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Intolerance? Allergy? Can someone help clear this up?

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So, I'm feeling somewhat frustrated...and confused. :/

I was diagnosed with CD a little over two years ago and have been

gluten-free ever since--and feeling great!! I feel that I've really

adapted to the GF lifestyle. Ever since I was first diagnosed I've

tried really hard to keep up with the latest news, recipes, etc, and

I really try to let people know that CD is out there (without

seeming pushy or anything, of course). I'm also very clear about the

fact that this is an intolerance, not an allergy (even though my

roommate still does not seem to understand the difference after 2+

years, and my family sometimes doesn't get it). Anyhow...we always

read that it's a gluten intolerance vs an allergy. So, now the

confusion...

Ever since I was diagnosed, I've been trying to get my family to get

tested. But they are all stubborn, despite the fact that my mother,

my brother and one of my little sisters all seem to have some sort

of a GI disorder. Now, two years later, my little sister is finally

getting tested. Her blood tests came back positive, so her doctor

sent her down to University of MD, where she just had her first appt

with one of the TOP CD doctors. And he had some interesting things

to say...

He told my parents that very few people actually have CD. In fact,

he told my parents that he could almost guarantee them that I do not

actually have the disease (after my parents told him all of my

extreme symptoms I had prior to going GF and the symptoms I have if

I accidently ingest gluten). He says that what all of us claiming to

have CD really have is an allergy to gluten. (He said that the test

to determine whether or not one really has CD or not is outrageously

expensive) He told my parents that if I really did have CD, my body

would not show any symptoms/I would not react to accidently eating

gluten. Rather, it would be a slow process and, eventually, symptoms

would show up and it would be apparent that I had ingested gluten.

The doctor told my parents that those of us with these types of

symptoms actually are allergic to gluten (that's why we have the

symptoms if we accidently eat it) and are not truly intolerant to

it. The doctor insists that with this " gluten allergy, " we could, in

fact, out-grown our sensitivity and be able to eat gluten once

again. The thing is--who really wants to try this intentionally?

(The doctor himself admitted this). So, my parents obviously told

him everything that I had told them from my " research " after being

diagnosed (how it's an intolerance vs an allergy, my symptoms, etc)

and the doctor now wants to meet with ME and talk with me. And I'm

just really confused about all the stuff he is saying.

To go along with that...

The daughter of a close family friend was diagnosed as

having " gluten sensitivity " and has been GF for the past 6 years.

She just recently re-introduced gluten into her diet and is

completely fine! The doctor told her that her sensitivity was caused

by stress, and she can now eat gluten again. My parents feel that

this case supports the " gluten allergy " belief/thought.

I'm just really confused because everything this TOP doctor is

saying seems to contradict everything I thought I knew about CD. I'm

really perfectly fine being GF because I know that I'm healthy now!

But this just throws me for a loop! Can someone help? Has anyone

else heard this?

I'd appreciate any comments on this!

Sincerely,

Gaines

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ita-

My sister actually saw Swati Gadewar (a female dr). During their

visit, Karoly Horvath (a male doctor) came in to speak with my

sister and parents and told them everything I shared in my email.

Gadewar was in agreement with Horvath, who is the doctor who said it

isn't even worth it to get the genetic test done to see whether or

not you have CD b/c, as he says, he would bet money that you don't

( " you " meaning me, you, anyone with CD).Dr. Horvath is also the

doctor who said he would like to see me and he actually recommended

that I see Dr. Fasano, too. He seemed to give the impression that

the whole group of doctors-Fasano included- " preach the same thing. "

I appreciated your response, ita--exactly what I was thinking!

When my parents told me about their little excursion down to Univ.

of MD, I immediately went into a frenzy, going off about how they

saw one of those " bad " CD doctors who don't really understand, or

even believe in, CD! Aaagghhh! I'm so confused!

-

> Who was this " Top " doctor at the University of MD? Dr. Alessio

Fasano is

> the TOP doctor at University of MD and he would NEVER say those

things.

>

> ita

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First, I am not a doctor, but this is the way I understand it. (I am a

biopsy and serologically diagnosed celiac.)

Celiac disease and gluten allergies are discovered by different tests.

Allergies are generally tested via " IgE " testing - classic allergy testing.

There are some who believe that IgG testing may further give information to

an " intolerance " that causes symptoms, but NO ongoing damage. Celiac

disease is investigated through anti-tissue transglutaminase IgA testing

(and anit-endomysial testing), and a small bowel biopsy showing flattened

villi and an increase in intraepethelial lymphocytes, and sometime crypt

hypoplasia. While allergies can cause GI symptoms, they are not widely

known to cause the specific intestinal damage that is associated with CD. I

have 1 daughter who is not celiac, but is gluten intolerant. (Her blood

work for celiac came back negative, and her biopsy was negative - she is not

IgA deficient.) She may grow out of this some day, but for now she reacts

quite negatively to any amount of gluten. I would hesitate to allow her to

try it again for some time. My other daughter and I are celiac.

You can get good informationm from the University of Chicago Celiac Disease

Program. I am sure they would be happy to provide you with some excellent

sources of good, reliable information that is up to date. You can do your

own search on www.pubmed.com, and hopefully find some info to help educate

this Doctor, who is living in the dark ages of celiac disease. Good luck to

you.

Suzie in AZ

Intolerance? Allergy? Can someone help clear this up?

>

>

> So, I'm feeling somewhat frustrated...and confused. :/

> I was diagnosed with CD a little over two years ago and have been

> gluten-free ever since--and feeling great!! I feel that I've really

> adapted to the GF lifestyle. Ever since I was first diagnosed I've

> tried really hard to keep up with the latest news, recipes, etc, and

> I really try to let people know that CD is out there (without

> seeming pushy or anything, of course). I'm also very clear about the

> fact that this is an intolerance, not an allergy (even though my

> roommate still does not seem to understand the difference after 2+

> years, and my family sometimes doesn't get it). Anyhow...we always

> read that it's a gluten intolerance vs an allergy. So, now the

> confusion...

>

> Ever since I was diagnosed, I've been trying to get my family to get

> tested. But they are all stubborn, despite the fact that my mother,

> my brother and one of my little sisters all seem to have some sort

> of a GI disorder. Now, two years later, my little sister is finally

> getting tested. Her blood tests came back positive, so her doctor

> sent her down to University of MD, where she just had her first appt

> with one of the TOP CD doctors. And he had some interesting things

> to say...

> He told my parents that very few people actually have CD. In fact,

> he told my parents that he could almost guarantee them that I do not

> actually have the disease (after my parents told him all of my

> extreme symptoms I had prior to going GF and the symptoms I have if

> I accidently ingest gluten). He says that what all of us claiming to

> have CD really have is an allergy to gluten. (He said that the test

> to determine whether or not one really has CD or not is outrageously

> expensive) He told my parents that if I really did have CD, my body

> would not show any symptoms/I would not react to accidently eating

> gluten. Rather, it would be a slow process and, eventually, symptoms

> would show up and it would be apparent that I had ingested gluten.

> The doctor told my parents that those of us with these types of

> symptoms actually are allergic to gluten (that's why we have the

> symptoms if we accidently eat it) and are not truly intolerant to

> it. The doctor insists that with this " gluten allergy, " we could, in

> fact, out-grown our sensitivity and be able to eat gluten once

> again. The thing is--who really wants to try this intentionally?

> (The doctor himself admitted this). So, my parents obviously told

> him everything that I had told them from my " research " after being

> diagnosed (how it's an intolerance vs an allergy, my symptoms, etc)

> and the doctor now wants to meet with ME and talk with me. And I'm

> just really confused about all the stuff he is saying.

>

> To go along with that...

> The daughter of a close family friend was diagnosed as

> having " gluten sensitivity " and has been GF for the past 6 years.

> She just recently re-introduced gluten into her diet and is

> completely fine! The doctor told her that her sensitivity was caused

> by stress, and she can now eat gluten again. My parents feel that

> this case supports the " gluten allergy " belief/thought.

>

> I'm just really confused because everything this TOP doctor is

> saying seems to contradict everything I thought I knew about CD. I'm

> really perfectly fine being GF because I know that I'm healthy now!

> But this just throws me for a loop! Can someone help? Has anyone

> else heard this?

>

> I'd appreciate any comments on this!

>

> Sincerely,

> Gaines

>

>

>

>

>

>

>

>

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i would take them up on their offer to see Dr. Fasano, then I'd question him up

and down...funny, they sell those CD bracelets for research. What are they doing

with the money if they don't believe in it?? ;-)

I have to agree about the gene test, even if you have the gene it doesn't mean

you'll have CD. It just means you COULD get CD.

Bridget

________________________________

From: jjangel_23

Sent: Sun 2/20/2005 1:08 PM

To: SillyYaks

Subject: Re: Intolerance? Allergy? Can someone help clear this up?

ita-

My sister actually saw Swati Gadewar (a female dr). During their

visit, Karoly Horvath (a male doctor) came in to speak with my

sister and parents and told them everything I shared in my email.

Gadewar was in agreement with Horvath, who is the doctor who said it

isn't even worth it to get the genetic test done to see whether or

not you have CD b/c, as he says, he would bet money that you don't

( " you " meaning me, you, anyone with CD).Dr. Horvath is also the

doctor who said he would like to see me and he actually recommended

that I see Dr. Fasano, too. He seemed to give the impression that

the whole group of doctors-Fasano included- " preach the same thing. "

I appreciated your response, ita--exactly what I was thinking!

When my parents told me about their little excursion down to Univ.

of MD, I immediately went into a frenzy, going off about how they

saw one of those " bad " CD doctors who don't really understand, or

even believe in, CD! Aaagghhh! I'm so confused!

-

> Who was this " Top " doctor at the University of MD? Dr. Alessio

Fasano is

> the TOP doctor at University of MD and he would NEVER say those

things.

>

> ita

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> I read that a true allergy is where you have severe, life-

threatening results if you eat the food you are allergic to, and that

an intolerance means you can tolerate a small amount without getting

sick. Also, I met someone who " had " celiac disease and is now fine

and can eat whatever she wants. Who knows??? :)

>

An intolerance is a reactivity to a food in which some non-immune

chemsitry is involved. For example Phenylketouriacs are intolerant to

phenylalanine, Lactose intolerance means you lack a factors for

metabolizing lactose (whereas the bacteria in your gut do not, and

they go hog wild with the windfall of milk sugar -> CO2 -> Gas).

The intolerance of CD is the result of the reactivity of gliadin with

tTG therefore altering the nature of gliadin and the immunogenicity

of tTG. Why tTG misbehaves toward gliadin is unclear, but it has

something to do with intestinal damage. CD is perpetuated by the

gliadin/ tTG reaction cycle in DQ2.3 and DQ8 individuals via an

immune process.

Therefore

1. The Immune system is a mediator

2. tTG is a mediator.

3. DQ molecules mediate

4. Unknown factors mediate.

For other food allergies it appears that #2 tTG is not a mediator.

Therefore CD is an allergy with other added components that transform

the downstream responses to gluten.

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> First, I am not a doctor, but this is the way I understand it. (I

am a

> biopsy and serologically diagnosed celiac.)

>

> Celiac disease and gluten allergies are discovered by different

tests.

> Allergies are generally tested via " IgE " testing - classic allergy

testing.

> There are some who believe that IgG testing may further give

information to

> an " intolerance " that causes symptoms, but NO ongoing damage.

Celiac

> disease is investigated through anti-tissue transglutaminase IgA

testing

> (and anit-endomysial testing), and a small bowel biopsy showing

flattened

> villi and an increase in intraepethelial lymphocytes, and sometime

crypt

> hypoplasia. While allergies can cause GI symptoms, they are not

widely

> known to cause the specific intestinal damage that is associated

with CD. I

> have 1 daughter who is not celiac, but is gluten intolerant. (Her

blood

> work for celiac came back negative, and her biopsy was negative -

she is not

> IgA deficient.) She may grow out of this some day, but for now she

reacts

> quite negatively to any amount of gluten. I would hesitate to

allow her to

> try it again for some time. My other daughter and I are celiac.

>

> You can get good informationm from the University of Chicago Celiac

Disease

> Program. I am sure they would be happy to provide you with some

excellent

> sources of good, reliable information that is up to date. You can

do your

> own search on www.pubmed.com, and hopefully find some info to help

educate

> this Doctor, who is living in the dark ages of celiac disease.

Yep.

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My personal feeling is that there is no difference in the "allergic reaction to gluten" and gluten intolerance or celiac. I think it is just a problem with diagnosis of celiac. I went through the same song and dance and was never properly diagnosed by the endoscopy, but after having it done after being on the diet. Also, maybe the endoscopy was done incorrectly. According to Dr. Fasano, they need to go deeper into the small bowel and take 6 - 8 snips. My doctor forgot to do it the first time and then put me on the diet and later on did it again and only took 2 snips. Then there is the problem with the pathologist not being familiar with what they are looking at and misdiagnosing it. I really think the "allergy" "intolerance" is all one and the same but misdiagnosed.

I have personally asked Dr. Fasano what is the difference in the long-term effect on the small bowel with the "allergy" and "celiac" and he says they do not know yet. It could be just as damaging with the allergy as with diagnosed celiac. Again, I think they are all celiac, just misdiagnosed. One day we will know.

Dr. Fasano will be speaking at our support group meeting in Rockville, MD. on March 5th. That would be a good Q & A at the end.

ita

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>

> I actually agree with the " allergy " theory. It just goes to show

> that even the medical community is not in agreement about Celiac,

so

> why should we be? I think we're years away from a definitive test

to

> say someone is Celiac, or just gluten intolorent, or even just

> allergic.

>

> My own case seems to point to allergy.

>

> I was a perfectly healthy child and young adult. Normal height and

> weight, appetite and GI function. Suddenly at age 26 I began to

have

> problems.

>

> When I started gluten free diet, I felt better, but I never had a

> test. The natural health store (run by a U of MD pharmacist) I went

> to suggested I " temporarily " stop eating gluten. The idea being I

> could eventually re-introduce wheat into my diet.

>

> I plan to do that this weekend. I've been gluten free for 6 months,

> and feel fine, but I want to test my own body. I know it may sound

> suicidal to some of you, but I don't trust the medical community to

> diagnose things anymore. I will just listen to what my body tells

me.

>

> I'll keep you posted.

Gluten challenge was a diagnostic methodology once applied to CD, up

and until it was found that CD was a caustive agent of other

autoimmune diseases and lymphomas. In a recent review it was

questioned whether gluten challenge was an intelligent thing to do.

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