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Hello all:

I apologize for the delay in summarizing.

Thank you for all your responses. I received 43 responses - more than
for any other question/post I have ever sent to this list in my 10
years (more or less) of being on it!
Thank you for your encouragement and sympathy and for some
interesting ideas which I will summarize here.

A number of people suggested that I take my son off Ritalin
altogether and go for biofeedback and homeopathic therapies. Some
suggested 'alternative medicine'. I don't live in the US, not do I
have an "HMO" that follows the rules of those in the US, so I have to
see what I can afford within the basket of services we can reasonably
pay for. Some other prescription drugs like Concerta are too new in
Israel and are not included in the subsidized meds that the Sick
Funds prescribe. Concerta is still prohibitively expensive. There is
a drug available in the US called Adderall that is GF and works like
Ritalin. It was a suggestion and I have no details on it. Other
substitutes with the same active ingredient methylphenidate are
Dexedrine, and Metadate, and a non-stimulant version called Strattera.

A comment was made that doctors cannot be expected to know what is in
each drug - only pharmacists might know, or call the manufacturer
itself. I tend to think that specialists, like neurologists, do know
what the components are in the drugs they prescribe. They have to
know, since many medical conditions contraindicate the ingestion of
certain meds, etc. Ritalin is common enough and there are certainly
enough Israelis with celiac, besides, I told the dr. before hand.
They always ask about allergies. Besides, there is a pharmaceutical
guide that I have seen in just about every dr's office I've ever been
to that has the ingredients listed.

One e-mail in particular had a number of references and suggestions
for research ideas and web addresses to start my search. Anyone
interested in particulars here, please write me separately.

Someone suggested the Feingold Diet and another suggested I take my
son out of school, Ritalin not withstanding, and then referred me to
this site: http://www.ritalindeath.com/

Another responses suggested that I contact the manufacturer,  which I
am still trying to do. One said that Novartis was one of the most
irresponsible companies to do biz in the US. It is essential to speak
to a chemist who knows what he's doing, or someone at the co. in
charge of registration of the drug. I am also contacting the
importer. See note at the end of this post. My gratitude to the
Israel Celiac Society which has used its influence to push for better
labeling of drugs. Without their accomplishments in this area, the
wheat starch ingredient wouldn't even have appeared on the label here
in Israel.

Others suggested that I take my son off milk products, and even egg
and soy and have him tested for a range of other food allergies. One
suggested a sensitivity to tomato paste. I have heard this a number
of times in other contexts. This is definitely a possibility, but
since we eat meat only once a week, much of what our family's diet is
based on is milk products. This will be really tough and I will have
to do some reading on the subject.

The 3rd major division of replies I received dealt with doctors and
what they know (the limits of their expertise, esp. when it comes to
celiac patients), particularly neurologists. Some shared their own
horror stories, so my story was put more in  proportion. One even
went so far as to blame me for my stupidity in trusting them!
(Unfortunately, there is some validity to this!)

Two responses suggested I try having the drug compounded at a
'compounding pharmacy'. Interesting idea but I don't know if this
drug can be prepared by a pharmacist in Israel. Would be a good
question to ask.

Someone even suggested that ADD be treated with thyroid drugs, rather
than with Ritalin, as it may be that the child has low thyroid
function. Besides, Ritalin is artificial and has side effects,
whereas thyroid drugs are natural. They suggested reading Ken
Blanchard's book entitled "What Your Doctor May Not Tell You about
Hypothyroidism" and finding a doctor who would be willing to try it.

In talking to the biggest pharmacy in our town, I have discovered
that there are 5 kinds of Ritalin produced by Novatris:
Ritalin 10 mg (regular one) - contains wheat starch
Ritalin SR 20 mg (slow release) - does not contain gluten
Ritalin LA 20 mg (modified release) - coming soon to Israel, so GF
status not yet known
Ritalin LA 30 mg (modified release) - coming soon to Israel, so GF
status not yet known
Ritalin LA 40 mg (modified release) - coming soon to Israel, so GF
status not yet known

As I gather more information and speak to (another) neurologist, I
will update the List on interesting ideas to consider for those of
you in similar situations.

Thanks again for all the responses,
Sharon Marcus
Israel

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