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The history of the protocols and methods involved in the diagnosis and treatment of what was known in the 19th century as "celiac disease" is a fascinating glimpse into how the practice of medicine evolves in light of new scientific research. while Edward is examining in depth the causes of overeating in America from the peculiar perspective of a former head of the FDA, I will now take a brief look into the new (i.e. post WWII) and even NEWER (up to the minute) ongoing research to show that celiac disease, and its non-classical expression - gluten sensitivity - is on the rapid rise in the USA, and one of its previously-unknown expressions is obesity and sudden weight gain. Scramble over the fold with me to read a whole lot of big words about my intestinal villi.
WHAT ?
Yes, Turtles, celiac disease, or what is more accurately termed "gluten sensitivity" is a genetically-predisposed illness which, according to the newest, latest research, has a constellation of "latent-compensated" symptoms of underlying disease: here is a figure showing the types of symptoms that 'unmask' the underlying gluten sensitivity that is genetically pre-determined but was there from birth:
from Celiac Disease: A Brief Overview,, by Debbie Williamson and Michael N. Marsh, in Methods and Protocols, Humana Press, 2000.
Okay, what does that mean in plain English? More specifically, what does it mean in my case? It means that I've always had this time bomb in my gut, ticking away, and so do untold millions of others. And some of the most invisible, and unrelated symptoms that would never otherwise point to celiac disease, as it is in my case, are innocuous, explainable, and even non-intestinal symptoms. This does not mean they are unimportant; however, a critical problem in the lives of celiac suffers is malabsorption of nutrients. The classical historic view of celiac disease (i.e. post-WWII era) is that it is a pediatric disease evidenced by diarrhea, weight loss, and wasting. Nobody ever looked for a chubby adolescent with uncontrollable hunger for bread as a celiac!! Whoops - lesson learned? Well, not quite.
Doctors don't know, and won't investigate, much less diagnose. No doctor diagnosed me; I was diagnosed by a friend whose sister works in gluten sensitivity research and put together this magical list of symptoms. Look at it closely, because if you have this constellation of symptoms, you may, like I did, want to seriously consider the simple, yet challenging alternative diet that I have followed for the past four years, but which has not, as yet (through other factors both related and unrelated to celiac disease) restored me to the thin, athletic child I had been at the age of 14 before it all went wrong. Here is the CURRENT list of gastrointestinal symptoms:
A partial listing of gastrointestinal symptoms:
* Abdominal pain
* Abdominal distention, bloating, gas, indigestion
* Constipation
* Decreased appetite (may also be increased or unchanged)
* Diarrhea, chronic or occasional
* Lactose intolerance (common upon diagnosis, usually goes away following treatment)
* Nausea and vomiting
* Stools that float, are foul smelling, bloody, or "fatty"
* Unexplained weight loss (although people can be overweight or of normal weight upon diagnosis)
And now for the NON-intestinal symptoms:
A partial listing of nonintestinal symptoms:
* Anemia (low blood count)
* Bone and joint pain
* Bone disease (osteoporosis, kyphoscoliosis, fracture)
* Breathlessness (due to anemia)
* Bruising easily
* Dental enamel defects and discoloration
* Depression
* Fatigue
* Growth delay in children
* Hair loss
* Hypoglycemia (low blood sugar)
* Irritability and behavioral changes
* Malnutrition
* Mouth ulcers
* Muscle cramps
* Nosebleed
* Seizures
* Short stature, unexplained
* Skin disorders (dermatitis herpetiformis)
* Swelling, general or abdominal
* Vitamin or mineral deficiency, single or multiple nutrient (for example, iron, folate, vitamin K)
I had all of the intestinal symptoms - OCCASIONALLY.
I had, and still suffer from, 19 of the NON-intestinal symptoms. I have celiac disease, and do not need a doctor to tell me. Why? Because, following the advice of my friend, I did a Gluten Elimination Diet. I removed all sources of gluten from my diet for a period of three weeks in October, 2005. Within 48 hours my diarrhea and bloating after meals was arrested, I stopped wheezing and coughing from active asthma, my skin reactions and irritations were much less, and most importantly: my uncontrollable hunger abated.
And three weeks later, when I did a challenge test with rye crackers, (which contains one of the two proteins and which I have never included as part of a regular diet) , it took only a half an hour for the food to get into my digestive tract before I began to itch, and then to cough, and then to need my emergency asthma inhaler. I didn't need further evidence: I stopped eating gluten.
Why is this important for a discussion of fitness and overeating, weight loss and health? Because, as the title here states, sometimes a reason IS a reason. I have endured - even here at DailyKos, the naive and arrogant comments from others in discussion of weight loss: "Just put down the damn Twinkies and go for a walk!" I haven't eaten a Twinkie since 1974. And judging from extensive food diaries, the only reason I can see for my occasional tendency to overeat is malabsorption of nutrients and the appetite triggered by the physiological need for nutrients that I am not getting. If this sounds familiar to you, dig and do more research; and feel free to contact me off-list: I have been gluten-free for four years now, and my health for the most part, is improved.
Problems linger: and in the case of dermatitis herpetiformis, it will take at least ten years for my epidermis to regenerate to the point where I will not get new lesions. Getting exposed to gluten in food additives, food supplements, and in prepared food is a constant challenge and can create outbreaks and setbacks. More and more I have retreated from dining out, simply because of the profound ignorance that exists in the restaurant industry about what constitutes "gluten free". As with all things uniquely American, the desire to make a buck overrides food safety; and make no mistake, gluten sensitivity is life-threatening, and has led to (and continues to lead to) bowel and intestinal cancer in an unknown number of Americans, malnutrition and severe nutrient deficiencies in adults, and is one of the most commonly wrongly-diagnosed illnesses in America today.
Turtle Says: Put down the Prilosec and the whole wheat toast, and find out if you are grain-damaged if you have any of the symptoms above.
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