A Doctor Shares The Signs That You Might Have Celiac Disease
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Research suggests that approximately 2 million Americans are affected by celiac disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases. In an exclusive interview, Health Map spoke with Dr. Wendie Trubow, a certified functional medicine physician and President of the National Celiac Association, and author of "Dirty Girl: Ditch the Toxins, Look Great, and Feel Freaking Amazing!" Dr. Trubow went into detail about what signs and symptoms may be indicative of celiac disease.
She starts off by explaining how gluten affects the gut. "The gene that puts us at risk for celiac is carried by approximately 40% of the population. Whether you have that gene or not, anyone who eats gluten opens up the lining of the gut," Dr. Trubow states. "If you don't have the gene, it lasts for 15 minutes or so, and if you have the gene the tight junctions open up for around 4 hours per gluten-containing meal," she says.
Dr. Trubow goes on to further explain, "When the tight junctions are open, your inside world/immune system/bloodstream are exposed to bacteria, fungi, mycotoxins, food particles, environmental toxins, etc., and depending on your unique makeup, can aggravate varied systems. Sometimes [those manifest] in the gut, and sometimes not," she says.
Why celiac disease can be difficult to recognize
"Most people won't get celiac, however, it's estimated that the people currently diagnosed with celiac represent only 1% of the people who truly have celiac," Dr. Trubow tells us in our exclusive chat. "There are a million reasons for it; but one major one is that celiac can present with 'extra-abdominal' symptoms. [M]eaning, the problems aren't with the gut, they're somewhere else," she states.
"One major 'somewhere else' is the bones, because one consequence of celiac is that people don't absorb minerals and nutrients well, which leads to bone loss." Because celiac disease can present with symptoms similar to those of many other conditions, Dr. Trubow notes that it can be challenging for patients to recognize. "It's essentially an illness that can look like a ton of other issues," she says. "Others would be autoimmune disease(s), degenerative disease(s), chronic fatigue ... the list goes on and on."
Dr. Trubow goes on to tell Health Map that while there has been an increased understanding of celiac disease within the medical community, we still have a long way to go. "Fortunately, the awareness is rising of celiac/non-celiac gluten sensitivity somewhat," she states. "Unfortunately, there's a vast divide between the people who need testing and the awareness of those recommending it. Testing is vastly underutilized."
When to request celiac disease testing
"If a physician has celiac on their radar, then they will recommend it; however, more physicians than not don't think of celiac," Dr. Trubow points out. "So if you're a patient and just don't feel well, or if you have a collection of complaints/concerns that linger, it would be worth requesting testing." While test results are often negative, Dr. Trubow notes that a person may still have a gluten sensitivity, which can leave one more susceptible to celiac disease if they are genetically predisposed to the condition. "The traditional route to obtain a diagnosis is an endoscopy with biopsies," she explains. "A screening test for celiac is a blood test, which looks at the antibodies the body is producing against gluten."
For those diagnosed with celiac disease, Dr. Trubow says there are a number of steps one can take to manage the condition and improve quality of life. "Eliminate and avoid gluten. Restore the gut through what's called the 5R program (Remove, Replace, Reinoculate, Repair, and Rebalance)," she advises. "Support healthy digestion with digestive aids like pancreatic support, stomach acid. Check minerals and nutrients to ensure that you aren't too depleted from having developed celiac," she adds. In closing, Dr. Trubow notes that caring for one's mental health is also important. "Manage stress properly, as it has a negative impact on gut health," she states.