<<Disclaimer: Verify this information before applying it to your situation.>>

Thanks so much to the dozens of list members who responded to my question: "Ha
ve we been overly concerned about the tiny amount of gluten that could exist
in a pill?" I had posed it because my MD was very impatient when I asked him
if the medication he was prescribing, Vioxx, is gf, and said the amount of
gluten in a pill couldn't hurt me.

I'm sorry I was unable to respond to everyone sooner and individually; I just
got a new job and have been overly busy.

Since I asked the question, I've spoken or corresponded with three medical
experts. One does research on cd; he said no one really knows if tiny amounts
are harmful and that they may be so to very sensitive individuals. One person
who teaches pharmacology at a university said he thinks tiny amounts should
be avoided because he has seen his students react allergically to dust from
ingredients when preparing medications. The third is my kindly uncle, a
retired physician, who said, if I am satisfied with my doctor in other
respects, I should investigate everything he prescribes on my own. If I find
a prescription contains gluten, I should request a substitute. Then he said,
if I need medicine in an emergency, I "may have to insist that the doctor
find out" if it is gluten free for me.

Here are other responses. (Thank you to all!) If you don't have time to read
all, please skip to the bottom for a very interesting idea on self-help:

Most respondants were concerned that my doctor was insensitive to my
concerns. A few told me to get a new doctor. (Not always an easy option.)

One non-medical person summed it up: "I don't think anyone knows, to be
honest with you, if that small amount will hurt you.  Obviously some are more
sensitive than others."

One person echoed the frustrations of many when her mother's doctor said she
should look for a new doctor because she asks "too many questions."

Several persons said I should always check on gf status myself (with
pharmacist or manufacturer). A pharmacist wrote to say Vioxx is gf. [Thanks!]

One person thinks she had a reaction to gluten in Benadryl capsules. She said
that after switching to the liquid: "In two days, I have started to get
better.  So no one can tell me that those few "molecules" don't matter."

One person pointed out that the doctor may think the benefits of the
medication outweigh its risks. However, she felt even tiny amounts are
potentially dangerous.

One said, "Show him the statement from the celiac orgs that a molecule of
gluten is the same as a lb." [I haven't verified if they say that.]

One person said, "Instead of medication for arthritis have you tried carrot
juice? I took so many anti inflamatories when I was young that I no longer am
able to use them. I was finally pain free when I drank a glass of carrot
juice (with 2 golden delicious apples) every morning and night along with
taking Yucca (dried in capsule form) for pain. Within a week I was pain free
doing whatever I wanted." [Boy, that sounds great!]

"Another uninformed Dr.(stupid) ask him if he'd like just a little bit of rat
poison ever day? A little bit in time can cause lymphoma and or so much
damage you can't eat anything"

Some said the risk of lymphoma is too serious to not avoid tiny amounts of
gluten. "From my reading on celiac disease, we face an increased risk of
intestinal cancer if we do not maintain a gf diet.  That's gluten-FREE, not
gluten-LITTLE."

One person said pharmacies are required by law to have the book with
telephone numbers of drug manufacturers.

One person pointed out that doctors are well paid to respond to our concerns.

"I check every pill I put in my mouth for gluten.  I was taking Vioxx last
year for rheumatoid arthritis and it is gf.  Not only does my doctors check
the gf status of meds before they prescribe them to me but my pharmacist does
too.  They call the manufacturer on the spot.  I have learned from a friend
who's a dermotologist that if the ingredient just labeled "starch" is in a
drug in the U.S., it is from corn.  This is not true in other countries.  But
I check every drug.  I buy only vitamins/supplements that are gf and call the
manufacturers myself on over the counter drugs.  I buy vitamins from Vitamin
World (they have a website) and they're all gf."

"He may be a very good doctor, but even good doctors are human and I'm
learning they don't know everything. I think you were right to be concerned."

"But YES! even a small amount can be important. It only takes a tiny little
dose to cause BIG problems. And if it's a daily medication, you might as well
not be on the gf diet. These doctors need educating."

"Maybe you could have the dr that diagnosed your CD talk to him about it? I
read that a molecule is as harmful as a pound of gluten.  I think it was on
this website http://www.csaceliacs.org/

There is also a list of some medications listed, and you can get a book with
more detail."

"The whole point of this disease is to avoid any amount of gluten..."

"I don't think anyone, including the Doctors knows how much a little can
mean.  It is probably different in different people.  The attitude that most
Celiacs I know take, is that if a med is temporary like an antibiotic, and is
necessary on a very timely basis, they take it.  If it is going to be an
ongoing use, they check it out with the manufacturer and try to use a GF."

"That tiny amount of gluten in a pill builds up over time. It is the BUILD-UP
of gluten that causes the problems in many cases. Incidentally, when I went
gluten-free, my arthritis cleared up in 5 months! I had been told to expect
to have a hip replacement op!" [Awesome!]

The pharmacist (Valerie Cullen, and the phone # is 1-888-838-2872  Ext. 5272)
assured me that at this time none of the products that TEVA manufactures
contain gluten, either in the coating or the capsule that contain the
medication.

"There is an article in the archives by Dr. Joseph Murray, a leading
authority on CD and DH. In the article Dr. Murray states that CD and DH
patients should treat gluten the same way that they would treat arsenic
poisoning."

"In no way are you over-reacting when considering the amount of gluten in a
pill.  I got very sick from one pill that turned out not to be gluten-free."

"...you may not notice a reaction, but your gut could still be damaged. You
do not want to get cancer of the small intestine. What about going back to
the doc who diagnosed your CD, and having that doc call your doc to explain
that a molecule is just like a mouthful!"

"If you needed to take that pill very day, for a long time it would have a
cumulative effect.  While it might not cause digestive symptoms, you might
experience fatigue, brain fog (unable to think clearly), irritibility,  or
other very subtle, but very definitely gluten related symptoms.  The more
gluten you take out of your diet, the more sensitive you become and the less
it takes to cause a problem."

"...those of us who suffer from cd know that the amount of gluten found on 1
postage stamp can be harmful."

"...Stokes Pharmacy in Medford, NJ (and other companies that your drug plan
knows about) will compound medications for you gluten-free. Obviously, there
may come a time when I need a drug immediately to save my life. Then I'd
chance a celiac episode, but not if I can avoid it."

"You can contact Dr. Alessio Fasano at University of Maryland, he is an
expert and is at the forefront of research in cd.  Ask him if he can send you
some printed material to give to your Dr.  Don't give in-EDUCATE!!"

[Here's a real gem of an idea!] "My pharmacist, bless his little heart,
gave me the following suggestion when we were trying to figure out what
was going on with me, prior to a celiac diagnosis.  I was having all
kinds of reactions to meds. He told me to take a pill, crush it and
place it in the crook of my arm, covering it with a damp bandage.  I was
to wait an hour, remove it and examine the skin for welts, rashes etc.
I lasted ten min with glucophage before I tore the bandage off.  The arm
looked like I had been attacked by bees.  The pharmacist suggested that
periodically one should do this with meds to see if an allergy has built
up.  He does this with his own father. If you are using capsules, just
remove the contents and proceed as above."