Celiac Disease & Treatment at Excell

Anyone knowing a Type 1 diabetic, please have them tested for Celiac Disease (at diagnosis & every year) – this strikes at least 10% and according to an endocrinologist I heard speak recently maybe even 33% of all Type 1 diabetics. It is most often undiagnosed leading to MANY problems*** Celiac Disease & Type 1 Diabetes hits squarely at home for me, Dr. Lisa, as I will discuss below. I do know our great Lord is working through me to keep learning and healing nutritionally, physically, and spiritually in my home and Excell families.

But first, what is all the buzz about GF (gluten free) foods? Well for the many gluten sensitive people (and those with “leaky gut”), going GF can mean a direct improvement in health – like finally being able to lose weight, or getting rid of migraines, fatigue, rashes and more. However for the nearly 1% of our population and most undiagnosed (meaning 1 in 100 people!), going GF means the difference between quality life and pain, disease, debility, serious vitamin deficiency, pregnancy losses, cancer, and early death… With our Excell providers great experience in holistic medicine, food sensitivities, and Celiac Disease, Excell is the place for those families with food sensitivities and Celiac Disease to get their medical care, prevention, and to keep growing in knowledge.

Celiac Disease is one of the most under-diagnosed diseases in America, one of the most common genetic diseases in the world, and one of the most common causes of malnutrition and vitamin deficiency. Celiac disease is an autoimmune disease (the body killing its own cells) which leads to the breakdown and flattening of small intestine cells. The Celiac person’s body makes antibodies to attack and destroy its own small intestine cells. The exact method of Celiac Disease development is unknown, but involves genetic susceptibility, environmental triggers, and an immune process. Then the autoimmune process is triggered by ingesting even trace amounts of gluten (the protein found in wheat, rye, barley, and triticale).

Case Study: This little girl in kindergarten was easily at the top of her class. Then in 1st grade her Mom noted that school was more difficult for her, with less focus and attention in her schoolwork. That year she horribly fractured both bones in her right forearm while doing a back handspring on a mat in the gym. Mom asked her orthopedist whether he felt her bones looked frail because of the unusual nature of the fracture, but he didn’t think there was a problem. Three years later at age 10, Annika developed Type 1 diabetes and a lifelong need of an insulin pump to live, with 7-12 finger stick blood sugars a day, carb counting anything she eats forever, bolusing her insulin 7-12 times a day, seeing an endocrinologist with blood draws quarterly, and having frequent severe reactions to low blood sugars. Then at age 11 as a Godsend from our great Lord, this little girl’s mother, our Dr. Lisa, checked a comprehensive food allergy profile that included a Celiac test. Annika’s Celiac tests were extremely positive, along with many severe vitamin deficiencies. After a very challenging food changing forever year of treatment (with an extremely strict gluten free diet and about 30 supplement capsules/day), Annika is in all high ability classes and can read three times faster. She is now a voracious reader, gets her honors homework done exceedingly fast, and is developing more in line with her age. (And Annika now realizes that she did have abdominal pain with gluten foods, but she thought it was normal to have stomach pain and never had told her Mom about it!)… Dr. Lisa had her other 3 children tested, and her oldest daughter Christina has Celiac disease (absolutely no symptoms), and her 2 sons do not (though they fall into the high risk category and do have wheat/gluten sensitivities).

Patients and physicians must be alert for the potential of Celiac Disease because over 50% of people with Celiac Disease are undiagnosed, and therefore at great risk! The diagnosis is most commonly made by a simple blood test, total IgA and tissue transglutaminase IgA (the antibody the Celiac’s body makes against its own small intestine cell), and occasionally by an upper endoscopy (gastroenterologist looking with a scope into a patient’s stomach and small intestine) or unusual vitamin deficiency. We then extensively advise the patient and their family on a strict gluten free diet for life, and monitor the levels to make sure they come back to normal (and then yearly).

Symptoms patients may have at the time of diagnosis are (some people with Celiac like my oldest daughter have NO symptoms): diarrhea, abdominal pain, abdominal distention/bloating, nausea/vomiting, constipation, osteoporosis or unusual fractures, dental enamel defects, infertility & miscarriages, significant vitamin D and other vitamin deficiencies, iron or B12 deficiency anemia, chronic fatigue, short stature, delayed puberty, failure to thrive in children, dermatitis herpetiformis, intestinal lymphoma (cancer), and more.

High risk groups for Celiac Disease are: Type 1 diabetes, 1st degree relatives of Celiac patients, autoimmune thyroiditis, Down syndrome, selective immunoglobulin A deficiency, any other type of autoimmune disease (like lupus, crohn’s, rheumatoid arthritis), Turner syndrome, and Williams syndrome.

The only known treatment for Celiac disease at this time is a lifelong adherence to a gluten free diet (GFD), and the long term prognosis of patients diagnosed and well treated is excellent. The most common pitfall to a GFD are foods with hidden gluten, and it is best for family members living in the same household to all be gluten free. Please read my recent blog article “Hot to Go …Free” for a great overview, and Elizabeth Hasselbeck’s book “The G Free Diet”. Other good resources: Celiac Disease Foundation (www.celiac.org), Celiac Sprue Association/USA (www.csacialic.org), Canadian Celiac Association (www.celiac.ca), Gluten Intolerance Group of America (www.gluten.net), Children’s Digestive Health and Nutrition Foundation (http://celiachealth.org), Gluten Free Girl (www.glutenfreegirl.com).

CELIAC: 6 Key Elements in Management of Celiac Disease (from the NIH statement on Celiac disease)

Consultation with a skilled dietician

Education about the disease

Lifelong adherence to a gluten free diet

Identification and treatment of nutritional deficiencies

Access to an advocacy group

Continuous long-term follow-up by an experienced physician

My prayers for all in the world with Celiac disease, and all of us patients in the world (=everyone!) and healers!

Dr. Lisa