Feb
29
2020

Celiac Disease in Various Disguises

Dr. Tom O’Bryan gave a lecture in Las Vegas on Dec. 13, 2019 about celiac disease in various disguises. This was at the 27th Annual World Congress on Anti-Aging Medicine. The title of his talk: “An Ounce of Prevention Is Worth a Pound of Protocols: Halting Our Brains Slow Deterioration”.

Case # 1: 44-year old male with an assumed diagnosis of ALS

In the first place a 44-year old male had a history of a right leg weakness that developed over the last 6 months. He had intermittent spasms in his right quadriceps muscle. In addition, over the last few months he noticed a weakness develop in his right arm with difficulties writing. Significantly, his family history revealed that a maternal aunt had celiac disease. Moreover, a sister had Crohn’s disease and his maternal grandmother had multiple sclerosis. Electromyographic studies showed widespread acute denervation. An MRI scan of the spine showed hyperintensity in the corticospinal tracts. A diagnosis of amyotrophic lateral sclerosis (ALS) followed as a result based on the MRI scan findings.

Further tests

At the same time blood tests revealed that his anti-endomysial antibodies were elevated.  Duodenal biopsy demonstrated villous atrophy, crypt-hyperplasia and increased intraepithelial lymphocytes consistent with gluten-sensitive enteropathy (celiac disease). An MRI scan of the brain also showed some hyperintense lesion in the left-brain hemisphere.

Gluten free diet instituted

It was clear with these test results that the initial diagnosis was a misdiagnosis. The real diagnosis was celiac disease. 7 months after the onset of his symptoms he started on a gluten free diet. He received no medications. Notably, his right arm function returned to normal after 9 month of the gluten free diet. Although there was some improvement in his right leg function, he still had some muscle wasting and spasticity in his right leg. However, he could now walk without any aid. His hand-writing was back to normal, and he could button his shirts again. Repeat MRI scans followed 2 months and 9 months after the start of the gluten free diet. At two months after initiation of the gluten free diet the brain lesion in the left brain was somewhat larger than before, but at 9 months it was half the original size.

Case #2: Autism in children, youth depression and Alzheimer’s patients

The autism spectrum disorder (ASD) has significantly increased from 1 in 166 in 2004 to 1 in 40 in 2018. In addition, Dr. O’Bryan also mentioned that in 2017 statistics showed that 13.3% among youth aged 12 to 17 in the US suffered major depressive episodes. 1 in every 12 youth suffer from severe behavioral and emotional problems. According to the CDC since 1994 the number of children on psycho-stimulants increased 5-fold. In the same time children under 18 with bipolar disorder have increased 40-fold. There has been a 6-fold increase of prescriptions for antipsychotic medications for children in the same time frame.

Other effects on adolescents

However, I like to point out that there are other powerful factors that can explain increased depression and emotional problems in adolescence. The Canadian Medical Association published an article about social media and smart phones and the effects they have on adolescence.

On the other end of the life cycle 1 in 3 seniors die with Alzheimer’s disease or dementia. Between 2000 and 2015 death from Alzheimer’s disease has increased by 213%.

Breakdown of the blood brain barrier

According to Dr. O’Bryan autism in children, behavioral and emotional problems in teenagers and dementia from Alzheimer’s disease are all related to the same process, namely a breakdown of the gut barrier, often called leaky gut syndrome. It is important to realize that this leads to a secondary breakdown of the blood brain barrier. The end result is a compromise of the brain, where antibodies attack the brain protein. In young children this causes lower adaptive and cognitive function and behaviors typical for autism. Teenagers are more likely to present with depression or schizophrenia. In older people the breakdown of the blood brain barrier can result in Alzheimer’s disease and other forms of dementia.

25 to 30% of protein in wheat are non-gluten. Antibodies can be directed against gluten, but also against non-gluten protein.

IgG antibodies against gluten cross placenta

In the later stages of pregnancy IgG antibodies cross the placenta easily. They provide passive immunity from various viral infections. Unfortunately, antibodies against gluten also cross through the placenta, which can lead to a breakdown of the fetal gut lining, in the sense of leaky gut syndrome. In this study 211 children were found to have a risk of 1.7-fold to develop psychosis later in life. The mothers were positive for anti-gliadin IgG antibodies in the last 4 weeks of pregnancy. Anti-casein antibodies did not have this psychosis effect (risk only 0.8-fold). The investigators felt that an allergy to wheat in the mother set up general inflammation. Psychosis in the offspring only develops when inflammatory mediators reached the brain of the fetus. It was the brain inflammation, which caused the subsequent psychosis later in the child.

Blood brain barrier and healthy gut barrier

Another key point is that the barrier both in the gut and in the blood brain barrier consists of a single epithelial layer. The cells are held together by zonulin and occludin proteins. Autistic children were exposed already in the uterus to mother’s wheat induced anti-gliadin antibodies. This led to a break-down of the children’s blood brain barrier and the symptoms of the autism spectrum disorder. These children have a lot of brain inflammation and in addition often have impaired gut barrier integrity. It must be remembered that they require a comprehensive program to improve the gut flora, build up the gut barrier integrity and re-establish the blood brain barrier.

Effects of phthalates on young children

A 2014 study measured urinary metabolites of phthalates and related this to the children when they were 7 years old.

The investigators did several cognitive tests and measured the IQ (Wechsler Intelligence Scale). Children of mothers with the highest quartile of phthalates had an IQ, which was on average 7.0 points lower than the control group of the lowest quartile of phthalates. Dr. O’Bryan showed a slide taken from this study.

With this in mind, it points out that a pregnant woman has an intact blood brain barrier, which prevents antibodies from entering. However, the immature brain of the fetus has not developed an efficient blood brain barrier yet. This allows maternal gliadin antibodies from wheat intolerance to enter the fetal brain and cause autism spectrum disorder (ASD).

PCB’s disrupt the blood brain barrier

In mouse experiments the effects of PCB’s were investigated. By the same token, researchers found that the blood brain barrier was broken down by PCB’s that are known to have carcinogenic and neurotoxic properties on the brain. The researchers injected melanoma cells into the animals and found that the PCB pretreated mice sustained brain metastases. However, the control animals that did not have PCB pre-treatment did not develop brain metastases. They concluded from this that PCB’s are breaking down the blood brain barrier.

Maternal brain antibodies causing autism in children

This publication examined antibodies to two different brain proteins. The researchers found that 86% of the children from mothers with two different fetal brain antibodies were diagnosed with autistic regression. According to this publication there are at least 50 different epitopes of gluten peptides that exert cytotoxic, gut permeating and immunomodulatory activities.

DNA microarray technology can now detect many subtypes of food disorders and gluten sensitivities. The tests for celiac disease have a sensitivity of 97% for IgG and 99% for IgA. With regard to specificity the test is now 98% accurate for IgG and 100% for IgA.

Case #3: 34-year old female vegan patient with depression and mild cognitive decline

A 34-year old woman has followed a Vegan lifestyle for 10 years. She has been working long hours and had a lot of stress. In addition, her thyroid was borderline low with high TPO antibodies. A blood test for vitamin D showed vitamin D deficiency. For the past year her energy level was low and she had developed chronic depression. Her physician did a genetic test that found she carried the gene that converts GABA into glutamate. She thinks that she has small intestinal bacterial overgrowth (SIBO). A review of her dietary habits revealed that she ate more cooked foods and less raw food. Her memory is slightly off, her speech not as fluid and she has some cognitive decline.

Her blood tests showed anti-immunity to RAGE peptides. To put it another way, RAGE stands for “receptor for advanced glycation end products”. When you eat too much overcooked foods you ingest advanced glycation end products. This can have adverse effects on your body, particularly the brain.

More tests regarding this woman

Another specific test revealed a blood brain barrier disruption with the presence of anti-brain antibodies. A stool sample was obtained. It showed low Akkermansia, low Faecali bacterium, low Bifido longum and low Bifido adolescentis bacteria. A chemical analysis revealed low butyrate, propionate and acetate. The treating physician concluded that she had a gut dysbiosis and a dysfunctional gut barrier. This has also affected her blood brain barrier. The constellation of symptoms and blood tests explain her clinical condition. She has developed autoantibodies that affect her thyroid gland and her brain because of the antibodies against her RAGE peptides. People can develop Alzheimer’s disease given enough time with exposure to these antibodies. The leaky gut has led to a break-down of her blood brain barrier and exposed her brain to autoimmune antibodies directed against brain cells.

Treatment of gut dysbiosis

This patient started a gluten free diet (GFD). But one of the problems of the GFD is that wheat is removed that normally provides 69% inulin and 71% oligofructose, both important prebiotics that are necessary for probiotics to work with. Inulin is contained in beets, leeks, asparagus, onions, garlic and bananas. Oligofructose is contained in chicory root, bananas, onion, and garlic.

When people consume a typical Western diet, they get between 1 and 4 grams of inulin daily. But others who eat balanced diets get up to 25 to 100 grams of inulin per day. Dr. O’Bryan explained that going on a GFD leads to an altered microbiome.

Experiment with volunteers to measure the effects of a gluten free diet

He discussed an experiment on 10 healthy volunteers who were fed a GFD for 1 month.

The researchers ordere stool samples in the beginning and at the end of the experiment. There was less of the good bacteria and more of the the bad bacteria. This led to a less protective and more inflammatory environment. The remedy for that is to eat 1 root vegetable and 2 other prebiotics per day. The patient on a GFD must supplement with prebiotic-rich foods to prevent this from happening.

Non-digestible oligosaccharide supplement

Inulin and oligosaccharides support the intestinal microbiota.  Dr. O’Brien suggested to add a supplement, called Precision Prebiotic™, non-digestible oligosaccharides that can increase microbial diversity. This supplement supports the growth of the healthy bacteria. These are keystone bacteria like Akkermansia muciniphila, Faecal bacterium prausnitzii, and Bifidobacteria.

Other supportive measures for the gut

  • 1 tablespoon of fermented vegetables like sauerkraut once per day
  • The ingestion of fermented foods increases the beneficial gut bacteria by a factor of 10,000-fold!
  • A 100% spore-based probiotic supplement increases diversity of the gut flora and helps to maintain the gut barrier
  • Sodium butyrate, which comes from fermented food is an important modulator of the central nervous system
  • In addition, sodium butyrate also inhibits pathological gut bacteria and maintains the gastrointestinal balance
  • In neurodegenerative disorders sodium butyrate provides anti-inflammatory and neuroprotective effects
  • Sodium butyrate restores the blood brain barrier
  • Following heart attacks or strokes sodium butyrate promotes tissue repair and recovery through cell survival
Celiac Disease in Various Disguises

Celiac Disease in Various Disguises

Conclusion

Dr. Tom O’Bryan delivered a lecture at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas on Dec.13, 2019. Wheat allergies have increased in the last decades. Researchers have found that in many people there is a deterioration of the gut flora and a breakdown of the gut barrier. This leads to antibody formation against gluten or gliadin (wheat proteins). This exposes the body to many proteins from the gut. The body reacts by producing antibodies to them. These are also affecting cells in the body as they cross react with body proteins. The inflammation from the autoantibodies cause the blood brain barrier to break down. Now the immune system can produce antibodies against brain tissue. In the past  with an intact blood brain barrier this was not possible.

Autoantibodies in various life epochs

At a young age autism can develop because of antibodies against gliadin from wheat. In our youth schizophrenia and depression can occur from gut dysbiosis and a subsequent break down of our blood brain barrier. In old age Alzheimer’s disease develops in 1 out of 3 people due to gut dysbiosis and a breakdown of the blood brain barrier with anti-brain antibodies. Dr. O’Bryan explained how a person can turn this negative spiral around and start a new life without these problems. You can avoid a lot of these diseases by eliminating wheat and processed food from your diet.

Jan
06
2018

Lyme Disease The Great Imitator

Dr. Pamela Smith talked about Lyme disease the great imitator when she gave a presentation. This was at the 25th Congress of the American Academy of Anti-Aging Medicine, Dec. 14-17, 2017, which I attended. Dr. Smith gave a talk about how to approach a complex patient when multiple systems are affected. Part of that talk dealt with Lyme disease, which I will review below in some detail.

Transmission of Lyme disease

Lyme disease is one of the fastest growing infectious diseases in the US. As a result about 200,000 new cases of Lyme disease occur in the US every year.

The transmission occurs through ticks that that carry a spirochete, called Borrelia burgdorferi.

This bacterium, much as syphilis, which also is caused by a spirochete, produces imitator disease patterns. Clinically it can be a challenge to diagnose Lyme disease.

The common way of transmission to humans is by infected ticks that bite the skin. But Dr. Smith said that transmission of the spirochete can also occur by breastfeeding, blood transfusions, in vitro fertilization and finally by sex. Although originally Lyme disease infected ticks were found on deer, other species can also be carriers. Ticks from mice, foxes, raccoons, songbirds, chipmunks, and squirrels can also transmit Lyme disease.

Clinical presentation of Lyme disease

Only 30 – 40% of adults with Lyme disease have the characteristic rash of the “bull’s-eye lesion” (erythema migrans). With children this presentation is even less common (only 10% have erythema migrans). If there is a bull’s-eye lesion, this will last from one week to several months. A laboratory test using an enzyme-linked immunosorbent assay (ELISA test) can confirm the diagnosis of the disease.

Disseminated early or late Lyme disease

Fatigue, headaches and weakness can be non-specific symptoms of Lyme disease. Furthermore, other non-specific symptoms like back pain, muscle and joint pains as well as chills can detract the physician from diagnosing Lyme disease. In addition irregular heartbeats, nausea, vomiting, swollen lymph glands, memory loss, gait problems, bladder and kidney problems are other symptoms. Finally, liver problems, sore throat, fever, seizures, depression, dementia, hallucinations, mood swings and arthritis can be other symptoms.Even eating disorders, verbal aggression, schizophrenia and suicide can be symptoms of Lyme disease.

Common symptoms that have a link to Lyme disease

Common symptoms of Lyme disease include headaches, fatigue, joint pain and swelling of joints, stiffness of the neck or back. There can be difficulties with concentration, speech or writing. Further symptoms are sleep disturbances, numbness or tingling of arms or feet and forgetfulness. 

Lyme disease development

Borrelia burgdorferi can be found inside body cells and outside of cells as biofilms. This form makes them resistant as it allows Borrelia burgdorferi to exchange DNA and makes them resistant to antibiotics. There are also two major forms of Borrelia burgdorferi, namely cell-wall forms and cystic forms. Once the patient has been bitten by the infected tick Borrelia can quickly change shape into the more difficult to treat cystic form. Within 24 hours Lyme disease can spread to other parts of the body. Common such areas are the eyes, brain tissue and glial cells, heart, collagen, synovial fluid of joints and skeletal muscle fibers.

Lyme disease can also complicate many other diseases. These are ALS, Alzheimer’s disease, fibromyalgia, MS, bipolar disorder, neurological disease, heart disease (Lyme carditis) and autism.

Treatment of Lyme disease

  1. Dr. Smith said that Lyme disease is often complicated by dysfunctional gut flora. She prefers to start patients on a sugar-free and gluten-free diet. The patient also has to take probiotics.
  2. 75% of Lyme disease patients show a cure after three weeks of Doxycycline 100 mg twice per day. Alternatively cefuroxime 500 mg twice per day is a medication of choice.
  3. Cefuroxime only treats the cell‐wall forms. Doxycycline treats the intracellular forms. Metronidazole or tinidazole will help to eradicate the cystic forms of Lyme disease.
  4. Grapefruit seed extract is another treatment modality if the patient is allergic to Metronidazole. It eradicates the cystic form of Lyme disease.
  5. Serrapeptase from whole leaf stevia extract will also help to eradicate Borrelia biofilms and persisters.
  6. Monolaurin, a coconut oil extract is effective in treating all three morphological forms of Borrelia burgdorferi.

Patients with neurological symptoms

Patients with neck stiffness, headaches or neuropathy need treatment for a longer period of time. These patients also need monitoring for recurrent Lyme disease at the end of the treatment.

Case presentation of a patient with Lyme disease

Dr. Smith presented one of her patients with Lyme disease in detail. She was a 45-year old executive. She suffered from extreme fatigue. It took quite a few tests to find out that her antibody titers against Lyme disease were very high.

Here is her long list of symptoms: hair loss, four urinary tract infections in quick succession, brain fog, extreme fatigue, systemic pain, musculoskeletal pain, anxiety and depression, eczema, psoriasis, itching, stomach ache, trouble eating, weight loss of 12 pounds, flu, strep presented like meningitis.

Comprehensive treatment of patient with Lyme disease

Dr. Pamela Smith instituted a comprehensive treatment protocol. It turned out that she had developed gastritis, which was the reason for her weight loss. This needed conventional treatment. After the treatment with antibiotics, her energy picked up, and her appetite came back. She also engaged in yoga and other self-awareness programs. She deliberately slowed down her lifestyle activities. Her symptoms were mostly gone or significantly diminished. She was able to function. She experienced energy, joy, and could focus again. The only symptoms left were some mild pain, some bladder problems, some limitations with her diet and mild brain fog.

Husband had Lyme disease

Part of the work-up was to test her husband for Lyme disease. He tested positive. He was also treated although he was entirely asymptomatic. When his treatment was finished, the doctor tested him for a specific antibody and this came back as negative. This meant that he now was free of Borrelia burgdorferi and would no longer be able to infect her. The doctor thought that it was most likely through sex that she had contracted Lyme disease. The problem is that some people are completely asymptomatic, but nevertheless they can be carriers of Lyme disease.

Lyme Disease The Great Imitator

Lyme Disease The Great Imitator

Conclusion

Lyme disease, the great imitator, has become a more common disease in the US and around the world. Years back Lyme disease was often overlooked. But lately physicians have diagnosed Lyme disease earlier as diagnostic tests have improved. With earlier treatment a lot of suffering of the patient can be prevented. But in many cases symptoms are confusing as Lyme disease involves several organ systems. This makes the diagnosis more difficult. By diagnosing Lyme disease earlier, treatment can start at an earlier stage, and the patient will soon return to a state of wellness.

Mar
29
2014

Alternative Treatment Of Hyperactivity (ADHD)

Attention Deficit Hyperactivity Disorder (ADHD or ADD, attention deficit disorder) has been in the spotlight on and off over the years. It affects 8% to 10% of school-aged children, and about 2% to 5% of adults who still have this condition.

Typically a parent receives a note from school that they must come to a teacher/parent meeting and it is discussed that the child is disruptive in class, not paying attention, interrupting the teacher inappropriately and forgetting to do their homework. The teacher suggests that this may be a sign of hyperactivity. The school nurse is also of this opinion and they suggest getting a prescription for Ritalin or Adderall (amphetamine type medications), drugs that have been shown in other kids to be fairly effective in treating the symptoms.

Next the child is seen by the doctor who confirms the diagnosis and Ritalin (methylphenidate) is prescribed.

In an attempt to quickly control the situation, the side effects of Ritalin are often not discussed in detail: agitation, insomnia, nervousness, anxiety, nausea, vomiting and loss of appetite, palpitations, dizziness, headaches, an increase in the heart rate, blood pressure elevation, and even psychosis (Ref.1).

It is easy to just write a prescription for Ritalin and hope that all is well. Had the parents heard of all the possible side effects, they may have asked whether there were alternative treatments available.

The causes of hyperactivity (ADHD)

The exact cause of ADHD remains unknown, but there is a clustering of this condition in some families, so there seems to be a clear genetic component (Ref.2). It appears that several genes are involved, namely those associated with serotonin and glutamate transporters, but also those affecting dopamine metabolism. Males are affected with ADHD more often than females (in children 3:1, in adults 1:1).

Alternative Treatment Of Hyperactivity (ADHD)

Alternative Treatment Of Hyperactivity (ADHD)

Some remarks regarding brain development are in order: Dr. Kharrazian describes that the grey matter of the brain develops before the age of 9 and the development of the white matter is completed by the age of 19 (Ref. 3, p.3). In ADHD patients the frontal brain is underdeveloped resulting in an inability to suppress unacceptable behavior, immediate desires and impulses. Prescription drugs may alter the behavior on the surface, but the frontal brain development is still lagging behind. The only thing that can influence this is behavioral/cognitive therapy and extra tutoring while the symptoms are controlled. The window of opportunity is closed by the time the ADHD patient has reached the age of 19. After that a juvenile ADHD turns into a permanent adult ADHD. The cases that had only childhood ADHD and outgrew it were the ones where the frontal lobe abnormalities had corrected themselves before the age of 19.

This review article has noted that there is an association between a Western style diet (sugar and fat rich) and ADHD.

Interestingly both Ref. 1 and 2, which I would categorize as having originated from mainstream conventional medicine circles, deny such an association. But the link also noted that a healthy diet with fiber, folate, and omega-3 fatty acids as well as supplementation with iron and zinc when these minerals are found to be low in the blood, do make a significant difference in ADHD patients towards normalization of their symptoms.

One of the under diagnosed causes of ADHD is gluten sensitivity as Dr. Perlmutter described in his book (Ref. 4, pages 150-158). This can spare the child or teenager the toxic side effects of anxiolytics, antidepressants or antipsychotics that may be inappropriately prescribed by their physicians, and a gluten free diet would allow the brain to recover very quickly in such cases. A food sensitivity history and some simple gluten sensitivity blood screening tests will diagnose this condition or rule it out.

To complicate matters even more, Dr. Amen has mentioned in several books that there are at least 7 different subcategories of ADHD that he has found in ADHD patients when studying thousands of single-photon emission computed tomography brain scans (SPECT brain scans). Dr. Amen mentions that the 7 subcategories of ADHD are the combined type ADD, the primarily inattentive ADD subtype, overfocused ADD, temporal lobe ADD, limbic ADD, ring of fire ADD and trauma induced ADD. Dr. Amen explains that each of these types needs to be treated differently and some of the treatment failures are explained by the fact that the wrong type of ADD was treated (Ref.5).

Treatment of ADHD

In the following I mention 5 steps that are useful for treating ADHD patients.

  1. A first step toward normalization of the metabolic changes in the brain metabolism of the affected child or adult is to adopt a diet that has been linked with low risk for ADHD: avoid food additives, cut out refined sugar, avoid known food allergies like gluten sensitivity and others. You may need to test the patient for food allergies using an elimination diet. Add a good amount of molecularly distilled omega-3 fatty acids (the pure form of omega-3 without mercury, lead or PCBs) as this has shown beneficial effects in ADHD patients.
  2. Involve a behavioral psychologist for behavioral/cognitive therapy treatments. This is particularly effective in the 9 to 19 year old category where the frontal region of the brain is still developing.
  3. Work together with the schoolteacher and get supplemental teaching in areas of academic weakness to reduce the frustrations in the classroom setting.
  4. In adolescent girls who just started their period, a relative lack of progesterone (estrogen dominance) may be a contributory factor. A small dose (20mg to 30 mg) of bioidentical progesterone from day 6 to 16 of the menstrual cycle may help significantly in alleviating the symptoms of ADHD. You may need to consult a naturopathic doctor or anti-aging physician to get a prescription for that.
  5. If all of this helps only marginally, then a smaller amount of Ritalin may be helpful; however, blood tests should be drawn from time to time to monitor for drug toxicity as the rate of absorption and elimination of the drug varies significantly from patient to patient.

It is interesting that studies have shown that a combination of Ritalin or Adderall with alternative treatment methods had a better outcome than either method alone.

Conclusion

It is important to think about the various possible causes of ADHD and not just get caught up in the knee-jerk reflex of treating ADHD with Ritalin (note that this was only step 5 above, if all the other things failed). In co-operation with the school system and using alternative ways at home first (change of diet, possible addition of low dose bioidentical progesterone cream in girls) and additional tutoring in weak school subjects the need for Ritalin may be avoided. If all else fails, the conservative approach is still available, but I suggest that drug monitoring (blood levels that should be done from time to time to avoid toxicity) is important.

More information about ADHD: http://nethealthbook.com/mental-illness-mental-disorders/developmental-disorders/attention-deficithyperactivity-disorder/

References

1. Ferri: Ferri’s Clinical Advisor 2014, 1st ed., © 2013 Mosby.

2. Jacobson: Psychiatric Secrets, 2nd ed., © 2001 Hanley and Belfus

3. Dr. Datis Kharrazian: “Why Isn’t My Brain Working?” © 2013, Elephant Press, Carlsbad, CA 92011

4. David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

5. Daniel G. Amen: “Use Your Brain To Change Your Age” © 2012, Harmony Books, An imprint of Crown Publishing.

Last edited Nov. 7, 2014

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Mar
01
2007

Dental Signs Indicators for Celiac Disease

Celiac disease is a condition, where a person is unable to tolerate wheat products. In other words they have a wheat allergy. It is not enough to avoid the standard foods like bread and other bakery goods that contain wheat. Wheat makes its appearance in many foods and also in taste enhancers like monosodium glutamate. Alone for this reason it is important for a person with celiac disease to carefully read labels in order to avoid foods that contain gluten, which is the offending substance. Often celiac disease goes undetected for many years, but there are early signs that can help to take action sooner rather than later.

Dr.T.Malahias, D.D.S., a dentist from Groton, Conn presented his findings at a recent international symposium for celiac disease. He pointed out that there are signs that are visible in the dental enamel, which will already be present in childhood, once the permanent teeth appear at about age 6. The bilateral symmetrical markings are defects in the tooth enamel. they can be brownish, yellow or white and are most commonly seen on the central incisors. They give the tooth a mottled, non-shiny appearance. Patients with this appearance may also have problems with the delayed eruption of the permanent teeth. These markings are permanent, and even after following a gluten-free diet they will stay, as the development of the enamel started already in the third or fourth month of life. While there may be other reasons for this abnormality, celiac disease should be considered in the context of the patient’s history.

Dental Signs Indicators for Celiac Disease

Dental enamel defects may be the only signs of celiac disease

The results are quite significant in pediatric groups: in patients less than 12 years of age who had celiac disease the rate of enamel defects ran at 90% as compared to 44% of the others without celiac disease. People who have recurrent unexplained aphthous ulcers should take notice too. Five percent have been found to have undiagnosed celiac disease as a result of the constant and chronic overstimulation of the immune system by gluten substances. Once celiac patients start with a gluten-free diet, the ulcers will occur less frequently.

More information on celiac disease: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/celiac-disease/

Reference: Based on MD Consult News, January 31, 2007

Last edited November 2, 2014