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Dental Issues and Celiac Disease EP039

Did you know that it is possible to diagnose celiac disease with a smile?

Damage from gluten starts in the mouth, and today the Gluten Free RN explores the important role dentists can play in identifying undiagnosed celiac disease. She outlines the symptoms of celiac disease that present in the mouth, the follow-up questions dentists should ask when they notice dental enamel defects or aphthous ulcers, and the nature of the tongue as an indicator of overall health.

This episode covers how the plastics in orthodontic retainers might contain gluten and what to do if you are accidentally exposed. Nadine also explains the relationship between fat-soluble vitamins and celiac disease, as well as the nutrient deficiencies a potential celiac patient should test for. You’re never fully dressed without a smile, so listen in to understand how to keep your mouth healthy—and prevent the accumulation of complications from celiac disease with a whole food, gluten-free diet!

What’s Discussed: 

How the GI tract functions

  • Starts at mouth, ends at rectum
  • Allows us to consume food, liquid
  • Only extract what body needs
  • Expel the rest

How damage from gluten presents

  • Malabsorption of nutrients
  • Inflammation
  • Autoimmune issues
  • Type 1 diabetes
  • ALS
  • Lupus
  • MS
  • Sjögren’s
  • Leaky gut

How dentists can play an important role in identifying undiagnosed celiac disease

The symptoms of celiac disease that present in the mouth

  • Dental enamel defects
  • Aphthous ulcers (canker sores)
  • Cheilosis (cracks, open sores where upper and lower lip join)
  • Dry, cracked lips
  • TMJ—temporal mandibular joint disorder
  • Pain where jaws meet
  • Inflammation of the jaw
  • Clicking
  • Lock jaw
  • Mouth pain, burning
  • Oral lesions
  • Tongue pain, tingling
  • Redness, swelling of the tongue
  • Tongue sores
  • Changes in taste, smell
  • Diminished sensory input
  • Dry mouth
  • Sore throat
  • Difficulty swallowing
  • Increased thirst
  • Bleeding gums
  • Delayed eruption of teeth
  • Pyrosis
  • Oral lichen planus
  • Glossitis (inflammation of tongue)
  • Clearing throat
  • Sinus infections
  • Redness, swelling of the uvula

How Nadine treats gluten exposure

  • Activated charcoal
  • Drink water

The grains to look for in personal care products (e.g.: lip balm)

  • Wheat
  • Barley
  • Rye
  • Oats

The relationship between fat soluble vitamins and celiac disease

  • Gluten causes malabsorption
  • Vitamins A, D, E and K are fat soluble
  • Under 40 in vitamin D may indicate deficiency in all

How we tested for celiac disease in children in the early 20th century

  • Fecal fat score
  • Pale stool that floats suggests malabsorption of A, D, E and K

Why parents should be tested for celiac disease prior to pregnancy

The fetal development issues that may present if an expectant mother is unable to absorb nutrients

  • Dental enamel defects
  • Smaller jaw formation
  • Smaller airway passages

Why Nadine advocates for a mass screening

How gluten in plastics, personal care products can prevent celiac patients from healing

The questions dentists should ask when they notice dental enamel defects, aphthous ulcers

  • Other clinical celiac symptoms (abdominal pain, diarrhea, weight loss, anemia, fatigue)
  • Associated disorders (type 1 diabetes, thyroiditis, etc.)
  • Family history of celiac disease

Why we need to get much better at recognizing celiac signs and symptoms

  • Even in Canada, diagnosis takes 11.7 years

Why Eastern medicine examines the tongue as an indicator of overall health

The genes that indicate a predisposition to celiac disease

  • HLA-DQ2
  • HLA-DQ8

Why it is acceptable to adopt a gluten-free diet if your antibody test is negative for celiac disease

The deficiencies a potential celiac patient should test for

  • Calcium
  • Magnesium RBC
  • Vitamin D
  • Zinc
  • Folic acid

Why thrush may be an indicator of celiac disease or gluten sensitivity

Why one negative test for celiac disease doesn’t rule anyone out

The importance of early diagnosis

  • Symptoms accumulate over the years

The Paleo diet Nadine suggests for celiac and gluten-sensitive patients

  • Whole food
  • Focus on local, fresh
  • 100% grass-fed meat (no antibiotic, no hormone)
  • Fish and eggs
  • Nuts and seeds
  • 100% organic fruits and vegetables

Resources:

 “An Orthodontic Retainer Preventing Remission in Celiac Disease”  in Clinical Pediatrics

“Oral Manifestations of Celiac Disease: A Clinical Guide for Dentists” in the Journal of the Canadian Dental Association

Gluten Free RN Podcast EP027: Type 1 Diabetes and Celiac Disease

“The Association Between Celiac Disease, Dental Enamel Defects, and Aphthous Ulcers in a United States Cohort” in the Journal of Clinical Gastroenterology

“Small-Bowel Changes in Recurrent Ulceration of the Mouth” in Hepatogastroenterology

“Oral Signs and HLA-DQB1*02 Haploytypes in the Celiac Paediatric Patient: A Preliminary Study” in Autoimmune Diseases

“The Oral Manifestations of Celiac Disease: Information for the Pediatric Dentist” in Pediatric Dentistry

“Oral Aphthous Ulcers and Dental Enamel Defects in Children with Coeliac Disease” in Acta Paediatrica

“Oral and Dental Manifestations of Celiac Disease” in the New York State Dental Journal

“Jejunal Mucosal Abnormalities in Patients with Recurrent Aphthous Ulceration” in The British Medical Journal

“Dental Enamel Defects in Adult Coeliac Disease” in the European Journal of Internal Medicine

“Screening for Celiac Disease in Children with Dental Enamel Defects”  in ISRN Pediatrics

“Celiac Disease Associated with Recurrent Aphthae” in Gut

“Importance of Oral Signs in the Diagnosis of Atypical Forms of Celiac Disease” in Recenti Progressi in Medicina

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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The Impact of Undiagnosed Celiac Disease on Fetal Development and Maternal Health EP024


‘With our technology, every time a woman dies, it’s a medical error.’

 Recent reports have uncovered some alarming statistics regarding maternal mortality rates in the United States. While these numbers are on the decline in every other developed nation, pregnant women in the US are at greater risk of dying than they were in recent years. We know that undiagnosed celiac disease has a significant impact on maternal health and fetal development, and we must identify expectant mothers (and fathers) who have the potential to reap remarkable benefits from a simple diet change.

This issue is especially important to the Gluten Free RN as a mother herself – as well as an emergency ER nurse certified in PALS, NLS and pediatric emergency nursing. She shares the stories of women who had difficulty getting pregnant or maintaining pregnancies as a result of undiagnosed celiac disease and gluten sensitivity, and explains how a mass screening could work to prevent such intense suffering.

Listen to learn how adopting a gluten-free or Paleo diet can help women carry their babies to full-term and deliver healthy, thriving children!

What’s Discussed: 

Nadine’s mission to get women tested for celiac disease prior to pregnancy

  • Allows to absorb nutrients during pregnancy (including prenatal vitamins)
  • Can deliver healthy, thriving child

 The story of Alice Bast

  • Suffered miscarriage and still births
  • Multiple doctors couldn’t provide answers
  • Vet gave idea to test for celiac disease
  • Founded the National Foundation for Celiac Awareness

 The necessity for a mass screening of men and women

  • Identify HLA-DQ2 and HLA-DQ8 gene carriers
  • Genes of both parents affect fetal health
  • Ratio of women to men with celiac disease is 1:1
  • Ratio of women to men diagnosed with celiac disease is 3:1

 The increased risks for pregnant women with undiagnosed celiac disease

  • Miscarriage
  • Still birth
  • Low birth weight
  • Failure to thrive in children
  • Pre-eclampsia/eclampsia (dangerously high blood pressure)

 The role men play in infertility

  • ED, low sperm count and low libido may be attributed to undiagnosed celiac disease
  • Symptoms include deficiencies in zinc, magnesium and B vitamins as well as anemia and osteoporosis

 The argument that a mass screening for celiac disease is too expensive

  • The cost associated with undiagnosed celiac disease is much higher
  • Consists of medical costs from complications
  • Also includes decreased productivity and morbidity/mortality
  • Study published in Science Digest found that 42,000 children may die annually due to undiagnosed celiac disease

 Conditions that indicate high risk for celiac disease

  • Chronic GI issues
  • Irritable bowel syndrome
  • Weight loss/gain
  • Iron deficiency anemia
  • Vitamin/mineral deficiencies
  • Secondary hyperparathyroidism
  • Unexplained elevations in liver function
  • Down, Turner or Williams syndrome
  • Type 1 diabetes
  • Lupus
  • Autoimmune thyroid disease

 Sam’s story

  • Delayed puberty (didn’t get period until 17-years-old)
  • Diagnosed with celiac disease at 19
  • Doctors warned she would probably never have children
  • Raising two healthy boys

 Why Nadine is concerned about the current generation of children

  • Higher rates of autoimmune diseases, cancer and learning disabilities

 The appropriate diet to promote maternal health and proper fetal development

  • Gluten- and dairy-free
  • Paleo is best
  • Humans have enzymes to break down meat proteins
  • Humans do not have enzymes to break down grain proteins
  • Avoid wheat, barley, rye and oats
  • Embrace meat, fish, eggs, fruits, vegetables, nuts and seeds

 Deficiencies that can be corrected to promote healthy pregnancy

  • B6 and B12
  • A, D, E and K (the fat-soluble vitamins)
  • Magnesium RBC
  • Zinc

 The US maternal mortality rate compared to other developed nations

  • Rising in the US, declining in other developed nations
  • 28 deaths for every 100,000 births in 2013, up from 23 in 2005

Resources:

“Maternal Mortality Rate in US Rises, Defying Global Trend, Study Finds” in The New York Times

“Focus on Infants During Childbirth Leaves US Moms in Danger” on NPR

Beyond Celiac: Alice Bast

“Reproductive Changes Associated with Celiac Disease” from the World Journal of Gastroenterology

“Celiac Disease and Reproductive Health” from Celiac Disease: A Comprehensive Review and Update

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

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Celiac Disease and Gluten Intolerance in the Elderly Population EP007


In this episode of ‘Gluten Free RN,’ Nadine discusses potential signs of celiac disease and gluten intolerance in those 65 and older. Many go undiagnosed because their symptoms are dismissed as a normal part of aging.

Nadine explains how nutritional deficiencies triggered by gluten intolerance can cause the elderly to acquire a list of diagnoses and medications that might not be necessary and do not address the underlying cause of degeneration.

This episode outlines how health setbacks common in the older population (osteoporosis, GI issues, dementia and degenerative disease) may be symptoms of celiac disease that could be improved or even eliminated with a gluten-free diet. Listen and learn how to improve the quality of life for those 65 and up!

What’s Discussed:

The prevalence of celiac disease in the older population

  • 30% of people diagnosed with celiac disease are over the age of 60
  • The elderly population has a prevalence of celiac disease 1-2% greater than the general population

The recommended diet for elderly celiac patients

  • Nadine advocates both a gluten- and casein-free diet

The genes that carry celiac disease

Nadine’s story

  • Undiagnosed celiac disease left her with multi-system organ failure at the age of 40
  • A gluten-free diet fixed the nutritional deficiencies and allowed her body to regenerate

The benefits of adopting a gluten-free diet as an older adult

  • Reverse damage done by gluten
  • Prevent health problems like dementia, osteoporosis, and osteopenia

GI issues that may be symptoms of celiac disease and gluten intolerance in older adults

How a nutritional panel can reveal deficiencies that may be caused by gluten intolerance

  • Low levels of vitamins D, B6, B12, iron, and zinc point to a difficulty absorbing important nutrients
  • An imbalance of magnesium and/or calcium can cause heart arrhythmia and muscle fasciculation

Why men suffering from osteoporosis and anemia should be tested for celiac disease

The connection between erectile dysfunction and potential gluten intolerance

  • ED can be either a neurological disorder or a condition caused by hypoxia

The probable link between Type 1 or 2 diabetes and celiac disease

The importance of testing patients on cholesterol or blood pressure medication for celiac disease

Why Nadine recommends all patients 65 and older be tested for celiac disease yearly

  • Not every patient will test positive but can seroconvert at anytime

How the appropriate absorption of fat can help older patients with gluten intolerance “get their brains back”

  • Our brains are made of fat and every nerve is covered with myelin
  • A brain starved of fat can cause a patient to suffer from brain fog and dementia

The good, high-fat foods that prevent brain atrophy

  • Listen for the list!

Miss Gloria’s story

  • Grumpy and agoraphobic, Gloria rarely left her bed
  • After testing positive for celiac disease, she eventually agreed to try a gluten-free diet
  • Gloria’s health improved to a point where she was able to leave the house regularly and finally move to Savannah, where she spent her last years with her son

How identifying celiac disease and gluten intolerance in the elderly can prevent suffering and early death

Resources Mentioned:

Gluten Free RN on iTunes

Gluten Free RN on Stitcher

Connect with Nadine: 

Instagram

Facebook

Contact via Email

Books by Nadine:

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