In the process called villous atrophy, your immune system's response to gluten ingestion actually erodes those poor villi, leaving you unable (or nearly so) to properly absorb nutrients. Those with the most severe celiac-related damage literally have no intestinal villi left, while those with less-severe damage have short little stubby villi instead of healthy, longer ones.
Once you're diagnosed, those villi start to recover (and most people start to feel better). But how long does it take for your villi to recover completely? Sadly, medical studies indicate that, in many people, the intestinal villi never recover completely.
I share the details here: How long will it take for my small intestine to recover from celiac disease?
It's not clear why some people never recover fully, although some researchers blame constant low-level gluten cross-contamination. Genetics, your age at diagnosis and the amount of damage you had also likely play a role -- children recover faster and more completely than adults.
What can you do to speed recovery and improve your chances of a full recovery? For a start, don't ever cheat on the diet. In addition, you should try to eliminate as much trace gluten as possible ... which means limiting "gluten-free" grain products and other processed foods, and reserving restaurant meals out only for special occasions.
Image Courtesy of the National Digestive Diseases Information Clearinghouse
Is gluten the reason you can't get pregnant? This week marks National Infertility Awareness Week, and it seems like a good opportunity to highlight the links between gluten-related health problems and infertility.
Celiac disease has been linked to otherwise unexplained infertility in both men and women, and anecdotal evidence indicates non-celiac gluten sensitivity also may play a role. In the studies that have been done on people with celiac disease, ditching gluten has helped many get pregnant.
Does that mean you'll get pregnant immediately if you go gluten-free? Not necessarily, of course -- there are many possible factors involved in infertility, as About.com's Expert on Infertility explains. But can it help? Maybe.
Here's some more information on gluten and infertility:
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Yesterday I wrote about roast lamb for Easter dinner (a common family tradition), so I'd be remiss if I didn't also mention ham, the other traditional Easter main course.
There's a good reason why tradition dictates ham for Easter in many families: back in the days of no refrigeration, preserved meats such as ham usually were the only type of meat left in the larder by spring. Therefore, ham became the default choice for Easter, an early spring holiday.
These days, of course, we don't need to worry about refrigeration, but the tradition has stuck ... and we can continue it even if we eat gluten-free. Here are the details on which hams to purchase:
- Gluten-Free Ham Options (updated this week)
Make sure you watch out for the glazes, as they're not always gluten-free (I include some recipes for gluten-free glazes you can substitute). Enjoy, and happy Easter!
Photo © Getty Images/James Baigrie
Many people traditionally serve leg of lamb on Easter Sunday, but did you know that tradition started with the Hebrews and their very first Passover?
According to Peggy Trowbridge Filippone, About.com's Expert on Home Cooking, the Hebrews served a sacrificial lamb along with bitter herbs and unleavened break, or matzo, in the hopes that the angel of God would pass over their homes. (Learn more from Peggy about Easter food traditions here: Traditional Easter Foods History). This tradition came with the Hebrews when they converted to Christianity.
Enjoy, and have a happy Easter!
Photo © Getty Images/Luca Trovato
I frequently read comments from people with celiac disease who say they know they're not getting any trace gluten in their diets. How do they know this with such certainty? Because their follow-up celiac blood test results are negative, they say.
But are those blood tests really a good way to track how well you're doing on the gluten-free diet?
As it turns out, they're not. It takes a lot of gluten to turn a negative result on those tests into a positive one ... a lot of gluten. You'd pretty much have to cheat blatantly on a regular basis (I'm talking full-gluten pizza, muffins and bread every week) to generate a positive celiac blood test result once you've been gluten-free for a while.
Read more about this here: Can celiac blood tests show how well you're following the gluten-free diet?
So should follow-up blood tests be part of your care once you've been diagnosed with celiac? That's something for you and your doctor to decide -- as I detail in the above article, blood tests can be helpful in the first year or so after your diagnosis as a rough gauge of how well your villous atrophy is healing.
But blood tests will not show you're getting gluten cross-contamination in trace amounts. For that, you'll need to rely on your symptoms (if you have them), and on careful research to determine what's gluten-free and what's not. Repeat blood tests won't help.
Image © Getty Images/TS Photography
Medical research is starting to back what many of us have known intuitively for a long time: gluten causes feelings of depression in those with non-celiac gluten sensitivity.
The link between depression and celiac disease is strong: multiple studies have documented higher levels of diagnosed depression in people who have celiac. But despite anecdotal evidence that many of those who react to gluten but who do not have celiac disease also suffer from depression, there's been little firm evidence of a connection.
- More on this: Is Gluten Why You're Depressed?
That's beginning to change. A new study published in the medical journal Alimentary Pharmacology and Therapeutics finds short-term exposure to gluten in people with gluten sensitivity elicited feelings of depression, even when the gluten didn't seem to cause gastrointestinal symptoms. Read More...
Could celiac disease be linked to a heightened risk of heart disease? A study presented at the American Academy of Cardiology's annual meeting says it might be.
The study, which is the first to look at connections between celiac and coronary artery disease (the narrowing of the arteries that provide blood to your heart muscle), adds to what the authors called "the evolving understanding of how systemic inflammation and autoimmune processes might influence cardiovascular disease development."
"People with celiac disease have some persistent low-grade inflammation in the gut that can spill immune mediators into the bloodstream, which can then accelerate the process of atherosclerosis and, in turn, coronary artery disease," said study co-author Dr. R.D. Gajulapalli of the Cleveland Clinic in a statement.
In other words: If your digestive tract is chronically inflamed due to an ongoing reaction to the gluten protein, that can affect more than just your small intestine -- it can affect your circulatory system, too.
The researchers used electronic health records to look at nearly 22.4 million patients over a 14-year period. A total of 24,530 of those were diagnosed with celiac disease.
Celiac patients had similar rates of smoking and diabetes, two factors that contribute to the development or coronary artery disease. They also had slightly higher cholesterol and slightly lower blood pressure than those who didn't have celiac disease.
The study found that 9.5% of those with celiac disease also had coronary artery disease, compared with a 5.6% rate of coronary artery disease in those without celiac disease. Those with celiac disease also had a slightly higher risk of stroke, and younger people with celiac were just as likely to have the increased heart disease risk as those older than age 65.
"This is an important study because it highlights a specific patient population who might be at higher risk for coronary artery disease, even in the absence of traditional cardiovascular risk factors," Dr. Gajulapalli said. "We were surprised by the strength of the association, especially in younger people."
Dr. Gajulapalli says more research is needed to confirm these results and to look at "how the severity of celiac disease may play a role." He also said research should look at whether those with non-celiac gluten sensitivity also are at risk for coronary artery disease.
In the meantime, what can you do to mitigate your risk? Dr. Gajulapalli suggests maintaining a healthy lifestyle and being aware of traditional cardiovascular risk factors, including diabetes, high blood pressure and high cholesterol.
And, I would add that it can't hurt to get as much trace gluten out of your diet as possible -- there's no research showing this, but my theory is that lowering your exposure to gluten might also lower your systemic inflammation levels, which might in turn slow the coronary artery disease process. It can't hurt, and it might help.
Photo © Getty Images/Science Photo Library
It's just about impossible to find a ready-made candy-filled Easter basket that's already entirely gluten-free, but the good news is, you can make one yourself.
My daughter and I (both gluten-free) created the Easter basket in the photo a couple of years ago, and it was entirely safe for her (and me) to enjoy. Here's the blueprint:
You'll need a chocolate bunny for the centerpiece. The only gluten-free chocolate bunnies I've found that are readily available in most stores are those made by Dove, so look for one of those (but always make sure to double-check the label).
We didn't include marshmallow Peeps in this particular Easter basket, but they would go well ... and they're safely gluten-free. We stock up on Peeps this time of year and try to make them last until the Halloween Peeps appear in stores in September.
For the rest of your gluten-free Easter details, check out this article:
Photo © Danielle Cassell
Passover begins Monday at sundown, so many of you likely will be spending at least part of your weekend preparing for the holiday.
Fortunately, Passover is one of the most gluten-free-friendly holidays on the calendar, since the foods served cannot contain leavened versions of wheat, barley, rye and oats (a.k.a., the gluten grains). Unleavened versions of these are okay (which means you can't throw caution to the wind, and you can't eat conventional matzo), but our potential available food choices do increase.
Here's a selection of possible Passover menu choices:
Be aware that many Passover recipes contain matzo crumbs, and those won't be safe unless they're made with gluten-free matzo.
Gluten-free matzo frequently is prepared with oats (if you're wondering if you can eat oats, check out this article: I can't have gluten. Can I safely eat oats?), but it's possible to find oat-free matzo, as well. Here's everything you need to know:
Photo © Teri Lee Gruss
If you thought gluten could only damage your small intestine, think again. In some people, that evil protein sets its sights on the brain instead of (or in addition to) the intestinal villi.
Its specific target is the cerebellum, the part of your brain that controls your coordination, balance and movements. Damage in this area due to gluten can lead to progressive balance issues, and eventually could force you to use a walker or a wheelchair to get around.
Sounds really scary, doesn't it? Gluten ataxia actually is a pretty scary condition.
Last year around this time, I wrapped up a series of articles on gluten ataxia, and in it I tried to explore everything medical science knows (and doesn't yet know) about the condition:
I also provided a place for readers to share their stories about gluten ataxia symptoms and diagnosis: Do You Have Gluten Ataxia?
I've been amazed at the response to these articles -- so many people have written to me, saying they have similar symptoms. Hopefully these articles will continue to help shed some light on what has been, up until now, a poorly understood (and yes, very scary) condition linked to gluten.
Image © ADAM