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- 74 - A Nurse’s Story of Celiac Disease from 1953 EP074
What did we know about celiac disease in 1953?
The truth is, we knew quite a bit about sensitivity to gluten 65 years ago when Matilda Babbitz’s son Bobby was diagnosed with celiac disease. A nurse by profession, Matilda carefully observed her baby and kept detailed records of his reactions to foods, working with doctors to determine an appropriate diet for Bobby.
Today, the Gluten Free RN is sharing an article published in the March 1953 edition of the American Journal of Nursing written by Matilda herself. She covers how Bobby presented with celiac disease at six months of age and the dramatic change in his health and behavior after a diet change.
Nadine discusses the systematic approach Bobby’s healthcare team took in creating a custom diet, the relationship between the baby’s irritability and his inability to digest food, and his growth and development before and after treatment. She also addresses the misunderstanding that children will ‘grow out of’ celiac disease, explaining that we’ve since learned patients must adhere to a 100% gluten-free diet for life. Listen in for insight around what we can learn from past case studies of celiac disease and understand what we already knew about celiac disease back when Eisenhower was president and Gentlemen Prefer Blondes was on the big screen!
What’s Discussed:How Bobby presented with celiac disease at six months of age
Sudden attack of diarrhea, upper respiratory infection History of GI difficulty + distended abdomen, increased gas Marked irritability, weight loss, inability to move arms/legsThe dramatic change in Bobby’s behavior after a diet change
Symptoms of diarrhea, vomiting and weakness disappeared Irritability subsided with shift to skim milkThe new pediatrician’s approach when Bobby’s progress stalled
Shift to goat’s milk, added complete multivitamin supplementThe relationship between irritable behavior and the inability to digest foods
Nurse/mom kept detailed records of foods eaten, reactionsBobby’s growth and development before and after diagnosis
Lost ability to perform gross motor activity prior to diagnosis Caught up with age group after diet change (walked at 18 months)How Bobby’s mother dealt with social pressure to eat with others
Replaced cookies and ice cream with sherbet and lollipops Kept away from parties so not conscious of being left outThe chronic nature of celiac disease
No one ‘grows out of’ being celiac 100% gluten-free diet for lifeNadine’s insight around what we knew about celiac disease in 1953
Many celiac patients unable to digest cow’s milk Need supplementation with vitamins, certain fats Recognized impairment of immune system Resources‘Bobby Has Celiac Disease’ in the American Journal of Nursing
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal
Subscribe to The Gluten Free RN Podcast:Fri, 22 Jun 2018 - 19min - 73 - Musings & Truths From the Gluten Free RN EP073
‘Know your own truth and let that guide you.’
How do you cut through the noise and misinformation around gluten sensitivity and celiac disease in order to make the best choices for your health and happiness? By tapping into your intuition and asking WHY when the answers don’t feel right—and reaching out to the right people for support when you need it.
Today, the Gluten Free RN is sharing her Top 10 Musings and Truths for health and wellbeing, empowering you to be self-protective and surround yourself with the people who genuinely care enough to speak up for—and with you. She shares the value in setting goals for your physical and mental health and taking your power back from the people who may have victimized you in the past.
Nadine also encourages you to get educated and engage in critical thinking, questioning the information you are given and saying ‘no’ to anyone who suggests you eat gluten—even if they happen to be a doctor. Listen in to understand the idea that ‘you are your own experiment’ and learn to be the healthiest YOU you can be by committing to a 100% gluten-free diet!
What’s Discussed:- Commit to being 100% gluten-free, dairy-free and ideally Paleo
- Be self-protective
- Find your tribe
- Set goals for what you want your life to look like
- Be powerful (even if you don’t feel it)
- Get educated and educate others
- Don’t believe everything you hear, read or say
- Don’t eat gluten for anyone
- Be the healthiest YOU, you can be
- You are your own experiment
‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal
Fri, 15 Jun 2018 - 26min - 72 - African Americans & Celiac Disease EP072
Much existing propaganda claims that African Americans do not suffer from celiac disease. Even the Gluten Free RN was surprised to find out that her adopted daughter had a genetic predisposition to the disease back in 2006, as research available at the time regarded the HLA-DQ2 and HLA-DQ8 genes to be primarily Caucasian traits. And until we take steps to conduct a mass screening, we simply don’t know how common celiac disease is among people of African descent.
Today, the Gluten Free RN is exploring celiac disease in the African American population. She covers a 2006 study out of Columbia University that assessed African American celiac patients, discussing the variety of ways the subjects presented with celiac disease and the potential reasons for their poor compliance with the prescribed gluten-free diet.
Nadine also considers the prevalence of celiac disease on the continent of Africa, explaining why she believes the number of celiac patients will explode with the population’s growing exposure to wheat. Listen in for the Gluten Free RN’s insight on other health issues that may point to undiagnosed celiac disease and learn how we can prevent celiac disease among the African American population with access to testing, social support and gluten-free food!
What’s Discussed:The 2006 Columbia University study of celiac disease in African Americans
Identified nine patients with biopsy-proven celiac disease Presented with diarrhea, iron deficiency anemia and autoimmune disordersWhy patients in the Columbia study demonstrated poor dietary compliance
Expense, availability and palatability of gluten-free food Lack of symptoms at diagnosis, inaccurate dietary informationNadine’s prediction around the number of celiac patients in Africa
Increasing exposure to wheat will cause explosionThe statistics regarding the mortality burden of celiac disease
Science Daily reported estimates of 42K child deaths every year in 2011 Majority from Africa and AsiaThe overlap between diabetes and celiac disease
Every type 1 diabetic is HLA-DQ2/8 gene carrierThe health issues that may indicate undiagnosed celiac disease
Type 1 diabetes, cardiac issues, stroke and heart attack Obesity (stems from lack of nutrient absorption)How to prevent celiac disease among the African American population
Access to testing, social support and gluten-free food Resources:Celiac Disease and How Gluten Affects Your Skin EP011
‘Your Skin on Gluten’ on YouTube
‘Celiac Disease in African-Americans’ in Digestive Diseases and Sciences
‘First Global Estimates of Coeliac Disease and Its Mortality Burden’ in Science Daily
Neurological Disorders Associated with Celiac Disease EP012
‘HLA Typing and Celiac Disease in Moroccans’ in Medical Sciences
University of Chicago: Celiac Disease Facts and Figures
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal
Fri, 08 Jun 2018 - 28min - 71 - Celiac Disease & Why No One Should Have Belly Pain EP071
Approximately 50% of ER visits are associated with abdominal pain, and the vast majority of those patients are given a diagnosis of ‘abdominal pain of an unknown origin’ and directed to come back if the condition gets worse. This is little comfort to people suffering from severe discomfort who need answers around the cause of their belly pain, not just medication to mask it temporarily. Could undiagnosed celiac disease be the source of their suffering?
Today, the Gluten Free RN is diving into the issue of belly pain and undiagnosed celiac disease, discussing the expensive testing often conducted to determine the cause of abdominal discomfort—testing that rarely includes a celiac panel. She covers several of the common misdiagnoses of celiac patients as well as the incredibly high prevalence of abdominal pain in children.
Nadine shares the case study of a child-patient who was misdiagnosed with appendicitis and the research published in Digestive and Liver Disease outlining the unnecessary surgical interventions endured by undiagnosed celiac patients. Listen in for the Gluten Free RN’s advice to patients with idiopathic abdominal discomfort and learn why no one should suffer from belly pain!
What’s Discussed:The statistics around ER visits and abdominal pain
50% of visits associated with belly painThe most common abdominal pain diagnoses
Abdominal pain of unknown ideology, idiopathic abdominal painHow patients are treated for idiopathic abdominal pain
Medication, directive to return if condition gets worseThe testing to find the cause of chronic abdominal pain
Expensive blood workups, rarely include celiac panelHow many children suffer from belly pain
30% report abdominal discomfortNadine’s patient who received a misdiagnosis of appendicitis
Mother of child-patient sought second opinion prior to surgery Child didn’t have appendicitis, cause of pain still unknownA research study around abdominal surgery and celiac disease
Patients with celiac disease at increased risk of abdominal surgery Misdiagnosis leads to inappropriate interventions (i.e.: appendectomy)Nadine’s advice for patients diagnosed with idiopathic abdominal pain
Initiate clinical trail of gluten-free or Paleo diet Resources:‘Increased Rate of Abdominal Surgery Both Before and After Diagnosis of Celiac Disease’ in Digestive and Liver Disease
‘Screening for Celiac Disease in Children with Recurrent Abdominal Pain’ in the Journal of Pediatric Gastroenterology and Nutrition
‘Effect of a Gluten-Free Diet on Gastrointestinal Symptoms in Celiac Disease’ in the American Journal of Clinical Nutrition
‘Clinical Features and Symptom Recovery on a Gluten-Free Diet in Canadian Adults with Celiac Disease’ in the Canadian Journal of Gastroenterology
‘Association of Adult Celiac Disease with Surgical Abdominal Pain’ in Annals of Surgery
‘A New Insight into Non-Specific Abdominal Pain’ in The Annals of The Royal College of Surgeons of England
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal
Fri, 25 May 2018 - 20min - 70 - Blood Disorders and Celiac Disease EP070
If you are being treated for a blood disorder, it is time to look deeper and explore the underlying cause. Rather than simply addressing iron- or B12-deficiency anemia in isolation, ask WHY you have a deficiency in the first place. It is possible that damage to your intestines caused by gluten is preventing your body from absorbing the nutrients necessary to grow your red blood cells and keep your immune system healthy. And anemia is not the only blood disorder associated with celiac disease and non-celiac gluten sensitivity!
The Gluten Free RN is taking a closer look at the hematologic manifestations of celiac disease from anemia to hyposplenism. She explains the connection between disorders of the blood and bones, offering insight around why men with both anemia and osteoporosis are also likely to have celiac disease.
Nadine discusses the danger in taking H2 blockers or proton pump inhibitors for GERD long-term, describing how those medications decrease the gastric acid necessary for breaking down food. She also addresses what you can do to identify any nutritional deficiencies in your blood and reminds us why celiac patients have difficulty absorbing the nutrients necessary to form red blood cells. Listen in to understand how the skin reflects what’s happening internally and learn how to prevent a number of blood disorders with a gluten-free diet!
What’s Discussed:The hematologic manifestations of celiac disease
Anemia secondary to malabsorption of iron, folate and vitamin B12 Thrombocytosis, thrombocytopenia, leukopenia, venous thromboembolism Hyposplenism, IgA deficiency and increased risk of lymphomaWhy iron supplements didn’t solve Nadine’s anemia
Couldn’t absorb supplements due to undiagnosed celiac diseaseThe connection between anemia, osteoporosis and celiac disease
B12 forms red blood cells made in long bonesThe danger of taking H2 blockers and PPIs long-term
Decreases levels of gastric acid necessary to liquify food Leads to bacterial overgrowth, gastritisHow to uncover potential nutrient deficiencies in your blood
CBC with differential (breakdown of red blood cells)The conclusions of the 2007 study in Blood
Anemia and hyposplenism are most common complications of celiac disease Obtain small-bowel biopsy in all patients with iron-deficiency anemiaThe fat-soluble vitamins
A, D, E and K Deficiency in one indicates malabsorption, potential celiac diseaseThe connection between DH and celiac disease
Skin disorders begin in intestines Resources:‘Hematologic Manifestations of Celiac Disease’ in Blood
Celiac Disease and Your Spleen
Dr. Ben Lynch: Folic Acid vs. Folate
‘The Thrombophilic Network of Autoantibodies in Celiac Disease’ in BMC Medicine
‘Hematologic Manifestations of Celiac Disease’ in Celiac Disease— From Pathophysiology to Advanced Therapies
‘Sarcoidosis, Celiac Disease and Deep Venous Thrombosis: A Rare Association’ in Balkan Medical Journal
‘Celiac Disease Manifesting with Deep Venous Thrombosis: A Case Report’ in Govaresh
‘How Often Do Hematologists Consider Celiac Disease in Iron-Deficiency Anemia?’ in Clinical Advances in Hematology & Oncology
‘Deep Vein Thrombosis Associated with Celiac Disease’ in Bratislavske Lekarske Listy
‘Celiac Disease Presenting with Immune Thrombocytopenic Purpura’ in Case Reports in Hematology
‘Lower Extremity Deep Vein Thrombosis Associated with Gluten-Sensitivity Celiac Disease’ in Terapevticheskii Arkhiv
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal
Fri, 04 May 2018 - 21min - 69 - Eosinophilic Esophagitis and Celiac Disease EP069
Your gastrointestinal tract is approximately 30 feet long, and it runs from your mouth all the way to the anus! We know that celiac disease can impact any part of the digestive tract. But there is another disease that wreaks havoc on the GI tract as well, a condition called eosinophilic esophagitis or EoE.
The Gluten Free RN is explaining the fundamentals of eosinophilic esophagitis, from its characteristic inflammation of the esophagus and elevated eosinophils in the blood to the common symptoms of vomiting and upper abdominal pain. She walks us through the treatment for EoE, an elimination diet or steroid therapy.
Nadine speaks to the research exploring a possible connection between eosinophilic esophagitis and celiac disease, citing a paper that found a higher prevalence of EoE in children with celiac disease than the general population as well as the case study of a woman with both celiac disease and elevated eosinophils in her blood. Listen in for the Gluten Free RN’s insight on the best EoE clinics and physicians in the country and learn why further study is needed around EoE and celiac disease!
What’s Discussed:The fundamentals of eosinophilic esophagitis
Allergic response to dietary antigens Causes inflammation of esophagus, increased eosinophils in bloodThe benefits of unsedated transnasal endoscopy for children with EoE
Monitors esophageal mucosa without sedation Safer, faster and less costlySome common symptoms of eosinophilic esophagitis
Vomiting, difficulty swallowing, food stuck in throat Chest pain, heartburn, upper abdominal painThe condition of achalasia
Muscles of esophagus don’t work appropriately Causes spasms or constrictionThe treatment for EoE
Elimination diet (remove wheat, eggs, milk, soy, shellfish and seafood, peanuts and tree nuts) Topical or systemic steroidsThe potential increased prevalence of EoE in children with celiac disease
2015 paper found prevalence of 10.7% (much higher than general population) Other research articles argue no increased prevalence of EoE in CDThe case study of a 30-year-old woman with celiac disease and elevated eosinophils
Presented with abdominal pain and distension, vomiting and frequent bowel movement Treated with IV hydrocortisone, but developed steroid induced psychosisNadine’s insight on the best specialty clinics for EoE in the US
University of Colorado (Denver School of Medicine) PennsylvaniaDr. Glenn Furuta’s insight on the difficulty of diagnosing EoE
Relatively new disease, tendency to diagnose based on pathology report alone Elevated eosinophils also found in GERD, inflammatory bowel disease and celiac diseaseSpecial considerations for pediatric patients with EoE
- Consultation with dietician Limited exposure to corticosteroids Attention to development of feeding skills Potential psychosocial, behavioral problems
‘Unsedated Transnasal Esophagoscopy for Monitoring Therapy in Pediatric Eosinophilic Esophagitis’ in Gastrointestinal Endoscopy
‘Eosinophilic Esophagitis Associated with Celiac Disease in Children’ in BMC Research Notes
‘Eosinophilic Gastrointestinal Disorder in Coeliac Disease: A Case Report and Review’ in Case Reports in Gastrointestinal Medicine
‘Eosinophilic Esophagitis in Children and Adults’ in Gastroenterology and Hepatology
‘The Association Between Celiac Disease and Eosinophilic Esophagitis in Children and Adults’ in BMC Gastroenterology
‘Eosinophils in Gastrointestinal Disorders’ in Immunology and Allergy Clinics of North America
‘2013 Update on Celiac Disease and Eosinophilic Esophagitis’ in Nutrients
‘Eosinophilic Esophagitis: New Insights in Pathogenesis and Therapy’ in the World Journal of Gastrointestinal Pharmacology and Therapeutics
‘Incidence and Prevalence of Eosinophilic Esophagitis in Children’ in the Journal of Pediatric Gastroenterology and Nutrition
‘Management of Eosinophilic Esophagitis and Celiac Disease’ in Current Opinion in Pharmacology
‘Increased Risk of Esophageal Eosinophilia and Eosinophilic Esophagitis in Patients with Active Celiac Disease on Biopsy’ in Clinical Gastroenterology and Hepatology
‘Individuals Affected by Eosinophilic Gastrointestinal Disorders Have Complex Unmet Needs and Frequently Experience Unique Barriers to Care’ in Clinics and Research in Hepatology and Gastroenterology
‘Eosinophilic Esophagitis and Celiac Disease: A True Association or Coincidence?’ in the Journal of Pediatric Gastroenterology and Nutrition
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal
Fri, 27 Apr 2018 - 31min - 68 - Why No Dairy on a Gluten-Free Diet? EP068
If you’re just getting used to eliminating gluten from your diet, it may feel like a burden to remove dairy as well—especially if you’re a fan of comfort foods like cheese and ice cream. Why exactly do many practitioners recommend a gluten- AND dairy-free diet to patients diagnosed with celiac disease and non-celiac gluten sensitivity?
The Gluten Free RN is walking us through the similarities between gliadin and casein, explaining how the proteins found in gluten, milk and cheese impact our brains. She discusses how Marsh 1 damage from celiac disease leads to an inability to break down the sugar in milk and why we crave the very foods that are making us sick.
Nadine shares the story of a young man with autism whose health improved once his family went gluten-free, describing the well-documented gut-brain connection and how the right high-fat diet can repair the neurological system. Listen in for the Gluten Free RN’s insight around dairy replacement options and get empowered to reclaim your health with a gluten- and diary-free diet!
What’s Discussed:The similarities between the gluten and casein proteins
Molecularly very similar, bodies read as toxins Both capable of crossing blood-brain barrierHow the casein protein impacts the brain
Causes inflammation, hypoxia (decrease flow of oxygen) Brain fog, anxiety, depression, irritability and fatigueThe effect of Marsh 1 damage due to celiac disease
Microvilli damaged or destroyed Can’t produce enzymes that break down sugar in milkHow gluten and casein proteins act as exorphins
Bind with opium receptors in brain Crave foods that make us sickNadine’s recommendations for dairy replacements
Coconut, hemp, almond or hazelnut milk Kite Hill and NuCulture cheese optionsHow a gluten-free diet helped a young man with autism
More interaction with family, fewer GI issues High-fat diet repairs neurological systemThe story of Dr. Terry Wahls
Diagnosed with MS, healed on gluten-free diet Resources:The Wahls Protocol by Dr. Terry Wahls
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal
Fri, 20 Apr 2018 - 21min - 67 - Indigenous Populations, Celiac Disease and NCGS EP067
‘Globally, indigenous peoples suffer from poorer health, are more likely to experience disability and reduced quality of life, and ultimately die younger than their non-indigenous counterparts.’
A UN Report on the health of indigenous peoples points to a significant problem, but the question is WHY? Why are native populations more prone to autoimmune disorders and type 1 diabetes? Why do they have a higher incidence of alcoholism and drug addiction? And why the lower life expectancy?
The Gluten Free RN is exploring the role of food in health outcomes for indigenous populations around the world. She begins with an explanation of the dietary differences between hunter-gatherer and agricultural societies, discussing how native populations were exposed to the gluten in grains only when European conquerors came to occupy their lands.
Nadine shares her challenge in finding information about indigenous populations and celiac disease, explaining why further study is necessary. She speaks to the highly processed nature of the commodity foods provided to Native Americans in the US and the shortcomings of Canada’s Food Guide when it comes to the health of First Nations people. Listen in and learn the significance of educating indigenous populations around celiac disease and non-celiac gluten sensitivity, empowering those groups to make choices that will improve their health and quality of life!
What’s Discussed:The global indigenous population
370M in 70-plus countries Rich diversity of culturesThe health status of indigenous populations
Higher incidence of autoimmune disorders, T1D Higher prevalence of addictive disorders, cardiovascular disease Lower life expectancy, increased morbidity/mortalityWhy indigenous populations have more health issues
Access to health care, isolation and lifestyle Food (hunter-gatherer vs. agricultural society)The lack of information around indigenous populations and celiac disease
Very few studies availableThe impact of grains on the native population
Significant change in health care outcomes, quality of lifeThe prevalence of celiac disease in indigenous populations
At least 1%, likely 3% or higher No way to know without mass screeningWhy eating healthy is a challenge for the indigenous population
Food scarcity, desserts Reliance on commodity foods provided by governmentThe conclusions of the Prairie Nymph blog on Canada’s Food Guide
Based on diet of European origins, doesn’t mention celiac disease Ignores health benefits of traditional diet for First Nations peopleWhy it’s important to educate indigenous people around celiac disease
Empower to make food choices with better health outcomes Resources:Guns, Germs, and Steel: The Fates of Human Societies by Jaren M. Diamond
Dough Nation by Nadine Grzeskowiak
USDA Commodity Supplemental Food Program
‘Canada’s Food Guide and Native Women’ by Prairie Nymph
The Sioux Chef’s Indigenous Kitchen by Sean Sherman
American Indian and Alaska Native Health
‘Celiac Disease: A Life-Changing Diagnosis’ in Indian Country Today
‘Government Food Boxes? It’s Nothing New for Native Americans’ on WDET
UN Indigenous Peoples Fact Sheet
Summary of Aboriginal and Torres Strait Islander Health
WHO Health of Indigenous Peoples
WHO Indigenous Peoples and Substance Abuse
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal
Fri, 13 Apr 2018 - 25min - 66 - How to Easily Go Gluten-Free or Paleo EP066
‘It’s too hard.’ ‘It’s too expensive.’ ‘It’s time-consuming.’ ‘My family won’t support me.’
There are lots of excuses why you can’t go gluten-free or Paleo, but the Gluten Free RN argues that if it’s hard, you’re doing it wrong. And today, she’s prepared to explain how to easily go gluten-free or Paleo and either maintain or regain your health.
Nadine begins with a discussion of the connection between food and pain or discomfort. She explains how the processed, non-food that most people consume causes damage that prevents us from absorbing the nutrients our bodies need. She offers insight around where to go for gluten-free, organic food and how to jump-start a gluten-free or Paleo diet.
The Gluten Free RN provides tips on taking control of your food choices, trying new foods, and gluten-free cooking—minus the cheap fillers. She also outlines a shopping list for nutrient-dense foods that will heal your leaky gut and feed your neurologic system. Listen in and learn the easy way to go gluten-free or Paleo and optimize your health!
What’s Discussed:The value in recognizing how you feel
Shouldn’t have pain, discomfort daily Underlying cause traced back to foodNadine’s response to excuses for not going gluten-free
No more expensive, must buy food anyway Food is medicine, good choices can improve healthHow to avoid non-food with empty calories
Stay away from soda, sugary coffees Pass up highly processed and fast non-foodThe difference between organic and conventional food
Conventional food—herbicides, pesticides, genetically modified Roundup causes leaky gut, even in absence of celiac diseaseNadine’s suggestions around where to go for gluten-free food
Grocery stores that cater to gluten-free population Local food co-ops, farmersNadine’s advice for going gluten-free or Paleo
Try new foods in the produce section Learn to pack simple breakfast, lunch and dinner Consider putting in garden Get re-educated, take control of food choices Replace cutting boards, toasters, etc.How to get started on a gluten-free or Paleo diet
Whole30 Program (eliminate grains, sugar and dairy)Nadine’s shopping list for a gluten-free diet
Fruits and vegetables Nuts and seeds Meat, fish and eggs Resources:Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal
Fri, 06 Apr 2018 - 31min - 65 - Russia and Celiac Disease EP065
As stories about Russia continue to dominate the news cycle, you are probably familiar with the recent sanctions against the country, Vladimir Putin’s reelection, and even the expulsion of Russian diplomats from the EU and US. But what do you know about celiac disease in Russia?
The Gluten Free RN is taking a closer look at the limited information about celiac disease in Russia, giving us an overview of the country’s size and population and the likely number of celiac cases based on the global tendency. She discusses the thriving wheat production industry in Russia as well as the gluten-containing traditional Russian diet.
Nadine walks us through a presentation created by Dr. Elena Roslavtseva at the Scientific Center for Children’s Health in Moscow, sharing how the diagnoses of celiac disease changed from the 1970’s through the 2000’s, the inconsistencies with testing for celiac disease around the nation, and the challenges of maintaining a gluten-free diet in Russia. Listen in as the Gluten Free RN covers the Journal of Immunology Research’s overview of celiac disease in Russia, explaining why the reported frequency probably doesn’t reflect the true prevalence and the necessity of a mass screening.
What’s Discussed:General information about the country of Russia
Population of 144.3M Dual nation state, 185 ethnic groups Largest country by land massRussia’s thriving wheat production industry
Very high, exported to Middle East and Africa Ban on genetically modified wheatThe first diagnoses of celiac disease in Russia
Late 1970’s—1980’s Cases of severe malabsorption No gluten-free foods availableHow celiac diagnoses changed in the 2000’s
Diagnosed more often, well-known in most regions Research done in many universities, med centersThe Eastern European countries that have done mass screenings
Romania, Slovakia, Slovenia, EstoniaWhy the data around celiac disease in Russia is unreliable
Variation in how practitioners test for celiac disease Belarus—HLA-typing not available in most cases Latvia—mandatory screening for patients with IDDM and AITThe problems associated with celiac disease in Russia
Unreliable data in absence of mass screening Gluten-containing traditional Russian foodThe overview presented in the Journal of Immunology Research
Diagnostic tools for celiac disease in Russia vary significantly Reported frequency of 0.2-0.6%, but real rate unknown Resources:‘Coeliac Disease and Gluten Related Disorders in Russia and Former Soviet Republics’ by Dr. Elena Roslavtseva
‘Overview of Celiac Disease in Russia: Regional Data and Estimated Prevalence’ in the Journal of Immunology Research
‘Russia, Argentina and Canada Displace US, Europe in Global Wheat Trade’ in agriCENSUS
‘Russian Wheat Sales Expand Global Reach with Surge in Sudan’ in Bloomberg
‘Russia’s Wheat Industry: Implications for Australia’ from the Australian Export Grains Innovation Centre
‘Growing Importance of Russian Milling Wheat Worldwide’ from Solaris Commodities
‘How an Oil Giant (Russia) Came to Dominate Wheat’ in Bloomberg
‘Celiac Disease in Russia and the Former Soviet Republics’ in The Celiac Scene
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal
Fri, 30 Mar 2018 - 18min - 64 - Review of Colombia University Celiac Disease Conference 2018 EP064
When faced with new information, it’s important to consider the source. Stop for a moment and examine whether the material is coming from someone with YOUR best interests at heart. The Gluten Free RN has just returned from the Colombia University Celiac Disease Conference, and she is breaking down the information presented to determine what’s useful—and what might be tainted by the pharmaceutical or food industry agenda.
Nadine begins with a workshop led by General Mills that offered some questionable information about how grains are processed at their factories and a talk led by University of Chicago faculty on the topic of a gluten challenge. She also speaks to the differences between celiac management in the US and countries with universal healthcare like Italy and Australia.
Nadine covers new testing that detects gluten exposure in stool or urine and what that reveals about the systemic nature of gluten damage as well as her take on practitioners who perpetuate the myth that grains are necessary and nutritious. Listen in for the Gluten Free RN’s insight around pharmaceutical treatments for celiac disease and the danger in volunteering for studies backed by drug companies.
What’s Discussed:The two programs available at Colombia’s 2018 conference
Clinical (nurses, RDs and laypeople) International (doctors, scientists, industry and VC)How celiac disease is managed in Italy
Presentation by Dr. Carolina Ciacci Law mandates gluten-free optionsNadine’s frustration with the General Mills presentation
Major sponsor of conference Claim to separate grains at factoryNadine’s take on gluten-free Cheerios
Should be avoided, not truly gluten-freeNadine’s confusion around Dr. Bana Jabri’s comments
Wouldn’t put ‘potential celiac patient’ on gluten-containing diet Did not include patients with positive antibody test but negative biopsyWhy the biopsy for celiac disease is problematic
Only tests one foot into duodenum GI tract is 30 feet in lengthNadine’s insight on a gluten-free challenge
No possible benefit for patient Unnecessary, unethicalThe systemic nature of gluten damage
New tests detect gluten exposure in stool, urine Urine test indicates passage through every systemNadine’s stance on pharmaceutical treatments for celiac disease
No pill or vaccine will treat or cure CD Harmful to people in studiesThe myth that grains are necessary and nutritious
Practitioners who perpetuate are ‘toeing company line’Why it’s important to understand the source of your information
Should be untainted by pharmaceutical money, agendaAustralia’s requirements for gluten-free food
Standard of less than 3 ppm Resources:Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal
Fri, 23 Mar 2018 - 27min - 63 - Poland and Celiac Disease EP063
To pierogi or not to pierogi…
If you have celiac disease, there is no question that you should avoid anything made with flour or grains, no matter how delicious the dish may be. Although the Gluten Free RN has fond memories of her Polish grandmothers making traditional pastries, she contends that you don’t have to eat customary Polish food to celebrate your Polish heritage.
In preparation for her upcoming trip to Warsaw in July, Nadine is taking a closer look at celiac disease in Poland. She discusses a 2009 study assessing the prevalence of celiac disease in Polish children, highlighting the asymptomatic and oligosymptomatic nature of the disease and explaining her own false negative test. Listen in for the Gluten Free RN’s insight around preparing for a trip to Poland, including research on the available gluten-free food and adult beverages!
What’s Discussed:Why Nadine is concerned about her upcoming trip to Poland
Flour, grains used in cooking and bakingNadine’s Polish heritage
Fond memories of grandmothers making pierogi, pastriesThe 2009 study of celiac disease in Poland
Assessed prevalence in children, only screened for IgA EmA, IgG EmA 3,235 children in Bydgoszcz tested, 25 identified (seven with Marsh III) Predominantly asymptomatic or oligosymptomaticNadine’s genetic predisposition for celiac disease
HLA-DQ2.5 homozygousHow Nadine is preparing for travel in Poland
Aware of Polish translations for gluten-free, celiac (bezglutenowe, trzewny) Take ‘rescue food’ for emergenciesThe prevalence of celiac disease in Poland
1:100 (matches worldwide estimate)The gluten-free alcoholic beverages available in Poland
Potato vodka, honey meadNadine’s caution against eating bread in Europe
Wheat, grain causes damage regardless of locationThe overlap between autoimmune and celiac disease
CD is grossly unrecognized, underdiagnosedNadine’s suggested diet for celiac patients
Meat, fish and eggs Nuts and seeds Fruits and vegetables Resources:NIH Consensus Development Conference on Celiac Disease
‘Screening for Celiac Disease in Poland’ in the Medical Science Monitor
Gluten-Free Globetrotter Blog on Poland
Gluten-Free Travel in Poland—Coeliac Youth of Europe
Poland Travel Guide—Coeliac UK
‘Graves’ Disease, Celiac Disease and Liver Function Abnormalities in a Patient—Clinical Manifestation and Diagnostic Difficulties’ in ACTA Biochimica Polonica
‘Neuropsychiatric Symptoms and Celiac Disease’ in Neuropsychiatric Disease and Treatment
‘Evaluation of HLA-DQ2/DQ8 Genotype in Patients with Celiac Disease Hospitalised in 2012 at the Department of Paediatrics’ in Przeglad Gastroenterologiczny
For Visitors with Coeliac Disease—Polskie Stowarzyszenie Osob z Celiakia i na Diecie Bezglutenowej
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 09 Mar 2018 - 23min - 62 - The Irish and Celiac Disease EP062
The Irish are known for being lucky… But does that luck hold out when it comes to celiac disease?
The prevalence of celiac disease among the Iris is 1:100, about the same as the rest of the world. And if you are a redhead of Irish descent, there is a good chance that you are an HLA-DQ2 or HLA-DQ8 gene carrier.
Today, the Gluten Free RN explores Irish ancestry and celiac disease, discussing how the Potato Famine led to a change in diet for much of the surviving population. She walks us through a paper published by Irish College of General Practitioners explaining the clinical presentations and complications of celiac disease.
Nadine shares her experience running the Dublin marathon and the health consequences she suffered after touring the Guinness brewery. Listen in to understand the work of the Coeliac Society of Ireland and learn about the trends in celiac disease among the Irish.
What’s Discussed:Why red hair is associated with celiac disease
Tend to be HLA-DQ2 and/or HLA-DQ8 gene carriersThe prevalence of celiac disease in Irish Setters
Do much better on a gluten-free/Paleo dietThe Irish Potato Famine
Potato-based diet, little access to grains Famine from 1845-1849 One million died, many emigratedThe myth that celiac disease is more prevalent in Europe than the US
30-50% of the population carries HLA-DQ2, HLA-DQ8 geneThe myth that women are more susceptible to celiac disease
Statistics don’t support this beliefThe Irish College of General Practitioners paper on celiac disease
Clinical presentations, complications of celiac disease Conditions associated with increased prevalenceThe prevalence of celiac disease in Ireland
1:100 (matches rest of world)The appropriate testing for celiac disease and NCGS
Blood test for total IgA/IgG, DGP and AGANadine’s experience running the Dublin marathon in 1998
Extreme edema in lower extremitiesThe information provided by the Coeliac Society of Ireland
Health ramifications of undiagnosed CD Average duration from symptoms to diagnosis (nine months) Resources:‘Gluten-Sensitive Enteropathy in a Family of Irish Setters’ in The Canadian Veterinary Journal
‘Diagnosis and Management of Adult Coeliac Disease’ in ICGP
‘Prevalence and Incidence of Celiac Disease in Edinburgh and the Lothian Region of Scotland’ in Gastroenterology
‘Prevalence and Diagnosis’ by the Coeliac Society of Ireland
‘Coeliac Disease in Europe’ in Alimentary Pharmacology & Therapeutics
‘Escalation in the Amount of Adults Diagnosed with Coeliac Disease’ in Lifestyle Health
‘Gluten-Free Foods’ by the Food Safety Authority of Ireland
‘How Irish Diets of the Past Affect the Present’ in The Irish Times
‘Changes in Presentation of Celiac Disease in Ireland from the 1960s to 2015’ in Clinical Gastroenterology and Hepatology
‘Coeliac Disease: A Personal Perspective’ in Irish Health
‘Coeliac Disease: More Common Than You Think in Irish Health
‘Pathology and Management of Coeliac Disease’ by the Dublin Academic Medical Centre & UCD
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 02 Mar 2018 - 26min - 61 - The US Military and Celiac Disease EP061
It goes without saying that anyone who serves in the military needs to be healthy and strong—and that military leaders have an obligation to keep enlisted servicemen and women as safe and healthy as possible. So, it makes sense that people with food allergies (including celiac patients) are disqualified from military service, but it is less clear why celiac testing is not a part of the medical exam to qualify for enlistment.
Today, the Gluten Free RN addresses the issue of celiac disease in the military. She explains the challenges of preparing gluten-free food in a mess hall setting and describes the consequences for an active duty soldier who is found to have celiac disease.
Nadine shares a research study exploring celiac trends among active duty military as well as a case study around veterans and celiac disease. Listen in for insight on what’s behind the increased prevalence of celiac disease among military personnel and the confirmed association between celiac disease and other complex health issues.
What’s Discussed:Why celiac patients are disqualified from enlisting in any branch of service
Unable to provide safe foodWhat happens to military personnel who are found to have celiac disease
Will receive medical dischargeThe US military policy around food allergies and intolerances
No accommodations madeCountries that allow celiac patients to serve
Israel, Finland and ScandinaviaThe Mayo Clinic study of celiac trends among active duty military
Healthy worker population with medical diagnostic coding Incidence of celiac disease increased five-fold from 1999-2008 Combination of increased suspicion and environmental factorsThe challenge of preparing gluten-free food in a military setting
High risk of cross-contaminationA case study involving military veterans and celiac disease
Confirmed association between CD and other complex issuesThe benefits of a gluten-free diet
Preventative for autoimmune disorders, nutritional deficiencies and cancerNadine’s argument for celiac testing prior to enlistment
Obligation to safety of servicemen/women
Resources:Military Standards of Medical Fitness
‘The Incidence and Risk of Celiac Disease in a Healthy US Adult Population’ in the American Journal of Gastroenterology
‘Celiac Sprue Among US Military Veterans: Associated Disorders and Clinical Manifestations’ in Digestive Diseases and Sciences
‘Gluten-Free Soldier in Afghanistan’ in Gluten-Free Living
‘Medical Mix-Up Sidelines Army Sergeant’s Career’ in Military Times
Celiac Disease-Related Veterans Affairs Case
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 23 Feb 2018 - 24min - 60 - Hepatitis B Vaccine and Celiac Disease EP060
We get vaccinated to protect ourselves, to gain an immunity to a particular disease. But in the case of hepatitis B, celiac patients may come to find out that we are NOT immune—despite having done the right thing in getting a hepatitis B vaccination.
Today, the Gluten Free RN is walking us through the latest research around vaccination and celiac disease. She explores the fact that celiac patients are more likely to be non-responsive to HBV than the general population, explaining the fundamentals of hepatitis B and the two main theories as to why the vaccine doesn’t work for some celiac patients.
Nadine shares her take on immunizations, explaining why she is a proponent of an alternate vaccination schedule for infants who may be immunocompromised. Listen in and learn how to determine whether you are truly immune to hepatitis B and protect yourself from potentially life-threatening disease!
What’s Discussed:The basics of hepatitis B (HBV)
Viral infection that attacks liver Transmitted through blood, body fluidsThe prevalence of hepatitis B
257M people infected 887K deaths in 2015The 2013 Italian study around celiac disease and the hepatitis B vaccine
Number of non-responders to vaccine higher in CD patients May be genetic OR caused by gluten intake during vaccinationNadine’s experience with vaccination as a child
Contracted mumps despite MMRNadine’s take on vaccination
Advocates for immunization to prevent disease Giving babies multiple vaccines at once may not be bestThe conclusion of a 2017 Italian study
Administer booster shots of hepatitis B vaccine as needed Evaluate response to vaccine in newly diagnosed celiac patients Revaccinate one year after adoption of gluten-free dietThe value of a hepatitis B titer
Confirms whether really immune If not, test for celiac disease Resources:‘Vaccinations in Celiac Disease’ in the Journal of Pediatric Gastroenterology and Nutrition
‘Immune Response to Vaccines in Children with Celiac Disease’ in the World Journal of Gastroenterology
‘Immune Response to Hepatitis B Vaccine in Patients with Celiac Disease: A Systematic Review and Met-Analysis’ in Human Vaccines and Immunotherapeutics
‘Early Vaccinations are Not Risk Factors for Celiac Disease’ in Pediatrics
‘Gluten Intake Interferes with the Humoral Immune Response to Recombinant Hepatitis B Vaccine in Patients with Celiac Disease’ in Pediatrics
‘Effect of Pentavac and Measles-Mumps-Rubella (MMR) Vaccination on the Intestine’ in Gut
‘Normal of Defective Immune Response to Hepatitis B Vaccine in Patients with Diabetes and Celiac Disease’ in Human Vaccines and Immunotherapeutics
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 09 Feb 2018 - 17min - 59 - Hypothyroid, Pulmonary Edema and Celiac Disease EP059
When the Gluten Free RN went on a gluten-free diet 11 years ago, her thyroid settled down and the associated symptoms and disorders—Graves’ disease, weight gain and hair loss—resolved.
But when Nadine was inadvertently hit with gluten two years ago, several of those symptoms returned, along with a few new ones. She was losing hair and gaining water weight again. On top of that, her sinuses were congested. She developed asthma, a rash on her lower right leg and a scary case of pulmonary edema (excess fluid in the lungs).
Hindsight being 20/20, Nadine realizes that her recent diagnosis of hypothyroidism is associated with that accidental gluten ingestion. Further study made it clear that there is a potential connection between her thyroid problems and pulmonary edema, as the leaky gut that comes with celiac disease can cause fluid shifts into body tissues.
Today the Gluten Free RN explores the links among celiac disease, thyroid disorders and pulmonary edema. She explains the function of the endocrine system, the symptoms associated with hypothyroidism, and the diet she recommends for patients with thyroid issues. Listen in for Nadine’s insight around how gluten affects the thyroid gland and why the resulting low sodium levels might trigger edema in celiac patients.
What’s Discussed:The function of the endocrine system
Glands in body that make hormonesThe connection between celiac disease and thyroid disorders
Thyroid especially vulnerable to gluten protein in wheat, barley, rye and oatsNadine’s symptoms of hypothyroidism
Lower extremity edema Congested sinuses Hair falling out Pulmonary edema Asthma Rash on legHow damp rash lotion resolved Nadine’s symptoms
Prescribed by acupuncturist in Chiang Mai Rash cleared, could breathe easy Symptoms returned within four weeks of return to USNadine’s thyroid-stimulating hormone (TSH) levels
Within normal limits despite thyroid issues Practitioner declined to order thyroid panelThe relationship between thyroid issues and edema
Sodium = major electrolyte, maintains body’s pH Hypothyroidism means low sodium levels Leaky gut of celiac disease leads to fluid shifts (edema)The research around thyroid disorders and celiac disease in Current Allergy and Asthma Reports
Association between CD and thyroid disorders well documented Increased prevalence of autoimmune thyroiditis and Graves’ disease in celiac populationsThe diet Nadine recommends for celiac patients with potential thyroid issues
Gluten-free, dairy-free Whole food, PaleoWhy patients with unexplained pulmonary edema should be tested for celiac disease AND thyroid disorders
Potential connection among all threeThe symptoms associated with hypothyroidism
Puffy face, constipation, fatigue Muscle weakness, aches and pains Irregular, delayed menstrual periods Hair loss, thinning hair Slower heartrate, hypothermia Depression, memory problems Resources:‘Pregnancy Complicated with Pulmonary Edema Due to Hyperthyroidism’ in the Journal of the Chinese Medical Association
‘Sleep Apnea, Hypothyroidism and Pulmonary Edema’ in CHEST Journal Letters to the Editor
‘Thyroid and Fluid Retention’ on the Wilson’s Syndrome Site
‘Acute Pulmonary Edema as a First Manifestation of Hyperthyroidism in a Pregnant Woman’ in Revista Medica de Chile
‘Hypothyroidism and Non-Cardiogenic Pulmonary Edema: Are We Missing Something Here?’ in Endocrinology, Diabetes & Metabolism Case Reports
‘Celiac Disease and Autoimmune Thyroid Disease’ in Clinical Medicine & Research
‘Celiac Disease and Autoimmunity: Review and Controversies’ in Current Allergy and Asthma Reports
‘An Unusual Cause of Flash Pulmonary Oedema’ in BMJ Case Reports
‘Challenges in the Management of a Patient with Myxoedema Coma in Ghana: A Case Report’ in Ghana Medical Journal
‘Hyponatremia and the Thyroid: Causality or Association?’ in the Journal of Clinical Medicine
‘Interactions Between Thyroid Disorders and Kidney Disease’ in the Indian Journal of Endocrinology and Metabolism
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 02 Feb 2018 - 19min - 58 - Mental Health Disorders and Celiac Disease EP058
An estimated 50% of Americans are on some type of psychotropic drug. Half of the US population!
What is causing such widespread prevalence of mental health disorders? Prescription anti-depressants and sedatives don’t solve the underlying problem… So how do we get to the bottom of this?
The Gluten Free RN contends that there may be a connection between mental health and undiagnosed celiac disease. Today she explains how several disorders (anxiety, depression and paranoia, among others) have been linked to gluten, discussing how a leaky blood-brain barrier can lead to hypoxia, an inflammation of the brain.
Nadine walks us through the best research in mental health disorders and gluten sensitivity, sharing two landmark studies that emphasize the gut/brain connection and characterize celiac disease as primarily a neurological disorder. Nadine offers her insight around working with schizophrenic patients and the increasing number of children suffering from anxiety. Listen in to understand how gluten impacts your mental health, and learn how to eliminate brain fog, get off prescription meds, and enjoy a higher quality of life!
What’s Discussed:The connection between gluten and hypoxia
Leaky blood-brain barrier leads to inflammation of brain, decreased oxygen flowThe shocking statistics around Americans and psychotropic drugs
Estimated 50% of US population on psychotropic medicationThe potential relationship between mental health disorders and undiagnosed celiac disease
High instance of depression, anxiety, fatigue and paranoia May have difficulty sleeping, headaches or seizure disorder Nearly all experience brain fogThe health consequences of undiagnosed celiac disease
Malabsorption of nutrients Damaged immune system Neurological symptoms Hormonal imbalance Neurotransmitter disruptionThe findings of the landmark Cooke study in 1966
Ten of 16 patients with celiac disease had severe progressive neuropathy All 16 had severe malabsorptionThe conclusion of an editorial published in Neurology, Neurosurgery & Psychiatry
Celiac disease, NCGS is primarily neurologicalHow a gluten-free diet can resolve gastrointestinal and psychiatric symptoms
Celiac disease can manifest as depression, anxiety or psychosis Research published in International Journal of Celiac Disease demonstrates gut/brain connectionNadine’s experience with schizophrenia patients
Majority are gene positive for HLA-DQ2, HLA-DQ8The increasing number of children diagnosed with anxiety disorder
May be caused by undiagnosed sensitivity to glutenThe concept of food as medicine
Body may read gluten as toxic, must remove from dietResources:
‘Psychiatric Complications of Celiac Disease’ in the International Journal of Celiac Disease
‘Genetic Hypothesis of Idiopathic Schizophrenia: Its Exorphin Connection’ in Schizophrenia Bulletin
‘Markers of Gluten Sensitivity and Celiac Disease in Bipolar Disorder’ in Bipolar Disorders
‘Neuropsychiatric Symptoms and Celiac Disease’ in Neuropsychiatric Disease and Treatment
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 26 Jan 2018 - 19min - 57 - My Health and Lessons for You EP057
Two and a half years ago, Nadine was inadvertently hit with gluten—three times in a row. In the past, it had taken about ten weeks for her symptoms to resolve after an accidental exposure, but this time they stuck around. It started with feeling cold. Then she began experiencing abdominal distention and pain. Her dermatitis herpetiformis returned, she was plagued with sinus congestion, and she was gaining weight. Most concerning of all, she developed pulmonary edema, a condition caused by excess fluid in the lungs.
Today, the Gluten Free RN is getting real, revealing the health struggles she has been dealing with since 2015. She explains the circumstances that led to her accidental gluten exposure and recounts the ten scary nights she spent in a recliner, forced to sit up in order to breathe.
Nadine takes us along on her global search for the answers that began with a practitioner in Thailand and a tiny container of damp rash lotion, and ended with a diagnosis of myxedema from a naturopath here in the States. Nadine discusses how those three consecutive hits of gluten targeted her thyroid gland and how T3 is working to resolve her symptoms. Listen in and learn how the Gluten Free RN is reclaiming her Superwoman status and how you, too, can reach your full potential with good health and wellbeing!
What’s Discussed:Maslow’s hierarchy of needs
Physiological, safety needs must be taken care of first Difficult to achieve self-actualization with poor healthNadine’s health struggle the past 30 months
Inadvertently hit with gluten three times in a row Symptoms persisted past usual ten weeks Sinus congestion, DH, pulmonary edema and weight gainNadine’s search for the underlying cause
Saw practitioner in Chiang Mai, damp rash lotion resolved symptoms Naturopath in Oregon diagnosed myxedema (hypothyroidism)How Nadine is reclaiming her health
Taking T3 to resolve symptomsHow a damaged thyroid gland impacted Nadine
Affected sleep, ability to do challenging physical activityThe importance of support in getting your health back
Need relationships to support choices Resources:Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 19 Jan 2018 - 22min - 56 - Celiac Disease for Nurses EP056
Celiac disease is messy. It can develop at any age, in any ethnicity, in both men and women, with any symptom or no symptom at all. Every patient is different, and each one presents differently. There is nothing cut and dried about celiac disease, except that a 100% gluten-free diet is necessary for healing.
Nurses are in a unique position to make sense of this chaos and advocate for patients, recognizing possible celiac disease and non-celiac gluten sensitivity and recommending appropriate testing when necessary. Today, the Gluten Free RN covers the basics of celiac disease for nurses, explaining the frequency with which the disorder is misdiagnosed or goes undiagnosed for years. She walks us through the testing required for a diagnosis of celiac disease proper, who should undergo testing, and why one negative test doesn’t rule out the disease.
Nadine speaks to the 300-plus signs of celiac disease, reviewing the most common symptoms and the overlap between celiac disease and autoimmune disorders like type 1 diabetes. She also shares the discouraging statistics around the impact of undiagnosed celiac disease on fetal development and maternal health. Listen in to understand why Nadine encourages fellow nurses include celiac disease as part of their differential diagnosis, providing gluten-sensitive patients with a safe, gluten-free environment and a higher quality of life!
What’s Discussed:The frequency with which celiac disease is misdiagnosed or goes undiagnosed
94% of people with celiac disease are undiagnosed Current estimate is 3% of US population Takes average of 9-15 years for diagnosisThe challenges around getting a diagnosis of celiac disease proper
Requires genetic test, celiac antibody test and documented villous atrophy Celiac antibody test = 70% false negative in USThe chronic nature of celiac disease
Patients must go 100% gluten-free for lifeThe 300-plus signs and symptoms of celiac disease
Primarily a neurological disorderWhy celiac patients must be tested for potential nutritional deficiencies
May need B12, Mg RBC, D3, Zn or I supplementsThe detrimental impact of undiagnosed celiac disease on fetal development, maternal health
800-900% increase in miscarriage Increased risk of stillbirth, premature birth and neural defectsWhere gluten is hiding
Medications, personal care products and food itemsWho should be tested for celiac disease
Patients with mental health issues, developmental delays Anyone with an autoimmune disorder (e.g.: type 1 diabetes) Family members of celiac patientsWhy one negative test doesn’t rule out celiac disease
Can seroconvert at any timeHow a gluten-free diet can benefit children with stunted growth
Growth resumes if diagnosed before epiphyseal plates seal Resources:Celiac Disease and Non-Celiac Gluten Sensitivity for Nurses
Recognizing Celiac Disease: Signs, Symptoms, Associated Disorders & Complications by Cleo J. Libonati
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 12 Jan 2018 - 35min - 55 - Hopes and Wishes for Celiac Disease in 2018 EP055
As we ring in the New Year, many of us take the time to jot down our aspirations for the next twelve months. What are your hopes and dreams for 2018? Health and happiness? An opportunity to travel? Stronger relationships?
Whether you have big plans to hike the Grand Canyon this year, or you simply resolve to get a little more sleep, it’s likely that aspects of health and wellness are a big part of your vision for 2018. The Gluten Free RN wants you to be happy and healthy in the coming year, and today she is sharing her hopes and wishes around celiac disease for 2018.
Nadine offers insight on taking control of what you can, including the food you eat. She shares her wish for widespread access to high-quality food and nutritional information that is NOT influenced by corporations. She explains the need for universal healthcare, better comprehensive testing for celiac disease (performed annually), and appropriate follow-up care for patients with a celiac diagnosis. Listen in to understand why Nadine advocates for a global celiac education campaign and learn how to evaluate new information about the disease with a critical ear. Let’s get happy and healthy in 2018 so that we can pursue all of our hopes and dreams!
What’s Discussed:Nadine’s wish for health, happiness and wellness
Reevaluate your choices and control what you can (sleep, food, activities)Why Nadine advocates for universal healthcare
Everyone deserves access to high-quality healthcare without financial strainThe need for better comprehensive testing
Healthcare providers should be educated in ordering, interpreting labsNadine’s hope for worldwide knowledge of celiac disease
Patients in US not diagnosed correctly for 70 years Consider mini-mass screening of patients/familyThe importance of accurate media coverage
Stories not influenced by sponsors, pharmaceuticals, etc.Why friends and family should be tested every year
Early diagnosis important Can be ruled in, not ruled outThe value of nutritional information not influenced by food companies
Understand where food comes from, how processedNadine’s aspiration for universal access to high-quality food
Organic, whole foods with minimal processing Provides fuel today, building blocks of healingThe need for appropriate follow-up care
Labs to address nutritional deficiencies, associated issuesNadine’s insight around celiac education
Seek information, evaluate with critical ear
Resources:Columbia University Celiac Disease Center
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 05 Jan 2018 - 23min - 54 - Thoughts on Celiac Disease EP054
In 11 years as the Gluten Free RN, Nadine has done an incredible amount of research on celiac disease and delivered more than 2,000 lectures. No question she is frustrated to see misinformation continue to make its way onto celiac support sites and Facebook groups. How does the average person sift through all the material that’s out there—material that may be influenced by corporations and pharmaceutical companies with a vested interest in the way celiac disease is perceived—to get to the most accurate information?
Just in time for the holidays, the Gluten Free RN is sharing her wish list around the direction of celiac disease and non-celiac gluten sensitivity in the next ten years. She discusses the need for a global mass screening, explaining how celiac disease meets the World Health Organization’s criteria. She covers the reasons why pharmaceutical companies have no place in celiac research as well as the bad publicity the gluten-free community receives in the media.
Nadine speaks to the grievous lack of education about celiac disease among healthcare providers and shares her hope for a cultural shift to support people on a gluten-free diet, explaining the role nurses can play in ending the needless suffering. She talks about why a gluten-free diet is NOT dangerous and how to make the best food choices based on your lifestyle and current situation. Listen in and get empowered to accept responsibility for your health!
What’s Discussed:The need for a global mass screening
Celiac disease meets WHO criteria 30-50% of population carries geneWhy pharmaceutical companies should not be involved in celiac research
Diet change resolves symptoms Pharmaceutical involvement gives false hope for cureThe misinformation about celiac disease in the media
Misrepresentation in recent episode of Freakonomics RadioThe need to educate healthcare providers around celiac disease
Recommended in 2004 NIH Consensus Statement Never happened in standardized formNadine’s call for support of people on a gluten-free diet
Don’t assume intentionally being difficultThe unique position of nurses to use their influence
Prevent needless suffering with understanding of celiac diseaseWhy you must accept responsibility for your own health
Take advantage of available resources Find practitioners open to other modalitiesHow to avoid processed foods
Focus on raw, whole foods Choose fresh fruits, vegetables Don’t fall victim to convenience marketing Use community, intuition to make decisionsWhy a gluten-free diet is NOT dangerous
Nadine restored her health by eliminating grains Unethical to suggest that celiac patient go off gluten-free diet Resources:Freakonomics Radio: The Demonization of Gluten
2004 NIH Consensus Statement on Celiac Disease
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 15 Dec 2017 - 25min - 53 - Alex Michaels from LPI on Vitamin C EP053
You know that vitamin C is good for you. It is necessary for the growth, development and repair of all your body tissues, and it plays a role in the healthy functioning of your immune system. But evidence shows that the RDA—90mg for men and 75mg for women—may be woefully inadequate. And if you are suffering from certain types of cancer or sepsis, vitamin C may be the key to recovery.
The Gluten Free RN is joined by vitamin C researcher Alex Michaels from the Linus Pauling Institute at Oregon State University to discuss the latest developments in vitamin C, explaining how intravenous vitamin C works to kill certain cancer cells and reverses the organ failure associated with sepsis. He also covers the difference between vitamin C inadequacy and vitamin C deficiency and the debilitating symptoms of scurvy.
Nadine and Alex speak to the best food sources of vitamin C and how it impacts other vitamins and minerals like iron and copper. Alex offers his advice around how much vitamin C you should get on a daily basis and explains why synthetic and natural vitamin C are identical. Learn about the LPI mission to determine the optimal ranges of micronutrients and phytochemicals you should be getting on a daily basis and how you can benefit from their research!
What’s Discussed:Micronutrients vs. macronutrients
Micronutrients are vitamins, essential minerals needed in small amounts (milligrams or micrograms/day) Macronutrients include fats, carbs and proteins (grams/day) Phytochemicals come from plants, affect health but not essential nutrientsThe difference between intravenous and oral vitamin C
Intravenous bypasses GI system, high concentration in bloodstream (up to 100 grams) Body can only absorb certain amount of oral vitamin C, inflammation may prevent absorptionVitamin C’s resurgence as a cancer therapy
High levels of intravenous vitamin C can covert oxygen to hydrogen peroxide Hydrogen peroxide floods and kills some cancer cells (e.g.: pancreatic tumors)Vitamin C’s role in the treatment of sepsis
Reverses organ failure, decreases inflammation May restore vitamin C to normal levels, protect from negative effects of ironThe availability of intravenous vitamin C
Difficult to obtain, naturopaths usually have dedicated supplier More readily available in Australia, New ZealandThe fundamentals of scurvy
Defined as deficiency in vitamin C Symptoms include bleeding gums, corkscrew hair growth, open wounds, malaise and low energy Very rare in western world, would have to go without any fruits or vegetables for months May have vitamin C inadequacy without any outward signs of problemThe best food sources of vitamin C
Chili peppers Tropical fruits (papayas, Kakadu plum, camu camu)Factors that are known to denigrate vitamin C
Heat, light and air Mechanical disruption (i.e.: juicer) Basic pH (anything above 7) Enzymatic factors Iron, copperHow vitamin C impacts other vitamins and minerals
Enhances iron absorption, some must be careful of iron overload Synthetic vitamin C may deplete copper concentrationAlex’s take on the appropriate daily intake of vitamin C
400 mg/day recommended RDA much too low Resources:Micronutrient Information Center
Biochemical, Physiological, and Molecular Aspects of Human Nutrition by Martha H. Stipanuk PhD and Marie A. Caudill
Cancer and Vitamin C by Ewan Cameron and Linus Pauling
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 08 Dec 2017 - 46min - 52 - Go Gluten Free for Good EP052
How do you successfully transition to and maintain a 100% gluten-free diet for the rest of your life? The prospect of eliminating wheat, barley and rye from your diet may seem daunting, but it is possible to go gluten free for good—for the good of your family and your health!
The Gluten Free RN explains the addictive nature of gluten and what to expect during the detox process as you begin your gluten-free journey. She offers valuable advice around how to choose the best quality food products while avoiding potential sources of cross-contamination.
Nadine discusses the need for supplements that will help you heal faster and more completely, speaking to the vitamin levels you should monitor along the way. Listen and learn her best tips for navigating the grocery store and maintaining a positive attitude throughout the process of going gluten-free—for GOOD!
What’s Discussed:The addictive nature of gluten
Gliadin, gluten proteins bind to opioid receptors Wheat, barley and rye are cheap and readily availableWhat to expect during the detox process
Different for everyone Consider elimination diet to reboot system May feel worse before feel better Headaches, low energy and feeling hungry are commonWhy you shouldn’t cheat on a gluten-free diet
Same autoimmune response, even if symptom-freePotential sources of cross-contamination
Processed foods Unwashed fresh fruits, vegetables Bulk bins Restaurants Own home (i.e.: cutting boards, hands, pets, utensils, appliances, etc.)Nadine’s rules around choosing quality food products
Five ingredients or less Picture every ingredient Certified gluten-free 100% grain-freeWhy there is no such thing as cheap food
Pay for quick-fixes to treat symptomsThe necessity of additional vitamins, supplements
Helps heal faster, more completely Use multivitamin, fish oil, pre- and probiotics Check levels of D3, Zinc, B6 and B12 Liquid, chewables and capsules are easier to break downNadine’s advice around navigating the grocery store
Plan menus in advance Bring list of safe foods Read labels carefully Consider local co-ops, natural grocers and farmers marketsNadine’s best tips for going gluten-free
Concentrate on what you can eat Accept more cooking, baking and meal planning Find support group Stay current on research, food labeling Practice mindfulness, maintain positive attitudeResources:
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 01 Dec 2017 - 36min - 51 - Nutrient Dense Foods EP051
‘When in doubt, go without.’
The problem with processed food is that you simply can’t be sure that it is gluten-free. The risk of cross-contamination is high, and no one at the big corporations is accountable for your health. Not to mention the fact that processed foods have been irradiated to make them shelf-stable, effectively killing any probiotics. Even certified gluten-free products are often low in nutrients, high in calories—and expensive!
So what should you eat? The Gluten Free RN is on the case with her best suggestions around finding organic, whole foods that contain the healthy fat you need to heal. She explains her revised, gluten-free version of the food pyramid and discusses how these nutrient-dense foods support the healing process.
Nadine provides a list of the best nutrient-dense foods, offering the benefits of each. She also speaks to the most appropriate vitamins and supplements available to solve your nutrient deficiencies. You are what you eat, so make sure you are filling your tank with nutrient-dense foods that will improve your health and quality of life!
What’s Discussed:How nutrient dense foods support healing
Regenerate villi Reduce inflammation of intestines Heal immune systemWhy Nadine recommends staying away from gluten-free junk foods
Low in nutrients, high in calories Risk of cross-contamination (processed in facilities with wheat products)The best sources of nutrient-dense foods
Whole foods, organic Farmers market (few/no fertilizers)Why shelf-stable products lack nutrients
Food dead from irradiation, no live probioticsThe risk of contamination in processed foods
No one accountable at big corporation ‘When in doubt, go without’Nadine’s revised food pyramid
Fruits and vegetables at base Meat, fish and eggs Nuts, seeds and berriesThe importance of eating healthy fats
Heals intestines Absorb fat-soluble vitamins (A, D, E and K) Fix deficiencies Healthy brain cells, nervous system Balance hormonesNadine’s recommendations around the best nutrient-dense foods
Sweet potatoes Leafy greens (e.g.: kale, collard greens) Berries Coconuts Black molasses Avocados Pumpkin, chia seeds Meat and fish High-quality eggs Licorice root, peppermint tea CinnamonNadine’s vegetable challenge
Expand your vegetable repertoire Try one new veggie per weekNadine’s suggestions around additional vitamins, supplements
Good quality multivitamin Fish oil (i.e.: Nordic Naturals) Pre/probiotics Vitamin DHow to avoid cross-contamination
Avoid bulk food bins Wash produce Resources:National Nurses in Business Association
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 24 Nov 2017 - 38min - 50 - Managing the Holidays with Celiac Disease EP050
With the approach of the holidays, you may be nervous about navigating family and workplace gatherings—especially if you are newly diagnosed with celiac disease. How do you explain your dietary restrictions and keep yourself safe, eating well without getting ‘glutened’?
Today the Gluten Free RN shares her best advice around managing the holidays with celiac disease. She offers ten key tenants to help you enjoy the holiday season and mitigate stress, without feeling like you’re missing out. She shares some things you need to avoid, including unsafe situations, people who make you miserable, and cheating on your gluten-free diet! But she also discusses strategies you can implement to make the season bright, such as creating new traditions, getting creative in the kitchen, and finding your tribe—the people who will support you in your gluten-free journey.
Nadine also gives tips around where to go for gluten-free ingredients and holiday recipes, and how to develop a backup plan so you won’t go hungry if the food you encounter is questionable. You are likely to encounter well-intentioned friends and family members who have no idea how to feed you safely at holiday parties. Listen in and learn how to be clear about your dietary needs and take control of your health without isolating yourself from loved ones during this most wonderful time of the year!
What’s Discussed:#1 Don’t eat anything contaminated with wheat
Cannot eat center of pie, any part of turkey with bread stuffing#2 Beware of good-intentioned people
Don’t eat anything questionable Bring a snack with you just in case#3 Be prepared to establish new traditions
Get creative in kitchen#4 Don’t isolate yourself
Find support group, create your own#5 Gather recipes early
Reference Paleo Magazine, gluten-free cookbooks Follow Sara Ballantyne#6 Order ingredients in advance
Consider organic, free range turkey#7 Don’t invite people who make you miserable
Set clear boundaries (no complaints, ridicule)#8 Eat before you go or take your own plate
‘Desperate people make desperate decisions’ Take a dish to share, take your portion first#9 Don’t be a victim
Be clear about your needs#10 Find your people
Those who truly love you don’t want you to be sick Resources:Paleo Principles: The Science Behind the Paleo Template, Step-by-Step Guides, Meal Plans, and 200+ Healthy & Delicious Recipes for Real Life by Sarah Ballantyne
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 17 Nov 2017 - 30min - 49 - Lyme Infection and Celiac Disease EP049
If you’ve been following a strict gluten-free diet, but continue to suffer from lingering neurological symptoms, you may need to explore the possibility that you have Lyme disease. In fact, there are many parallels between celiac disease and Lyme, and the Gluten Free RN has called in an expert to discuss the similarities between the two disorders and why a gluten-free diet is part of the proper treatment for both.
Dr. Usha Honeyman, a chiropractic and naturopathic physician out of Corvallis, Oregon, joins Nadine to explain the fundamentals of Lyme disease. She shares her best advice around prevention and treatment, exploring why it can be difficult to get an accurate diagnosis.
Nadine and Usha also cover the inflammation of the gut that plagues both celiac and Lyme patients, the neurological component of Lyme disease, and the relationship between Lyme and illnesses like MS, Parkinson’s and ALS. Listen in to understand what can happen when Lyme goes untreated and how antibiotics coupled with a gluten-free diet may restore your health!
What’s Discussed:The fundamentals of Lyme disease
Most common insect-borne disease in US Primarily carried by tics (disable immune system at bite site) CDC estimates 300K new cases each yearHow to prevent Lyme infection
Repellants, Insect Shield clothingHow the political controversy in medicine has led to conflicting information around Lyme disease
The treatment for Lyme disease
Long-term antibiotics T3 to raise body temperature, make white blood cells more efficient Probiotics to support immune systemWhy Dr. Honeyman advises Lyme patients to go gluten-free
Lyme causes inflammation of gutThe neurological component of Lyme disease
Spirochetes permeate blood-brain barrier Cause brain fog, balance issues, sensory disorders, etc.The alpha-gal reaction in Lyme patients in the Southeast US
The strange gait and lower-face movement in Lyme patients
Bell’s palsy is red flag for Lyme diseaseThe importance of having a Lyme-literate doctor
Skin scraping of rash for diagnosis available in research setting ELISA and Western blot miss 80-90% of Lyme patientsThe consequences of untreated Lyme disease
The three forms of Borrelia
Spirochete-form, intracellular and cysticResources:
Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar—Your Brain’s Silent Killers by David Perlmutter
International Lyme and Associated Diseases Society
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 10 Nov 2017 - 49min - 48 - Gluten Free Products EP048
The increasing number of gluten-free products on the market can be both a blessing and a curse. Yes, it gives us more options, but are those options truly safe and healthy?
Today the Gluten Free RN goes over the important questions to ask about the products you consume, explaining how the foods promoted by some gluten-free groups may be influenced by their corporate sponsors. She reminds us why we can’t simply trust the products labeled ‘gluten-free’ or ‘gluten removed,’ discussing the lack of oversight and standardization around classification and the cumulative effect of consuming a number of products that are just under the 20 ppm cutoff.
Nadine also shares a list of companies she trusts to consistently produce gluten-free products and offers suggestions around new food options we might explore. Listen in and learn to choose the nutrient-dense foods that will help your body heal!
What’s Discussed:The importance of questioning the source of your information
Gluten-free groups take money from sponsors (corporations, pharmaceutical companies)Why Nadine avoids the ‘gluten removed’ label
The questions to ask about gluten-free products
Is it manufactured in a designated facility? From where do they source the ingredients? Do they batch test those ingredients?The cumulative effect of eating many products just under 20 ppm
Reliable companies that consistently produce truly gluten-free products
The challenges faced by newly diagnosed celiac patients
Feeling different Loss of convenienceWhy Nadine avoids gluten-free breads
New food options to explore as a celiac patient
Why Nadine recommends reevaluating the foods you consume
Ensure they are nutrient dense, don’t cause inflammationWhy you can’t trust product labels
Corporations given six months to update after ingredients change Not required to test products labeled gluten-free (no oversight, standardization)Nadine’s rules around choosing products
Five ingredients or less Must be able to picture ingredients Resources:The Gluten Intolerance Group of North America
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 03 Nov 2017 - 34min - 47 - FAQ’s About Celiac Disease Answered EP047
How do I get over feeling sad about giving up the foods I love? Don’t celiac patients look a certain way? Can I eat wheat when I travel to Europe?
Today the Gluten Free RN is answering your frequently asked questions about celiac disease, clearing up misconceptions around the safety of wheat in Europe, the appearance of a celiac patient, and the percentage of the population that suffers from gluten sensitivity. She speaks to the challenges of getting your healthcare provider to do appropriate testing for celiac disease and the learning curve associated with changing your diet.
Nadine also explains the risks of embarking on a gluten challenge and the benefits of a super-good high fat diet. She discusses why a single breadcrumb can trigger an autoimmune response and how she uses tools like a Nima Sensor when she eats out. Listen in and learn why one negative test doesn’t rule you out for celiac disease, especially if you suffer from type 1 diabetes.
Having celiac disease doesn’t mean you have to live in a bubble. The Gluten Free RN wants to give you the answers you need to navigate the world—happy, healthy and gluten-free!
What’s Discussed:‘My sister has celiac disease, but I tested negative. I do have type 1 diabetes… What should I do?’
Get genetic test for HLA-DQ2, HLA-DQ8 Virtually every type 1 diabetic is gene carrier One test doesn’t rule you out‘Why do you use a Nima Sensor or EZ Gluten test strips? Doesn’t it give you a false sense of security?’
Have to trust others to prepare food when out Not foolproof, but does give decent idea‘A single breadcrumb or dusting of flour can trigger an autoimmune response? Really?’
‘I am overweight, I have dark hair, and I’m not of European descent. Don’t celiac patients look a certain way?’
Can’t see genes, celiac disease can affect any population worldwide Overweight patients tend to be malnourished (unable to absorb nutrients) Never rule out based on appearance, may not show physical symptoms‘Why do you recommend a super-good high-fat diet?’
‘I’m already on a gluten-free diet. Do I need to go back to gluten to prove I have celiac disease?’
‘My cousin was just diagnosed with celiac disease, and she is very sad about giving up the food she grew up with. How can she get started on a gluten-free diet?’
Steep learning curve goes with process Okay to feel sad, angry Remember you will get better without surgery, medication Try to see as an adventure‘Why won’t my doctor order tests for celiac disease?’
Countries with for-profit healthcare tend to do poor job of testing, follow-up care Fragmented, inaccurate education around celiac disease Be own best advocate‘Can I eat wheat in Europe?’
‘Is it true that celiac disease affects 1% of the population?’
1% translates to 3M people 3% is more accurate statistic Won’t know for sure until conduct mass screening Resources:Gluten Free RN EP027: Type 1 Diabetes and Celiac Disease
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 27 Oct 2017 - 30min - 46 - Where Gluten Hides EP046
Never assume. It makes an ass of u and me!
Not only do assumptions make you feel foolish, they can be dangerous. If you suffer from celiac disease or non-celiac gluten sensitivity, assuming that a product is safe and gluten-free can be hazardous to your health! Gluten is hiding is some surprising places, from cashews to PlayDoh, and it is in your best interest to remember that anything processed in the same facility with wheat is at risk for contamination.
Today the Gluten Free RN shares the many places she has discovered gluten ‘hiding in plain sight,’ including personal care products, olive oil and communion wafers. She offers advice around supporting companies that are 100% gluten-free, alternatives to gluten-containing products, and choosing nutrient-dense foods that will help you heal.
Nadine also covers labels, discussing why you can’t necessarily trust the information you find there, the many different names for wheat to look out for, and why you should take a look even when the product should be naturally gluten-free. She reveals some of her favorite gluten-free products as well as several companies that are committed to maintaining gluten-zero production facilities. Listen in and learn how to make good choices—without giving up the activities you love. Eating gluten-free doesn’t have to be a punishment, and the Gluten Free RN can’t wait to share!
What’s Discussed:Why Nadine sticks with clearly marked gluten-free products
Some of the surprising places gluten hides
Olive oil, kombucha, hard ciders, smoothies and other drinks Alcohol and malted beverages Lipsticks, lip balms and gloss Communion wafers Supplements and medications Play-DohWhy you can never assume a product is naturally gluten-free
Anything processed in same facility with wheat is at-risk for contaminationWhy Nadine encourages the support of companies striving to be 100% gluten-free
Don’t have to worry about safety Sends message to companies with unclear labelsThe many different names for wheat to watch out for on labels
Alternatives to gluten-containing products like bread, crackers and chocolate
Why you can’t trust labels
Companies have six months to change a label after ingredients, info has changed Must read label every time buy product, refill prescription medicationThe cumulative effect of consuming products that contain just under 20 ppm of gluten
Why Nadine urges you to be picky
Don’t settle for cheap filler foods Only nutrient-dense foods will help you heal Resources:Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 20 Oct 2017 - 31min - 45 - The Psychology of Eating Gluten Free EP045
We all just want to fit in, so it can be embarrassing to have special needs when it comes to your diet. Whether you are gluten-free, Paleo, or suffering from food allergies, a feeling of isolation is not uncommon. After all, you have to eat differently from the rest of your friends, family, or colleagues—and that makes you stand out. You run the risk of being perceived as picky or annoying, when the truth is that certain foods are toxic to your system!
Today the Gluten Free RN speaks to the psychology of eating gluten-free, explaining the sense of disbelief many gluten-sensitive individuals feel when the food they love turns out to be poison. She discusses ‘food ideology’ and why changing your diet can be so challenging.
Nadine also covers the doubt, mocking, and even anger that celiac and gluten-sensitive individuals face, offering suggestions for building connections with a like-minded, gluten-free community. Listen in as she outlines her approach to dating on a Paleo diet and reassuring family and friends who find a gluten-free diet too restrictive for kids. Learn to be your own best advocate and resist the social pressure to eat the standard American diet!
What’s Discussed:Why gluten sensitive patients must be willing to experiment
Learn how body works best Identify foods that allow body to heal Pinpoint foods that cause symptomsA downtown Corvallis business owner’s testimonial
Couldn’t get doctor to test for celiac disease Family gave hard time Gluten-free for year Bloating, abdominal pain went away Head clearHow to research the possibility that gluten is causing your symptoms
Search PubMed Use both spellings (celiac, coeliac)Why people are resistant to diet change
Subscribe to particular food ideology Media, social pressure to eat standard American dietThe difficulty around getting a celiac diagnosis
The value of preventative medicine
Dating on a gluten-free diet
Look for someone open to new ideas Nadine’s partner is supportive, willing to change On food path together Health benefits whether celiac or notThe human need to be part of a community
Celiac patients may feel isolated from family, at work/school Find ‘your people’ (gluten-free support group, cross-fit gym)The global shift to a Western diet
Export fast food to world Increased consumption of wheat, barley, rye and oatsWhy Nadine recommends a Whole30 diet
Remove all grains, dairy, alcohol and sugar Eat meat and fish, nuts and seeds, fruits and vegetables Allows body to reboot Evaluate how you feelThe narcotic-like effect of gluten on the brain
Comfort foods (pasta, pizza) contain wheat, dairy Cause chemical reaction in brainNadine’s recent experience in hospitals
Only nutrient-deficient, packaged foods available Offerings toxic, full of sugarNadine’s rules around ingredients in packaged foods
Five ingredients or less Must be able to picture every ingredientWhy people on a gluten-free diet are reluctant to tell others
Don’t want to be difficult, needy Don’t want to call attention, be seen as ‘other’ May be questioned or face anger, mocking Demoralizing to go to restaurant, grocery store (can’t eat 90%)How to approach neighbors or family who view a gluten-free diet as too restrictive for kids
Ensure that kids are healthy, thriving Let them know ‘not missing out’The psychology of denial
Some celiac patients believe okay to cheat Bread crumb, dusting of flour can cause autoimmune responseNadine’s opposition to a gluten challenge
Can cause organ damage Some never recoverThe genes that indicate a predisposition to celiac disease
HLA-DQ2 HLA-DQ8 Resources:Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Fri, 13 Oct 2017 - 38min - 44 - Staying Healthy in the Hospital with Celiac Disease EP044
Hospitalization is nearly always the result of a sudden, unexpected event. So how do you plan ahead to keep yourself safe in the event that a health emergency lands you in the nearest emergency room? What steps can you take to stay healthy in the hospital as a celiac or gluten-sensitive patient?
Thanks to a listener suggestion and Nadine’s recent experience with a client recovering from surgery, the Gluten Free RN is addressing the cross-contamination risk in hospital kitchens and the nutrient-deficient foods available in hospital gift shops and vending machines. She also covers the responsibilities of the pharmacist to ensure that medications are gluten-free as well as resources you can use to verify that your prescriptions are safe.
Listen in as Nadine explains the significance of having an advocate with you at the hospital, who can prevent inadvertent gluten exposure and bring in the nutrient-dense food you need to heal. Learn how to communicate your needs as a celiac patient to resistant doctors, nurses, pharmacists and RDs, and plan ahead to stay safe and healthy—even when you’re in the vulnerable position of being in the hospital.
What’s Discussed:Why celiac patients should be skeptical of gluten-free menus in the hospital
Nadine has patient in hospital for hip surgery Found out food all cooked on same grill Risk of cross-contamination very high Gluten protein extremely heat stable Made arrangements to bring in safe foodThe quality of food available in hospitals
Gift shops, kitchens and vending machines ‘abysmal’ Often nutrient-deficient, high in gluten Gas station lineup of junk foodHow to verify that medications are gluten-free
Can’t bring medication from home in US Must check prescriptions every time Use Gluten Free Drugs websiteThe role of the pharmacist in providing gluten-free medication
Job to ensure safety Should never say ‘don’t have time,’ pass responsibility to patient Must check prescriptions, over-the-counter meds, topical treatments Enteral supplements (through tube) must be checked as wellWhat you can do to communicate your needs to hospital staff
Band indicating gluten allergy, celiac status Proper labels on all records Bring vigilant advocate to assist Provide letter(s) from Gluten Intolerance Group of North AmericaThe significance of having an advocate
Friend/family member, fellow support group member or paid advocate Provide access to safe food brought in (too many variables in hospital) Can speak for you when vulnerable (e.g.: crackers after surgery) Assign person before in position to need (sudden, unexpected events)Gluten-free options for patients on a liquid or soft food diet
Bone broth Soup with vegetablesThe role of nutrient-dense food in healing the body
Bring 100% gluten-free ‘safe stash’ to hospital Refer to Nadine’s list of nutrient-dense options Remember products labeled gluten-free = < 20ppm (not zero)The Catch 22 of gluten and hospitals
Getting hit with gluten can put in hospital (i.e.: dehydration, GI bleed) Difficult to stay gluten-free in hospital Already at-risk to get sickerHow antibiotics affect your system
Wipe out good normal flora along with bad bacteria Need good probiotics, fermented foods to reestablish microbiome
Resources:Dough Nation by Nadine Grzeskowiak
Emergency Preparedness with Nutrient Dense Foods
GIG Resource: Hospital Stays Made Safe
Gluten Intolerance Group of North America
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Fri, 06 Oct 2017 - 28min - 43 - Eating Disorders and Celiac Disease EP043
Imagine being admitted to a psychiatric hospital and accused of being a pathological liar because no matter how carefully you follow the high-carb diet prescribed by your physicians, you continue to lose weight. In the introduction to his book, How Doctors Think, Dr. Jerome Groopman shares the story of a woman who was misdiagnosed with anorexia nervosa. The patient was ready to give up when one last doctor discovered villous atrophy and determined that it was celiac disease—not an eating disorder—that was causing her malnourishment.
Today the Gluten Free RN explores the reasons why celiac disease and gluten sensitivity are often mistaken for anorexia nervosa. She shares the limited research in the field, as well as the symptoms related to malnourishment that may be caused by gluten, including several mental health disorders.
Listen in as Nadine covers the use of PWAG (people who avoid gluten) as a derogatory term and shares her frustration with labels like ‘orthorexia nervosa’ which imply that gluten-sensitive patients are obsessed with healthy food: ‘I avoid gluten like the plague because it is, in fact, the plague for those of us who have celiac disease.’
What’s Discussed:The use of PWAG as a derogatory term
‘People who avoid gluten’ Half of people in US Implies food crazed/obsessedThe new term orthorexia nervosa
Refers to obsessive behavior in pursuit of healthy diet Not clinical term/official diagnosisThe concept of food as medicine
Anecdotal evidence of celiac disease misdiagnosed as anorexia
Introduction of Dr. Jerome Groopman’s book, How Doctors Think Woman admitted to psychiatric hospital (thought to be pathological liar) Continued to lose weight despite prescribed high-carb diet Biopsy revealed Marsh 4 damage Gluten-free diet resolved symptomsWhy celiac disease and gluten sensitivity are misdiagnosed as eating disorders
Inability to absorb nutrients results in severe weight loss, malnutrition Become picky eaters because food causes suffering Practice food avoidanceThe prevalence of celiac disease
3% of the US population Millions undiagnosedHow gluten affects a celiac patient
Gluten protein as neurotoxin Damages intestines Impairs immune system Causes inflammation Heart attack Stroke Joint, muscle pain Any -itisNadine’s recommended variation of a Paleo diet
Local, organic, whole foods 100% grass-fed beef (no antibiotics/hormones) Nutrient denseThe study of celiac disease and eating disorders
Very few research studies in last 11 years Handful of case studies in literatureThe issues associated with malnourishment
Little body fat Cachectic Hormonal disruption Thyroid issuesThe anger and contempt Nadine has experienced as the Gluten Free RN
Gluten, dairy associated with comfort food People resistant to give upThe mental health issues associated with malnourishment
Significant cognitive impairment Hypoxia Brain atrophy (shrinking)The effect of gluten on epithelial tissue
Leaky skin, lungs, blood vessels, blood-brain barrier Causes increased/decreased blood pressure, POTSThe consequences of gluten getting through the blood-brain barrier
Causes hypoxia Brain needs oxygen to work appropriately Brain fog (irritability, anger) Early onset dementiaThe shocking statistics around psychotropic medication in the US
Up to 50% of population on anti-depressants, mood-altering drugs Gluten-free diet could help ‘get brain back’Nadine’s advice for parents of children who miss multiple days of school
Could be undiagnosed celiac disease No downside to clinical trial of gluten-, dairy-free diet Consider Whole30 Diet (eliminate sugar, grains, legumes)The process of a gluten detox
Gluten has narcotic-like effect on brain May feel worse before you feel better One day to two monthsThe benefits of maintaining a gluten-free diet
Anxiety goes away Mood improves Able to sleep Pain resolves Heal intestines, epithelial tissue Reduce inflammation Heal immune system Brain receives necessary oxygenThe foods Nadine recommends as part of a super-good, high fat diet
Avocados Olive oil Coconut oil Coconut milk Hemp milkWhy Nadine chooses not to eat if there is any risk of gluten contamination in her food
The places where gluten hides
Single bread crumb Dusting of flour Oil French fries cooked in Personal care products Resources:How Doctors Think by Jerome Groopman, MD
“The Interaction Between Eating Disorders and Celiac Disease: An Exploration of 10 Cases” in the European Journal of Gastroenterology & Hepatology
“Orthorexia and Anorexia Nervosa: Two Distinct Phenomena? A Cross-Cultural Comparison of Orthorexic Behaviours in BMC Psychiatry
“Predictors of Orthorexic Behaviours in Patients with Eating Disorders: A Preliminary Study” in BMC Psychiatry
“Eating Disorders and Celiac Disease: A Case Report” in The International Journal of Eating Disorders
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 29 Sep 2017 - 33min - 42 - The 2017 International Celiac Disease Symposium Recap #1 EP042
In his opening talk at the 2017 International Celiac Disease Symposium, celiac expert Dr. Abul Abbas of UC San Francisco said, “We are drowning in data, but thirsting for information.” Though there is still much debate around celiac disease and non-celiac gluten sensitivity (even among global experts), the featured ICDS speakers sifted through the numbers to help practitioners interpret what the latest studies can tell us about the negative effects of gluten and how celiac disease presents in populations all over the world.
Today the globetrotting Gluten Free RN is coming to us from Thailand, after attending the International Celiac Disease Symposium in New Delhi, India. Armed with the latest information from the ICDS clinical forum, Nadine covers talks given by Dr. Abbas on gluten and the immunological system, and Dr. Alessio Fasano on the spectrum of gluten-related disorders. She relays information regarding the barriers researchers face in studying autoimmune disease as well as gluten’s negative impact on body tissue, including that of our brain.
Nadine also shares the most up-to-date statistics around the big business that is celiac disease and the increasing prevalence of gluten intolerance in the US and Asia. She discusses the importance of celiac testing in patients with other autoimmune and neurological disorders and the need for a global education campaign. Listen as Nadine educates you about what gluten is, where it hides, what you can do to avoid it, and how to undo the damage and get healthy again!
What’s Discussed:The challenge of eating gluten-free in India
Conference food wasn’t entirely gluten-free Nima sensor helped identify unsafe meals Travel with stash of safe food Carry Gluten Free Passport Allergy Cards to communicate dietary needsThe highlights of Dr. Abul Abbas’ talk on the immunological system
Celiac disease as autoimmune issue ‘Drowning in data, but thirsting for info’The importance of the thymus gland
T cells manufactured thereWhy the ‘mouse model’ doesn’t work well in the study of celiac disease
The impossibility of in vivo experiments for celiac research
The significance of epithelial barriers in a functioning immune system
First line of defense against microorganisms Produce local antibodiesThe difficulty of studying the dendritic cells
Inside tissuesHow the immune system recognizes double-stranded RNA (viruses)
Can’t escape autoimmune response Should not recognize own single-stranded as ‘invader’Dr. Terry Wahls’ work around the mitochondria
Cured MS with Paleo dietDr. Alessio Fasano’s presentation
‘Spectrum of Gluten-Related Disorders’ Controversy re: who should go gluten-free Gluten affects every tissue in body (even brain) Celiac cases double every 15 years in US 1:2 in US will try gluten-free diet this yearThe big business of celiac disease
$17.6B industry at end of 2017 Largest untapped market in worldWho is affected by the gluten protein
Gluten can’t be digested by human body (long chain amino acid) Triggers autoimmune response, especially in HLA-DQ2/HLA-DQ8 gene carriers Patients without genetic predisposition can present with villous atrophy In absence of celiac diagnosis, may still have non-celiac gluten sensitivity AGA-positive patients at risk for developing neurological issuesHow infants exposed to gluten are at an increased risk for developing celiac disease
Includes exposure in utero, breast milk No downside to eliminating gluten from baby’s dietThe value of avoiding gluten exposure for infants
Emotionally stable Grow, develop appropriatelyThe latest statistics regarding the prevalence of celiac disease
Increased to 3% in US (not 1% consistently reported) 30-50% of world population has genetic predisposition Global prevalence of 1.37%Celiac disease in the Asian population
Used to say could not develop celiac disease At increased risk of developing neurological disorders 6-8M people in east, south Asia 50 countries make up 60% of world population 35B people in China have celiac disease 22B people in India have celiac disease 19% of Chinese 16-25 tested positive for celiac disease in studyHow the Chinese diet has evolved over time
Older Chinese ate much less wheat Fast food has become common in recent years Despite rice-based diet, many products contain wheat (soy sauce, cashews)Other disorders that may indicate undiagnosed celiac disease
Anemia Osteoporosis Elevated liver enzymes Eating disorders Type 1 diabetes Autoimmune thyroiditisWhy patients should be tested for celiac disease annually
Can seroconvert at anytime Develops at any age with any/no symptomsThe new information about a potential connection between Wilson’s and celiac disease
3% of Wilson’s patients tested positiveWhat celiac experts agreed on at ICDS 2017
Poor support, understanding of celiac disease Need to increase knowledge base (general practitioners, food manufacturers, public) Important to find where gluten hides Must take education campaign to non-traditional settings Resources:Gluten Free RN Travel Podcast EP036
Gluten Free Passport Allergy Cards
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 22 Sep 2017 - 31min - 41 - The History of Celiac Disease EP041
Perhaps the most intriguing thing about the history of celiac disease in the US is its absence—from medical textbooks, the vast majority of research studies, and the news—from 1952 through the 1990’s. Why did celiac disease disappear from the healthcare consciousness as well as the public eye?
Today the Gluten Free RN takes a closer look at the story of celiac disease, starting with the first doctor to understand it as a dietary issue back in 1888. She highlights the important progress made by pediatricians Willem Dicke who is credited with identifying gluten as the issue and Sidney Haas who honed the gluten-free diet to exclude specific carbohydrates. Nadine explores the period of time when celiac disease seemingly ‘went dark’ in the United States, discussing the handful of renegade authors and researchers who continued to study the disease despite its absence from health education.
Nadine also explains the resurgence of gluten sensitivity to the public consciousness in the 1990’s, when medical professionals from abroad questioned the claim that there was no celiac disease in the US. She covers our evolving understanding of the symptoms of celiac disease and the woefully inadequate training around gluten in medical and nursing schools. Listen in to find out why the mass screening proposed by the National Institute of Health never materialized and how the for-profit healthcare system impacts celiac patients. Let’s honor the practitioners who dedicated their careers to understanding celiac disease and write our own history through celiac advocacy!
What’s Discussed:The first doctor to identify celiac disease
Samuel Gee, 1888 Established dietary approach to treatmentThe role of Dr. Sidney V. Haas in advancing celiac treatment
All carbs and fats had been eliminated from celiac diet Haas discovered that kind of carbs made difference Experimented with fats, learned that could be absorbed 370 celiac cases studied at Bellevue, only 2.2% not curedThe conclusions of a New York Times article from May of 1950
Late 1800’s, celiac disease ‘incurable and often fatal’ By 1950, 90% cured and deaths rare Cause still unknownThe grains that contain gluten
Wheat Barley Rye Oats (cross-contamination)How Dr. Willem Dicke developed the gluten-free diet
Dutch pediatrician during WWII No access to grains during famine, previously sick children improved Mothers realized that when grains returned to diet, sickness returned Dicke credited with determining that gluten causes damageThe myth that celiac is a childhood disease
Patients do not ‘grow out of it’ When gluten is reintroduced, disease returns (along with other disorders)Elaine Gottschall’s work in developing the Specific Carbohydrate Diet
Grains containing proteins other than gluten have negative effect on digestive tract Gottschall’s model removes all grains Paleo/whole food diet considered idealThe elimination of celiac disease from medical training
Stopped teaching in 1952 Debate over carbs vs. proteins Same paragraph appears in medical textbooks from 1952-2008 Still taught incorrectly (if at all) in medical, nursing schools Should be part of every differential diagnosisThe Paleo diet Nadine suggests for celiac and gluten-sensitive patients
Gluten-, dairy-free Whole food Low carb, super-good high fat Appropriate supplements to remedy deficienciesHilda Cherry Hill’s 1976 book Good Food, Gluten Free
Hill cured invalid husband with gluten-free diet Whole food, no grain derivativesThe classical symptoms of celiac disease
Fatty stool Malabsorption Short stature Low energy InfirmThe expanded picture of how celiac disease may present
Osteoporosis Short stature Delayed puberty Iron deficiency anemia Hepatitis Recurrent canker sores Elevated liver enzymes Dental enamel defects Peripheral neuropathy Celiac cerebellar ataxia Seizure disorders Migraine headachesThe genes that indicate a predisposition to celiac disease
HLA-DQ2 HLA-DQ8 Occur in 30-50% of the populationHow recognition of celiac disease resurfaced in the 1990’s
Gastroenterologists from abroad asking questionsThe 2004 NIH Consensus Statement on Celiac Disease
Determined that celiac disease grossly underdiagnosed in US Proposed mass screening, healthcare education program Mass screening never materialized (‘too cost-prohibitive’)How the US for-profit healthcare system impacts celiac patients
System profits from incorrect diagnoses Celiac tends to be last thing we test for Patients often spend hundreds of thousands of dollars out-of-pocketNadine’s advice for celiac patients around choosing healthcare providers
Many still don’t know how to manage celiac disease Look for practitioner of functional/integrated medicineWhat has changed since the NIH Consensus Statement in 2004
Little real change More media attention, some doctors testing Medical professionals still not educated in testing, follow-up Little support, assistance for patients in adopting gluten-free dietDr. Rodney Ford’s role in celiac advocacy
Pediatrician, gastroenterologist and allergist Promotes ‘gluten zero world’ Gut-brain-skin connectionNadine’s guidance for vegetarians and vegans
Work with nutritionist to be sure not malnourished Consider changing diet for optimal healthThe vulnerable populations particularly at risk for celiac disease and non-celiac gluten sensitivity
Children Williams, Turner or Down syndrome Developmentally delayed, cystic fibrosis communities Autoimmune patients Resources:“Celiac Disease: Most Children are Now Cured but Cause is Still Unknown” in The New York Times
Management of Celiac Disease by Sidney Valentine Haas and Merrill Patterson Haas
“Whatever Happened to the Cure for Coeliac Disease? in Nutritional Therapy Today
“The Erie Country Survey of Long-Term Childhood Illness” in the American Journal of Public Health
Good Food, Gluten Free by Hilda Cherry Hills
Dr. Alessio Fasano’s 2003 Celiac Study
2004 NIH Consensus Statement on Celiac Disease
Gluten: ZERO Global by Dr. Rodney Ford
International Celiac Disease Symposium
“Small Intestinal Mucosal Abnormalities in Relatives of Patients with Dermatitis Herpetiformis” in Gut
“Adult Coeliac Disease and Other Disorders Associated with Steatorrhoea” in the British Medical Journal
The University of Chicago: Celiac Disease Facts and Figures
“A History of Coeliac Disease” in Digestive Diseases
“Dermatitis Herpetiformis in Two Patients with Idiopathic Steatorrhoea” in the British Medical Journal
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 15 Sep 2017 - 36min - 40 - Multiple Sclerosis and Celiac Disease EP040
According to the University of Chicago Celiac Disease Center, 10% of MS patients also suffer from celiac disease. Studies conducted in Italy and Spain uncovered a significant increased prevalence of celiac disease in first-degree relatives of MS patients, 18% and 32% respectively. Additional research has identified situations in which celiac disease mimicked other neurological disorders such as MS and ALS.
With evidence like that, it is definitely worth it to further explore the relationship between MS and celiac disease. Today, the Gluten Free RN investigates whether MS and celiac disease are similar, related, or perhaps the same thing, as she shares case studies from the literature and her own experience.
Nadine discusses the story of Dr. Terry Wahls, explaining how she was able to resolve her symptoms of MS with a variation of a Paleo diet. She outlines the analogous symptoms of MS and celiac cerebellar ataxia, the neurological damage caused by gluten, and how malabsorption of nutrients caused by intestinal damage can extend to medication. Listen and learn how Nadine and others have resolved symptoms of MS and other neurological disorders on a gluten-free diet!
What’s Discussed:Nadine’s MS scare
Bouts with falling, dragging feet Numbness, tingling (neuropathy) Symptoms disappeared after adopting gluten-free diet Takes two to three years to resolve neurological symptomsDr. Terry Wahls’ story
Diagnosed with MS, confined to wheelchair Continued to research condition Adopted version of Paleo diet Now walks without cane, rides bike again Conducts seminars to share how healed mitochondriaThe commonalities between celiac disease and MS
Both autoimmune issues Studies necessary to determine if conditions are similar, related, or the sameHow celiac disease affects the body
Triggered by ingestion of gluten Causes villous atrophy, cryptic hyperplasia in small intestines, damage to immune system Primarily neurological disorderThe symptoms of celiac cerebellar ataxia
Poor balance Hard to distinguish where body is in space Trip, stumble or fall Related to visionThe multi-organ manifestations of celiac disease in the central nervous system
White matter lesions Inflammatory cerebral spinal fluid syndrome Sinus venous thrombosis Epilepsy, seizure disorders Cerebellar pontine atrophy Encephalopathy Myelopathy Dementia Gluten ataxia Migraines, headaches Depression, anxiety Cerebellar ataxiaNadine’s patient who wasn’t responding to MS medication
Nadine recommended celiac testing Panel negative, but gene carrier Already adopted gluten-free diet Fewer medications necessary Hope to decrease, discontinue meds Malabsorption issues extend to medications, could stem from undiagnosed celiac diseaseThe 2014 study in Vienna regarding celiac disease and MS
Concluded that celiac disease may mimic MS Celiac disease may be present despite absence of anti-gliadin antibodies If patient history indicates gastrointestinal issues, celiac disease should be considered even if CSF and MRI findings suggest MSThe new evidence around seronegativity in celiac disease
Most labs only test for tissue transglutaminase 2 Transglutaminase 6 is specific for neurological damage caused by glutenThe 2014 Italian study of the genetic overlap between celiac disease and MS
Sites significant increased prevalence of celiac disease in MS first-degree relatives (18%) Recommends celiac testing in MS patients who aren’t responding to MS treatment or present with ataxiaThe association between MS and celiac disease as reported by the University of Chicago Celiac Disease Center
Approximately 10% of those who have MS also have celiac diseaseThe genes that indicate a predisposition to celiac disease
HLA-DQ2 HLA-DQ8The 2013 Iranian case study of a celiac patient diagnosed with MS
37-year-old woman with history of chronic abdominal pain Diagnosed with celiac disease, adopted gluten-free diet Became ataxic, met with neurologist MRI indicated multiple sclerosis Nadine argues that patient likely re-exposed to glutenHow gluten acts as a neurotoxin
Pastor exposed to gluten in cookies had acute neurological event Shaking, tremors (similar to stroke)The 2007 Oxford case study of celiac disease mimicking ALS
44-year-old man with progressive right-sided spastic hemiparesis (muscle wasting) Remote family history of celiac disease Strict gluten-free diet resolved most symptomsWhy patients with neurological symptoms should be tested for celiac disease
The anti-gliadin antibody is excellent biomarker for gluten sensitivityWhy it is acceptable to adopt a gluten-free diet if your antibody test is negative for celiac disease
The Paleo diet Nadine suggests for celiac and gluten-sensitive patients
Gluten-, dairy-free Whole food Low carb, super-good high fatThe increased prevalence of celiac disease in MS patients revealed in a 2011 study
Increased prevalence found in eight of 72 MS patients (11.1%) Also in first-degree relatives (13/126 or 32%) Advises increased efforts aimed at early detection and dietary treatmentThe fundamentals of MS
Chronic disease of unknown etiology T-cell mediated antibody response Leads to demyelination of central nervous system Associated with autoimmunity (body attacking itself) Damage to enteric nervous system can lead to constipationHow to conduct your own research around celiac disease and neurological disorders
Celiac researcher Dr. Marios HadjivassiliouHow long it takes to heal on a gluten-free diet
Villous atrophy heals in six months to one year Neurological damage takes two to four yearsThe nutrients a celiac patient is missing that contribute to neurological issues
B vitamins Trace amounts of copper Magnesium ZincThe autoimmune symptoms Nadine resolved/reversed with a gluten-free diet
MS symptoms Graves’ disease Positive ANA panelWhy it’s important for celiac patients to work with educated practitioners who understand functional medicine
Resources:The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principle by Terry Wahls MD
“Celiac Disease with Cerebral and Peripheral Nerve Involvement Mimicking Multiple Sclerosis” in the Journal of Medicine and Life
“Celiac Disease in Multiple Sclerosis: A Controversial Issue” in the International Journal of Neurology and Neurotherapy
University of Chicago Celiac Disease Center MS Info
“Multiple Sclerosis or Neurological Manifestations of Celiac Disease” in Advanced Biomedical Research
“A Case of Celiac Disease Mimicking Amyotrophic Lateral Sclerosis” in Nature Clinical Practice Neurology
“Prevalence of Celiac Disease in Multiple Sclerosis” in BMC Neurology
“A Case of Concurrent Multiple Sclerosis and Celiac Disease” in Govaresh
“Neurological Disorders in Adult Celiac Disease” in the Canadian Journal of Gastroenterology
“A Case of Multiple Sclerosis and Celiac Disease” in Case Reports in Neurological Medicine
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 08 Sep 2017 - 30min - 39 - Dental Issues and Celiac Disease EP039
Did you know that it is possible to diagnose celiac disease with a smile?
Damage from gluten starts in the mouth, and today the Gluten Free RN explores the important role dentists can play in identifying undiagnosed celiac disease. She outlines the symptoms of celiac disease that present in the mouth, the follow-up questions dentists should ask when they notice dental enamel defects or aphthous ulcers, and the nature of the tongue as an indicator of overall health.
This episode covers how the plastics in orthodontic retainers might contain gluten and what to do if you are accidentally exposed. Nadine also explains the relationship between fat-soluble vitamins and celiac disease, as well as the nutrient deficiencies a potential celiac patient should test for. You’re never fully dressed without a smile, so listen in to understand how to keep your mouth healthy—and prevent the accumulation of complications from celiac disease with a whole food, gluten-free diet!
What’s Discussed:How the GI tract functions
Starts at mouth, ends at rectum Allows us to consume food, liquid Only extract what body needs Expel the restHow damage from gluten presents
Malabsorption of nutrients Inflammation Autoimmune issues Type 1 diabetes ALS Lupus MS Sjögren’s Leaky gutHow dentists can play an important role in identifying undiagnosed celiac disease
The symptoms of celiac disease that present in the mouth
Dental enamel defects Aphthous ulcers (canker sores) Cheilosis (cracks, open sores where upper and lower lip join) Dry, cracked lips TMJ—temporal mandibular joint disorder Pain where jaws meet Inflammation of the jaw Clicking Lock jaw Mouth pain, burning Oral lesions Tongue pain, tingling Redness, swelling of the tongue Tongue sores Changes in taste, smell Diminished sensory input Dry mouth Sore throat Difficulty swallowing Increased thirst Bleeding gums Delayed eruption of teeth Pyrosis Oral lichen planus Glossitis (inflammation of tongue) Clearing throat Sinus infections Redness, swelling of the uvulaHow Nadine treats gluten exposure
Activated charcoal Drink waterThe grains to look for in personal care products (e.g.: lip balm)
Wheat Barley Rye OatsThe relationship between fat soluble vitamins and celiac disease
Gluten causes malabsorption Vitamins A, D, E and K are fat soluble Under 40 in vitamin D may indicate deficiency in allHow we tested for celiac disease in children in the early 20th century
Fecal fat score Pale stool that floats suggests malabsorption of A, D, E and KWhy parents should be tested for celiac disease prior to pregnancy
The fetal development issues that may present if an expectant mother is unable to absorb nutrients
Dental enamel defects Smaller jaw formation Smaller airway passagesWhy Nadine advocates for a mass screening
How gluten in plastics, personal care products can prevent celiac patients from healing
The questions dentists should ask when they notice dental enamel defects, aphthous ulcers
Other clinical celiac symptoms (abdominal pain, diarrhea, weight loss, anemia, fatigue) Associated disorders (type 1 diabetes, thyroiditis, etc.) Family history of celiac diseaseWhy we need to get much better at recognizing celiac signs and symptoms
Even in Canada, diagnosis takes 11.7 yearsWhy Eastern medicine examines the tongue as an indicator of overall health
The genes that indicate a predisposition to celiac disease
HLA-DQ2 HLA-DQ8Why it is acceptable to adopt a gluten-free diet if your antibody test is negative for celiac disease
The deficiencies a potential celiac patient should test for
Calcium Magnesium RBC Vitamin D Zinc Folic acidWhy thrush may be an indicator of celiac disease or gluten sensitivity
Why one negative test for celiac disease doesn’t rule anyone out
The importance of early diagnosis
Symptoms accumulate over the yearsThe Paleo diet Nadine suggests for celiac and gluten-sensitive patients
Whole food Focus on local, fresh 100% grass-fed meat (no antibiotic, no hormone) Fish and eggs Nuts and seeds 100% organic fruits and vegetables Resources:“An Orthodontic Retainer Preventing Remission in Celiac Disease” in Clinical Pediatrics
“Oral Manifestations of Celiac Disease: A Clinical Guide for Dentists” in the Journal of the Canadian Dental Association
Gluten Free RN Podcast EP027: Type 1 Diabetes and Celiac Disease
“The Association Between Celiac Disease, Dental Enamel Defects, and Aphthous Ulcers in a United States Cohort” in the Journal of Clinical Gastroenterology
“Small-Bowel Changes in Recurrent Ulceration of the Mouth” in Hepatogastroenterology
“Oral Signs and HLA-DQB1*02 Haploytypes in the Celiac Paediatric Patient: A Preliminary Study” in Autoimmune Diseases
“The Oral Manifestations of Celiac Disease: Information for the Pediatric Dentist” in Pediatric Dentistry
“Oral Aphthous Ulcers and Dental Enamel Defects in Children with Coeliac Disease” in Acta Paediatrica
“Oral and Dental Manifestations of Celiac Disease” in the New York State Dental Journal
“Jejunal Mucosal Abnormalities in Patients with Recurrent Aphthous Ulceration” in The British Medical Journal
“Dental Enamel Defects in Adult Coeliac Disease” in the European Journal of Internal Medicine
“Screening for Celiac Disease in Children with Dental Enamel Defects” in ISRN Pediatrics
“Celiac Disease Associated with Recurrent Aphthae” in Gut
“Importance of Oral Signs in the Diagnosis of Atypical Forms of Celiac Disease” in Recenti Progressi in Medicina
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 01 Sep 2017 - 30min - 38 - Celiac Disease, Suicide, Morbidity and Mortality EP038
People are suffering. From a feeling of hopelessness. From depression and anxiety. Add to that a despair that no one supports them, and you have a desperate individual at an increased risk of committing suicide.
This topic hits close to home for Nadine, as she lost a nephew to suicide in 2007. Ian struggled with addiction issues, and he took his life at the age of 19. Because her family is predisposed to celiac disease, Nadine wonders if undiagnosed celiac disease may have been partially to blame for her nephew’s issues. Today she explores the mental health disorders that are associated with gluten getting through the blood-brain barrier. She also explains how undiagnosed celiac disease puts patients at an increased risk for morbidity, and stresses the fact that celiac disease can—and will—kill you if it goes untreated.
Listen in as the Gluten Free RN tells her own story of improved mental health on a gluten-free diet. She also covers the types of cancers that might be prevented by going gluten-free, the connection between AFib and celiac disease, and how dermatitis herpetiformis affects patients. Listen and learn the best diet to help you get better, faster, and why medical professionals need to pay more attention to the intestines!
What’s Discussed:How to define morbidity and mortality
Morbidity = sickness Mortality = death People with undiagnosed celiac disease have increased risk for morbidityHow morbidity presents itself in undiagnosed celiac patients
Chronic anemia Fatigue Osteoporosis Failure to thrive, grow Infertility Thyroid issues Autoimmune disorders Type 1 diabetes Lupus MS Sjögren’sInformation from the World Health Organization (WHO)
Diarrheal diseases are #1 killer of children Only funded one celiac study 1:19 rate in pediatric patients of Sahrawi descentThe prominent mental health issues associated with celiac disease
Depression Anxiety Anti-social behavior SuicideHow removing gluten from her diet improved Nadine’s mental health
Brain fog went away ‘Got brain back’ Embrace all life has to offer Freeing to know cause of symptomsThe grains that contain gluten
Wheat Barley Rye Oats (cross-contamination)The Paleo diet Nadine suggests for celiac and gluten-sensitive patients
Whole food Focus on local, fresh 100% grass-fed meat (no antibiotic, no hormone) Fish and eggs Nuts and seeds 100% organic fruits and vegetablesNadine’s experience with celiac disease
Multi-system organ failure, seven auto-immune disorders Dermatitis herpetiformis Diagnosed by dermatologist Tests negative, but HLA-DQ2.5 gene carrier (both parents)The connection between AFib and celiac disease
AFib puts patient at risk for stroke, sudden death Check for magnesium RBC deficiency Can be corrected with gluten-free diet Resolve without pharmaceuticalsHow dermatitis herpetiformis affects patients
Extremely painful, itchy skin Manifestation of celiac disease Suicide rate higher in patients with DH Dapsone alone will not heal Must also go gluten-free Prolonged use of Dapsone is toxic to liver (bowel cancer, lymphoma)The cancers that are potentially preventable on a gluten-free diet
Lymphoma Small intestinal adenocarcinoma Esophageal cancer Oral pharyngealThe genes that indicate a predisposition to celiac disease
HLA-DQ2 HLA-DQ8Other disorders that could be mitigated by a gluten-free diet
Chronic anemia Osteoporosis Osteomalacia Thyroid disorder Dementia Alzheimer’s MS Type 1 diabetesHow long it takes to receive celiac diagnosis in US
9-15 yearsThe risks for patients diagnosed with celiac disease in childhood
Threefold increased risk of death (suicide, accidental death, violence)Nadine’s research around celiac testing in autopsy
Couldn’t get straight answer from medical examiner (state of Oregon) Study conducted in 1974 concluded that despite systematically positive response to gluten-free diet, some patients ended up with lymphomaHow Nadine periodically gives her system a detox
Limited fast (three to seven days) Give organs, immune system a restWhy medical professionals should give more attention to the intestines
Vast majority of signs, symptoms originate in intestines 70-90% of immune system in intestines Homocysteine levels higher in newly diagnosed celiac patients, related to other health issuesThe issues that can result from undiagnosed celiac disease
Heart attack Stroke Appendix removed Gall bladder removedThe definition of refractory celiac disease
Intestines don’t heal even on gluten-free diet Sometimes caused by continued exposure to trace amounts of gluten Some patients past point of being able to healWhy it’s crucial to remove all gluten from the environment
Celiac patients should feel safe where live, work and go to school Even trace amounts cause continued symptoms, early death Takes an emotional toll to be hypervigilant, mocked by loved onesThe connection between undiagnosed celiac disease the despair that leads to suicide
No hope of getting better Don’t feel supported, believed (celiac is real disease) Depression, anxiety and other mental health disorders More vulnerable if undiagnosed and enduring abusive relationshipWhat happens when gluten gets through a leaky blood-brain barrier
Inflammation of the brain Hypoxia (decreased oxygen flow) Low end—brain fog, anxiety, depression, fatigue High end—bipolar disease, antisocial behavior, learning disabilities, schizophreniaThe risks associated with eating traditionally grown fruits and vegetables
Glyphosate in Roundup causes leaky gutThe goals of the first six months on a gluten-free diet
Remove all gluten Allow villi to grow back Heal inflammation Repair immune system Resources:Celiac Disease and Gluten Sensitivity in Down, Turner and Williams Syndrome
“Necropsy Studies on Adult Coeliac Disease” in the Journal of Clinical Pathology
“Mortality in Celiac Disease” in Gastroenterology
“The Global Burden of Celiac Disease” in PLoSONE
“The Unknown Burden and Cost of Celiac Disease in the US” in Expert Review of Pharmacoeconomics and Outcomes Research
“Long-Term Mortality in People with Celiac Disease Diagnosed in Childhood Compared with Adulthood” in the American Journal of Gastroenterology
“Increased Risk of Atrial Fibrillation in Patients with Coeliac Disease: A Nationwide Cohort Study” in the European Heart Journal
“Increased Suicide Risk in Coeliac Disease—A Swedish Nationwide Cohort Study” in Digestive and Liver Disease
“The Burden of Celiac Disease and the Value of Having It Diagnosed” by Fredrik Norström of UMEA University
“Complications of Coeliac Disease: Are All Patients at Risk?”
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 25 Aug 2017 - 35min - 37 - Celiac Disease for Nurses EP037
Nadine spent 17 years working as a nurse in the ER. She holds a membership in the Emergency Nurses Association, as well as a Certified Emergency Nurse certification. During the course of her career, Nadine obtained ACLS, PALS, NALS, ENPC and TNCC certifications, honing her skills in advanced cardiac life support, neonatal advanced life support, pediatric advanced life support, and trauma. Despite this impressive background and experience, she had never been educated about celiac disease, and didn’t know what to look for until she was diagnosed herself.
Nurses are in a unique position to recognize potential celiac patients and act appropriately. Though most nurses don’t have the authority to diagnose, they do have an obligation to act as patient advocates. Because celiac disease is the most underdiagnosed and misdiagnosed autoimmune disease in the world, it is important that nurses get educated about the fundamentals of celiac disease, the wide array of symptoms an undiagnosed patient may present, and how to keep celiac patients safe in and out of the hospital.
Today on the podcast, the Gluten Free RN addresses nurses, explaining how celiac disease damages the GI tract, the consequences of a ravaged immune system, and the neurological nature of the disease. She also reviews the genes that indicate a predisposition to celiac disease, the best available tests for gluten sensitivity, and the need for a worldwide mass screening. This is a must-listen for medical professionals, offering an overview of the most current celiac studies and an explanation of how to approach doing research on your own. Celiac disease is on the rise and it doesn’t discriminate, so it is crucial that the nursing community get educated – STAT.
What’s Discussed:Why nurses need to employ a high index of suspicion regarding celiac disease
Most undiagnosed and misdiagnosed autoimmune disease in worldThe lack of training around celiac disease in the medical community
Nadine was nurse for 17 years Didn’t know symptoms of celiac disease Diagnosed ‘by accident’The celiac symptoms Nadine thought to be ‘normal’
Canker sores Intermittent constipation, diarrhea Eczema on hands Difficult time gaining weight Whole family had gasWhat nurses need to know about celiac disease
What it is, what it entails Symptoms may present with How to keep patients safe (in and out of hospital) How to request testing How to interpret lab resultsHow long it takes to receive celiac diagnosis in US
9-15 yearsThe restrictions of being a nurse
Can’t diagnose (can recognize, treat appropriately) Can’t perform surgery Can’t prescribe meds, take patient off medicationNadine’s experience leading up to her celiac diagnosis
Nadine’s celiac diagnosis
Dermatologist diagnosed Blood test, skin biopsy negative HLA-DQ2.5 gene carrier (super-celiac category)Why a negative blood test, skin biopsy doesn’t rule out celiac disease
Nadine’s current health
Why Nadine stopped working as an ER nurse
Celiac diagnosis was life-changing Started own businesses RN On Call, Inc The Gluten Free RN Celiac Nurse ConsultingThe increased prevalence of mortality in undiagnosed celiac patients
Undiagnosed celiac disease associated with 4-fold increased risk of death (45 years of follow-up) Prevalence of undiagnosed celiac disease has increased dramatically in US over last 50 yearsThe grains that contain gluten
Wheat Barley Rye Oats (cross-contamination)The products that may contain gluten
Medication Food Personal care productsThe search terms to use when doing celiac research
Gluten-related disorders Both spellings (celiac, coeliac)Why celiac disease is primarily a neurological disorder
Involves enteric nervous system (in intestines) Vagus nerve (superhighway of information from intestines to brain)Why celiac disease is not an allergy
Allergy is IgE-mediated antibody response Celiac tends to be IgA, IgG-mediated antibody responsesThe genes that indicate a predisposition to celiac disease
HLA-DQ2 HLA-DQ8Why Nadine advocates for a world-wide mass celiac screening
The relationship between celiac disease and infertility
People with infertility issues, difficulty maintaining pregnancy should be testedThe chronic nature of celiac disease
Never goes away Gluten is neurotoxin Must be 100% gluten-free for lifeHow gluten exposure presents for Nadine
Blisters in mouth within 10 minutesHow gluten can cause damage along entire length of GI tract
28 to 32 feet in length Person-to-person variabilityHow damage to GI tract presents
Canker sores Difficulty swallowing, dysphasia GERD Eosinophilic esophagitis Gas, bloating Diarrhea constipation Crohn’s disease Atypical diseases Idiopathic diseases Ulcerative colitis Diverticulitis Diverticulosis Rectal cancer Bowel cancer HemorrhoidsHow constipation can be a neurological issue
Gluten as neurotoxin can paralyze nervous system, intestines Stool cannot get pushed through Can result in colon cancer, megacolonDisorders that may be caused by undiagnosed celiac disease
Diabetes Heart problems Sudden cardiac deaths Strokes Bowel, rectal cancer (recent increase in young people)Why a biopsy is no longer considered the gold standard of celiac testing
Positive anti-tissue transglutaminase and positive EMA indicates damage to intestines Endoscopist should take six to 15 samples in duodenum, jejunum (damage can be patchy)The stages of intestinal damage caused by celiac disease
Marsh 1 – microvilli destroyed Marsh 2, 3 – villi themselves fall over, blunt or atrophy Marsh 4 – looks like hot, inflamed sponge and immune system compromisedThe consequences of a damaged immune system
Hypo-responsive (doesn’t respond) Hyper-responsive (reacts to everything)The importance of including a total IgA and IgG in the celiac antibody panel
Ensure patient is not IgA deficientHow the US has gone backwards in the last 70 years
Times article from 1950 declares ‘cures certain in 90% of cases’ and ‘deaths rare’ Celiac disease has gone unrecognized since thenThe testing for celiac disease
Celiac antibody test (baseline) Small intestinal biopsy Nutritional panel (D3, B6, B12, magnesium RBC, zinc, ferritin) Follow-up to track healing, ability to absorb nutrientsThe difficulty with the celiac antibody test
70% false negativeThe best available celiac testing
EnteroLab Gluten Sensitivity Stool Test Cyrex Laboratories Array 3Factors that might interfere with accurate celiac testing
IgA deficiency Benicar (blood pressure med) known to cause villous atrophy in absence of celiac disease Lab-to-lab variability Only tests for anti-tissue transglutaminase 2How to carry out a clinical trial for celiac disease or gluten sensitivity
Adopt gluten-, dairy-free diet for at least three months It takes six months to a year for intestines to heal Recommended for patients with genetic predisposition, regardless of negative blood testThe Paleo diet Nadine suggests for celiac and gluten-sensitive patients
Whole food Meat, fish and eggs Nuts and seeds Fruits and vegetablesThe findings of a celiac study published in the Journal of Insurance Medicine
Atypical, non-diarrheal presentations now most frequent Celiac disease is grossly underdiagnosed in US Average delay in diagnosis for adult patients ranges from four to 11 years Diagnosis and treatment with gluten-free diet leads to improved quality of life Medical costs in celiac cohort were 31% lower over three-year periodWhy celiac disease should be on every primary care physician’s differential diagnosis
The rise of celiac disease
1:501 in 1974 1:219 in 1989 1:100 is current estimate Doubles every 15 years (according to Mayo Clinic)Why Celiac disease is a worldwide issue
Affects every ethnicity Frequency of tTGA in Mexico City study was 1:37 Increasing diagnoses in North Africa, Middle East and Northern IndiaHow celiac disease can lead to obesity
Patient cannot absorb nutrients (malnourished) Body responds by storing fat for cheap energyHow the risk of cancer increases exponentially in undiagnosed celiac patients
Why nurses must be patient advocates
Nadine’s advice around research and celiac disease for nurses
Not taught in nursing programs Do your own research to keep up with current infoResources:
Snarky Nurses on Instagram
National Nurses in Business Association
“Increased Prevalence and Mortality in Undiagnosed Celiac Disease” in Gastroenterology
New York Times Article, May 1950
“Economic Benefits of Increased Diagnosis of Celiac Disease in a National Managed Care Population in the United States” in the Journal of Insurance Medicine
“Celiac Disease Could be a Frequent Disease in Mexico: Prevalence of Tissue Transglutaminase Antibody in Healthy Blood Donors” in the Journal of Clinical Gastroenterology
“Celiac Disease in African-Americans” in Digestive Diseases and Sciences
“Coeliac Disease” in The Lancet
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 18 Aug 2017 - 43min - 36 - Safely Traveling on a Gluten-Free or Paleo Diet EP036
Wanderlust.
It is human nature to want to explore, to experience a geography and culture different from our own. Travel can truly enrich our lives. Yet if you have celiac disease or non-celiac gluten sensitivity, the prospect of being away from the familiar for an extended period can be intimidating. Will I be able to find a grocery store? How do I locate a gluten-free restaurant that I can trust? What do I need to bring with me to ensure that I am avoiding gluten? And what if, despite my best efforts, I am accidentally exposed to the gluten protein?
No one wants their trip ruined by an unexpected illness, but you shouldn’t let the fear of gluten exposure keep you from going on an important business trip or taking that vacation you’ve always dreamed of. The Gluten Free RN has ten years of experience helping people discover that they can travel safely on a gluten-free or Paleo diet, and today she shares her recent travel experiences with you. Road trip with Nadine and learn how she locates safe restaurants, what she takes along to avoid inadvertent gluten exposure, and which apps and online resources offer the best advice for gluten-free travel!
What’s Discussed:The danger of living in a bubble
Leads to isolation No way to liveNadine’s mission to teach people how to travel safely on gluten-free/Paleo diet
Follow her travels on social Posts include pics of locations, food Various travel tipsHow Nadine packed her cooler for a summer road trip to Boston
Applegate deli meat Kite Hill cheese Fresh fruits and vegetables Mary’s crackers Jilz Crackerz EPIC barsThe challenge of eating out on the road
Lucky to live in Pacific Northwest 37 100% gluten-free restaurants in Portland Accommodating to food intolerance More difficult other places Stressful when unfamiliar with establishmentThe fundamentals of a food desert
Little/no access to fresh fruits, vegetables Most available food is highly processedNadine’s advice around locating grocery stores, fresh foods when traveling
Research local Whole Foods, Natural Grocers locations Look up local Farmer’s Markets and Co-opsNadine’s tips for locating safe restaurants
Employ the Find Me Gluten Free app Read Yelp reviews, though can be deceptive Avoid restaurants that make pizza Flour stays in air for up to 72 hours Enormous risk of cross-contaminationThe myth that heat breaks down the gluten protein
Gluten protein is heat stable Very difficult to denature (even at temperatures of 1200°) Applies to woks, fryers and grillsHow Nadine is able to go without a meal when necessary
Nutrient ‘gas tank’ is full High levels of vitamin D, B6, B12 and magnesium Better to skip than be sick for days, weeks or monthsWho to talk to when you are eating out
Start with wait staff, chef Speak with manager, if necessaryNadine’s experience at a highly-rated restaurant in Boston
Selected for positive Yelp reviews Friend used Nima sensor, daughter’s meal contained gluten Notified wait staff, spoke to chef and manager Though establishment caters to gluten-free community, next four meals also tested positive for gluten Learned that pizza was also made in kitchen Stopped by grocery store on way back to hotel Made great, quick and easy dinner in roomNadine’s gluten-free travel supply packing list
Bamboo utensils Pans Nima sensor or EZ Gluten strips Gluten Free Passport allergy cards Activated charcoal (to take with water after accidental exposure) Sense of humorThe best gluten-free online travel resources
Gluten-Free Globetrotter Gluten Free PassportWhy you should avoid fast food/restaurant chains that claim to have gluten-free offerings
Risk of cross-contamination too high May not truly understand what it means to be gluten-free Using gluten-free label as marketing toolNadine’s upcoming River Cruise on the Danube
Opportunity for safe travel Responsible, attentive chefs Nadine on hand to confirm food is gluten-free, PaleoThe food options available to the gluten-free population
Meat, fish and eggs Nuts and seeds Fruits and vegetables Resources:International Celiac Disease Symposium
Gluten Free Portland Restaurant List
Amy Fothergill of the Warm Kitchen
Melodies of the Danube Brochure
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 11 Aug 2017 - 26min - 35 - Men and Celiac Disease EP035
When boys are hurt, we tell them to ‘rub some dirt on it’ and get back in the game. So it comes as no surprise that men have a tough time admitting weakness, especially to something as innocuous as a slice of bread. Perhaps this explains why celiac disease is considered a women’s issue, when in reality the male-to-female ratio is closer to 1:1.
Today the Gluten Free RN discusses the large numbers of men in the US who go undiagnosed or misdiagnosed, sharing several anecdotes of patients whose symptoms resolved on a gluten-free diet. She covers the particular social challenges for men with celiac disease, the laundry list of symptoms men may encounter, and the specifics of nutrition she recommends for gluten-sensitive patients.
Through it may be difficult to give up pizza and beer with the guys, it is worth the effort to go from sick and struggling to happy and healthy. Listen in and learn how to make going gluten-free simple and easy, even for men with limited culinary skills. Add bacon fat to your greens AND regain your abs with advice from the Gluten Free RN!
What’s Discussed:The myth that men are less likely to suffer from celiac disease
3 women diagnosed for every man Actual ratio of men to women is 1:1 Huge numbers of undiagnosed celiac patients in USThe addictive nature of gluten
Morphine-like effect Difficult to give up pizza, beerCase study of man diagnosed with pancreatitis
Athletic entrepreneur in 40’s Tested positive for celiac disease Adopted gluten-free diet Pancreatitis resolved Fatigue and throat-clearing went awayCommon symptoms of celiac disease in men
Fatigue Thyroid issues Anemia Osteoporosis Bowel issues Difficulty swallowing Chronic cough GERD Gastritis Hemorrhoids Gas Bloating Diarrhea Constipation Irritability IBS Urinary incontinence IBH Erectile dysfunction Prostatitis Prostate cancer Facial ticksWhy men with osteoporosis and anemia together should assume they have celiac disease
Review labs for red blood cell count Check for hemoglobin and hematocrit in right rangeNadine’s patient with a climbing PSA (lab indicator of prostate cancer)
Patient had difficulty sleeping, snoring issues Had to eat bread or cereal before coffee to avoid abdominal pain Suffered from chronic belching, brittle nails Adopted variation of Paleo diet, symptoms resolvedHow Nadine’s doctor had a change of heart around celiac disease
Nicknamed her ‘Gluten Insufficiency Nurse’ Called to request consultation Endoscopy report indicated he had celiac disease Symptoms resolved on gluten-free diet No longer needed CialisThe lack of celiac understanding exhibited by healthcare practitioners in the US
Doug’s story
PA diagnosed with atypical Crohn’s Three trips to ER with GI bleeding Endured surgery to resect bowels Followed Nadine’s instructions for gluten-free diet No longer has Crohn’s, rectal bleeding Feels significantly betterHow gluten causes excessive gas, explosive diarrhea and constipation
Gluten can trigger paralysis of intestines Normal BM with diet changeNadine’s advice around nutrition for gluten sensitive patients
Super-good, high fat diet Paleo, whole food diet is ideal Incorporate meat, fish, eggs, fruits, vegetables, nuts and seeds Eliminate all grains, legumes and processed foods Replace starches with potatoes, rice Make choices based on preference and nutritional value Select fewer processed, more fresh foods Don’t just replace gluten-containing foods with gluten-free version (processed = nutrient deficient)The benefits of bacon
Can use bacon fat to sauté greens Body uses fat to heal, keep brain and nervous system healthy, prevent neurological disordersWhy men may be more resistant to diet change
Nadine’s advice for men on eating fresh, gluten-free food
Find a few easy-to-prepare recipes you like Use a Crock-Pot Incorporate fruits and vegetables ‘If it’s hard, you’re doing it wrong’Why subsidized ingredients are found in countless products
Government pays food manufactures to incorporate Wheat, corn, soy and peanuts in surprising foodstuffs like catsup, tunaThe social challenges for men with celiac disease
Don’t want to be perceived as needy, weak Others may be unkind if express special dietary needs Especially difficult if others cooking for you, at special events (e.g.: wedding)How switching from vegan or vegetarian to Paleo has affected Nadine’s male patients
Realize healthy weight Able to gain muscle mass Pain issues resolve Improved mood Resources:The Whole 30: The 30-Day Guide to Total Health and Food Freedom by Melissa and Dallas Hartwig
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 04 Aug 2017 - 33min - 34 - Addiction Issues, Celiac Disease and Gluten EP034
Few things are as painful as losing a loved one to an overdose. Addiction is such a powerful demon, and most of us have friends or family who are facing it right now. It is easy to feel helpless, believing that there is little you can do to ease their pain. But what if a diet change could resolve the physical and psychological pain at the root of the dependency? You might be surprised to learn that gluten binds with the opioid receptors in the brain, functioning as a ‘gateway drug’ to other addictions.
Today the Gluten Free RN shares her experiences with addiction and overdose during her 17-year career in the ER, explaining how she made the connection between undiagnosed celiac disease and addiction issues. She discusses the US opioid epidemic and how a mass screening for celiac disease could prevent such widespread substance abuse. Listen as she describes the morphine-like effects of gluten on your brain, the role of the microbiome in dictating cravings, and why gluten may be at the root of the pain that leads patients to self-medicate with dangerous recreational drugs.
The sad truth is that 91 Americans die every day from an opioid overdose. Because undiagnosed celiac disease goes hand in hand with addiction, is it past time to get our loved ones tested. Suggest it today -- it could save a life.
What’s Discussed:The recent flood of headlines regarding the US opioid epidemic
How exorphins affect the brain
Endorphins release chemical to make person feel good (i.e.: runner’s high) Ingest exorphins, make feel differently (e.g.: good, tired, sedate) Includes food, alcohol, pharmaceuticals and recreation medications (marijuana, cocaine, heroin, methamphetamines)How Narcan reverses a heroin overdose
Binds with opioid receptorsThe potential connection between gluten and opioid addiction
Gluten binds with same receptors in brain Addiction to gluten, dairy may be precursor to other addictions Many self-medicate with ‘comfort food’ containing wheat and dairy (i.e.: pizza, mac and cheese)The morphine-like effects of gluten and dairy on your brain
Very similar to narcotics Elimination diet causes uncomfortable detox process Can take a few days, several weeks May experience fatigue, depression, abdominal pain, headaches Feel better once body clear of damaging proteinsThe substances patients abuse to treat pain
Prescription drugs Over-the-counter drugs Alcohol Cigarettes Recreational drugs (e.g.: methamphetamine, marijuana)The symptoms of pain patients may experience due to gluten
Autoimmune issues Intractable headaches Psychological, emotional anguishThe data around opioid overdose in the US
91 Americans die every day 32,000 people die annually Numbers likely much higherHow gluten sensitivity may lead to pain med addiction
Opioid receptors may be damaged, destroyed by gluten Patient cannot absorb pain meds due to villous atrophy Need stronger meds, higher doseCommon prescription meds for pain
Vicodin Percocet Morphine DilaudidWhy patients turn to heroin for pain relief
Less expensive to acquire Easily accessibleHow food can act as a ‘gateway drug’ to other addictions
Celiac disease causes nutrient deficiencies Magnesium Folic acid B vitamins D3 Addictions to alcohol, cigarettes, shopping, etc. seek to fill void Eliminate gluten and heal intestines, addictions resolveWhy Nadine advocates a mass screening for celiac disease
HLA-DQ2, HLA-DQ8 gene carriers more susceptible to addiction issues Identification can prevent opioid addictionHow ER departments treat alcoholics
Banana bag (liter of saline + multivitamin, thiamin, folic acid and magnesium sulfate) Addresses nutrient deficiencies Prevent the shakes, help patient detox gradually Celiac disease may be underlying issueThe power of the microbiome
Tiny bacteria live in intestine Dictate what we eat, drink through cravings Communicate with brain (e.g.: yeast signals need for sugar)The mental health issues caused by untreated celiac disease that may lead patients to self-medicate
Depression Anxiety Hallucinations Schizophrenia Bipolar disorder Resources:“Here’s How a Key Part of the Opioid Legislation is Not Working” in the Boston Globe
“Malabsorption of Opioid Medications” in Practical Pain Management
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 28 Jul 2017 - 28min - 33 - 21 Important Facts About Celiac Disease EP033
There are a number of misconceptions about celiac disease, even within the medical community! Despite a growing body of research to the contrary, many practitioners still believe celiac disease to be strictly a gastrointestinal issue with a just a few tell-tale symptoms. It’s time to get the facts, and today the Gluten Free RN shares 21 important truths about celiac disease that you need to know.
Nadine shares her take on the list compiled by Gluten Free Works, covering the truth about who is at risk, the wide variety of neurological symptoms a celiac patient might present, and the components of an optimal treatment plan. As the most common genetic autoimmune disease in the world, it is incredibly important that we understand how gluten exposure can damage the intestines and cause debilitating nutrient deficiencies.
Nadine also explains why celiac disease often goes undiagnosed and how an astute practitioner is able to accurately interpret biopsies, antibody screenings and lab work. Get familiar with these 21 important facts about celiac disease, and become your own advocate!
What’s Discussed:- Celiac disease is the most common genetic autoimmune disease in the world
- Celiac disease is the most commonly misdiagnosed disease in the world
- Celiac disease blood tests are not pass/fail
- Celiac disease can affect any genetically predisposed person of every race of gender and can first present symptoms at any age
- Optimal treatment of celiac disease includes a 100% strict gluten-free diet, nutrient deficiency identification and replenishment, and education and support that meet the physical and emotional needs of the patient
- Most cases of unresponsive celiac disease are due to inadvertent gluten exposure, where the person is consuming gluten without realizing it
- The average person with celiac disease has a normal body mass index
- Silent celiac disease refers to a person who tests positive on blood test and villous atrophy on intestinal biopsy, but exhibits no overt symptoms
- Celiac disease presents submicroscopic damage causing nutrient deficiencies before villous atrophy
- 50% of people diagnosed with celiac disease exhibit neurological symptoms at the time of diagnosis
- Doctors consider celiac disease to be a gastrointestinal disease
- Anxiety can be the only symptom of celiac disease
- Celiac disease tests are not pass/fail
- Patient education is the most important predictor of good clinical outcome in celiac disease
- Celiac disease symptoms can be completely different among family members Celiac symptoms number over 300, affecting every system and any organ
- Symptoms in celiac disease are due to inflammation and/or nutrient deficiencies from chronic intestinal damage
- Celiac disease diagnosis can take ten years or more from the time symptoms first present
- Celiac disease affects over three million people in the US, yet the vast majority are not diagnosed
- Exposure to gluten is the most important environmental factor in celiac disease
- Although celiac disease is now known to cause over 300 symptoms, the medical community has traditionally instructed doctors that celiac disease affects children, presenting symptoms of diarrhea, wasting muscles, anemia, and abdominal distention
Resources:Recognizing Celiac Disease: Signs, Symptoms, Associated Disorders and Complications by Cleo J. Libonati
21 Important Celiac Disease Facts You Need to Know…
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 21 Jul 2017 - 28min - 32 - Why a Gluten Challenge is NOT Recommended EP032
You don’t have to prove to anyone that you have celiac disease proper. Because food functions as both medicine and poison, it is important to have all the facts before you get talked into a gluten challenge … and the fact is, going back on gluten after you have adopted a gluten-free diet will cause organ damage.
The Gluten Free RN speaks to the motivation behind doing a gluten challenge, the consequences for celiac and gluten sensitive patients, and her work as a patient advocate to discourage people from being talked into a gluten challenge. She offers a detailed risk versus reward analysis of braving a gluten challenge, explaining how the maintenance of a gluten-free diet prevents the development of celiac disease and other autoimmune disorders.
Nadine also covers the unreliable nature of celiac testing in the US, where the medical community lacks savvy in interpreting results, and explains why biopsy results are no longer considered the gold standard of celiac testing. Listen in to understand the recommended diet for those who have adopted a gluten-free lifestyle and why it requires a long-term commitment. Get armed with information and protect yourself and your family from the dangerous, irreversible consequences of a gluten challenge!
What’s Discussed:The gluten free lifestyle
Involves long-term change Can’t take days offWhy you should be cautious of restaurants with a gluten-free menu
Very few actually deliver gluten-free meal Employees may not understand contamination, cross-contaminationThe advantages of living in the Northwest US
Almost 50 designated gluten-free/Paleo restaurants in Portland Farmer’s markets Whole Foods, Natural Grocers Local food Co-ops (First Alternative, LifeSource)Nadine’s recommendations re: food options
Organic produce Grass-fed meat Whole foods produced locallyThe misguided reason why people do a gluten challenge
Want to prove presence of celiac disease You don’t have to prove to anyone, especially if HLA-DQ2 or HLA-DQ8 gene carrier 30-50% of population has genetic predisposition to celiac diseaseThe value of a gluten-free diet in preventative medicine
Averts celiac disease and associated issues Prevents other autoimmune disorders Type 1 diabetes Lupus Sjögren’s Rheumatoid arthritis MS ALSWhat it means to do a gluten challenge
Targets patients who have adopted a gluten-free diet Requires they consume gluten (2-6 slices of bread/day)The consequences of a gluten challenge on celiac and gluten sensitive patients
Seizures GI bleeds Appearance of bowel cancer, bone cancer Inability to get out of bed Organ damageThe risks vs. rewards of enduring a gluten challenge
No benefit other than proving presence of celiac disease Can be thrown into refractory celiac disease (permanent, irreversible damage to intestines)Why Nadine would never do a gluten challenge
Why biopsy results are no longer considered the gold standard of celiac testing
Often misinterpreted, read incorrectly Damage can be patchyWhy an antibody panel can be unreliable in identifying celiac disease
Takes time for body to mount autoimmune response 70% false negative nationwideHow long it takes to obtain celiac diagnosis
Two to three weeks in countries where medical community is savvy about celiac disease Nine to 15 years in USNadine’s advice around celiac testing
Seek practitioner with experience reading results Request total IgA, IgG Consider Cyrex Laboratories, LabCorp or EnteroLabThe enduring nature of celiac disease
Doesn’t go away Children don’t grow out of itNadine’s nutrition guidelines for celiac patients
Gluten- and dairy-free Ideally Paleo Nutrient dense foodsNadine’s work as a patient advocate
Seeks to help people stay healthy, avoid illness/disease Patients get lives back, active and thriving Resources:Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 14 Jul 2017 - 19min - 31 - Celiac Disease for Health Care Providers EP031
Celiac disease is grossly underdiagnosed in the United States in large part because the medical community is operating on outdated information about the condition. And despite the recommendations of the National Institute of Health back in 2004, we have yet to implement a mass screening for celiac disease, and health care providers remain alarmingly uninformed.
The Gluten Free RN is taking steps to remedy the situation by sharing the basics for medical professionals. Today she covers the WHO’s definition of celiac disease, how our understanding of the condition has change over time, and some common misconceptions about celiac disease. She also explains the top symptoms, recommended testing for celiac disease and gluten sensitivity, and the neurological nature of the disorder.
Listen in to learn what health care providers need to know about this undiagnosed epidemic, the complex web of health issues that may result from undiagnosed celiac disease, and why it is important to have a high index of suspicion and include celiac testing on every differential diagnosis. Help your patients go gluten-free and collect something other than autoimmune disorders!
What’s Discussed:The standard of care in the US
Providers should have diagnosed at least 1% of patients with celiac disease Undiagnosed for 70 years, must overcome to prevent further pain and sufferingThe goals of Nadine’s consulting business
Works with facilities to protect celiac patients Ensure compliance with ADAHow the media portrays the gluten-free lifestyle
Dissuades people from adopting diet (program sponsors influence messaging) Negative headlinesHow our understanding of celiac disease has changed over time
The recommendations of the 2004 NIH consensus meeting regarding celiac disease
Mass screening (meets WHO criteria) Education for health care providersThe World Health Organization criteria for mass screening
Early clinical detection essential Condition is common Screening tests highly sensitive and specific Effective treatment available Untreated condition leads to complicationsThe autoimmune disorders associated with undiagnosed celiac disease
MS Type 1 diabetes Lupus Rheumatoid arthritis Sjögren’s VitiligoThe WHO definition of celiac disease
Characterized by hypersensitivity to gluten Prevalence currently estimated at 1:1,000 worldwide Screening trials suggest prevalence of 1:100 Results in weight loss, diarrhea, nutritional deficiencies Caused by villous atrophy May present as extraintestinal manifestations or remain clinically silentWhy celiac disease can’t be ruled out with a single test
Can be triggered at any point HLA-DQ2 and HLA-DQ8 genes indicate genetic predispositionMisconceptions about celiac disease in the US medical community
Thought to be digestive disorder, but really neurological Can present with seizures, numbness, constipation, balance issues, celiac cerebellar ataxiaHow skin issues are a reflection of what is going on internally
Epithelial skin is same tissue as insideHow damage to the small intestine leads to multiple health issues
Increased permeability of intestinal wall Leaky blood brain barrier Leaky blood vessels Leaky lungs and skinThe classic symptoms of celiac disease
Chronic diarrhea Malabsorption Extreme weight loss MalnutritionWhat celiac disease looks like in children
Diarrhea, constipation General abdominal pain Failure to thrive Falling off growth chart Short stature Learning disabilities ADD, ADHD, ODD Autism Skin issues (eczema, cirrhosis, acne) Delayed puberty Dental problems Anorexia, obesity Bed wettingThe prevalence of celiac disease in older adults
30% of people diagnosed with celiac disease are over 60Potential signs of celiac disease in the aging population
Dementia Alzheimer’s Vision, hearing loss Urinary problems Cancer diagnosis (especially bowel cancer) Ataxia Arthritis Hair loss Fatigue Osteoporosis AnemiaThe elements that get into your blood stream as a result of villous atrophy
Toxins Heavy metals Undigested food particles Yeast, fungus Parasites, other harmful bacteriaTop symptoms of celiac disease
Chronic anemia Fatigue Muscle, joint pain Depression, irritability Thyroid disorders Infertility issues GI problems (from mouth to rectum) Migraine headaches Psychiatric disorders Seizures Dermatitis herpetiformis Down, Turner or Williams syndrome CardiomyopathyThe effects of gluten on the brain
Anger Depression, anxiety Learning disabilities Lethargy Insomnia Brain fog Schizophrenia DyslexiaPopulations affected by celiac disease
Any age, race, gender 3 million people all over the world Study of healthy blood donors in Mexico found unexpectedly high prevalence of tTGA positivity Now recognized as common disease among Middle Eastern and North African populations 1:7 Americans suffer from non-celiac gluten sensitivity (43 million people)The findings of an economic study by Columbia University
Non-diarrheal presentations now most frequent Celiac disease grossly underdiagnosed in US Average delay in diagnosis is 4-11 years for adults in North America Significant improvement in quality of life when patients diagnosed and treated appropriatelyThe importance of ensuring that medications are gluten-free
Nadine’s recommendations around nutrition for celiac patients
Gluten- and dairy-free Ideally Paleo Super-good high fatThings to consider re: the results of a celiac panel
A positive test guarantees intestinal damage Include total IgA and IgG 70% produce a false negativeAdditional tests that offer valuable information
Fecal fat score (ask for #, over 300 indicates malabsorption) Complete blood count Comprehensive metabolic panel Vitamin D3 level (below 40 ng/ml is critically low) Vitamins A, E & K levels Vitamin B6 & B12 levels MTHFR gene test Magnesium RBC test Zinc level Iodine level B9/Folate level Ferritin level Iron level Thyroid panel Bone density test Lipid panel ANA test (autoimmune issues) ESR test CRP testSurprising facts around celiac disease contrary to conventional wisdom
Only 15% of celiac patients have chronic diarrhea 39% of celiac patients are overweight Shampoos, cosmetics and airborne gluten affect patients with gluten intolerance and celiac disease Super-good high fat diet is essential for celiac patients
Resources:“Where Have All the American Celiacs Gone?” in Acta Pediatrica
CDC 2013 Report Antibiotic Resistance Threats
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 07 Jul 2017 - 48min - 30 - Small Intestinal Bacterial Overgrowth and Celiac Disease EP030
Nobody wants bad bacteria, parasites, yeast or food particles hanging around their small intestine! There are a number of causes of small intestinal bacterial overgrowth (SIBO), and undiagnosed celiac disease just happens to be one of them.
The Gluten Free RN is prepared to discuss the complexity of health issues celiac patients must resolve after going on a gluten free diet, one of which may be SIBO. She shares the symptoms of small intestinal bacterial overgrowth, how we test for SIBO, and potential treatments for the condition. Listen in to learn how foods and medication affect the microbiome and alter the environment of your intestines.
What’s Discussed:The complexity of healing once a celiac patient goes gluten free
Very rarely does diet change heal all associated disorders Other issues like SIBO must be treated once intestines healThe causes of irritable bowel syndrome
Thought to be caused by stress Studies now show food poisoning may be triggerHow food, drink and medication affect your intestines
Certain food/drink can move in bad bacteria, push out good Antibiotics change pH of stomach acid Bacteria, parasites, yeast and food particles get into small intestineThe consequences of damaged villi due to undiagnosed celiac disease
Compromised immune system Inflammation Body can’t absorb nutrientsThe process of healing your intestines
Takes six months to a year Must eliminate all foods that cause inflammation (gluten, dairy, soy, etc.) After villi heal, deal with additional health issues (i.e.: SIBO) Villi MUST grow back before good bacteria can returnThe symptoms of SIBO
Gas, bloating Abdominal pain Diarrhea ConstipationHow to test for SIBO
Consume sugary drink, then breathe into tube Hydrogen sulfate associated with diarrhea Methane connected to constipation Gives snapshot of what is happening in intestinesHow SIBO is treated
Antibiotics (rifaximin) Herbs (i.e.: oregano oil, berberine, neem) Fecal microbial transplantRisk factors for SIBO
Any course of antibiotics Diabetes Bowel surgery Crohn’s disease Undiagnosed celiac disease Resources:“Small Intestinal Bacterial Overgrowth: A Comprehensive Review” in Gastroenterology and Hepatology
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 30 Jun 2017 - 26min - 29 - Celiac Disease and Your Spleen EP029
Did you know that the spleen plays a leading role in a properly functioning immune system? As the largest organ in your lymphatic system, the spleen spends its time fighting infection and keeping you healthy. Unfortunately, research points to a connection between disorders of the spleen and celiac disease. And if your immune system is already compromised because of gluten damage to your intestines, a spleen issue leaves you at heightened risk for a variety of infections and autoimmune diseases.
Today the Gluten Free RN shares her personal connection to genetic spherocytosis and how spleen damage affected her family. She also covers several studies that document the correlation between spleen issues and celiac disease. Listen in to understand how your spleen functions, the symptoms of spleen disorder, and the autoimmune diseases you may develop if your spleen is damaged or removed.
What’s Discussed:How your spleen works to keep you healthy
Filters used/damaged red blood cells Harvests iron to recycle Produces antibodies, white blood cells Fights infection Vital to immune systemConditions you may acquire if spleen is damaged (increased risk)
Pneumonia UTI Overwhelming sepsisInstances in which spleen may be enlarged
Mononucleosis Some bacterial infections, metabolic disorders Liver diseases Some blood cancers, lymphoma Blood clots in veins of liver, spleenSymptoms of spleen issues
Pain in upper left quadrant Fatigue Anemia Bruise easily BloatedThe correlation between genetic spherocytosis and celiac disease
As high as 88% in some studiesHow the ratio of spleen diameter to RDW can indicate celiac disease
Two-thirds of celiac patients in study had elevated red blood cell distribution width Small spleen in 80% of celiac patients Spleen diameter to RDW ratio under 6 had 88.5% specificity in predicting celiac diseaseWhy patients with hyposplenism should get tested for celiac disease
25-75% of celiac patients have hyposplenism Look for red blood cell abnormality HLA-DQ2 and HLA-DQ8 genes indicate predisposition for celiac disease Antibody test available from EnteroLab or Cyrex Laboratories Ask for total IgA, IgGOther autoimmune diseases patients with hyposplenism may develop (increased risk)
Type 1 diabetes Lupus Sjögren’s syndrome Vitiligo Raynaud’s Autoimmune thyroiditis ALS, MS, any demyelination of nervous system Idiopathic thrombocytopenia Autoimmune hepatitisNadine’s recommendations around nutrition
Local, organic Nutrient dense Gluten-free, PaleoThe link between hyposplenism and autoimmune manifestations of celiac disease
Autoimmune disorders may cause splenic hypofunction or vice versa Study hypothesizes that higher risk for splenic function in celiac patients may be related to celiac disease rather than autoimmunity Prevalence of celiac disease-associated hyposplenism increased from 19% in uncomplicated patients to 59% in those with autoimmune disordersWhy celiac patients may not benefit from iron supplements, infusions
Damaged intestines cannot absorb iron Damaged spleen destroys healthy red blood cells Resources:“Ratio of Spleen Diameter to Red Blood Cell Distributions Width” in Medicine (Baltimore)
“Hyposplenism in Gastrointestinal Disease” in Gut BMJ
“Hyposplenism, Adult Coeliac Disease, and Autoimmunity” in Gut BMJ
“Splenic Volume Differentiates Complicated and Non-Complicated Celiac Disease” in UEG Journal
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 23 Jun 2017 - 25min - 28 - The Relationship Between the Respiratory System and Celiac Disease EP028
The average human takes between 14 and 20 breaths per minute. But if you are conscious of those breaths, that’s a problem. Perhaps you’re experiencing chest tightness, clogged sinuses or a nagging cough that make you very aware of every breath you take. If so, the ingestion of gluten may be a contributing factor to these respiratory issues.
Today Nadine explores the relationship between the lungs and celiac disease, offering anecdotal evidence as well as explaining the way that inflammation can lead to a number of respiratory problems. Because 70-90% of your immune system is housed in your intestines, it is no surprise that a leaky gut could make you more vulnerable to respiratory tract infections.
Despite the fact that current literature considers respiratory challenges to be an atypical presentation of celiac disease, the Gluten Free RN argues that there is enough anecdotal evidence to merit further study. Listen in to understand the vitamin deficiencies that likely contribute to respiratory issues, how those health concerns might be corrected by going gluten-free, and why your body heals more quickly on a high fat, whole food diet. It’s time to go gluten-free and breathe easy again!
What’s Discussed:
How gluten ingestion likely affects the respiratory system
Body keeps fluids separate unless tissues leaky Gluten alters epithelial tissue, including that of lungsNadine’s anecdotal evidence of a connection between gluten and respiratory issues
Fellow nurse had lung removed as child Always needed inhalers Went gluten-free with Nadine Inflammation in lungs cleared, asthma gone No longer needed inhalersRespiratory issues that may be corrected on a gluten-free diet
Anemia (lack of red blood cells to carry oxygen causes shortness of breath with minimal exertion) Recurrent respiratory infections Cystic fibrosis COPD IPH (bleeding lung) Pulmonary edemaVitamin deficiencies caused by gluten ingestion that lead to respiratory problems
Vitamin K deficiencies initiate easy bruising, nose bleeds and bleeding lungWhy going gluten-free eliminates many respiratory issues
Gluten causes inflammation (-itis = inflammation) Removing the cause heals intestines, repairs immune system Patients operate on a higher levelCommon symptoms of respiratory issues
Difficulty breathing Chest tightness Nagging cough Clogged sinuses Post-nasal dripNadine’s recommendations around diet and nutrition
Gluten- and dairy-free at a minimum Ideally variation of Paleo diet Whole foods (meat, fish, eggs, fruits, vegetables, nuts and seeds) High fat (body needs to absorb fat-soluble nutrients – A, D, E & K) Maintain Gluten Zero (takes six months to a year for intestinal villi to heal)Why your body heals more quickly on a high fat, whole food diet
Body knows how to break down, utilize nutrients Fat-soluble vitamins repair connective tissue, leaky gutThe genes that indicate a predisposition for celiac disease
HLA-DQ2 HLA-DQ8 Resources:“Respiratory Symptoms as Atypical Manifestation of Celiac Disease” in the Pediatric Oncall Journal
“Pneumococcal Septic Shock in the Setting of Hyposplenic Celiac Disease” in Hospital Physician
Coeliac Australia: Associated Conditions
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 16 Jun 2017 - 19min - 27 - Type 1 Diabetes and Celiac Disease EP027
Struggling to maintain control of your blood sugar? A gluten-free diet may be the answer! If you have one autoimmune disorder, you have a 30-50% greater risk of developing another, and both type 1 diabetes and celiac disease fall into that category.
As more and more research points to an enormous overlap between type 1 diabetes and celiac disease, it is in our best interests to mitigate additional risk by getting screened and/or adopting a gluten-free or Paleo diet to mitigate further risk. Today Nadine discusses the prevalence of diabetes, several research studies that explore the connection between type 1 diabetes and celiac disease, and the potential risks for type 1 diabetics who are undiagnosed celiac patients.
Listen and learn how your diet may be affecting your blood sugar and why going gluten-free could improve your health and quality of life!
What’s Discussed:The prevalence of diabetes
By 2050, half the population will have diabetes According to CDC, 29.1 million have diabetes One out of four don’t know they are diabetic 18,000 young people diagnosed from 2008-2009The difference between type 1 and type 2 diabetes
Minimize risk for type 2 through diet and exercise Type 1 is autoimmune disorder, don’t produce enough insulin to break down sugarSymptoms of type 1 diabetes
Extreme thirst Urgency to urinate frequently Fatigue WeaknessThe enormous genetic overlap between type 1 diabetes and celiac disease
Scottish study found 94% of type 1 diabetics were HLA-DQ2 or HLA-DQ8 gene carriers 100% overlap if include HLA-DQ2.2 Prevalence of celiac disease among type 1 diabetics is 20% higher than general populationThe importance of testing all type 1 diabetics for celiac disease annually
Can develop celiac disease at any ageThe consequences of undiagnosed celiac disease in children with type 1 diabetes
Short stature Failure to thrive Early onset osteopenia, osteoporosis Easily broken or rubbery bones Difficulty maintaining glycemic control (low blood sugar, spikes) AnemiaThe decreased quality of life for type 1 diabetics who are undiagnosed celiac
Development of infections Difficulty with blood sugar maintenanceResearch studies re: the percentages of type 1 diabetics who also have celiac disease
Iraq – 11.2% Mexican participants – 5.9% Denmark – 12.3%Nadine’s anecdotal evidence of the overlap
Volunteers at community outreach clinic Young man struggling to control blood sugar Nadine recommended gluten-free diet Improved health and quality of lifeHealth risks associated with an inability to control blood sugar
Blindness Kidney failure Amputation of extremities Difficulty healing wounds Heart attacks StrokesWhy carb counting doesn’t control blood sugar
Carbs with little/no nutrient value cause spikes in blood sugarThe diet Nadine recommends for type 1 diabetics
Variation of Paleo diet Nutrient dense foods Meat and fish Eggs Fruits and vegetables Nuts and seedsThe benefits of a gluten-free diet for type 1 diabetics
Weight easier to control Immune system works better Tighter control on blood sugarThe lack of uniformity in screening guidelines
Additional autoimmune diseases that may be avoided with a gluten-free diet
Multiple sclerosis Lupus Sjögren’s Scleroderma Autoimmune thyroiditis Graves’ disease Hashimoto’s Vitiligo Raynaud’sPotential triggers for autoimmune disorders
Gluten Change in microbiome Stress to body (i.e.: cold, food poisoning, travel)Treatments for small intestinal bacterial overgrowth
Low FODMAPs or specific carb diet Rifaximin (antibiotic)The dangers of maintaining high blood sugar
Damage to kidneys, eyes, capillaries, fingers and toes Neuropathy GastroparesisThe long history of a connection between type 1 diabetes and celiac disease
The need for information re: the connection in diabetic education services
Resources:“Co-occurrence of Type 1 Diabetes Mellitus and Celiac Disease” in the World Journal of Diabetes
“Coexistence of Coeliac Disease and Type 1 Diabetes” in Przeglad Gastroenterologiczny
“Screening for Celiac Disease in Type 1 Diabetes: A Systematic Review” in AAP News and Journals
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 09 Jun 2017 - 31min - 26 - Celiac Disease and the Media EP026
The gluten-free movement is often dismissed in the media as a fad. Even so-called experts actively discredit the gluten-free diet and apply a negative connotation to terms like PWAG. Have you ever wondered why there is so much misinformation about celiac disease and non-celiac gluten sensitivity in the media? And who sponsors the coverage that dissuades people from going gluten-free?
Today, Nadine explains how the big business of wheat affects which voices we hear in media treatment of the gluten-free movement. In addition, she covers how the for-profit healthcare system in the US affects the timely diagnosis of celiac disease and non-celiac gluten sensitivity.
Celiac disease is a medical, social and economic issue with political implications. Listen and learn how to choose high quality, nutrient dense foods, and leverage your power as a gluten-free consumer!
What’s Discussed:Misinformation in the media
Some coverage dissuades from adopting a gluten-free diet Program/print sponsors may be corporations that depend on people eating wheat Wheat/grain industry threatened by rise of gluten-free diet (33% of people in US and Canada on variation of gluten free diet)The illusion of options in the area of food production
8-10 corporations own nearly every food company Nadine patronizes farmer’s markets, co-ops and local companiesNadine’s rules for buying food products
Label must be clear, easy to read Five or fewer ingredients Must be able to picture each ingredientThe importance of reading labels
May be gluten in products that are typically gluten-free (i.e.: pesto, kombucha) Companies are given six months to update labels after making changes Barley and rye are not on list of allergensNadine’s story
Multi-system organ failure Negative test for celiac disease despite being homozygous gene carrier Healed quickly on a Paleo dietWhy countries with universal healthcare take celiac disease seriously
Early diagnosis saves money Finland: 70% of people w/ celiac disease have been diagnosed Italy, UK and Canada: 30-40% have been diagnosed US: Less than 1% of those with celiac disease have been diagnosedHow long it takes to be diagnosed with celiac disease (for-profit vs. universal systems)
US: 9-15 years Italy: 2-3 weeksHow doctors/experts discredit gluten-free as a fad
Use PWAG as derogatory term Placebo effect Nocebo effect (expect to feel poorly)The inaccuracy of blood tests for celiac disease
70% false negativeHow companies profit from undiagnosed celiac patients
Products geared toward people with health issues (i.e.: compression socks, hypoallergenic sheets)The prominence of wheat as a publicly traded commodity
Top export of US/CanadaThe health risk associated with genetically modified wheat
The benefits of a gluten-free diet
Symptoms resolve No longer need medicine, surgeryNadine’s advice re: selecting gluten-free products
Avoid nutrient deficient gluten-free options (cheap fillers, empty carbs) Focus on high quality, nutrient dense foodsHow to leverage your power as a gluten-free consumer
Hold food producers accountable (standards, production methods) ‘Vote carefully with your dollar’ Speak up when you see inaccurate media coverageWhy you cannot assume that gluten-free menu items are truly free of gluten
Uneducated restaurant staff Possibility of contamination, cross-contaminationWhat a ‘gluten free’ designation means in labeling
GIG certification indicates less than ten parts per million Standard in US/Europe is less than 20 parts per millionThe Gluten Free RN mission
Educate people globally about celiac disease and non-celiac gluten sensitivity Empower people to improve their health and quality of life with food Resources:Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 02 Jun 2017 - 38min - 25 - Non-Alcoholic Steatohepatitis (NASH) and Celiac Disease EP025
We typically associate liver disease with alcoholism. But the liver functions as a filter, and over time it can be damaged by certain pharmaceuticals and even food. In fact, research suggests a strong correlation between undiagnosed celiac disease and non-alcoholic steatohepatitis (NASH).
The Gluten Free RN shares a number of case studies in which a diet change reversed liver damage and prevented the need for an organ transplant. She also takes us through the alarming statistics regarding NASH in children and discusses her approach to treating NASH patients.
Listen to understand the obesity trends in the US and how a sedentary lifestyle plays a part in liver disease. Join Nadine’s campaign to educate the population about the benefits of a gluten- and dairy-free, whole food diet – and prevent NASH!
What’s Discussed:Nadine’s introduction to NASH in children
Videoconference of pediatricians Discovered NASH on autopsies Few had signs/symptomsThe fundamentals of NASH
Liver failure caused by changing environmental factors Dietary culprits (e.g.: sodas, fast food, processed foods, alcohol, high fructose corn syrup, nutrient-deficient carbs) Up to 90% of patients undergoing bariatric surgery have fatty liver disease Only diagnostic tool is liver biopsyObesity trends in the United States
60% of people in 13 states will be obese by 2030 Link between poverty and obesityWhy starving people are obese
Lack of nutrient-dense food results in low nutrient levels Body compensates for deficiencies by storing fat as cheap energyThe correlation between undiagnosed celiac disease and NASH
Celiac disease found in 10% of patients with unexplained abnormal liver panels and 3.5% of patients with NASH Anyone with bump in liver enzymes should be screened for celiac disease and given gluten-free diet optionThe 2015 Canadian study re: liver transplant
NASH as most common indication for liver transplant in North America NASH projected to be leading cause by 2025 Identified obesity, sedentary lifestyle, highly processed foods, undiagnosed celiac disease, MS and type 2 diabetes as causesThe basics of non-alcoholic fatty liver disease (NAFL)
Buildup of fat in liver cells Largely asymptomatic until have profound liver/organ failureWhich populations are at increased risk for NASH
Obese Hispanic Native American PediatricLiver transplant statistics
16,000 people on waiting list for liver transplant Only 6,000 liver transplants performed each yearCase study demonstrating the reversal of liver damage on gluten-free diet
19-year-old woman referred for emergency liver transplantation Recovered quickly on gluten-free diet, normal liver and small intestines after 20 months No surgery requiredThe correlation between celiac disease and liver disease
Celiac patients at increased risk of NAFLD compared to general population Most common cause of chronic liver disease in children and adolescents in western nationsHow Nadine approaches a patient with NASH
Examine diet (food as medicine/poison) Replace highly processed fats Leverage minimally processed foodsHow to combat obesity
Educate people about the value of nutrient-dense food Provide medical and social supportThe liver as a detoxing organ
Functions as a filter Can be damaged over time by foods, acetaminophen, alcoholWhat a good, whole food diet looks like
Gluten- and dairy-free (ideally Paleo) Includes meat and fish, nuts and seeds, organic fruits and vegetablesThe need for access to accurate nutritional information
Not influenced by politics, food corporations, agribusiness or pharmaceutical companies Resources:“Non-Invasive Diagnostic Biomarkers” by Dr. Rohit Loomba of UC San Diego
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 26 May 2017 - 23min - 24 - The Impact of Undiagnosed Celiac Disease on Fetal Development and Maternal Health EP024
‘With our technology, every time a woman dies, it’s a medical error.’
Recent reports have uncovered some alarming statistics regarding maternal mortality rates in the United States. While these numbers are on the decline in every other developed nation, pregnant women in the US are at greater risk of dying than they were in recent years. We know that undiagnosed celiac disease has a significant impact on maternal health and fetal development, and we must identify expectant mothers (and fathers) who have the potential to reap remarkable benefits from a simple diet change.
This issue is especially important to the Gluten Free RN as a mother herself – as well as an emergency ER nurse certified in PALS, NLS and pediatric emergency nursing. She shares the stories of women who had difficulty getting pregnant or maintaining pregnancies as a result of undiagnosed celiac disease and gluten sensitivity, and explains how a mass screening could work to prevent such intense suffering.
Listen to learn how adopting a gluten-free or Paleo diet can help women carry their babies to full-term and deliver healthy, thriving children!
What’s Discussed:Nadine’s mission to get women tested for celiac disease prior to pregnancy
Allows to absorb nutrients during pregnancy (including prenatal vitamins) Can deliver healthy, thriving childThe story of Alice Bast
Suffered miscarriage and still births Multiple doctors couldn’t provide answers Vet gave idea to test for celiac disease Founded the National Foundation for Celiac AwarenessThe necessity for a mass screening of men and women
Identify HLA-DQ2 and HLA-DQ8 gene carriers Genes of both parents affect fetal health Ratio of women to men with celiac disease is 1:1 Ratio of women to men diagnosed with celiac disease is 3:1The increased risks for pregnant women with undiagnosed celiac disease
Miscarriage Still birth Low birth weight Failure to thrive in children Pre-eclampsia/eclampsia (dangerously high blood pressure)The role men play in infertility
ED, low sperm count and low libido may be attributed to undiagnosed celiac disease Symptoms include deficiencies in zinc, magnesium and B vitamins as well as anemia and osteoporosisThe argument that a mass screening for celiac disease is too expensive
The cost associated with undiagnosed celiac disease is much higher Consists of medical costs from complications Also includes decreased productivity and morbidity/mortality Study published in Science Digest found that 42,000 children may die annually due to undiagnosed celiac diseaseConditions that indicate high risk for celiac disease
Chronic GI issues Irritable bowel syndrome Weight loss/gain Iron deficiency anemia Vitamin/mineral deficiencies Secondary hyperparathyroidism Unexplained elevations in liver function Down, Turner or Williams syndrome Type 1 diabetes Lupus Autoimmune thyroid diseaseSam’s story
Delayed puberty (didn’t get period until 17-years-old) Diagnosed with celiac disease at 19 Doctors warned she would probably never have children Raising two healthy boysWhy Nadine is concerned about the current generation of children
Higher rates of autoimmune diseases, cancer and learning disabilitiesThe appropriate diet to promote maternal health and proper fetal development
Gluten- and dairy-free Paleo is best Humans have enzymes to break down meat proteins Humans do not have enzymes to break down grain proteins Avoid wheat, barley, rye and oats Embrace meat, fish, eggs, fruits, vegetables, nuts and seedsDeficiencies that can be corrected to promote healthy pregnancy
B6 and B12 A, D, E and K (the fat-soluble vitamins) Magnesium RBC ZincThe US maternal mortality rate compared to other developed nations
Rising in the US, declining in other developed nations 28 deaths for every 100,000 births in 2013, up from 23 in 2005 Resources:“Maternal Mortality Rate in US Rises, Defying Global Trend, Study Finds” in The New York Times
“Focus on Infants During Childbirth Leaves US Moms in Danger” on NPR
“Reproductive Changes Associated with Celiac Disease” from the World Journal of Gastroenterology
“Celiac Disease and Reproductive Health” from Celiac Disease: A Comprehensive Review and Update
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 19 May 2017 - 26min - 23 - Cardiac Issues Associated with Celiac Disease and Gluten Intolerance EP023
Given the choice between a heart transplant and a gluten-free diet, the vast majority – if not all – of us would quickly opt for the diet! Yet the medical community continues to ignore celiac disease as a potential cause of cardiac complications, despite documented connections between the two conditions.
The Gluten Free RN is sharing her experience with heart attack and stroke victims in the ER, and discussing the necessity of screening cardiac patients for celiac disease. She gets into the nitty gritty of how intestinal damage leads to nutrient deficiencies that affect the cardiac system, and reveals the cardiac symptoms that may resolve on a gluten-free diet.
Listen in and learn about the actual cause of heart attack and stroke (spoiler alert – it’s not high cholesterol) and how Nadine has achieved a lipid panel akin to that of a ‘23-year-old marathon runner’!
What’s Discussed:The connection between cardiac issues and celiac disease
Study linked celiac disease to almost doubled risk of CAD Documented connection between gluten and cardiomyopathyThe real cause of heart attack and stroke
Thought to be high cholesterol Actual cause is inflammation/malabsorptionHow a gluten-free diet can resolve cardiomyopathy
Medical community claims cardiomyopathy can be treated with meds, but not cured Patient eventually needs heart transplant Anecdotal evidence proves that removing gluten may cure profound heart failureNadine’s experience in treating cardiac patients as a critical care nurse in the ER
ER staff does not take a magnesium panel Deficiencies in magnesium or calcium can cause arrhythmias (irregular heartbeat) Even when patient tested for ‘everything,’ celiac disease and nutritional panels often omittedHow to correct a magnesium deficiency
Food (pumpkin seeds, molasses, etc.) Magnesium supplements (including calcium, zinc and vitamin D)How intestinal damage leads to nutrient deficiencies that affect the cardiac system
Thiamine deficiency may lead to wet beriberi or acute pernicious beriberi Low electrolytes may lead to arrhythmia Low iron, B vitamin may lead to anemia (less oxygen in blood) Low vitamin K levels affects protein S and protein C levels (involved in clotting)Cardiac symptoms that may resolve on a gluten-free or Paleo diet
Arrhythmias Chest pain Difficulty breathingThe myth that fat is bad for us
Nadine consumes a super-good high fat diet Her lipid panel ‘looks like a 23-year-old marathon runners’ Cardiac risk factor very lowNadine’s call for a worldwide mass screening for celiac disease
Find undiagnosed Prevent cardiac disease, stroke Resources:“Celiac Disease Linked to Almost Doubled Risk of CAD” by Marlene Busko
Gluten Toxicity: The Mysterious Symptoms of Celiac Disease, Dermatitis Herpetiformis, and Non-Celiac Gluten Intolerance by Shelly L. Stuart
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 12 May 2017 - 24min - 22 - The Connection Between Undiagnosed Celiac Disease and Sleep Disorders EP022
We all know how it feels to struggle through the day when you didn’t get enough sleep the night before. Your brain feels fuzzy, it’s tough to focus, and you simply aren’t the best version of yourself! The good news is, there may be a simple explanation for your sleep disorder – and there are steps you can take to eliminate the potential celiac symptoms that are keeping you up at night.
Today the Gluten Free RN shares her struggle with sleep deprivation as an undiagnosed celiac patient who also worked the night shift in the ER. Find out how she leveraged a Paleo diet and went from having a contentious relationship with sleep to becoming a champion ‘Olympic Sleeper’ who enjoys at least eight hours of rest every night!
She also covers the components of an ideal sleep space, suggestions for implementing an evening routine, and the benefits of a good night’s rest. Listen and learn about the connection between sleep disorders and undiagnosed celiac disease or non-celiac gluten sensitivity.
What’s Discussed:
Nadine’s struggle with sleep working the night shift
10 years as ER nurse working 12-hour night shifts Difficult to shift into normal sleep pattern on days off Circadian rhythm thrown off, felt fuzzy-brained Needed extra sleep Struggle to block out distractionsThe correlation between undiagnosed celiac disease and sleep disorders
Celiac symptoms can keep you awake at night May experience joint pain, muscle pain, DH, eczema, headaches, muscle twitches, restless leg syndromeHow a Paleo lifestyle can alleviate symptoms preventing sleep
How many hours of sleep you should be getting each night
Nadine recommends 8-10 hours of good quality sleep Provides the energy for your body to carry out the tasks of daily livingThe components of an ideal sleep space
Comfortable mattress Quality sheets Plenty of supportive pillows Appropriate temperature Fresh air, if possible No electronic equipment in the room (i.e.: phones, televisions, computers) Source of white noise (e.g.: fan, music)The model evening routine
Limit screen time in the hours before bed Try relaxing activities like reading or knitting instead Take a warm bath with Epsom salt (muscle relaxer, source of magnesium) Consider magnesium supplementsCeliac symptoms that can cause sleep apnea
How your body heals neurological damage in the absence of gluten
The repercussions of vitamin C deficiency
Signs of sleep disorders in children that may be caused by undiagnosed celiac disease
Can’t or don’t want to go to sleep, crying Cranky and fatigued during the day Decreased productivity Learning disabilities Difficulty with focusSigns of celiac disease in children
Short stature Anemia Falling off growth chart Learning disabilities Seizure disordersWhy anyone with sleep disorders should get tested for celiac disease
How Nadine’s sleep issues went away on a gluten-free diet
Eliminated back pain, joint pain, skin discomfort, muscle pain, muscle spasms and leg cramps Now she qualifies as an ‘Olympic Sleeper’The unhealthy approach to compensating for lack of sleep
Take in stimulants to make it through the day (e.g.: coffee, sugar) Take depressants at night to help fall asleep (e.g.: alcohol, prescription meds) Everything you consume impacts your health and ability to sleepA healthy option that functions as a sleep aid
The benefits of a good night’s rest
When to take multivitamins
In the morning with food At night before bed (absorbed differently)The risks associated with prescription medications
Connect with Nadine:
‘Your Skin on Gluten’ on YouTube
Books by Nadine:
Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 05 May 2017 - 27min - 21 - The Potential Connection Between Parkinson’s and Celiac Disease EP021
A diagnosis of Parkinson’s disease is devastating, and the associated symptoms – difficulty walking, tremors, memory issues – are debilitating. But what if those symptoms aren’t necessarily indicative of Parkinson’s after all? What if a simple diet change could improve or even eliminate those symptoms?
Today Nadine explores anecdotal evidence suggesting that the symptoms of Parkinson’s and other demyelination syndromes might be actually be caused by celiac disease or non-celiac gluten sensitivity. She argues that as Parkinson’s diagnoses become more and more common, it is imperative that we explore the potential connection between Parkinson’s and celiac disease.
Listen in to understand how gluten can affect the neurological system, why Parkinson’s patients should be tested for celiac disease, and how a gluten-free diet can heal neurological damage.
What’s Discussed:Nadine’s Parkinson’s patient
Diagnosed with celiac disease as a child in the 1940’s Recently diagnosed with Parkinson’s Symptoms included difficulty walking, falling, stooped gait, masked appearance, tremors, memory issues and confusion Discovered unintentional gluten exposure in the home Moved to adult foster home to ensure gluten-free diet Many symptoms went away Working with neurologist to wean off Parkinson’s medsWhy patients diagnosed with Parkinson’s, ALS and MS should get test for celiac disease and gluten sensitivity
Every nerve in the body is insulated with myelin Myelin is made of fat Gluten prevents the absorption of fats Parkinson’s, ALS and MS are all demyelination syndromesThe need for research regarding the potential connection between Parkinson’s and celiac disease
The University of Chicago asserts there is ‘no published evidence of a connection between Parkinson’s and celiac disease’ Nadine argues that enough anecdotal evidence exists to suggest that a connection should be investigatedNadine’s recommendation for a comprehensive celiac lab test
Cyrex Labs tests for 25 of the gluten intolerant antibodies, including tTG-2, tTG-3 and tTG-6 Ask for a total IgA and IgG in addition to the Cyrex Array 3 Insurance should cover the tests Can be ordered by any practitionerCeliac diagnoses in patients over 60
30% of newly diagnosed celiac patients are over 60 Many have neurological issues Neuropathy Headaches Migraines Seizure disorders Difficulty walking Falling Balance issues MS Nadine’s patients improve on a Paleo dietThe Stanford idiopathic familial narcolepsy study
Entire family diagnosed with narcolepsy Found that family members had celiac disease Adopting a gluten-free diet eliminated the narcolepsy Family now runs organic farmThe increasing number of Parkinson’s diagnoses
More and more common UK neurological expert routinely tests for celiac disease and non-celiac gluten sensitivityHow your body heals neurological damage in the absence of gluten
Heal intestines Eliminate inflammation Repair immune system Replete nutrient deficienciesVitamin D
Cancer preventative Level should be between 60-80 Indicator of all fat-soluble vitamins (A, D, E and K) ‘Sunshine’ vitamin synthesized through skin Must also be taken in dietarily Little chance of overdosing on D3What your nails can tell you about your health
Look for white spots, cracked nails, hangnails May indicate lack of zinc, D3, or B vitaminsDr. Terry Wahls’ MS misdiagnosis
Diagnosed with MS and required wheelchair Healed with a gluten-free diet Can ride her bike and walk without a caneNadine’s story
At 40, her symptoms suggested MS Issues with clumsiness (falling, dragging feet, dropping things, difficulty with balance) Problems went away on a gluten-free diet Nutrient deficiencies were causing neurological issuesCeliac cerebellar ataxia
Caused by lesions on or inflammation of the brain Results in inability to walk straight Tissue can be healed on a gluten free diet Resources:The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles - by Terry Wahls, MD and Eve Adamson
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 28 Apr 2017 - 26min - 20 - Weight Loss and Weight Gain Associated with Celiac Disease EP020
Forget everything you thought you knew about obesity.
68% of the population of the US is overweight, and we know that there are a number of health risks associated with the issue. But did you know that people are overweight because their bodies are actually starving?
Today the Gluten Free RN is challenging your assumptions about weight gain and celiac disease, revealing the surprising way your body compensates for malnourishment, the necessity of fat in nutrient absorption, and the healing power of a whole food gluten-free diet.
Listen and learn why more people are overweight when diagnosed with celiac disease than underweight, more have constipation than diarrhea, and more have neurological disorders than gastrointestinal issues. Nadine is prepared to shake up your idea of what it means to have celiac disease and offer guidance regarding the food we should be eating in order to heal, and lose – or gain – weight in the process!
What’s Discussed:The classic symptoms of celiac disease
Used to be identified by weight loss and chronic diarrhea We now know there are well over 300 signs and symptomsThe obesity epidemic in the US
68% of the population is overweight Obesity increases morbidity and mortality The majority of celiac patients are overweightWhy celiac patients are overweight
Damage to intestines prevents absorption of nutrients Body is starving, so it compensates by storing fat as cheap energyThe health risks associated with obesity
The failings of fast food
Little to no nutritional value ‘Bad’ fat Little use as energyThe whole food diet Nadine recommends for celiac and gluten sensitive patients
The rapid weight loss of overweight celiac patients once they adopt a gluten-free diet
Why wounds may not heal appropriately in celiac patients
Body is malnourished and cannot absorb nutrients Nutrients are necessary to heal tissueHow to heal your body with food
Choose fermented foods Regenerate villi in intestines Build diverse microbiomeNadine’s patient with tunneling wound in sacral area
Wound would not heal, required daily dressing changes Patient was HLA-DQ2 gene carrier Wound healed after 10 days on a gluten-free dietHow a gluten-free diet affects underweight celiac patients
Muscle and tissue build appropriately Weight increases as nutrients are absorbedThe necessity of a high-fat diet for celiac patients
Vitamins A, D, E and K are fat-soluble The brain is made of fat‘Good’ fats that Nadine recommends incorporating into your diet
Listen in for the full list!! Connect with Nadine: Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 21 Apr 2017 - 23min - 19 - Legal Issues Surrounding Celiac Disease EP019
In Italy, it takes only two to three weeks to get diagnosed with celiac disease. In the United States, however, it typically takes nine to 15 years. Why is there such a huge discrepancy? And what are the legal ramifications for practitioners who overlook celiac disease and non-celiac gluten sensitivity, causing patients unnecessary pain and suffering?
On this episode, Nadine explores the legal issues surrounding celiac disease as well as the potential reasons for delayed diagnosis in the US. She also explains the differences between universal healthcare and the for-profit system and how each appears to influence celiac diagnosis.
Listen and learn what medical practitioners need to know about celiac disease and gluten sensitivity in order to avoid being sued for malpractice, the value of standardization in celiac testing and follow-up care, and how you can get involved in advocating for universal coverage.
What’s Discussed:How the US health insurance system works
Usually purchased through employer Loss of job often means loss of coverage ACA provides coverage for many who were uninsured For-profit systemWhy Nadine is an advocate for a single-payer system
People treated in ER with or without insurance (we pay regardless) US healthcare is very expensive, yet outcomes poorCeliac disease diagnoses around the world
Italy: 2-3 weeks; standardized follow-up care US: 9-15 years; patients endure numerous other tests, misdiagnoses, unnecessary medications Canada: effective early diagnosis, but follow-up care lackingThe excuses practitioners use to avoid diagnosing celiac disease
Don’t believe in it, despite research and documentation Don’t want to learn about another illness Gluten-free diet is too difficult for patientsSymptoms Nadine encountered as an ER nurse that may have signaled celiac disease
Migraine headaches Abdominal pain Neurological disorders (headaches, difficulty with balance) FeverWhy practitioners should be concerned about malpractice suits if celiac disease goes undiagnosed
Ignorance is not a defense Michael Marsh contends that failure to do appropriate screening signals liability Avoid by learning the basics of celiac disease, how to diagnose and follow-upWhy celiac disease needs to be part of differential diagnosis for every patient
Indicators of celiac disease and non-celiac gluten sensitivity
HLA-DQ2 or HLA-DQ8 gene denotes predisposition for celiac proper AGA antibody suggests gluten sensitivityMaladies suffered by patients whose celiac disease went undiagnosed
Mental health issues Neurological disorders Seizures Balance issues Abdominal pain Incorrect diagnosis of Crohn’s or colitis Hemorrhoids GERD High blood pressure Heart attack Stroke CancerWhy standardization of testing and follow-up care is a necessity
Screenings are often misinterpreted Celiac patients who follow a gluten-free diet are often told that they have been cured or that the initial test was a false positive when follow-up shows antibodies in normal rangeThe story of Nadine’s 70-year-old celiac patient
Diagnosed with celiac disease by biopsy, but received no follow-up care Suffered from significant neurological issues (e.g.: gluten ataxia, falling) Nadine recommended standard lab tests Primary care doctor refused Patient returned to Nadine in distress Doctor culpable for patient’s neurological damageWhy celiac patients should consider advocating for universal coverage
The differences between celiac diagnoses under universal vs. for-profit insurance systems
Financial benefit to early diagnosis under universal system (i.e.: UK, Canada, Italy) No benefit to early diagnosis for insurers under for-profit structure Resources Mentioned:Physicians for a National Health Program
Mid-Valley Health Care Advocates
Additional Resources:Connect with Nadine: Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 14 Apr 2017 - 29min - 18 - Celiac Disease and Gluten Sensitivity in Down, Turner and Williams Syndrome EP018
The medical community has an obligation to protect vulnerable populations, speaking up for any group that may not be able to advocate for themselves, and patients with Down, Turner, and Williams syndrome certainly fall into this category. Yet one facet of their health – one that could vastly improve quality of life – often goes overlooked.
There is a high prevalence of celiac disease among individuals with Down, Turner, and Williams syndrome, and it is recommended that these patients get tested annually. Unfortunately, many of the symptoms of celiac disease are attributed to the syndrome instead, and gluten sensitivity goes undiagnosed.
Today Nadine shares several case studies as well as her own experience working with patients with developmental delays. She covers the high incidence of celiac disease and non-celiac gluten sensitivity in Down, Turner, and Williams syndrome patients, the signs and symptoms of gluten damage, and the importance of annual screening in this population.
What’s Discussed:
The prevalence of celiac disease and non-celiac gluten sensitivity in individuals with Down, Tuner and Williams syndrome
Annual testing is recommended Signs and symptoms can be eliminated with a gluten-free dietTiffany’s story
Williams syndrome patient Suffered from stage 4 liver failure and diabetes Endured cracked, bleeding skin and fluid in the abdomen Tested positive for celiac disease Gluten-free diet resolved most of her symptomsAlternatives to the standard blood test that could reveal non-celiac gluten sensitivity in Down syndrome patients
The anti-gliadin antibody (AGA) is an excellent biomarker In a study published in the World Journal of Gastroenterology, 41% of Down syndrome patients had AGA antibodiesThe importance of testing family members
A mother who is malnourished during pregnancy may have a child with Down, Turner or Williams syndrome Celiac disease may disrupt fetal developmentThe overlap of celiac disease and Down syndrome
Study found that 18 of 284 subjects ages two to 15 tested positive for celiac disease In another study, 11 of 47 had positive blood testsSymptoms of celiac disease and non-celiac gluten sensitivity
Diarrhea Abdominal pain Gas Bloating Constipation Short stature Brittle bones Osteoporosis Osteopenia Thyroid issues Anemia Type 1 diabetes Skin rash Decreased appetite Yeast overgrowth Lichen planus Difficulty swallowingNadine’s story of an autistic patient
Sweet gentleman who lived in group home Suffered from diabetes, repeated infections and self-harm Paleo diet made him calmer, didn’t irritate his throat He enjoyed an improved quality of lifeCases of asymptomatic celiac disease in children with Down syndrome
Study published in the International Journal of Pediatrics Toddlers screened at around 24 months Biopsy proven celiac disease identified in 3-9% of children with Down syndrome Not all patients with positive screens receive a biopsy if asymptomatic One child in the study gained weight and energy on a gluten-free diet A second child had less constipation and diarrhea Follow-up study reported that 66% had health improvementResources Mentioned:
Other Resources:
“Celiac Disease” from the Pediatric Gastroenterology Board Review Manual
“Coeliac Disease in Williams Syndrome” from the Journal of Medical Genetics
“Turner Syndrome and Celiac Disease: A Case-Control Study” from Pediatrics
Connect with Nadine:
Books by Nadine:
Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 07 Apr 2017 - 28min - 17 - What in the World Do I Eat? EP017
“Cheap food is an illusion. There is no such thing as cheap food. The real cost of the food is paid somewhere. And if it isn’t paid at the cash register, it’s charged to the environment or to the public purse in the form of subsidies. And it’s charged to your health.”
–Michael Pollan
Adopting a gluten-free lifestyle can be incredibly overwhelming, and many are resistant to the idea. Maybe you don’t want to give up the foods you love, or you don’t think you can do without pizza and beer. But the truth is that in order to heal, coping is your only option.
Nadine is here to tell you that going gluten-free is not as difficult as you think. In fact, if it’s hard – you’re doing it wrong! She recommends a number of healthy gluten-free and Paleo-friendly food options, explains how your taste buds will change as you rid your body of addictive proteins, and discusses how to approach your grocer to request gluten-free alternatives. It’s time to stop eating for convenience and begin eating to enjoy high-quality food!
What’s Discussed:Why going gluten-free can be challenging
Emotional attachment to food Function as reward/comfortHow to change your mindset to embrace the gluten-free lifestyle
Remember that there is plenty of other food to eat Create a new ‘country’Why celiac patients should avoid eating meat from cattle fed on grass treated with glyphosate
Celiac patients are trying to heal increased permeability of the intestinal wall Chemical in Roundup can cause ‘leaky gut’Nadine’s tips for realizing a healthy gluten-free diet
Don’t simply replace gluten-containing with gluten-free products Focus on nutrient dense, whole foods high in good fat Choose organic fruits and vegetables Select 100% grass-fed, antibiotic free meat Avoid dairy (proteins are molecularly similar to gluten) Use almond, coconut or hemp milk and Kite Hill cheese/yogurt Satisfy your sweet tooth with molasses, honey and occasionally maple syrup Pick foods that have been processed very little or not at all Explore new vegetables Try bars when you are on the go (e.g.: Lärabar, EPIC, KIND) Freeze fruits and vegetables to savor year round Consider going Paleo (fruits, vegetables, nuts, seeds, meat, fish and eggs)The benefits of turning your lawn into a garden
‘Growing food is like planting money’ Allows you to enjoy kale, tomatoes, beans, peas, peppers, squash, etc.How to tailgate on a gluten-free diet
Explore gluten-free alcohol options (i.e.: Ground Breaker, 2 Towns, honey mead) Try gluten free snack foods like Kettle Brand or Jackson’s Honest chips and Jilz Crackers Enjoy guacamole, salsa, hummus and pesto dips Sample desserts like Hail Merry Miracle TartsNadine’s guidelines for selecting healthy foods
No more than five ingredients Should be able to picture each ingredientQuality sources of fat
Bacon Pumpkin seed and nut butters Olive oil Avocados Eggs Resources Mentioned:Connect with Nadine: Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 31 Mar 2017 - 30min - 16 - Celiac Disease Worldwide EP016
Wherever there is wheat, there is susceptibility to celiac disease and non-celiac gluten sensitivity. Gluten is a growing global problem, exacerbated by the popularity of the western diet around the world. This issue has personal, social and political implications as it places a significant economic burden on individuals, communities, and even entire nations.
The Gluten Free RN brings us a ‘big picture’ perspective of the celiac and gluten sensitive population around the world, as we learn about how other countries support these individuals. She also covers the industries that have begun to recognize the power of the gluten free population as a consumer group.
Nadine will be doing some globe-trotting herself come September for the International Celiac Disease Symposium in New Delhi, and she is currently soliciting advice regarding where and how to eat safely during her travels in India and Thailand. Feel free to message her with recommendations!
What’s Discussed:When and where wheat originated
Fertile Crescent (Northern Africa and the Middle East) 10,000 years ago High prevalence of celiac disease in these regions nowThe International Celiac Disease Symposium
September 2017 in New Delhi Held every two years Scientists, medical professionals and other interested parties Share latest researchWhere celiac disease is common
Anywhere people are eating grains More widespread as other regions adopt a western diet Increased risk in Punjab population of IndiaThe basics of celiac disease and non-celiac gluten sensitivity
Can present in many ways (300+ signs and symptoms) #1 autoimmune disease in the world More likely to recover the sooner identified 30-50% of the population carry the genes (HLA-DQ2 and HLA-DQ8) that indicate predisposition Body doesn’t have enzymes to break down gluten proteins Gluten damages intestines Nadine recommends adopting a Paleo diet in order to healThe World Health Organization’s “burden of disease”
Measures the impact of celiac disease Based on financial cost, mortality, morbidity, etc.How Italy supports celiac patients
Provide extra days off work for doctor’s appointments, shopping Ship gluten free foodPotential symptoms of celiac disease affecting every ethnicity
Odd gait (gluten ataxia) Skin rash (dermatitis herpetiformis)The power of celiac and gluten-sensitive patients as a group
Largest untapped market in the world Some industries taking notice (pharmaceutical, food) Use influence to heal selves and educate othersWhy some people are so resistant to eliminating grains
Sometimes crave what is bad for you Nutritional deficiencies may cause addiction Resources Mentioned:Guns, Germs, and Steel: The Fates of Human Societies - by Jared M. Diamond
Connect with Nadine: Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 24 Mar 2017 - 25min - 15 - Emergency Preparedness with Nutrient Dense Foods EP015
It’s not a matter of if, but rather when you will encounter an emergency situation. And if you suffer from celiac disease or gluten intolerance, it is incredibly important that you are prepared with the appropriate supplies you will need to endure a hurricane, earthquake, blizzard, or other disaster.
Nadine teaches you how to stock your cupboards with nutrient dense foods should you need to shelter in place for an extended period of time. She also outlines other essentials you will need to stay alive and assist others who may need help!
What’s Discussed:Nadine’s experience responding to Hurricane Katrina
People were unprepared FEMA provided only cheap filler foodsWhy it’s important to stock nutrient dense foods in case of emergency
Alleviates stress Allows you to feed yourself for a period of timeNadine’s list of nutrient dense foods to stock
Protein bars Gelatin Jerky (without soy, teriyaki sauce) Canned tuna, sardines Canned chicken, turkey Protein powder Seaweed Nuts Pumpkin seed butter Chocolate bars (80-100% cocoa, no milk) Many more! Listen for the full list!How to cope with a loss of electricity
Consume foods stored in freezer first Prioritize eating perishablesThe importance of being self-reliant during a time of emergency
Helps you avoid overburdened hospitals and clinicsOther essentials to have on hand in case of emergency
Multi-vitamins Prescription medications (keep list in wallet/purse) Can opener Heat source (paper, wood) Sleeping bags, pillows and blankets Flashlights w/ working batteries Extra batteries Socks and shoes First aid kit Waterproof containers Gluten free shampoos, lotions Extra contact lenses and solution/glasses Cash Pet foodHow to obtain water if forced to shelter in place
Utilize water heater Resources Mentioned:Connect with Nadine: Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 17 Mar 2017 - 31min - 14 - Recommended Labs and Follow-up for Celiac Disease and Gluten Intolerance EP014
Freeze your poop and mail it to Texas!
In all seriousness, a stool analysis can offer vital information about your body’s absorption of fat and nutrients, and today the Gluten Free RN explains the significance of knowing your fecal fat score and other baseline labs that can offer clues about how gluten has adversely affected your health.
Nadine outlines recommended labs for celiac disease and gluten intolerance, discussing how each test can inform the way you tweak your diet or add necessary supplements to your health care routine. She also reviews the importance of follow-up labs to track how you are healing and help you get better, faster!
What’s Discussed:The importance of standardization in celiac testing and follow-up labs
Things to consider re: the results of a celiac panel
70% produce a false negative A positive test guarantees intestinal damage Lab to lab variability can be problematic Must include total IgA and IgG Interpretation can be problematic Ask for a hard copy of your resultsWhy a “gluten challenge” is dangerous
No medical or social reason to do so May cause organ damageAdditional tests that can offer valuable information
Fecal fat score (ask for #, over 300 indicates malabsorption) Complete blood count Comprehensive metabolic panel Vitamin D3 level (below 40 ng/ml is critically low) Vitamins A, E & K levels Vitamin B6 & B12 levels MTHFR gene test Magnesium RBC test Zinc level Iodine level B9/Folate level Ferritin level Iron level Thyroid panel Bone density test Lipid panel ANA test (autoimmune issues) ESR test CRP testHow to obtain reimbursement for labs
Why a diet change is preferable to medication in lowering cholesterol
Statin drugs don’t treat the underlying cause of chronic inflammation Still at risk for heart attack and strokeWhat a stool analysis can tell you about your microbiome
Why you should avoid food allergy testing in the first year of a gluten-free diet
Resources Mentioned:Connect with Nadine: Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 10 Mar 2017 - 34min - 13 - Getting Started on a Gluten-Free Diet EP013
On this episode of the ‘Gluten Free RN,’ Nadine helps you get on the road to recovery with a gluten-free, casein-free diet. She walks you through what to expect and offers tactics that will support your success.
Nadine breaks down the steps you should take to make your home a gluten-free space and ensure your comfort and health when you are on the go. She also talks you through how to carefully select food that is not just gluten-free, but also nutrient dense.
Nadine explains the significance building a support system that includes a knowledgeable healthcare team and peers who’ve adopted a gluten-free lifestyle. Listen and learn how to get better, faster as you get started on a gluten-free diet!
What’s Discussed:Why it is necessary to eliminate both gluten and casein
Microvilli that break down sucrose and lactase are first destroyed, last to grow back The gluten and casein proteins are molecularly very similar The body reads casein as a threat and triggers the immune systemThe particulars of taking a daily liquid multivitamin
Consider twice a day, morning and night (when your body heals) Take with food and high-quality fat Make sure it doesn’t contain wheat grass or barley grassHow to clean your home thoroughly to remove all gluten
Meticulously clean out kitchens and cupboards Give away wooden utensils, cutting boards, pastry cloths, rolling pins and colanders Eliminate personal care products and pet supplies containing gluten Wash your hands before you eat Wash fruits and vegetables before eatingWhy it’s important to carry snacks with you
The challenges of eating out on a gluten-free, casein-free diet
Staff may not have a clear understanding of a gluten-free diet Cross-contamination risk can be very highHow to rebuild your microbiome
Eat things that are alive, i.e.: sauerkraut, fermented food, kombucha Especially important if you’ve ever taken antibioticsWhat to expect in the first days of going gluten-free
The feeling you can’t get enough to eat Cravings for gluten and dairy products Symptoms of illness as your body detoxes (headaches, fatigue, diarrhea)How to read labels to ensure gluten-free food is high-quality
Look for certified gluten-free labels Make sure it’s also nutrient-dense Nadine suggests only buying products with a maximum of five ingredients Only buy products if you can picture each of the ingredients listedThe importance of joining a support group
Share experiences, resources People to shop and eat withThe necessity of building healthcare team to assist with your lifestyle transition
Understand the baseline and follow-up labs needed Might include Nurse Practitioner, MD, DO, Naturopath, Acupuncturist, Chiropractor and Massage TherapistThe benefits of keeping a diary or food log
Allows practitioners to offer feedback Could include pictures of any painful areas Track your progress with new photos every three months Resources Mentioned:Nadine’s Getting Started One-Pager
Connect with Nadine:
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 03 Mar 2017 - 27min - 12 - Neurological Disorders Associated with Celiac Disease and Gluten Sensitivity EP012
Nadine covers the neurological symptoms associated with celiac disease and non-celiac gluten sensitivity. Celiac disease is primarily a neurological disorder, but the neurological symptoms are often misdiagnosed.
Nadine shares her own story as well as client anecdotes regarding the neurological issues faced by celiac patients and those with non-celiac gluten sensitivity. She outlines the common symptoms and discusses how to either slow their progression or eliminate them entirely.
Nadine explains the way gluten affects your neurological system and how a Paleo lifestyle can help you heal. Listen and understand how to get your brain back!
What’s Discussed:How an immobile patient misdiagnosed with MS was able to walk again
Inspired by Dr. Terry Wahls book, The Wahls Protocol, she adopted a Paleo diet Food can be medicine or poisonMisdiagnoses given to people who actually suffered from gluten ataxia
Parkinson’s ALS MS Psychosomatic disorderWhy experts advocate for including an AGA in celiac testing
It provides a biomarker for non-celiac gluten sensitivityWhy the neurological component of celiac disease and non-celiac gluten sensitivity is so significant
The entire enteric nervous system is located in the bowels Constipation and diarrhea occur when peristalsis is paralyzed due to glutenThe neurological symptoms of celiac disease and non-celiac gluten sensitivity
Why patients diagnosed with Alzheimer’s or dementia could be restored by a Paleo diet
An autopsy is the only way to definitively diagnose Alzheimer’s Many patients have improved significantly after removing gluten from their dietsThe components of a Paleo diet
Meats and fish Nuts and seeds Fruits and vegetablesHow a Paleo lifestyle cleared Nadine’s neurological issues
Her balance issues went away She no longer suffered frequent fallsThe standard nutritional panels for a celiac patient
How glyphosates can cause leaky gut even in the absence of celiac disease or non-celiac gluten sensitivity
The health benefits Nadine has witnessed in patients who adopt a Paleo diet
No longer take prescription medication Normal blood pressure Desirable cholesterol level Absorb nutrients appropriately Body heals Resources Mentioned:The Wahls Protocol by Dr. Terry Wahls
Discovery Health: Celiac Disease
Connect with Nadine: Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 24 Feb 2017 - 27min - 11 - Celiac Disease and How Gluten Affects Your Skin EP011
On this episode of the ‘Gluten Free RN,’ Nadine explains how gluten affects your skin. If you have celiac disease or a gluten intolerance, you may also suffer from dermatitis herpetiformis, a painful rash that is often misdiagnosed.
Nadine shares her struggle with DH and offers advice about eliminating gluten from both your diet and personal care regime in order to heal your skin. The only treatment for this issue is a 100% gluten-free diet.
Your skin is the largest organ in your body, so listen and learn how to keep it looking and feeling good!
What’s Discussed:The definition of Dermatitis Herpetiformis (DH)
Blistering, vesicular rash that is typically round Itchy, very painful and distracting Caused by IgA deposits under the skin May appear on hands, legs, back, armpits, buttocks, elbows, knees, scalp, torso and even eyes Not contagious The only treatment is a 100% gluten-free dietNadine’s struggle with DH
Blisters, itchy and painful hands as a child Irritated by latex gloves as a nurse, hands developed rash Misdiagnosed by several dermatologists DH finally identified by Dr. Abigail Haberman Rash had exploded all over Nadine’s body and she was near death Most of the rash resolved quickly after adopting a gluten-free dietWhy steroid creams, long-term antibiotics and dapsone aren’t the answer
DH is an external expression of what’s happening internally Topical creams don’t treat the underlying cause Long-term antibiotics disrupt the microbiome and put you at risk for developing other infections Dapsone is associated with serious side effects for the blood and liver Removing gluten from your diet and personal care products is the only cureThe importance of eliminating gluten from personal care products
Anything you put on your skin can travel through to your bloodstream Discontinue the use of products that contain wheat, barley, rye or oats Nadine also recommends eliminating products that contain chemicals such as lauryl sulfates and paraffins Resources Mentioned: Connect with Nadine: Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 17 Feb 2017 - 29min - 10 - Celiac Disease and its Associated Autoimmune Disorders EP010
This time on the ‘Gluten Free RN’ podcast, Nadine examines the many autoimmune disorders that are associated with celiac disease. Once you have acquired one autoimmune disease, your chances of developing another increase exponentially – Nadine had seven!
Nadine shares how she was able to heal the inflammation in her intestines that caused those autoimmune disorders and go from a positive ANA panel to a negative one in just a year on a Paleo diet.
Listen and understand which autoimmune diseases are linked to gluten intolerance and how to dodge those bullets by going gluten-free!
What’s Discussed:
The chances of developing additional autoimmune disorders
Once you have one autoimmune disease, your chances of developing another are 30% -50% greaterNadine’s ‘collection’ of autoimmune disorders
Raynaud’s phenomenon is a circulation issue that gave her purple/white hands and feet Sjogren’s syndrome dried out her mucus membranes She suffered from arthritis and joint pain Alopecia caused her hair to thin and fall outWhy celiac disease is sometimes misdiagnosed as MS, ALS or Parkinson’s
How Dr. Terry Wahls went from a wheelchair to riding a bike by eliminating gluten
How it is possible for your body to heal the inflammation causing autoimmune disorders, regardless of what the medical establishment says
Remove the things that cause damage Replace the nutrients your body needsAdditional autoimmune disorders associated with celiac disease
Liver disease (primary biliary cirrhosis, autoimmune hepatitis, primary sclerosing cholangitis) Type 1 diabetes Autoimmune thyroiditis Addison’s disease Dermatitis herpetiformis Alopecia Vitiligo Neurological issues (gluten ataxia, peripheral neuropathies) Connective tissue diseases (rheumatoid arthritis, juvenile rheumatoid arthritis, juvenile idiopathic arthritis) Sjogren’s syndrome Systemic lupus erythematosus Ehlers-Danlos syndrome Dilated cardiomyopathy Autoimmune pericarditis Psoriasis Sarcoidosis Idiopathic thrombocytopenic purpura Pancreatitis Microscopic colitis Enteropathy-associated T-cell lymphoma Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis Wilson’s diseaseThe importance of checking magnesium RBC levels in cardiac patients
The genetic overlap between Type 1 diabetes and celiac disease
A study in Scotland found that 94% of Type 1 diabetics carry the HLA-DQ2/-DQ8 genesResources Mentioned:
The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles by Terry Wahls MD and Eve Adamson
Terry Wahls MD Research Study Update
Connect with Nadine:
Books by Nadine:
Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 10 Feb 2017 - 29min - 9 - Regain and Maintain Your Health with a Paleo Diet EP009
This episode of the ‘Gluten Free RN’ podcast outlines the benefits of adopting a Paleo diet in order to regain and then maintain your health. Patients with celiac disease or gluten intolerance can get better, faster by choosing the Paleo option.
Nadine shares how changing her eating habits had an incredibly positive impact on her health as she went from feeling better on a gluten-free diet to feeling fantastic on her own variation of a Paleo diet.
Nadine gets specific about the foods you can and cannot eat and the incredible health benefits of going Paleo. Listen in and learn how to get back the health you deserve by focusing on good food!
What’s Discussed:
The foods to avoid on a Paleo diet
The foods you can eat on a Paleo diet
Nadine’s story
The concept of food as medicine
All disease starts in the gutWhere to locate organic fruits and vegetables and meat with no antibiotics/no hormones
The health benefits of a Paleo diet
Clears up lingering gluten issues Helps achieve sustainable weight loss Affords clearer, smoother skin Improves the immune system Allows for better sleepThe importance of sleep hygiene
Your body heals while you sleep Eight to ten hours is optimalWhy fat is essential in absorbing nutrients
Vitamins A, D, E & K are fat solubleThe best sources of fat for nutrient absorption
Avocadoes Grass fed meats Olive oil or coconut oil Nuts Nut butters Fish oil EggsResources Mentioned:
The Paleo Solution: The Original Human Diet by Robb Wolf
Practical Paleo by Diane Sanfilippo
The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body by Sarah Ballantyne
Midway Farms http://www.midwayfarmsoregon.com/
Connect with Nadine:
Books by Nadine:
Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 03 Feb 2017 - 36min - 8 - Intestinal Health and Antibiotic Resistant Threats EP008
This time on the ‘Gluten Free RN’ podcast, Nadine explores the connection between gluten intolerance and antibiotic-resistant threats. Because damaged intestines compromise the immune system, undiagnosed celiac patients are more likely to develop infections that necessitate antibiotics.
Nadine summarizes the 2013 CDC report, Antibiotic Resistance Threats in the United States, explaining the three microorganisms identified in the report with a Threat Level of Urgent. Listen and learn how to protect yourself and your family from the public health threat posed by these bacteria!
What’s Discussed:The prevalence of undiagnosed celiac disease and gluten intolerance
30-50% of the population carry the HLA-DQ2 and/or DQ8 genesThe importance of healthy intestinal tissue
70-90% of the immune system is in your intestinesThe soldier analogy
Healthy villi are like rested soldiers with loaded weapons on a clear day who can easily take out antigens that don’t belong Damaged villi are like soldiers on a bender with inadequate weaponry, operating in smoke and fire – they either don’t work at all or fire randomly at antigensThe need for a more judicious approach to prescribing antibiotics
Overuse of antibiotics wipes out good microbiome along with badHow to rebuild microbiome
Kombucha High-quality probiotics Fermented foods Apple cider vinegarThe need for IgA and IgG testing to complement a celiac panel
The public health threat posed by antibiotic-resistant bacteria
The 2013 CDC report details 2 million illnesses and 23,000 deaths yearlyThe connection between damaged intestines and a higher risk of bacterial infection requiring antibiotics
The three microorganisms with a Threat Level of Urgent
Clostridium difficile (causes profuse diarrhea, 14,000 deaths/year) Carbapenem-resistant Enterobacteriaceae (50% fatal, 600 deaths/year) Neisseria gonorrhoeaeThe causes of inflammation in your intestines
Gluten Dairy SugarWhy Nadine has concerns about the potential pandemic and huge loss of life presented by large numbers of undiagnosed celiac patients who are susceptible to bacterial infections
Resources Mentioned:CDC Report: Antibiotic Resistance Threats in the United States, 2013
Connect with Nadine: Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 27 Jan 2017 - 25min - 7 - Celiac Disease and Gluten Intolerance in the Elderly Population EP007
In this episode of ‘Gluten Free RN,’ Nadine discusses potential signs of celiac disease and gluten intolerance in those 65 and older. Many go undiagnosed because their symptoms are dismissed as a normal part of aging.
Nadine explains how nutritional deficiencies triggered by gluten intolerance can cause the elderly to acquire a list of diagnoses and medications that might not be necessary and do not address the underlying cause of degeneration.
This episode outlines how health setbacks common in the older population (osteoporosis, GI issues, dementia and degenerative disease) may be symptoms of celiac disease that could be improved or even eliminated with a gluten-free diet. Listen and learn how to improve the quality of life for those 65 and up!
What’s Discussed:The prevalence of celiac disease in the older population
30% of people diagnosed with celiac disease are over the age of 60 The elderly population has a prevalence of celiac disease 1-2% greater than the general populationThe recommended diet for elderly celiac patients
Nadine advocates both a gluten- and casein-free dietThe genes that carry celiac disease
Nadine’s story
Undiagnosed celiac disease left her with multi-system organ failure at the age of 40 A gluten-free diet fixed the nutritional deficiencies and allowed her body to regenerateThe benefits of adopting a gluten-free diet as an older adult
Reverse damage done by gluten Prevent health problems like dementia, osteoporosis, and osteopeniaGI issues that may be symptoms of celiac disease and gluten intolerance in older adults
How a nutritional panel can reveal deficiencies that may be caused by gluten intolerance
Low levels of vitamins D, B6, B12, iron, and zinc point to a difficulty absorbing important nutrients An imbalance of magnesium and/or calcium can cause heart arrhythmia and muscle fasciculationWhy men suffering from osteoporosis and anemia should be tested for celiac disease
The connection between erectile dysfunction and potential gluten intolerance
ED can be either a neurological disorder or a condition caused by hypoxiaThe probable link between Type 1 or 2 diabetes and celiac disease
The importance of testing patients on cholesterol or blood pressure medication for celiac disease
Why Nadine recommends all patients 65 and older be tested for celiac disease yearly
Not every patient will test positive but can seroconvert at anytimeHow the appropriate absorption of fat can help older patients with gluten intolerance “get their brains back”
Our brains are made of fat and every nerve is covered with myelin A brain starved of fat can cause a patient to suffer from brain fog and dementiaThe good, high-fat foods that prevent brain atrophy
Listen for the list!Miss Gloria’s story
Grumpy and agoraphobic, Gloria rarely left her bed After testing positive for celiac disease, she eventually agreed to try a gluten-free diet Gloria’s health improved to a point where she was able to leave the house regularly and finally move to Savannah, where she spent her last years with her sonHow identifying celiac disease and gluten intolerance in the elderly can prevent suffering and early death
Resources Mentioned:Connect with Nadine: Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 20 Jan 2017 - 27min - 6 - Signs and Symptoms of Celiac Disease and Gluten Intolerance in Children EP006
In this episode of ‘Gluten Free RN,’ Nadine discusses common signs and symptoms of gluten intolerance in children as well as the importance of identifying celiac disease early to allow for the growth and development of body and brain.
Nadine employs anecdotes about her own clients at the Gluten Free RN office to illustrate the myriad of ways that gluten can affect the health and development of undiagnosed kids.
This episode explains the GI problems, developmental delays, autoimmune disorders and neurological issues that children with gluten intolerance face as long as they remain undiagnosed. Click and listen to recognize the warning signs!
What’s Discussed:The common dismissal of celiac symptoms in children
The profound impact of gluten intolerance on fetal development and maternal health
It typically takes 9-15 years for a person to be diagnosed correctlySigns and symptoms of celiac disease and gluten intolerance in children
Failure to thrive
Low birthweight Short stature, stunted growth and delayed development Lactose intolerance Abdominal pain and vomiting Focus and retention issues (ADD, ADHD, ODD) Autism Psychiatric issues Delayed puberty Listen for the full listKatie’s story
After suffering from chronic constipation, her colon was removed – but her health did not improve until she learned about celiac disease and changed her diet Because her growth was stunted as a result of malnourishment, Katie only grew to 5’3” despite having a size 10 footWhy vitamins, minerals and supplements don’t help children with celiac disease or gluten intolerance
Why undiagnosed celiac disease patients suffer from focus issues and psychiatric disorders
Inflammation of the brain causes hypoxia Low oxygen flow results in ‘brain fog’Sam’s story
At 17, she was overweight and suffering from abdominal pain She was still wetting the bed and had yet to get her period After receiving a celiac diagnosis and adopting a gluten-free diet, Sam lost 100 pounds and has gone on to have two healthy childrenThe importance of testing the entire family for celiac disease once one member has received a diagnosis
The high percentage of celiac patients who are asymptomatic
Roughly 50% of people diagnosed with celiac disease would say they have no symptomsThe increased chances of developing autoimmune disorders when children with celiac disease go undiagnosed
The enormous genetic overlap between celiac disease and Type 1 diabetes
Why parents should be tested for celiac disease prior to a pregnancy
Undiagnosed expectant mothers are at an increased risk of miscarriage, complications and delivering babies with low birthweight and neural defectsHow to navigate birthday parties, camps, school events, etc.
Proper planning and communication make it easy Resources Mentioned:How Doctors Think by Jerone Groopman
University of Chicago Medicine Celiac Disease Center Website
EnteroLab Celiac Testing Resources
Connect with Nadine: Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 13 Jan 2017 - 32min - 5 - Symptoms of Undiagnosed Celiac Disease and Gluten Intolerance EP005
This time on ‘Gluten Free RN,’ Nadine continues to cover the basics of celiac disease and gluten intolerance, reviewing the consequences of intestinal damage and gluten in the bloodstream and discussing what you can and cannot eat as part of a gluten-free diet.
A registered nurse certified in emergency care and a celiac patient herself, Nadine is well-versed in
the health complications and symptoms you might experience with undiagnosed celiac disease or gluten intolerance, including neurological disorders, dermatologic difficulties and even mental health issues.
Join the Gluten Free RN on this podcast to learn the signs of undiagnosed celiac disease and gluten intolerance so that we can all be healthy and vital for years to come!
What’s Discussed:
The definition of celiac disease and its chronic nature
Diagnosis requires HLA-DQ2 and/or DQ8 genes and documented villous atrophyThe importance of healthy intestinal tissue
70-90% of the immune system is in your intestinesGrains to avoid that contain gluten
Wheat Barley Rye Oats (due to cross-contamination)Places where gluten may be hiding
Gluten-free, nutrient dense foods
Complications caused by gluten in patients with celiac disease or gluten intolerance
Chronic inflammation (suffering from an -itus of any kind) Autoimmune disorders Damaged immune system Malnutrition/deficienciesThe increased risk of cancer in patients with undiagnosed celiac disease
Symptoms doctors look for before testing for celiac disease
Chronic diarrhea Malabsorption Extreme weight loss or malnutritionComponents of the test for celiac disease
Blood test (celiac panel) Biopsy of the small intestinesThe amount of time it takes to regenerate damaged villi in the absence of gluten
Nadine recommends you continue the clinical trial of a gluten-free diet for at least six to 12 monthsAdditional signs of a possible gluten intolerance or celiac disease
Additional symptoms Nadine has encountered in undiagnosed patients
Indicators of gluten intolerance in children and elders
Resources Mentioned:
Gluten: Zero Global by Rodney Ford
Connect with Nadine:
Books by Nadine:
Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 06 Jan 2017 - 30min - 4 - Intro to Celiac Disease and Gluten Intolerance - EP004
This episode of ‘Gluten Free RN’ covers the basics of celiac disease and gluten intolerance – what those terms mean and what they might mean for you. Nadine explains which genes suggest a predisposition to gluten intolerance and what circumstances lead to a diagnosis of celiac disease proper.
Nadine talks you through what happens in your digestive tract that leads to gluten proteins attacking your organs and preventing your body from absorbing the nutrients it needs. She also outlines the foods and products you need to avoid to achieve ‘gluten-zero,’ as well as the foods you can enjoy as part of a gluten-free diet.
Listen in and learn where gluten is hiding and how to modify your diet to reverse the adverse effects of gluten!
What’s Discussed:
The definition of celiac disease and its chronic nature 30-50% of the population carries the genes How a trigger event (i.e.: a cold, pregnancy, stress, an injury) initiates the autoimmune disorder Options for getting tested for the genetic predisposition The closed system of the digestive tractand how food is processed While some food is used for energy, much just passes through Villous atrophy and the four stages of tissue damage Marsh 1: microvilli destroyed; body cannot break down sugar and milk Marsh 2/3: villi themselves fold over or atrophy; tight junctures between villi (that keep things your body can’t utilize in the GI tract and out of your bloodstream) open up Marsh 4: villi gone and only red, inflamed tissue remains; ‘leaky gut’ The effects of increased permeability of the intestinal wall Damaged immune system Rather than passing through the GI tract, gluten proteins get into bloodstream and wreak havoc on organs Body can’t absorb nutrients out of food The importance of healthy intestinal tissue 70-90% of the immune system is in your intestines The soldier analogy Healthy villi are like rested soldiers with loaded weapons on a clear day who can easily take out antigens that don’t belong Damaged villi are like soldiers on a bender with inadequate weaponry, operating in smoke and fire – they either don’t work at all or fire randomly at antigens The long road to recovering from villous atrophy It takes 6 months to a year to reverse the damage Grains to avoid that contain gluten Wheat Barley Rye Oats (due to cross-contamination) Places where gluten may be hiding Gluten-free foods Fresh fruits and vegetables Plain meats and fish (not breaded or beer battered) Beans/legumes Tree nuts Rice, corn and potatoes Quinoa and teff Dairy What a gluten-free rating means The Gluten Intolerance Group (GIG) certifies products that contain less than ten parts per millionResources Mentioned:
Gluten: Zero Global by Rodney Ford
Connect with Nadine:
Books by Nadine:
Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Fri, 30 Dec 2016 - 33min - 3 - Gluten and Your Urinary Health - EP003
In this episode of ‘Gluten Free RN,’ Nadine discusses the urinary system and urinary issues associated with the ingestion of gluten, gluten intolerance and/or celiac disease. If you are experiencing health problems related to the urinary system, it is possible that eliminating gluten and dairy will eliminate the problem.
Nadine utilizes anecdotes from her own experience and those of her friend and colleague Wendy Cohan, author of The Better Bladder Book, to illustrate the connection between diet and urinary health.
This episode explains how your urinary system works and outlines the difficulties you may be experiencing. Click and listen to learn how changing your diet could alleviate your pain!
What’s Discussed:
The symptoms of interstitial cystitis (IC) The connection between gluten and IC After adopting a gluten-free diet, colleague Wendy Cohan no longer has IC Other urinary issues that may be caused by the ingestion of gluten Kidney and brain stones Repeat urinary tract infections Bed wetting The health problems specific to men that are caused by inflammation in the urinary system Chronic prostatitis (CP) Prostate cancer Erectile dysfunction (ED) When it is appropriate to treat urinary infection with antibiotics Antibiotic stewardship means we use them judiciously Why implementing a gluten-free diet may be better than taking medication for urinary issues 95% of female IC patients and 77% of male CP patients reported food sensitivities The ways in which other body systems are affected by urinary issues It is rare for these difficulties to occur in isolation Large numbers of IC and CP patients report having additional symptoms, i.e.: irritable bowel syndrome, fibromyalgia The importance of addressing the underlying cause of your urinary issues The components of the urinary system What healthy urine looks like The need for additional research to confirm the effects of gluten on urinary healthResources Mentioned:
The Better Bladder Book: A Holistic Approach to Healing Interstitial Cystitis and Chronic Pelvic Pain by Wendy L. Cohan https://www.amazon.com/Better-Bladder-Book-Holistic-Interstitial/dp/0897935551/ref=sr_1_1?s=books&ie=UTF8&qid=1481754556&sr=1-1&keywords=wendy+cohan+the+better+bladder+book
Connect with Nadine:
Website http://glutenfreern.com/
Instagram https://www.instagram.com/glutenfreern/
Facebook https://www.facebook.com/GlutenFreeRN
Email nadine@glutenfreern.com
Books by Nadine:
Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Mon, 19 Dec 2016 - 26min - 2 - The Benefits of a Gluten-Free Diet for Pets - EP002
This week on ‘Gluten Free RN,’ Nadine explores gluten intolerance in pets. She looks at the health problems pets have experienced in increasing numbers in the last several decades and contends that a Paleo Diet is more appropriate for your furry friends than a diet that includes grains.
Nadine also explains the risk of cross-contamination and the importance of removing all products containing gluten (including pet food) from your home if you have a sensitivity to it.
Listen and learn the ways in which a gluten-free diet is more appropriate to your pet’s biology and get pet food brand recommendations from Nadine!
What’s Discussed:
How Nadine discovered the benefits of a gluten-free diet for pet health As her gastrointestinal issues improved, so did Slugs’ Why grains are not appropriate for dogs and cats Historically, dogs and cats are omnivores by instinct A Paleo Diet including meat and plant matter will improve your pet’s health The diseases pets have developed over the last several decades Many of these conditions are similar to the health problems humans have developed Why it’s difficult to test pets for gluten intolerance and celiac disease A clinical trial is often the only way to determine if gluten is causing your pet’s health issues The symptoms your pet might exhibit that could point to a gluten intolerance The risks of cross-contamination for people who are exposed to the grain in their pet’s food For a celiac patient, exposure to a bread crumb can trigger the same auto-immune reaction as an entire piece of cake The foods you should never give your pets The pet food brands with zero or very low (less than 10 ppm) gluten content Animal Crackers has a huge selection of grain-free, high-quality pet food How to test food for the presence of glutenResources Mentioned:
“Gluten-sensitive enteropathy in a family of Irish setters” by Sylvie C. Daminet https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1576718/?page=1
EZ Gluten Test Kit http://ezgluten.com/
Connect with Nadine:
Website http://glutenfreern.com/
Instagram https://www.instagram.com/glutenfreern/
Facebook https://www.facebook.com/GlutenFreeRN
Email nadine@glutenfreern.com
Books by Nadine:
Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Mon, 19 Dec 2016 - 31min - 1 - Food is Medicine - EP001
In the premier episode of ‘Gluten Free RN’ Nadine tells us a bit about her journey in regaining her health and why it’s so important to understand that food is medicine to our bodies. If we think about food as medicine, we will make better food choices which will lead to much better health in both the short and long term.
Nadine also discusses the increasing rate of Celiac disease diagnosis and some factors that may be influencing this.
Listen in to learn why it’s so important to make good food choices and how making the right ones will help you maintain or even regain your health!
What’s Discussed:
Nadine’s background Nurse for 25 years, 10 years as the Gluten Free RN At the time, Nadine didn’t know that gluten intolerance and Celiac disease were often big factors in her patients' health problems Why Nadine considers herself to be a “Connectologist” Nadine connects some dots that may not have been previously connected Why Gluten sensitivity and/or Celiac disease is often common denominator in health problems Why food is medicine and how that affects our health Nadine’s journey back from bad health Learned she had Celiac disease at the age of 40 Your GI Tract and immune system 70-90 % of your immune system is in your GI tract As humans, we do not have do not have enzymes to break down gluten proteins Why you may be predisposed to Celiac disease 30-50% of our population carries the genes that predispose us to Celiac disease The increasing rate of Celiac disease diagnosis The importance of having a plan for remaining or getting healthy into your 60’s, 70’s, 80’s and 90’s It’s easier to maintain your health than to regain it Nadine’s diet recommendations Common problems of a bad diet Topics that will be discussed in future episodes!Resources Mentioned:
“Seeds of Deception” by Jeffery Smith
Connect with Nadine:
Email: Nadine@GlutenFreeRN.com
Books by Nadine:
Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
Mon, 12 Dec 2016 - 37min
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