MedWire News: Poor growth in children with coeliac disease (CD) could relate to the pituitary gland, Italian study findings suggest.
Children newly diagnosed with CD were more likely to be positive for anti-pituitary antibodies (APA) than those without the disease.
Testing positive for APA correlated with restricted height, and the researchers speculate this is mediated by a reduction in insulin growth factor (IGF)-1.
The possible autoimmune involvement of the pituitary gland in patients with CD has only been demonstrated in a few patients on a gluten-free diet, say Maurizio Delvecchio, from IRCCS Casa Sollievo della Sofferenza in San Giovanni Rotondo, and colleagues.
They recruited 119 patients aged up to 16 years who had CD and attended an inpatient clinic, and compared them with 98 gender- and age-matched control individuals.
APA, all of class IgG, were detected in 50 (42.0%) patients, 15 with high titre defined as detectable at a dilution of at least one in 16, and 35 with low titre detectable at less than one in eight dilution.
This compared with detectable low titre APA in just two controls, the authors report in the American Journal of Gastroenterology.
IGF-1 levels were significantly higher in patients negative for APA than in those with either a low or high titre. APA patients with a high titre were also shorter than in those testing APA negative.
Height was positively correlated with IGF-1 and negatively correlated with the age of individuals. IGF-1 was positively correlated with body mass index.
Alessio Fasano and Debra Counts, from the University of Maryland Medical Center in Baltimore, USA, comment in an editorial accompanying the study.
They write: “Given the strong association of CD with other autoimmune disease, including autoimmune endocrine disease, these authors’ findings show one possible etiology for the poor growth seen in children with CD.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
DEPRESSION & CD/GLUTEN SENSITIVITY
Patients
with depression are told they have a chemical imbalance.
If someone else in their family is also depressed, the “gene card” is played.
“Your depression is genetic”, they are told.
I have been in practice for over 20 years and I find the above data to be
false.
Consistently we find patients who are suffering from depression and anxiety
to be gluten sensitive.
How could a food cause depression? Let’s take a look.
After the digestive tract, the most commonly affected system to be affected by
gluten is the nervous system.
It is thought that depression can be caused by gluten in one of two ways.
The first area addresses the inflammatory changes gluten can cause.
A gluten sensitive individual’s immune system responds to the protein gliadin.
Unfortunately, that protein is similar in structure to other proteins present
in the body, including those of the brain and nerve cells.
A cross reactivity can occur whereby the immune system “confuses” proteins in
the body for the protein gliadin. This is called cellular mimicry and the
result is the body attacking it’s own tissues with inflammation resulting. When
inflammation happens in the brain and nervous system, a variety of symptoms can
occur, including depression.
Research shows us that patients with symptoms involving the nervous system
suffer from digestive problems only 13% of the time. This is significant
because mainstream medicine equates gluten sensitivity almost exclusively with
digestive complaints.
In a study examining blood flow to the brain, 15 patients with untreated celiac
disease were compared to 15 patients treated with a gluten-free diet for a
year.
The findings were amazing. In the untreated group, 73% had abnormalities in
brain circulation by testing while only 7% in the treated group showed any
abnormalities. The patients with the brain circulation problems were frequently
suffering from anxiety and depression as well.
In addition to circulation problems, other research looks at the association
between gluten sensitivity and its interference with protein absorption.
Specifically the amino acid tryptophan can be deficient.
Tryptophan is a protein in the brain responsible for a feeling of well-being
and relaxation.
A deficiency can be correlated to feelings of depression and anxiety.
Our society is too willing to accept a “chemical imbalance” as an explanation
for their symptoms and instead of getting to the root cause of the condition,
simply swallow a pill – a pill that in the case of anti-depressants has very
dangerous and sometimes lethal side effects.
The frequency with which we are able to successfully taper patients off their
anti-depressants is considered “unbelievable” to many mainstream doctors, yet
we do it regularly.
How is that possible? We actually diagnose the root cause of the depression.
Frequently the culprit is gluten, and in such cases a gluten-free diet is the
main path to recovery.
Publ Dr. Vikki Petersen D.C, C.C.N published 03/2/2009
27th July 2010 – The charity Coeliac UK says there’s widespread misdiagnosis of the condition. It carried out a survey of more than 1,600 of its members and found that nearly 60% of them had previously been incorrectly diagnosed with irritable bowel syndrome (IBS) instead of being tested and diagnosed with coeliac disease.
The charity says one in 100 people in the UK have coeliac disease, an auto-immune condition caused by gluten intolerance. Left untreated by the diet it can lead to osteoporosis, infertility and bowel cancer.
The survey also found that nearly 60% of people had also been diagnosed with anaemia without being tested for the cause.
Other conditions that had been diagnosed instead of Coeliac disease included anxiety and depression, ‘holiday tummy’, gastroenteritis, gallstones, duodenal ulcer, ME (or chronic fatigue syndrome), appendicitis and hypochondria.
The survey also asked for how long they had visited their GP with coeliac symptoms before they were diagnosed. For 23%, it took 11 years or more to be correctly diagnosed. For a further 11%, it took 20 years.
32% of those surveyed thought GPs’ knowledge about coeliac disease was poor or very poor.
Coeliac UK launched its survey in 2009 just as the National Institute of Health and Clinical Excellence (NICE) issued guidance on coeliac disease.
Sarah Sleet, Chief Executive of Coeliac UK says in a news release: “It is too early to tell if the NICE guidelines are improving diagnosis rates but as a charity we are receiving around 1,000 new member requests a month from people who have just been diagnosed. But with around 500,000 people currently undiagnosed in the UK there is still a long way to go and it will be another 30 years at the current rate of progress before we crack the problem.”
“The NICE guideline is an important first step but we need a sea change in practice among GPs.”
SOURCES:
Coeliac UK news release.