Non-Coeliac Gluten Sensitivity

He even went through periods where he could not walk properly – CK

non-celiac gluten sensitivityI’ve been told personally that a little gluten never hurt anyone. Clinical experience proves otherwise. The combination of misunderstanding, ignorance and rise in everything pervasively gluten-free has made the topic seem like a modern day fad. Unfortunately, this phenomenon affects those most for whom gluten sensitivity is a real, clinical issue.

It is now becoming clear that, besides those with coeliac disease or wheat allergy, there are people with gluten sensitivity in whom neither allergic nor autoimmune mechanisms can be identified1. It has been estimated that for every person with coeliac disease there should be at least 6 or 7 people with non-coeliac gluten sensitivity (NCGS)1. In 2011 in London, a panel of 15 experts announced a new classification of gluten-related disorders (see yellow boxes below) that was then published in February 20122. The Second Expert Meeting on gluten sensitivity that was held in Munich in 2012, decided to change the name of gluten sensitivity to non-coeliac gluten sensitivity in order to avoid confusion with coeliac disease3.

The challenge with diagnosing NCGS is that currently there are no laboratory biomarkers specific for gluten sensitivity and the diagnosis is based mainly on exclusion criteria: elimination of gluten-containing foods from the diet and monitoring symptoms. Occasionally people will say they have attempted a gluten-free diet, yet symptoms persist. The problem with this is, firstly, foodstuffs nowadays are a complex minefield of chemicals and people may exhibit cross-reactivity with other wheat-based molecules and, secondly, the person may not have been strict enough with the diet or persisted long enough to heal the gut. Being completely gluten-free is incredibly challenging and often too difficult, so alternative diagnoses to gluten sensitivity are sought and the underlying issue is missed.

Many people that are intolerant of gluten are also intolerant of other proteins found in foods like dairy, eggs, and even coffee and milk protein. Critics of the gluten-free diet argue that people with irritable bowel syndrome (IBS) are not sensitive to gluten, but instead are reacting to a group of poorly absorbed carbohydrates called FODMAPs4 (figure below). From a practical perspective, wheat and many other gluten-containing grains are FODMAPs and should be avoided by people with gluten sensitivity anyway.

IBS FODMAPS

Coeliac disease is easier to diagnose than NCGS. Most doctors today know how to screen for coeliac disease. They will typically test for antibodies to alpha gliadin, transglutaminase-2, deamidated gliadin, and endomysium, and if positive do a biopsy to determine if tissue damage is present. However, we now know that people can (and do) react to several other components of wheat above and beyond alpha gliadin, the component that is implicated in coeliac disease. These include other epitopes of gliadin (beta, gamma, omega), glutenin, wheat germ agglutinin (WGA), gluteomorphin, and deamidated gliadin5,6.

The bottom line is standard blood tests by general practitioners are not comprehensive enough. The person may be reacting to deamidated gliadin, glutenin, gluteomorphin, and either transglutaminase-3 or -6, but not reacting to alpha gliadin or transglutaminase-2 (the antibodies used to screen for coeliac disease by most doctors). They will remain undiagnosed and continue to eat gluten for the rest of their lives, suffering symptoms and putting themselves at serious risk for autoimmune diseases.

The typical presentation of NCGS is a combination of IBS and systemic manifestations like headache, joint and muscle pain, muscle contractions, leg or arm numbness, chronic fatigue, “brain fog”, body mass loss and anaemia. Symptoms can also include behavioural disturbances such as changes in attention or depression2 (Table of NCGS symptoms).

IBS can include abdominal pain, nausea, bloating, flatulence, diarrhoea or constipation. People with IBS who respond well to a gluten-free diet can suffer from one of the three diseases: coeliac disease, wheat allergy or NCGS, where NCGS is the most likely option (figure above). In children, NCGS manifests with intestinal symptoms – abdominal pain and chronic diarrhoea – but also symptoms beyond the gut.

Extragastrointestinal manifestations seem to be less frequent but the most common is chronic tiredness. When a person with NCGS consumes wheat or other gluten-containing foods, he or she may not always experience the classic digestive symptoms associated with gut because they do not produce antibodies to transglutaminase-2 (which is mostly expressed in the gut). Instead, the intolerance of wheat may manifest in skin conditions like eczema or psoriasis; and in neurological or brain-related conditions like depression, peripheral neuropathy (pain, numbness, burning, tingling), ataxia (difficulty walking) or ADHD7. Current evidence suggests that neurological manifestations are immune-mediated and that there is cross-reactivity between immune cells, nerve cells and gluten proteins.

Gluten sensitivity is a common disorder that manifests in diverse ways, making it a difficult condition to diagnose. Many people who present with neurological manifestations of gluten sensitivity have no gastrointestinal symptoms7

Read more

Power vs. Force

power-vs-forcePower vs. Force, by David R. Hawkins, MD, PhD.

“On examination, we’ll see that power arises from meaning. It has to do with motive, and it has to do with principle. Power is always associated with that which supports the significance of life itself. It appeals to that part of human nature that we call noble – in contrast to force, which appeals to that which we call crass. Power appeals to what uplifts, dignifies, and enobles. Force must always be justified, whereas power requires no justification. Force is associated with the partial, power with the whole.

If we analyze the nature of force, it becomes readily apparent why it must always succumb to power; this is in accordance with one of the basic laws of physics. Because force automatically creates counterforce, its effect is limited by definition. We could say that force is a movement – it goes from here to there (or tries to) against opposition. Power, on the other hand, is still. It’s like a standing field that doesn’t move. Gravity itself, for instance, doesn’t move against anything. Its power moves all objects within its field, but the gravity field itself does not move.

Force always moves against something, whereas power doesn’t move against anything at all. Force is incomplete and therefore it has to be fed energy constantly. Power is total and complete in itself and requires nothing from outside. It makes no demands; it has no needs. Because force has an insatiable appetite, it constantly consumes. Power, in contrast, energizes, gives forth, supplies, and supports. Power gives life and energy – force takes these away. We notice that power is associated with compassion and makes us feel positively about ourselves. Force is associated with judgment and makes us feel poorly about ourselves.

Force always creates counterforce; its effect is to polarize rather than unify. Polarization always implies conflict; its cost, therefore, is always high. Because force incites polarization, it inevitably produces a win/lose dichotomy; and because somebody always loses, enemies are created. Constantly faced with enemies, force requires constant defence. Defensiveness is invariably costly, whether in the marketplace, politics, or international affairs.

In looking for the source of power, we’ve noted that it’s associated with meaning, and this meaning has to do with the significance of life itself. Force is concrete, literal, and arguable. It requires proof and support. The sources of power, however, are inarguable and aren’t subject to proof. The self-evident isn’t arguable. That health is more important than disease, that honour is preferable to dishonour, that faith and trust are preferable to doubt and cynicism, that the constructive is preferable to the destructive – all are self-evident statements not subjects to proof. Ultimately, the only thing we can say about a source of power that it just “is”.

Every civilization is characterised by native principles. If the principles of a civilization are noble, it succeeds; if they’re selfish, it falls. As a term, principles may sound abstract, but the consequences of principle are quite concrete. If we examine principles, we’ll see that they reside in an invisible realm within consciousness itself. Although we can point out examples of honesty in the world, honesty itself as an organising principle central to civilization does not independently exist anywhere in the external world. True power, then, emanates from consciousness itself; what we see is a visible manifestation of the invisible.”

Reference: Hawkins, D. R. Power vs. force: the hidden determinants of human behavior. USA. Veritas Publishing. 1995.

Hearing Loss

“I was pleasantly surprised after the first couple of sessions with you to note the highs and lows of my hearing seemed to have evened out.”

First rule of research: Never quote Wikipedia.

“I was deaf 17 years and I expected to always remain so, for I had doctored a great deal without any benefit. I had long ago made up my mind to not take any more ear treatments, for it did me no good. Last January Dr. Palmer told me that my deafness came from an injury in my spine. This was new to me; but it is a fact that my back was injured at the time I went deaf. Dr. Palmer treated me on the spine; in two treatments I could hear quite well. That was eight months ago. My hearing remains good. HARVEY LILLARD, 320 W. Eleventh St., Davenport, Iowa.” Wikipedia.

The spine? What a heretic.

And so the story goes. As a student, I wondered whether I’d ever see a Harvey Lillard case:  The supposed first application of chiropractic by the founder around 1895 to a janitor whose hearing was magically restored. The surfeit of scientific rationalisation as to how this happened since then has been unending and most debates usually come to rest at the foot of clichéd tenets like “the power that made the body heals the body” or at the pub.

Besides the majority of good responses we get with tinnitus, this case was close enough to Harvey for me.

The more we understand about neurosensory processing at the level of the brainstem and reticular formation where most feedback from the spine and body confluences, the more we gain an understanding that problems which begin neurosensorily (usually stress) have great potential to be helped by chiropractic. Namely, nausea, vomiting, tinnitus, dizziness, visual changes, and in this case, sensorineural hearing loss. Read more


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