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Aging: Why does it happen and what we can do to slow it down

Posted on August 23, 2014 at 12:30 AM Comments comments (1813)


The basics of aging

Over 50 years ago, two researchers, Drs. Hayflick and Moorehead, discovered that individual human cells have a limited lifespan. This is known as the Hayflick Limit.1,2 Since then, many researchers have studied how humans age and if aging could either be slowed down—or, if they were feeling particularly hopeful—if the aging process could be stopped completely. But, let’s be realistic here—the emphasis should be on limiting the aging process, allowing people to live longer, healthier and hopefully happier lives—after all, human cells that have no Hayflick Limit are called cancer cells! So, it is not likely that we will ever achieve immortality…BUT, we have very strong evidence that we CAN slow down the aging process and act and feel younger for longer periods of time.

Today, we understand aging and the effects of aging to be related to something called oxidative stress. And, you know if it is called stress, it can’t be all that good! Aging also appears to be accelerated because of inflammation.

Oxidative stress is really the normal outcome of biochemical reactions going on in our bodies where there are transfers of electrons (negatively charged particles). The byproducts of these reactions are called “free radicals” and are normally taken care of by naturally occurring anti-oxidants in our bodies. If these free radicals are allowed to build up, however, they can damage every cell, tissue and organ in your body. The end results are the signs of aging—wrinkles, aches, pains, changes in sleep patterns and all the other lovely changes we see as we age. 3-6

Inflammation, which is always present along with oxidative stress, is a related problem. Inflammation is a normal process required for wound healing and removing infections and eliminating cellular debris. But, when inflammation is uncontrolled, as it is in most chronic diseases associated with aging, it can accelerate the aging process.7-9

Proven approaches to slow down the effects of aging

There are four primary approaches that have been found in numerous research studies—and by examining people who live long and healthy lives—to slow down the effects of oxidative stress and inflammation. These are:

• Caloric restriction with optimal nutrition (CRON), primarily by limiting complex carbohydrates and fats and emphasizing a plant-based, nutrient rich diet with some source of omega-3 fats.4,10-18 Recent studies have shown CRON results in better health, while not always significantly increasing longevity (at least in monkeys…)19 Still, there are human studies in what are known as “blue zones” where dietary habits and lifestyles appear to be responsible for healthier and longer life-spans.20

• Increasing the amount of anti-oxidants and omega-3 fats in your diet.21-37 These nutrients—especially the anti-oxidants can directly decrease the presence of free radicals in cells and minimize the damage that is believed to result in premature aging. The main anti-oxidant system is the glutathione system, but various nutrients such as vitamins A, C and E and a number of phytonutrients from foods can also help remove these free radicals. Some of these phytonutrients (nutrients from plant foods) include the yellow-red carotenoids, the many different colored flavenoids such as resveratrol, curcumin and green tea extract, the phytoestrogens and many, many more. The omega-3 fats are necessary to reduce the inflammation that always accompanies oxidative stress. These fats increase the production of natural anti-inflammatory substances in the body. Plus, the omega-3 fats are thought to help with some of the cognitive problems that can accompany aging…like “Now, where did I put my car keys?” or “Why did I go upstairs?”

• By staying physically active, a person can maintain efficient blood flows and heart rates, getting oxygen to tissues, maintaining bone strength as well as muscular strength.3,32-47 This is also very important to maximize the elimination of waste products and their damaging effects. It is important to remember that staying physically active can mean taking walks every day, doing Tai chi or Qigong and resistance training—it doesn’t have to mean doing a triathalon, doing bench presses or running 5 miles every day!

• Getting enough sleep plays a very important role in healthy aging.48-52 Sleep restores energy levels and is a needed “daily reset” stage for various metabolic processes. Poor sleep patterns are associated with depression, loss of cognitive function and an overall poorer quality of life.49 As people get older, their sleep patterns tend to change—most commonly, they go to bed earlier and wake up earlier. Another common concern is getting to sleep and staying asleep—many older people tend to wake up more often during the night.

Anti-aging “tips”

So, what can a person do if they want to minimize aging and maximize health? Quite a bit, it turns out! You can increase the amounts and varieties of vegetables, fruits and fish that you eat. This will lower your caloric intake while maintaining good nutrition. Vegetables, fruit and fish are a great source of anti-oxidants, nutrients and omega-3 oils. You can also make sure you begin to increase your physical activity—start slowly by, for example, parking your car further away from the grocery store or walking up a flight or two of stairs rather than taking the elevator. You can also find an activity that you enjoy—perhaps gardening, walking the dog or hiking. Remember not to overdo it! It should be fun or at least something you can do relatively easily! Finally, try to make sure you get enough sleep so that you feel rested and restored the next morning. It may not be that easy, but the time to try may never get any better….now may just be the best time to revisit those earlier days when you managed to sleep in!


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9. Cesari M, Kritchevsky SB, Nicklas B, et al. Oxidative damage, platelet activation, and inflammation to predict mobility disability and mortality in older persons: results from the health aging and body composition study. Journals of Gerontology Series A: Biological Sciences & Medical Sciences 2012;67:671-6.

10. Rochon J, Bales CW, Ravussin E, et al. Design and conduct of the CALERIE study: comprehensive assessment of the long-term effects of reducing intake of energy. The Journals Of Gerontology Series A, Biological Sciences And Medical Sciences 2011;66:97-108.

11. Lefevre M, Redman LM, Heilbronn LK, et al. Caloric restriction alone and with exercise improves CVD risk in healthy non-obese individuals. Atherosclerosis 2009;203:206-13.

12. Heilbronn LK, de Jonge L, Frisard MI, et al. Effect of 6-month calorie restriction on biomarkers of longevity, metabolic adaptation, and oxidative stress in overweight individuals: a randomized controlled trial. JAMA : the journal of the American Medical Association 2006;295:1539-48.

13. Weiss EP, Fontana L. Caloric restriction: powerful protection for the aging heart and vasculature. American Journal Of Physiology Heart And Circulatory Physiology 2011;301:H1205-H19.

14. Trepanowski JF, Canale RE, Marshall KE, Kabir MM, Bloomer RJ. Impact of caloric and dietary restriction regimens on markers of health and longevity in humans and animals: a summary of available findings. Nutrition Journal 2011;10:107-.

15. Teng NIMF, Shahar S, Manaf ZA, Das SK, Taha CSC, Ngah WZW. Efficacy of fasting calorie restriction on quality of life among aging men. Physiology & Behavior 2011;104:1059-64.

16. Redman LM, Huffman KM, Landerman LR, et al. Effect of caloric restriction with and without exercise on metabolic intermediates in nonobese men and women. The Journal Of Clinical Endocrinology And Metabolism 2011;96:E312-e21.

17. Li Y, Daniel M, Tollefsbol TO. Epigenetic regulation of caloric restriction in aging. BMC Medicine 2011;9:98-.

18. Anderson RM, Weindruch R. The caloric restriction paradigm: implications for healthy human aging. American Journal Of Human Biology: The Official Journal Of The Human Biology Council 2012;24:101-6.

19. Mattison J, Roth G, Beasley T, Tilmont E, al e. Impact of caloric restriction on health and survival in rhesus monkeys from the NIA study. Nature 2012 489:318-21.

20. Appel L. Dietary patterns and longevity: expanding the blue zones. Circulation 2008 118:214-5.

21. Turner J. Your Brain on Food: A Nutrient-Rich Diet Can Protect Cognitive Health. Generations 2011;35:99-106.

22. Quiles JL, Barja G, Battino M, Mataix J, Solfrizzi V. Role of olive oil and monounsaturated fatty acids in mitochondrial oxidative stress and aging... Health effects of olive oil and the Mediterranean diet. Olive Oil and Health: First International Congress, October 21-23, 2004, Jaen, Spain. Nutrition Reviews 2006;64:S31-9.

23. Polidori MC, Praticó D, Mangialasche F, et al. High fruit and vegetable intake is positively correlated with antioxidant status and cognitive performance in healthy subjects. Journal of Alzheimer's Disease 2009;17:921-7.

24. Mandel SA, Amit T, Weinreb O, Youdim MBH. Understanding the broad-spectrum neuroprotective action profile of green tea polyphenols in aging and neurodegenerative diseases. Journal of Alzheimer's Disease 2011;25:187-208.

25. Kosaraju SLLDMIL. Delivering polyphenols for healthy ageing. Nutrition & Dietetics 2008;65:S48-S52.

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30. Brown LA, Riby LM, Reay JL. Supplementing cognitive aging: A selective review of the effects of ginkgo biloba and a number of everyday nutritional substances. Experimental Aging Research 2010;36:105-22.

31. Woo J. Nutritional strategies for successful aging. Medical Clinics of North America 2011;95:477-93.

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36. Danthiir V, Burns NR, Nettelbeck T, Wilson C, Wittert G. The older people, omega-3, and cognitive health (EPOCH) trial design and methodology: a randomised, double-blind, controlled trial investigating the effect of long-chain omega-3 fatty acids on cognitive ageing and wellbeing in cognitively healthy older adults. Nutrition Journal 2011;10:117-.

37. Cole GMQ-LMSA. Dietary fatty acids and the aging brain. Nutrition Reviews 2010;68:S102-S11.

38. Colbert LHVMEMTRPNABKSBPMDRBJSTB. Physical Activity, Exercise, and Inflammatory Markers in Older Adults: Findings from The Health, Aging and Body Composition Study. Journal of the American Geriatrics Society 2004;52:1098-104.

39. Woo EMJ. COGNITIVE AGING AND PHYSICAL EXERCISE. Educational Gerontology 2003;29:327.

40. Louis J, Nosaka K, Brisswalter J. The endurance master athlete, a model of successful ageing. SCIENCE AND SPORTS 2012;27:63.

41. Masley SC, Weaver W, Peri G, Phillips SE. Efficacy of lifestyle changes in modifying practical markers of wellness and aging. ALTERNATIVE THERAPIES IN HEALTH AND MEDICINE 2008;14:24-9.

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43. Kemmler W, von Stengel S, Engelke K, Häberle L, Mayhew JL, Kalender WA. Exercise, body composition, and functional ability: a randomized controlled trial. American Journal of Preventive Medicine 2010;38:279-87.

44. Jouper J, Hassmen P. Exercise intention, age and stress predict increased qigong exercise adherence. JOURNAL OF BODYWORK AND MOVEMENT THERAPIES 2009.

45. Huebschmann AG, Kohrt WM, Regensteiner JG. Exercise attenuates the premature cardiovascular aging effects of type 2 diabetes mellitus. Vascular Medicine (London, England) 2011;16:378-90.

46. Hand BD, Cavanaugh S, Forbes W, Govern J, Cress ME. Changes in health-related quality of life and functional fitness with exercise training in older adults who attend senior centers. Activities, Adaptation & Aging 2012;36:29-54.

47. Archer T. Physical exercise alleviates debilities of normal aging and Alzheimer's disease. Acta Neurologica Scandinavica 2011;123:221-38.

48. Simpson NDF. Sleep and Inflammation. Nutrition Reviews 2007;65:S244-S52.

49. Crowley K. Sleep and sleep disorders in older adults. Neuropsychology Review 2011;21:41-53.

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52. Millman RP. Sleep and aging. Medicine And Health, Rhode Island 2012;95:88-90.




Alzheimer's Disease and Inflammation:The potential advantages of the anti-inflammatory and the anti-aging diet

Posted on August 23, 2014 at 12:30 AM Comments comments (1275)




Alzheimer’s disease (AD), a disorder where abnormal brain proteins collect and disrupt normal thinking is recognized as having inflammatory components. (1-3) Remember, inflammation happens when you get a thorn or splinter under your skin—and it happens because the thorn or splinter isn’t supposed to be there—inflammation is one of the ways the body gets rid of foreign objects or proteins. In AD, the “thorn” is the collection of abnormal proteins (beta amyloid and tau protein) and the inflammation is one way the body tries to take care of that thorn.

We don’t completely understand how Alzheimer’s disease develops—the signs, including memory loss, confusion, problems with completing familiar activities, changes in mood or personality or difficulties in forming thoughts or full sentences can start very slowly and be thought of as simply the price of getting older. We all sometimes forget where we left the car keys or what we came into the room for. In AD, however, these moments begin to be more and more common. In early-stage AD, often only those people who know you best might begin to think something is wrong. A physician, taking a very careful history and asking a number of specific questions may also begin to suspect AD.

Alzheimers disease, epigenetics and the anti-inflammatory and anti-aging diet

There are some risk factors in AD that can’t be changed—you can’t change your genetics, your family history or your age. But—you CAN potentially change the way your body responds to very early AD. There is a relatively new and exciting area of study called epigenetics—where it has been shown that diet and lifestyle can change your risks because these lifestyle changes alter the control of your DNA—allowing some genes to be “silent” and some to be “active”—and these differences can affect the way your body responds to inflammation, AD, cancer and to chronic disease. Recent studies are indicating that a diet rich in anti-inflammatory foods can help protect you from diseases such as AD, cancer and can help protect you from the signs ofo aging. (4-6)

So, what are these anti-inflammatory foods? What are the anti-aging foods?

First of all- we’ve used the terms anti-inflammatory and anti-aging diet. Are they different? Not really—because anti-inflammatory foods are also anti-aging foods. The opposite is true as well, because any food that fights the signs of aging is also an anti-inflammatory food and should be part of your anti-aging diet. Here is a (partial) list of the best anti-aging foods and the best anti-inflammatory foods.

Vegetables are the first choice- raw or lightly cooked will give you the highest nutrient yield.

• Broccoli (yes…. broccoli, just like your wise momma told you)

• Cauliflower,

• Brussel sprouts

• Asparagus

• Leafy green vegetables

o Swiss chard,

o the greens from mustard, collard and beets,

o kale, spinach, field greens and the variety of lettuces

• Fruits and berries—the more brightly colored they are, the better.

• Many herbs and spices are anti-inflammatory as well. Here is a small sampling-

o green tea

o onions and garlic,

o ginger and turmeric

• Fish—especially fish like salmon, sardines, smelt and anchovies are high in the anti-inflammatory omega-3 oils.

All these foods can help reduce inflammation and reduce your risk of a number of different conditions(4) –including AD, cancer, arthritis and the signs of aging. Eat a selection of each of these foods at least 2-3 times a day, and you’ll be glad you did!



1. Ricci S, Fuso A, Ippoliti F, Businaro R. 2012. Stress-induced cytokines and neuronal dysfunction in Alzheimer's disease. Journal of Alzheimer's Disease 28:11-24

2. Klatz RR. 2012. Literature Review: Inflammation as a Mechanism of Aging. Townsend Letter:34-5

3. Ferretti MT, Bruno MA, Ducatenzeiler A, Klein WL, Cuello AC. 2012. Intracellular Aβ-oligomers and early inflammation in a model of Alzheimer's disease. Neurobiology of Aging 33:1329-42

4. Dauncey MJ. 2012. Recent advances in nutrition, genes and brain health. The Proceedings Of The Nutrition Society 71:581-91

5. Kwok JBJ. 2010. Role of epigenetics in Alzheimer's and Parkinson's disease. Epigenomics 2:671-82

6. Migliore L, Coppedè F. 2009. Genetics, environmental factors and the emerging role of epigenetics in neurodegenerative diseases. Mutation Research 667:82-97




Aging and the Anti-inflammatory Diet

Posted on August 23, 2014 at 12:25 AM Comments comments (1488)



At first glance, you might wonder what an anti-inflammatory diet has to do with aging.

Well, quite a lot, it seems!

Aging can be seen as an inflammatory process—those normal biochemical reactions that produce free radicals like reactive oxygen species (ROS) and reactive nitrogen species (RNS) which can, if not limited, produce the damage that we see as aging.  Some of this damage is seen as:

• Chronic diseases such as diabetes, heart disease, and circulatory problems are much more common the older we get

• Wrinkles and fine (and not-so-fine) lines on our faces and the rest of our bodies. (Gravity, too, seems to play an important role with body parts that feel and look like they are sagging, sinking or drooping...)

• Changes in sleep patterns as we age

• Increased problems with obesity. Obesity, by the way, is actually considered to be a chronic disease.

An anti-inflammatory diet can help get rid of any excess free radicals and minimize their aging effects. As an added bonus, the foods recommended in an anti-inflammatory diet can help prevent heart disease, diabetes and obesity. While “diets” can be tough to stick to, the anti-inflammatory diet is not really all that complicated and you don’t really need to keep track of calories, “good fats” or “bad fats” or much of anything else. One useful motto to keep in mind is “eat like your ancestors did”. This means fresh fruits, berries and vegetables, whole grains (or gluten-free grains if needed), fresh fish, grass-feed beef and pork, free range chicken and poultry and lots and lots of water. Look for hormone-free meats. Organic foods are preferred, but not essential (I’ll get into that recent Stanford study some other time). This also means that an anti-inflammatory diet requires some old-fashioned cooking and preparation. Remember, no processed or prepackaged foods were available for your ancestors! They didn’t sit down to eat “Mac ‘N Cheese” unless they made the noodles themselves and perhaps got the cheese wheel from a local dairy farm!

An anti-inflammatory diet is high in:

• Vegetables, especially leafy green vegetables (spinach, mustard greens, kale, Swiss chard) that are high in anti-oxidants, vitamins and minerals. Vegetables also have loads of fiber—and fiber increases bowel regularity—and that ensures that toxins and by-products that can increase free radicals are regularly removed.

• Variously colored fruits and berries are high in anti-oxidants, vitamins and fiber. Getting fresh fruit in the summer is easy—and the best places to find a variety of fresh local fruit are at farmer’s markets (the same is true for vegetables). In the winter months, however, its not so easy. One way to get around this is to use frozen berries and fruits in smoothies. Frozen fruit is a great choice. You can also use dried fruit as long as no sulfites are used. Sulfites are associated with a number of adverse reactions.1-3 Click here and here for ways to dry fruit at home.

• Whole grain foods—unless, and this is a BIG unless—you are gluten sensitive. Gluten can be an inflammatory food for some people. Gluten sensitivity has a wide range of possible symptoms—some people get mainly digestive symptoms like gas, abdominal discomfort, acid indigestion, constipation, diarrhea or cramping. Other people may get headaches, fatigue, eczema, other types of skin rashes, joint pain or neurological symptoms. The simplest approach in determining if you are gluten sensitive is to try going gluten-free for two weeks at least. If, at the end of the two weeks, if you are feeling better and don’t have the same symptoms –whatever they were in your particular case—well, you may very well be gluten sensitive, and should avoid gluten as an inflammatory food.

• Lots of fish—the omega-3 fats found in fish are very anti-inflammatory. Salmon is one of the best choices. The omega-3 fats also seem to be beneficial for those of us who can’t remember why we walked into a room!4,5

• Use various herbs and spices in your cooking. Anti-inflammatory herbs and spices include:

o Onions and garlic

o Ginger

o Curry, Cumin and Turmeric

o Rosemary

o Sage

• Drink lots of water—and lots of teas. Green tea is an exceptional anti-inflammatory tea, but there are many herbal teas that work as well. These include chamomile, and a few others you may not have heard about or have tried, like elderberry leaf tea, goldenseal, Una de Gato (Cats claw), feverfew, licorice, nettles and Rooibos (Red Bush tree).

What about foods to avoid?

Here’s a quick list.

• Sugar

• Processed or refined foods—a reasonable rule of thumb is to avoid white foods like white bread or rice.

• Fried foods and “trans” fats. Avoid any cooking oils other than olive, macadamia and canola oil. Avoid margarine and vegetable shortenings. Absolutely avoid any oil that includes “partially hydrogenated oils”

• Alcohol

• Dairy products, particularly if you are lactose intolerant.

Another bonus is that while the anti-inflammatory diet is not really designed for weight loss, many people find that they DO lose weight. Also, you will be eating better and feeling better …AND you will also be reducing the signs of aging, both inside and outside!


1. Randhawa S, Bahna SL. Hypersensitivity reactions to food additives. Current Opinion in Allergy & Clinical Immunology 2009;9:278-83.

2. Armentia A. Adverse reactions to wine: think outside the bottle. Current Opinion in Allergy & Clinical Immunology 2008;8:266-9.

3. Food and drink: red wine headaches. Harvard Health Letter 2002;27:6-.

4. Danthiir V, Burns NR, Nettelbeck T, Wilson C, Wittert G. The older people, omega-3, and cognitive health (EPOCH) trial design and methodology: a randomised, double-blind, controlled trial investigating the effect of long-chain omega-3 fatty acids on cognitive ageing and wellbeing in cognitively healthy older adults. Nutrition Journal 2011;10:117-.

5. Centre for R, Dissemination. Effects of omega‐3 fatty acids on cognitive performance: a meta‐analysis (Provisional abstract). In: Mazereeuw G, Lanctot KL, Chau SA, Swardfager W, Herrmann N, eds.; 2012.




Vitamin D and Celiac disease or gluten intolerance

Posted on August 23, 2014 at 12:10 AM Comments comments (1546)


If you didn’t know any better, you might think vitamin D had just been discovered, with all the “news” about it! Well, Vitamin D has been around for awhile, it’s just celebrating a sort of “rebirth” in the mainstream media and medical profession. It is a vitamin AND a hormone, but it was rather ignored for years. Researchers, scientists and doctors are now beginning to recognize vitamin D for the various functions it performs—and for its importance to overall health. First, why did I call it a vitamin and a hormone? By definition, a hormone is produced in one place (a gland, like the thyroid or adrenal glands, or in the case of vitamin D, skin cells exposed to sunlight) and is transported by the blood to function in another part of the body. A vitamin is defined as a substance that is necessary in small quantities for normal growth and activity. Both those definitions fit Vitamin D. Chemically, vitamin D also looks very much like steroid hormones. It is also fat-soluble, meaning it can be stored in fat—something that may be important during those sun-deficient winter months.

We don’t know all the functions that vitamin D has, but we do know that Vitamin D is critically important for strong teeth and bones, and in maintaining calcium and phosphate levels. We also know that vitamin D is required for proper cell growth, muscle function, inflammatory responses and immunity. Extreme and severe vitamin D deficiency can result in the disorder known as rickets—a softening of the bones in children. These kids actually have bent bones because their bones literally bend under the children’s weight! Less severe deficiencies in vitamin D are associated with colon and other cancers, autoimmune disease, infectious diseases, obesity , depression , and heart disease. It has also been linked to food sensitivities ….hmmmm. Colon problems? Autoimmune disease? Food sensitivities? Gee…..could vitamin D be important in celiac and in gluten sensitivities? As a friend of mine used to say… ya think!! It turns out vitamin D is important in celiac disease and gluten sensitivity….more about that in a bit, first, let’s see where we get vitamin D from!

The main natural source of Vitamin D is though sun exposure. Deep down (well, not so deep…;) I have a crazy notion that part of the reason that Vitamin D deficiencies have become so important and widespread is that for years we have been told to minimize skin exposure to sun because of the risks of skin cancer. Don’t forget your SPF 30gazillion!! Avoid the sun if you don’t want to get skin cancer!! Well, the fact is that we can usually get about 90% of our vitamin D from sun exposure. And, another important fact is that the rates of skin cancer have NOT gone down despite all the slathering of sunblock that has gone on! Now, I am not saying you should spend hours and hours sun bathing with no protection, but I am saying that exposing your face, arms, back and/or legs 2 - 3 times a week to the early afternoon sun for 10-30 minutes will probably give you a sufficient amount of vitamin D and not increase your risk of skin cancer substantially.

There was a recent article in the American Journal of Clinical Nutrition that stated “The major cause of vitamin D deficiency is the lack of appreciation that sun exposure in moderation (emphasis added) is the major source of vitamin D for most humans.” Now, moderation means a lot of different things to different people! Ask me what a moderate amount of chocolate ice cream is….and it very well may be more that a moderate amount for someone else! A lot also depends on your skin tone—the darker your skin, the more exposure you need, but a “moderate” amount of sunlight is likely to be safe—after all, we evolved in the sun and most people feel better with the sun! There’s that whole problem with Seasonal Affective Disorder (SAD) that occurs when the amount of sun we receive decreases.

We don’t really know how much is too much—but recent studies at the Australian National University (and from what I hear, they get quite a bit of sun!) indicate that more lives are lost and more diseases are caused by a lack of sunlight than are caused by too much sunlight. So, the idea of getting 10-30 minutes of sun 2-3 times a week seems reasonable.

The sunlight we get consists of three types of ultraviolet (UV) radiation—UVA, UVB and UVC. Only UVB can stimulate vitamin D synthesis by converting 7-dehydrocholesterol to previtamin D3. Previtamin D3 is further converted in the liver and kidneys to vitamin D3. Other than the sun, other sources of Vitamin D are fish, dairy foods, and eggs.

How much vitamin D should we take as a supplement if we live in an area without much sun? Here’s the part where it gets a bit controversial—some reasons are technical, others because we simply don’t know enough. Conventional medicine has decided that in adults, vitamin D deficiency is defined as a serum vitamin D3 level of less than 20 ng/mL and insufficiency as a vitamin D level of 20-30 ng/mL. But, during a recent (50/11) talk I attended, Dr Alan Gaby, author of Nutritional Medicine and with over 30 years experience in nutritional medicine put forth some important questions about these levels. I’ve borrowed his suggestions on the amount of sun to get. He also suggested taking vitamin D as a supplement at 800-1200 IU/day, primarily during the winter months.

So, what’s the connection with celiac disease and gluten sensitivity? First, since vitamin D is a fat soluble vitamin, people with celiac and gluten sensitivity won’t absorb much vitamin D from whatever food sources they eat—and that can lead to osteomalacia or a softening of the bones that has been increasingly associated with CD. , , If you get most of your vitamin D from sun, that won’t be a problem because it won’t have to be absorbed by the gut! Second, CD and gluten sensitivity are auto-immune disorders—vitamin D also works with immune cells to shift the body towards an anti-inflammatory state—in other words, vitamin D can help reduce the inflammation in CD and gluten sensitivity. Third, vitamin D helps maintain a proper balance of gut bacteria—thought to be absolutely critical to the development of food sensitivities of all kinds.10,

The common mainstream approach to suspected vitamin D deficiency is the use of the intramuscular shot of 50,000IU of ergocalciferol. Ergocalciferol is a synthetic, man-made derivative—a synthetic vitamin D2 and not the D3 you usually read about. It does NOT work the same way that vitamin D3 does. , You may be better off trying to achieve the greater the presumed optimal 30ng/mL level of vitamin D more slowly—by getting some sun and supplementing (with advice from your physician) in the range of 800-1200 IU/day.



Posted on August 23, 2014 at 12:10 AM Comments comments (1382)



Two of the conditions that may be associated with gluten sensitivity (GS) and/or Celiac Disease (CD) are osteoporosis (thinning and weakening of the bones) and osteopenia (softening of the bones.

Bones go through a continuous process of forming and re-forming. For the most part, this slows down as we age—and the bones can become brittle (osteoporosis) or soft (osteopenia). Both may be due to a number of factors and complicating conditions. It’s a long list, but that list includes GS and CD as well as hereditary disorders, endocrine disorders, chronic disease and cancers. Other risk factors include decreased physical activity, using steroids such as prednisone for more than 3 months, deficiency in Vitamin D, calcium and phosphorus, heavy alcohol use, a family history of osteoporosis, having a white or an Asian ethnic background, low body weight and a history of smoking. There are few symptoms of early osteoporosis or osteopenia—later in the disease, bone pain or tenderness may appear—often in the neck or low back. Unfortunately, the first sign of bone disease is sometimes a fracture or break at the wrist, or in the bones of the spine, the vertebrae. One of the well-known leading causes of osteoporosis is the drop in estrogen that accompanies menopause, though men are at risk for osteoporosis as well. There have been some patients who were diagnosed with previously unknown GS or CD because of their complaints of muscle weakness and bone pain that turned out to be osteoporosis secondary to nutritional deficiencies that have been associated with GS/CD. ,

CD and GS put a person at risk for osteoporosis and osteopenia, mainly it appears, because of problems getting adequate levels of calcium and vitamin D, as well as other nutrients. The rates are estimated to range to up to 34% of patients with CD—these rates may be similar for GS. There may, however, be additional factors. One line of thinking is that poor absorption of calcium and a vitamin D deficiency may set up what is known as secondary hyperparathyroidism.1, , The term secondary is used because the parathyroid is affected as a result of GS/CD—in other words, the first problem was GS/CD and the parathyroid condition was the second problem—and that second problem was related to the development of osteoporosis.

The parathyroid glands are located on the thyroid gland which is at the base of your neck. The thyroid gland controls a great deal of your energy and metabolism—all the biochemical reactions going on in every cell of your body. The parathyroid glands are four small areas on the thyroid—these glands regulate calcium (Ca), phosphorus (P) and vitamin D activities. They are about the size of a grain of rice and are actually located behind the thyroid gland. These parathyroid glands secrete a hormone, aptly named parathyroid hormone (PTH) or sometimes parathormone. The main role of parathyroid hormone is to keep the body’s calcium levels within a very narrow range—too much or too little calcium in the blood and tissues can seriously affect your health, particularly your heart, skeletal muscle and your nervous system. When the calcium levels drop below a certain level, the parathyroid gland begins to produce and secrete PTH. PTH increases the calcium levels in the blood by stimulating the release of calcium from bones. PTH will at the same time increase the absorption of calcium from foods and prevent the kidneys from excreting calcium. PTH works along with vitamin D to increase the absorption of calcium from your foods. Vitamin D is required to make calcium-binding proteins that allow for this increased absorption from foods. As the calcium levels in the blood are increase, the phosphorus levels (in the form of phosphates) decrease—so as the calcium goes up, the phosphates are reduced. While phosphates don’t appear to directly affect the secretion of PTH, diets high in phosphates—diets with high amounts of meat, for example, can cause increased secretion of PTH.

Calcium (and phosphates) is essentially stored in the bones. So, if a long-term calcium deficiency exists because of dietary deficiencies or malabsorption because of long-term GS, the parathyroid gland may become overactive—grabbing more and more Ca from the bones. A vitamin D deficiency worsens the problem. The eventual result may be osteoporosis.

In a recent study, individuals with osteoporosis were found to be 10 times more likely to have biopsy-proven CD. And, in another recent study of 255 postmenopausal women with osteoporosis but without any signs or suspicion of either GS or CD, almost 10% were positive for serum antigliadin antibodies and positive for tissue transglutaminase antibodies. This may suggest that GS and CD may be under-diagnosed in postmenopausal women and patients being treated for osteoporosis.

What would be the recommendation for people with GC or CD for calcium and vitamin D supplementation? Calcium carbonate (essentially, chalk….no, really!) is the least expensive but is best absorbed with food. As an aside, those antacids that tell you they are a source of calcium….not so much, because they decrease stomach acid—and calcium is best absorbed with higher stomach acid. Calcium citrate or glycinate—and other forms of calcium—can be taken on an empty stomach, but are more expensive. Talk to your health care professional for specifics—there may be some concern if you are at risk for heart attacks, but 1000-1500 mg of calcium a day is generally recommended. As always, your best source of calcium is in whole foods—and those best sources are spinach, turnip greens, mustard greens, collard greens, sardines, yogurt, goat and cow milk, and blackstrap molasses.

Vitamin D is best gained from 10-15 minutes in afternoon sun 3-4 times a week. If you live in a northern area with little sun during those winter months, the Institute of Medicine suggests that you can safely take 2000IU of vitamin D every day. There is some controversy as to what normal blood levels of vitamin D should be, but most agree that it should at least be greater than 30ng/mL. Food sources of vitamin D are cod liver oil, fish such as salmon, mackerel, tuna and sardines, dairy products, liver and eggs. Vitamin D is a fat/oil-soluble vitamin—so again, watch for the marketing for the vitamin D fortified foods! Orange juice, for example, is mostly water….ever try to mix any oil with water? Yep—you be the judge! The chemist in me is doubtful…..









Posted on August 23, 2014 at 12:10 AM Comments comments (1881)



It happens all the time—it may be accidental (as in “Dr. Zora, I went over to my friend’s house and ate some of her snacks! I didn’t know there was gluten in those snacks!”;),or it may be the fact that is not always easy to stay away from pizza, pasta or that sandwich. Sometimes, the way gluten is measured—a food label may say it’s gluten-free, but as was recently stated in the Journal of the American Dietetic Association, “The degree of confidence that can be placed in a manufacturer's assertion that a product is gluten-free is based on the assay used to determine the gluten content and the specific food analyzed.” And sometimes, it’s just because we were in a hurry and didn’t read the label. It can happen, and it pays to have some ways to deal with being “glutened”.

First of all, if you are on a gluten-free diet—this is not a way that should be used to get around the diet. People with celiac disease or with gluten intolerance simply should not have any gluten. There is no known “limit” that won’t bring on the symptoms . An amount of gluten that bothers one person may be quite different than the amount that gives symptoms to another—and, as you know, the symptoms can be quite varied in intensity. These suggestions are for those times when, for whatever reason, you ate something containing gluten, and are now paying the price.

• Enzymes- For gluten intolerance or sensitivity, the best enzymes appear to be those that contain dipeptidyl dipeptidase IV (DPP IV). This enzyme seems to be particularly important for people with celiac disease and gluten-sensitive people. Its best to have the enzymes before you eat—but, since we are talking about accidental ingestion of gluten, taking enzymes within 30-40 minutes of eating the “offender” should help somewhat.

• Many people recommend PeptoBismol™ (bismuth subsalicylate). We don’t really know how it works, but the salicylate may act as an anti-inflammatory agent, or to limit the antibody response in Celiac disease. PeptoBismol™ can help coat the stomach and limit the absorption of the gluten. If you are taking aspirin, blood thinners (anticoagulants), insulin, methotrexate, valproic acid, angiotensin-converting enzyme (ACE) inhibitors (eg, lisinopril) or sulfinpyrazone, talk to a health care professional first—they may interact with PeptoBismol™ either increasing or decreasing the drug effects.

• Herbs known as demulcents can help. A demulcent is a substance that coats and protects. (The word, demulcent comes from the Latin demulcere, which means " to caress") Some of my favorites for the GI tract are:

o Slippery elm/Ulmus fulva—the bark of the Indian Elm tree has been used to soothe the pain of ulcers, indigestion and GI inflammation.

o Marshmallow/Althea officinalis (the plant, not the sugary puff you roast over the campfire!)—has a high content of mucilage—a slippery substance that can help coat and soothe the GI tract.

o Fenugreek/ Trigonella Foenum Gracum – the leaves and seeds of the plant reduce inflammation.

o Licorice/ Glycyrrhiza glabra—again, this is not the licorice candy that comes in twists or strings—but from the licorice plant.

o Stinging and dwarf nettles/ Urtica dioica(urens)—these plants have been used for centuries for various purposes. One of the major uses has been to reduce allergic responses. A recent review of Urtica has shown it has anti-inflammatory properties.


• Another suggestion is to use an over-the-counter anti-histamine to try and reduce the immune response. There are supplements that reduce histamine as well and may be useful when you’ve been “glutened”.

o Vitamin C—is required by the immune system. We don’t completely understand why, but Vitamin C seems to limit allergic responses, possibly through its anti-inflammatory effects.

o Quercitin —quercitin is a flavenol derived from many different plants—it stabilizes the cells which release the histamine. The net effect of quercitin is to reduce the amount of histamine released.

o Rutin —rutin is chemically related to quercitin and is also a strong anti-oxidant. It also appears to reduce the amount of histamine released by the cells.

With any of these, you may find some relief. There is no single “fix” for being “glutened”, so the best defense is a good offense—stick to the gluten free diet, but be prepared for the occasional accidental ingestion.




Posted on August 23, 2014 at 12:10 AM Comments comments (1054)



Food sensitivities and allergic reactions to food are increasing in Westernized societies—the rates have almost doubled in the last 20 years. To make matters even worse, not only have the rates doubled, the severity of the reactions seem to have gotten worse. It is fair to say that something is going on….

First, let’s define some terms—it has been many patient’s experience that if they are not precise in using some medical terms, some in the medical profession may latch on to that imprecision and use it to dismiss the patient’s condition—you know “You are NOT allergic to gluten because your skin test tells me you are not. Now, here, take this anti-depressant and don’t call me for 6 weeks!” Or, you may have been told something like that.

An allergic response (Figure 1) to food is defined as one where a type of immune protein, IgE (an antibody), is produced that reacts with that food. At the end of a chain of reactions when IgE is present, histamine is released from cells—and the result may be itching, hives, respiratory symptoms such as wheezing or shortness of breath, a tightening of the throat or hoarseness, watery eyes, a runny nose and a host of other symptoms which may include abdominal pain or discomfort, swelling around the eyes, mouth and tongue, cramping, nausea, diarrhea, dizziness and vomiting. There is no absolutely definitive lab test that will always diagnose a true food allergy. The most common true food allergies are to peanuts and other tree nuts (walnuts, pecan, almonds), shellfish, milk, eggs, soy products and wheat.1

Food intolerance or sensitivity may involve the immune system but it doesn’t involve the IgE/histamine system (Figure 2). In fact, some will define “food allergy” as being either IgE-controlled or non-IgE controlled; food intolerance is non-IgE controlled and isn’t the “traditional” allergic response to foods (IgE-controlled). It may involve other arms of the immune system—for example it may involve IgG, IgA and/or IgM antibodies, but not IgE. Food intolerances may also involve missing enzymes—for example, those who are lactose intolerant are missing an enzyme (lactase) which helps break down and digest lactose, the type of sugar in milk. Symptoms of food intolerance are not as immediate as food allergies but include—you guessed it—nausea, stomach or abdominal pain, gas, cramping or bloating, vomiting, heartburn, headaches, diarrhea, runny nose, itching, respiratory symptoms and skin rashes.


So, clinically, food allergies and food sensitivities have similar symptoms, but a food allergy is very fast and is controlled by an IgE/histamine response. Food sensitivity or intolerance is slower to develop and may be controlled by an IgA/IgG/IgM response. Simple, right?

There are a number of theories as to why food intolerance/sensitivities are on the rise. These include:

• Genetics and family history—your unique genetic background may determine what food sensitivities or allergies—if any—you may develop. For example, a child will have a 7 times greater risk of having a peanut allergy if their parent or sibling has an allergy to peanuts.

• The Hygeine Hypothesis3, , —as humans, we have co-evolved with our gut bacteria. While for many people, it’s an “ewww” moment to think about, these gut bacteria are incredibly important to our health. For one thing, they are absolutely essential for helping the immune system react appropriately to, and absorb food properly. Where do these bacteria originally come from? They come from our environment and when we are ultra-careful about “germs”, our children may not be exposed to the right bacteria at the right times. There is evidence, for example, that children raised on rural farms have a decreased risk of allergic disorders including eczema, asthma and hay fever.4,5

• Early introduction of solid foods and/or formula feeding (as opposed to exclusive breast feeding for the first 6 months to a year). The jury is still out on this as far as the evidence—there are conflicting studies. 3 It is likely that it is not simply the early introduction of solid foods that can explain the increase in food sensitivities.

• Combined factors: It is more likely that an early introduction, formula feeding, combined with a family history and an imbalance in gut bacteria populations all share a role in the development of both food allergies and food sensitivities. We live in a contaminated and polluted world and it is becoming increasingly evident that there are fewer and fewer conditions caused by a single factor.

If you have been dealing with gluten sensitivity, you already know the general approach to dealing with food sensitivities—elimination. Often, people with gluten sensitivities have other food intolerances and allergies as well. The more you can eliminate other sensitivities, the better you and your family will feel. It’s not an easy (or inexpensive) way to go, but it can make a real difference in your health! Stick with whole, unprocessed foods –organic foods as much as possible. This will limit your exposure to pesticides. Limiting household allergens can help as well— furnace or air-conditioning filters can minimize dust and animal dander. Take a quality probiotic every day—or eat 1-2 servings of yogurt with active cultures every day. Using non-synthetic building materials and furnishings can help too. The fact is, you can control only so much in your life—but the more you limit your exposure to other potentially sensitizing products, the greater the favor you will be doing yourself and your family.





Celiac Disease, Gluten Sensitivity and Neurological Issues

Posted on August 23, 2014 at 12:05 AM Comments comments (798)



We tend to think about Celiac Disease (CD) and Gluten Sensitivity (GS) as primarily problems with our guts and how our guts respond to gluten and other gliadins in wheat and other cereal grains. Recent research has shown what many of us have known for a long time—CD and GS are not just a problem for our digestive systems, all of our body systems can be affected until we get gluten free—and, some of the effects of long-term exposure to glutens may be longer lasting than others. It is important to know that the neurological problems may be the first things people will notice—so it is important that anyone with “unexplained” neurological symptoms be checked for gluten sensitivity.

One of the systems adversely affected by CD and GS is the neurological (nervous) system. There are many possible symptoms including developmental delays and learning disorders in children, depression, migraine, and headache.

One of the most common effects on the nervous system is cerebellar ataxia, which can be defined as a “sudden, uncoordinated muscle movement due to disease or injury to the cerebellum in the brain” Symptoms can involve areas of the body from the neck to the hips, the arms or the legs. These movements can be a sudden side-to-side motion or a back and forth motion. The arm and leg movements can be swaying as well. Someone with cerebellar ataxia can also have slurred or awkward speech, problems with walking, and/or repetitive or uncontrolled eye movements.2 This type of movement disorder is actually sometimes called “gluten ataxia”! Early treatment by removing gluten from the diet most often leads to great improvement and will often completely stop the progression of the neurological damage.3

Another common problem is called peripheral neuropathy. Peripheral neuropathy (PN) affects the hands and feet and is usually described as feelings of numbness, pain or tingling along with a possible loss of sensations such as touch or sensitivity to vibration or temperature. It is often referred to as a “stocking and glove” neuropathy because some people will describe a burning and others may describe the loss of sensation, feeling like they are wearing socks or gloves.

There are many causes of peripheral neuropathy—it can be caused by injuries, infections with viruses or bacteria, exposure to various toxins (such as gluten) and by other conditions such as diabetes. The “bridge” between all of these is damage to the peripheral (outer) nerves of the hands and feet.

The most common type of PN in people with gluten sensitivity involves both sensations and movements. Feeling differences between hot and cold, feeling vibrations and knowing how well you are holding on to, say, a cup of coffee may be the first symptom. A sense of “clumsiness” or a feeling as if you don’t know where your feet are or where your arms are may be another. Movement may be affected as well with a sense of clumsiness walking or moving around.

In fact, there are some who feel that CD and GS are more neurological disorders than immunological ones! In a recent article in the journal Medical Hypotheses, the author suggests just that—that both CD and GS should be considered a neurological disorder because the neurological symptoms can show up in people without any intestinal (i.e, microvillous) damage. The problem for me here is the assumption that you have to have evidence of extensive damage to the microvilli—and I think that this biopsy test that is usually considered diagnostic is actually the endpoint of the damage that has taken years to happen. Generally, diagnosis of CD is made with an antibody test (not always so very reliable) and confirmed with a biopsy of the intestine—if the microvilli are flat or shrunken, then the diagnosis of CD can be made—but for that amount of damage to occur, a long time must have passed, which is why I say it is an endpoint. For example, if you look at a section of intestinal tissue long before this endpoint, you will see plenty of inflammation and harm going on long before the type of damage that is considered diagnostic for CD is present.1,3, ,

The damage to the nerves is mediated by the immune system in both CD and GS.6, , It appears that the same antibodies that are produced by the immune system by gluten bind, or attach to, certain cells in the nervous system and cause the damage. At some point in the process of both CD and GS, your immune system may become overwhelmed and “confused” and begin to produce antibodies to self (autoantibodies) that aggravate the process even further. , , This may also be part of the reason that people with CD and GS have a condition called dermatitis herpetiformis—these same autoantibodies react with cells in the skin and can cause the rash.

Complicated, right? But, the straightforward “take-home” lesson is that CD and GS are not just disorders of the digestive system—but, staying gluten free can prevent, stop and even reverse these symptoms!




The Advantages of Quinoa

Posted on August 23, 2014 at 12:05 AM Comments comments (468)

The Advantages of Quinoa


Why quinoa? Perhaps first, what is quinoa (pronounced keen-wah) and why should anyone with celiac or gluten sensitivity want to know about it?


Quinoa is not a grain, truly, but more closely related to beets and spinach—and it is actually the seeds of the quinoa plant. It is native to the Andes and was domesticated for human use over 4000 years ago—and may have been used as food for over 7000 years! The Incans believed quinoa to be a sacred food and called it chisaya mama or 'mother of all grains'. The Spanish conquistadores actually prevented the native Incans from growing it because quinoa had been such an important part of their religion and culture! It’s a tough plant—grown in the high Andes with times of both intense heat and cold—and little rainfall.


Quinoa has a very high protein and amino acid content (~18%)-and, it contains all the essential amino acids. It also is high in fiber (almost 12g per cup), and contains the minerals calcium, iron, phosphorus, potassium, zinc, copper, manganese, selenium and magnesium. It contains all the B vitamins, as well as Vitamins A, E and beta carotenes. It is also rich in a number of essential fatty acids, but with zero cholesterol. In fact, quinoa is such a complete food and is so easy to grow and cultivate, NASA is considering using it for prolonged space flights. And, the United Nations has designated it as a “super crop” because of its nutritional value.


Cooked, quinoa is light and fluffy—most people describe it as having a slightly nutty, earthy flavor. It has a low glycemic index and a low glycemic load—making it a great addition for diabetics as well! There are three main types of quinoa—white, red and black. All have a slightly different flavor and all can be cooked very quickly—it’s almost an instant food! Generally, you can use two parts liquid to 1 part quinoa, bring it to a boil and turn down the heat—about 15minutes usually! Quinoa can be used just like you would use rice or pasta—in soups, stews, on the side, with a sauce, in a cold salad or as a breakfast cereal. You can even sprout the seeds and use it in salads as a raw, live food. Quinoa flour can be used to make breads and pastas. You can add your favorite herbs and spices (I always add some garlic and onions and usually some basil….as a breakfast cereal, I add some cinnamon and a touch of honey)


Most importantly for those of us with celiac or gluten sensitivity—quinoa is totally gluten/gliadin free! It came as a welcome relief to me when I first went gluten-free. I love to roast the quinoa in olive oil and then either add directly to vegetables or use it alone. My personal favorite is the red quinoa because it adds some color to the dishes. Very few people are sensitive to quinoa—and often, it is because the quinoa has not been properly washed—the raw quinoa has a coating of saponins which can give the quinoa a bitter taste—the saponins work well for quinoa because that bitter taste keeps birds, insects and fungus away from it. All you need to do with the quinoa before you cook it is put a cup in the strainer and rinse with cold water for a minute or two—that generally is sufficient to remove any residual saponins.


Most stores and many restaurants now carry quinoa—sometimes in the “nutritional section”…meaning the organic foods section. I laugh at that—and even one time asked one of the grocery clerks “If the organic section is the nutritional one, what do you call the other sections?” I thought it was funny….he didn’t….


So, if you haven’t tried quinoa already—please do! Add it to your menu of gluten-free, delicious foods.

 Text Box: Toasted Quinoa Salad*
3/4 cup uncooked quinoa 
1 cup diced carrots/peas/corn etc. 
1/2 cup chopped mixed bell pepper s (red/yellow/green)
1/4 cup minced parsley or cilantro 
2 sliced green onions  or ¼ cup chives
juice of 1 lemon and 1 lime (or 1 - 2 tablespoons of each) 
1-1/2 tablespoons tamari soy sauce 
2 cloves minced or pressed garlic 

Rinse quinoa and drain. Put in a pot and dry toast (with a touch of olive oil) until a few grains begin to pop. Add 1-1/2 cups of water, bring to a boil, cover and simmer for about 15 minutes, or until the water is absorbed. Remove from heat and let stand for 10 minutes. Fluff with a fork and let cool.
Mix carrot, red pepper, parsley and green onion in large bowl. Add cold quinoa and toss to combine, Whisk together lemon and lime juices, tamari, garlic and whatever else moves you. Combine and chill. 
Almond Rosemary Quinoa*
1 tablespoon sesame or olive oil 
1 small onion 
1-1/2 cups quinoa, rinsed in boiling water and drained 
1 small red/green/yellow bell pepper, diced 
3 cups water 
1 tablespoon Tamari soy sauce (or, for a change, balsamic vinegar) 
1 teaspoon fresh rosemary or 1/2 teaspoon dried 
1 cup fresh or frozen peas, thawed if frozen (or any vegetable you prefer—I like chopped spinach)
1/4 cup almonds, chopped or slivered.
Preheat oven to 3500. Heat oil in a medium saucepan; add onion and quinoa. Sauté over medium heat, stirring constantly for about 3 minutes. Add bell pepper and sauté an additional 2 minutes. Add water, soy sauce, rosemary and peas (if using fresh peas).
Bring to a boil and cover; simmer 15 minutes or until water is absorbed. Meanwhile, roast walnuts in 3500 oven for 5 to 10 minutes. When quinoa is cooked, turn off heat and mix in almonds and frozen vegetables. Let sit an additional 10 minutes and serve.
*Recipes adapted from those  found at:



Celiac Disease, Gluten Sensitivity and Autoimmune dysfunction

Posted on August 23, 2014 at 12:00 AM Comments comments (1597)



So you have found out that you “have” celiac disease (CD) or gluten sensitivity (GS). You have learned how to eat gluten-free and are enjoying that you are feeling SO much better. Done, right? Well, almost done. You also need to be aware that CD and GS can be associated with a number of autoimmune disorders as well. Education is knowledge, and knowledge is power—best to know ahead of time, don’t you think?

First, a bit about our immune system. The immune system has been called our “sixth sense” because part of its function is to distinguish between “self” (what is part of you and what isn’t) and non-self (bacteria, viruses, fungi, cancer cells). When our immune system loses that ability, autoimmune disease can be a result. There are essentially two ways that the immune system functions—the first is called the “innate” immune system and works mainly from the gut—it’s innate because we are generally born with this ability. The second way is by the immune system learning what is self and what isn’t. Lot’s of this educational process is carried out by the thymus gland and develops in the womb, after birth (one reason why breastfeeding is so important) and throughout a person’s growth and development. Also, there are two basic arms of the immune system—the humoral, or antibody-mediated response and the cellular-mediated response. All of these are involved in the development of both CD and GS.

So, when we start eating solid foods containing gluten—and have the genetic background that means we are sensitive to gluten, the immune system begins to respond, first, we think, in the gut and digestive system. But, that isn’t the only site where the immune system is activated. The immune system can sometimes get confused because, for example, gluten “looks” too much like other substances in the body—maybe to one person’s immune system, it looks like certain parts of a nerve cell and for another person’s immune system, gluten “looks” very much like parts of the thyroid gland while in others, the gluten “looks” too much like pancreatic cells. The end result may be that an individual with CD or GS may develop an autoimmune disorder because these “look-alikes” produce cross-reactivity with those immune cells and antibodies directed against gluten. Those immune cells and antibodies then begin to react with, bind to and damage other organs. If these antibodies and immune cells react with the pancreatic cells, autoimmune insulin dependent diabetes may result. If, on the other hand, these antibodies and immune cells react with nerve cells, peripheral neuropathy and movement disorders may result. Or, if these antibodies and immune cells react with the thyroid, hypothyroid (low thyroid) or hyperthyroid (overactive thyroid) disorders may result. Other autoimmune disorders that may be associated with CD or GS are immune arthritis, Sjogren’s Syndrome, (the most common symptoms here are dry eyes and a dry mouth with potentially some joint pain and swelling), skin disorders such as dermatitis herpetiformis, psoriasis, vitiligo, hair loss and others, other intestinal disorders, anemias and other glandular (endocrine) disorders.2,3,4, , , , , , As far as endocrine glands, the adrenals and the thyroid appear to be most affected.5

Osteoporosis is also associated with CD and GS. , , It may be somewhat dependent on autoimmunity, but it seems to more closely associated with how long CD or GS was undiagnosed and how long an individual has been gluten-free, because again, going gluten-free is the best treatment and results in the improvement of bone mineral density (BMD). , , Read more about osteoporosis and CD/GS in another article!

I want to emphasize here that the risk for all of these associated autoimmune disorders is not greatly elevated – and can be reduced—once you go on a gluten-free diet. The key is to stick with the gluten-free diet because all else appears to arise from the gluten sensitivity. The longer you delay going gluten-free—or the more you “fall off the wagon”, well, the likelihood of “confusing” your immune system is there. Getting and staying gluten free is the best approach—and it works!