Archive for ◊ September, 2009 ◊

26 Sep 2009 Dining Out Gluten-Free at Ethnic Restaurants
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by KAY INAMINE
co-founder of Triumph Dining
Triumph Dining

Too many Celiacs are missing a tasty and exciting opportunity: ethnic restaurants. In particular, Thai and Indian food have a wide variety of gluten-free dishes. While it’s true that ethnic restaurants pose unique challenges – unfamiliar foods and language and cultural barriers – these can all be overcome with a little patience, research, and a lot of heart.

First, make sure the restaurant is willing to accommodate you before you sit down. This can be done simply by politely asking the host or manager “I have a restricted diet and cannot eat certain grains like wheat, will you be able to accommodate me?” Why even bother asking? Well, people generally like to keep their word. If a manager says yes and pledges her help, she’ll go that extra mile to make good on her word. Plus, now she’ll be able to point you to the waitperson best equipped to help you.

Especially at ethnic restaurants, however, there is a chance that the host and staff won’t understand you well, or at all. In which case, count yourself lucky that you didn’t already sit down and go find another restaurant. (Luckily, in over a year of gluten-free ethnic restaurant dining, this has never happened to me.)

Now that you have a pledge of help from the restaurant and know that their staff understands you, it’s time to place an order. Don’t be afraid to ask questions! Especially if you communicate how happy you are to be there and how grateful you are for their help, it’s hard for them not to feel a bit flattered and want to help by answering all your questions. If your waitperson does not know the answers to your questions, politely, but firmly, ask them to check with the chef.

Another key to safe dining is asking the right questions, even when you already know the answer! It sounds counter-intuitive, but asking the right questions is a way to get the wait staff thinking about which foods will safe for you. For example, in a Chinese restaurant, you might say “Oh, wontons, those are so good, but those are probably made with wheat, don’t you think?” Sure, you know wontons are made of wheat, but you’re asking not because you don’t know the answer, but to get the waiter’s mind jogging.

And, remember this: it takes months for most Celiacs to learn the gluten-free diet. Sure, it’s easy to spot the obvious offenders like bread, but who knew that soy sauce contained wheat? In other words, don’t expect that your chef can immediately intuit what it took you months to learn!

That means doing a little cuisine-specific research. After all, if the food is different, the sources of gluten – both hidden and common — will be different. That’s why I find most dining cards unhelpful, even when translated into the restaurant’s native language. They simply say “no wheat, rye, barley or oats” and expect the chef to magically understand all the nuances. To address this problem, my husband and I created dining cards for 10 cuisines with cuisine-specific “can eat” and “can’t eat” sections written in the restaurant’s native language, which are available at Triumph Dining – including The Essential Gluten Free Restaurant Guide and Triumph Dining Cards.

Or, you can do your own research. Just make sure it’s first-hand – that is, by talking to the chefs, reading cookbooks, and studying labels at the local ethnic grocer – unfortunately, there’s a lot of incorrect information floating around in Celiac websites and books.

By now, you’ve probably gotten a terrific gluten-free meal! But the process doesn’t end there. Make sure to heartily thank your waitperson, the manager, chef, and anyone else that’s helped you. Tip generously. Tell them how wonderful their food was and that you’ll be back again. You’ll be surprised the next time around at the restaurant’s willingness to go the extra mile and custom create gluten free food just for you!

26 Sep 2009 Voice of Experience

Professional Articles

Celiac Stories
(Submissions Accepted)
Professional Articles

Medically Speaking
May 2006

WHAT IS CELIAC DISEASE?
by: DOUGLAS D. DYKMAN, MD, FACG, FACP
ANNE ARUNDEL GASTROENTEROLOGY ASSOCIATES

Celiac disease, also known as Sprue, or Gluten Sensitive Enteropathy, is a disease that affects the small intestines decreasing its ability to absorb nutrients. Villi, small finger-like protrusions within the small intestines, absorb nutrients from food and pass it into the bloodstream. In Celiac disease, the villi become damaged and can no longer absorb nutrients properly, leading to malnutrition. The damage to the villi is caused whenever gluten, a type of protein, is consumed. The cause of the gluten sensitivity is unknown. Recent studies suggest that Celiac disease, a hereditary disease, is linked with genes on Chromosome 6 involved in the regulation of the body’s response to the gluten protein.
When a person with Celiac disease consumes gluten, their immune system detects the gluten as a foreign substance and attacks the villi, preventing proper absorption of nutrients; resulting in damage to the villi and malnutrition.
Celiac disease is a genetic autoimmune food allergy with symptoms easily mistaken for Irritable Bowel Syndrome, Crohns, and chronic fatigue. Reactions to gluten vary from person to person. The most common symptom in children is irritability. Although uncommon, some people have no symptoms at all, or just subtle nutritional deficiencies or anemia. This can make diagnosis difficult.
When a patient presents with symptoms that may suggest Celiac disease, blood tests or small intestinal biopsies are necessary. Most patients with Celiac disease have increased levels of certain antibodies. A small intestinal biopsy is necessary to confirm the diagnosis. To obtain this biopsy, a small thin tube, called an endoscope, will be inserted into the mouth and sent down to the small intestines for a tissue sample. Most patients prefer to be sedated for this procedure.
Celiac disease is treatable. A lifetime gluten free diet is the only treatment. Villi will self repair and, in most people, within a few months be completely healed and once again functioning properly. Without the consumption of gluten, the immune system stops attacking the villi and the nutrients can be properly absorbed.
Read labels carefully. As of January 1, 2006 the FDA required food labels to clearly state if food products contain protein derived from milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, or soybeans. However, rye, barley, and other grains also contain gluten, and may not be listed.

ARE OATS HARMLESS IN CELIAC DISEASE?
Published on-line, Summer 2005 at www.celiac.com
By Dr. Thomas O’Bryan, DC, CCN, DABCN

Less than a decade ago in Chicago, there was a time when thousands of residents would have claimed that the best basketball team of all time was right here, right now. In the 1990’s, the combined magic of Michael Jordan, Scottie Pippen and the rest of that stellar Bulls team was, to a basketball fan, like nothing ever experienced in the past.
But then, there are those who would argue that a different team of the past (perhaps Larry Bird and the Boston Celtics, or Magic Johnson & Kareem Abdul Jabar of the Los Angeles Lakers) was the best ever. And, there are statistics, personal experience and memories of games played to validate each position; everyone was right within their own world of experience. For an individual with Celiac disease (often referred to as “an allergy to wheat and gluten products”), there are several factors to consider in determining if oats is a safe food. Questions commonly asked by patients with known wheat or gluten sensitivity include:
Oats are not a wheat product. Are oats safe for me to eat?
Can oats have gluten?
My Doctor says that oats are Ok, but I’ve read conflicting reports that say oats are to be avoided. Which is true?
As with the greatest basketball team of all time (the Chicago Bulls), the answer depends on your point of view. You can easily find doctors and researchers who will offer evidence on both sides of these questions. Here’s the latest information to help you in answering these questions for yourself.

There are three factors to be addressed:
1) Is there gluten in oats?
2) Can oats trigger a gluten-type sensitivity reaction?
3) Is there anything else in oats that can be offensive?

Let’s consider these factors one at a time.
First, is there gluten in oats? The clear and uncontested answer is no, there is no gluten in oats. And, yes, there is gluten in oats.
Confused? Here’s why: gluten is an offensive prolamin (simple protein found in seeds) protein found in wheat. It is known to be one of the triggers to the symptoms of Celiac Disease. Avenin is the prolamin protein of oats. It has a different chemical structure than gluten and ‘avenins have been predicted to contain only a few glutamines that can be deaminated by tissue transglutaminase, presumably making avenins less immunogenic’, thus substantially less offensive to the lining of the intestines than gluten [15,16]. The offensive protein in oats is not gluten. So, no, there is no gluten in oats.
And now to the yes answer regarding the gluten content of oats.
In a recent study entitled ‘Gluten Contamination of Commercial Oat Products in the United States’ 14, the author purchased 12 containers of rolled or steel-cut oats representing four different lots of each of three (3) different brands between October 2003 and March 2004 [14]. The three brands were Quaker (processed in Chicago—selected because it is a popular brand of oatmeal in the U.S.), Country Choice (Eden Prairie, Minnesota—because it is certified to be organic) and McCann’s (Odlum Group, Nass, Ireland— because it is processed in an oats-only facility).
Following the Codex limit for naturally occurring gluten-free foods, oat samples were considered gluten-free if they contained 20 parts per million (20 ppm) or less of gluten [17]. The results were startling. All three brands of oats had gluten contamination above 20 ppm in at least two of the four samples tested. Ranges of gluten in the 4 samples from the 3 different companies ranged from:

McCann’s, none to 725 ppm

Country Choice, none to 210 ppm, and

Quaker, 338 to 1807 ppm.

Even the best of the three (Country Choice) was 10 times above the safe limit of gluten contamination, and the worst was 90 times above the limit.
So, even though oats are not composed of gluten, it appears that oats contain gluten more than half the time. And the amount of gluten present is often dangerously high for someone with Celiac Disease.
So, you are asking: Where does the gluten in oats come from? The author of the study wrote: Celiac organizations across the United States continue to advise against the consumption of oats because of concerns that commercial oat products may be contaminated with wheat, barley, or rye during harvesting, transporting, milling and processing. [18]
Can oats trigger a gluten-type sensitivity reaction?
Once again, there are two answers. On one hand, if oats are contaminated with gluten at dangerously high levels more than half the time, the answer would have to be ‘yes’, oats can trigger a gluten-type sensitivity reaction. So, if you are following a strict gluten-free diet, doing very well at food selections, AND eating oats (”because there is no gluten in oats”), you could still have complications of Celiac Disease.
We know that Celiac Disease is a chronic inflammatory immune response in the intestines and other tissues due to gluten exposure[1]. Is it safe to eat oats on a gluten-free diet? Given the above information, it is likely not safe for celiac patients to eat oats or oat products. Can oats trigger a gluten-type sensitivity reaction? This second question has to do with the composition of oats. Due to the protein in oats (avenin) having such a different chemical structure, it has been predicted to be much less offensive to the immune system making oats less immunogenic (immune system stimulating) [2,3]. And there have been a number of studies that have suggested oats do not trigger the same type of immune response as gluten [4-11].
However, there have been studies on the other side of the coin that identify an immune response of some type. A recent study of 39 Finnish patients randomized to eat a gluten-free diet with 50 grams of oats daily or a standard gluten-free diet for one year reported more intestinal symptoms and more gut inflammation in the group of patients eating oats [13]. The researchers wanted to find out why this was happening to some Celiac patients. When searching for the mechanism that was causing an oat-sensitivity reaction for some celiacs, they discovered a similar-to-gluten type of immune system response in the intestines. They described their rational as:
“We established oats-avenin-specific and -reactive intestinal T-cell lines from these three patients, as well as from two other patients who appeared to tolerate oats. The avenin-reactive T-cell lines recognized avenin peptides in the context of HLA-DQ2. These peptides have sequences rich in proline and glutamine residues closely resembling wheat gluten epitopes. Deamidation(glutamine!glutamic acid conversion) by tissue transglutaminase was involved in the avenin epitope formation. We conclude that some celiac disease patients have avenin-reactive mucosal T-cells that can cause mucosal inflammation. Oat intolerance may be a reason for villous atrophy and inflammation in patients with celiac disease who are eating oats but otherwise are adhering to a strict gluten-free diet. Clinical follow-up of celiac disease patients eating oats is advisable.” [12]

SUMMARY
Although technically there is no gluten in oats, and Celiac Disease is associated with gluten exposure, it is a roll of the dice for celiac patients to eat oats for 2 reasons:
given the frequency of contamination of oats with gluten, it is impossible to be assured of a gluten-free oat product.
some Celiac patients (and as of yet it is impossible to know who), appear to have an immune system sensitivity reaction to oats similar to gluten.
Thus the safest approach at this point, may be to include elimination of oats to a gluten-free diet, allow the intestines to heal (and have that documented with a recheck endoscopic exam), then do an oat-challenge diet and recheck for indicators of an immune-reactivated response (fecal transglutaminase, serum antibody elevations, endoscopic re-evaluation) for the beginnings of intestinal damage reoccurring. This is a timely process (and a nuisance for the patient), but if one wants to eat oats, it may be the only way to be certain of its safety.

Bibliography
1) Sollid LM (2002) Coeliac disease: Dissecting a complex inflammatory disorder. Nat Rev Immunol 2: 647-655.
2) Vader LW, de Ru A, van Der WY, Kooy YM, Benckhuijsen W, et al. (2002), Specificity of tissue transglutaminase explains cereal toxicity in celiac disease. J Exp Med 195: 643-649.
3) Piper JL, Gray GM, Khosla C (2002) High selectivity of human tissue transglutaminase for immunoactive gliadin peptides: Implications for celiac sprue. Biochemistry 41: 386-393.
4) Janatuinen EK, Pikkarainen PH, Kemppainen TA, Kosma VM, Jarvinen RM, et al. (1995) A comparison of diets with and without oats in adults with celiac disease. N Engl J Med 333: 1033-1037.
5) Srinivasan U, Leonard N, Jones E, Kasarda DD, Weir DG, et al. (1996) Absence of oats toxicity in adult coeliac disease. BMJ 313: 1300-1301.
6) Hardman CM, Garioch JJ, Leonard JN, Thomas HJ, Walker MM, et al. (1997) Absence of toxicity of oats in patients with dermatitis herpetiformis. N Engl J Med 337: 1884-1887.
7) Reunala T, Collin P, Holm K, Pikkarainen P, Miettinen A, et al. (1998) Tolerance to oats in dermatitis herpetiformis. Gut 43: 490-493.
8) Hoffenberg EJ, Haas J, Drescher A, Barnhurst R, Osberg I, et al. (2000) A trial of oats in children with newly diagnosed celiac disease. J Pediatr 137: 361-366.
9) Janatuinen EK, Kemppainen TA, Julkunen RJ, Kosma VM, Maki M, et al.(2002) No harm from five year ingestion of oats in coeliac disease. Gut 50:332-335.
10) Størsrud S, Olsson M, Arvidsson LR, Nilsson LA, Nilsson O, et al. (2003),Adult coeliac patients do tolerate large amounts of oats. Eur J Clin Nutr 57:163-169.
11) HÖ gberg L, Laurin P, Fa¨ lth-Magnusson K, Grant C, Grodzinsky E, et al.(2004) Oats to children with newly diagnosed coeliac disease: A randomized double blind study. Gut 53: 649-654.
12) Helene Arentz-Hansen1, Burkhard Fleckenstein1,2, Øyvind Molberg1, Helge Scott3, Frits Koning4, Gunther Jung5, Peter Roepstorff2, Knut E. A. Lundin1,6, Ludvig M. Sollid1*, The Molecular Basis for Oat Intolerance in Patients with Celiac Disease, PLoS Medicine | http://www.plosmedicine.org, October 2004 | Volume 1 | Issue
13) Pera¨ aho M, Kaukinen K, Mustalahti K, Vuolteenaho N, Ma¨ ki M, et al. (2004) Effect of an oats-containing gluten-free diet on symptoms and quality of life in coeliac disease. A randomized study. Scand J Gastroenterol 39: 27-31
14) Thompson,T., Gluten Contamination of Commercial Oat Products in the United States, NEJM,Nov.4,2004,2021-22
15) Vader LW, de Ru A, van Der WY, Kooy YM, Benckhuijsen W, et al. (2002) Specificity of tissue transglutaminase explains cereal toxicity in celiac disease. J Exp Med 195: 643-649.
16) Piper JL, Gray GM, Khosla C (2002) High selectivity of human tissue transglutaminase for immunoactive gliadin peptides: Implications for celiac sprue. Biochemistry 41: 386-393.
17) Joint FAO/WHO Food Standards Program, Codex Committee on Nutrition and Foods for Special Dietary Uses. Draft revised standard for gluten-free foods. CX/NFSDU 98/4 July 1998: 1-4, http://intl-spectrum.diabetesjournals.org/cgi/content/full/15/3/197
18) Thompson,T. Oats and the Gluten-Free Diet, J Am Diet Assoc. 2003;103,876-9.

Celiac Stories

A Young Celiac’s Story
April 2006

As far back as I can remember I would frequently get stomach pains and cramps to a point where I was bent over crying. Naturally, the doctor said it was just stomach aches, maybe from something that didn’t agree with me. I was nine when my mom took me to another pediatrician, for the same reasons. My new doctor wanted me to have an Upper GI. He concluded that I had Acid Reflux Disease and put me on medication. Still, the pain persisted. Soon afterwards, I was diagnosed with Lactose Intolerance, which seemed likely because my sister has it. While the symptoms felt somewhat relieved, I would still experience stomach pain. For six years, I avoided dairy completely. In that span of time, I was tested for other illnesses such as diabetes, because I was still not feeling 100%. Every test came back negative. It wasn’t until my first year of college when the symptoms became so severe that I decided it was time to get down to the bottom of things. I had almost completely stopped eating, for every time I ate, my stomach would blow up so much it looked like I was six months pregnant, and the pain was so intense that all I could do was curl myself up in a ball and cry, and just wait until it passed. Right after Christmas of that year, I first saw my primary care physician. She sent me to a gastroenterologist who ran a series of tests on me. I had a sigmyoscopy, upper endoscopy, and he put me on medicine, for once again, Acid Reflux Disease. He also said I could possibly have Irritable Bowl Syndrome and put me on medication for that as well. Within a couple weeks, I had an appointment with him because neither medication was helping me. At this visit, he told me it was in my head and to take up yoga. That was the last time I went to him. Within this time, I was taken to the emergency room twice. My body was so weak and frail, and I was constantly sick. The first time I was in the hospital, I had a CT scan done and, as usual, empty results. The doctor there sent me to a gynecologist, and again, no answers.

My second trip to the hospital was pretty much the same. I had x-rays taken and yet another CT scan, which shockingly, showed nothing! At this point, I spent more time in bed then out of bed, and at one time, I lost 11 pounds in just a week and a half. I finally found a gastroenterologist who actually wanted to help me and find out what was wrong with me. He ordered an array of tests to be done on me such as a pelvic sonogram, an upper GI, a small bowel series, a colonoscopy, and blood work for something he called Celiac Sprue. After going through these series of tests, which all came back negative, I received a phone call from one of his nurses one afternoon. She explained to me that my Celiac Sprue level from my blood work came back severely elevated and the doctor wanted to do an endoscopy to confirm the results. I had no idea what Celiac was, or what I was in for. I immediately researched it online and while I was reading about it, I thought to myself, “How am I ever going to deal with this?” I was put on a gluten-free diet and responded to it so well, that within two weeks, my symptoms almost disappeared. From the beginning, I still avoided dairy, but I eventually reintroduced it back into my diet and found that I can only tolerate small amounts of it here and there. I also developed Hypoglycemia and had to learn how to control that as well. Now, I have been a Celiac for a little over a year and I am still discovering the world of our food, and what it is like being gluten-free.

I am the only one in my family who has been diagnosed with Celiac Disease. My sister was the only other family member who was screened for it; however, it was negative. At first, it was extremely difficult, especially with cross contamination. Some people think it is ridiculous having an intolerance to wheat, or gluten, and I used to get all sorts of comments and looks because of that, even from some of my own extended family members. With the help of my mom, we tried educating others about Celiac Disease and the foods I can and cannot eat. Also, that it is just not simply, oops- I ate gluten, oh well, but rather, if I ingest gluten by mistake it basically eats away my insides. Over time, they slowly got a grasp on what Celiac is all about, however, to them; it is much easier to ignore it, then to deal with it. At family gatherings, my mom always has food for me, and will bring “my” food over to others houses as well. She’ll put it off in the corner so no one else touches it. I learned not to eat from salad bars, or appetizers, which have the same effect of a salad bar with cross contamination. I learned not to trust anyone outside of my immediate family when they say it’s “gluten-free.” I learned to have my own toaster, jar of peanut butter, mayo, jelly, etc., and LABEL them as mine. My mom has “my” own shelf in her pantry and freezer. I am still learning about Celiac Disease everyday, and how to bake without real flour.

I have been attending Anne Arundel Community College for the past two years and will be transferring to the University of Maryland, College Park in the fall and be living on my own for the first time. I am bracing myself for what is ahead, because I know it’s not going to be easy dealing with Celiac Disease in that type of environment. We are still figuring out if I will be able to use a meal plan, which is very unlikely, and making sure that I have access to a full kitchen to do my own cooking. Hopefully, I will be able to enrich the universities knowledge of Celiac and increase their awareness about gluten intolerances in regards to their food preparation.

The one thing I told my family from the beginning was not to change their eating habits because of me. It took me awhile to realize that this is permanent, that it’s not going away, so I have to accept it and learn to live with it. It’s still strange not being able to receive communion at church, but that doesn’t mean I cannot receive it in my heart. I always look at it this way: it could be a lot worse, and after what I went through, I thank God I can still eat. Like I said, the hardest part is cross contamination, and getting others to understand what exactly it is I have. And watching others eat pizza!

Julianne Valle
2006

An Adult Celiac’s Story
April 2006

I knew there was something wrong with me. My hands and toes were stiff and painful. I would have bouts of fever before the pain would start. I also had terrible insomnia. I went to my family doctor, several rheumatologists, a neurologist, an infectious disease specialist and an acupuncturist over the course of five years. Nobody seemed to know what was wrong. I started to feel like I was going crazy. One doctor even told me “you just have an auto-immune disease of unknown name that you will just have to live with.”

It was frustrating and made me feel like I was some kind of hypochondriac. Finally, my sister got diagnosed with celiac disease and she told the whole family to get tested. As soon as I was tested and had my small intestine biopsy done, I found out I had celiac disease.

Once I eliminated gluten, the pain stopped and I slept better than ever. I also discovered I have hypothyroidism.

Several things have been frustrating about the diagnosis and the disease. I kept reading that most celiacs are diagnosed after a dramatic weight loss. Didn’t happen to me…..which truly seemed unfair in the whole scheme of things. Then, the doctors said I’d probably lose weight on the diet….didn’t happen. I have struggled with my weight over the years so I kind of felt like I was shortchanged….I got a crappy disease and I didn’t get to have some of the weight loss associated with it. It sounds a bit silly, but it’s just how I felt.

One of the more challenging aspects of the disease for me has been the social aspect. I’ve had a couple of people say to me, “well, I don’t know what to make for you so I’m not sure you’ll want to come to my house.” That has hurt. I’ve tried to help guide them with what I can eat but I find it can be a tough balancing act of getting the food you need and not getting the hosts in a tizzy. In a way, celiac disease has been like other major life-changing events…..marriage, funerals, births….you end up cleaning up your list of friends during each of those events….eliminating some and adding others. I didn’t expect that to happen with my diagnosis and that has saddened me in some ways to discover that some people who I considered friends really have not accepted my reality and have resisted my dietary changes.

The other part of this that has surprised me is that celiac disease really has magnified for me how human doctors and health practitioners really are. I was so frustrated at how limited doctors were in their medical knowledge and later after finally being diagnosed, I was upset at the poor guidance I got from dieticians.

The best guidance I’ve gotten on what to eat and what not to eat has been from an online group called the Silly Yaks and from celiac support groups in Annapolis and Northern Virginia. I know when I inadvertently get gluten because my hands hurt and I don’t sleep well. Restaurants are definitely the toughest place to be because even those that claim to have gluten-free menus can be a pain. I went on a date with my husband to a Legal Seafood’s in Arlington, for example, because they supposedly have gluten-free menus, but after picking three different dishes on that menu (none of which they had that day supposedly), I ended up in tears because they didn’t seem to have anything for me. I look back on that incident and think “I shouldhave left right there and then” and even though I didn’t do it then, that is what I do now if I can’t find something on the menu or the restaurant is unwilling to work with me so that incident served as a proactive learning lesson for me.

I live with my husband and two daughters and fortunately none of them have celiac disease and they are pretty supportive of the dietary changes we have adopted in the house. They tend to like the gluten-free stuff more than I do. I’ve been fortunate to find a lot of different gluten-free foods that I like but I still struggle with trying to find the right balance of how much to eat of them. Since I’m not eating gluten-containing foods, I catch myself eating more gluten-free substitutions to meet that craving. For example, I went to a gluten-free restaurant in New York with my family and ordered like three entrees. I would never have done that in a regular restaurant. I hope with time that craziness will pass.

I have two sisters who have celiac disease and while I never would wish this upon anybody, it helps to have their support and understanding. We can joke about it, compare notes and agonize over it. I know they understand and I feel blessed that they do.

My emotional state is upbeat most of the time, but I won’t kid you and say that it doesn’t bother me. I have several friends struggling with aggressive cancers so my celiac disease seems, if you will, smaller compared to those struggles. But, I know that celiac disease is also my cross to bear and when there is a big pizza and beer party or birthday cake to share at someone’s house, the isolation can be acute. I’m only in my first year of this and one of the blessings in all of this is that I’m taking better care of myself and trusting my ability to read my body better. I’ve always had a love-hate relationship with food and celiac disease has changed that relationship. I look at food from an analytical standpoint so food really isn’t on my mind as much as it used to be. I guess that is one positive outcome.

Ines Alicea
Alexandria, VA

A Parent of Celiac Children
April 2006

I am a Mother of two children with Celiac Disease. My son Aidan, 3, was diagnosed in the Fall of 2005. My daughter Lydia, 5, soon followed with the diagnosis, much to our surprise. Both had blood work and the endoscope to confirm their illness. We were treated by Dr. Fasano at the University of Maryland.

Aidan has always been on the “small” side. Both my husband and I are petite. So though we expressed our concerns about his lack of growth, doctors just eyeballed us and said something like, “Well, he is obviously not going to be a line backer.” But as a Mom you know when something is not quite right. I couldn’t buy him shoes even though he was walking, because they didn’t come that small. He was still wearing 24 months at age 3. In addition, he always had loose, floating stools, perhaps 4 to 5 a day. He struggled further with reflux and asthma-like symptoms, particularly in the winter. In the summer of 2005 his health began to deteriorate. He had chronic asthma problems and developed pneumonia. He also began to complain of stomach pain. “My stomach is hot Mommy.” Doctor’s felt it was a virus, or a side effects of an antibiotic, whatever was going around at the time. In the evening after yet another frustrating visit to the pediatrician’s office, my son grew increasingly worse. At 10:00 p.m. that night his stomach grew quite distended and he sat on the couch in my husband’s arms crying in pain. I was so confused and frightened yet determined to be more assertive for my child’s sake. So I called the pediatrician, at his home, and said “Look, this is not right. He is in extreme pain.” Off to the E.R. we went. Only to come home with a diagnosis of diarrhea and abdominal pain probably related to Rotavirus (It was going around.)

At the same time this was happening, my husband and I were researching on our own and began to suspect Celiac Disease. So the day after our E.R. visit we followed up with our pediatrician and spoke about Celiac Disease. We asked for blood work. A week later, the results confirmed that he was indeed Celiac. From there we went to see Dr. Fasano.

As this disease is genetic, we were all tested. To our surprise and great sadness, we were told Lydia was Celiac too. Looking back, her symptoms were there, just very different then Aidan’s. When Lydia was 10 months old her weight began to drop. (About the same time she would have been eating a lot of gluten!) Our pediatrician at the time referred us to a pediatric gastroenterologist. She briefly mentioned Celiac Disease but dismissed it as an unlikely diagnosis. Unlike Aidan, Lydia has always been in the 95% of height. Her symptoms included constipation and almost daily complaints of stomachaches. We were told to increase her fluids and try stool softeners. In addition, Lydia would often awaken in the middle of the night crying her legs hurt. We had her X-rayed twice; no findings. The pediatricians said it was “growing pains.” We now know it was joint pain, a symptom of Celiac Disease.

Living with the disease…ah, the gluten free life! The good news is that we noticed changes in both children within a week. No more stomach aches! With 6 months of gluten-free food in their bellies both children are doing great. Aidan grew two shoe sizes in a mater of months. His belly is no longer the biggest part of him. He tires less and his asthma-like symptoms have almost disappeared. We were able to manage his colds this winter with just over the counter medication. He is still on medicine for reflux and growth is still slow, though Dr. Fasano thinks he will catch up as it is still early in his recovery. Lydia’s stomachaches and joint pain disappeared almost immediately!

How do you cope as a family? You don’t have much time to think about your emotions because you need to learn quickly as your children are waiting with hungry mouths for their next meal. It is stressful, overwhelming, and confusing to say the least. But you learn as you go. Initially, my husband and I were very depressed. I think I withdrew from friends and family for the first four months. Mostly to take it all in and read, read, read. I cried in the grocery stores walking down isles of food my children would never know about let alone taste. No more free cookies at the bakery department. How was I going to explain this one to my 3 year old? Ugh! I became angry at food and how it dominated every gathering – friends, family, holidays. Was there a get-together where food was not an issue – No!

My newest phase of grief – and it truly is a grieving process – is guilt. My husband and I have tested negative thus far. (Though we are looking in to gene testing and will need to get our antibodies checked annually.) We sneak a bagel from time to time, or go for pizza when we have a sitter. We try to enjoy it but we often feel guilty. I know we have more obstacles ahead of us: school lunches, birthday parties, sport celebrations…just to mention a few. I imagine each obstacle we hurdle will tap into different emotions for us all. Sometimes my husband and I will project into the future and feel sad about a certain situation our kids will have to experience that might isolate them. But as my daughter says, “Some day they will find a cure. So keep this candy for me until then.”

The kids are positive about their illness. We are open and honest with each other but we don’t dwell. Kids prefer to socialize and play more often then eat anyway. (We should all try this!) I often mention to them how blessed we are to have them and their celiac bellies. Our kitchen is so much healthier now. And so are we!

Nancy McCamish
Annapolis, MD

P.S. Did I mention that I have never liked to cook and going to more than one grocery store just seemed silly? Boy, am I growing in ways that I didn’t plan!

26 Sep 2009 CCSG Dining Out
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Title: CCSG Dining Out
Location: Lure’s Bar & Grill in Crownsville, MD
Description: CCSG hosted a gluten-free dining experience!  From appetizer to dessert!  We want to thank Lure’s Bar and Grill in Crownsville, MD for doing such a marvelous job and Freedom Bakery in Severna Park for the delicious cakes!  As you can see, everyone had a great time and the food was fabulous! Our plan is to have a quarterly ‘Dining Out’ at local restaurants. If you have any suggestions for locations or would like to help set up a ‘Dining Out’ experience, please contact either Pat  patminn@verizon.net or Bambi sturgeon309@verizon.net.

25 Sep 2009 Caesar’s Pasta All Natural Gluten-Free and Wheat-Free Pasta

Caesar’s Pasta All Natural Gluten-Free and Wheat-Free Pasta Meals Now Available at Select Whole Foods Market Stores 10:04a ET July 8, 2009 (Market Wire)

Caesar’s Pasta Products, a third generation family owned and operated business founded in 1967 that has provided the finest frozen pasta to millions of customers for 42 years, announced today that its new product line of all natural gluten-free and wheat-free pasta meals are now available at select Whole Foods Market stores. Caesar’s organic pasta lines have been available at select Whole Foods Market stores for some time and the partnership expanded with the gluten-free line.

“We are thrilled with our ongoing relationship with Whole Foods Market and to have our gluten-free varieties available at many of their stores. As the leading natural and organic food supermarket, we are pleased to have our product line in their stores. With 42 years’ experience in the pasta industry, people can be assured that we use only the finest ingredients in our products,” said Ronald Lodato, Sr., Vice President at Caesar’s Pasta.

Caesar’s gluten-free and wheat-free specialty pasta meals have received rave reviews from consumers for tasting exactly as “traditional Italian food should taste.” Varieties include stuffed shells in marinara sauce, manicotti in marinara sauce, cheese lasagna and vegetable lasagna. Caesar’s gluten-free meals include pasta noodles made with rice and its perfect texture is tender to the bite.

About Caesar’s Pasta Products

As a family owned and operated business, Caesar’s oversees every step in the manufacturing process to ensure the highest quality and consistency of its food line. For the last 42 years the company has been known exclusively for its dedication to safety and quality; the company uses only the finest ingredients manufactured in their U.S.D.A, HACCP compliant facility. For more information on Caesar’s Pasta, please visit www.caesarspasta.com or call 1-888-43-Caesar.

Submitted by Bonnie Sysko

25 Sep 2009 Is Gluten Making Your Pet Sick?

Food Intolerance – Man and Animals versus Gluten, Casein, Soy, and Corn or How We Won the Battle of “Helm’s Deep” by Dogtor J.

(This is going to be a bit different from most of your medical lectures, I think. I hope you are up for “different”. If nothing else, the hard copy in your conference notes will give you something to read on the plane home.)

“Hmmm… Which metaphor do I use to best illustrate the fate of conventional medicine as we now know it? Which one will give the clearest vision of the dramatic paradigm shift that is now taking place, one that will change the way we practice the art of healing for the rest of man’s days? Which will they grasp, take to heart, and run with to share with their clients, patients, and loved ones, to give them the good news…the fabulous news…this ‘gospel’ of medicine: That we are in sooooooo much more control of our health destinies than we have ever believed, certainly more than we have ever been told? This is awesome news. But how do I take them from the deception that we are “genetically-flawed organisms at the mercy of man’s mechanical and pharmaceutical creations” to the truth that we reap what we sow? Yes, even in medicine, that timeless principle applies. But once again, this is GOOD news.”

Melodrama??? Is this opening statement simply a gimmick to get the attention of the audience? I personally don’t think so…but I hope it worked. It is the truth.

We are all witnessing, at this very moment, the most important shift in medicine of all time as far as I can see. We should be extremely excited to be alive to observe this phenomenal event firsthand, especially those who have been waiting for years to see this transition occur as many of you have. Certainly, there have been many who have known the folly of long-term symptomatic medication: taking aspirin for fevers caused by viruses, stopping intestinal symptoms at all costs, and “relieving” the airway obstructions of nasal congestion and bronchoconstriction that were designed to limit the offending agents that caused the symptoms in the first place. “Oh, now you’re sounding like one of those holistic nuts!” Yup. And their wisdom has been suppressed long enough. The approach that the body never makes mistakes and that all symptoms serve a purpose has been buried long enough….too long…and it is time for it to be resurrected.

So, on to our first metaphor. Man, I love Tolkien. What a phenomenally wise guy, his epic tales overflowing with truth and wisdom about man’s struggle with himself and the forces-at-be. And the conflict for the possession of Middle Earth serves as a fantastic parallel to the one that we face everyday, with every bite and every breath… and every pill… in the battle for our health. There are many foe and there are huge towers that loom over the battlefield, housing those that create the enemy and direct them into our fields. One of these towers was constructed by men and the forces that drive them in what will be seen as a vain attempt to control man’s medical plight through the use of “magic”, potions as they were once called, to reverse symptoms that came upon the unfortunate victims of illness. “Do you have fever? Not any more. We have a pill for that. Do you have heartburn? Not anymore. We have a bunch of pills for that. Do you have fibromyalgia? Well, we have lots of pills for that one. And, they work ‘OK’, but you will still suffer a bit… as your bank account dwindles. Do you have cancer? Well, we have soooo much that we can do, but it is a bit of a crap-shoot. You may survive your particular form of this disease with therapy or you may die actually sooner if we treat you. On the other hand, you may conquer this one but die of a different cancer. We won’t really know ’til we try.”

Folks, we are in the year 2005 as I write this piece. We have now placed man-made landers on the moon, Mars, and Titan…one of the moons of Saturn, on the other side of the asteroid belt and Jupiter (Wow!)…but we still don’t know that it is total folly to artificially kill a fever that our body produces solely to control the virus that caused it. Yes, we are still in the Dark Ages of medicine, so the Lord of the Rings analogy is very appropriate. We might as well be wearing animal skins to work instead of lab coats. If we don’t know that it is totally insane to stop a vital fever then we certainly can’t see that acid blockers unleash Helicobacter pylori, (who has been cultured from atherosclerotic plaques of coronary and carotid arteries) or that some of the immunosuppressive elements of cancer “therapy” are counterproductive when it comes to fighting all of the viruses that caused the cancer to begin with. (Just thought I’d quickly throw in a little actual medicine at this point.)

But…BUT… here’s the cool thing. We have just been through the battle at Helm’s Deep. For you Tolkien fans, you know that this was a huge turning point in J. R. R. Tolkien’s portrayal of the battle for Middle Earth. The forces that were bent on the destruction of mankind were coming against the remnants of man, who were hold-up in a fortress built into a mountain. It was a seemingly solid foundation from which to defend against the oncoming hordes, but the numbers and armaments of the enemy were potentially devastating. As the evil forces approached and the battle ensued, it appeared hopeless for man, battling side by side with elves (angels) and dwarfs. The leaders of those in the fortress decided to ride out to meet the enemy, a valiant move but one that seemed certain to seal their doom. But then, over the hill…in a flash of light…came Gandalf and a tremendous army on horseback, who divided the enemy, slaying many and sending the remainder running back to their towers to recover and regroup. Victory was man’s, for the moment. We dodged a bullet as they say today. But shortly, the real battle was to begin…the final battle for Middle Earth and the ultimate survival of mankind.

Oh, how myth puts things in perspective, eh? As a wise author named John Eldridge just wrote in his book Waking the Dead, myths are not simply fictional stories made up to entertain us. They are poignant tales that illustrate timeless truths. They paint mental pictures of these truths that we can draw upon to visualize things that we know to be true in our hearts. They give us faith, hope, and strength to go against what often seem like insurmountable odds to accomplish vitally important tasks and reach our goals. In those myths, we win Helm’s Deep against all odds; Cinderella rises from the ashes to marry the Prince; the Lion King grows up, remembers who he is, and takes his rightful place in the Kingdom; Fiona finds out that she would rather be an ogre and live happily ever after with Shrek than take her “rightful” place in her previous world. They all illustrate how man’s undying spirit can help conquer those circumstances that would hold him back.

In my mind, nothing illustrates our struggle to learn the truth about medicine (and other life lessons) better than Tolkien’s trilogy. All of the elements are there, including things “seen” and “unseen”. It is the classic struggle involving good and “evil“, with man and his knowledge, beliefs, and shortcomings all working together and in opposition to produce the battle of…and for…our lifetime. All of the players are there: the wise masters; those that were seduced by “the dark side”; elements of greed, ignorance, and lust for power; and the undercurrent in which man searching desperately for truth, wisdom, and justice and the reason that all of this is taking place.

“So, enough of the stage-setting.” you might be saying. “How in the world did you get Helm’s Deep out of the current medical situation in which we find ourselves and why all of the ‘prophetic’ references?” Well then, let’s get to it. We’ll start with a news flash. A relatively small band of men have finally understood the vital importance of…this is so cool…FOOD in our health. Wow! What year is it again? How long have we been saying, “You are what you eat?” But, how many have understood this and grasped the full meaning of that statement and what has unfortunately become a worn out cliché’?

Many think in limited terms, I’m afraid, supposing that this expression means things like “eat your broccoli” or “don’t eat too much saturated fat”. Little do they know that the actual staples of their diet are harming them with every bite and setting the stage for most of the plagues that will befall them. When we add in the man-made chemicals, preservatives, colorings, and flavor enhancers, the self-induced nature of our suffering should become readily apparent.

A whopping 75% of the calories in the Standard American Diet (appropriately abbreviated the S.A.D.) come from the number one and number two human, dog, and cat food allergens: cow’s milk and wheat. Why they are the top allergens and why soy and corn join them to round out the top four will be the main topics of this discussion. But as if this is not bad enough, 90% of prepared human foods have hydrogenated oils in them and 60% have MSG (monosodium glutamate), which we will be talking about very shortly. Throw in things like aspartame (a known neurotoxin and MSG’s evil twin), tons of sugar and salt, preservatives, chemicals, estrogens, pesticide residues, and more and you have a pretty good start on how we arrived at Helm’s Deep. When we see that the vast majority of pet foods are made with their main allergens, then we can understand why these little angels (elves) and dwarves are fighting right along side of us. Oh, and we can’t forget the horses. They are vitally involved in this battle.

But, the real question (and this is huge) is “Why are cow milk and wheat the number one and two human, dog, and cat food allergens?” The answer is so simply that it is literally stupefying. There are substances in these “foods” and the other primary food allergens (soy and corn) that do physical harm to the intestinal tract, thereby eliciting an immune response. Part of this response is intended to go off to distant locations (skin, ears, lungs, brain, etc) to warn us that the damage is taking place. Yes, the enemy is sneaky and their initial attack on the headquarters of our camp is cloaked in secrecy. But, those with their eyes open should see the smoke rising from that assault.

In cow’s milk the culprit is casein, a very powerful glycoprotein, from which they make waterproof industrial adhesives. “What?” Yes, they make GLUE from casein. Who’s picture is on the bottle of a very popular brand of household glue, one that the kids could eat in elementary school if they had a craving for it (which we will also cover)? Yep, a well-known dairy company makes that glue and the cow is on the label. It is made from casein. And, it DOES stick to your (and your pet’s) gut, primarily that first stretch of the intestinal tract known as the duodenum, keeping this vital section of bowel from functioning optimally. Its adhesive properties are advertised in the form of a moustache in the ever-popular “Got glue?” ads. Stick out your tongue after drinking milk. Yuck! Is it really a stretch to think that it sticks to out intestinal tract? The thinking person is saying, “But the stomach breaks it down, doesn’t it?” The bad news is that, even with the tons of acid it produces…and the heartburn and chronic gastritis that follows…the glue still survives to reach the duodenum. (Only the fermentation process that takes place in the fore stomachs of the ruminant destroys this glue.)

Who knows this and how do we know? Most doctors both know and don’t understand this. (”Huh?”) It’s a conundrum to me, too. How can they know to tell you not to take certain medications with milk because it will block the absorption of that drug and not know that milk physically blocks other things at the same time? How can some pediatricians tell new moms not to give cow milk products until the baby is on an iron-rich diet and not see that this same milk blocks iron absorption in adults, contributing to the fact that iron-deficiency anemia is the number one nutritional deficiency in the world, including in these United States…the red-meat-consumption capital of the world. How can that be? Simply stated, we are not absorbing what we consume. And now we know EXACTLY why, don’t we? But, cow’s milk and casein are only the beginning. (Note: Why do I keep specifying cow’s milk? Here is the neat thing: goat milk is nearly devoid of casein, which is real reason why goat milk is considered the “universal foster milk”…and why the Greeks elevated the goat into the heavens…for the milk it gave. All mammals could be successfully raised on goat milk. BUT, feed those same infant mammals cow‘s milk and watch how many come apart at the seams. The casein is the culprit, NOT the lactose. Goat’s milk has plenty of lactose. So much for that deception.)

Here is the important thing. The other “foods” that coat (and subsequently damage) the intestinal villi…and the ONLY ones that do this along with casein…are gluten, soy, and corn. These are the big four or the “four horsemen of the apocalypse” as I now like to call them. And it is man and animals against casein, gluten, soy, and corn as the title implies. The strongest evidence of their potential harm is found in the fact that all of these food elements are used to make adhesives…powerful adhesives. Casein, gluten and soy are the strongest, stickiest, and most powerfully antigenic glycoproteins while corn is a slightly less powerful but nonetheless very significant player (especially the corn that we have recently created). They put cars together with the super-glues manufactured from soy protein. They make waterproof industrial adhesives from casein and gluten that are used for numerous purposes ranging from the glue on stamps and envelopes to putting metal together. But, the “best” they can do with corn glues is to put cardboard boxes together. So, we see why the FDA and veterinary lists of food allergens are what they are: in order, the (primary) food allergens are cow’s milk, wheat, soy, and corn. (We will discuss “secondary” allergens in a moment.) Soy could become number one…if that were possible. Fortunately, there are too many soy opponents who will keep this from happening.

Now, here is what should really grab attention of veterinarians and (hopefully) not let go. Talk about hindsight being 20:20. When I graduated from vet school 26 years ago, dog foods were corn-based. (Keep in mind that corn has been modified to “death” over the past 25 years. Ever hear the term “hybrid corn“? Do you remember the Starlink /CRY9C corn scare a while back and how Taco Bell took the fall for that one? You only heard the beginning of that story.) The bottom line is that corn was bad enough and was, in retrospect, causing so many of the problems that we saw back then, especially in the “trouble breeds”: the German shepherd, Poodle, Cocker, Shar Pei, some giant breeds, and the Irish setter. (Remember when there were Irish setters around? We’ll be getting to that soon.)

But…BUT…when we started adding wheat to the diet of pets about ten years later, we effectively landed the single-most devastating blow to veterinary health that we had struck since adding a milk coating to the puppy and kitten chows. Don’t let that last part slip past you, either. The cow’s milk coating we had on the growth formulas was a HUGE problem that we are just now seeing the vital importance of. In a recent medical study, researchers in human medicine found that our children that ingested cow’s milk in the first five days of life had a staggering 40-50 times higher rate of asthma, type-1 diabetes, and juvenile-onset rheumatoid arthritis when compared to the general population. Oh, no! How could that be? You need to remember what is going on in the gut and immune system of the newborn during the first five days of life as well as understand the concept of “lectins”…antibody-sized glycoproteins derived from the big four…to really grasp the importance of this cataclysmic mistake. Much of this particular issue is outside of the time restraints of this presentation but I think you will find that this “fun fact” fits right into the grand scheme of things. We will discuss lectins a bit later, however.

So, we added wheat to the pet foods about 16 years ago. Why? Did we not know better? Yes, we did. Veterinary texts in print at that time boldly listed cow milk and wheat as the leading food allergens. So, why did we do it? (Hmmm… Remember those powers and principalities I alluded to in the opening comments. Their two most formidable manifestations are greed and ignorance.) Actually, there was a geopolitical phenomenon that occurred at that time. We had a “wheat glut” develop in this country as a result of numerous factors, including the fact that China became the number one grower of wheat in the world and thereby stopped importing it from us (an amazing transition in their diet which has its own prophetic implications). We had more wheat in this country than we knew what to do with (and we are repeating history with SOY right now. There is no new thing under the sun. Ecclesiastes 1:9). Therefore, wheat became cheaper than corn and the pet food companies started making kibble from wheat instead of corn. So easy to see…in retrospect.

The fact is that I remember that time now like it was yesterday. I was practicing in California and suddenly my colleagues and I were talking about how sick dogs and cats were rather than our golf games when we went to lunch. It is now a well-defined moment of time in my memory that still shocks me when I think about it. Man, talk again about 20:20 hindsight. Suddenly, every dog had allergies, immune-mediated diseases, and cancer, not just the usual suspects. When I went to school the subject of allergies (atopy) was just another lecture, not the lecture. In an instant, the mutts from the pound were just as riddled with allergies as the pure-breeds. The old adage of “Heinz 57″ dogs being healthier than pure breeds was becoming less and less true. Breeds like the Golden retriever were turning into money pits and their owners were saying things like “I love this breed but I can’t afford to have another one.” You as veterinarians remember this all happening, don’t you? If not, you may be too young or just need your memory jogged…or your glasses adjusted…as did some of my educators.

I was at an orthopedic seminar recently put on by the guys who taught me at Auburn University. They were concentrating on the topic of juvenile bone diseases and the same breeds kept popping up on the slides: the Rottweiler, the Lab, the German shepherd, the Rottie again, another Lab, another Lab, and yet another Lab. You get the picture. They also mentioned how they had learned through experience that the puppy chows were harming these dogs more than the adult foods. They weren’t sure exactly why that was so but they no longer recommended the “high-powered” puppy foods for rapidly growing breeds that were prone to these conditions. I was squirming in my chair like a four year old that needed to go to the restroom.

After the lecture, I approached one of the instructors (one of my favorites of all time…still is) and asked him a question. “Where are all of the Irish setters these days? I noticed that you don’t have them up there in your slides anymore,” and I smiled a really big, leading smile. He said, “I don’t know. Now that you mention it, we don’t see that breed much anymore, do we? Why do you ask? Do you know why we don’t see them?” (Chuckle, chuckle.) I said “As a matter of fact, I do know why they’re not around much anymore. That’s what happens when you feed a celiac lots and lots of wheat.” (Blank stare). I asked, “Do you remember what celiac disease is?” He thought for a pretty long moment and said that he didn’t. It sounded familiar but he couldn’t recall. I reminded him that celiac disease was gluten intolerance, an immune-mediated reaction to gluten in wheat, and that the Irish setter was the only breed KNOWN to be afflicted with this condition in the veterinary literature. I went on to explain how we transitioned from corn to wheat after I graduated and that once we did, the Irish setter became nearly “extinct”…end of story. He was truly amazed at my insight. As people were starting to crowd around him, I told him that this was just the tip of the tip of the tip of the iceberg and that I would talk to him more about it later. I went on to compose a five-page letter on my laptop that day and give it to all of the lecturers at the end of the session, explaining how this had become my “mission” (and that this was going to be the contribution that the Upjohn representative was “expecting” when he handed me the Upjohn Award for outstanding senior student in small animal medicine…twenty-some-odd years late). I never heard from any of those instructors again, despite follow-up Emails.

Why didn’t they see the vital importance of what I was trying to share with them? Why didn’t they see the link between celiac disease, the demise of certain breeds, and the fact that puppy chows were worsening juvenile bone diseases? It was right in front of their faces. Are we all that blind? Have we all had the brains washed right out of us in medical schools? Do we really think we know everything when, in fact, we understand very little and are confounded by the knowledge that we do have?

Here is the key!!! As lecturers (and preachers) are fond of saying, “If you get one thing from what I say today then please get this.” The duodenum is “Pandora’s Box”. There. Got it? You can go home now. LOL. What? You don’t understand? I’ll say it more slowly. “The duodenum….is…..Pandora’s…….Box.” Of course you don’t understand…. yet! But you will and this little gimmick will help to keep it in your frontal lobe, I hope. Why do I call the duodenum “Pandora’s Box”? Because, once you “open” it (damage it), you unleash the plagues…and potentially all of the plagues…that can befall man and animals. “Now wait a minute”, you might say. “I have been following this up to now but you are waaaay over the top now.” Hold on. This is going to be good…really good.

The sad and startling fact is that I have yet to meet a health professional (MD, DVM, or nurse) that has been able to tell me what the duodenum ABSORBS. In fact, I have had numerous casual conversations with members of all of these professions during which they looked me in the eye and boldly stated that the duodenum absorbs “nothing”. Then, once I remove the dagger from my heart (not throwing stones, of course, because before five years ago, I didn’t know either), I go on to explain that the duodenum does nothing less than absorb the vast majority of our calcium, iron, iodine, B complex, vitamin C, zinc, boron, lithium, chromium, magnesium, lithium, manganese, blah, blah, and blah. In fact, it absorbs just about everything but our calories, proteins, fats, and fat-soluble vitamins (which is a lot of course). The amazing fact is that 95% of our vitamin D activity takes place in the proximal one-third of our duodenum, where the initial and majority of damage caused by the “big four” glue-foods take place.

Yes, the “glue foods” (as I like to refer to them) leave the stomach…glug, glug, glug…and coat the villi of the duodenum (and jejunum), especially the first one-third of the duodenum. Then, those glycoproteins from the gluten grains (wheat, barley, and rye), casein, soy, and corn induce an immune response in susceptible individuals. Certainly, not all people or pets have an immune response to these glues, but according to recent studies, the incidence is so much higher than once thought that anyone who understands this should have the same medical “revelation” that I have had…that we have found the “mother lode”.

When I was diagnosed as a celiac 5 years ago, it was considered a “rare disorder occurring in less than 1:5,000 people”. No wonder doctors (and veterinarians) had forgotten about it. But, in the first week of study about my new-found condition…the one that explained everything that was currently plaguing me and all that had been wrong with me since I could remember…I found that they were diagnosing people on the other side of the Atlantic at the rate of over 1:100. “Say what??? How could it be rare over here, when most of us came from those people…Anglo-Saxons, Italians, Scandinavians, French and Germans?” Yes, there was something amiss. So, I jumped into the study of celiac disease with both feet, discovering that casein, soy, and corn all did the same thing as gluten. I also found out the truth about hydrogenated oils, MSG, aspartame, sugar, the lactose myth, air pollution, and much, much more. (It was so profound that I started a parallel study in religion and prophecy. But that’s a whole ‘nother sermon. Smile.)

I began writing to one of my best friends from high school, an internist at one of our biggest local hospitals. He casually stated that he was glad to see that I was feeling well but that celiac disease was “rare” and that I was simply doing what many do that finally get properly diagnosed with a chronic condition… projecting my illness upon others. At the time, that upset me and I started writing to him like an angry prophet, advising him that if he wanted to get way ahead of the pack, he would start learning all that he could about celiac disease. I even asked him if he believed in God, “because this revelation was Biblical in proportion”. That settled it… I was “nuts”.

But, he was the one who sent me the New England Journal of Medicine article about eight months later that boldly labeled celiac disease as the most under-diagnosed (and misdiagnosed) condition in the country and stated that it was occurring in at least 1:250 Americans without their knowledge. “Na, na, na, na, na,!” (LOL). Actually, I did not call him and rub it in. By then, I had experienced a few of what I call “Jonah experiences”, learning that you catch more flies with honey. Plus, I had received a pretty good glimpse of how and why something this important could be so unknown and misunderstood…and why things were sooooo upside down. The fact is that the Mayo Clinic and Johns Hopkins University published their incidence studies last year and found celiac disease to afflict 1:122 Americans. Yes, that is the new “official” number. However, the unofficial number published by celiac authorities is 1:33. Whoa!

But here’s the “bad news”. (Actually, you will come to see that this, again, is good news.) We are only talking about celiac disease here. And wheat is the number two food allergen. What is number one again? Cow’s milk (with casein). I wonder what the true incidence of casein-intolerance is? Is it more frequent than gluten intolerance? I would have to believe so. While wheat-containing foods (the targets of Dr. Atkins’ partial truth) make up nearly 25% of the calories of the S.A.D., cow milk products make up a whopping 40% of our overall caloric intake. Errrh!!! What about soy…the “third plague” as I like to call it.. Errrh, again!!! How about corn, the fourth horseman? Here’s a scary thought: What about a mix and match of the four…some or all of the “big four”? Think that happens? Of course it does. These guys can ride separately or they can form a gang. We all know a gang is harder to control, don’t we?

Now for the pathophysiology that you have been waiting for. The food allergies are just the indicators. During the time that the body is reacting to the “glue” from these foods, the IgE antibody…the allergy antibody…is formed to go out and warn us of the damage that is taking place in the duodenum. Otherwise, this is a stealth condition in most cases, with only one-fourth of celiacs and related food intolerants having gastrointestinal symptoms. Get that? That is very important. In fact, this is CRITICAL for all to understand, as it explains much and opens a door through which all truth-seekers must pass. (”There he goes, getting all melodramatic again.”)

Individuals…whether they are humans, dogs, cats, or horses… can go years and years before the bottom drops out of this condition. And it takes the bottom dropping out for most of us to wake up to what’s going on, doesn’t it? We are the masters of denial as well as the patsies of deception. “I’ll do it ’til I have problems. Then, I’ll quit.” (e.g. cigarette smoking, drugs, alcohol, or over-eating). The bad news is that by the time you have obvious problems with your lungs, liver, kidneys, heart, brain, immune system or duodenum, then you are waaaay down the wrong road. It is a consistent pattern that we can live on about 25% of our organ function…one half of one kidney, a fourth of our liver, multiple coronary arteries occluded, numerous neurons destroyed, etc. before (BEFORE) we even start having symptoms. That’s a good news/bad news thing isn’t it? As vets, we know that most of our conditions in the pet are “acute-on-chronic”…acute manifestations of chronic problems. I used to think that this was due to unobservant owners or the laid-back lifestyle of the pet. But when I started seeing friends and loved ones dropping dead of heart attacks and strokes without warning and I found out that atherosclerosis starts as early as 5 years old, I knew that we were missing something. Yep, we are made to take a licking and keep on ticking as the old Timex ads used to say. The bad news is that we are beating our poor bodies (and those of our pets) to death and don’t know it or, at least we don’t fully understand the magnitude of what we are doing with every bite… and breath.

Imagine now that over 1:30 humans have celiac disease or are afflicted with the other related food intolerances (casein, soy, and/or corn)…food induced villous atrophy of the duodenum. It can affect the jejunum as well. We know that this also occurs in the dog, with our old “extinct” friend the Irish setter being the glaring example. (I was absolutely ecstatic to hear that there was a pathologist in a major university in the northeast who has reopened the book on celiac disease.) Now, combine that fact with the consequences of the chronic malabsorption of calcium, iron, iodine, B complex, C, and numerous trace minerals, all of which are vital in the development and normal functioning of our bodies and immune systems. Do you have it in your mind yet? Let it sink in for a second. (Pause)

Which symptoms or clinical signs are likely to show up first? If you said gastrointestinal signs, you would be wrong (unfortunately). If you said signs associated with chronic calcium malabsorption or allergies you would be right. In some it is the former while in others the latter. The “worst of the worst”…those that have the earliest immune reaction to the glue foods…will have the IgE and IgG related symptoms first. These are your infants, human or pets, with congestion, itching, rashes, irritability, chronically sore throats, and ear problems. Some of them do have colic and diarrhea but these should not be required signs to make one suspicious of food problems. The “best of the worst” (and I rarely use the term the “best of the best” anymore) have the signs of calcium malabsorption first if they have any signs at all. Remember: the proximal one-third of the duodenum is greatly responsible for calcium metabolism and absorption. In the best-case scenario, these glue foods form a coating on these villi and keep them from performing optimally. (Here you go. Think of a beautiful coral reef with gorgeous sea anemones and multi-colored sponges. Got it? The “villi” of the anemones are swaying back and forth in the crystal clear water, absorbing small particles of food floating in the water. So serene, so perfect. NOW, imagine that same reef after the oil spill from the Exxon Valdez. Got that? How well do those anemones do when they are coated with oil? Some will survive but many, many will die. I think you have the picture.)

This is what the glycoproteins from gluten, casein, soy, and corn do. They coat the villi…at best…and “kill” the villi at worst, with the first and most severe damage taking place in the proximal third of the duodenum. No wonder I had flat feet, short legs, rib abnormalities and painful joint laxity…and bad teeth…as a child and later developed rotator cuff problems, bilateral inguinal hernias, and premature disc ruptures of my neck and back. I’m a classic celiac.

But now YOU know why the most food allergic dogs have the worst orthopedic problems. How cool is that??? Think about them: the Labs, Rottweilers, German shepherds, the Labs, the Rotties, the Labs, the Labs. Hmmm… I’ve heard that before. (smile). Why is it that they can’t nail down the genetics of hip dysplasia? Hmmm…again. AND, now you know why two of the most food allergic small breeds…the Cocker and Shi Tzu…hold the age record for when they start blowing intervertebral discs. Yep, they do it as early as ONE YEAR OF AGE, don’t they? Why again? They have been malabsorbing the building blocks of their skeletal system (calcium and vitamin C) since they were first put on the grain-infested puppy chows. What makes up collagen, again? So, you also know why the Cavalier King Charles Spaniel (and I have yet to see one that wasn’t severely food allergic) dies of acute mitral valve prolapse at 5 years of age. What is that valve made of again? How did we create the chondrodysplastic breeds like the food allergy afflicted, Demodex-encrusted, cherry-eyed, respiratory challenged, squatty body English bulldog, anyway? Shall I continue? I could give countless examples that would keep us into the wee hours of the morning. I think you are seeing the pattern here, right? The allergies are there to warn us that the damage is taking place in the gut. Again, the allergies are things “seen” to help us understand the things “unseen”. Watch for this pattern. It will come up again and again.

This is only the beginning, unfortunately and fortunately. (Please keep in the very front of your mind that the malabsorption syndrome leads to chronic deficiencies in so many vital nutrients. This is paramount in importance. Keep chanting, “Pandora’s Box, Pandora’s Box.”) We are still on the tip of the tip of the iceberg. And perhaps this is a good time to throw in the other analogy with which I was considering opening this dissertation. Try this one on for size:

Conventional medicine is steaming headlong into an enormous obstacle that is titanic in importance and yet has only a small piece of its mass protruding from the surface right now. The medical establishment (including both human and veterinary) has built a mighty vessel that many would deem unsinkable. “We have made such great gains in extending life” comes the announcement from the captain. “And one day, we will find the cures for cancer and the diseases that plague us all.” And the passengers all say “Hooray!!! It will be clear sailing from there!” The applause dies down and the captain exclaims, “And we are working on better ways to make these necessary drugs more available, more well-known by the public, and more affordable to you. Very soon, many of these drugs will be available over-the-counter and you will no longer need to even consult with your physician about them. Simply choose what is right for you by watching your television and then going to your local drugstore, supermarket, or gas station food mart to pick them up. You will be wise enough to choose for yourself.” Again, the crowd roars with approval.

But, there is something looming in the waters, just off the port bow. Some call it an iceberg. Others call it a “rock”. I call it the Truth. This treatise so far has mapped out the tip of the tip of this iceberg. With the binoculars you now have, you can see it. Do you see it??? If your eyes are good enough, you can see much of what is below the surface, too. The water is a lot clearer out in the ocean than you may think. And this “unsinkable” vessel that man has created is heading straight for it. Why? They are not looking for it. Many are happy, quite content with the cruise they are on. Others don’t really know any other way to behave on a cruise like this. Others are desperately trying to keep those who would worry about icebergs distracted so that they don’t spoil the cruise for the others. Ignorance and greed are at the controls…our two biggest nemeses… with contentment being a first mate.

Suddenly…WHAM…the mighty craft hits “the rock”. It starts to take on water. People are dying from drugs they have taken for years: HRT, NSAIDS, nasal decongestants, and what will be the next group- the cholesterol statin drugs. The epilepsy drugs don’t work anymore and the pets on board are being put to sleep for “non-responsive epilepsy”. The vaccines that were meant to protect us “turn on us”, making us question their role in everything from producing the full clinical disease to hard-to-detect/prove sub-total entities of that disease, such as epilepsy, chronic liver disease, immune glomerulonephritis, cardiomyopathy, or worse. The captain is shouting, “Don’t panic. We will figure out what to do. Calmly man the lifeboats.” But some do panic as they had so much faith in this indestructible piece of man’s technology, the same technology that put landers on the moon, Mars, and Titan.

But, it is this same technology that does not seem to understand that taking an NSAID for a fever caused by a viral infection is not a wise thing to do. It is the same captain’s mates that don’t see that Helicobacter pylori…the opportunistic bacteria that causes deep stomach ulcers…hates an acid stomach and that heartburn is designed partly to control his growth. If they don’t know that, then they certainly can’t see how this beast that they have been feeding with antacids and problem foods leaves the stomach when the individual’s immune system takes a nose dive (after a lifetime of malabsorbing nutrients vital to its health) and takes up residence in a cholesterol plaque (that is safe-guarding a weakened artery) and causes it to break off, inducing a stroke or a myocardial infarction. How can they see that? They have their eyes on the moon and the stars. (And yet, a study done by a group of cardiologists found that a shocking 85% of atherosclerotic plaques that were cultured for H. pylori were positive for this critter. Think about that for a second. Sinking in?)

The iceberg starts by scratching the hull. The captain and crew had early warning signs but it all happened so quickly from there. The destruction continues on and the hull is breached, allowing water to rush in. We are seeing this happen now. People are starting to perish aren’t they?. Next, the boat starts to list to starboard. Passengers are abandoning ship while the crew goes into emergency status. The pumps are started and priorities set. It’s a bit chaotic but many are still being hopeful and thinking positively. Those with vision imagine the worst-case scenario and act accordingly. “I think we can patch this thing up if we back away now and try not to drive this rock any deeper.”

Unfortunately, this is man’s ‘M.O.’, isn’t it? We do have to hit the rocks before we learn many of the important things in life. Well, we have hit them and hit them hard. As I stated so melodramatically in the opening, you are alive to see this paradigm shift that has resulted from hitting this iceberg. The ship is going down. One drug after another has been placed under “the microscope” and failed the acid test. The cans are all falling off the shelf. For those in medicine, the colon contents have hit the fan. Pick a metaphor and run with it.

Thank God there are lifeboats! And there are lots of them…enough to rescue the entire compliment of passengers and crew. It’s just that they are small, spread out, and there doesn’t appear to be enough of them. But there are adequate provisions if we stay calm, work together, pool our resources, and WANT to survive. We have to want to get better and we have to believe that there are lifeboats that can get us to safety. The lifeboats are people who understand nutrition and how the body works. They are wise doctors who listen to their patients before prescribing medication, whether they are conventional or holistic preparations. I look at the Internet as a set of lifeboats, although some of them have holes in them.

What’s the expression? Oh yeah “Knowledge is power.” That is partly right, for sure. Faith is extremely important, as is courage. You must believe and act upon what you think is true. You must be confident, strong, and persistent. So, we need to cover a few more things to build up your faith in the idea that we are in charge of our health destiny more than we have ever been led to believe. It’s not hard to imagine now that you know about the extremely common malabsorption syndrome being induced by the staples of our diet, right? There is more, though…much more.

The two biggest killers of human beings are atherosclerosis and cancer. A person every 3.5 seconds dies of a stroke or heart attack in this country. And yet, the dog does not suffer from this as a lethal, clinical entity… yet! Veterinary pathologists are seeing atherosclerotic changes in the vessels of dogs on necropsy. And this is very important for us to understand. Dogs can have atherosclerosis but they don’t have it badly enough to cause clinical disease. They develop so many of the conditions that take human life, including a higher incidence of cancer, but dogs don’t suffer from this deadly disease process. Why is that? Simply put, they don’t get “enough” hydrogenated oils in their diet. I believe down to my socks that trans fats are the single-most important factor in the development of atherosclerosis…the “solvents” that allow things into the walls of the arteries of those that consume them and set the stage for the inflammatory process that follows. Dogs do get some trans fats in their diet, as they are fed french fries, snack foods and bits of human desserts that are loaded with these culprits. But, they clearly do not get enough to lead to a clinical syndrome. (Please read Hydrogenated Oils-The Silent Killers, by David Dewey on the Internet. Whoa! You will clearly see how and why the first recorded myocardial infarction took place only ten years after hydrogenated oils hit the shelves in the form of margarine. You will also see how and why another plague…type 2 diabetes…”adult-onset” diabetes…followed ten years after that. Hey, dogs don’t get that one either…yet! “20:20″.)

But cancer??? Oh yeah, dogs have lots and lots of cancer. Why is that? Because they have plenty of the viruses that cause cancer and experience the same immune suppression as humans stemming from their diet, the environment, and the drugs they receive. “Back up for minute. That’s the second time you’ve said viruses cause cancer.” Yes, once again, there are medical researchers who have believed for over thirty years that all cancer is viral in origin…not just some, not even most, but all. I personally believe that this is true, especially after spending as much time studying about these guys as I have. And this belief positions all other “carcinogens” where I think they belong: as secondary factors, facilitating the action of the virus by causing immune suppression, chronic tissue damage, and/or damage to our actual DNA, where I believe many of these culprits reside.

The “four horsemen” fit right into the clinical picture here by inducing at least two of the three factors- causing immune suppression and inciting chronic tissue inflammation and damage. The immunosuppressive effects of the big four should be easily imagined. Back to the coral reef covered with oil. How can those villi that are coated with the problem glycoproteins manage to absorb optimal levels of B complex, vitamin C, and other nutrients critical to the health of the immune system? How can they do it when they are leveled by the immune response to the glue foods in true celiac disease or the related conditions of true casein, soy, or corn intolerance? This should be a no-brainer… and it is…. literally. The brain suffers tremendously from the lack of these nutrients along with a concurrent deficiency in calcium, zinc, iron, iodine, and the pandemic omega three fatty acid deficiencies that exist in humans and pets.

Therefore, it shouldn’t be a mystery that cancer is rampant among the three species. The fact that viruses cause cancer is a done deal in veterinary medicine and has been for quite some time. I won’t bore you with the list of examples. And yet, in was not until March of this year…2005…that the American Cancer Society put viruses on their list of carcinogens. How can that be? Are you as baffled by that as I am? Remember those landers on Mars?

Wherever you have immune suppression and chronic inflammation come together then you should look for cancer. Estrogens fit the bill here and therefore should not surprise anyone as leading carcinogens in breast (mammary) cancer. The good news is that the ovaries of the female do not make enough estrogen by themselves to create this dilemma. It is what the individual is consuming (including hormone replacement therapy) or exposed to in the environment (pesticides, environmental toxins, food animal additives, etc) that tips the scales in favor of the cancer (or endometriosis, polycystic ovaries, PMS, catamenial seizures, or other estrogen-related disorders). The “big four” foods fit right in here because the gluten grains, dairy, and soy are loaded with estrogens. Dairy is a huge factor here as it also provides cholesterol precursors to the formation of these hormones. Seeing a pattern here? Yes, the foods that are bad for us are so in a number of ways. So, we should not be surprised to see that Asians have a 15 times lower rate of breast cancer and a 5 times lower rate of prostate cancer…on their native diets. It is NOT because they eat soy. The truth is that they eat very little soy. But they do NOT eat dairy, wheat, or corn in their original diets. Just go to any authentic Japanese or Chinese restaurant and look for the cheese, bread, or corn chips.

Which brings us to “lectins”, something I mentioned a while back. Lectin is the term that has been given to the antibody-sized glycoprotein that is derived from the consumption of foods that are part carbohydrate and part protein (thus the term glyco-protein). Once again, the big four foods are glycoproteins by structure. Our antibodies are also glycoproteins, a protein core with a sticky carbohydrate outer covering to facilitate adherence to foreign proteins such a viruses, bacteria, and the like. In fact, viruses have glycoprotein receptors on them. Normally, our antibodies attach to these sites. Hmmm…I wonder if dietary lectins ever do? Could one plausible explanation for food-induced immune-mediated disease episodes be that the chronic latent viruses in situ in our tissue become coated with dietary glycoproteins rather than our antibodies and that when we develop IgE, IgG, and other antibodies to these foods that our immune system starts to react to these “food-coated” viruses in the host tissue and attack that tissue just as it would if it were a viral infection coated with our own antibodies? Could that be how food lectins such as those from wheat, dairy, soy, or corn auto-agglutinate red blood cells. Maybe it is just the glycoprotein itself that does it in most cases but it sure would help to explain why some “autoimmune diseases” are triggered by foods while others follow viral infections, either naturally acquired or through vaccination. It would also help to explain why avoidance of the trouble foods could greatly reduce the incidence of recurrence of these attacks. (For a well-written discussion on lectins, please look up The Lectin Report on the Internet. It goes into great detail about how these tiny glycoproteins “unlock” the cell and allow things to enter it, inciting inflammation and causing cell death. It’s all about the same guys. The four horsemen ride again.)

The fantastic news is that sooooo much starts going right once the big four are avoided completely and for a long enough time. By avoiding the casein, gluten, soy, and corn, the gut starts to heal and the malabsorption syndrome begins to reverse. How long does it take for the intestine to heal once the offending foods are withdrawn? Well, according to the celiac literature, it takes anywhere from 6 months to 2 years for the duodenum to return to normal. Does that make sense? Not to me, unless you consider the fact that gluten is not the only thing doing the harm to those duodenal villi. This was my first quest, to get on celiac forums and make sure they knew the truth about casein, soy, and corn. I hated reading about celiacs that had struggled so valiantly to be gluten-free only to find that they were shooting themselves in the foot big time by the continued consumption of the other three culprits. Statistically, celiacs have a 50% chance of also being casein intolerant. I have to believe that it is much more common than that. But soy and corn are looming larger and larger as we fall for the myth that soy is a health food, we turn to vegetarianism for various reasons, and we continue to genetically modify corn to death.

Assuming that we do enough right, the gut does heal and probably much more quickly than we currently believe. After all, it is one of the fastest healing tissues in the body. Once healed, it starts to take in all of the calcium, iron, iodine, B complex, vitamin C, and trace minerals that it has been starving for over the past years, often from the moment the individual started consuming the big four. The thyroid becomes healthy, the iron deficiency resolves, enzyme systems start operating at peak efficiency, tissue repairs, and the immune system gets back to normal. And that last item is critical. That’s when many of the long-term symptoms finally resolve…the allergies, GI signs, skin problems, and in the best case scenario, the immune-mediated diseases. I would love to think that the risk of cancer then plummets, as well. What couldn’t our immune system accomplish if it were in optimal condition? I can no longer put limitations of what our body is capable of doing in the way of healing or prevention when I think about that last statement. However, I know that our environment…with its staggering levels of serious pollution…is a HUGE limiting factor. I would love to dive into that topic but time constraints do prevent that.

The really cool thing is that some “completely unexpected” things can happen when individuals go GFCFSFCF (gluten-free, casein-free, soy-free, corn-free). In retrospect, they were “unexpected” only because we had not fully grasped the impact of what we had learned. The most notable…the most amazing…the coolest of the cool…the “hook” as I now call it…was the response of epileptics to this elimination diet. I find it just so utterly fascinating that something we stumble upon can wind up be the glaring example of everything we know… AND end up leading us into realms that we could only dream about in the past. Epilepsy is just that condition.

Man, I could talk about epilepsy for the full two hours- how it all comes about and what the study of this condition has done to my knowledge base . Thankfully, I have chronicled the entire journey on my Website (www.dogtorj.com), starting with how I read the captivating fact that celiac children with epilepsy who went gluten-free often had major reductions in…if not total cessation of…their seizures. “Wow. I wonder why that happens?” I asked myself. “Epilepsy is considered idiopathic in veterinary medicine. There has to be something about wheat that leads to seizures.” Elementary thinking, I know. But, this was novel stuff to me. How about you?

It did not take long at all to find that MSG (monosodium glutamate) could trigger seizures and that wheat gluten was an incredible 25% glutamic acid by weight. “Eureka! Is it that simple? I then found that soy had even more glutamate, almost twice as much as wheat. “Oh, oh.” Casein is 20% glutamic acid by structure. Yep, three of the four horsemen are packing glutamate in their saddlebags. Do the food sources of these neurostimulating… potentially neurotoxic…non-essential amino acids (glutamate and aspartate), really do the same thing to our brain that the “crack cocaine” versions (MSG and aspartame, respectively) do?” I assumed so and started putting my epileptic canine patients on gluten-free diets and, son-of-a-gun, they became vastly improved. Some stopped having seizures completely within 24 hours of the diet change and never seized again. We were onto something… and it was big…really big.

As the significance of these findings sunk in, I threw myself into the study of neurological, psychiatric, and other “idiopathic” neurodegenerative conditions that affect us all. The “excitotoxins” ( MSG and aspartame), as Dr. Russell Blaylock termed them, were well-known culprits and played roles in epilepsy, ADHD, bipolar disease, and more. It wasn’t until later that I would finally start reading about their involvement in the other “big 4″: MS, ALS, Alzheimer’s and Parkinson’s. But still, no one was talking about the FOOD sources of these non-essential amino acids. But it was so simple, and a little something called “insomnia” illustrated the point I was trying to make. These neuroactive amino acids were clearly responsible for waking people up like a shot at 1-2 AM, 5-6 hours after eating dinner and dessert and I was a living example. And that was the exact time interval I was finding between meals and seizures in my un-medicated dogs. Once I published my work on the Web and contacted over 500 breeders in the process (oh, how I love the passion of breeders), the testimonies to these finding were flowing in on a regular basis. And, the pieces to this puzzle started fitting together…phenomenally well.

And here is where it all comes together. I had written a totally different summary for the end of this discussion, but upon proofreading the pages, I realized that the discussion of epilepsy…the condition that grabbed my attention and pulled me into this epic battle at Helm’s Deep…would serve that purpose. It would illustrate all of the principles that I “preach” every day in the exam room and will attempt to enlighten people with (hopefully not bore to death) in lectures like this for the rest of my days.

Principle number one: The foods that are bad for us are bad in numerous ways. The “four horsemen”…gluten (from the grains wheat, barley, rye), casein, soy, and corn terrorize us in more ways than simply inducing villous atrophy, which results in the chronic malabsorption of the essential nutrients that we have covered. These foods provide staggering levels of glutamate (and aspartate), estrogens, allergens, and lectins, and when prepared for consumption, act as carriers of many of man’s worst creations in the form of GMO’s, hormones, and chemical additives. So these foods damage our gut, cause malnutrition of our entire body, and provide many of the ingredients necessary to generate symptoms including pain, sleeplessness, high blood pressure, behavioral disturbances, and seizures.

Applying this to epilepsy, the brain suffers from the malnutrition, the immune system going down, and the rise of chronic latent viruses The war begins. Add to that the vaccination with modified live virus vaccines made with viruses that love the central nervous system. These viruses naturally take up residence in the glial cells of the brain, those cells that control the level of the normal neurotransmitter…our friend glutamate…at the synapse. We have seen vaccine-induced disease in the past, right? How hard is it to believe that this is happening “sub-clinically”? These top allergy-producing foods are also stimulating histamine production, the release of which causes the blood brain barrier to become more permeable to glutamate, a normal occurrence that serves to counteract the depressing effects of histamine. These same foods contain estrogens, both naturally occurring and those from pesticide residues, which are neurostimulating, irritating, and immunosuppressive. P.M.S. anyone? How about catamenial seizures? I hear about them all of the time. The malnutrition that we have discussed then starts to compromise enzyme systems in the liver, kidneys, and elsewhere in the body, some of which are responsible for controlling the blood levels of the evil twins, glutamate and aspartate. No wonder some of us have seizures. The way I see things now, it’s a bigger wonder that more of us don’t have epilepsy.

Are you seeing “Pandora’s Box” opening yet? Have you grasped what these foods – the damage they do and the ingredients they contain – are capable of? Thank Goodness our body knows what to do with all of this mess we put it through, eh? And it does.

Therefore, principle number two: Our body never makes mistakes…ever. Only we make bad choices about what we do to this vessel of ours. “What about birth defects?” is always the first challenge. Certainly, this degenerative process sometimes begins prenatally, leading to premature births and birth defects, but we are ultimately responsible for these occurrences. The more you learn about this topic (and study celiac disease as a model), the less you will simply write off to “genetics” or Providence.

Fevers, heartburn, sore throats, nasal congestion, bronchoconstriction, diarrhea, hives, headaches, and even “autoimmune” attacks have a purpose. Some clinical signs are warning signs that we have made a mistake while others are therapeutic measures on our body’s part. Others are both. “But autoimmune disorders?”, you might question. Yes, I believe down to my socks that viruses are vitally involved in most (if not all) immune-mediated diseases. I believe that the immune-mediated diseases are our immune system’s valiant attempt to wipe out these viruses before they have the opportunity to do what they really “want” to do…cause cancer. This would help to explain why people with chronic active hepatitis have such a high incidence of liver cancer. But it might also help to explain why the same breeds of dogs that develop panosteitis…the ones with all of the allergies and other juvenile bone diseases…are the guys that go on to develop bone cancer at age six and a half. So, is eosinophilic panosteitis our body’s attempt to rid the bone of viruses that might later go on to cause cancer? What are eosinophils involved in other than allergic reactions?

“But get back to seizures. I can’t wait to hear how a seizure is a good thing”, the skeptics are saying. Yes, I am convinced that even seizures serve a vital purpose, that being to burn up the excessive glutamate in the brain. As you may know, no matter what the cause of our bodily death may be, the brain dies as a result of the “glutamate cascade”…the sudden rise of glutamate in the brain resulting from the dying glial cells and increased permeability of the blood brain barrier. Glutamate is potentially…and eventually…neurolethal. How hard is it to believe that seizures are designed to keep the death of vital neurons from happening? The sufferers of ALS (Lou Gehrig’s Disease) sure wish a peripheral neuron could have a seizure. But because they can’t, the neurons eventually die as a result of the excess glutamate in the synapse. But guess what. ALS sufferers have also reported benefits from what I now call “The G.A.R.D”…. the glutamate-aspartate restricted diet. So have people with ADHD, chronic pain, insomnia, MS, and other conditions that have the “excitotoxins” as part of their pathophysiology. This is all on my site.

Seizures may even serve to limit viral infections, if through no other mode of action other than to encourage a rise in body temperature, something that viruses hate. We know that viral infections of the central nervous system are usually accompanied by high fever, right? Remember: That’s a good thing. (I wonder how many people who died of West Nile Virus might have survived if we didn’t treat them so aggressively? Its a parallel to that cancer thing we talked about earlier.)

So, do you see why I got so excited about the role epilepsy would play in bringing people into the fold? It has all of the elements we have discussed…all of the necessary cast, plot, and scenery to make a great and epic tale of how the four horsemen road into town and stole our health. But we really did it to ourselves, didn’t we? We made these bad choices. The fact is man created the wheat we now eat in about 400 AD, introducing lethal quantities of gluten into our diet. A millennium later, we changed milk sources from goats to cows, adding casein to the mix. Now, five hundred years later, we want to start eating soy…“the third plague”…something that has been previously relegated to the lowly positions of a nitrogen-fixing, rotational crop and a mere condiment on the table of our Oriental restaurants. Did we really just get smart enough to see the health benefits of consuming the soybeans themselves? Do we really think that loading our bodies up with plant estrogens, goitrogens, anti-nutrients, villous atrophy inducing “glues”, and staggering levels of the non-essential, epileptogenic amino acid glutamate is going to improve our health. How many trips to Mars are we gonna take, anyway?

We do reap what we sow. Through the eyes of food intolerance, medicine becomes so simple that even* the layperson can understand it. (* I say “even” because I know a growing number of lay people who understand these things much more than the doctors who look down their noses at the “untrained”.) Isn’t that the way it should be? Shouldn’t we all be able to comprehend our medical lives? It is, after all, one of the most important aspects of our existence, isn’t it?

The way I look at it now, our medical lives are divided into three phases: the acquisition of viruses, the progressive malfunction of our body and immune system, and the failure of our immune system. I think you now have a very good idea why that occurs. In a word, malnutrition. Symptomatically, it usually also breaks down into three phases: allergies, immune-mediated diseases, and cancer. We see this so clearly in certain breeds of dogs but I have also heard this sort of history from many, many from people I have interviewed about their own health. Hopefully how and why these three phases occur is much clearer now. The allergies…phase one.. are the warning signs that you are making mistakes. The immune system is throwing warning signs at us while closing the doors to further invasion.

Phase two…the immune-mediated diseases…is the first set of conditions that these allergies were warning you of. They are also a second set of warning signs of increased severity because we didn’t act upon the first set. We usually still have time to get things right owing to the fact that our organs can take a beating and still survive and repair…usually we still have time. Unfortunately, some are lost in phase two due to overwhelming lupus, glomerulonephritis, or the chronic active hepatitis that finally raised its ugly head. As I have mentioned, the last condition in that list is a glaring example of the type of condition that has led me to make some bold statements concerning the role of viruses in immune-mediated diseases AND why phase three…immune failure…often manifests as cancer.

I spoke of bone cancer occurring in problem breeds at 6.5 years of age. What else happens at six to seven years of age in the dog? Better put, what doesn’t happen at that age: tons of immune-mediated diseases, cruciate ruptures, spinal disorders, heart murmurs, worsening allergies, numerous benign skin tumors, and more. It’s a crisis period, isn’t it? Just like 40-50 years of age is in the person. If these conditions are all “genetic”, why do they wait so long to show up? Hmmm…great question. Something is waiting, right? What??? Can we think of anything that we have in our bodies that might be “waiting”? I can. They’re called viruses. We have been acquiring them our entire lives. Our parents even gave some to us. “What?” Can’t viruses be transmitted vertically? How about genetically? Others we acquired “naturally” during our lifetime and still others we acquired through vaccination. (Most of our pets and us are too unhealthy to take on any more modified live vaccines, aren’t we?) And as I have mentioned , we invited many in to stay by killing the fever that was designed to limit the infection. We have become walking virus hotels…”mobile homes” for these guys, if you will. The startling fact is that we are riddled with ‘em. And they are waiting for their chance. They are the ultimate opportunist…the consummate terrorist. Sure, there are others: bacteria, mycoplasms, fungi, and more. But the virus is the guy who incorporates his genetic material into our cells and then bosses them around. He’s the guy who our immune system hates enough to risk killing our own tissue to root him out. He’s the guy that can go anywhere in our body and do anything he wants ONCE we get to that point of immune suppression that we are destined to reach once we have done enough wrong to this body of ours. In my mind, he wasn’t designed to be. Viruses are ubiquitous in nature and critical to its development, variety, and adaptation. So why did they turn on us? “Shoot…look at the time. We’ll have to go down that rabbit hole after this presentation.” I think you can figure it out, anyway.

Yes, we DO have our health destiny more in our own hands than we ever believed. Yes, we DO reap what we sow. We just didn’t realize that we were sowing such bad seed all of these years did we? We have had glimpses of our wrongdoing and our conscience has told us not to overindulge and to try to eat properly. That’s just common sense, right? But whodathunk that the staples of our diet were killing us? Who would believe that cow’s milk, wheat, and the “newest health food”…soy (errrrrh)…were plagues on mankind, brought on by our own doing? And who would believe that the “simple” elimination of the big four would lead to the vast improvements in our health that I have personally experienced. (I cannot overstate the phenomenal changes that have taken place in my body over the past 5 years)

I’ll tell you who would believe such things: those that know that our body does not make mistakes…ever. (Only we make mistakes in our choices of what to put into this body.); those that can still remember why our body does what it does instead of just covering up the symptoms should believe this (Who would believe that heartburn might be a symptom that we ate something wrong? Wow!); and those that have eyes to see and ears to hear and can still be taught something. They are fewer in number than I ever thought existed.

BUT, there have been enough wise people over the years to carry this torch. There have been a select number of doctors, researchers, and lay people that have been beating this drum for years and years and stood their ground against the onslaught of drugs and misinformation…the “magic” (pharmakeia) and slight of hand…that has taken away the motivation of the masses to find real answers to their health problems. Is the white tiger really gone or does he lurk off stage, sometimes even attacking his master? Yes, celiac researchers, holistic health advocates, naturopaths, and the like have been finally vindicated. They rode out to meet the enemy years ago and are finally being joined by a ever-growing cavalry. Against seemingly insurmountable odds, the message has survived…”We are what we eat. You do have control of your health’s destiny.” It is through the valiant efforts of this Brotherhood…and the prevailing nature of Truth…that we have won at Helm’s Deep.

Now, it’s on to the final battle.

Dogtor J.

copy2005 DogtorJ.com

24 Sep 2009 Big Fish Grille has a gluten free menu
 |  Category: Nutrition, Resources  | Leave a Comment

It’s Sarah from the Freedom Bakery. Just letting you know that the Big Fish Grille in Crofton has a gluten free menu, and also carries a gluten free cake!! How exciting the gluten free dining options are expanding right before our eyes!

Also, BB Bistro in West Annapolis is giving our bread a trial run, so everybody can go get a sandwich from them!

Thanks!
Sarah Pulcher