Saturday, November 25, 2006
GLUTEN INTOLERANCE AND YOUR PET
By John B. Symes, D.V.M
"Chomp, chomp, chomp, chomp....GULP. Slurp, slurp, slurp, slurp....BELCH." This is the sound of "Fido" eating his scientifically formulated, well-balanced dog food. It can be purchased at the grocery store, but the discerning owner travels to the local pet shop to buy the better quality food. Most people know that you get what you pay for in a pet food and that the higher grade foods come from certain recognizable manufacturers and can only be found at specialty pet supply outlets. But, is that axiom true? Does purchasing the most expensive food guarantee that your pet will be receiving the best in nutrition that the industry has to offer?
The unfortunate truth is that pet food is not as scientifically formulated as most would like to think. For the most part, Fido's food is made with convenience and cost of manufacturing in mind more than science. Yes, the first few ingredients look appetizing enough and there are essential nutrients such as vitamins and minerals added to the mix. But are these ingredients natural for the pet and are they readily available for absorption and use by their body? Here in lies the crux of the matter.
The wake-up call comes when one realizes that once the meat source is removed from the diet, the remaining ingredients are mostly unnatural for the pet. If we exclude the beef, poultry, fish, and lamb, the remaining calorie sources are mostly wheat, barley, corn, rice, and oats, all of which are man-raised crops that the dog and cat would never consume in the wild. I love to inquire of my clients "How would a pet get rice? Swim to Viet Nam?"
But what is the problem with these complex carbohydrates being in the diet? Humans consume these with every meal and they are doing just fine, aren't they? Ahhhh. Are we? If we were, those reading this paper would be reading something else right now, wouldn't they? The problem is that the grains listed above have some universal problems among humans and pets alike, as do a couple of other problem foods that eclipse even the grains in health issues.
To digress for just a moment, I am a recovered celiac. For forty-something years, I suffered like most other celiacs of a myriad of symptoms, including allergies, heart burn and intestinal problems, depression/chronic fatigue, memory and balance difficulties, joint pain, and even fibromyalgia. I was taking at least four drugs twice daily; caffeine addicted, and was quite frankly not having any fun anymore. I am now two and a half years gluten AND casein-free, off all drugs, symptom-free, and feeling better than I did when I was twelve. This miraculous recovery got my attention as a patient and as a doctor. How could this be? How could I be suffering from what millions of people and pets were experiencing but be well in such a short period of time? How could all of these conditions be linked together?
The readers of www.celiac.com and its publications have read many a testimony like this. Many have experienced similar responses while others are still wondering when wellness is going to happen to them. Those in the latter category have been trying to faithfully adhere to the gluten-free regime but are frustrated by the fact that they are making such huge sacrifices with less than optimal responses.
Well, "Fido" is about to teach you something. The fact is that the celiac is a "who's who" of what is wrong with human beings but the conditions that we suffer from are not limited to those who walk upright. When I read the list of conditions that we as gluten intolerants experience, my first thought was that "This is me. This describes me to a T." My second thought was "...but this describes everything that is wrong with everyone, including their dogs and cats." And it does. Suddenly, medicine through the eyes of celiac disease (and other similar food intolerances) made sense. I tell everyone that it was like someone had finally put the right program into a stalled computer and it began operating at lightning speed. All of the idiopathic conditions that are so poorly understood in medicine became "open season" for this medical headhunter.
And, the answers did come one after another. I launched into two years of intensive research while applying the newly unveiled principles to my patients as well as myself. Miracles started happening around me. Allergies abated, intestinal problems cleared up, older pets became less painful and more active, and yes, even their epilepsy stopped. "Wait a second! Epileptic seizures stopped?", you may be asking. Yes, 100% of my epileptics have stopped having seizures, just like many celiac children that were placed on gluten-free diets have responded. I got the idea from the celiac literature. How that occurs is totally explainable but beyond the scope of this article. It can be found in my paper entitled The Answer on my Website, www.dogtorj.net.
In a nutshell, after all of my research into so many of the medical problems and conditions that plague pets and mankind, I decided that the center of our health universe lies in that "J-shaped" stretch of intestine known as your duodenum. Most celiacs are aware of the pathophysiology of their condition and are familiar with the terms malabsorption and "leaky gut syndrome". But, many are like I was in that they don't understand all of the fine details.
There are three food ingredients that adhere to the villi of the duodenum and induce the change that is characteristic of celiac disease known as villous atrophy. These three substances are gluten (from the grains), casein (from cow milk products), and soy protein. Oh oh. Did you know that the last one was on the list? Hopefully so.
What is it that links these substances together? For one, they are all use as adhesives, either as non-food glues or as binders in the foods we consume. Gluten, casein, soy and even corn are all used in industry as adhesives, some even being waterproof. Put "gluten", "casein", "soy protein adhesive" or "corn adhesive" in the search engine of any computer and read the responses. Wow! They are not only used in the food industry to hold items such as oats together but they are put to use in industry to hold just about anything together.
As we all know, it is the nature of the starches to be sticky. And, as it turns out, the foods that are the "stickiest" are the ones that cause the most problems. This should not be a surprise once this issue is introduced. Casein and gluten are used for the most powerful adhesives. Therefore, it should be not be a shock that they are the number one and number two childhood food allergens according to the FDA. What is number four? Soy. What is number three? Eggs. (This is the first secondary allergen brought about by the damage done to the gut by the first two.)
Now, imagine these proteins leaving the stomach of a human or their pet. I have always used the illustration of three slices of pizza leaving our stomach. But, for this sake of this article, I will use a wheat, barley, or soy-based pet food to drive the point home. Now that you have an idea of where we are headed, you can imagine the stomach is filled with "glue-containing" food. This "glue" leaves the stomach after it has been worked on as much as possible by that organ. Of course, not being a ruminant like a cow or sheep, these foods are not completely broken down any more than the cellulose that they eat that non-ruminants are unable to digest. As simple-stomached animals, our pets and we are not designed to eat grasses like the ruminants do and all of the grains are in the grass family. They are all grasses that man has chosen to consume, with those in Asia picking their grass (rice), the Europeans choosing their grasses (wheat and barley), and those in central America picking corn. Here in America, we consume them all and in abundance.
In an attempt to digest these grasses and their "glue" (along with dairy and soy), our stomach adds as much acid as possible to break them down. Heart burn, anyone? (Yes, my two years of acid reflux abated after just one week of being gluten- free. This, again, should be no surprise.) But, the increased acid is inadequate to eliminate the "glue". It is this sticky substance that adheres to the villi of the duodenum. Whether it be from wheat, cow milk, soy, corn, or the others mentioned, it adheres to these finger-like projections of the intestine that are vital for the absorption of nutrients, effectively reducing the amount of those essential ingredients that would be absorbed into the bloodstream.
What are those nutrients? The vital substances are calcium, iron, iodine, all B complex, vitamin C, most water-soluble vitamins, and most of our trace minerals such as zinc, boron, manganese, magnesium and more. In other words, just about everything that is important other than our proteins, fats, and calories are absorbed by the duodenum. How well can this organ function when it is coated with "glue"? The important thing to realize here is that this happens to everyone and every pet that eats these foods.
That bears repeating. This happens to everyone and just about every simple-stomach creature that eats these foods. We have simply focused on the worst-of-the-worst.... as in the celiacs, casein intolerants, and soy intolerants...in which an immune response is mounted against the glue leading to severe villous atrophy. This immune assault also generates the warning antibodies that we call "allergies" to tell you that this is process is taking place. Otherwise, it would be a "stealth operation" that goes on undetected for years and years until the bottom falls out. Yes, this is all too familiar of a scenario as well, isn't it? It happens in pets all of the time, I'm afraid.
So, the ultimate question is whether pets suffer from celiac disease? My answer is that it doesn't really matter. In the pet, every bite of the average commercial food has "glue" in it, whether it is of wheat, barley, soy, corn, or rice origin. Yes, there are better glues" than others and they are in line with what we see as the principle allergens in the pet, just as one would expect. Wheat and soy are the worst (now that dairy has been eliminated from pet foods) while oats and rice are the best...the least sticky. Corn is in the middle. This is exactly what we see as the main sources of food allergies in the pet, a problem of huge importance in dogs and cats. Now people can understand why lamb and rice foods have become so popular. Rice is the least of the adhesives and thereby less allergenic and lamb is (or at least used to be) an unusual protein source compared to beef and others, which have become the main secondary allergens in the pet. It does all make sense.
But celiac disease has occurred in the dog. It has been definitively identified in one breed, which is almost extinct now.... the Irish setter. This hapless breed was effectively sent the way of the buffalo when the industry added wheat, the number one dog and cat food allergen, to the pet foods about 15 years ago. Thanks to the wheat glut in this country, corn-based diets were quickly replaced with wheat and the subsequent decline in our pet's health began. Veterinarians found themselves wondering why the immune system of the dog and cat were having such problems, ranging from worsening allergies to a rapid rise in immune-mediated diseases. The answer was right before us: you don't add the number one dog and cat food allergen to the diet without having some major repercussions. The veterinary profession was just as shortsighted as the medical profession is today about the ramifications of consuming the top food allergens as the bulk of the diet. 60-70% of the American diet is comprised of cow milk products and wheat alone, with 40-50% being the number one food allergen, dairy products. There is a price to pay for this sort of ignorance and it is heavier than most realize.
The main cost is the disruption of duodenal function. Once the essential nutrients have been malabsorbed for a long enough time, Pandora's Box is opened. This may occur every early in life or very late, partly governed by the degree of immune-mediated component. The worst of the worst will experience severe problems by the time they are adolescents while the more resilient will not be affected until late in life. But, as I tell my clients, I believe that with the top three foods...wheat, dairy and soy...it is a matter of when they cause problems, not if. The "glue" will eventually affect everyone and every pet with it' nutrient-blocking qualities.
Suddenly, conditions such as hip dysplasia, elbow and shoulder problems, intervertebral disc syndrome, cruciate ligament ruptures, and even heart valve failure all have better explanations. All of these problems are caused by failing cartilage and connective tissue, both of which are structured similarly and made up of calcium and collagen. Collagen is the building block of most of your skeletal support structures. The principle component of collagen is vitamin C. Therefore, when it is understood that calcium and vitamin C are absorbed by the duodenum, then it is easily seen that inadequate amounts of these in the diet or failure of their absorption will compromise the integrity of these structures...all of them.
Imagine that a German shepherd puppy begins eating a wheat, barley, corn, or soy-based diet from the moment it is weaned. If inadequate levels of calcium and vitamin C are absorbed, what are the chances that its hips, elbows, spine, and other cartilaginous structures are going to form properly? I would say "Not good". Most people familiar with dogs know that this breed has a reputation for horrible hip dysplasia. But, they also have serious allergies and other immune-related disorders. This, of course, is no coincidence. Once it is understood that the allergies form in the area of the gut that is being damaged or coated by the "glue", it is easy to see why the trouble breeds like the German Shepherd, Cocker Spaniel, Shih Tzu, and others have their "genetic" tendencies such as allergic skin and ear problems, orthopedic abnormalities, intervertebral disc ruptures, and cancers. Once again, Pandora's Box is opened and unleashed upon these poor breeds through one basic mechanism: malnutrition via malabsorption taking place in the duodenum.
I used to be concerned that the veterinary profession had somehow missed the incidence of celiac disease in breeds other than the Irish setter. But, now that I understand the effects of the "glue" on the absorptive ability of the duodenal villi, I believe this possible oversight to be much less important. I believe the same to be true for humans. The "glues" affect all that consume them. Certainly, the "worst of the worst"...the celiacs, casein intolerants, and soy intolerants...have the most to be concerned about. But, with these trouble foods, it is a matter of when they will create a problem, not if. Those who test negative for these food intolerances should not be lulled to sleep with a false sense of security. These fortunate souls will just be healthier longer. This is clearly one of the things that make us individuals, placing us on a spectrum of wellness that ranges from serious illness during the first year of life to a clean bill of health well into the twilight years. The same is true of our pets.
One important determinant will be the length of time it takes for an individual to deplete their reserves of these vital nutrients. We must realize that a condition like osteoporosis is an end-stage result of chronic calcium deficiency and that there existed less identified but significant symptoms that preceded this dreaded outcome. Certainly we can affect the pace of these syndromes through supplementation and eating correctly in other regards. However, if we continue to consume the blocking agents, the "glues", I am afraid that we will eventually lose the battle.
If we don't understand this, it is a matter of when...not if.
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John B. Symes, D.V.M graduated from Auburn University’s School of Veterinary Medicine in 1979. He then completed a 14 month internship at Angell Memorial Animal Hospital in Boston in 1980. Following his academic studies, he entered private practice in which he has been involved for the past 26 years. He is has practiced in Massachusetts, South Carolina, and California and now owns and operates a small animal practice in Mobile, Alabama. Dr. In April of 2000, Symes discovered that he suffered from celiac disease (gluten intolerance), the diagnosis of which changed his entire life. Following his remarkable recovery from a myriad of long-term symptoms, he plunged into medical research in a desperate attempt to fully understand how such diet changes could have such a profound effect on chronic illness. In doing so, he discovered that his veterinary patients responded in the same fashion to this new elimination diet (“The G.A.R.D.”) and began a major campaign in his own profession to raise awareness of these issues. On the Internet, Dr. Symes is known as “DogtorJ”, as he offers consultations through two Websites that bear this name. He now speaks to both veterinary and human medical groups concerning the vital relationship between diet and health. www.dogtorj.net
Tuesday, November 21, 2006
Celiac Disease and Obesity—There is a Connection by Melissa Croda
Copyright © 1995-2006
This article appeared in the Winter 2006 edition of Celiac.com's Scott-Free Newsletter.
Celiac.com 07/10/2006 - Three years ago my father was diagnosed with celiac disease and I was told by my mother that it is hereditary and that I too should get screened for it. I did some research and immediately knew that I had this disease. I wouldn’t admit it to anyone at the time because how on earth could I possibly live without pasta and fresh-baked bread for the rest of my life?! You should know that I have been sick for my entire life—I had colic until I was six, got ulcers when I was eight, appendicitis at 14, calcium bone spurs at 17, 19, 24 and 36, infertility at 24, gall stones at 37—just to mention a few of the conditions I’ve had that were likely related to my untreated celiac disease.
About six months later I decided to go see my doctor—I was in a severe state of depression, and I had lost the ability to think—much less talk. Carrying on a full conversation was nearly impossible because of my inability to speak in full sentences. I was extremely sick with a severe cold, and I had an infection or the flu at least once each month for the preceding two to three years. I told my doctor that I thought that he should test me for celiac disease. Since I weighed in at over 300 pounds he literally laughed at this idea. According to him there was absolutely no way that I could have celiac disease—because I was fat!
Shortly after that my parents came to visit and tried to talk me into eating gluten-free—at least during the time that they were here. I agreed because I had to cook gluten-free for them anyway. Within three days of starting a gluten-free diet I felt like a million bucks. My depression lifted and within a month I was losing weight and my brain started working again. I have been gluten-free for three years now—not only do I feel like a million bucks, but I have lost over 100 pounds. I shudder at the idea that I was literally eating myself to death—and it was not because I didn’t have any will power or that I was eating "bad" food—it was because my body couldn’t process and absorb the food that I was eating. My personal experience, combined with my research, has left me completely convinced that celiac disease is (and will continue to be) a significant cause of obesity—and that this will continue to be the case until there is a better understanding of the disease and its relationship to obesity.
What is Celiac Disease?
Celiac disease is a permanent intolerance to gluten1, which is a protein found in, wheat, rye, and barley. When gluten is ingested the digestive system is unable to properly break it down, and an autoimmune response is triggered in the gut that causes the villi of the small intestine to become damaged—leading to malabsorption of crucial nutrients. There is no cure, and the only way to control it is through a 100% gluten-free diet.
The disease has a vast array of symptoms, and it is rare that two people will exhibit the same ones. Some will have diarrhea while others will have constipation, and some will not have either but instead may have osteoporosis, diabetes, headaches, fatigue, autoimmune thyroid disorder or any number of other conditions and symptoms found to be associated with it. In many cases these symptoms are associated with the inability to gain weight—children with celiac disease are often small and fail to thrive 1.
Nearly every source that I consulted for this paper referred to malabsorption and how most people with celiac disease lost weight or couldn’t gain weight. Only a few sources even mentioned obesity—and when they did it was only in passing. As celiac disease awareness steadily increases and more research is done on it hopefully it will become apparent that many cases of obesity are also related to it.
The Common Thread
Autoimmune thyroid disease has recently been linked to celiac disease. Recent research has demonstrated that 3.4% of patients with autoimmune thyroid disease also have celiac disease2. The thyroid gland secretes hormones to control the body’s metabolic rate3, and to accomplish this it must have iodine. When celiac disease is present along with autoimmune thyroid disorder, the body does not have the ability to absorb the iodine to produce the necessary hormones. Additionally there are many different disorders such as obesity, diabetes, allergies, weight-loss, gastrointestinal problems, etc., that can be caused by having a damaged or compromised thyroid gland3 (all of these disorders, by the way, can be related to celiac disease). It has been known for years that obesity has been linked to thyroid problems, and that the thyroid "produces 5-monodeiodinase, the body’s natural method of conserving fuel during shortage,” and the body “elicits the same physical reaction as famine,” which can then cause the affected person to gain weight3.
Another disorder commonly associated with celiac disease is malabsorption, which can also lead to malnutrition. When someone with celiac disease eats foods that contain gluten it results in damage to the surface of the small intestine and destruction of their nutrient-absorbing villi. This can lead to leaky gut and an inability for them to absorb vital nutrients from their food. By continuing to eat foods containing gluten, eventually vital organs including the brain, thyroid, liver, kidneys—essentially any organ that depends heavily on nutrients—will be starved, which will leave them susceptible to other diseases and conditions. I personally experienced brain malfunctions, gall bladder problems, and was diagnosed numerous times with an under-active thyroid. Naturally treatments for this proposed thyroid condition didn’t work because their true cause had not yet been found. At one point a doctor asked me to consider the idea that my obesity was the result of my body’s attempt to cope with malnourishment4. This phenomenon is similar to yo-yo dieting, where dieters who have deprived themselves or proper nutrition for too long gain weight at faster rates than non-dieters after they resume eating normally. I always thought that I had fallen victim to "yo-yo dieting," and that I had dieted myself into a permanent state of obesity. I now understand that it was because I had undiagnosed celiac disease, and my body was actually malnourished.
Under normal nutritional conditions humans only absorb about 80 percent of the nutrients from the food they eat, and the rest of the nutrients pass through the body4. With celiac disease, however, the body is unable to absorb the necessary nutrients, which causes some people’s bodies to become a super-efficient machine that begins storing as much fat as possible in order to survive. This nutrient deficiency "convinces" the body that it is starving to death, which sends it into starvation-mode. Since humans need a certain percentage of body fat reserves to stay alive—and because it takes more work for the body to burn fats than carbohydrates—a body that is in starvation mode tends to crave carbohydrates and more efficiently convert them to fat for later use4.
There has been much research that links celiac disease to diabetes. Diabetes occurs when the body’s cells are unable to absorb enough blood sugar5. Although the cause is different, the resulting malabsorption is similar to that seem in celiac disease—although in the latter the malabsorption is not just limited to sugar. The connection between diabetes and celiac disease as described by Marschilok:
"Both diseases have genetic and environmental origins. This means an individual is more at risk of developing either problem when a close relative also has it. On the genetic side, development of one reveals the pre-existing and larger risk that the genes for the other may be present. At least two genes and gene locations are connected with each disease. One gene for each disease is near one gene for the other on the same chromosome. Nearby genes are more likely to pass together to offspring.
However, while the genes are necessary, they are not sufficient to produce the diseases. On the environmental side, researchers know gluten is needed to produce celiac disease, but they also know it's not the only environmental cause. With diabetes, the environmental causes are being extensively studied for prevention and cure. Roughly ten percent of celiacs either have Type I diabetes or might develop Type II diabetes6" .
An astonishing 40% of people with diabetes are also obese—even though there was not very much in the way of medical research to indicate why this is so. Diabetes is described as your cells’ inability to produce or absorb insulin, which leads to an excess of sugar in the blood stream7. If a person injects or produces too much insulin it will increase the level of hunger and cause obesity. I personally find this information disturbing as there are some in the medical community who still blame obesity on character flaws—I can’t begin to tell you how many times I have been told: "if you just didn’t eat so much you wouldn’t be fat".
A number of overweight and obese acquaintances of mine have asked me how I managed to lose over 100 pounds and look so healthy while doing it. I explained my celiac disease diagnosis and gluten-free diet to them, and how the diet has made me not feel hungry for the first time in my life—due to the fact that I am now absorbing nutrients properly. Six of these extremely obese people have actually gone to their physicians to get tested for celiac disease—and each was met with the same skepticism as me. They persisted and finally got their doctors to perform the necessary tests—and to the surprise of all each were diagnosed with celiac disease! Immediately after going on the gluten-free diet they all experienced a decrease in hunger and massive weight-loss. For the first time they were eating only when their bodies were truly hungry, instead of eating too much due to starvation signals caused by malabsorption.
This could also be part of the reason that high protein, low carbohydrate diets work so well for many people. By removing the carbohydrates from one’s diet you generally remove a large portion of the gluten as well, which can cause those with celiac disease who are obese to loose weight quickly—at least for a month or so. However, on the high protein diet you are still not removing all gluten which will eventually cause them to gain the weight back—even though they are still on the diet. This was my experience with the low carbohydrate diet, and I suspect that a lot of others who are obese and have undiagnosed celiac disease had or will have the same experience.
I once had a family member literally yell at me about my weight and ask me why I was being so selfish and not thinking about my husband and daughter—they told me that I should just lose the weight. I was devastated, I truly had tried every diet on the face of the earth and each and every time I would loose 20-30 pounds quickly (regardless of the type of diet), only to gain it back (while still following the program)—sometimes as much as two fold! Since being diagnosed with celiac disease three years ago I have not only lost the weight but I have also kept it off, and each week a little bit more comes off. I am completely convinced that celiac disease does and will continue to be a common cause of obesity until the medical community—through scientific research—realizes that there is a connection.
Many obese people might not be overweight if they were just properly diagnosed and treated. Certainly it is not the case that all obese people are that way because they just plain eat too much and do not have any will power. I suspect that there are better medical reasons to explain most cases of obesity, and celiac disease is just one of them. Not too long ago it was estimated that celiac disease only affected 1 in 10,000 Americans8. That figure was then revised to 1 in 5,000, and now, after much research, it is at least 1 in 133. The actual diagnosis rate, however, is only about 1 in 5,000, which is only a small fraction of those who have it. Similarly, the causes of obesity in America are not fully understood, and more research needs to be done to determine just how many cases of obesity are caused by untreated celiac disease. I believe that a significant percentage of obese people have undiagnosed celiac disease, and that celiac disease screening should be part of ordinary blood workups for all obese people.
Adams, S. (May 2005). A Celiac Disease and Gluten-Free Resource since 1995. Retrieved May 18, 2005, from www.celiac.com.
Collin, Kaukinen, Valimaki & Salmi, (2002). Endocinological Disorders and Celiac Disease, Endocrine Reviews (pp 1-38).
3. Life Extension, Thyroid Deficiency, Online reference for Health Concerns. Retrieved May 26, 2005 from www.lef.org/protocols/prtcls-txt/t-prtcl-1
Balley, L. (June 2004) Obesity in Developing Countries Compares to U.S. Yo-Yo Dieting. Retrieved June 16, 2005 from: http://www.eurekalert.org/pub_releases/200
Katz H., (2005). Hope for Obesity and Diabetes. Retrieved June 19, 2005 from http://www.reporter-archive.mcgill.ca/Rep/
Marschilok, K., (1997). Diabetes and celiac Disease. Gluten-free Living.
Hoover, J., (2001). Obesity Causes Diabetes–Fat Chance! Diabetes Health Magazine. Retrieved June 19, 2005 from http://www.diabeteshealth.com/read,1009,21
Vogren, C.L., (September 15, 2003). Awareness Can Be Best Medicine: Parents who lost son to celiac disease want to shed light on often-overlooked ailment. The Gazette. Retrieved June 19, 2005 from http://www.csaceliacs.org/CDintheNews/COSp
Friday, November 03, 2006
God grant me the serenity
to accept the things I cannot change -- Lay's potato chips will always be there;
courage to change the things I can -- run from the room in which they reside;
and wisdom to know the difference -- the difference in my ankles from water retention.
Per the nutritionist: it takes 3 days to recover from heavy salt intake. Sigh. I did it again. I'm an addict.
Friday, November 03, 2006
I forgot how to make a blog entry - kept looking for the link, but I had to "edit" to find it! Der.
Anyheww, my CT scan was negative for lung cancer or TB. It's nice to be safer than sorry, so I'm glad to know. On another note, I remembered about 13 years ago after having a bad case of bronchitis getting an x-ray. The doc told me "has anyone told you you had an enlarged heart?" Well, no. I didn't followup with that either. Just kept it in the back of my mind.
So I call up the Scan place and ask for the doc to ask if he could look and see. Well, the first doc Nibley was a "substitute", so I talked with the regular doc (Satanic - but spelled differently!). He said yes, indeed, I should go see a cardiologist to make sure the valves are okay. I DO continue to have palpitations since going gluten free, but they're not as often. Well, good thing I thought to bring it up. I guess if you're there for lungs, they only look at lungs? Hmmm. Talk about having to be your own advocate!
Saturday, October 07, 2006
I was naive and thought today's CT scan was benign like a digital xray, and that all I'd have to do was sit there.
I had to sign release forms about using the Ultravist iodine solution and barium solution. Wha? I had no idea. I'm going to "Google University," and I would have been researching the hell out of that! I didn't know what to do ... but decided in the end that the purpose of my going was to find out if my chronic cough was due to lung cancer.
I asked repeatedly to Keith, the CT tech, if the solution had gluten. He said others had asked the same thing and it was fine. I asked if he even knew what gluten or celiac was, and he said NO! I told him I was concerned because I had a friend with hypothyroidism with an iodine allergy, and I was hypothyroid. He said - there's no gluten. (Later called that friend to tell her about my reaction, and she told me there's no connection to thyroid and iodine allergy ... um, my mistake!)
I drank the Readi-Cat 2 Barium Sulfate Suspension drink and it tasted a bit like an orangesicle. Five minutes after starting the IV, my throat was itching, and I started wanting to sneeze - I didn't want to sneeze in the middle of "holding my breath" -- so I plugged my nose with my free hand (rt). The solution going through my body was kinda cold through the veins, yet also very warm in your "warm" places - I felt like I had to pee ... kinda. These are things they should tell you! He did tell me it should take 12 hours to get out of my body by urination (97% by urine, 2% in poop).
They ended the test (hope they got what they needed cause it had to only be 5 minutes), and when I was righted from my reclining position, I promptly started sneezing 3x in a row. My nose became clogged and I needed to blow my nose (and I was embarrassed to do so with the doctor watching my every move) -- esp with my magombas without a bra (no underwire allowed during scan of course). He took my pulse, then got a stethascope. I told him I was having palpitations, which I occasionally have, due to vitamin deficiencies I presume. He had the scope on my chest, but said he didn't hear anything (even when I felt a palpitation)? My head was in a slow motion dizzy spell - I was woozy.
The doc, Dr. Nibletts?, checked my blood pressure with a small cuff - I asked him what it was and he said 160something over 80. I said that was way high for me - I'd just had it taken with a small cuff at the doctor's office 2 days before, and it was 124/80 or 120/80. He was looking for a larger cuff, but didn't or couldn't find one. He said he was looking to make sure it wasn't too low anyway. Then he had Keith put 50ml or ccs? of liquid Benadryl in my IV - I asked if it was gluten free! He said yes.
So, I had an allergic reaction. If I do this in the future, I'm to premedicate with Benadryl to prevent this from happening. What about a hypoallergenic dye? I will google! DH had to pick me up and take me home as the doc wouldn't have me driving in my condition. Good advice, though of course, I wanted to drive anyway (much like an alcoholic would want to). I acquiesced, as we both agreed: better safe than sorry.
And I will look into a medic alert bracelet! "Help, I've fallen and I can't get up" is getting closer to me all the time! lol
For those wondering about iodine and shellfish allergies: from www.womansdiagnosticcyber.com (I think):
Allergies are a serious business. Sometimes a skin rash is the main manifestation of an allergy but it can also range from gastrointestinal upset to asthmatic wheezing and even to death (1). People who are allergic to one compound may also have other allergens they are sensitive to. For some reason certain allergies get linked together even though they may be totally unrelated. This is what has happened with iodine and shellfish. There is no actual relationship between iodine allergy and the various seafood allergies. You could have a reaction to both iodine and to ingested crab, but it is much more likely that you are not truly allergic to either.
A true food allergy such as that to shrimp or crab starts within about thirty minutes after ingestion. The reaction is to a muscle protein in the food. Since a true allergic reaction can be life-threatening, intravenous glucocorticoids, antihistamine and sometimes subcutaneous epinephrine is required just like a bee sting kit for people allergic to bees (2). To know for sure about both the iodine and the crab, you should see an allergist and at least be skin tested or use one of the home tests using IgE antibodies to see.
Most allergies to xray contrast media are to the specific media itself, not necessarily the iodine component. It just so happened that when most of the allergies to xray contrast dyes were initially reported that all of the dyes contained iodine in some form so it was assumed that the iodine was the allergen. There are also allergies to non-iodine containing contrast media which are almost as common as to the iodine containing ones. Therefore you have to have a skin test to the specific contrast media to know for sure.
Does an allergy to iodine mean I cannot have iodized salt?
No, it does not. Iodine is a natural element and part of many proteins in the body. Iodized salt is not known to cause an allergic reaction. Even if you have a skin sensitivity to iodine containing products, you can still ingest iodized salt without worry.
Iodine contact allergies are sometimes seen to providone-iodine (Betadine®) scrub used as surgical preps. In one study, 10 people who had skin reactions to providone-iodine were further tested and only one was found to be skin allergic to the iodine, 5 were allergic to the providone-iodine solution itself and the other 4 just had direct skin irritation reactions but not allergic responses (3).
Iodinated contrast material used in certain x-ray studies has the same variability as far as true allergic responses. One study of 165 people who had reactions to iodine containing radiographic contrast material identified only 2-3% who had true allergic responses as measured by IgE antibody response (4).
Is a shellfish allergy the same as an iodine allergy
An allergy to shrimp or crab or salmon, for example, has nothing to do with allergy to iodine. A person could be allergic to both but the allergy to shrimp is due to a protein in the shrimp, not to iodine.
Identified seafood allergens belong to a group of muscle proteins, such as the parvalbumins in codfish and salmon and tropomyosin in crustaceans (shrimp, lobster and crabs). In addition, tropomyosin is a cross-reactive allergen among crustaceans and mollusks such as oysters and scallops (5). Eating the seafood is not the only way to have an shellfish allergic reaction; it has also been reported to be air-borne in places such as a fish market (6).
If I am allergic to shrimp, am I likely to be allergic to other seafood?
Yes. There are some seafood allergies that tend to run together(7). People allergic to shrimp may also be allergic to crab, lobster, clams and oysters. Salmon, trout and mackerel allergy may frequently occur together just as does cod and tuna, and octopus and squid.
The most accurate way to find out what one is allergic to is through skin testing by an allergist. If someone seems to have multiple seafood allergies, however, the true test is to be given the actual food in a double-blind, placebo-controlled food challenge, administered under the care of an allergist or other physician (8). Blood tests for food antibody specific IgE are not quite as accurate as skin tests or food challenges, however you do not have to be exposed to the allergen (and its probably allergic response) in order to be diagnosed.
Why can I sometimes eat shellfish and other times I get quite sick?
Not all reactions to seafood are allergies to the seafood protein itself. In fact a parasite called anisakiasis which frequently contaminates seafood is a major cause of gastrointestinal upset that many people interpret as a food allergy. This parasite is killed by deep freezing the shellfish so if you find you can tolerate shrimp that has been frozen but sometimes get sick eating fresh shrimp, it may be the parasite contamination rather than a seafood allergy (9, 10).
Also, you may just be having a show of food intolerance and not an allergic response. Food intolerance and food allergies are NOT the same. A food allergy that stimulates the immune system to cause a serious reaction such as:
hives, itching or skin eczema
swelling of the lips, face, tongue and throat, or other parts of the body
wheezing, nasal congestion or trouble breathing
dizziness, lightheadedness or fainting
is much more serious than a food that your body may be sensitive to resulting in nausea, vomiting, cramping and diarrhea but not a true allergic response.
What is food intolerance?
Food intolerance is a direct irritation of the body by a food or associated chemical or toxin rather than one which stimulates the body's own immune system to attack itself. Food intolerance may be due to the lack of an enzyme such as lactose which results in many people having a problem eating milk, ice milk or other milk products without becoming bloated along with cramping, diarrhea and excess gas. Sometimes food may contain a toxin from bacteria that causes you to react adversely. This does not mean that you cannot ever eat that food again; it just means you should not eat that food when it is contaminated again. Mushrooms, rhubarb, and spoiled tuna or other fish are foods more likely to be come contaminated with toxins. It can be very difficult to differentiate an intolerance to the food itself or to a substance or ingredient used in the preparation of the food. This is especially true of foods containing lactose, wheat or sulfites. For example, wheat can cause a food intolerance but it also can cause an immune allergic response known a celiac disease or sprue.
On the other hand, if you are truly allergic to a food such as:
even a small amount could give you a serious health reaction. If you suspect that any food is causing you a serious allergic response, be sure to see an allergist to have it diagnosed thoroughly. Skin tests for allergies are considered the best way to diagnose an immune response but sometimes you may have much less of a reaction by just having a blood test known as an in-vitro allergen-specific IgG or IgE antibody test. The home tests use a drop or two of blood from a finger stick which check IgE allergic sensitivities.
Does an iodine allergy mean I cannot have xray dyes?
Again no, it does not. But you need to let the radiologist know about the iodine allergy. Sometimes the dye used can be switched to a non iodine containing contrast material and at other times it may just be suggested to have a skin sensitivity allergy test to the actual dye to be used if there is not a suitable substitute dye available.
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