quarterly

‘Neuropsychiatric Symptoms and Celiac Disease’ in Neuropsychiatric Disease and Treatment

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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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

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‘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