OVitaminPro

Getting a proper diagnosis about your body’s reaction to gluten is vital. Gluten has been shown in study after study to increase the probability of serious disease along with increased rate of mortality at every age if you are sensitive to gluten and continue to eat it.

Even if you have full-blown celiac disease, your chance of having that properly diagnosed in a medical doctor’s office is about 2%. Doctors in general still miss the signs and is unfamiliar with proper diagnostic protocols. If you have what is called non-celiac gluten sensitivity, the symptoms can be more subtle and your chance of having that properly diagnosed is less likely still.

Most people on a gluten free diet have diagnosed themselves. This approach has some merit as an observant person can notice that some symptoms worsen when they eat gluten and go away when they don’t. Many mothers have put their kids on a gluten free diet as they notice that many allergies and behavioral problems are dramatically improved on a gluten free diet.

This approach is effective but still won’t pick up everyone at risk. What if your primary problem is osteoporosis because the bone building cells (osteoblasts) are being inhibited from doing their job by gluten stimulated antibodies? What if the problem is interference with certain enzymes in the brain that leads to gluten ataxia or loss of cerebellar function after 50 years of gluten ingestion?

Therefore we can conclude that some people can tell by simple observation that gluten is detrimental for them and some cannot.

This is where lab testing comes in. For celiac disease, the smoking gun is the small intestine biopsy. Even this is not full proof however. Some studies have shown that the commonly used light microscope analysis only picks up the more serious and advanced cases. The detail revealed by an electron microscope exam is needed to be truly diagnostic. This technique is not used either because not enough people read those articles and/or because it is cost prohibitive.

About the time that biopsies had begun being used for diagnosis, one researcher noticed that gluten stimulated certain antibody reactions too. Most labs have a basic celiac screening panel that has a high correlation with light microscope biopsies.

At OVitaminPro.com we use a variety of specialized tests from a few different labs to help determine negative reactions to gluten. Each has its own approach and they are all valid. Which one we use depends on what we are looking for. The labs are Enterolab, Cyrex Labs and Alcat. Enterolab and Cyrex are looking for antibodies. In addition, Enterolab does some genetic testing. The Alcat test is looking at the actual response of live neutrophils to gluten and other common foods or allergens. It is unlikely that you are gluten sensitive and would still show negative in tests from these labs. For more information you can check with http://www.ovitaminpro.com/glre1.html to access our gluten resources pages.

The majority of people are self-diagnosing their gluten sensitivity. Is this valid? Are people over-diagnosing their problems with gluten? Is there such a thing as gluten sensitivity apart from celiac disease?

For a long time, most experts would say that you shouldn’t start a gluten-free diet without a confirmed celiac diagnosis because gluten was only an issue in those cases. Observant clinicians have disagreed and finally in 2011, a great study was published by some big names in the gluten field, showing that gluten-related disorders come in at least two forms: celiac disease and gluten sensitivity. (Search Gluten and BMC Med. 2011 Mar 9;9:23.)

To better understand the diagnosis problem, a short history is helpful. The first writings about the intestinal problems, related to diet, were in the first century A.D. The specific cause was unknown until the 1940’s, when gluten was finally identified. In 1980 it was generally accepted that about 1:5000 people had celiac disease. By 2003 that number had changed to 1:110, based on blood tests that are known to correlate well with positive intestinal biopsies. At that time most experts considered celiac disease to be the only form of gluten sensitivity.

In 1998 a neurologist in England, M. Hadjivassiliou, began publishing studies about gluten sensitivity and the neurological implications. By 2002 or so, he departed from talking about celiac disease and began to reference certain types of brain disorders that he could identify with imaging studies. He would do imaging studies on people who had problems like migraine headaches, identify the brain lesions, put people on a gluten-free diet for about a year, and then redo the imaging studies. He found that about 7 in 8 people had a reversal of the brain lesions, along with a resolution of symptoms.

So now we have excellent and varied scientific information about gluten sensitivity that supports what many of you have known all along, that is you don’t have to have a celiac diagnosis to suffer adverse effects from dietary gluten and therefore, you will greatly benefit from a gluten-free diet, too. If you are gluten sensitive and continue to eat gluten, you are subject to a wide range of autoimmune and other disorders that increase your risk of death at every age, from whatever people die from, will be the same as a celiac patient.

At OVitaminPro.com we recommend clinical lab testing to learn if you are a candidate for a gluten-free diet. Which tests we run depend on the clinical presentation and your budget. You can read more about this on our web site’s gluten resource page.

What’s different about non-celiac gluten sensitivity according the previously mentioned study?

Those last three rows are cytokines that the immune system uses for communication and are good indicators of certain types of disorders. Watch for subsequent articles on the latest in diagnostic techniques.

Fish Oil Supplements

We have known about the anti-inflammatory and cardiovascular protective qualities of EPA and DHA (essential fatty acids common in cold water fish and other sources) since I began in practice in the late 70’s and early 80’s. These benefits were confirmed over the next 30 years with thousands of studies.

A recent study [Arch Intern Med. 2012 Apr 9 Efficacy of Omega-3 Fatty Acid Supplements (Eicosapentaenoic Acid and Docosahexaenoic Acid) in the Secondary Prevention of Cardiovascular Disease] disputes this. This review out of South Korea looked at controlled double blind studies and concluded that the evidence was insufficient to support and claim of reducing any effect of heart disease including all-cause mortality, sudden cardiac death, myocardial infarction, congestive heart failure, or transient ischemic attack and stroke.

It is important to keep in mind that the scientific community did not rush to the conclusion that these essential fatty acids were beneficial. The conclusion was based on epidemiological and observational studies as well as clinical trials looking at a variety of cardiovascular disease outcomes.

Experts have pointed out that this particular meta-analysis cherry-picked 14 randomized clinical trials (RCTs), most of which were small, short-term studies (less than one year of follow-up), leaving out other RCTs of longer length and greater relevance, all observational studies, and three well-respected systematic reviews designed to look specifically at CVD outcomes. For example, two large trials not included in this meta-analysis demonstrated significant benefits of fish oil supplementation.  Search GISSI-Prevenzione and GISSI-Heart Failure trials. These studies showed a significant advantage of using EPA/DHA to combat fatal cardiovascular disease.

Science is a process and this one analysis is not a very good one and will not add much to our knowledge.