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Why Am I Not Getting Better?Why Am I Not Getting Better?
Gluten Intolerance Group of Greater DallasGluten Intolerance Group of Greater DallasSaturday July 21, 2012Saturday July 21, 2012
byby
Ron Overberg, Ph.D., C.C.N., R.D., L.D. Ron Overberg, Ph.D., C.C.N., R.D., L.D.
(Certified Clinical Nutritionist and Registered Dietitian)(Certified Clinical Nutritionist and Registered Dietitian)
Why Am I Not Getting Better?Why Am I Not Getting Better?
• The latest numbers indicate that as many as one in every 5 people have some form of gluten-sensitivity. Eur Rev Med Pharmacol Sci. 2010 Jun;14(6):567-72
• Key point:
• After an average of 12 years on a GFD, 31% of patients still have increased inflammation in their intestines. Gut 2005;54:769-774.
Why celiac disease is underdiagnosed in the US
• Under-performance of small bowel biopsy during endoscopy may be a major reason that celiac disease remains underdiagnosed in the United States, physicians did a small bowel biopsy in only 43 percent of the more than 13,000 patients having an endoscopy during this 6 year period.
• Men were less likely to have a biopsy as compared to women. This may provide a clue to understanding a long-observed curiosity: the lopsided gender ratio among patients with celiac disease.
Why gluten-free may not be healthyPosted on June 28, 2012 by Stone Hearth News
• Are products labeled “gluten-free” healthier?
• Take a good hard look at those labels.
• “Just because a product says it’s gluten-free doesn’t mean it’s healthy,” he said.
• The gluten-free product likely contains as many calories as gluten options, Haub said, because a gram of sorghum, corn or rice flour appears to be metabolically similar to a gram of wheat flour.
ARRAY 3WHEAT/GLUTEN PROTEOME REACTIVITY &
AUTOIMMUNITY
Why Array 3 Testing?
• Present multiple symptoms complaints (CFS, FMS)
• Abnormal immune cell count and function
• Blood-brain barrier permeability, depression, autoimmunity
• Thyroiditis, Arthiritis, Myocarditis, Dermatitis, Endocrinopathy, Polyendocrinopathy, Osteoarthritis, Pernicious Anemia
• Complain of chemical hypersensitivity
• Always go over the health history, over and over again!
POSITIVEREACTIONTO:
GLUTEN-REACTIVITY
WHEAT &GLUTEN-REACTIVITY
WHEAT-SENSITIVITY
LECTIN-SENSITIVITY
AUTOIMMUNEREACTION
Wheat
WGA
•-Gliadin15 MER
•-Gliadin17 MER
•-Gliadin33 MER
•-Gliadin17 MER
Glutenin21 MER
GluteomorhpinProdynorphin
Gliadin-tTG2 Complex
tTG2
tTG3
tTG6
Client 1, age 6
Client 1, age 6
• Gluten Sensitivity Gene TestHLA-DQB1 Molecular analysis, Allele 1 0301
HLA-DQB1 Molecular analysis, Allele 2 0502
Serologic equivalent: HLA-DQ 3,1 (Subtype 7,5)
Interpretation Of HLA-DQ Testing: Although you do not possess the main HLA-DQB1 genes predisposing to celiac sprue (HLA-DQB1*0201 or HLA-
DQB1*0302), HLA gene analysis reveals that you have two copies of a gene that predisposes to gluten sensitivity (any DQ1, DQ2 not by HLA-DQB1*0201, or DQ3 not by HLA-DQB1*0302). Having two copies of a gluten sensitive gene means that each of your parents and all of your children (if you have them) will possess at least one copy of the gene. Two copies also means there is an even stronger predisposition to gluten sensitivity than having one gene and the resultant immunologic gluten sensitivity may be more severe.
Client 1, age 6 (adult ranges)
Client 2, age 21
Client 3, age 43
Client 4, age 17 (adult ranges)
Client 5, age 13, Gluten Addiction, (adult ranges)
ARRAY 1MUCOSAL GLUTEN REACTIVITY SCREEN
• Total Secretory IgA• Alpha-Gliadin IgA + IgM• Transglutaminase 2 IgA + IgM
• A quick, convenient test before there is mucosal damage
When To Use Array 1• Do you have mucosal abnormalities? (The mucosal lining is
the tissue which lines various passages and cavities exposed to the air - such as the mouth, nose, GI tract, vagina. and the lungs. It is the first, the earliest response of the immune system to allergenic foods.)
• Are you suspected of having Gluten Sensitivity or Celiac Disease
• Do you have relatives with Gluten Sensitivity or Celiac Disease • Do you have a family history of autoimmune Disorders• For those unable or who refuse to do a more comprehensive
blood test• For clients not responding as expected to any health concern• Saliva is the best way to detect gluten sensitivity early, even
before symptoms manifest. The gut has to be severely damaged in order for a blood test to be dependable. Because it uses a saliva sample, this test is easy to use with children
Secretory IgANative + DeamidatedAlpha-Gliadin-33-mer
IgA + IgM
Transglutaminase - 2IgA + IgM
Mucosal Immunity Gluten Reactivity Autoimmunity
Oral Fluid Assessment for Mucosal Immune Response to Gluten.
ARRAY 2INTESTINAL BARRIER HEALTH
ASSSESSMENT
• Actomyosin Network IgA• Occludin/Zonulin IgG, IgA, IgM• Lipopolysaccharides IgG, IgA, IgM
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The pathways of antigen invasion through Paracellular and Transcellular routes.
Breakdown of Actomyosin Network
Tight Junction Dysfunction
©Cyrex Laboratories, LLC
Client 5, age 13, (adult ranges)
Client 3, age 43
How and why did you get “leaky”
• Gut flora imbalance
• Followed by antibiotics
• Stress (Divorce, work, tractor, exercise)
• Poor digestion and allergies (gluten)
• Pharmaceuticals, aspirin
• Not enough sleep
“Leaky” Can Contribute To:
• Gluten sensitivity and celiac disease
• Food allergies (chicken or the egg?)
• Inflammatory bowel disease (UC, Crohns’s)
• Autoimmune diseases (RA, JRA, Psoriasis, Type 1 Diabetes, Hasimoto’s, SLE (80+))
• Neurological conditions (MS, Guillian Barre)
• Cognitive Dysfunction (depression, anxiety, schizophrenia, brain fog, etc.)
• Others (CFS, chronic yeast overgrowth)
Vitamin D3 – Role in Health
• Who knows their Vitamin D3 level?
• Who takes Vitamin D3?
• How to get Vitamin D3 from the sun?
• When do you take your Vitamin D3?
Recent Vitamin D Articles
• 25 (OH) Dà 1,25 (OH)2D3 ”the hormone”
• D and T-cells inhibit Th1 and Th2
• D and B-cells inhibit AB secretion and AutoAB production
• D inhibits antigen presenting by macrophages and dendritic cells
• D promote monocytes to macrophages and modulates their inflammatory response
• D multiple immunosuppressant properties
Vitamin D3 – Essential!
• What is your 25-OH Vitamin D3 level?
• What form do you take?
• How much do you take?
• It is so simple, why not take it?
Healing the Intestinal Tract: Total Load
• Support its function
• Structure – nutrients to repair
• Inhabitants - Use “Kill Agents” and beneficial organisms
• Avoidance: Foods, pollens, grasses, trees, algae, pesticides, herbicides, chemicals.
• Pharmaceuticals
• Stress reduction. Stop keeping up with the Joneses!
• Get enough sleep
Healing the Intestinal Tract: Support
• Immune 26, an egg powder which produced by repeatedly immunizing chickens with at least 24 inactivated bacteria including Shigella dysenteriae, Staphylococcus epidermidis and simulans, Escherichia coli (E. coli), Salmonella enteritidis and typhimurium, Pseudomonas aeruginosa, Klebsiella pneumoniae, Haemophilus influenzae, and at least 6 species of Streptococcus.
• IgG 2000DF, a highly concentrated, non-dairy source of serum-derived immunoglobulin antibodies and immuno-proteins
Healing the Intestinal Tract: Support
• Colostrum, provides transfer factor, Proline-Rich Polypeptides, lactoferrin and other immune factors
• Proline-Rich Polypeptides (PRPs) are an isolate from Colostrum. These stimulate the immune system to produce cytokines that regulate the duration and intensity of the body’s immune response. They balance over and under activity of the immune system.
• Transfer factor
Healing the Intestinal Tract: Structure
• Protein
• L-Glutamine
• Fats, inc. EPA / DHA
• Butyric acid
• Vitamin A
• Sialex (mucin)
• N-Acetyl Glucosamine
• Colostrum
• Vitamin D
• Probiotics
• Zinc carnosine
• Mastica
• Aloe Vera
• DGL, deglycyrrhizinated licorice
• Slippery Elm
• Marshmallow
• Okra
• Chamomille
• Irish Moss
Healing the Intestinal Tract: Flora
• Garlic
• Oregano
• Olive leaf
• Black Walnut
• Uva Ursi
• Caprylic acid
• Tanalbit
• Curcumin
• Beneficial bacteria
• Aloe vera
• Berberine
• Grapefruit seed extract
• Cranberry extract
• Monolaurin
• Cat’s claw
• Artemisinin
• Cranberry extract
• S. Boulardi
Healing the Intestinal tract: Avoidance
• Drugs:
• Medicines example: Aspirin
• Chemicals
• Foods
• Fungi, Molds, Yeast
• Food allergens: wheat, dairy, nightshades. Any food is a possibility!
• All allergens lower your tolerance!
ARRAY 4GLUTEN-ASSOCIATED CROSS-REACTIVE
FOODS and FOODS SENSITIVITY
• Cow’s Milk• Alpha + Beta-
Casein• Casomorphin• Milk Butyrophilin• Whey• Chocolate (milk)• Gluten Grains• Oats
• Yeast• Coffee• Sesame• Buckwheat• Sorghum• Millet• Hemp• Amaranth
• Quinoa• Tapioca• Teff• Soybean• Egg• Corn• Rice• Potato
POSITIVE REACTION TO:
DAIRY-SENSITIVITY
IN VITROCROSS-REACTION TO α-GLIADIN
NEWLYINTRODUCEDFOODS ON GFD
OVER-CONSUMED ON GFD
SPECIAL COMMENT
Rye, Barley, Spelt, Polish wheat*
Cow’s Milk
•-Casein +•-Casein
Casomorphin
MilkButyrophilin
Whey Protein
Chocolate (milk)
Oats
Yeast
Coffee
Sesame
Buckwheat
Sorghum
Millet
Hemp
Amaranth
Quinoa
Tapioca
Teff
Soy Common food allergen
Egg Common food allergen
Corn
Rice Cross-reacts to wheat, but not gliadin
Potato
Client 1, age 6
Client 6, age 17
ARRAY 5MULTIPLE AUTOIMMUNE REACTIVITY
SCREEN• Parietal Cell +
ATPase• Intrinsic Factor• ASCA + ANCA• Tropomyosin• Thyroglobulin• Thyroid Peroxidase• 21 Hydroxylase• Myocardial Peptide• α-Myosin
• Phospholipid • Platelet
Glycoprotein• Ovary/Testis• Fibulin• Collagen
Complex • Arthritic
Peptide• Bone
• Cytochrome P450
• Insulin + Islet Cell
• GAD 65• Myelin Basic
Protein• GM1• α+β Tubulin• Cerebellar• Synapsin
Why Array 5
• 25% more likely• à Among 374 children in whom Celiac Disease was diagnosed before the
age of 2, 5% developed an auto-immune disorder while on a gluten-free diet. Of those who went gluten-free, had years of no symptoms, then went back on a gluten-containing diet, 3.65% prevalence of systemic auto-immune disease with less than 12 months of eating gluten 9.1 % prevalence for 13-36 months of eating gluten again, 26.3% prevalence for > 36 months of eating gluten again.
•• à This means 1 out of 4 people who were sensitive to gluten, went
gluten-free, eliminated all of their symptoms, and then began eating gluten again developed auto-immune diseases within 3 years. Gastroenterology 1999;117:297-303
• Autoimmune disorders occur 10 times more commonly in the Gluten Sensitive Enteropathy Celiac Disease than in the general population.CMLS, Cell. Mol. Life Sci. 62 (2005) 791-799
GASTROINTESTINAL
• Parietal Cell + ATPase
• Intrinsic Factor
• ASCA + ANCA
• Tropomyosin
HEART
• Myocardial Peptide
• α-Myosin
• Phospholipid
• Platelet Glycoprotein
THYROID
• Thyroglobulin
• Thyroid Peroxidase
ADRENAL
• 21 Hydroxylase (Adrenal Cortex)
REPRODUCTIVE ORGANS
• Ovary/Testis
MUSCULOSKELETAL
• Fibulin
• Collagen Complex
• Arthritic Peptide
• BoneNEURONAL
• Myelin Basic Protein
• Asialoglanglioside GM1
• α + β Tubulin
• Cerebellar
• Synapsin
LIVER AND ENDOCRINE
• Cytochrome P450
• Insulin + Islet Cell
• Glutamic Acid Decarboxylase 65
4949
Questions?Questions?
Ron Overberg, Ph.D., C.C.N., R.D., L.D. Ron Overberg, Ph.D., C.C.N., R.D., L.D.
(Certified Clinical Nutritionist and Registered Dietitian)(Certified Clinical Nutritionist and Registered Dietitian)
Certified Gluten Practitioner Certified Gluten Practitioner
NutriWellness & Environmental Health Center NutriWellness & Environmental Health Center -- DallasDallas
Email: Email: [email protected]@nutriwellness.com
Phone: 972 239Phone: 972 239--11481148