<<Disclaimer: Verify this information before applying it to your situation.>>
In early March I wrote:
"I know that rheumatoid arthritis, and difficulty digesting fat and dairy
products can becaused by cd. Does anyone know if they can also be caused by
allergy to wheat and gluten?"
I asked because my cd diagnosis was based upon medical history and diagnostic
diet rather than biopsy, and I wondered if some of my symptoms, which have
been reduced with my gf diet, prove cd status rather than allergies to wheat
and gluten. The following info is very long and interesting, and I don't
think I should edit or summarize because I wouldn't want to leave out
something that might matter to you. The responses require 2 postings because
of length. So many people asked for the long responses, that I am posting to
all. I hope the info will be helpful.
Best wishes,
Mara Levin Massachusetts, USA
<You might be interested in the book "Arthritis: the Allergy Connection" by
John Mansfield, M.D. He has a clinic in England and treats all types of
arthritis by diet. This book is the one that got me interested in food
allergies and in fact, "cured" my arthritis.
Marilyn Gioannini
Author of "The Complete Food Allergy Cookbook">
<Studies have shown that restriction of wheat , and or, the other toxic
grains may also benefit patients who suffer with other diseases. Promising
results have been obtained in the treatment of autism, epilepsy and
schizophrenia. An article entitled iDefinitions Associated With Celiac
Diseasei appeared in the spring 1996 issue of iLifelinei, a newsletter from
the Celiac Sprue Association United States of America (CSA/USA). In the
article Leon H. Rottmann, Editor and Publications Board Chairman of CSA/USA,
summarized the medical research of Seamus OiMahony, Ann Ferguson and Willem
Karel Dicke, findings that correlate celiac disease with other disorders:
Definite Associations: diabetes mellitus; thyrotoxicosis; hypothyroidism;
encephalopathy; sarcoidosis; vasculitis; dermatitis herpetiformis;
encephalopathy and cerebellar atrophy; myasthenia; peripheral neuropathy;
malignant lymphomas; small-intestinal adenocarcinomas; esophageal and
pharyngeal squamous carcinoma.
Probable Associations: Addisonis disease; rheumatoid arthritis; Sjogrenis
syndrome; bird fancieris lung; farmeris lung; pernicious anemia; exocrine
pancreatic insufficiency; inflammatory bowel disease; primary biliary
cirrhosis; collagenous colitis.
These lists suggest that if this disease were eliminated, the incidence of
many other diseases could be reduced as well.
Bill Vellios Sr.
St. Louis, MO, USA>
<Extracted from "Nutrition Therapy"
by Stephen J. Gislason MD...
Arthritis
Arthritis may be an allergic response to
materials in the food supply. Diet revision may be
helpful in reducing the activity of inflammatory
arthritis and in some instances may halt the
progression of the disease.
There are many patterns of arthritis. A group of
related joint and connective disorders have been
called rheumatic diseases. All these diseases are
immune-mediated, and all are expressions of
inflammation in connective tissues. Inflammation
damages joints and surrounding tissues resulting
in loss of function and deformities. Variations in
the patterns of these diseases reflect the many
possibilities for immune damage to disturb and
distort structure and function. Severity ranges
from mildly painful, chronic activity to drastic,
disabling disease. Rheumatoid arthritis, often
severe and disabling, is the dominant rheumatic
disease which can attack all joints in the body.
Rheumatoid arthritis is often considered to be
an autoimmune disease. Our idea is that no disease
is just internally generated and must involve
outside contributions. Arthritis is often associated
with inflammatory bowel disease. The
mechanisms of food allergy link abnormal
Gastrointestinal Tract (GIT) function with
immune attacks on connective tissue. In all
arthritic patients, normal GIT function should be
rigorously sought by adaptive dietary adjustments.
Simple allergic arthritis is a definite entity that is
often not recognized as a food allergy. Typically,
a dramatic, acute, and painful swelling develops
in one or more joints asymmetrically. The joint
inflammation is usually brought on by eating a
food, either an unusual food eaten for the first
time or sometimes a regular food eaten in excess.
This presentation is similar to and often confused
with gout. Any food can cause allergic arthritis.
Staple foods such as milk, eggs, and wheat (rye,
oats, barley), coffee, beef, pork, and food
additives are the most common food triggers.
Carinini and Brostroff reviewed the concepts of
and evidence for food-induced arthritis. They
stated:
"Despite an increasing interest in food allergy
and the conviction of innumerable patients with
joint disease that certain foods exacerbate their
symptoms, relatively little scientific attention has
been paid to this relationship. Abnormalities of
the gastrointestinal tract are commonly found in
rheumatic disease...Support for an intestinal
origin of antigens comes from studies of patients
whose joint symptoms have improved on the
avoidance of certain foods antigens, and become
worse on consuming them. These have included
patients with both intermittent symptoms,
palindromic rheumatism and more chronic
disease."
In another study, 33 of 45 patients with
rheumatoid arthritis improved significantly on a
hypoallergenic diet. The authors concluded:
"Increasing numbers of scientific studies
suggest that dietary manipulation may help at
least some rheumatoid patients and perhaps the
greatest need now is for more careful and well-
designed research so that preconceptions may
be put aside and role of diet, as a specific or
even a non-specific adjunctive therapy, may be
determined."
Unfortunately, dairy products, wheat and its close
relatives, oats, barley, and rye, have proved to be a
major problem in the diets of our patients. There
are many possible reasons for cereal grains to
become pathogenic. Hypersensitivity mechanisms
triggered by grain proteins, collectively called
"Gluten", are the likely cause of the illnesses
related to intake of cereal grains. Gluten is a
mixture of individual proteins classified in two
groups, the Prolamines and the Glutelins. The
prolamine fraction of gluten concerns us the most
when grain intolerance is suspected. The
prolamine, Gliadin, seems to be a problem in
celiac disease; gliadin antibodies are commonly
found in the immune complexes associated with
this disease. Recently marketed grains, spelt and
kamut, are wheat variants (despite claims to the
contrary) and are likely to cause problems similar
to other wheat varieties.
A wheat gluten mechanism has been studied in
rheumatoid arthritis patients. The clinical
observation is that wheat ingestion is followed
within hours by increased joint swelling and pain.
Little and his colleagues studied the mechanism,
as it developed sequentially following gluten
ingestion. Dr. Parke and colleagues concurred
with this explanation of the gut-arthritis link in
their report of three patients with celiac disease
and rheumatoid arthritis. The mechanism
involves several stages:
GIT must be permeable to antigenic proteins or
peptide fragments, derived from digested gluten.
The food antigens appear in the blood stream and
are bound by a specific antibody (probably of IgA or
IgG, not IgE class), forming an antigen-antibody
complex, a circulating immune complex (CIC)
The antigen-antibody complex then activates the
rest of the immune response, beginning with the
release of mediators - serotonin is released from the
blood platelets. Serotonin release causes
"symptoms" as it circulates in the blood stream and
enhances the deposition of CICs in joint tissues.
Once in the joint, the immune complexes activate
complement, which in turn damages cells and
activates inflammation. More inflammation results in
more pain, swelling, stiffness, and loss of mobility.
Arthritis is usually treated with salicylates or
related anti-inflammatory drugs generally
referred to as NSAIDs. These drugs alleviate the
terrible pain of active arthritis but do not
favorably affect the outcome of the disease. All
anti-arthritic medication can produce asthma or
chronic rhinitis and a variety of allergic skin
rashes. Gastrointestinal surface irritation,
bleeding, and ulceration are routine problems of
anti-arthritic medication.
The first attack of joint swelling and pain should
be treated as an urgent problem to be solved.
Inflammation may damage joints. Often NSAIDs
and physiotherapy are the only treatments
prescribed and inflammation is given every
opportunity to ravage tissues. We have seen
countless patients, just treated with NSAIDs, who
progressed rapidly to a severe disabling disease,
often with poor pain control. In unlucky patients,
severe deformities of joints accumulate in the
first few months of a severe attack. There is a
trend to recommend more aggressive treatments,
using drugs that impair the immune response. The
best drug is prednisone, but it is seldom used
because it has long-term side effects which scare
both physicians and patients. Prednisone is often a
magic drug that relieves terrible pain and
suffering often in the first 48 hours of therapy.
Beyond prednisone, there is a grab bag of immune
suppressant drugs to treat arthritis -chloroquine,
penicillamine, gold and methotrexate have
emerged as the favored drug therapies. All these
drugs have impressive side effects and great
potential for toxicity.
Our preference is to try to stop the inflammatory
activity as soon as possible with diet revision. All
inflammation is likened to a fire. You get out the
fire-extinguishers and go to work. No matter what
pattern the immune attack assumes, our standard
defense can be tried first. The Core Program
method of diet revision is used. Food is replaced
with an elemental nutrient formula, ENFood, for
a clearing period of 10 to 20 days. Prednisone
and/or NSAIDs are drug options during the
clearing period and then the dosage is reduced
after pain and swelling have subsided.
Improvement is followed by slow food
reintroduction (see Core Program). Each
returning food is carefully screened for arthritis-
triggering effects. You hope that food allergy
caused the problem and that food control can be
successful controlling the disease in the long-
term. Nothing is lost by taking this approach and
complete control of the disease can sometimes be
obtained. If strict food control proves to be
inadequate, then other drug treatments can be
instituted.
Carinini C, Brostroff J. Gut and joint disease. Annals of
Allergy 1985;55:624-625.
Darlington et al. Lancet Feb 1 1986;236-238.
Keiffer M et al. Wheat gliadin fractions and other cereal
antigens reactive with antibodies in the sera of of celiac
patients. Clin Exp Immunol 1982;50:651-60.
Little C, Stewart AG, Fennesy MR. Platelet serotonin
release in rheumatoid arthritis: a study in food intolerant
patients. Lancet 1983;297-9.
Parke AI et al. Celiac disease and rheumatoid arthritis.
Annals of Rheum Dis 1984;43:378-380.
Voorneveld CR, Rubin LA Disease-modifying
antirheumatic drugs: early use is better. Medicine North
Amer. Oct 1991 3177-3184
========================================
For more information on the above mentioned food intolerances see:
The Gluten-Free Page: http://www.panix.com/~donwiss/
The No Milk Page: http://www.panix.com/~nomilk/
Don.>
<An allergic response is when the body has an immune response to an allergen
(eg gluten) and produces antibodies to fight against that allergen.
This is exactly what the Celiac's body does in response to gluten, so I am
afraid I cannot see that there would be a difference.
Following is some information I haven't read yet, but may answer your
question:
Copyright c. 1996 Amsterdam Clinic. You may reproduce this entire electronic
brochure and pass it on as shareware. All other rights reserved.
Introduction
Through his writings, we know that Hippocrates, the father of medicine, had
already recognized the presence of allergic reactions in people as early as
ancient times. However, the term "allergy" is a relatively new one, as
compared to many other commonly used medical terms. In 1906, Viennese
peiatrician Baron Clemens von Pirquet used the term for the first time to
describe an "altered response" of his patients' bodies. Von Pirquet believed
that this altered reaction manifested itself in changes of the immune system,
effected by external influences on the body, such as: food intake, the air
breathed or direct skin contact. The term "allergen" (the substance
responsible for the altered reaction) was born. At that point in time,
however, von Pirquet had no means of scientifically proving that these
immunological changes actually occurred in the body. It was not until the
mid-1920's, that a second significant event occurred.
Researchers found that, by injecting a minute quantity of purified allergen
under the skin, certain individuals would develop a clear skin response; a
welt, with or without itching and redness, could be provoked. This positive
skin test for allergies would show itself most prominently in patients with
hay fever, asthma, chronic rhinitis, hives and eczema. The "prick test"
became a method of demonstrating the involvement of the immune system in
allergic reactions. However, the precise biological reason for the reaction
continued to remain a mystery.
It was not until the Sixties, when an important discovery occurred which
provided long-awaited scientific support for the classical allergy theory and
removed any doubts about the relationship of the immune system with
allergies. This breakthrough came about with the scientific discovery of
immunoglobulin E (IgE) by a Japanese couple named Ishizaka.
Classical Allergic Reaction
The following are the chain of events which happen in allergic
reactions:
An allergen must be present in the body. This allergen is the substance
which causes us to have an abnormal immunological response. Allergens tend to
be protein molecules. Interestingly enough, the immune system only detects
particles of a certain size as potential troublemakers and protein molecules
are just the right size. In a small number of cases, the body actually
responds to molecules other than proteins. These molecules, which are
generally much smaller, are called haptens. By combining with protein
molecules, haptens form larger complexes which can then be detected by the
immune system.
The allergen is detected by the B cells. These are specialized immune
cells, capable of producing antibodies. Just like allergens, antibodies are
protein molecules, which have the capacity to neutralize allergens.
Every B cell produces its own, specific antibody, depending on the type
of intruder it needs to respond to. It is easy to understand why the body
must have a ready pool of millions of antibodies, in order to combat these
numerous offenders. There are five main categories of antibodies (IgG, IgA,
IgM, IgD and IgE) which the body releases under different circumstances (for
instance to fight off various infections, etc.). In the case of allergies,
the body produces the antibody immunoglobulin E (IgE), first discovered by
the Ishizakas.
Usually, antibodies will bind directly to the appropriate damaging
substance and neutralise it. However, IgE deviates from this common path. It
first attaches one of its "legs" to one of the body's numerous mast cells.
The other leg is used to hold on to the offending allergen. This action
signals the mast cells to begin disintegrating, thereby releasing histamine.
Histamine is a chemical substance responsible for a great number of
complaints which may arise during allergic reactions. It causes muscle cramps
and an inflammation-like process with redness and swelling of mucous
membranes.
Allergic reactions can occur under a variety of circumstances. For instance,
inhaling certain substances, such as grass pollen, house dust, etc., may
cause an allergic response. However, the consumption of certain foods may do
the same. Allergies typically bring on complaints very rapidly upon contact
with the allergen. Complaints may vary from a runny nose, sinusitis, earache
or runny eyes to itching of the skin, eczema and shortness of breath.
Intolerance
Conventional medicine can easily diagnose and treat allergies for foods or
inhalants. Here, the so-called RAST test plays a very important role, because
this test can demonstrate the presence of IgE.
However, demonstrating the presence of intolerance is more difficult. In this
situation, similar to the case of classical allergies, the body responds
abnormally and, in addition, the immune system does not produce IgE. It quite
often takes much longer for complaints to come on, thereby masking the
possible link between the offensive substance and the complaints themselves.
These are only a few of the reasons why food intolerance is considered a
fairly controversial concept in conventional medicine.
Intolerance can be responsible for a wide variety of complaints which,
at first glance, seem to lack a plausible explanation.
Intolerance can manifest themselves as the following:
rointestinal complaints: stomach ache, irritable bowel, Crohn's
disease, ulcerative colitis
skin complaints: itching, eczema, hives, acne (in adults)
joint and muscle complaints: ranging from atypical pains to
rheumatoid arthritis
headache and migraine
chronic fatigue
asthma, chronic rhinitis or sinusitis
pre-menstrual syndrome
hypoglycaemia
depression, anxiety
sleeping disorders
Diagnosing Intolerance
It is impossible to accurately demonstrate intolerance through
conventional testing methods.
The Amsterdam Clinic currently uses two test procedures which have proven to
be very reliable.
In the cytotoxic test, a drop of the patient's blood is mixed with a
drop of pure, liquefied food concentrate. If the body has a normal tolerance
to this specific food, microscopic examination will show that certain white
blood cells (granulocytes, which deal with immune response) remain intact.
However, in response to lesser degrees of tolerance, these white blood cells
swell and possibly granulate. In severe cases the cells will actually blow up
and disintegrate. Detection of intolerance with this method can be done with
an 80% reliability.
Another useful test is the IgG(4) antibody test. Here, the presence of
IgG(4) antibodies is determined. These antibodies are the slowly occurring
variety, which do not appear in the blood until 24 to 48 hours after exposure
to an offending food or substance. The reliability of this test varies
between 80 and 90%.
Treatment
Diet
In the treatment of inhalant allergies (such as asthma, hay fever) and food
allergies and intolerance, avoidance (elimination) of allergens plays an
extremely important role. In the case of food sensitivities, either the
cytotoxic test or IgG(4) test can help determine reactions to specific foods.
Based on the test results, an elimination/rotation diet can be specifically
tailored.
Foods causing strong reactions in these tests, should (temporarily) be
excluded from the diet. More moderate reactions allow for rotation of certain
food items in the diet. These may be eaten once every four days. Especially
during the first week(s) of the diet, withdrawal symptoms, similar to
complaints stemming from the cessation of coffee, tobacco or alcohol
consumption, may occur. The body seems to crave offending food items.
Generally, these withdrawal symptoms disappear after a couple of weeks.
Concurrently, those complaints relating to food sensitivity also diminish.
Using this dietary approach, the reaction to food allergens may decrease in
the course of time. After a three month moratorium, reintroduction of
"forbidden" food items can be attempted, one at a time. In this way, food
items still causing reactions can be isolated more easily. Often, at least
part of existing intolerance completely disappear after an
elimination/rotation diet.
With the treatment for inhalant allergies, elimination is also the first
step. It is obvious that patients having an allergy for cats or dogs, should
avoid any contact with these pets. The situation becomes more difficult when
dealing with allergies to grass or tree pollen, since total elimination is
basically impossible. The same goes for house dust mite allergy. The house
dust mite lives in mattresses, pillows, carpeting, drapes, upholstery, etc.
Through mite-killing pesticides, special mattress and pillow covers,
non-carpeted floors, etc. reasonable results can be obtained.
Medication
Medicines for inhalant allergies, such as antihistamines (Triludan),
corticosteroids (Prednisone, Pulmicort, Becotide), cromoglycates (Lomudal,
Lomusol), and airway dilating medication (Ventolin, Berotec, Atrovent) do
suppress symptoms, however, they do not cure the allergy! In the realm of
conventional medicine, effective medications for food allergy and intolerance
do not exist at all.
Desensitisation
Enzyme-potentiated desensitisation (EPD) and the
provocation/neutralization method are very effective treatments for food
allergy/intolerance and inhalant allergy problems. These methods tackle
allergy problems at the root.
During EPD treatment, a small quantity of a food or inhalant
allergen mixture is injected intradermally into the skin, in
combination causes the body to gradually adjust its exaggerated responses to
food and inhalant allergens. In this way, the immune system is readjusted and
reset. Initially, the injections have to be given once every two months.
Gradually, however, the intervals between injections become longer and the
injections can often be discontinued after a time. According to conservative
estimates, at least 80% of those patients treated with EPD show considerable
improvement in the course of time.
Provocation/neutralisation can be used both diagnostically and
therapeutically. Here, separate extracts of food or inhalants,
suspected as possibly offending, are injected intradermally. This causes
a welt to appear in the skin. After 10 minutes, the size and nature
(firmness, colour, etc.) of the welt are evaluated. A positive welt will
generally bring on symptoms (provocation).
Depending on the size and nature of the welt, as well as, the presence
of symptoms, varying concentrations are injected, until a dose is found which
does not cause any welt changes or symptoms. This is the neutralising dose.
Injections with the proper
neutralising dose will bring on immediate protection against the
symptoms caused by the offending food and/or inhalant.
For further information please contact:
Amsterdam Clinic
Located at THE HALE CLINIC
7 Park Crescent
London W1N 3HE
Telephone 44 (0)171 631 0156
Telefax 44 (0)171 323 1693
Also in THE NETHERLANDS:
Amsterdam Kliniek
Reigersbos 100
1107 ES Amsterdam Z.O.
Telephone 31 (0)20 697 53 61
Telefax 31 (0)20 697 53 67
Lydia S. Boeken M.D. London/Amsterdam: e-mail:
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---------------------------------------------------
~(~ Carol R McKay mailto:[log in to unmask]
@ GPO Box 562, Sydney NSW 2001, Australia>
<Interesting question...My grandparents suffered from arthritis in their
later years (after the age of 55) and they were both celiacs who died of
colon cancer. Interesting to pinpoint the arthritis concept...>
<Problems with fat consumption are legion in celiac disease. The reason is
that the damage to the duodenum causes a stoppage in cholecystokinin
production. This is the very hormone that is produced in response to fats. It
signals the gall bladder to contract and push its contents down the common
bile duct, to facilitate the digestion of fats. Problems with dairy are often
the result of damage to the villi, which destroys the enzymes necessary for
cleaving the sugars in milk. The circulating antibodies associated with RA
are sometimes attributed to a dynamic referred to as molecular mimicry, and
are thought (by some researchers) to result from the gliadins in grains.
These dynamics are, IMHO, more consistent with cd than with an IgE response
(which is the immune response usually called an allergy.)
I hope that is helpful.
Best Wishes,
Ron Hoggan Calgary, Alberta, Canada>
Thank you again to all who generously responded.
Mara Levin Massachusetts, USA
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