Saul Marcus, ND - Naturopathic Doctor

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8. Gluten sensitivity, celiac disease and autoimmune thyroid disease

What is celiac disease?

Celiac disease is a caused by gluten sensitivity. The immune system creates an inflammatory cascade in response to reacts to a protein in wheat and other grains (gluten). People with celiac disease need to avoid all gluten containing foods for life. Celiac disease may cause destruction (the phrase used in medicine is “villous atrophy”) of the lining of the small intestine. Therefore celiac disease has generally been recognized as a digestive disorder.

Your doctor may have been trained that celiac disease is a rare genetic diseases usually diagnosed in childhood. This view is totally outdated. Research over the last 20 years has shown celiac disease is a complex, auto-immune disease that can injure other systems other than the gastrointestinal tract. Often the digestive system is uninjured, while damage occurs elsewhere. [48]

From the The New England Journal of medicine:
The clinical presentation of this condition [celiac disease] can range from the typical syndrome of malabsorption (chronic diarrhea, weight loss, and abdominal distention) to symptoms and conditions that can affect any organ system. [49]

It has been estimated that for every person diagnosed with celiac, 14 others have it who are not diagnosed. [50] In another study it was estimated that for every symptomatic patient with celiac disease, there are 8 patients with celiac and no gastrointestinal symptoms. [51]

They thyroid is one of the most common targets of celiac disease. [52] Celiac patients have approximately 10 times more auto-immune thyroid disease than people without celiac disease. [53]

Other common targets of gluten sensitivity include:

Dermatitis herpetiformis, IgA deficiency, type 1 diabetes, sjogren's syndrome, microscopic colitis, rheumatoid arthritis, down syndrome, IgA nephropathy, anemia, osteoporosis/osteopenia, dental enamel hypoplasia, vitamin K deficiency, hypertransaminasemia, thrombocytosis, arthralgia, poly neuropathy, ataxia, epilepsy, infertility, anxiety and depression, follicular keratosis, alopecia. There are also possible associates with congenital heart disease, recurrent pericarditis, sarcoidosis, cystic fibrosis, fibrosing alveolitis, lung cavities. pulmonary hemosiderosis, inflammatory bowel disease, autoimmune hepatitis, primary biliary cirrhosis, Addison's disease, systemic lupus erythematosus, vasculitis, polymyositis, myasthenia gravis, schizophrenia. [54]

To spell it out in other words, celiac disease is an under appreciated killer. It should be a consideration in any inflammatory or auto-immune disease that has no other explained cause.

The web site celiac.com has more information on this illness and all it's complications.

Gluten free (wheat free) diet

Patients with auto immune hypothyroidism have celiac disease so often that a gluten free diet is always a consideration.

"This diet unfortunately takes some effort, as it mean absolutely no gluten in any amount. All it takes is a grain of an offending food to set of the auto immune reaction. One study has even said, “non adherence to the gluten free diet, defined as eating gluten once per month, increased the relative risk of death 600%” From Mortality in Patients with Coeliac Disease and Their Relatives: a Cohort Study. Lancet 2001 [55]

Most sources recommend that only the following grains need to be avoided:

However, there are different gliadins in all grains. It's possible to have an immune system response to other grains as well. So the list of foods that need to be avoided can be larger.

Endoscopy

If you ask a gastro-enterologist how to diagnose celiac disease, you will probably be told that a doctor must do an invasive procedure called an endoscopy. Then they can then visualize damage with a camera, and remove a small sample of tissue (called a biopsy) for examination.

In certain cases this may be an important procedure. However, in some people (especially as we get older) celiac disease affects other organs, and may leave the digestive tract alone. Therefore, just because someone does not have celiac disease based on a biopsy that does not mean they do not have celiac disease. [56]

Lab tests to diagnose celiac and gluten sensitivity

Celiac disease is just one possible symptoms of gluten sensitivity. A sensitivity to gluten could contribute to autoimmune disease without necessarily effecting the entire digestivesystem. Genetic testing is the best way to identify Gluten Sensitivity. Other tests look for specific immune system markers, which may not be present despite an overall immune system response.