Yesterday I attended a presentation by a local Ph.D in Biochemistry regarding balancing women’s hormones and mood, and while she has great success treating her clients with blood analysis only, she states that saliva testing is never appropriate. Unfortunately, this blanket-type statement may not be fully correct, as there is documented validity of salivary testing in certain circumstances, and this discrepancy in understanding further illustrates the misunderstandings of functional vs. traditional allopathic medicine.
While blood (serum) testing has long been the “gold standard” for traditionally accepted medical testing and medical disease, recent developments, technology and understanding have brought other testing methods to the playing field. These include urinary metabolites and salivary testing. This testing is not intended to be a replacement or substitute for serum (blood) testing, but rather that it allows for the assessment of different functionality, for different criteria.
Tuesday January 7th at 1:30pm and 5:30pm at The Athletic Club at the Westin in Avon, Colorado
Informational presentation by Dr. Jacqui Slavin D.C.
Cardiologist Bill Davis MD author of Wheat Belly, and Neurologist David Perlmutter MD author of Grain Brain, reawakened the discussion of how wheat and gluten affect our health by specifically addressing the link to heart disease and brain degeneration. Many people are still confused about Celiac Disease, gluten sensitivity, and grains and whether it is just a fad or an important dietary concern.
This presentation aims to dispel some of the confusion by reviewing the physiology of high cholesterol and brain degeneration presented by the authors, as well as a explaining in greater detail why gluten and wheat seem to be of increased concern in the past few years.
Dr. Jacqui Slavin D.C. is a local functional medicine and nutrition expert who has lived in the valley for 17 years and understands the goals of both locals and destination guests, and the requirements for our active lifestyle.
By focussing on the underlying cause versus just reducing the symptoms, Dr. Slavin is passionate about helping people to optimize their health by combining both natural and traditional medicine, as well as focusing on preventative therapeutic lifestyle medicine.
Specialization in common health concerns includes high cholesterol, thyroid imbalance, weight-loss, digestive dysfunction (gas, bloating, heartburn, constipation, diarrhea), food sensitivities, and hormone imbalance (PMS, menopause, infertility).
Dr. Slavin participates in community education classes on gluten, thyroid, brain health, weight-loss and other topics, and has presented for the Eagle County Parkinson’s Support Group; Eagle, Edwards and Vail Rotary Clubs; Walking Mountains; Fresh Approach – bringing healthy foods to Eagle County Schools, and other local organizations, and as an adjunct faculty member at Colorado Mountain College teaching Anatomy and Physiology and healthy cooking classes.
Every day we are learning more about the benefits of adequate levels of Vitamin D, and this often raises concerns about how much
we should supplement on a daily basis, and what our goal for blood levels should be. Monitoring of Vitamin D blood levels is
important when supplementing to support a metabolic process or disorder, and should not be done without the care of a trained
Vitamin D also behaves more like a hormone than a vitamin, and is often called a pro- or pre-hormone. Research confirms that
Vitmain D functions as a unique hormone that can modulate pain and inflammation, support blood sugar regulation, cardiovascular
health, immune system function, as well as mood modulation. While low to moderate levels of Vitamin D in the blood can help to
prevent the severe skeletal disorder Rickets, higher concentrations of this fat soluble molecule have been shown to be effective /
preventative for several types of cancers. Serious disorders such as Multiple Sclerosis, Autism, and Diabetes have also been associated
with Vitamin D deficiency.
The attached graph has a very useful, simple outline of blood levels that have been associated with preventative and therapeutic
outcomes from Vitamin D supplementation.
Since Vitamin D is one of the “fat soluble vitamins” (- remember that from biology class) – it can be important to take it along with the other fat soluble vitamins – A, E and K.
Specifically, Vitamin K2 has been shown to be necessary for maintaining calcium deposits in the tissues at a normal level. Vitamin K is also known for it’s ability to improve
the utilization of Vitamin D.
(If you are on any blood thinning medications or agents; or if you have parathyroid disorder or elevated calcium levels in your blood– it is critical that you talk with your
doctor before adding any supplements or medications to your regimen – especially Vitamin D and Vitamin K.)
Today I received an email from one of my highly educated, well researched clients.
She came across an article on Gluten Free Society .com, and was seeking my input
on the “validity / quality” of the information.
In a nutshell the article and the study it referred to seems to present the perspective
that serious health consequences are not associated with “Gluten Sensitivity” (GS),
but only with true “Celiac Disease” (CD).
They state that only Celiac Disease is associated with other autoimmune dysfunction
and disease or more severe issues like cancer. I would have to challenge this opinion
in a bitter fight, since I know that I have what are considered the Non-Celiac-Gluten-
Sensitivity genes. (The HLA-DQ genes 2 or 8 are considered the Celiac Gluten-Sensitivity
genes, in that most people who develop Celiac Disease have at least one gene of the 2 or the
8 variety). Having Non-Celiac-Gluten-Sensitivity genes simply means it is more likely that
you will not develop “Celiac Disease” as defined by 1) testing positive for certain antibodies,
and 2) testing positive to a biopsy of the small intestine (showing atrophy of the small finger-
like projections called villi).
Both of these tests commonly used in traditional medicine have several shortcomings. If you
are interested in additional details on how these test produce many “false negatives” I would
be happy to go into detail in another post, or directly with you. For now I will stay focused on
the above mentioned article / study.
The study goes on to say that the “Gluten Sensitive subjects do not test positive for transglutaminase…..”
This is a very interesting statement since just yesterday Cyrex Labs – the true GOLD STANDARD for
gluten testing and research announced that they are adding two additional transglutaminase tests to
their packages. Highlighting the fact that there is indeed more than one transglutaminase!
Transglutaminase is best known for its connection to Celiac Disease in that gluten stimulates and an
anti-transglutaminase antibody (ATA), which leads to the autoimmune attack on the gastrointestinal tract.
Even Wiki mentions that the common transglutaminase (TG) that is associated with Celiac Disease and the
gut is TG2 – which is expressed in epithelial cells of the gastrointestinal tract.
The other transglutaminase enzymes are tTG3 (dermis) and tTG6 (neuronal). It is well known that there are
several neurological and skin disorders associated with Celiac disease AS WELL AS non-Celiac disease gluten-reactivity.
I personally do not test positive for tTG2 but do have anti-bodies for BOTH tTG3 and tTG6!
On January 17, 2012 the Wall Street Journal published an article A Gut Check For Many Ailments where they state the following:
“New research indicates problems in the gut may cause problems in the brain, just as a mental ailment, such as anxiety, can upset the stomach”
So, what do I say to my confused well informed patient about the “accuracy / quality of the info” of a study performed
by Anna Sapone, Karen M Lammers, Vincenzo Casolaro, Marcella Cammarota, Maria T Giuliano, Mario De Rosa,
Rosita Stefanile, Giuseppe Mazzarella, Carlo Tolone, Maria I Russo, Pasquale Esposito, Franca Ferraraccio, Maria Carteni
Gabriele Riegler, Laura de Magistris, Alessio Fasano published in BMC Medicine 2011, 9:23 doi:10.1186/1741-7015-9-23?
I would have to say there is still a lot of information that is not commonly well known out there, and perhaps sometimes there
are people who have agendas to publish research that is in line with some other theory….. However, you cannot lie with chemistry,
and you cannot lie with physiology. It is what it is. If there is more than one transglutaminase (which there is) and only one is tested,
it might not be prudent to make generalized conclusions as if other molecules in the human body did not exist…
A few weeks ago in the New York Times there was a “Think Like a Doctor” challenge from
Lisa Sanders, MD, where she outlines a case and asks readers to respond with further testing
they would perform and possible theories on a diagnosis.
There were almost 450 posts and very few pursued a gluten issue or Celiac Disease, which
is what the case turned out to be, even though previous testing did indicate elevated antibodies
to gluten. The issue that seemed to throw people off was that it was stated that the patient had
tried a gluten free diet and did not experience any improvement. This is where a detailed intake
and not rushing through a history can be so important.
This patient did try removing some gluten foods from her diet, but perhaps did not understand
the various sources of gluten, nor the hidden sources. Additionally, many people with Celiac Disease
or gluten sensitivity are also sensitive to other grains that are often used as substitutes for gluten
containing grains. If these “non-gluten” grains do react (even to a lesser degree), the patient may
not experience the improvement expected and gluten will be ruled out.
Wheat in the United States has been dramatically modified over the past 5 or so decades and is not
the ancient grain it used to be. The way wheat is stored and processed also contributes to why more
people are experiencing symptoms when consuming wheat products.
Symptoms can be extremely varied, leading to an increased complexity in diagnosis. Common symptoms
include: headache, stomach pain, bloating, gas, belching, brain fog, mental sluggishness, acne, obesity,
diarrhea, constipation, skin rash, neurological dysfunction, depression, anxiety, moodiness, muscle pain,
poor digestion, nutrient deficiencies, seizures, migraines, thyroid and sex hormone dysfunction, PMS, the
list is virtually endless.
Just because you have been tested (in the NYT case the patient had an upper endoscopy – thought to be the
gold standard in medicine), and the results come back negative, it does not really mean that you don’t have
a gluten issue or possibly even Celiac Disease. There are many reason why antibody levels may not be elevated,
why biopsies may not be accurate, or even why the results were misinterpreted. There are many more false negatives
with gluten or Celiac testing than false positives.
If you continue to have symptoms that do not resolve, or your doctors begin to tell you it’s “in your head”, visit with
another professional who can help you understand the complexities of gluten sensitivity and Celiac Disease.
Dr. Slavin is an adviser to the Eagle County Gluten Free and Celiac Disease Support Group. She has extensive training
in gluten sensitivity and other bowel dysfunction. If you are experiencing digestive problems, call Functional Wellness
today to talk with Dr. Slavin.