April Showers bring May Flowers and….info about Celiac Disease!
May is Celiac Disease Awareness Month
Celiac Disease is an autoimmune disease where the person afflicted has symptoms from a reaction to “gluten”. Gluten is the protein found in wheat, barley and rye (and most cross-contaminated oats). The only treatment for Celiac Disease is a lifelong adherence to a strict diet free from any gluten-containing foods. To read more about which foods contain gluten (and which don’t) and my own personal story with gluten, head over here.
Common Symptoms of Celiac Disease:
- Diarrhea OR constipation
- Delayed growth (in children)
- Joint Pain
- Poor weight gain
- Pale mouth sores
How to get tested:
- Celiac disease triggers the immune system to produce certain antibodies. Blood tests that find and measure these antibodies include:
- IgAtTG: Immunoglobulin A (IgA) anti-tissue transglutaminase (tTG) antibody.
- IgAEMA: Immunoglobulin A (IgA) antiendomysial antibody (EMA).
- Endoscopy Test:
- During an endoscopy performed by a Gastroenterologist, they will take a small section (biopsy) of your intestinal villi to assess for damage. If there is damage or inflammation, Celiac disease will be confirmed. *Keep in mind: you MUST be eating gluten for this to show up. If you are already following a gluten-free diet, the test won’t work.
- Other tests:
- They may do other tests to check for things like sometimes go hand-in-hand with Celiac Disease, i.e. anemia (low iron), stool fat test, complete blood count, Vitamin D, etc just to see what else is going on or what issues Celiac Disease may be contributing to.
This is a great table that explains the tests and findings:
|Anti-ttg antibodies, IgA||total iga||anti-ttg antibodies, IgG||Anti-DGP, IGA||ANTI-DGP, IGG||diagnosis|
|Positive||Normal||Not performed||Not performed||Not performed||Presumptive celiac disease|
|Negative||Normal||Negative||Negative||Negative||Symptoms not likely due to celiac disease|
|Negative||Low||Positive||Negative||Positive||Possible celiac disease (false negative anti-tTG, IgA and anti-DGP, IgA are due to total IgA deficiency)|
|Negative||Normal||Negative||Positive||Positive (or not performed)||Possible celiac disease (may be seen in children less than 3 years old)|
Once a blood test has been shown positive, then the biopsy will be performed.
*Celiac Disease does tend to be genetic, so if a family member has Celiac Disease and you have any signs or symptoms, it is highly recommended to get tested.
Sometimes it takes years for the damage to show up in someone’s intestinal villi, which could be problematic and give a false-negative test result. For issues like this, I suggest doing a stool test as well. This is what I did that confirmed my gluten intolerance. Once it has been confirmed via a stool test, follow a strict gluten-free diet for many weeks to see if symptoms improve. Then, reintroduce gluten for a day or two. If symptoms return ferociously (like mine sure did), then gluten intolerance is confirmed and you don’t really need to pay for an Endoscopy. If it is obvious after cutting every morsel of gluten out of your diet and your symptoms went away, and the symptoms came right back once gluten was reintroduced in the diet, there should be no reason to continue to eat gluten if you tested negative for just 1 celiac test. You CAN have severe gluten intolerance without having full-blown (or properly diagnosed) Celiac Disease. An article about the inaccuracy of some Celiac tests and more info about stool testing can be found here.
MYTH OR FACT?
1. Gluten-free is a weight loss diet.
MYTH! Some people think gluten-free is the latest fad diet to shed some extra pounds. This is a complete misconception! People who truly require to be on a gluten-free diet sometimes actually gain weight, because they finally are absorbing foods and nutrients again. Weight loss is a common symptom of Celiac Disease, so when those afflicted finally get gluten out of their diets, they tend to return to a healthier weight. The reason some people do lose weight on a gluten free diet is because they can’t eat processed cookies, crackers, microwavable dinners, desserts, pies, fast food, fried chicken, bagels, pasta, rolls, muffins, pizza, etc… due to the gluten. SO, if those who follow a GF diet eat more fruits and veggies that are naturally free of gluten then yes, they tend to lose weight now that they aren’t eating as much sugar, processed and salty foods, and refined carbs. However, many gluten-free replacement products (i.e. pizza, crusts, cookies, etc) tend to actually be HIGHER in calories or fat than their gluten counterpart because they have to add in more fillers (flavorings, eggs, binders, fat, etc) to replace the lack of gluten. If someone is trying to lose weight but does not medically need to be gluten-free, they should just focus on eating less processed/pre-packaged foods and sticking with foods as close to nature as possible: whole grains, fruits, vegetables, nuts, seeds, low-fat dairy, and lean protein.
A gluten-free cookie is STILL a cookie…
2. Eating gluten free is much more expensive.
MYTH! This totally depends on how much foods you buy, whether you buy organic or not, and what you are eating! Fresh foods like apples, brown rice, beans, etc tend to be super cheap! The more expensive foods would be fancy juices, organic foods, already cut/pre-sliced fruits, etc. Shop local and in season, and only buy gluten-free products that you really want or need. You don’t have to shop only in the fancy healthy section of grocery stores to find gluten-free foods! Corn tortillas….$1 or less for a bag. Gluten-free does NOT necessarily mean more expensive! Stock up on staples like brown rice, eggs, low-fat yogurt, corn tortillas, whole fruits and veggies, and nuts and seeds. No need to buy the $10 box of quinoa when you can buy a $4 bag of brown rice (they are still both a nutritious gluten-free whole grain). You just gotta shop around and compare prices.
3. Celiac Disease is different from a Wheat allergy.
FACT! Celiac Disease is an autoimmune disease, whereas a Wheat Allergy is an allergic response to wheat (which contains gluten), but not the whole gluten category, and its symptoms include rashes, hives, and even anaphylactic shock. There is no destruction to the body tissues like with Celiac Disease and the symptoms are different.
4. You can’t eat out on a gluten free diet.
MYTH! You absolutely can enjoy a meal out safely on a gluten-free diet. There are many restaurants nowadays that have menu items listed as gluten free, as well as naturally gluten free foods you can order. Sauteed veggies, plain baked chicken, salads without croutons or fried onions, etc should be safe, steak (without any weird sauces), fresh fruit, omelets, etc are all great options that are naturally gluten free. When unsure, always speak with your waiter or the owner of the restaurant. Go online before heading out to eat and look up their menu to see what your options may be. Don’t be afraid to speak up! It is totally okay to ask what’s in a dish, to get a dish without a sauce, to ask for things on the sides, etc. Even fast-food chains have healthy gluten-free options like the grilled nuggets and fresh fries at chik fil a, grilled chicken sandwich without the bread at Wendy’s, and gluten-free pizza is now available at multiple pizza chain restaurants. Just speak up, ask, and do your research! 🙂
5. You must use gluten-free shampoo and cosmetics, too.
MYTH! It has been shown that since gluten is only a problem once INSIDE our bodies, there is absolutely no need to change out soaps, shampoos, detergents, etc to gluten-free. ONLY products that may potentially get ingested like lipbalm should maybe be gluten free. Shampoo, lotions, etc do not go through your skin and should not cause you any problems whatsoever.
6. You can have zero symptoms and still have Celiac Disease.
Some people (although very few) show NO symptoms at all and may not feel any different, as sometimes symptoms slightly come about, making the person not totally aware of them. As Celiac Disease is genetic, get yourself tested if anyone in your family has the disease even if you show no symptoms.
7. There are no complications to Celiac Disease, only the uncomfortable symptoms and having to cut out gluten for the rest of your life.
MYTH! Unfortunately, there are long-term complications if Celiac Disease is left untreated and the person continues to eat gluten. Some of these complications include infertility,malnutrition, decreased calcium absorption/osteoporosis, lactose intolerance, cancer, depression/anxiety, increased risk for schizophrenia, and short stature. SO, get yourself tested if you have symptoms or anyone in your family has Celiac Disease!
Hopefully this information helped you learn a little bit more about Celiac Disease, gluten intolerance, and why it is something that affects so many people! If you do need to follow a gluten-free diet, all of my recipes are completely gluten-free, and most are plant-based, so eat up!