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I am a New Zealand registered nurse and nutritionist (Grad Cert Sci: nutrition, Massey Univ). I am a Certified Zone Instructor, and have worked teaching Zone diet principles to hundreds of clients over the last 10 years. More recently after finding that eating Paleo food choices was the "icing on the cake" health wise, I have become a Paleo enthusiast and teacher. Follow me on twitter @juliannejtaylor

Non celiac gluten sensitivity

Sorry this is just a quick cut and paste of information on a really important topic. I’m buckling down to get an assignment finished which I hope will lead to some interesting blog posts. I’m looking at studies where micronutrients are given to those who are obese and the effect on fat mass and inflammation.

In a nutshell:

1. Overweight and obese have higher markers of inflammation

2. They have many nutrient deficiencies, it is not clear whether the nutrient deficiencies contribute to weight gain or weight gain contributes to nutrient deficiencies, likely both.

3. I’m looking specifically at double blind intervention studies where a nutrient or nutrients are given and its effect on fat mass and inflammation. I.e. does taking vitamins or minerals reduce fat mass and inflammation in overweight people?

Back to non celiac gluten sensitivity

This is a sensitivity to gluten in those that test negative for celiac disease. Many doctors are unaware that this exists. I know this because I have seen a number of clients who have gut issues such as IBS, foggy brain, aches and pains that go when gluten is removed. When they tell their doctor, they say something like – “that is great that it works for you, but you are not celiac. Not sure why this is”

This paper has just been released, it covers the topic well, and is free full text.

Non-Celiac Gluten Sensitivity: The New Frontier of Gluten Related Disorders

Here is an excerpt:

4. Clinical Picture and Natural History
NCGS is characterized by symptoms that usually occur soon after gluten ingestion, disappear with gluten withdrawal and relapse following gluten challenge, within hours or few days. The “classical” presentation of NCGS is a combination of IBS-like symptoms, including abdominal pain, bloating, bowel habit abnormalities (either diarrhea or constipation), and systemic manifestations such as “foggy mind”, headache, fatigue, joint and muscle pain, leg or arm numbness, dermatitis (eczema or skin rash), depression, and anemia [2,15]. When seen at the specialty clinic, many NCGS patients already report the causal relationship between the ingestion of gluten-containing food and worsening of symptoms. In children, NCGS manifests with typical gastrointestinal symptoms, such as abdominal pain and chronic diarrhea, while the extra-intestinal manifestations seem to be less frequent, the most common extra-intestinal symptom being tiredness [16]. During the last decade, several studies suggested a relationship between NCGS and neuropsychiatric disorders (see following paragraphs). While it is undisputable that in some cases the positive effect of gluten withdrawal can be explained by a placebo effect, this is not the case in true NCGS. In a double-blind randomized placebo-controlled study design, Biesiekierski et al. found that IBS-like symptoms of NCGS were more frequent in the gluten-treated group (68%) than in subjects on placebo (40%) [13].

This graph below comes from the Biesiekierski study which clearly shows the difference in symptoms eating gluten free bread or gluten containing bread:

gluten sensitivity

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4 Responses to “Non celiac gluten sensitivity”

  1. In this study, 3 of 10 of patients with primary biliary cirrhosis had occult celiac markers
    http://www.ncbi.nlm.nih.gov/pubmed/9580141
    “However, despite evidence of gluten intolerance, patients had minimal or no symptoms characteristic of celiac disease”

    Including the diagnosis of NCGS, I wonder what the correlation would have been?

    October 14, 2013 at 2:09 pm Reply
  2. Allison #

    Julianne, I hope you may have some thoughts on a challenging, possible Gluten puzzle. My 24 year old son was diagnosed with Cyclic Vomiting Syndrome and also has had clinical depression since ~ 13 yrs. old. This cyclic vomiting began ~ 3 years ago, almost always after eating in restaurants. After the first 3 times, we realized it couldn’t be food poisoning. It is truly terrible; Strong, almost violent vomiting that starts w/ diarrhea, & then his digestive system “shuts down”, he says, where there is no stool at all, but vomiting continues every 20min.-1hour for ~ 12-24 hours or more. It is incapacitating. (At some point, the vomiting turns to dry heaves, since nothing is left). Then, Matt resumes nutrition by easing into a liquid protein/ fat diet. I know that vomiting isn’t a classic Gluten sensitivity symptom, but I’m suspicious of the Cyclic Vomiting Syndrome “diagnosis” because it was made based on symptoms, not testing. (A CVS diagnosis should be one of exclusion, where many tests are done, & if you test negative for everything, CVS is then the diagnosis).

    Matt had a M.D. from the CVS Association list when he lived in California. (Even that M.D. did no testing)! He moved back home in June, and there are no CVSA M.D.’s in the Dallas area (It’s huge)! But, he hasn’t had Any episodes until camping this weekend with friends, where we had to go and pick him up. They had been eating typical greasy camping food, including hot dog buns & junk food. My Husband & I eat strict Paleo, so by default, Matt mostly does too. The only gluten exposure at home is he will sometimes eat a wholewheat sandwich, & has a few beers each week with no episodes. After reading your article & graphs, I wonder If gluten is really the culprit, & perhaps vomiting starts once he hits a particular gluten threshold.

    Please share Any thoughts! Also, do you think stool testing (Enterolab)is the most accurate for gluten sensitivity?

    THANK YOU SO MUCH, JULIANNE!!

    October 15, 2013 at 5:23 am Reply
    • I recently had a client whose daughter had that exact reaction to gluten – severe vomiting not long after eating it. She is diagnosed with celiac.
      Has he been tested for celiac whilst eating gluten? I’d suggest he does – and maybe enterolab tests to see if there is any other food sensivity.
      You might look at working with a functional health practicioner or paleo doctor.

      October 15, 2013 at 11:02 am Reply
      • Allison #

        Julianne, Thanks so much! Interestingly, Enterolab is a stone’s throw from where I live. Do you think that their stool antigen test is the most reliable test for celiac or gluten sensitivity? For example, my husband just had the ALCAT IgG testing done & it did show gluten sensitivity, w/ wheat in the severe category. But, after researching IgG testing, my impression is that they are unreliable (Same sample sent to different labs yielding different results, & inability to reproduce results per Scientific Method). Thanks for the idea to look for a Paleo Doc! I finally found a Paleo practitioner who is a DM[P], board cert. Chiropractor & professional Applied Kinesiologist. (No known Paleo M.D.’s in Dallas, TX area). She uses Cyrex labs blood test, so I’m wondering if that is very accurate to your knowledge? My Son’s appointment with her is on 11/26. I have suspected gluten problems, & am also hoping she can help him w/ Clinical Depression. He has grown up in a loving home, no abuse, but w/ the unfortunately common middle school-highschool feelings of not fitting in, being teased…The depression seems too severe to all be a result of life experiences. So, I keep thinking there must be a physiological basis for his depression. Any thoughts?

        As always, I appreciate your help, & recommend your site to everyone I know!

        November 16, 2013 at 5:12 am Reply

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