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

Dear List:
A propos the June 1998 article in Scientific American, The Neurobiology
of Depression by Charles B. Nemeroff, accessible at    www.sciam.com
I learned a lot, as usual, from the responses,and thank those who
replied, in such careful detail. Reading between the lines, I am quick
to acknowledge my emotionality about the disease after a lifetime of
misdiagnosis and terrible trouble.

I had 5 interesting replies:

1. I think there is a certain amount of denial in the Celiac community
more so than in the medical community.

First, active CD causes depression...

Second, active CD is associated with a lowered level of serotonin in
the central nervous system.  this condition is generally associated with
depression, migraine headaches, and binge eating of carbohydrates.

Third, in active CD abnormally large amounts of serotonin are lost
into the gut.  whether it is used by the enteric nervous system itself
in trying to control the intestines, or if it is used in the more common
role of a signaling agent trying to control the smooth muscles of the
intestines, is not clear to me.

Fourth, unless there is a novel mechanism in Celiacs, the system that
transports serotonin appears to have a lower capacity in Celiacs than in
other people.  this may be a persistent characteristic, not strictly
limited to active CD.

This respondent goes on to cite no less than 17 studies (I will
forward particulars to anyone who wants them)

2. My problem, with the medical profession, is that it looks for obscure
causes,  for biological disorder,  while ignoring the simple ones.  I
wonder how may of Dr. Nemeroff's patients would improve on a GF diet?

3. Informed me how to locate the article on the Internet.

4. Disagreed about deluging the magazine with letters to the editor.
"The article seems very accurate and unbiased. I am not
denying that celiac disease upsets the CRF and HPA, which will then
lead to depression. But there are othere disease that can upset these
paramters. Adrenal tumors, Hormonal imbalance due to anything, Kidney
malfunctions or various nephropathies, etc, etc. This article
helps identify how one with celiac disease develops depression."

5. I have reviewed Dr.  Nemeroff's article and find it to be clear,
balanced and consistant with the current state of knowledge re:
depression.  The fact that there may well be a celiac/depression
connection and that this is most likely serotonin mediated seems to me
yet another part of the puzzle.  Like CD there may be other
nutritive/metabolic processes which also influence mood and
psychological well-being.  I don't see these possibilities as being
excluded by Dr.  Nemeroff's article.  True, such possibilities are not
addressed directly but it seems an easy step to incorporate them into
the overall hypothesis.  As for "deluging the editor with letters", I
would think a simple observation of the CD/depression connection would
be enough to peak any scientist's interest.  Of course, this observation
would best be brought to Dr.  Nemeroff's attention whether by way of *a*
letter to the editor or directly.  In fact, I would be more than willing
to take up the idea with him and for that I thank you for bringing his
article to my attention.  As both a behavioral epidemiologist and celiac
who also suffers from depression, I can attest to the connection between
diet (i.e., gastrointestinal competency) and depression.  I knew Dr.
Nemeroff ...  and would relish the opportunity to discuss this
connection with him.  Again, thank you for bringing the matter to my
attention.

Nancy in nyc