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2015dec_logoDr. Todd A. Born, is a naturopathic doctor, co-owner and medical director of Born Naturopathic Associates, Inc., in Alameda, California. Dr. Born is also the Product Manager, Head of New Product Development, Scientific Advisor for Allergy Research Group, LLC and is Editor-in-Chief of their science Focus Newsletter. He is a Thought Leader for the UK-based Clinical Education, a free peer-to-peer service that offers clinicians a closed forum to ask clinical questions and receive evidence-based responses by experts in their fields.

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2015dec_logoGuidelines for diagnosing coeliac disease are rapidly evolving, as sensitive and specific laboratory assays are now available as part of the coeliac disease diagnostic algorithm. Though biopsy is still recommended as a gold standard by many gastroenterologists1, biopsies may still be inconclusive.2 Therefore, in many cases it may be possible to diagnose coeliac easily and quickly via a few essential blood tests. These include immunoglobulins produced against tissue transglutaminase (tTG) and deamidated gliadin peptide (DGP).

2015dec_logo2000 years ago on the coast of Tuscany, an eighteen year old girl died and her entombed body was carefully adorned with bronze and gold jewelry. She was one of the first known sufferers of coeliac disease, an autoimmune disorder triggered by ingestion of gluten. In spite of a healthy diet of fish, meat and vegetables—which researchers determined by analyzing isotopes in her skeleton—she was only four feet seven inches tall, and many of her bones were eroded at the tips. DNA analysis revealed she carried two copies of a gene commonly found in sufferers of coeliac, and her skeletal abnormalities indicated the kind of severe malnutrition that can accompany the condition. “She probably didn’t understand that she had this disease,” Gabriele Scorrano told Nature News magazine in 2014. Scorrano is the biological anthropologist at the University of Rome who published a study on the Italian woman’s remains.1,2

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cnsnddt-journal-coverA paper published in the journal CNS Neurology Disorders Drug Targets highlights some of the areas of dysfunction liked to adverse exposure to gluten and subsequent effects on functionality.[1]

The non-celiac gluten sensitivity (NCGS) is a chronic functional gastrointestinal disorder which is very common world-wide.

The human gut harbours microbiota which has a wide variety of microbial organisms; they are mainly symbiotic and important for well-being. However, “dysbiosis” – i.e. an alteration in normal commensal gut microbiome with an increase in pathogenic microbes, impacts homeostasis/health.

s13379569Dec 2013 saw a paper published in Interdisciplinary Toxicology that explored the notion that the popular herbicide called Roundup may have a relational link to its increased use.[1] In addition a number of other complex and distressing health conditions have been are increasingly attributed to this chemical.

Glyphosate was not originally designed as a herbicide. Patented by the Stauffer Chemical Company in 1964, it was introduced as a chelating agent. It avidly binds to metals. Glyphosate was first used as a descaling agent to clean out mineral deposits from the pipes in boilers and other hot water systems.

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journal.jpgIt has been proposed that risk for developing the autoimmune condition coeliac disease (CD) may be linked to the time that the infant is weaned to consume gluten containing foods. However, the timing of gluten introduction into an infant’s diet does not appear to influence a child’s subsequent risk of developing CD investigators report in an article published online January 19 in Pediatrics.[1] The new finding, from a multinational prospective birth cohort study, challenges some current ideas on how best to prevent the onset of the autoimmune disorder.

A recently published paper in the journal Nutrition in Clinical Practice[1] discussed the results from an Australian group exploring the global trend in self-diagnosis of non-coeliac gluten sensitivity (NCGS). We are all aware that the possibility that gluten and or related compounds may relate with our gastrointestinal tract and associated immune cells in a detrimental manner leading to a wide range of symptoms. Well we are not alone and many people are making the leap to exclude gluten without any formal diagnosis or even careful work up – so what some may say, well the Australian group suggest this may come with unanticipated risks.

Think Coeliac Disease

Tuesday, 07 January 2014 by

As Nutritional Therapists we are all aware of the problems linked to gluten exposure, from wheat allergy, non-coeliac gluten sensitivity and coeliac disease, yet at times it can be difficult to convince other clinicians of the increased frequency of diagnosis and the benefits of exclusion diets. The GP magazine Pulse has created a very useful resource site for Drs to explore current conventional thinking, the site is interesting and informative and if you have to write to a GP requesting investigative tests then it may well prove to be a useful referral site for their information expansion.

Coeliac disease is caused by a heightened immunological response to gluten in genetically susceptible people. Once triggered, the disease process can only be treated by eliminating gluten from the diet for life.

The Scientific Advisory Committee on Nutrition (SACN) and the Committee on Toxicity (COT) are both advisory committees of independent experts that provide advice to the Department of Health and Food Standards Agency in the United Kingdom.[1]

In March 2011, the committees jointly completed an in-depth review examining the most appropriate time to introduce gluten into an infant’s diet. They considered the available evidence to see whether the time that gluten is introduced into an infant’s diet affects the likelihood of developing coeliac disease and type 1 diabetes mellitus.

One of the questions that crops up in the clinical management of patients suspected of having coeliac disease, is: If my patient has been gluten free, or is going to try an exclusion from gluten containing foods, how long should they be free of gluten before undertaking a gluten challenge test?An article in GUT looks to explain this in some detail [1]

Our understanding of the pathophysiology of coeliac disease has advanced with associated improvement in diagnostic modalities. Recent studies have placed the prevalence of coeliac disease in Western populations at between 1:250 and 1:67. Coeliac disease is common throughout the world and most cases go undiagnosed. Understanding the risk factors, clinical presentations and diagnostic modalities is necessary to identify and treat patients with this commonly misdiagnosed disorder.

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