Nourishing Your Body for Better Health

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G-Free Breakfasts & Back to School

When I look through my archive of gluten-free breakfast posts, I’m always surprised at how short this list was years ago. Now there’s a range of packaged options in addition to the naturally gluten-free options.

oatmealWhether or not you’re back in school, it’s a nice time to re-evaluate breakfast options. We’ve all heard it—breakfast is the most important meal of the day, and gets us off to a good start.  We need energy to study, work, and play.  Many studies have shown improvements in concentration and learning for children who eat breakfast, and starting the day with a healthy breakfast helps adults, too.  As a nutritionist, I look for breakfasts that are a good source of fiber and protein, and little or no added sugar.

And as a gentle reminder, there are no rules of breakfasts. If you like having leftovers or soup for breakfast, so be it. You have my official approval. BTW, curious what people eat around the world for breakfast? I loved this video from WaPo.


Highest in fiber and protein:

Especially when it gets a little cooler, hot cereals can be a wonderful breakfast. You can cook up a big pot and have it all week, and they freeze well, too.

Cooked grains choices:

Making cereals healthier:

  • Add in some fresh or frozen fruit!
  • Add in ground flax or chia seed to increase fiber content.

Other naturally gluten-free healthier options:


  • Greek yogurt with fruit and chia
  • Eggs-Add some spinach, mushrooms, onions, peppers, etc.
  • Leaner, free-range sausage or turkey bacon
  • Garden Lites muffins <–these are pretty easy to find at many grocery stores.
  • Chia pods®
  • Evol has scramble cups  Some are certified GF, but check ingredients/products carefully–some products do have gluten, so make sure you’re grabbing the right box.
  • Omelet
  • Kefir and fruit. Good news for dairy-free peeps–it’s getting easier to find more options at Mom’s and Whole Foods.
  • Yogurt (or coconut or almond yogurt) and chia seeds and/or fruit
  • Breakfast smoothie: handful berries, some kind of protein (yogurt, protein powder) and a handful spinach or kale.

Love granola with your cereal? Kind has a whole grain granola. My grain-free friends–Paleo Krunch is delicious and great to sprinkle on yogurt, but it’s pricey. I have a MYO version here.

Two Mom’s in the Raw also have a certified GF granola option, and so does Go Raw. I’ve heard good things from clients but haven’t tried them out myself yet.

More and more, there are a wider range of cereal options, such as grits (marked GF), Chex, puffed rice, etc. There are also donut and muffin options in the freezer section as well. Obviously these aren’t as nutritionally dense.

Did I miss any of your favorites?

I don’t have Cheerios on the list intentionally, and as many of you know, there have been issues with Cheerios since they first launched, and the problems haven’t yet resolved.  General Mill’s has declared that Cheerios is a gluten-free cereal; however, they are not following the “purity protocol” for growing gluten-free oats. Instead, they’re sorting oats at the end. While some batches seem to test below 20ppm, some have been higher. They also are testing “lots” versus individual boxes, which makes it easier to miss patches of contamination.

The Canadian Celiac Association has a good explanation of why they recommend that people with Celiac avoid Cheerios until manufacturing practices improve.

And as always–do check labels every time. Ingredients and manufacturing practices change.

Back to school?

Sad news:

Last but not least, as many of you know, Dr. John Snyder, who was the head of the Celiac Center at Children’s National Medical Center in DC died unexpectedly this summer after a biking accident in France. I had the pleasure to work with him years ago on Celiac videos in 2008 (they’re a bit dated now). He was a truly lovely person, and a huge advocate for the Celiac community.

He was a great doctor with a big heart. His shoes will be very hard to fill.

Harris Whole Health offers individual sessions and group classes to help people eat healthier and feel better! Cheryl works with people to feel and look their best with a range of specialties, including Celiac Disease, food allergies, pregnancy, breastfeeding, vegetarian and vegan diets, promoting great health and “whole foods” eating. Let’s get you on your way to achieving your goals. For an appointment with Cheryl Harris, Registered Dietitian and Nutritionist, please click here, email or call 571-271-8742.

G-Free Summertime Fun, Giveaway & More

For many people, summertime is filled with cook outs, picnics, outdoor adventures and travel. With a little planning, you can make sure to have fun and take care of your health, too.

Picnics and cookouts tend to work well for a gluten-free diet. Most grilled foods, like 100% beef or turkey burgers,skewers of shrimp (watch the marinade!) hot dogs, chicken breasts, etc. are gluten-free in the regular grocery store, so you can coOLYMPUS DIGITAL CAMERAordinate with your host and ask about any marinades, or just bring your own food to grill. For vegetarians, grilled Portabella mushrooms, red peppers (my favorite) and veggie skewers work well. If your host is grilling buns, marinated meat, or anything else ‘glutenous’ in the same area, bring along aluminum foil to wrap your food and keep it safe from cross contamination. Just bring along your own bun, or in a pinch, use a lettuce leaf as a wrapper. It helps to carry a few little packets of condiments, in case there aren’t squeeze bottles of mayo or mustard. Green salads, fruit salads and watermelon are usually on the menu, and don’t forget grilled corn on the cob as a yummy treat!  Quinoa salads are wonderful in this weather, and are getting more popular. Ice cream, popsicles and frozen fruit bars are usually gluten-free, though it’s important to check the label because there are exceptions, like Fudgesicles, that contain barley malt. Since these events are often potlucks, it’s easy to bring along a safe dish that you’ll enjoy.

As for other summer gatherings, the general rules are to bring a dish you can safely eat and enjoy, bring clean utensils just for your dish, serve yourself first, scout out naturally gluten-free options (corn on the cob, watermelon, salad) but be on the look out for sources of cross-contamination. If all else fails, having a back up option like a gluten-free bar is a good idea.

Or, if you’re at home or entertaining, experiment with grilled fruit, like grilled mango, peaches or pineapple for a gourmet and simply elegant gluten-free treat!

Book Review:
Carol of Simply…Gluten-Free put out a cookbook, Simply Gluten Free 5 Ingredient Cookbook: Fast, Fresh & Simple! 15-Minute Recipes. I’ve been having fun with it. First of all, the pictures are amazing, and there are pictures for every single recipe. Part of what I like is that all the recipes are pretty simple dishes that happen to be gluten-free and most are the kinds of things I like to make. Many are dairy/soy/grain/sugar free, and there aren’t a ton of gluten-free flours used.  I’ve worked on the Simply Gluten-Free Magazine, Carol’s mag for years, so I know Carol’s work, and I was excited even before I got the cookbook! I have a review of three of the recipes and cookbook giveaway here. 

Interesting articles:

  • Medscape did a neat review on Celiac and gluten sensitivity and neurological dysfunction. You may need to set up a free account to read it.
  • A new study showed changes in bacteria are common in people with Chronic Fatigue.Syndrome. The hope is that this may be a path to an eventual treatment, including food as a way to alter symptoms.
  • Gluten-Free Watchdog has done testing on the gluten levels in probiotics. I can’t legally post the data here because there’s an effort to publish the data, but some common probiotics are higher than ideal and one was really high. If you’re interested to find out where yours fits, consider joining GFW.

Cheryl Harris, MPH, RD is a Registered Dietitian Nutritionist and Certified Wellcoach in Fairfax & Alexandria, VA.  She helps people with a range of dietary issues, including Celiac Disease, GI issues, food allergies, pregnancy, breastfeeding, vegetarian and vegan diets, preventing diseases and “whole foods” eating. Let’s get you on your way to achieving your goals and feeling great!  Email or call 571-271-8742.

March G-Free Roundup

Happy almost Springtime! Since March is flying by at, this is a short OLYMPUS DIGITAL CAMERAand sweet rundown of news & research:

Harris Whole Health offers individual sessions, family sessions and group classes to help people eat healthier and feel better! Cheryl works with people to feel and look their best with a range of specialties, including Celiac Disease, food allergies, pregnancy, breastfeeding, vegetarian and vegan diets, preventing diseases and “whole foods” eating. Let’s get you on your way to achieving your goals. For an appointment with Cheryl Harris, Registered Dietitian and Nutritionist, please click here, email or call 571-271-8742

Gluten-Free Sunshine: February Newsletter

  • Spread a little sunshine
  • Chocolate love
  • News

Spread a little sunshine this winter…All about Vitamin DOLYMPUS DIGITAL CAMERA

In the winter months, most of us aren’t getting much sunlight. It’s still dark when we leave our houses and often dark by the time we get home. When we go outside, we’re usually bundled up from head to toe. Not only does this tend to affect mood, but we also depend on sunlight as a source of Vitamin D. Even if someone were to go out dancing in the snow in a bathing suit in the winter months, in many areas it’s still impossible to get all of the vitamin D needed for good health. Skin pigmentation, age, sunscreen, and geographic location all play a role in determining how much vitamin D the body produces from sunlight.

When people think of vitamin D deficiency, they tend to think of rickets, or the bowed legs seen in children. Actually, the problem is much more widespread and affects most systems in the body. Researchers are increasingly learning that most people have Vitamin D levels are below the ideal, and this seems even more common in people avoiding gluten for various reasons. Recent studies are reinforcing the importance of vitamin D, showing that deficiency can cause joint pain and bone weakness, and lower vitamin D levels are linked to higher rates of cancer, Multiple Sclerosis, increased fall rates, lowered immune function, depression and more.

Vitamin D is especially important to people with Celiac disease, gluten intolerance and people following a gluten free/casein free (GFCF diet). Celiac disease often causes great damage to the small intestine, and the small intestine is where our bodies absorb vitamin D. Osteoporosis and osteopenia are frequently seen in Celiac patients, and Vitamin D is an essential component to both calcium absorption and the formation of healthy bones. Additionally, untreated Celiac disease also may lead to fat malabsorbtion, and vitamin D is a fat soluble vitamin.

Fortified milk and milk products are one of the few commonly eaten food sources of vitamin D. However, usually eating those foods alone isn’t enough to do the trick, and many gluten free folks are lactose intolerant, or avoid dairy products due to following a gluten free, casein free (GFCF) diet. The NIH just released a statement about a study showing that autistic boys tend to have thinner bones.So regardless of why you are GF, it is important to speak to your doctor and have your vitamin D levels tested.

There are several ways to get vitamin D in the winter months:

  • Eat vitamin D rich foods: fortified dairy, cod liver oil or other fatty fish, are good sources. For vegetarians or vegans, there are small amounts found in eggs, or some in mushrooms exposed to UV light.
  • Take vitamin D3 supplements: Many doctors recommend high doses of vitamin D initially to normalize vitamin levels in people who are deficient, but since Vitamin D is fat soluble and stored in the body, at some point it is possible to get an excess. Most people have vitamin D levels in the 20-30 range, and you don’t hit a risk of toxicity until the 100+ range, so that’s usually not an issue.
  • Take a vacation to somewhere warm and sunny: totally self explanatory, and my personal favorite way of getting vitamin D. However, this doesn’t mean that you need to sunbathe all day. Experts say that 15-20 minutes of sun in most warm areas 3-4 times a week is usually all that is needed. However, this does differ by season and latitude.choc 2

Chocolate love:

I love chocolate. So, for the sake of research, I tried a range of gluten-dairy-soy free chocolate bars and rated them. Yes, I had help, and I’ve been working my way through them since last May.

Here are a few of my favorite gluten and dairy free chocolate recipes:solo egg cream small

Chocolate Egg Cream: This old fashioned drink is really easy to make and it’s delicious. Although it’s called an egg cream, it’s actually vegan.

Amazing Chocolates or Hazelnut Buttercups. These MYO chocolates are delicious, and pretty easy to make, too.

haz buttercups






tuxedo strawberriers

Tuxedoed Strawberries Fruit in tasty formal ware. What’s not to love?



Chocolate Raspberry Pie Yes, there’s a secret ingredient, but don’t let that scare you. Bloggers at the Washingtonian tried it and gave it a thumbs up!


Harris Whole Health offers individual sessions and group classes to help people eat healthier and feel better! Cheryl works with people to feel and look their best with a range of specialties, including Celiac Disease, food allergies, pregnancy, breastfeeding, vegetarian and vegan diets, preventing diseases and “whole foods” eating. Let’s get you on your way to achieving your goals. For an appointment with Cheryl Harris, Registered Dietitian and Nutritionist, please click here, email or call 571-271-8742

Healthy, Happy Holiday Season 2014

Hopefully you’re all staying warm and cozy this December. It’s always a busy time for everyone, so here’s some good stuff for surviving and thriving this holiday season.celeriac soup

Wintertime generally means cold, and to me that means soup. Whenever I can, I make my own–I adore chicken and turkey  soup, and I love my Red Lentil DalCreamy Veggie SoupSniffle Stew…the list is endless!

Canned soup is a also great fallback. Here’s a list of soups that avoid BPA. BPA is an additive in many can liners, and research has indicated there are potential links between BPA blood pressure, weight, PCOS and/or endocrine conditions.

Of course, December is famous for reasons other than soup. For most people, mindless munching is also a huge part of the season, so here are my top 5 holiday mindless eating tips:

  1. Survey your options: Research shows that people at a normal weight are more likely to survey all of their options, then hone in on what they most enjoy. Otherwise, we have much more of a tendency to keep going back. Standing further from the buffet, facing away from the food and engaging in something else fun (conversation, dancing, photography) also can be a help.
  2. Surround yourself with what you want to see. Remember all that talk about a see-food and eat it diet? Make sure you’re seeing the foods you want to be eating. Put seasonal fruits such as grapefruits, mangos and my personal favorites, pomegranates, on the counter or in your refrigerator where they are easy to grab. Bonus points for putting them at eye level!
  3. Choose the special foods: If you can’t live without mint fudge, then plan to have a piece or two! Skip on the “filler” foods you can have every day, like chips and dip or even booze.
  4. Limit alcohol. I know that’s not always the easiest sell, but sometimes it’s helpful to consider which you’d enjoy more, that truffle or that 2nd glass of wine. Not only is alcohol empty calories that slow your metabolism, but it can be harder to make good choices after you’ve had a few. It can help to set a target before you go. WaPo included some of my tips for reducing excess last year.
  5. Keep the evidence: Out of sight, out of mind, right? If you don’t keep the wrappers or plate, it’s easier to conveniently forget how many mini plates you’ve already munched through.

And…why not plan ahead for a healthier January? One of my colleagues is running a Mindfulness Based Stress Reduction series in Annandale and Vienna. MBSR has a lot of research for helping improve mood and a variety of medical conditions, such as depression, stress, anxiety, IBS, IBD and more. IT’s a 8-week educational group that teaches mindfulness meditation as a health intervention. Created by Jon Kabat-Zinn, PhD., in 1979, MBSR offers participants the possibility to develop a different relationship to stress resulting from chronic stress, illness and psychological illnesses. Research outcomes have demonstrated positive improvements in physical and psychological symptoms, as well as changes in health attitudes and behaviors.

MBSR uses mindful movement, meditation, group discussion, and inquiry to teach students how to use mindfulness to relate differently to stress. The course teaches practical ways to integrate mindfulness into daily life and build and sustain a personal mindfulness practice.

Interested? Contact Mary VanDevanter, at or call 703-370-6525, ext. 3.

Wishing you a warm and wonderful holiday season, and a happy New Year!

Harris Whole Health offers individual sessions, family sessions and group classes to help people eat healthier and feel better! Cheryl works with people to feel and look their best with a range of specialties, including Celiac Disease, food allergies, pregnancy, breastfeeding, vegetarian and vegan diets, preventing diseases and “whole foods” eating. Let’s get you on your way to achieving your goals. For an appointment with Cheryl Harris, Registered Dietitian and Nutritionist, please click here, email or call 571-271-8742.

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Halloween Fun with Food Restrictions

c n pumpkinThink outside the candy dish…

About 10 years ago, I made the choice to stop giving out Halloween candy. Candy isn’t the only fun kind of treat, and I really didn’t need or want to be staring at a bowl of candy the month prior and the month after Halloween. My husband was definitely not happy with my decision, and I was a little nervous, until my first trick-or-treater ran back to his dad and said, “Cool! A slinky!” One year, a group of girls even told my husband that she looked forward to the “rubber ducky house” every year.  Somehow, I resisted the opportunity to say I told you so.

There are plenty of good options for stickers, toys, rubber duckies, mini games or even temporary tattoos for children you know well. Amazon has a ton of fun toy assortments (glow in the dark fangs, anyone?) Oriental Trading Company has a wide selection. G-free peeps, do remember that Play Doh has gluten. Some are more expensive than candy, but it depends on how you halloween treatslook at it. When you average in the bag of candy you bought on sale in September (and ate), the one in mid-October (trust me, that one will disappear as well) and the one you have to run out at the last minute and buy, it evens out in the end.

One of my clients, Stephanie, got really creative and put together goodie bags of her own (above). She found the DIY approach was cheaper than ones she could buy. I predict they’ll be a hit!

Extra bonus–if you decide to go the non-food-treat option, there’s a new registry so that children with food restrictions can find safe houses to visit. FARE also just announced the “Teal Pumpkin Project”, a new initiative for people with non-food treats to paint a pumpkin teal and put it on the doorstep, so children and parents know that safe options are available.

This isn’t a rant against candy. Like everyone, I have great memories eating excessive quantities of candy on Halloween as a little kid, and I trust there will still be more than enough to go around without my help. There’s nothing wrong with that on occasion. I’m a fan of eating treats when I really, really want them and will enjoy them, not eating treats because they’re sitting right in front of me and then *poof* where’d they go? You can also opt for healthier treOLYMPUS DIGITAL CAMERAats, like mini Larabars and mini Kind Bars, all fruit leathers, mini-packs of pistachio nuts, etc.

Tips for Enjoying Halloween with Food Restrictions

  • Talk to teachers and friends about focusing parties around activities (like pumpkin carving, apple bobbing, costume contest) rather than just trick or treating.
  • Pre-stock your Halloween bag with foods that are ‘legal’ for your child (and/or you) so that you can safely snack along the way. Some treats that are normally gluten-free or allergen free have different ingredients in the special holiday versions, so always double check.OLYMPUS DIGITAL CAMERA Here’s the 2014 list from CDF.
  • Stash safe bags of candy/treats at friend’s houses for your child.
  • Have a trade in. Your child can trade the “problem” candies and treats for “safe” treats, or games, prizes, special outings, etc. You can either stash the “problem” candy somewhere out of reach, or donate it to the foodbank.
  • Kids with Food Allergies has a great resource for safe Halloween activities, games, tips, etc.  Although it’s not directed at people avoiding gluten, a lot of the strategies are the same.

Fall recipes:

One of the things I love most about autumn is the beauty of the leaves. The food is a close second! Here are some of my favorites:

  • Butternut Squash Bisque: The tastiest way to get vitamin A! A wonderful soup for the fall or winter. Allergen friendly with a dairy free option.OLYMPUS DIGITAL CAMERA
  • Hot Mulled Apple Drink: a favorite at our annual pumpkin carving party. It’s the perfect drink for a crisp autumn day.
  • Pumpkin Seeds: several variations on this classic snack.
  • Roasted Green Beans: So easy to get green beans this time of year. Yum yum yum!


Cheryl Harris, MPH, RD is a Registered Dietitian Nutritionist and Certified Wellcoach in Fairfax & Alexandria, VA.  She helps people with a range of dietary issues , including Celiac Disease, GI issues,  food allergies, pregnancy, breastfeeding, vegetarian and vegan diets, preventing diseases and “whole foods” eating. Let’s get you on your way to achieving your goals and feeling great!  Email or call 571-271-8742.

Happy Gluten-Free New Year

Keeping it simple

Gluten-free foods are expensive.  And they can be harder to find.  Some don’t taste very good.  And many aren’t that healthy for you.  So as a good way to start off the new year, I’d encourage you to think about “normal” foods–real, simple whole foods that just so happen to be naturally gluten-free.  Why?  They’re usually  healthier, they’re cheaper, they’re easier to find, and often easier to prepare.  Of course, gluten free grains can be harder to come by and those are important too

Most of the foods that are wonderful parts of any healthy diet are already gluten free.  Fruits, veggies, nuts, beans, seeds, dairy, fish, poultry, water, and even common grains like rice, wild rice, etc.  I have yet to meet a client who nutritionally needs more cake and cookies, gluten-free or otherwise.  Here are a few ideas of easy things that you can to make your lifestyle healthier.

  • Beans are great in the winter! Think black bean soup, chili, lentil stew, hummus, etc.
  • Here, fishy fishy: add in some salmon, trout and oysters or other fish twice a week.  They are high in heart healthy omega 3 fatty acids and low in mercury.
  • Look for seasonal fruits and veggies. Clementines, pomegranates, grapefruit, pineapples and mangoes are wonderful in the winter, and kale, collards, sweet potatoes, winter squash, are too.Choose whole (fresh, frozen or dried) vegetables and fruits over juices, which have most of the fiber removed.
  • Add some ground flax seed to your yogurt, cereal, or on a salad for more fiber and healthy omega 3s.
  • Drink your water!  6-8 glasses a day are important to stay hydrated, especially when you increase the amount of fiber you eat.  Sometimes taking a water bottle along can help remind you.
  • Talk to your doctor about your Vitamin D level. Many people who are newly diagnosed with Celiac Disease are deficient, and it’s tough to get enough from food and sunlight in the winter months no matter what.
  • Grab some almonds and walnuts, an ounce a day actually promotes weight loss and provides a rich source of vitamins, minerals and fiber.
  • Get whole grains in your diet.  Try a whole grain hot cereal, brown rice bread, wild rice with dinner, or even quinoa pasta.
  • Use healthier oils when cooking like olive, walnut, grapeseed, etc. and limit or eliminate corn, soy or vegetable oil and trans fats.
  • Take care of yourself. This includes sleeping well, reducing stress, and doing things you enjoy.  You’re worth it.

Let this be the year you enjoy great health!


Want to make sure you’re eating a balanced gluten-free diet?  Seeing a Registered Dietitian can be a huge help.

As a health care professional, I was deeply disturbed when I realized that many insurance companies do not provide coverage for Medical Nutrition Therapy for Celiac Disease.  I began writing letters on behalf of of my clients to spread awareness, and much to my surprise, about half the time the insurance company eventually provides coverage .  To the best of my knowledge Medicare and Tricare have not ever covered services for Celiac Disease.

There are two letters here.  One for Registered Dietitians to file on behalf of their patients, and one is for  clients to file on their own behalf.


Celiac support groups are tremendously important.  They’re a great, fun, informative way of connecting with people in a similar situation, and  NIH recommends joining one, too.  We’ve got a few local groups, such as DC Celiacs, which meets 4-5 times yearly in DC, MD and VA, NOVA CSA group out of Reston,which has periodic events and a variety of meet up groups, too.

However, all of these groups are run by volunteers, and need funds to rent space for meetings, send out newsletters, have websites, and all that jazz.  So if you’re getting the benefit of the restaurant databases, meetings, yahoo groups with information, please consider paying dues so these great groups can continue giving the community fantastic information.


DC Celiacs

Next Meeting Date: Saturday, January 29, 2011, 2:00–4:00 pm

Meeting Topic: The FDA’s Drug Ingredient Labeling Requirements.
Speaker: Terrell Baptiste, Digestive Disease National Coalition

Location: Arlington Central Library (Virginia) – Metro accessible, parking available.
1015 N Quincy Street, Arlington, VA 22201


Harris Whole Health offers individual sessions, family sessions and group classes to help people eat healthier and feel better!  Cheryl works with people to feel and look their best with a range of specialties, including Celiac Disease, food allergies, pregnancy, breastfeeding, vegetarian and vegan diets, preventing diseases and “whole foods” eating.  Let’s get you on your way to achieving your goals. For an appointment with Cheryl Harris, Registered Dietitian and Nutritionist, please click here, email or call 571-271-8742.


  • Celiac and Thyroid Disease: Two of a Kind Please see my recent article, which published in Today’s Dietitian in November 2010 and was featured as the American College of Gasteroenterology’s Top Story.
  • Celiac Disease, gluten intolerance, child feeding and more: listen to me on Celiac Radio!  This August 2010 interview covers a wide range of topics for people on a gluten-free diet.

Celiac Disease and Thyroid Disease–Two of a Kind

by Cheryl Harris, MPH, RD and Gary Kaplan, DO

It’s a commonly misdiagnosed autoimmune condition. Its symptoms include fatigue, constipation or diarrhea, hair loss, depression, weight gain or loss, and infertility. And it greatly undermines the sufferer’s quality of life. Sound a lot like Celiac Disease? Actually, these are common symptoms of Autoimmune Thyroid Disease. Like Celiac Disease, physicians often miss the diagnosis. In fact, it is estimated that over half of the approximately 27 million people suffering with thyroid conditions have not yet been diagnosed.i

Furthermore, people with Celiac Disease are much more likely to develop Thyroid Disease than people without Celiac Disease. Similarly, people with a Thyroid Condition are more likely to develop Celiac than those without a Thyroid Condition, and this holds true even after the subject adopts a gluten-free diet.i A study by Dr. Fasano, a recognized expert on Celiac Disease, showed that half of the people diagnosed with Celiac disease also had Thyroid Disease.ii And while 1 in 133 Americans (just under 1%) have Celiac, recent thyroid review studies show that 2 to 7.8% (an average of 4.1%) have Celiac. This indicates that a person suffering with Thyroid Disease is about four times more likely to develop Celiac someone without a thyroid condition.

What is autoimmune thyroid disease?

The Thyroid is a gland in the neck that controls most of the other hormones in the body. It determines how quickly you burn calories, your heart rate, and other vital functions. The most common type of Thyroid Disease is an underactive thyroid, or hypothyroidism, which is usually caused by an autoimmune reaction where the body attacks the thyroid causing lower levels of thyroid hormones to be released into the body. This causes the body’s metabolism to slow down. Also known as “Hashimoto’s Disease,” hypothyroidism occurs most frequently in women during middle age. Another common thyroid disorder is hyperthyroidism or an overactive thyroid gland. It is caused by an autoimmune reaction (usually Graves’ Disease), where the body attacks itself, and the thyroid gland produces too much thyroid hormone.

What are the signs and symptoms of Thyroid Disease?
The signs and symptoms associated with Thyroid Disease vary depending upon whether the thyroid is under-active (hypothyroid) or over-active (hyperthyroid). Hypothyroidism typically presents with fatigue, a morning body temperature equal to or less than 97.6 degrees (compared to a normal temperature of 98.6 degrees), and dry skin and hair. Signs of hypothyroidism also may include weight gain, difficulty with mental concentration (“brain fog”), and irregular menstrual periods. People with an underactive thyroid often experience many other problems associated with weight gain including insulin resistance and diabetes, high blood pressure, and heart disease.

Signs of hyperthyroidism, on the other hand, may include high blood pressure, gastrointestinal problems, and a rapid heartbeat.

Sufferers of both types of thyroid disorders may experience sleep disorders, severe fatigue, and changes in bowel habits, ranging from constipation to diarrhea. Pregnant women, whose hormone levels change dramatically to accommodate the growing life within, may experience a variety of problems due to untreated thyroid conditions.

What might your doctor look at?

Too often medical providers get focused on one symptom or one disease process to the exclusion of other important medical evidence. In fact, the New England Journal of Medicine published a study suggesting that the number one mistake most doctors make is narrowing the differential diagnosis too quickly, which limits what we’re able to see, never mind accurately diagnose and treat. It’s critical to cast a wide net in the process of diagnosing a patient, and this takes time. Your physician will need to take the time to listen to and understand your medical history, conduct a thorough physical examination, order blood work, formulate a treatment plan for you, continually review your progress, and if necessary, retest and adjust your medications.

When thyroid disease is suspected, additional testing and treatment is required. First, a physical examination should be performed, including palpation of the thyroid gland in the neck to locate any enlargement, asymmetry, or the development of nodules. Second, blood work should be conducted to evaluate not just the patient’s TSH level (TSH is produced by the pituitary gland in the brain), but also their Free-T3 and Free-T4 levels.

Many physicians only test for TSH, and for example, when it is too high, simply direct their patients to take more T-4. The problem with this approach is that some patients with thyroid conditions lack the ability to convert T-4 to T-3. T-3 is the most active form of thyroid, which in combination with T-4, affects a person’s metabolism, heart rate, cholesterol levels, and adrenal function. Consequently, it is critical that we test for the presence of TSH and Free-T3 and Free-T4 in a patient’s bloodstream. Only with this information can we prescribe the supplemental hormones a patient needs for normal metabolic activities to occur.

If you’ve already been diagnosed with Celiac Disease and adopted a gluten-free diet, and you continue to experience any of the symptoms described above, talk with your doctor. It may be time for you to get a comprehensive physical exam and blood work. Similarly, if you’ve been diagnosed with Thyroid Disease and you’re still experiencing any of the symptoms described, consider making an appointment to talk with your doctor. You don’t “just have to live with it.”

Does a gluten-free diet help thyroid antibodies?

When someone with Celiac disease goes gluten-free, his or her autoimmune antibodies return to normal, as expected. Medical research also suggests, however, that when people with Celiac and Thyroid Disease adopt a gluten-free diet, not only do their Celiac-related antibody levels improve, but often their thyroid antibody levels also decrease dramatically. This suggests that a gluten-free diet improves thyroid function, and it may mean that people with Celiac who are gluten-free require less thyroid medication. As the authors of one study put it: “We believe that undiagnosed and untreated Celiac Disease may switch on some as-yet-unknown, immunological mechanism that sets off a cascade of other disorders.”i So, in other words, untreated autoimmune diseases such as Celiac Disease, lead to the development of more autoimmune diseases. While there is some speculation that eating a gluten-free diet may help improve thyroid function even in people without Celiac, there are no research findings proving this hypothesis.

Moral of the story:
People with Celiac Disease are at much greater risk for Thyroid Disease. So, if you have reason to suspect that you are suffering from either disorder, get tested!

iCanaris GJ et al. The Colorado Thyroid Disease Prevalence Study. Archives of Internal Medicine. 2000 Feb 28;160(4):526-34.
iiElfström, P. et al. Risk of Thyroid Disease in Individuals with Celiac Disease. Journal of Clinical Endocrinology and Metabolism, October 2008, 93(10):3915–3921.
iiiFasano, A. et al. Prevalence of Celiac Disease in At-Risk and Not-At-Risk Groups in the United States. Archives of Internal Medicine. 2003;163:286-292
ivBerti, I. Usefulness of Screening Program for Celiac Disease in Autoimmune Thyroiditis. Digestive Diseases and Sciences, Vol. 45, No. 2 (February 2000), pp. 403–406.

Halloween ROCK Candy List 09

The wonderful moms and dads of ROCK (Raising our Celiac Kids) have been hard at work, and here’s the 2009 link to the GF Candy list!

Gluten Free Candy List October 2009