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Hello everyone.  This is a summary of your very kind responses to my
question 'I started a gluten-free diet 18 months ago and am really strict...
However once a week I still get symptoms  - diarrhoea, abnormal tiredness,
brain fog etc'

Firstly a sincere apology for the delay - I have been on holiday.

35 people replied.  Of these, 11 stated that they were also not well yet.
Their replies gave me great encouragement:

1. 2 years (GF) to start improving and still having reactions.
2. Still not perfect - some good days, some bad
3. Still symptoms after 7 months in spite of normal repeat biopsy
4. Several years for me to improve.
5. 4 years gf and still problems but improving
6. 2 years and still improving
7. Still not better 'I know all too well what you mean!'
8. 'Thank God I'm not the only one!'
9. 11 months and still not better
10. 2 years and still not improving in spite of normal biopsy
11. 2 years to start improvment, and not complete at 3.

This was a massive 30% of replies, and indicates that patience and hope and
perseverence are the order of the day.

The advice given and other points were as follows:

3 people suggested other illnesses - anaemia, thyroid disease, stress. Also
yeast infection, refractory sprue, leaky gut.

7 people suggested a food diary, and this I'm doing.

10 people mentioned other foods: yeast, caramel, canola oil, white vinegar,
eggs and dairy, chicken, guar gum, tomatoes, soy, shell fish, casein, etc.
I will add tuna and strawberries.  Some of these foods have been found to
cause problems in some people.

9 people suggested hidden gluten - malt, medications, building materials
etc.

Remedies to prevent reactions: probiotics caps and l glutamine caps
(especially for leaky gut)
For reactions - papaya enzyme, metamucil, veratrum etc.

Thank you, all of you, for your tremendous help.  Keep well,
Tony (Staffordshire, UK)