Celiac Disease Underdiagnosed in 90% of Cases?

That’s the case according to U of T prof Ahmed El-Sohemy, whose research suggests that celiac disease is very much underdiagnosed in Canada, as with other parts of the world including the US and the UK.

When he took blood samples from over 2800 people, he found that celiac disease occurs in 1% of Canadians–that’s a similar frequency to other countries in the world.

What wasn’t similar was that this frequency of occurrence did not match the frequency of diagnosis. El-Sohemy estimated that 90% of the 1% go undiagnosed.

What does that mean in numbers? For Canada, a population of 35 million people means there are approximately 350,000 people with celiac. The same 1% as most places.

But if 90% of them are undiagnosed, then 315,000 of these people don’t know they have it.

What is celiac disease?

Celiac disease is an autoimmune condition. That means your own immune system is attacking a part of your own body. In the case of celiac, when a person eats gluten, that gluten activates the immune system in their digestive system and their immune system then attacks and destroys the intestinal lining.

The result is obvious symptoms such as abdominal pain, bloating, gas, and diarrhea. But the damage to the intestinal lining also results in poor absorption of nutrients. As a result, patients with celiac can have weight loss, failure to thrive, anemia and other complaints associated with nutrient deficiencies. In fact, whenever a patient comes to StoneTree clinic with unexplained iron deficiency anemia, this is one of the first culprits we consider.

Are celiac disease and gluten intolerance the same thing?

Nope.

Celiac disease is an autoimmune disease. The gluten activates the immune system to attack the person’s intestines.

Gluten intolerance is an inflammatory response to the gluten itself–the immune system sees the gluten as the problem and attacks it, creating inflammation. Why this happens is still not totally understood.

Theories include:

  • Wheat hybrids have been bred to have more gluten and therefore more antigenic.
  • We eat too much gluten so the inflammatory reaction never has a chance to die down.
  • Wheat GMO’s (round-up ready crops) create wheat that is irritating to the immune system.

How do you test for celiac disease?

For celiac disease, the gold standard for diagnosis is an intestinal biopsy to look for tell-tale signs of damage.

This way of testing has its limitations. First, the patient needs to go to a hospital, get sedated and have a piece of their intestines removed via scope–no fun at all. Also, the patient needs to be actually eating gluten or you could go through all that trouble and get a false negative result.

Other tests for celiac include blood tests for the auto-antibody. This is easier, but also the patient also needs to be eating gluten to ensure that there is not a false negative.

Gluten intolerance can be tested by looking for an IgG antibody in the blood.

You can also test using an elimination diet. Whether you have celiac or a gluten intolerance, an elimination diet can give your own body a chance to tell you if you have a problem with gluten without relying on a test to tell you. If you have GI symptoms like symptoms such as abdominal pain, bloating, gas, diarrhea, constipation and you suspect gluten might be the culprit – just remove it from your diet for 28 days and left your body talk to you. If gluten is an issue you will know, no blood test or biopsy needed. It’s simple and cheap, but not necessarily easy!

For more information on testing, contact the clinic anytime at 705-444-5331, or book online.

Need help with gluten-free foods? Check out The pantry at StoneTree Clinic. All foods, including pre-prepared meals, are gluten- and dairy- free.

World Diabetes Day: What’s Your Sugar Status?

World Diabetes Day started in 1991 and has been celebrated on November 14th every year since. It was initiated by the World Health Organization (WHO) and the International Diabetes Federation (IDF) in response to the rapid rise of diabetes incidence around the world.

This year, World Diabetes Day focuses on Women with Diabetes, and for good reason:

  • There are currently over 199 million women living with diabetes. This is projected to increase to 313 million by 2040.
  • Two out of every five women with diabetes are of reproductive age.
  • Diabetes is the ninth leading cause of death in women globally.
  • 1 in 7 births is affected by gestational diabetes.
  • 2% of live births to women in 2015 had some form of hyperglycemia in pregnancy.
  • Approximately half of women with a history of gestational diabetes go on to develop type 2 diabetes within five to ten years after delivery.
  • Half of all cases of hyperglycemia in pregnancy occur in women under the age of 30.

These are some sobering statistics, and they don’t begin to cover it all. Diabetes can lead to nerve damage, kidney failure, and blindness. If you have diabetes, your risk of developing heart disease is twice that of the rest of the population, and you’re more susceptible to depression and infections.

Diabetes is dangerous. But it’s also a largely treatable and more importantly preventable disease. In fact, according to the IDF, more than 70% of type 2 diabetes could be prevented through the healthy lifestyle.

Where do you begin? Diabetes is a lifestyle disease, and naturally, food and movement are key.

Eat right. Eat foods that nature makes, mostly plants, not too much. It really is as simple as that. If a food package is making a health claim, be suspicious. The foods sitting in the veggie aisle with no claims and no packaging are where your diet should be focused.

Start with these 10 recipes that will save your life!

Exercise regularly. You don’t need to be a marathon runner to get the diabetes prevention benefit of exercise. Walk every day for 30 minutes. It’s all you need to do to make an enormous difference.

Test your blood sugar. Find out if your blood sugar is a problem before it’s a problem–testing your blood sugar regularly can give you an idea if your body is heading down the diabetes track.

Blood sugar tests look at the following:

  • Fasting blood sugar. This is the test we are all very familiar with. We fast overnight and get our blood taken first thing in the morning. Any value over 6.0 mmol/L should get your attention that you may be heading down the wrong track.
  • Hemoglobin A1c. This test measures how much sugar is attached to the red blood cells. The more that is attached, the more likely you are not getting the sugar out of your blood fast enough. Because the lifespan of the RBC’s is around 3 months, this test gives us an idea of what your AVERAGE blood sugar has been over a 3 month period. Values over 6% are a sign that things are not going well.
  • Two-hour post-prandial blood glucose. This test measures how well your body deals with sugar within 2 hours of eating it. If your blood sugar is over 7.8 mmol/L 2 hours after eating the sugar, you could be heading down the wrong track.

Interested in learning about your blood sugar levels? Tests are inexpensive, and we can take your blood sample right here in the clinic! Book online, or call 705-444-5331 for more information.

Decreasing Heart Attack Risk by Tackling Inflammation

Recent research in the New England Journal of Medicine looked at 10,000 patients who had had a heart attack AND a positive hsCRP result. (This is a blood test for inflammation.)

All of the patients received high doses of statins, which is the present standard of care, then they were split into two groups. Half of the patients received an injection every three months of a drug called Canakinumab, the other half received a placebo injection of normal saline. This trial went on for four years.

Canakinumab is a form of anti-inflammatory medication. It’s used predominately in those with rheumatoid arthritis. But according to the research, when you give it to people with heart attack risk you get some interesting results:

  • 15% reduction in risk of a cardiovascular event like a fatal or non-fatal heart attack or stroke
  • 30% reduction in the need for expensive interventional procedures like bypasses or stents
  • No change in death rates in the 2 groups.

You can read some mainstream coverage of the news here, including the impact on cancer rates.

The short story? Reducing inflammation is good for your health, in particular your heart.

What’s the Catch?

All of this sounds like good news, and in theory, it is. But nothing comes for free. The problem with Canakinumab is that it decreases inflammation by suppressing the immune system. That means patients who take it may be more susceptible to infections, require increased healing time if injured.

Enter the Better News

Chronic inflammation is often lifestyle-related. A poor diet, being sedentary, being over-stressed and under-slept, smoking and/or exposures to other toxins—all of these things contribute to your overall inflammatory set point. And the magic of lifestyle issues is that they can often be fixed without medication.

Dealing with inflammation is a big part of what Naturopathic Doctors do. We have written about it often, and dealing with it in some form or another is a common part of our treatment plans.

It stands to reason that dealing with and improving your inflammatory lifestyle challenges would be helpful in decreasing inflammation. If you could reduce your risk without the need for intense anti-inflammatory medicines that suppress your immune system, wouldn’t you want to?

The starting point is easy. Finding out if inflammation is a problem for you is as simple as a quick and inexpensive blood test called hsCRP–the same one used in the study. All you need to do is get started!

For information on hsCRP testing or inflammation reduction, book online or call 705-444-5331.

Get Those Kids Moving!

A new study published in the Frontiers of Physiology in July offers a glimpse into the possible long-term importance of getting our young ones moving.

The study fed a group of baby lab rats a high-fat diet and then separated them into three groups. One group was denied exercise for their whole life, one group was denied exercise until they were adults, and the last group was allowed to exercise from the very beginning.

  • The researchers found that early exercise positively impacted the way the rat’s metabolism responded to the high-fat diet. They were able to transform fat into energy more effectively. This effect lasted for 60 days after the exercise stopped. No big surprise here.
  • But, the interesting part was that early exercise decreased overall inflammation as an adult. Even though the rats still all got fat from a diet that was too calorically rich, they did not seem to have the same negative health effects of a high-fat diet without exercise.

Clearly, kids aren’t rats, and no one is going to run a lifetime study denying humans exercise (although the fact that 1 in 10 kids meets the physical activity guidelines suggest we might be working towards it, sadly.)

But although it might be difficult to know what the long term studies will tell us for sure about humans, while you’re waiting there’s almost zero downside to getting kids moving!

This is one time when it’s probably quite reasonable to compare your kids to rats. 🙂

Reflux Meds: the Good, the Bad and the Ugly

Last month, the medical journal BMJ Open published research linking the use of PPI’s, or proton-pump inhibitors, with increased risk of death.

PPI’s are frequently used to treat serious gastrointestinal issues like ulcers, GI bleeds and reflux, and are one of the most commonly used classes of drugs. They’re a powerful tool, but research continues to show that long-term use is a bad idea.

PPI’s are generally meant to be short-term prescriptions, but people often end up taking them for months or years to control symptoms, especially in the US where they’re available over the counter in various forms.

According to the study, however, the longer the drugs are used, the higher the risk of mortality. Past research has also linked this class of drugs to kidney damage, dementia, and bone fractures.

The moral of the story? Take it when you need it and no more!

But My Digestive Issues are Ruining My Life!

GI issues can be extremely challenging to live with. It’s no wonder people turn to whatever works. But there are other solutions for many sufferers. Issues of the gastrointestinal tract are where naturopathic medicine shines, and there are many ways to treat upper GI complaints without prescription medications.

The place to start, of course, is your diet. That may seem obvious, but astonishingly, this is still frequently discounted in conventional medicine. Despite the fact that your entire GI tract exists to deal with food, we seemed determined to not see food as a GI issue. It is.

Here are a few suggestions from the naturopathic toolkit:

  • Food intolerances and inflammatory foods are real culprits here. Get yourself tested, and avoid reactive foods strictly.
  • Avoid coffee, cigarettes, and booze. They all stimulate acid secretion and an inflammatory response. If you are doing these things and also NOT eating, that makes things worse. You are stimulating the digestive tract and not putting anything in it–a double whammy.
  • Cultivate a healthy flora. Probiotics and foods that support healthy flora, like fermented foods, keep the digestive tract working well and help prevent H.pylori and other imbalances of GI bacteria that can cause trouble.
  • Talk to your chiropractor or osteopath. Sometimes the “valve” that keeps the contents of the stomach in the stomach gets stuck open. This can be made worse by sitting too much. An adjustment can get things back in line.
  • Better still, as always, stay active and maintain a healthy weight for your body type.

Digestive issues are among the most challenging to diagnose, and they often mean difficult lifestyle changes, at least in the short term. But compared to the side-effects of long-term PPI use, the sacrifices are small!

To uncover your food intolerances, or get to the root cause of your digestive troubles, book an appointment with one of our Collingwood naturopathic doctors. 

Whooping Cough Prevention and Treatment

In the last week, we have seen a couple of little ones show up with confirmed cases of whooping cough.

Whooping cough, or pertussis, is an infection of the respiratory tract caused by the bordetella pertussis bacteria. It starts out looking like the common cold–runny nose, fever, mild cough. This is then followed by severe coughing fits, sometimes with the characteristic “whoop” sound at the end of the fit. These coughing fits can go on for 10 weeks, giving it the nickname “the 100-day cough”.

You can hear the sounds of pertussis here.

But…I thought we had vaccines for pertussis?

Whooping cough is actually the second most common infectious childhood disease in Canada, after influenza. It’s endemic, meaning it’s always around, but it usually doesn’t show itself much–just in minor periodic outbreaks.

This isn’t unusual–the vaccine isn’t perfect. It’s estimated to have about an 80-85% effectiveness after three doses, and that effectiveness wears off over time. As a result, whooping cough re-emerges occasionally.

For an in depth look at the research on this, Dr. Suzanne Humphries, MD does a good job of outlining the issues. It is a long article but worth the read if you are a worried parent.

Prevention of Pertussis

Vaccination is currently the prevention method of choice. It is part of the infant vaccination schedule, which is important. There is a 0.5% mortality rate in infants under 1 year of age who contract pertussis. Before regular pertussis vaccination, moms who contracted the infection in childhood would be immune to it when they had their babies (a natural infection confers immunity for over 30 years). When they breastfed their babies they little ones would get the benefit of that immunity from their mothers.

Many mothers now have been part of public vaccination programs and their immunity is likely to have worn off, resulting in increased risk. A blood test can show if mom is immuno-competent.

Treatment

Conventional treatment is generally antibiotics, but they generally have very little positive effect. In fact, more and more evidence is coming forward about the negative effect of using antibiotics, especially when they are not needed. We’ve written about this before.

As naturopaths, we like to support the immune system in its efforts to deal with the infection, and Vitamin C is the core treatment tool.

The pertussis bacteria makes a “toxin” that is at least partly responsible for the lung symptoms. Vitamin C does a pretty good job of neutralizing that toxin. Again, Dr. Humphries does a great job discussing this issue. In our little ones, we use oral dosing, but in our teens and adults with the “100 day cough” weekly to bi-weekly treatments can decrease the duration of the illness.

Remember: If you are suspecting whooping cough in your child it is very important to seek assistance from a regulated health professional.

World Hypertension Day

The international society of hypertension initiated World Hypertension Day in 2005 and has promoted it yearly ever since.

Why?

Hypertension–you might know it better as high blood pressure–is called the silent killer because people who have it often don’t know it. And it’s a big deal, because the risk of stroke is four times greater in those with high blood pressure, and the risk of a heart attack is two times greater. Put it this way: as your blood pressure increases above the normal range, so do your chances of dying.

So what to do?

First of all, understand your risk. Then make sure you know what your blood pressure is. Normal range is 120/80 to 140/90. If it’s over 140/90 visit your health care provider.

Next, prevent or reduce hypertension. The biggest causes are lifestyle factors such as physical inactivity, a diet high in processed and fatty foods, and alcohol and tobacco use.

Hypertension is largely preventable and treatable through lifestyle change. The list should sound familiar:

  • Lose weight
  • Eat foods that nature makes – LOTS of fruits and veggies
  • Exercise regularly
  • STOP SMOKING
  • Drink alcohol sensibly – no more than 2/day for men and 1/day for women

What about salt? The connection between salt and hypertension is a story that’s been told for decades, but, as we’ve written about before, the connection is more complicated than it seems. A better approach? Focus on cooking your own meals and eating lots of whole food–good nutrition and exercise are the best tools you have.

If you’re curious about your cardiovascular health or have questions about lifestyle changes, contact the clinic anytime at 705-444-5331 or feelbetter@stonetreeclinic.com.

Heart and brain walking

Memory Issues? More Evidence that Exercise Helps

We have written endlessly about the value of exercise for overall health.

If you read through the research, it comes up over and over again. It’s good for our hearts. It helps moods. It keeps our bones strong. It keeps our weight stable. It even makes our brains bigger.

Here is more evidence to suggest it also makes our memory better.

In this study, they took women between 70-80 years old, all of whom were complaining of memory problems, or as the researchers referred to it, Mild Cognitive Impairment (MCI).

These women were divided into three groups. One did aerobic exercise, one did strength training and a third was a control group. The treatment groups engaged in activity twice a week for 60 minutes.

Compared to controls the treatment groups both had improved verbal and spatial memory, with the best gains being in the group who did the aerobic activity.

The findings make sense. Move the body, move the blood, get more oxygen to the brain, as well as more fuel and nutrients for the old thinker to work.

But this might be the most important takeaway: “aerobic activity” wasn’t intensive marathon training. It was a 60-minute walk outside at 60% of max heart rate TWICE a WEEK. That’s basically a brisk-ish walk.

The average Canadian spends dozens of hours a week in front of conventional TV and the web combined, consuming media of one type or another. Converting just TWO of those to walking seems like an achievable goal.

Migraines and Bacteria in Your Mouth

New research out of the University of California San Diego School of Medicine points to a potential link between certain bacteria in the mouth and the incidence of migraine headaches.

The bacteria, Rothia mucilaginosa and Haemophilus parainfluenzae, actually convert nitrates (found in chocolate, wine, and cured meats) into nitric oxide (a powerful vasodilator in the body).

These two bacteria are part of the normal flora of the body, but when given an opportunity they can cause trouble. (Just like another critter we know, candida albicans, which causes yeast infections!) The researchers suggest that the production of nitric oxide by these bacteria may be the cause of the migraines by increasing vasodilation in the head.

Of course, more research needs to be done to confirm this theory, but it’s yet another example of why a healthy microbiome is so important to our overall health.

Balanced flora keeps opportunistic bacteria in check and playing nice. When things get out of balance from antibiotics, hormones, chemical exposures and stress, it can throw the bacterial balance off and lead to all kinds of health complaints.

How to Support a Healthy Microbiome

  • Eat plenty of fermented food and fiber. This feeds our microbiome and helps to re-populate it.
  • Get outside and get your hands dirty. Garden, stack wood, rack leaves, move rocks.  Exposure yourself to nature and the wonderful bacteria that live it in. This inoculates our microbiome with lots of healthy critters.
  • Avoid antibiotics when you can, and take a probiotic when you can’t. Much research now has demonstrated the benefits of taking a probiotic, especially after and exposure to an antibiotic. Taking at least 10 billion for 2 weeks post antibiotics is a no brainer.
  • Lay off the antibiotic soaps. They’re not helping.

Ditch the Antibacterial Soaps

Last week the FDA announced that the use of antibacterial agents in soaps will no longer be permitted in the US.

Why?

The manufacturers of antibacterial soap products have failed to establish that they are any more effective than just regular soap and water, and there is also some question of their safety. There are 19 different ingredients on the list including triclosan and triclocarban, which have been linked to microbial resistance and hormone disruption.

Health Canada has not followed suit with this ban, though we hope they do in short order. In the meantime, read labels and vote with your dollars. Avoid all products with these ingredients in them.

The 19 banned ingredients are:

  • Cloflucarban
  • Fluorosalan
  • Hexachlorophene
  • Hexylresorcinol
  • Iodophors, which are iodine-containing ingredients
  • Iodine complex, which is ammonium ether sulfate and polyoxyethylene sorbitan monolaurate
  • Iodine complex of phosphate ester of alkylaryloxy polyethylene glycol
  • Nonylphenoxypoly, or ethyleneoxy, ethanoliodine
  • Poloxamer, an iodine complex of Povidone-iodine 5 percent to 10 percent
  • Undecoylium chloride iodine complex
  • Methylbenzethonium chloride
  • Phenol greater than 1.5 percent
  • Phenol less than 1.5 percent
  • Secondary amyltricresols
  • Sodium oxychlorosene
  • Tribromsalan
  • Triclocarban
  • Triclosan
  • Triple dye

Alternatives are easy to find. Visit our local farmers’ markets, Georgian Health Foods, Good Health Mart, The Environment Network, Creemore 100 Mile Store, From the Blue House in Creemore for a wide array of safe and natural soaps and skin care products.