Going Gluten-Free: What Every Newly Diagnosed Celiac Should Know & Why You Shouldn’t Wait To Get Tested
In theory, the cure for celiac disease and gluten sensitivity is simple; just stop eating gluten, that’s it! In reality, this one little change is a massive lifestyle adjustment that takes months, if not years to accept and adapt to. For lots people, the diagnosis comes after years of suffering, so removing gluten from their diet is a small price to pay for the road to recovery. For some however, it’s a new found reality that doesn’t make any sense. Not everyone exhibits the traditional digestive symptoms associated with celiac, not everyone is horribly sick, so to find out you can’t eat a staple food in your diet anymore, especially if you don’t have severe symptoms or any symptoms, is a hard sell.
DON’T WAIT. GET TESTED & FIND OUT FOR SURE
Celiac disease has one of the most widespread symptom pictures of any condition, it can affect almost every organ system in different ways for different people. That’s why it’s important to include screening for celiac disease when any of the above symptoms persist despite medical and/or lifestyle intervention- even more so if someone in your family has already been diagnosed as a celiac or with any other autoimmune condition, as this condition has a strong genetic component. Unmanaged celiac patients are at a greater risk of developing other autoimmune conditions and certain cancers so the sooner you know, the better you can prevent any further illness from happening.
CELIAC SCREENING & TESTING
Celiac screening typically begins with a blood test, TTG/IGA. This is an autoimmune marker specific for celiac disease. The test has a high sensitivity and specificity, meaning that, if a person tests positive for TTG, the likelihood of it being a true positive is strong; it is very unlikely that a positive TTG is elevated for any other reason than celiac disease. TTG is now always checked with IGA, one of the body’s antibodies. If a person has an IGA deficiency (which can be common amongst celiac patients), the test will show falsely negative; thus the two tests are run together to ensure accurate results. A person must have been consuming gluten daily for a minimum of 6 weeks in order to properly test TTG. A positive TTG warrants further investigation with a gastroenterologist; a small bowel biopsy is required to confirm an absolute diagnosis of celiac, and genetic testing may be performed as well.
OTHER IMPORTANT TESTING
Many patients, especially those with mild to no symptoms aren’t thoroughly evaluated for the degree of impact celiac disease has had on their body. Things like nutrient deficiencies, in particular B12, iron, Vitamin D, bone density, and a check for other autoimmune conditions should be worked up right away alongside a full physical exam. Regular re-examination, especially over the first year is a must. The inflammation from an uncontrolled autoimmune disease has widespread implications, so establishing a body healing plan, evaluating and optimizing hormones, checking for other food or environmental allergies and evaluating the microbiology of the entire digestive tract through stool and breath testing can greatly support recovery. Finding a well-versed naturopathic doctor is an asset; they will fill in any gaps in or augment the treatment plans established by your family physician and specialists to ensure you’re getting the gold-standard of care.
NUTRITIONAL & DIETARY COUNSELLING
We’re lucky we live in a city that readily accommodates so many different dietary choices and restrictions. That said, getting started on a new diet is a huge undertaking, no matter how many gluten-free restaurants are in your neighbourhood! How to heal the digestive tract, when to eat, what foods to eat more of, what foods to avoid, what foods contain gluten, how to prepare food safely, is all part of nutritional counselling. It’s a resource I highly encourage new gluten-sensitive and celiac patients to utilize.
IV NUTRIENT THERAPY
Celiac disease causes destruction of the absorptive surface of the small intestine leading to malabsorption of nutrients and eventual nutrient deficiencies. With strict adherence to a gluten-free diet, this inflammatory response stops and the intestines eventually recover, but the damage can take months or even years to reverse. One advantage of IV nutrient therapy is that it bypasses the digestive system, delivering a concentrated dose of vitamins, minerals, amino acids and antioxidants right to your tissues. Utilizing IV therapy as part of your treatment plan can help resolve nutrient deficiencies, speed healing and recovery time, help regulate your immune function, lower inflammation, support stress, manage anxiety or depression and boost energy and mental clarity – all things that are vital to feeling better more quickly!
COUNSELLING & EMOTIONAL SUPPORT
I can’t speak enough to the importance of self-care through counselling and stress-reduction treatments. When you’ve been unwell for so long, naturally you begin to isolate yourself. It’s hard enough to get out of bed in the morning, even harder to be present in your life when you’re suffering and it can begin to feel like no one really understands you or supports you. When your body and spirit are drained, a new diagnosis (though it provides clarity and a path to recovery) brings a whole new set of challenges. Suddenly you have a new identity you you have to wear, you must learn how to embrace something you didn’t ask for. Suddenly you’re someone who has to watch what they eat- for the rest of your life. It’s not easy. At first it’s exhausting and sad and unfair, but having someone to talk to really helps. Stress reduction therapies like massage, acupuncture or osteopathy can help lessen symptoms of anxiety, depression, pain, muscle & joint stiffness, digestive disturbance, and help get you to the other side of your journey.
GLUTEN-FREE EDUCATION
It’s sometimes difficult for family and friends to understand the gravity and implications of this diagnosis, it’s hard to appreciate all of the idiosyncrasies that go into gluten-free living as an unaffected person, so that’s where education comes in. Invite your friends and family to learn more about how to help you get better and stay better. Things like social eating, food prep & dining out tips, cross-contamination and how to avoid it are all topics covered with gluten-free education. Understanding celiac co-conditions, and the genetic component help families make decisions as a unit on how best to support their health.
If you think you might have a gluten-sensitivity or need to be screened for celiac disease, or if you are looking for ways to better optimize gluten-free living come and see one of our Naturopathic Doctors.
In Health,
Dr. Alaina Overton, ND
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