Gluten-free and allergy-free people have to pay more in general for their groceries. I love Whole Foods Market and am grateful that they carry so many gluten-free items. It’s just that I end up spending so much money there because I buy a lot of my other groceries there too. Great products, but it’s killing my bank account!

One thing I started doing this year to save money is shopping on Amazon. You can find great deals on, well, everything, but also on food. If you have products that have become regulars in your household, buying a case of your favorites can save you money.

Let’s do the math

Here’s a practical example of my money-saving technique: at Whole Foods I think I pay $4.59 for a package of Pamela’s bread mix (a staple in our house). On Amazon, I can buy a case for $23.80, which comes out to $3.97 per package. But wait, there’s more! Amazon now has a subscription service that allows you to set up regular shipments of products, either every 1 month, 2 months, 3 months or 6 months. Setting up a subscription saves you an extra 15% on every shipment. I figure I make bread (or something else with the mix, like pizza) every 1-2 weeks so I signed up for 1 case of 6 to be sent every 2 months. With the extra 15%, the case now costs $20.23, which works out to $3.37 per package. If you don’t use bread mixes, then think about other favorites like Erewhon crispy rice cereal or Larabars or Pamela’s pancake mix.

What about shipping?

Many grocery items qualify for Free Super Saver Shipping with a $25 minimum order. Now, if you are a serious Amazon shopper (as I am), sign up for Amazon Prime! You pay $79 for the year and get free 2-day shipping on anything that ships from Amazon. There is no minimum order. You even get the free 2-day shipping if you send it to someone else, which is great when you need to send a gift quick. I am an Amazon Prime customer and let me tell you, it is great to get your gluten-free groceries in only 2 days (especially when you need them for a party or a trip) and not have to pay any shipping.

Is this an ad for Amazon?

Really I just want to help everyone out there struggling with their grocery bills (not to mention the time and gas spent to go find all of the special products). I do get a small commission if you buy on Amazon when you click through from my site (at no extra cost to you). So if you want to show Sure Foods Living some love, you can either shop at my Amazon gluten-free store where I have hand-picked the products I recommend, or you can just click here to shop anywhere on Amazon. These links are also always available in the right sidebar. Every little bit helps keep this site going and I appreciate those of you who have been doing it!

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You have eliminated gluten from your diet and you feel a lot better. You are very careful about what you eat, but you still have symptoms that you blame on gluten somehow sneaking into your food via cross-contamination or because you were not being careful enough. You may be frustrated or confused as to why you are still have reactions when you can’t figure out where the gluten could be.

Perhaps you are getting traces of gluten, but the reality may be that you are reacting to another food. That’s right — you may be sensitive to more than just gluten! It’s not a pretty thought to have to cut another food (or foods) out of your life, but it may make you feel a lot better.

My discovery

After I was gluten-free and felt dramatically better, my body and especially my digestive system, felt clean… I don’t know how else to describe it, but it just felt like there was no turmoil going on inside, like a glass of water without any bubbles. If I did get a trace of gluten, I knew it, and I would track down the source. But then there were times when I had cooked at home and knew that there was no way I could have gotten glutenized (I am sure they will be adding this word to Webster soon!), but still didn’t feel perfect.

After keeping a mental food diary — really paying attention to when I didn’t feel well and what I had eaten prior — I realized that I was blaming gluten for those days when my tummy was feeling, well, bubbly. But it wasn’t gluten at all. It was… drumroll, please… soy! Yes, folks, I do not eat soy anymore. I do eat a little wheat-free soy sauce sometimes and soy lecithin, but other than that, no soy. My daughter is soy-intolerant also, so there you have it — genes at work. Lucky girl… at least she got some of my good genes too: charm, good looks, etc. — ha ha!

I’m not the only one with multiple food sensitivities. In fact, on the celiac.com forum, there is a whole category called Other Food Intolerance and Leaky Gut Issues with people talking about how they have realized that they are intolerant to more than just gluten. This is no coincidence…

Leaky Gut Syndrome

A reason that people can develop more food sensitivities could be leaky gut syndrome, also known as increased intestinal permeability. A very simple explanation of what happens with leaky gut syndrome is this:

1. Large spaces develop between the cells of the intestinal wall (due to many possible causes — see below).
2. Bacteria, toxins, and incompletely digested proteins and fats leak in. Normally these larger molecules would be kept within the intestines, but because of these holes in the intestinal lining, they leak through the intestinal wall into the bloodstream, where they normally shouldn’t go.
3. The immune system releases antibodies to fight what it sees as foreign invaders in the blood.
4. These antibodies also attack the body’s own cells, causing damage, allergic reactions, pain and inflammation throughout the body.

What causes leaky gut?

Some of the possible causes of leaky gut syndrome are:

• Damage caused by taking non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen
• Gastrointestinal disease, like celiac disease
• Eating allergenic foods
• Consuming alcohol
• Consuming caffeine
• Taking antibiotics
• Eating too much sugar
• Ingesting toxic chemicals
• Intestinal infection
• Parasites
• Stress

Food sensitivity can cause leaky gut, which can then cause other food sensitivities — it is a vicious cycle.

So, where do you go from here?

If you are gluten-free and you don’t know why you are still having reactions to the food you are eating, I would recommend that you keep a food diary — write down the time that you eat, what you eat, what symptoms you feel at what time of day. If you wake up in the morning and feel fine, and then have breakfast and feel rotten the rest of the day, examine everything you are eating in the morning, from coffee to juice to the milk you pour on your cereal. Once you think you know the problem food, cut it out and see how you feel. You can add it back in later and see if you react (please consult your doctor if you think you are at risk for a serious reaction to a food). In my case, after I cut soy out my diet, my lingering symptoms went away, and I have not wanted to try it again!

And what about that leaky gut? There are a lot of websites out there with advice about how to improve the permeability of your intestines. I am going to start doing some of these things for myself and my family in hopes of preventing more food sensitivities. Here are a few of the sites I found useful:

Liverdoctor.com
The Environmental Illness Resource
Dr. Weil
Leaky Gut Syndrome

Do you have more than one food sensitivity? Let me know in the comments… I’m curious!

Filed under: Celiac Disease, Food Allergies, Gluten Intolerance, Soy Allergy | 8 Comments »

Would you believe that 30-50% of celiacs do not always adhere to the gluten-free diet? How about that 20% of adult celiac patients’ biopsies do not normalize after diagnosis? According to researchers presenting at Digestive Disease Week 2008, an annual conference in San Diego for physicians and researchers, there is a “need for something beyond a gluten-free diet” in the treatment of celiac disease.

Treatment of celiac disease

In a talk led by Peter Green (leader in celiac disease research and author of the book Celiac Disease: A Hidden Epidemic, which I highly recommend), 2 research groups presented their progress in developing a treatment for celiac disease — Alvine Pharmaceuticals and Alba Therapeutics. Their approaches are different and their outcomes and uses remain undetermined, but both are trying to find a treatment for celiac disease, other than the gluten-free diet. You can hear both presentations in the video clip below.

Screening for celiac disease

Also discussed at the conference: could the criteria for the diagnosis of celiac disease be too strict?

The “gold standard” diagnosis for celiac disease is a positive blood test, followed by a small intestinal biopsy via endoscopy. If the patient has villous atrophy, meaning that the villi of the intestine is damaged to a certain degree, then the person has the official diagnosis of celiac disease.

Dr. Markku Maki from Finland presented his findings about whether this criteria for diagnosis is good enough. His study included 23 people who had elevated antibodies but had normal or only slightly inflamed intestinal lining. They therefore did not meet the criteria for celiac disease. The researchers put one half of this group on a gluten-free diet and the other half continued to eat gluten. They followed both groups for one year — their symptoms, antibodies, and endoscopy. After one year, the gluten-eaters’ symptoms worsened and their small bowels had deteriorated. The gluten-free people’s antibodies disappeared and their bowels became better than before. The gluten-eaters all wanted to go on the gluten-free diet and a year later everyone in that group improved also.

Dr. Maki’s conclusion is that “we have disease before we have gluten-induced small intestinal mucosal lesion.” In other words, perhaps our gold standard needs to be reevaluated, because according to this study, many people already have the disease before it shows up on a biopsy.

You can hear it all for yourself in this video from the conference.

Related reading:
Is a biopsy always necessary to detect celiac disease?
Blood tests are not the final say

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Some common symptoms of Celiac Disease include:

• Recurring bloating, gas, or abdominal pain
• Chronic diarrhea or constipation or both
• Unexplained weight loss or weight gain
• Pale, foul-smelling stool
• Unexplained anemia
• Bone or joint pain
• Migraine headaches
• Behavior changes/depression/irritability
• Vitamin K Deficiency
• Fatigue, weakness or lack of energy
• Delayed growth or onset of puberty
• Failure to thrive (in infants)
• Missed menstrual periods
• Infertility – Male/Female
• Spontaneous miscarriages
• Canker sores inside the mouth
• Tooth discoloration or loss of enamel

Anyone who can identify with one of more of the symptoms listed may have Celiac Disease and should consult a doctor for more thorough testing, which typically starts with a blood test.

In addition, anyone who has been diagnosed or has a family member who has been diagnosed with any of the following may also be at risk:

• Type 1 diabetes
• chronic fatigue syndrome
• fibromyalgia
• irritable bowel syndrome
• eczema
• Sjögren’s syndrome
• Peripheral neuropathy
• thyroid disease
• Dermatitis Herpetiformis
• osteoporosis

Thank you to Mary’s Gone Crackers and the Celiac Disease Foundation (CDF) for releasing the above checklist of symptoms in recognition of National Celiac Disease Awareness Month in May. More than three million Americans are estimated to have Celiac Disease, yet 97 percent of people go undiagnosed. The number of Celiacs is in fact greater than those with Crohn’s Disease, Cystic Fibrosis, Multiple Sclerosis and Parkinson’s Disease combined.

Celiac Disease is one of the most common genetic conditions in the world that often goes undiagnosed because it is a multi-symptom, multi-system disorder. Symptoms vary and are not always gastrointestinal.

“We are proud to partner with Mary’s Gone Crackers to help raise awareness of Celiac Disease, said Elaine Monarch, founder/executive director, Celiac Disease Foundation. “We hope this checklist will encourage people to consult their healthcare professionals for proper diagnosis.”

“Celiac Awareness Month is the perfect opportunity to shed some light on this widespread condition, and we are pleased to help educate people that there may be a name for the symptoms they thought they had to live with,” said Mary Waldner, co-founder of Mary’s Gone Crackers. “I spent years trying to find the source of my digestive pain and fatigue and my son’s migraines. I want others to know that they can achieve real health when they avoid gluten containing foods.”

Mary was inspired to create Mary’s Gone Crackers after she was finally diagnosed with Celiac Disease and had scoured store shelves for tasty foods that she and her son could enjoy. Mary’s Gone Crackers are delicious and nutritious — I highly recommend them! Whenever I serve them to guests, they have a pleasantly surprised look on their faces! I am looking forward to trying their new Sticks & Twigs snacks, coming this summer (hopefully I will have a sneak preview here!)

Learn more about celiac disease and its symptoms.

Filed under: Celiac Disease, Symptoms | No Comments »

Years ago, when a boyfriend of mine spent the night at my apartment for the first time (nothing happened, I swear!), he awoke to someone screaming. He jumped out of the bed in full combat mode, ready to attack whatever hideous creature was making those awful sounds. That hideous creature, of course, was me. “Help me! Help me!” I was shouting. “My legs! My legs!” Both of my calves were in painful cramps. If you have ever had one leg cramp, you know that you can pull yourself up and stretch it out. But double leg cramps means you are basically paralyzed, unable to maneuver yourself anywhere.

I gotta hand it to that boyfriend, he came through in crisis — he immediately grabbed my feet and pushed my toes toward me, slowly relieving the cramps. Surprisingly, he stuck around and got used to the middle-of-the-night cramp drill and even married me eventually, despite all my weird ailments!

The leg cramps were worse at night, but also occurred during the day. They came on stronger if I was dehydrated or if I drank beer. Sitting for a long time in one position could bring it on, such as the time I was on airplane returning from a weekend volleyball tournament, where days were spent playing in the hot sun and nights were spent in the bars. The plane had just landed, and as everybody rose to get ready to exit, both my quad muscles in my legs cramped. It was so painful that I involuntarily began shouting profanities (namely, the f-word). I looked up and saw a sea of faces looking down at me. “Leg cramps” I said in a little apologetic voice to the crowd. I looked over at my friend sitting next to me for support but she could only hide her own face and her giggles.

I not only had leg cramps, but I also got cramps in my hands, feet and a few times the muscle between my chin and neck cramped after I yawned (I didn’t even know I had a muscle there until it popped out!)

So what was causing these cramps? Not potassium deficiency, as everyone liked to believe. “Eat more bananas!” people would say. So I ate more bananas. I even drank tonic water because it contains quinine which was used to treat nocturnal leg cramps (now the FDA warns against using it). I had my potassium levels checked and they were normal.

It wasn’t until I had to change to a gluten-free diet after being diagnosed with celiac disease that the leg cramps went away. What a relief! Now I think that the cramps may have been related to my iron deficient anemia (caused by celiac), but no one is sure. All I know is that I don’t miss them one bit (and neither does my husband)!

Filed under: Celiac Disease, Gluten Intolerance, Symptoms | 9 Comments »

Q. I am 30 years old. My question is that for the last 6 months I have been getting really sick during the night. I have hypothyroidism, and am really hypoglycemic. It wakes me up at all hours of the night and running to bathroom with diarrhea. I called my doctor about 2 months ago and did a stool culture, but nothing showed up. I am at loss!! I have no idea what is going on with me? Is it stress?? I am going to school, but I don’t feel that stressed out. I am not on any thyroid med because for the last year my thyroid has been normal, I just had it checked two months ago. I had a really nasty stomach flu about 6 months ago, ever since then my stools are not normal. I am fine one minute and then sick the next. No throwing up, just the other end. All I know is I want to feel better. Any suggestions??? I am also wondering if I could have some sort of wheat or milk allergy? I eat a lot of wheat being hypoglycemic. And I do notice sometimes after having something from milk in my food, sometimes I wake up sick. The weird thing is that it happens in the night most. I do not feel like it is heart burn. Thank you for listening!! I would appreciate any suggestions!!

A. Any nocturnal diarrhea needs to be aggressively investigated. Celiac disease is a real possibility as is inflammatory bowel disease. Diabetes can present like this, and post-infectious irritable bowel syndrome is an outside possibility. You must see a gastroenterologist soon.

Health and happiness,
Dr. Aron

Have a question?

Filed under: Ask the Doc, Celiac Disease, Symptoms | 1 Comment »

Did you know?

• Celiac Disease is the most common genetic disorder in the world. It affects as many as 3 million Americans, or roughly 1% of the population.

• Type 1 Diabetes affects 1,177,500 people; 6% (70,650) of those diagnosed also have celiac disease.

• 610,000 women in the US experience unexplained infertility; 6% (36,600) of these women might never learn that celiac disease is the cause.

• 350,000 people in the United States are living with Down Syndrome; 12% (42,000) of them also have celiac disease.

• The number of people with celiac disease in the U.S. is roughly equal to the number of people living in the state of Nevada.

• The National Commission on Digestive Diseases (NCDD) recently noted that physicians and medical staff members are unaware of the how common celiac disease is or what symptoms to look for. One of the Commission’s goals is to “improve screening, diagnosis, prevention, and treatment of celiac disease.”

What can you do?

May has been designated National Celiac Awareness Month by the Celiac Disease Foundation, and a bill is up for a vote that asks Congress to support the goals and ideals of National Celiac Awareness Month.

The American Celiac Disease Alliance (the group responsible for getting Congress to require food labeling of allergens) has issued an action alert: share the facts above with the legislators in Congress. Raising awareness of celiac disease can lead to increased physician education and training. This goal and the bill are supported by the American Gastroenterology Association, American College of Gastroenterology, American Dietetic Association, and the American Osteopathic Association.

All you have to do is click this link, fill out the form and either email or mail the letter. Together we can really make a statement!

I am grateful to the American Celiac Disease Alliance for all their work!

Filed under: News & Research, Celiac Disease, Gluten Intolerance | No Comments »

I have good bones. In fact, I have never broken a single one (knock knock knock on wood). Somehow my untreated celiac disease decided to take out its anger on other parts of me, but left my bones strong and healthy. Some people’s bones, however, are weakened by the effects of gluten, making them more susceptible to fracture.

Untreated celiac disease can greatly affect the bone health in children and adults. A new report from the Laboratory of Pediatric Endocrinology and BoNetwork in Milan, Italy says that bone mass measurements are greatly reduced in children with untreated celiac disease compared to other children. Lower bone mass can lead to bones breaking more easily. Osteoporosis in adults has been linked to celiac disease, believed to be caused by either the inability to absorb necessary nutrients (calcium) for optimal bone health, or by chronic inflammation present in the body due to celiac disease.

Anyone with poor bone health should look at gluten as a cause, even if they don’t have the gastrointestinal symptoms of celiac disease. One study published in early 2008 suggested that screening of osteoporosis patients for celiac disease is advisable, since it may be the only sign of undiagnosed celiac disease.

Luckily, removing gluten from the child’s diet can restore bone mass to normal levels. The bone density of adults can also be improved with a gluten-free diet, but they may not regain bone mass to normal levels. Anyone diagnosed with celiac disease should talk to their doctor about having a bone mineral density test and about nutritional supplements to help restore bone mass.

Related reading:
About celiac disease
Symptoms of celiac disease

Filed under: News & Research, Celiac Disease, Gluten Intolerance, Symptoms | 1 Comment »

Q. When my husband was 17 he was diagnosed with Celiac Disease and then just 2 weeks ago his father was diagnosed as well. I know there is a good chance our 14 weeks old baby girl could possibly have it as well, however, I don’t know when we need to get her tested. At three weeks old she lost a whole pound while breast feeding and our doctor suggested putting her on formula. She has been putting on weight, but not much. She weighed 5 lbs 6 oz after losing weight at three months and as of last week she weighs 9 lbs 6 oz even though she eats 4 oz of formula every hour and a half. Not being able to gain weight is only one of many symptoms our little girl has. Even our doctor says she has a lot of flatulence for one so young, her bowel movements have never been regular, one day she has acidy diarrhea and then she will be completely constipated the next. She is also very fatigued taking 4 or 5 two or three hour naps during the day and then sleep a full nine hours every night since she was 3 weeks old. I just want to make sure that we get her tested early enough to see if she has celiac or not before she has to suffer like my husband and father in law did for so long. So when can I have her tested?

A. There is a strong possibility that your baby has celiac genes, but, with a lack of exposure to gluten, it is unlikely that this is a cause unless you have been ingesting gluten during breast feeding. Switching to formula is a good idea: be sure that it is gluten-free. Testing the baby for celiac should include HLA DQ2 DQ8 genes, and be done very soon.

Health and happiness,
Dr. Aron

Have a question?

Filed under: Ask the Doc, Babies & Kids, Celiac Disease | 2 Comments »

It is 1992 and I am on a train heading from the south of Spain to Madrid, where I am living and studying for the semester. I have just spent 5 days in Morocco, eating cous-cous, drinking mint tea and staying in beautiful mosaic hotel rooms. I am 21 years old and I am having trouble breathing and it is the first time it ever crosses my mind that I could actually die from an asthma attack.

Inhaler in hand, I take a puff every hour, then every half hour, eventually every few minutes and I am watching the clock to see how long I have until we arrive in Madrid, where I will have to take the subway and then walk to the boarding house where I live. It is taking so long. And I can only breathe short breaths, I can’t get air deep into my lungs. I am starting to feel panicky which only makes asthma worse. I talk to myself — you’re ok, you’re ok, we’re going to get there.

We arrive at the train station. I take the subway, and then a friend carries my duffel bag in addition to his because I can barely even carry myself up the steps of the house. I make it. I take the prednisone that I had left behind, never suspecting that I would need it. I lay sick in bed for 2 days, exhausted from trying so hard to breathe.

I have asthma, or as I now say, I had asthma. Since I was a kid I carried around my inhaler, taking a puff or two at the halftime of my soccer game or if I got a cold. Mine was not serious enough that I ever had to go to the hospital, but in my 20s, it got worse to the point that my doctor recommended I take a steroid inhaler every morning and every night to prevent attacks from happening.

It wasn’t until my diagnosis of celiac disease at age 32 that it ever occurred to me that my asthma could be triggered by food. Not one allergist had ever suggested it. It was my own idea to stop inhaling the steroid medication after 3 months on a gluten-free diet… I have not used it since.

I now know that my asthma was caused by gluten. It got worse with other triggers such as the flu, dust and exercise, but these weren’t the causes, they just made it worse. All those years I believed I had exercise-induced asthma, but within months of changing my diet, I ran an 8 mile race — without a puff!

To those of you out there suffering from asthma or whose kids are suffering from it, think about food being a cause. According to the American Academy of Allergy, Asthma & Immunology (AAAAI) website, “asthma symptoms such as coughing, wheezing, or difficulty breathing due to narrowed airways, may be triggered by food allergy, especially in infants and children.” According to the Asthma and Allergy Foundation of America website, “babies in particular may have food allergies that can bring on asthma symptoms. Some of the foods to which American children are commonly allergic are eggs, cow’s milk, wheat, soybean products, tree nuts and peanuts.” Even adult-onset asthma could be caused by food.

It’s up to you: try a change of diet or be on medication the rest of your life. If you decide to try it, look at which foods are being consumed the most, usually gluten and dairy, and trying cutting one or both out for a few months. Of course, consult your doctor before reducing any medications (not like I did), but also know that your doctor may not believe that food could be the cause of asthma. But it can. Just look at me.

Filed under: Babies & Kids, Celiac Disease, Food Allergies, Gluten Intolerance, Symptoms | 2 Comments »