By: Meera Dossa BSc, ND
KEEP THIS “CD” OFF OF YOUR PLAYLIST!
Celiac disease (CD), also known as celiac sprue, non-tropical sprue, and gluten-sensitive enteropathy, is an inherited autoimmune condition that affects almost one percent of the North American population. Though this disease can develop at any point in an individual’s life, from early infancy to late adulthood, those with a family history have the greatest risk for developing this disease due to its significant genetic component. It is also more prevalent in those of European descent, Caucasians and women.
CD is a disorder of gluten intolerance, in which the digestion of gluten, the protein component of grains such as wheat, barley, and rye, is impeded. In order for efficient absorption of food to occur, small fingerlike projections (called villi) that protrude from the small intestine are required for food to be absorbed through the walls of the intestine and into the bloodstream. When individuals with CD ingest gluten, their immune system produces a response by damaging or destroying the villi necessary for nutrient absorption. As a result, the symptoms of CD discussed below can manifest.
Diagnosing CD can be difficult, as the symptoms are not always pronounced. The degree of manifestation of symptoms depends largely on the amount of intestinal damage that has occurred. In cases where there are clear symptoms of abdominal pain, bloating, diarrhea, weight loss and foul-smelling, fatty stools, suspicion for a diagnosis of CD appears clearer. However, not all cases produce this “classic presentation,” resulting in a delayed diagnosis. Adults are less likely to present with the textbook digestive symptoms and can instead manifest a more vague variety of complaints consisting of unexplained iron deficiency anemia, fatigue, anxiety and depression, joint pain and issues surrounding fertility. Often, an itchy rash consisting of small clusters of red bumps may be the only clue that CD is underlying in an otherwise healthy adult.
YOU’VE GOT TO BE “GLUTEN” FREE!
Seeing as “gluten” clearly plays the role of the antagonist in CD, a brief discussion on what gluten is and where it can be found, or hidden, seems warranted. As stated early, gluten is a protein most commonly found in grains such as wheat, barley, and rye. It is a baker’s best friend as it helps to make the dough more pliable. Although there is no “cure” for CD, it can be effectively controlled by living gluten-free! There is a wide variety of grains available that are gluten-free and include: corn, rice, potato, amaranth, teff, quinoa, millet, buckwheat, arrowroot, and carob. Additionally, numerous food companies and restaurants are jumping on the G – FREE bandwagon, making living gluten-free an attainable goal.
Reading labels to identify the big three (wheat, barley, and rye) is the easy part of carrying out a G-FREE lifestyle. However, gluten does have a sneaky way of getting past the naked eye. Hidden sources of gluten to consider are lipsticks and balms, certain candies, soy sauce, grain alcohol (such as beer), vegetable protein sources (such as veggie burgers and hot dogs), imitation meats, malt (vinegar, extract or syrup) and even certain medications or supplements. If you know you have CD or are suspicious of gluten sensitivity, befriend your pharmacist or naturopathic doctor and make certain that what you are ingesting is indeed gluten-free.
AND THE MILLION DOLLAR QUESTION IS…
Could you possibly be ailing from CD? If either you or your healthcare provider, are suspicious of an underlying cause of CD, certain blood tests will aid in confirming a diagnosis. Individuals with CD will present with higher than normal levels of particular autoantibodies, namely: anti-tissue transglutaminase antibodies (tTGA), anti-endomysial antibodies and anti-gliadin antibodies (AGA). These can be ordered by your primary care practitioner, but require a blood draw and do not provide instantaneous results.
Here, at The Pacific Wellness Institute, we are now proud to offer a reliable, quick and virtually painless test for CD, which requires only a small blood sample from an individual’s finger. The test, performed in-house, measures the levels of transglutaminase autoantibodies, which are highly predictive markers of active CD, and provides results within minutes of obtaining the sample.
If you think that CD might be the underlying cause of your symptom picture, it is well worth investigating with the use of this simple test. However, if you have been on a G-FREE diet, for 30 days or more, the validity of your results will begin to decrease. This test will provide a clearer picture in terms of the activity of the disease, however, it is important to note that the gold standard to confirm the diagnosis of CD is, and always has been, intestinal biopsy.
For most, a positive result, coupled with nutritional guidelines from their naturopathic doctor is confirmation enough as they embark on their journey to recovery!
Meera Dossa, BSc, ND is a licensed naturopathic doctor at The Pacific Wellness Institute. To book an appointment with Dr. Dossa, please contact The Pacific Wellness Institute at 416-929-6958.