Question and Answers - Page 6

Q. Hi Roberta

I am 37 years old and have just been diagnosed with celiac disease. It was picked while doctor was trying to work out why I was not conceiving. I have been trying for a baby for the last 3 years.

Celiac disease can cause infertility, so my question is; is there anything I should be eating or taking to make me ovulate again? Are there any foods I should be avoiding like soya?

Thank you

A. Unless you have been found to not tolerate soya it shouldn't interfere with fertility, but I would say "eat in moderation", as is true with everything. Another important factor is eating enough calories for your body. Your body will "shut down" ovulation if it is not receiving enough nourishment, which in part is why eating gluten can prevent ovulation in some celiacs.

Since gluten causes the villi of your small intestine to flatten it also results in fewer nutrients being absorbed. In my case it may have been a cause of multiple miscarriages. It may take only a month or so for your body to recover from the lack of nourishment due to eating gluten or it may take several months, but don't give up hope–I had a healthy baby at age 43. Good luck!

Roberta

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Q. Dear Roberta,

Over the weekend we bought some potato chips that had starch in them. It just said starch.
Is this good or not good for the celiac? I tried to find out on the internet but wasn't able to find out exactly what I needed to know.

Thanks for the help!

A. If you bought these potato chips in the US and they were manufactured in the US they would have to indicate whether they were made with wheat or not. In other countries starch could be made from wheat or corn. Your best bet would be to contact the manufacturer.

Roberta

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Q. Dear Roberta,

How long do the effects of eating wheat last in the body?

A. If you have celiac disease and stop eating foods such as wheat which contain gluten you may see an immediate improvement but for some conditions (such as lactose intolerance) it might take up to a year gluten free to see a difference. It depends where on the villi the particular nutrient is normally digested. Although this is the case it seems to only take about 2 weeks of eating gluten before a blood test will show positive for celiac markers.

Roberta

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Q. Dear Roberta,

I am 27 years old, height: 152 cm, weight: 70 kg
I've done the GASTRIC BYPASS surgery from 3 years ago and i lost 25 kilos but later, after 2 years, i gain 8 kilos.

I am following now a diet plan with a dietician from 6 months and i lost 5 kilos but i stopped losing weight since 2 months.

My problem isn't food but chocolate and potatoes chips. i adore this kind of food and i don't think that i am able to stop eating them for a long time.

I feel very upset i want to lose weight as soon as possible because i feel that i have complex from my fatness and maybe i need a psychiatrist to help me but it is impossible because in my country people think that psychiatrist is only for people who are mad.

I need a second advice and I wish if it could be from you.

A. There are no good and bad foods–I would strongly recommend the book "Intuitive Eating" by Evelyn Tribole, RD and Elyse Resch, RD. These 2 dietitians have written a book that is not a diet book but teaches a new way of looking at eating. (Celiacs and others on gluten free diet: this book is primarily for someone who wishes to lose weight).

If possible you might want to check out one of the many good online diet support groups such as eDiets or Weight Watchers online.

Roberta

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Q. Dear Roberta,

I live in Australia and was diagnosed with Celiacs 4 months ago. It has been such a blessing to be diagnosed, because now I feel so well. I have been having a wonderful time researching, getting recipes together.

I love cooking and make home made ice cream (which everyone just loves),wonderful main meal recipes etc. I have dinner parties with all totally gluten free food and no one would know.
I have to say that I can not understand people having trouble with cooking. There are a lot of
products in the supermarket in Australia - gluten free gravies, custards, cereal etc. And there are so many good recipes books out there.

I feel great after a life time of weakness and tiredness. But people are right about the bread - I have tried making my own but you have to eat it immediately. I have not tried toasting it yet.

By the way is everyone aware of cross contamination with toasters, jam jars and margarine bottles. We must have our own.

However my question is about cosmetics as I read a question from another person. I had not thought about cosmetics - although I only use a moisturiser and lipstick.

I am 51 and have lovely skin and have never really bothered with all the other things. Do I need to check on the lipstick before I buy it?

I also noticed in another email that you said maltodextrin was gluten free. I am now a little confused because my doctor referred me to a dietarian just after it was discovered I had Celiacs and she told me that maltodextrin had gluten, but dextrin did not. Can you please clarify this for me.

Many thanks

A. Maltodextrin is gluten free in the US (unless it says "made from wheat") but may not be in other countries–the safest thing would be to check with the manufacturer. Dextrin does contain gluten.

Yes, I would recommend checking on lipsticks since I just read somewhere that the average woman consumes about a pound of lipstick in her lifetime! That sounds pretty disgusting but if it is true and the product contains gluten it would be worth it.

As far as moisturizer if you think there is a chance it would touch your mouth and therefore be digested you might want to check on that as well.

There is a company in the states (www.grandmaferdons.com) that makes a gluten free buttermilk bread dough that I would like to try as I'm sure fresh gluten free bread would be preferable to the alternative…if there are any companies in Australia that make this type of product you might want to try them as well.

I am so glad you wrote in with all your successes on the gluten free diet. I wish I could visit you "down under" and taste some of your ice cream!

Roberta

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Q. Dear Roberta,

I have read that folk with wheat/gluten allergy are deficient in this enzyme. Has it been isolated and can it be purchased, and if so where?

While in health food store recently I noticed a Naturopathic "remedy" for wheat/gluten. Do you know anything about this?

A. I have heard about this as well and in fact this weekend saw an enzyme product for sale in a local health food store that claimed to digest gluten. The thing about these type of products is that they are unregulated by the FDA as are all nutritional supplements and can really say whatever they want on the bottle.

Researchers in the US are working on a medication that would work similarly to Lactaid in that it would be taken prior to eating gluten and would break the gluten down so it does not cause the autoimmune reaction in celiacs. This product would have verified scientific studies behind it that would back up any claims made. Until that time, unfortunately, it's "buyer beware".

Roberta

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Q. Dear Roberta,

How do I achieve a healthy diet full of vitamins, minerals and fiber without eating any whole grains?

Thank you

A. I am attaching some information that should help you in terms of fiber. As far as vitamins and minerals, I personally take a gluten free vitamin mineral supplement once daily to insure I am getting what I need.

As your villi heal from a gluten free diet you should absorb more of the vitamins and minerals you take in which also helps..

Roberta

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Q. Dear Roberta,

I just recently found out that i'm on a Gluten Free diet. I have always trouble with being anemia but just recently since being on this diet my hemoglobin will not stay in normal range. It is hard for me to find a lot of fiber for my diet less not having any iron.

Is there ways that I can still get enough fiber/iron in my diet with out having to take about 112mg of iron pills which is killing me be so constipated so much. Can you help me?

A. You mentioned that you recently found out that you're on a Gluten Free diet (by which I'm assuming you mean "need to be" on a gluten free diet). If this was very recently (maybe within the last 6 months) your villi may not have regenerated to the point where you are sufficiently absorbing iron, thereby resulting in low hemoglobin.

Many doctors do not recommend high levels of iron to celiacs as they turn out not to be necessary once the gut heals. As far as fiber, I am attaching a good educational piece to this message that should help you.

Roberta

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Q. Dear Roberta,

Roberta, my 3 year old granddaughter has just been taken off gluten and dairy for 2 weeks to determine if she is allergic to 1 or both.

I have noticed in my search that there is gluten free meat products. When I look at meats in the grocery store I don't see that there is gluten in the list of ingredients of any product. What, therefore makes some meats gluten free?

A. Meat, in its natural state, is gluten free. However, there are many products such as self basting turkeys, hot dogs and other sausages, and meats with added gravies and sauces that may contain gluten.

Your safest choices are fresh beef, pork, chicken, turkey, and seafood with no additives. You can be assured these products do not contain gluten.

Roberta

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Q. Dear Roberta,

I am 20 years old and was diagnosed with celiac disease around a year ago.
Since then I have been feeling great, but I am extra careful and feel that I may be missing out on some foods that I am actually allowed to eat.

I don't get to see my nutritionist often, because I am away at college. Just wanted to know if you could clarify a few things for me:

1) Which oils are we supposed to stay away from? I'm not sure if I was told hydrogenated or hydrolyzed, and I usually stick to all organic oils. Just wondering if I am allowed one of those, because they seem to be in a lot of foods.

2) Is there a vinegar I am supposed to avoid? Currently I do not eat pickles, because I always notice the vinegar in the ingredients. Is it white vinegar I am supposed to avoid? distilled?

3) What about modified food starch? I avoid this even if it is modified corn starch, and am unsure if this is necessary.

4) Is whey allowed? Originally I wasn't eating this, and I have brought it back without a problem, but could it be doing some damage that I do not know about?

5) Does "glutenease" work? Should I buy it just incase I accidentally eat gluten in a restaurant, or incase I just don't feel right? Sometimes I react to milk, would this be helpful in this case?

Thank you so much for your help!

A.
1. Avoid wheat germ oil (all others should be ok).
2. I agree with those who say that the distilling process renders vinegar free of gluten molecules, although some people say they still have problems with vinegar made from wheat. If it bothers you, avoid it (cider vinegar should be ok).
3. In North America if the product does not say it contains wheat, but it does contain modified food starch, the product is gluten free.If the food is from other countries check with the manufacturer.
4. Whey does not contain gluten.
5. At this point in time there is no scientific evidence that gluteinase works (or any other enzyme that supposedly digrades gluten so it is harmless to celiacs). I have heard from some people that they use it before going out to eat somewhere where they are not sure if they will accidentally be "glutened". Just don't use it and intentionally eat something with gluten.

If you react to milk you may have a lactose intolerance, which often accompanies celiac disease until your intestinal villi heal from a gluten free diet for at least 6 months. I would recommend trying Lactaid to see if it helps with this.

Roberta

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Q. Dear Roberta,

I have had digestive problems for many years, and finally went to a gastro doctor last year. After a coloonoscopy and endoscopy, my doctor was confused because I had no villi in my small intestine.

(This should have been a no-brainer that I had Celiac Disease, but he didn't catch it.) He then did a blood test because I mentioned Celiac Sprue, which came out negative, so he sent me to Rush hospital in Chicago. There I was told that the biopsy was the golden standard, and I definitely had Celiac Disease.

I have been trying to faithfully follow the diet for the last 6 months. What my question is, how can I tell that I am succeeding at being gluten free? Would I need to do another biopsy since my blood work gives a false negative?

I really don't want to go back to the local doctor, but really want to make sure I am not accidentally failing. Thanks.

A. I would recommend consulting someone from the University of Chicago as they are the area experts in the field. My sister was diagnosed there after I was diagnosed and suggested she be tested. The name of the physician is Dr. Stephano Guandalini. They would be able to tell you if you would need another biopsy to confirm that the gluten free diet has resulted in your villi regenerating or whether you still have problems indicating celiac disease.

Roberta

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Q. Dear Roberta,

Thank you for the valuable service you provide.

My fudge bars list sorbital, lactitol, maltodextrin, polydestrose, microcrystalline cellulose, tricalcium phosphate, monoglycerides, guar gum, cellulose gum and polysorbate.

What is gluten free and what isn't? These things are probably really bad for me even if they don't involve gluten!! But, I thought I would ask. Thanks.

A. Well, believe it or not in all that chemistry there doesn't seem to be any gluten. It sounds like it is mostly low calorie sweeteners with thickeners and preservative. The only questionable ingredient would be the maltodextrin if it wasn't made in the US (if it was made in the US from wheat it is required to list wheat on the label).

Roberta

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Q. Dear Roberta,

I haven't had a period in over 5 months and wondered if this could be due to the coeliac diet although I haven't really been following it to the 't'.

I'm a bit worried for future fertility. Thanks.

A. If your body isn't properly nourished (which it probably isn't if you have celiac disease and are eating gluten) it can affect your hormones and thus your fertility. I would strongly recommend making an appointment with a gynecologist and getting checked out as it could be due to other factors as well. Meanwhile do your best to follow the diet as best as possible.

Roberta

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Q. Dear Roberta,

I was recently diagnosed with celiac in October of 2006. At first it was a shock and I had never heard of it and then detoxed and never knew this is what I was supposed to feel like.

Then the real problem came into place. I am having a hard time staying on it, frustrated! I am slightly overweight and need to diet and can't find any diet…and no I hate being a vegitarian. Is there any diet I can follow to loose 15 pounds?

I know it sounds silly, but I am very disgusted and need advise. I am also lactose intollerant and can't eat corn syrup or soy. I hate it. Please help!

A. Something I would recommend is to increase your fiber so you feel fuller and less hungry. See the attached handout for suggestions.

Another tip–avoid the tasty but fattening specialty gluten free cookies, candy, cake, pie, etc etc. They're gluten free but not calorie free!

Make sure to eat 3 meals a day — don't let yourself get famished or else you may decide "I have to eat this!!!"

Roberta

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Q. Dear Roberta,

Thanks for the work you do.

I am wondering if you know where the most knowledgeable experts/doctors on celiac are. I need to find a celiac specialist that has dermatology experience for my dermatitis herpetiformis, which is a major symptom of mine.

Do you know of people's happiness with any specialty clinics? I think there is one in NYC and maybe Maryland? The Boston Celiac group doesn't even have a dermatologist on staff.
Your thoughts about this would be appreciated. Or any sites you can send me to.

A. Places I would recommend:

Columbia in NYC (Dr. Peter Green) Center for Celiac Research in Baltimore MD (Dr. Alessio Fasano) University of Chicago

I know doctors at each of these places and I would highly recommend them for anyone with celiac disease or who suspects they have celiac disease.

Roberta

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