Celiac Disease for Health Care Providers EP031

Celiac disease is grossly underdiagnosed in the United States in large part because the medical community is operating on outdated information about the condition. And despite the recommendations of the National Institute of Health back in 2004, we have yet to implement a mass screening for celiac disease, and health care providers remain alarmingly uninformed.

The Gluten Free RN is taking steps to remedy the situation by sharing the basics for medical professionals. Today she covers the WHO’s definition of celiac disease, how our understanding of the condition has change over time, and some common misconceptions about celiac disease. She also explains the top symptoms, recommended testing for celiac disease and gluten sensitivity, and the neurological nature of the disorder.

Listen in to learn what health care providers need to know about this undiagnosed epidemic, the complex web of health issues that may result from undiagnosed celiac disease, and why it is important to have a high index of suspicion and include celiac testing on every differential diagnosis. Help your patients go gluten-free and collect something other than autoimmune disorders! 

What’s Discussed: 

The standard of care in the US

  • Providers should have diagnosed at least 1% of patients with celiac disease
  • Undiagnosed for 70 years, must overcome to prevent further pain and suffering

The goals of Nadine’s consulting business

  • Works with facilities to protect celiac patients
  • Ensure compliance with ADA

How the media portrays the gluten-free lifestyle

  • Dissuades people from adopting diet (program sponsors influence messaging)
  • Negative headlines

How our understanding of celiac disease has changed over time

The recommendations of the 2004 NIH consensus meeting regarding celiac disease

  • Mass screening (meets WHO criteria)
  • Education for health care providers

The World Health Organization criteria for mass screening

  • Early clinical detection essential
  • Condition is common
  • Screening tests highly sensitive and specific
  • Effective treatment available
  • Untreated condition leads to complications

The autoimmune disorders associated with undiagnosed celiac disease

  • MS
  • Type 1 diabetes
  • Lupus
  • Rheumatoid arthritis
  • Sjögren’s
  • Vitiligo

The WHO definition of celiac disease

  • Characterized by hypersensitivity to gluten
  • Prevalence currently estimated at 1:1,000 worldwide
  • Screening trials suggest prevalence of 1:100
  • Results in weight loss, diarrhea, nutritional deficiencies
  • Caused by villous atrophy
  • May present as extraintestinal manifestations or remain clinically silent

Why celiac disease can’t be ruled out with a single test

  • Can be triggered at any point
  • HLA-DQ2 and HLA-DQ8 genes indicate genetic predisposition

Misconceptions about celiac disease in the US medical community

  • Thought to be digestive disorder, but really neurological
  • Can present with seizures, numbness, constipation, balance issues, celiac cerebellar ataxia

How skin issues are a reflection of what is going on internally

  • Epithelial skin is same tissue as inside

How damage to the small intestine leads to multiple health issues

  • Increased permeability of intestinal wall
  • Leaky blood brain barrier
  • Leaky blood vessels
  • Leaky lungs and skin

The classic symptoms of celiac disease

  • Chronic diarrhea
  • Malabsorption
  • Extreme weight loss
  • Malnutrition

What celiac disease looks like in children

  • Diarrhea, constipation
  • General abdominal pain
  • Failure to thrive
  • Falling off growth chart
  • Short stature
  • Learning disabilities
  • Autism
  • Skin issues (eczema, cirrhosis, acne)
  • Delayed puberty
  • Dental problems
  • Anorexia, obesity
  • Bed wetting

The prevalence of celiac disease in older adults

  • 30% of people diagnosed with celiac disease are over 60

Potential signs of celiac disease in the aging population

  • Dementia
  • Alzheimer’s
  • Vision, hearing loss
  • Urinary problems
  • Cancer diagnosis (especially bowel cancer)
  • Ataxia
  • Arthritis
  • Hair loss
  • Fatigue
  • Osteoporosis
  • Anemia

The elements that get into your blood stream as a result of villous atrophy

  • Toxins
  • Heavy metals
  • Undigested food particles
  • Yeast, fungus
  • Parasites, other harmful bacteria

Top symptoms of celiac disease

  • Chronic anemia
  • Fatigue
  • Muscle, joint pain
  • Depression, irritability
  • Thyroid disorders
  • Infertility issues
  • GI problems (from mouth to rectum)
  • Migraine headaches
  • Psychiatric disorders
  • Seizures
  • Dermatitis herpetiformis
  • Down, Turner or Williams syndrome
  • Cardiomyopathy

The effects of gluten on the brain

  • Anger
  • Depression, anxiety
  • Learning disabilities
  • Lethargy
  • Insomnia
  • Brain fog
  • Schizophrenia
  • Dyslexia

Populations affected by celiac disease

  • Any age, race, gender
  • 3 million people all over the world
  • Study of healthy blood donors in Mexico found unexpectedly high prevalence of tTGA positivity
  • Now recognized as common disease among Middle Eastern and North African populations
  • 1:7 Americans suffer from non-celiac gluten sensitivity (43 million people)

The findings of an economic study by Columbia University

  • Non-diarrheal presentations now most frequent
  • Celiac disease grossly underdiagnosed in US
  • Average delay in diagnosis is 4-11 years for adults in North America
  • Significant improvement in quality of life when patients diagnosed and treated appropriately

The importance of ensuring that medications are gluten-free

Nadine’s recommendations around nutrition for celiac patients

  • Gluten- and dairy-free
  • Ideally Paleo
  • Super-good high fat

Things to consider re: the results of a celiac panel

  • A positive test guarantees intestinal damage
  • Include total IgA and IgG
  • 70% produce a false negative

Additional tests that offer valuable information

  • Fecal fat score (ask for #, over 300 indicates malabsorption)
  • Complete blood count
  • Comprehensive metabolic panel
  • Vitamin D3 level (below 40 ng/ml is critically low)
  • Vitamins A, E & K levels
  • Vitamin B6 & B12 levels
  • MTHFR gene test
  • Magnesium RBC test
  • Zinc level
  • Iodine level
  • B9/Folate level
  • Ferritin level
  • Iron level
  • Thyroid panel
  • Bone density test
  • Lipid panel
  • ANA test (autoimmune issues)
  • ESR test
  • CRP test

Surprising facts around celiac disease contrary to conventional wisdom

  • Only 15% of celiac patients have chronic diarrhea
  • 39% of celiac patients are overweight
  • Shampoos, cosmetics and airborne gluten affect patients with gluten intolerance and celiac disease
  • Super-good high fat diet is essential for celiac patients



NIH Consensus Statement

“Where Have All the American Celiacs Gone?” in Acta Pediatrica

Montana Gluten Free

“Economic Benefits of Increased Diagnosis of Celiac Disease in a National Managed Care Population in the United States” in the Journal of Insurance Medicine

“Celiac Disease Could be a Frequent Disease in Mexico: Prevalence of Tissue Transglutaminase Antibody in Healthy Blood Donors” in the Journal of Clinical Gastroenterology

“Celiac Disease in Middle Eastern and North African Countries: A New Burden? in the World Journal of Gastroenterology

Recommended Labs

CDC 2013 Report Antibiotic Resistance Threats

Cyrex Laboratories




Primal Docs

Connect with Nadine: 



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



Small Intestinal Bacterial Overgrowth and Celiac Disease EP030

Nobody wants bad bacteria, parasites, yeast or food particles hanging around their small intestine! There are a number of causes of small intestinal bacterial overgrowth (SIBO), and undiagnosed celiac disease just happens to be one of them.

The Gluten Free RN is prepared to discuss the complexity of health issues celiac patients must resolve after going on a gluten free diet, one of which may be SIBO. She shares the symptoms of small intestinal bacterial overgrowth, how we test for SIBO, and potential treatments for the condition. Listen in to learn how foods and medication affect the microbiome and alter the environment of your intestines.

What’s Discussed:

The complexity of healing once a celiac patient goes gluten free

  • Very rarely does diet change heal all associated disorders
  • Other issues like SIBO must be treated once intestines heal

The causes of irritable bowel syndrome

  • Thought to be caused by stress
  • Studies now show food poisoning may be trigger

How food, drink and medication affect your intestines

  • Certain food/drink can move in bad bacteria, push out good
  • Antibiotics change pH of stomach acid
  • Bacteria, parasites, yeast and food particles get into small intestine

The consequences of damaged villi due to undiagnosed celiac disease

  • Compromised immune system
  • Inflammation
  • Body can’t absorb nutrients

The process of healing your intestines

  • Takes six months to a year
  • Must eliminate all foods that cause inflammation (gluten, dairy, soy, etc.)
  • After villi heal, deal with additional health issues (i.e.: SIBO)
  • Villi MUST grow back before good bacteria can return

The symptoms of SIBO

  • Gas, bloating
  • Abdominal pain
  • Diarrhea
  • Constipation

How to test for SIBO

  • Consume sugary drink, then breathe into tube
  • Hydrogen sulfate associated with diarrhea
  • Methane connected to constipation
  • Gives snapshot of what is happening in intestines

How SIBO is treated

  • Antibiotics (rifaximin)
  • Herbs (i.e.: oregano oil, berberine, neem)
  • Fecal microbial transplant

Risk factors for SIBO

  • Any course of antibiotics
  • Diabetes
  • Bowel surgery
  • Crohn’s disease
  • Undiagnosed celiac disease


Primal Docs

SIBO Info Website

“Small Intestinal Bacterial Overgrowth: A Comprehensive Review” in Gastroenterology and Hepatology

Connect with Nadine: 



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



Celiac Disease and Your Spleen EP029

Did you know that the spleen plays a leading role in a properly functioning immune system? As the largest organ in your lymphatic system, the spleen spends its time fighting infection and keeping you healthy. Unfortunately, research points to a connection between disorders of the spleen and celiac disease. And if your immune system is already compromised because of gluten damage to your intestines, a spleen issue leaves you at heightened risk for a variety of infections and autoimmune diseases.

Today the Gluten Free RN shares her personal connection to genetic spherocytosis and how spleen damage affected her family. She also covers several studies that document the correlation between spleen issues and celiac disease. Listen in to understand how your spleen functions, the symptoms of spleen disorder, and the autoimmune diseases you may develop if your spleen is damaged or removed.

What’s Discussed:

How your spleen works to keep you healthy

  • Filters used/damaged red blood cells
  • Harvests iron to recycle
  • Produces antibodies, white blood cells
  • Fights infection
  • Vital to immune system

Conditions you may acquire if spleen is damaged (increased risk)

  • Pneumonia
  • UTI
  • Overwhelming sepsis

Instances in which spleen may be enlarged

  • Mononucleosis
  • Some bacterial infections, metabolic disorders
  • Liver diseases
  • Some blood cancers, lymphoma
  • Blood clots in veins of liver, spleen

Symptoms of spleen issues

  • Pain in upper left quadrant
  • Fatigue
  • Anemia
  • Bruise easily
  • Bloated

The correlation between genetic spherocytosis and celiac disease

  • As high as 88% in some studies

How the ratio of spleen diameter to RDW can indicate celiac disease

  • Two-thirds of celiac patients in study had elevated red blood cell distribution width
  • Small spleen in 80% of celiac patients
  • Spleen diameter to RDW ratio under 6 had 88.5% specificity in predicting celiac disease

Why patients with hyposplenism should get tested for celiac disease

  • 25-75% of celiac patients have hyposplenism
  • Look for red blood cell abnormality
  • HLA-DQ2 and HLA-DQ8 genes indicate predisposition for celiac disease
  • Antibody test available from EnteroLab or Cyrex Laboratories
  • Ask for total IgA, IgG

Other autoimmune diseases patients with hyposplenism may develop (increased risk)

  • Type 1 diabetes
  • Lupus
  • Sjögren’s syndrome
  • Vitiligo
  • Raynaud’s
  • Autoimmune thyroiditis
  • ALS, MS, any demyelination of nervous system
  • Idiopathic thrombocytopenia
  • Autoimmune hepatitis

Nadine’s recommendations around nutrition

  • Local, organic
  • Nutrient dense
  • Gluten-free, Paleo

The link between hyposplenism and autoimmune manifestations of celiac disease

  • Autoimmune disorders may cause splenic hypofunction or vice versa
  • Study hypothesizes that higher risk for splenic function in celiac patients may be related to celiac disease rather than autoimmunity
  • Prevalence of celiac disease-associated hyposplenism increased from 19% in uncomplicated patients to 59% in those with autoimmune disorders

Why celiac patients may not benefit from iron supplements, infusions

  • Damaged intestines cannot absorb iron
  • Damaged spleen destroys healthy red blood cells


“Ratio of Spleen Diameter to Red Blood Cell Distributions Width” in Medicine (Baltimore)


Cyrex Laboratories

“Is it Worth Investigating Splenic Function in Patients with Celiac Disease?” in the World Journal of Gastroenterology

“Hyposplenism in Gastrointestinal Disease” in Gut BMJ

“Hyposplenism, Adult Coeliac Disease, and Autoimmunity” in Gut BMJ

“Splenic Volume Differentiates Complicated and Non-Complicated Celiac Disease” in UEG Journal

Connect with Nadine: 



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



The Relationship Between the Respiratory System and Celiac Disease EP028

The average human takes between 14 and 20 breaths per minute. But if you are conscious of those breaths, that’s a problem. Perhaps you’re experiencing chest tightness, clogged sinuses or a nagging cough that make you very aware of every breath you take. If so, the ingestion of gluten may be a contributing factor to these respiratory issues.

Today Nadine explores the relationship between the lungs and celiac disease, offering anecdotal evidence as well as explaining the way that inflammation can lead to a number of respiratory problems. Because 70-90% of your immune system is housed in your intestines, it is no surprise that a leaky gut could make you more vulnerable to respiratory tract infections.

Despite the fact that current literature considers respiratory challenges to be an atypical presentation of celiac disease, the Gluten Free RN argues that there is enough anecdotal evidence to merit further study. Listen in to understand the vitamin deficiencies that likely contribute to respiratory issues, how those health concerns might be corrected by going gluten-free, and why your body heals more quickly on a high fat, whole food diet. It’s time to go gluten-free and breathe easy again!

What’s Discussed: 

How gluten ingestion likely affects the respiratory system

  • Body keeps fluids separate unless tissues leaky
  • Gluten alters epithelial tissue, including that of lungs

Nadine’s anecdotal evidence of a connection between gluten and respiratory issues

  • Fellow nurse had lung removed as child
  • Always needed inhalers
  • Went gluten-free with Nadine
  • Inflammation in lungs cleared, asthma gone
  • No longer needed inhalers

Respiratory issues that may be corrected on a gluten-free diet

  • Anemia (lack of red blood cells to carry oxygen causes shortness of breath with minimal exertion)
  • Recurrent respiratory infections
  • Cystic fibrosis
  • COPD
  • IPH (bleeding lung)
  • Pulmonary edema

Vitamin deficiencies caused by gluten ingestion that lead to respiratory problems

  • Vitamin K deficiencies initiate easy bruising, nose bleeds and bleeding lung

Why going gluten-free eliminates many respiratory issues

  • Gluten causes inflammation (-itis = inflammation)
  • Removing the cause heals intestines, repairs immune system
  • Patients operate on a higher level

Common symptoms of respiratory issues

  • Difficulty breathing
  • Chest tightness
  • Nagging cough
  • Clogged sinuses
  • Post-nasal drip

Nadine’s recommendations around diet and nutrition

  • Gluten- and dairy-free at a minimum
  • Ideally variation of Paleo diet
  • Whole foods (meat, fish, eggs, fruits, vegetables, nuts and seeds)
  • High fat (body needs to absorb fat-soluble nutrients – A, D, E & K)
  • Maintain Gluten Zero (takes six months to a year for intestinal villi to heal)

Why your body heals more quickly on a high fat, whole food diet

  • Body knows how to break down, utilize nutrients
  • Fat-soluble vitamins repair connective tissue, leaky gut

The genes that indicate a predisposition for celiac disease

  • HLA-DQ2
  • HLA-DQ8


“Hemoptysis in Patients of Celiac Disease with Disproportionately Severe Anemia” in Multidisciplinary Respiratory Medicine

“A Case of Cough, Lymphocytic Bronchoalveolitis and Coeliac Disease with Improvement Following a Gluten Free Diet” in Thorax

“Respiratory Symptoms as Atypical Manifestation of Celiac Disease” in the Pediatric Oncall Journal

“Recurrent Rhinitis and Pulmonary Infections Revealing Celiac Disease” in Revue de Pneumologie Clinique

“Pneumococcal Septic Shock in the Setting of Hyposplenic Celiac Disease” in Hospital Physician

Coeliac Australia: Associated Conditions

Connect with Nadine: 



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


Non-Alcoholic Steatohepatitis (NASH) and Celiac Disease EP025

We typically associate liver disease with alcoholism. But the liver functions as a filter, and over time it can be damaged by certain pharmaceuticals and even food. In fact, research suggests a strong correlation between undiagnosed celiac disease and non-alcoholic steatohepatitis (NASH).

The Gluten Free RN shares a number of case studies in which a diet change reversed liver damage and prevented the need for an organ transplant. She also takes us through the alarming statistics regarding NASH in children and discusses her approach to treating NASH patients. 

Listen to understand the obesity trends in the US and how a sedentary lifestyle plays a part in liver disease. Join Nadine’s campaign to educate the population about the benefits of a gluten- and dairy-free, whole food diet – and prevent NASH!

What’s Discussed: 

Nadine’s introduction to NASH in children

  • Videoconference of pediatricians
  • Discovered NASH on autopsies
  • Few had signs/symptoms

The fundamentals of NASH

  • Liver failure caused by changing environmental factors
  • Dietary culprits (e.g.: sodas, fast food, processed foods, alcohol, high fructose corn syrup, nutrient-deficient carbs)
  • Up to 90% of patients undergoing bariatric surgery have fatty liver disease
  • Only diagnostic tool is liver biopsy

Obesity trends in the United States

  • 60% of people in 13 states will be obese by 2030
  • Link between poverty and obesity

Why starving people are obese

  • Lack of nutrient-dense food results in low nutrient levels
  • Body compensates for deficiencies by storing fat as cheap energy

The correlation between undiagnosed celiac disease and NASH

  • Celiac disease found in 10% of patients with unexplained abnormal liver panels and 3.5% of patients with NASH
  • Anyone with bump in liver enzymes should be screened for celiac disease and given gluten-free diet option

The 2015 Canadian study re: liver transplant

  • NASH as most common indication for liver transplant in North America
  • NASH projected to be leading cause by 2025
  • Identified obesity, sedentary lifestyle, highly processed foods, undiagnosed celiac disease, MS and type 2 diabetes as causes

The basics of non-alcoholic fatty liver disease (NAFL)

  • Buildup of fat in liver cells
  • Largely asymptomatic until have profound liver/organ failure

Which populations are at increased risk for NASH

  • Obese
  • Hispanic
  • Native American
  • Pediatric

Liver transplant statistics

  • 16,000 people on waiting list for liver transplant
  • Only 6,000 liver transplants performed each year

Case study demonstrating the reversal of liver damage on gluten-free diet

  • 19-year-old woman referred for emergency liver transplantation
  • Recovered quickly on gluten-free diet, normal liver and small intestines after 20 months
  • No surgery required

The correlation between celiac disease and liver disease

  • Celiac patients at increased risk of NAFLD compared to general population
  • Most common cause of chronic liver disease in children and adolescents in western nations

How Nadine approaches a patient with NASH

  • Examine diet (food as medicine/poison)
  • Replace highly processed fats
  • Leverage minimally processed foods

How to combat obesity

  • Educate people about the value of nutrient-dense food
  • Provide medical and social support

The liver as a detoxing organ

  • Functions as a filter
  • Can be damaged over time by foods, acetaminophen, alcohol

What a good, whole food diet looks like

  • Gluten- and dairy-free (ideally Paleo)
  • Includes meat and fish, nuts and seeds, organic fruits and vegetables

The need for access to accurate nutritional information

  • Not influenced by politics, food corporations, agribusiness or pharmaceutical companies



“Sonographic Diagnosis of Coeliac Disease in a Case with Suspected Acute Liver Failure” in the European Journal of Gastroenterology and Hepatology

“Non-Invasive Diagnostic Biomarkers” by Dr. Rohit Loomba of UC San Diego

“Acute Cryptogenic Liver Failure in an Untreated Coeliac Patient” in the European Journal of Gastroenterology and Hepatology

“Increased Risk of Non-Alcoholic Fatty Liver Disease After Diagnosis of Celiac Disease” from the Journal of Hepatology

Connect with Nadine: 



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


Weight Loss and Weight Gain Associated with Celiac Disease EP020

Forget everything you thought you knew about obesity.

68% of the population of the US is overweight, and we know that there are a number of health risks associated with the issue. But did you know that people are overweight because their bodies are actually starving?

 Today the Gluten Free RN is challenging your assumptions about weight gain and celiac disease, revealing the surprising way your body compensates for malnourishment, the necessity of fat in nutrient absorption, and the healing power of a whole food gluten-free diet.

Listen and learn why more people are overweight when diagnosed with celiac disease than underweight, more have constipation than diarrhea, and more have neurological disorders than gastrointestinal issues. Nadine is prepared to shake up your idea of what it means to have celiac disease and offer guidance regarding the food we should be eating in order to heal, and lose – or gain – weight in the process!

What’s Discussed: 

The classic symptoms of celiac disease

  • Used to be identified by weight loss and chronic diarrhea
  • We now know there are well over 300 signs and symptoms

The obesity epidemic in the US

  • 68% of the population is overweight
  • Obesity increases morbidity and mortality
  • The majority of celiac patients are overweight

Why celiac patients are overweight

  • Damage to intestines prevents absorption of nutrients
  • Body is starving, so it compensates by storing fat as cheap energy

The health risks associated with obesity

The failings of fast food

  • Little to no nutritional value
  • ‘Bad’ fat
  • Little use as energy

The whole food diet Nadine recommends for celiac and gluten sensitive patients

 The rapid weight loss of overweight celiac patients once they adopt a gluten-free diet

Why wounds may not heal appropriately in celiac patients

  • Body is malnourished and cannot absorb nutrients
  • Nutrients are necessary to heal tissue

How to heal your body with food

  • Choose fermented foods
  • Regenerate villi in intestines
  • Build diverse microbiome

Nadine’s patient with tunneling wound in sacral area

  • Wound would not heal, required daily dressing changes
  • Patient was HLA-DQ2 gene carrier
  • Wound healed after 10 days on a gluten-free diet

How a gluten-free diet affects underweight celiac patients

  • Muscle and tissue build appropriately
  • Weight increases as nutrients are absorbed

The necessity of a high-fat diet for celiac patients

  • Vitamins A, D, E and K are fat-soluble
  • The brain is made of fat

‘Good’ fats that Nadine recommends incorporating into your diet

  • Listen in for the full list!!

Connect with Nadine: 



Contact via Email

Books by Nadine:

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


Signs and Symptoms of Celiac Disease and Gluten Intolerance in Children EP006

In this episode of ‘Gluten Free RN,’ Nadine discusses common signs and symptoms of gluten intolerance in children as well as the importance of identifying celiac disease early to allow for the growth and development of body and brain.

Nadine employs anecdotes about her own clients at the Gluten Free RN office to illustrate the myriad of ways that gluten can affect the health and development of undiagnosed kids.

This episode explains the GI problems, developmental delays, autoimmune disorders and neurological issues that children with gluten intolerance face as long as they remain undiagnosed. Click and listen to recognize the warning signs!

What’s Discussed: 

The common dismissal of celiac symptoms in children

The profound impact of gluten intolerance on fetal development and maternal health

  • It typically takes 9-15 years for a person to be diagnosed correctly

Signs and symptoms of celiac disease and gluten intolerance in children

Failure to thrive

  • Low birthweight
  • Short stature, stunted growth and delayed development
  • Lactose intolerance
  • Abdominal pain and vomiting
  • Focus and retention issues (ADD, ADHD, ODD)
  • Autism
  • Psychiatric issues
  • Delayed puberty
  • Listen for the full list

Katie’s story

  • After suffering from chronic constipation, her colon was removed – but her health did not improve until she learned about celiac disease and changed her diet
  • Because her growth was stunted as a result of malnourishment, Katie only grew to 5’3” despite having a size 10 foot

Why vitamins, minerals and supplements don’t help children with celiac disease or gluten intolerance

Why undiagnosed celiac disease patients suffer from focus issues and psychiatric disorders

  • Inflammation of the brain causes hypoxia
  • Low oxygen flow results in ‘brain fog’

Sam’s story

  • At 17, she was overweight and suffering from abdominal pain
  • She was still wetting the bed and had yet to get her period
  • After receiving a celiac diagnosis and adopting a gluten-free diet, Sam lost 100 pounds and has gone on to have two healthy children

The importance of testing the entire family for celiac disease once one member has received a diagnosis

The high percentage of celiac patients who are asymptomatic

  • Roughly 50% of people diagnosed with celiac disease would say they have no symptoms

The increased chances of developing autoimmune disorders when children with celiac disease go undiagnosed

The enormous genetic overlap between celiac disease and Type 1 diabetes

Why parents should be tested for celiac disease prior to a pregnancy

  • Undiagnosed expectant mothers are at an increased risk of miscarriage, complications and delivering babies with low birthweight and neural defects

How to navigate birthday parties, camps, school events, etc.

  • Proper planning and communication make it easy

Resources Mentioned: 

How Doctors Think by Jerone Groopman

 University of Chicago Medicine Celiac Disease Center Website

 EnteroLab Celiac Testing Resources

 Connect with Nadine: 



Contact via Email

Books by Nadine:

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


Intro to Celiac Disease and Gluten Intolerance EP004

This episode of ‘Gluten Free RN’ covers the basics of celiac disease and gluten intolerance – what those terms mean and what they might mean for you. Nadine explains which genes suggest a predisposition to gluten intolerance and what circumstances lead to a diagnosis of celiac disease proper.

 Nadine talks you through what happens in your digestive tract that leads to gluten proteins attacking your organs and preventing your body from absorbing the nutrients it needs. She also outlines the foods and products you need to avoid to achieve ‘gluten-zero,’ as well as the foods you can enjoy as part of a gluten-free diet.

 Listen in and learn where gluten is hiding and how to modify your diet to reverse the adverse effects of gluten!

What’s Discussed: 

  • The definition of celiac disease and its chronic nature
    • 30-50% of the population carries the genes
  • How a trigger event (i.e.: a cold, pregnancy, stress, an injury) initiates the autoimmune disorder
  • Options for getting tested for the genetic predisposition
  • The closed system of the digestive tractand how food is processed
    • While some food is used for energy, much just passes through
  • Villous atrophy and the four stages of tissue damage
    • Marsh 1: microvilli destroyed; body cannot break down sugar and milk
    • Marsh 2/3: villi themselves fold over or atrophy; tight junctures between villi (that keep things your body can’t utilize in the GI tract and out of your bloodstream) open up
    • Marsh 4: villi gone and only red, inflamed tissue remains; ‘leaky gut’
  • The effects of increased permeability of the intestinal wall
    • Damaged immune system
    • Rather than passing through the GI tract, gluten proteins get into bloodstream and wreak havoc on organs
    • Body can’t absorb nutrients out of food
  • The importance of healthy intestinal tissue
    • 70-90% of the immune system is in your intestines
  • The soldier analogy
    • Healthy villi are like rested soldiers with loaded weapons on a clear day who can easily take out antigens that don’t belong
    • Damaged villi are like soldiers on a bender with inadequate weaponry, operating in smoke and fire – they either don’t work at all or fire randomly at antigens
  • The long road to recovering from villous atrophy
    • It takes 6 months to a year to reverse the damage
  • Grains to avoid that contain gluten
    • Wheat
    • Barley
    • Rye
    • Oats (due to cross-contamination)
  • Places where gluten may be hiding
  • Gluten-free foods
    • Fresh fruits and vegetables
    • Plain meats and fish (not breaded or beer battered)
    • Beans/legumes
    • Tree nuts
    • Rice, corn and potatoes
    • Quinoa and teff
    • Dairy
  • What a gluten-free rating means
    • The Gluten Intolerance Group (GIG) certifies products that contain less than ten parts per million

Resources Mentioned: 

Gluten: Zero Global by Rodney Ford

 Enterolab Website

 Glutenpro Celiac Test

 Country Life Vitamins

 Kite Hill Foods

Connect with Nadine: 



Contact via Email

Books by Nadine:

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