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Hi,

Regarding the issue of whether mannitol derived from a wheat source
is of concern to celiacs...I did not get a good solid answer to this
question.

1. I wrote to nutritionist Shelley Case who contacted Margaret
Fowler, RPh, MS. Margaret wrote back to us as follows:

"This is a new one for me!   Mannitol is an alcohol, as best I can
figure out.  There is no test for protein contaminant in
pharmaceutical reference book. Compared to a test for protein in
Sodium Starch Glycolate, for example). Our Mannitol IV solutions
sometimes form crystals-- very long, sharp, thin crystals.  I do not
believe that proteins can do that; a protein contaminant would alter
the crystalline structure, it seems to me.

I wonder what Dr. Kasarda thinks of this issue.

We need an "insider" in Quality Control in a pharmaceutical plant to
help us with this..."

2. Cynthia Kupper, Executive Director of GIG wrote to me: "'ol' on a
sugar, such as mannitol implies the sugar is a sugar alcohol. From
everything I know about sugar alcohols this should not be a
problem..." She wondered if Shelley Case any more info.

3. Someone who works at Abbot Labs emailed me as follows: "I am
perplexed by this information regarding gluten in a mannitol source.
Gluten is a protein. Mannitol is a sugar.  Mannitol from wheat as an
ingredient should not provide gluten (gliadin), and therefore any
testing for "wheat" may be irrelevant anyway. I work at Abbott
Labs...I would like to follow up on this." She did follow up on it
and when she emailed me again, I contacted a chemist at Abbot Labs
myself. This chemist told me that this subject was "not her area of
expertise" and all the company could do was to provide info about
ingredients and their sources. It was up to consumers to make their
own decision. When pressed further, she was unable to direct me to
anyone who might have the knowledge to answer me.

4. I got an email from a List member who wrote: "Just in case you
didn't already know celiacs might want to avoid mannitol regardless
of the source especially if in large quantities.  It IS often used as
a *laxative for infants* and can mimic the effects & symptoms of CD.
If not made from wheat it can still lead you on a wild goose chase
trying to find the 'offender' that's
made you sick, if nothing else.  I was told be my pharmacist that
almost all mannitol is wheat free and that it's rare that any source
other than manna is used in pharmaceuticals. (key word almost)..."

I also received a LOT of emails from List members who were concerned
about mannitol and hoped to get a definitive answer as to whether
they should be concerned. Unfortunately, at this point, I can't
provide one. Does anyone have any ideas as to who we can contact for
more info?

Best wishes,
Lani K. Thompson
www.clanthompson.com

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