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Gluten Free RN

Gluten Free RN, Nadine Grzeskowiak RN BSN CEN, talks about every aspect of a gluten free lifestyle, diet, Paleo Lifestyle and all related issues.
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Jun 22, 2018

What did we know about celiac disease in 1953?

The truth is, we knew quite a bit about sensitivity to gluten 65 years ago when Matilda Babbitz’s son Bobby was diagnosed with celiac disease. A nurse by profession, Matilda carefully observed her baby and kept detailed records of his reactions to foods, working with doctors to determine an appropriate diet for Bobby.

Today, the Gluten Free RN is sharing an article published in the March 1953 edition of the American Journal of Nursing written by Matilda herself. She covers how Bobby presented with celiac disease at six months of age and the dramatic change in his health and behavior after a diet change.

Nadine discusses the systematic approach Bobby’s healthcare team took in creating a custom diet, the relationship between the baby’s irritability and his inability to digest food, and his growth and development before and after treatment. She also addresses the misunderstanding that children will ‘grow out of’ celiac disease, explaining that we’ve since learned patients must adhere to a 100% gluten-free diet for life. Listen in for insight around what we can learn from past case studies of celiac disease and understand what we already knew about celiac disease back when Eisenhower was president and Gentlemen Prefer Blondes was on the big screen!

What’s Discussed:

How Bobby presented with celiac disease at six months of age

  • Sudden attack of diarrhea, upper respiratory infection
  • History of GI difficulty + distended abdomen, increased gas
  • Marked irritability, weight loss, inability to move arms/legs

The dramatic change in Bobby’s behavior after a diet change

  • Symptoms of diarrhea, vomiting and weakness disappeared
  • Irritability subsided with shift to skim milk

The new pediatrician’s approach when Bobby’s progress stalled

  • Shift to goat’s milk, added complete multivitamin supplement

The relationship between irritable behavior and the inability to digest foods

  • Nurse/mom kept detailed records of foods eaten, reactions

Bobby’s growth and development before and after diagnosis

  • Lost ability to perform gross motor activity prior to diagnosis
  • Caught up with age group after diet change (walked at 18 months)

How Bobby’s mother dealt with social pressure to eat with others

  • Replaced cookies and ice cream with sherbet and lollipops
  • Kept away from parties so not conscious of being left out

The chronic nature of celiac disease

  • No one ‘grows out of’ being celiac
  • 100% gluten-free diet for life

Nadine’s insight around what we knew about celiac disease in 1953

  • Many celiac patients unable to digest cow’s milk
  • Need supplementation with vitamins, certain fats
  • Recognized impairment of immune system

Resources

‘Bobby Has Celiac Disease’ in the American Journal of Nursing

Connect with Nadine:

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Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

Subscribe to The Gluten Free RN Podcast:

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Jun 15, 2018

‘Know your own truth and let that guide you.’

How do you cut through the noise and misinformation around gluten sensitivity and celiac disease in order to make the best choices for your health and happiness? By tapping into your intuition and asking WHY when the answers don’t feel right—and reaching out to the right people for support when you need it.

Today, the Gluten Free RN is sharing her Top 10 Musings and Truths for health and wellbeing, empowering you to be self-protective and surround yourself with the people who genuinely care enough to speak up for—and with you. She shares the value in setting goals for your physical and mental health and taking your power back from the people who may have victimized you in the past.

Nadine also encourages you to get educated and engage in critical thinking, questioning the information you are given and saying ‘no’ to anyone who suggests you eat gluten—even if they happen to be a doctor. Listen in to understand the idea that ‘you are your own experiment’ and learn to be the healthiest YOU you can be by committing to a 100% gluten-free diet!

What’s Discussed:

  1. Commit to being 100% gluten-free, dairy-free and ideally Paleo
  • Focus on diet change for first year so intestines can heal
  1. Be self-protective
  • Lose people who aren’t supportive
  1. Find your tribe
  • People who speak up for/with you, willing to change diet
  1. Set goals for what you want your life to look like
  • Write down objectives to make real, move in that direction
  1. Be powerful (even if you don’t feel it)
  • Speak up and take power back, don’t be victim
  1. Get educated and educate others
  • Go to conferences, read and do research
  1. Don’t believe everything you hear, read or say
  • Get answers to questions, then question the answers (ask WHY)
  1. Don’t eat gluten for anyone
  • Not for friends/family, doctors or research study
  1. Be the healthiest YOU, you can be
  • Strive for MORE health, fun, good food and information
  1. You are your own experiment
  • Reassess and apply new information as needs change, work with team

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

Jun 8, 2018

Much existing propaganda claims that African Americans do not suffer from celiac disease. Even the Gluten Free RN was surprised to find out that her adopted daughter had a genetic predisposition to the disease back in 2006, as research available at the time regarded the HLA-DQ2 and HLA-DQ8 genes to be primarily Caucasian traits. And until we take steps to conduct a mass screening, we simply don’t know how common celiac disease is among people of African descent.

Today, the Gluten Free RN is exploring celiac disease in the African American population. She covers a 2006 study out of Columbia University that assessed African American celiac patients, discussing the variety of ways the subjects presented with celiac disease and the potential reasons for their poor compliance with the prescribed gluten-free diet.

Nadine also considers the prevalence of celiac disease on the continent of Africa, explaining why she believes the number of celiac patients will explode with the population’s growing exposure to wheat. Listen in for the Gluten Free RN’s insight on other health issues that may point to undiagnosed celiac disease and learn how we can prevent celiac disease among the African American population with access to testing, social support and gluten-free food!

What’s Discussed:

The 2006 Columbia University study of celiac disease in African Americans

  • Identified nine patients with biopsy-proven celiac disease
  • Presented with diarrhea, iron deficiency anemia and autoimmune disorders

Why patients in the Columbia study demonstrated poor dietary compliance

  • Expense, availability and palatability of gluten-free food
  • Lack of symptoms at diagnosis, inaccurate dietary information

Nadine’s prediction around the number of celiac patients in Africa

  • Increasing exposure to wheat will cause explosion

The statistics regarding the mortality burden of celiac disease

  • Science Daily reported estimates of 42K child deaths every year in 2011
  • Majority from Africa and Asia

The overlap between diabetes and celiac disease

  • Every type 1 diabetic is HLA-DQ2/8 gene carrier

The health issues that may indicate undiagnosed celiac disease

  • Type 1 diabetes, cardiac issues, stroke and heart attack
  • Obesity (stems from lack of nutrient absorption)

How to prevent celiac disease among the African American population

  • Access to testing, social support and gluten-free food

Resources:

Celiac Disease and How Gluten Affects Your Skin EP011

‘Your Skin on Gluten’ on YouTube

‘Celiac Disease in African-Americans’ in Digestive Diseases and Sciences

‘First Global Estimates of Coeliac Disease and Its Mortality Burden’ in Science Daily

Neurological Disorders Associated with Celiac Disease EP012

‘Celiac Disease in the Developing Countries: A New and Challenging Public Health Problem’ in the World Journal of Gastroenterology

‘Systematic Review: Worldwide Variation in the Frequency of Coeliac Disease and Changes Over Time’ in Alimentary Pharmacology and Therapeutics

‘HLA Typing and Celiac Disease in Moroccans’ in Medical Sciences

‘A Historical Assessment of Sources and Uses of Wheat Varietal Innovations in South Africa’ in the South African Journal of Science

University of Chicago: Celiac Disease Facts and Figures

‘Adult Coeliac Disease in South Africa: An Analysis of 20 Cases Emphasizing Atypical Presentations’ in the South African Medical Journal  

‘Epidemiological and Clinical Features in Immigrant Children with Coeliac Disease: An Italian Multicentre Study’ in Digestive and Liver Disease

‘Prevalence of Positive Coeliac Serology in a Cohort of South African Children with Type 1 Diabetes Mellitus’ in the South African Journal of Child Health

ESPGHAN Goes Africa Course

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

May 25, 2018

Approximately 50% of ER visits are associated with abdominal pain, and the vast majority of those patients are given a diagnosis of ‘abdominal pain of an unknown origin’ and directed to come back if the condition gets worse. This is little comfort to people suffering from severe discomfort who need answers around the cause of their belly pain, not just medication to mask it temporarily. Could undiagnosed celiac disease be the source of their suffering?

Today, the Gluten Free RN is diving into the issue of belly pain and undiagnosed celiac disease, discussing the expensive testing often conducted to determine the cause of abdominal discomfort—testing that rarely includes a celiac panel. She covers several of the common misdiagnoses of celiac patients as well as the incredibly high prevalence of abdominal pain in children. 

Nadine shares the case study of a child-patient who was misdiagnosed with appendicitis and the research published in Digestive and Liver Disease outlining the unnecessary surgical interventions endured by undiagnosed celiac patients. Listen in for the Gluten Free RN’s advice to patients with idiopathic abdominal discomfort and learn why no one should suffer from belly pain!

What’s Discussed:

The statistics around ER visits and abdominal pain

  • 50% of visits associated with belly pain

The most common abdominal pain diagnoses

  • Abdominal pain of unknown ideology, idiopathic abdominal pain

How patients are treated for idiopathic abdominal pain

  • Medication, directive to return if condition gets worse

The testing to find the cause of chronic abdominal pain

  • Expensive blood workups, rarely include celiac panel

How many children suffer from belly pain

  • 30% report abdominal discomfort

Nadine’s patient who received a misdiagnosis of appendicitis

  • Mother of child-patient sought second opinion prior to surgery
  • Child didn’t have appendicitis, cause of pain still unknown

A research study around abdominal surgery and celiac disease

  • Patients with celiac disease at increased risk of abdominal surgery
  • Misdiagnosis leads to inappropriate interventions (i.e.: appendectomy)

Nadine’s advice for patients diagnosed with idiopathic abdominal pain

  • Initiate clinical trail of gluten-free or Paleo diet

Resources:

‘Increased Rate of Abdominal Surgery Both Before and After Diagnosis of Celiac Disease’ in Digestive and Liver Disease

‘Screening for Celiac Disease in Children with Recurrent Abdominal Pain’ in the Journal of Pediatric Gastroenterology and Nutrition

‘Effect of a Gluten-Free Diet on Gastrointestinal Symptoms in Celiac Disease’ in the American Journal of Clinical Nutrition

‘Clinical Features and Symptom Recovery on a Gluten-Free Diet in Canadian Adults with Celiac Disease’ in the Canadian Journal of Gastroenterology

‘Association of Adult Celiac Disease with Surgical Abdominal Pain’ in Annals of Surgery

‘A New Insight into Non-Specific Abdominal Pain’ in The Annals of The Royal College of Surgeons of England

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

May 4, 2018

If you are being treated for a blood disorder, it is time to look deeper and explore the underlying cause. Rather than simply addressing iron- or B12-deficiency anemia in isolation, ask WHY you have a deficiency in the first place. It is possible that damage to your intestines caused by gluten is preventing your body from absorbing the nutrients necessary to grow your red blood cells and keep your immune system healthy. And anemia is not the only blood disorder associated with celiac disease and non-celiac gluten sensitivity!

The Gluten Free RN is taking a closer look at the hematologic manifestations of celiac disease from anemia to hyposplenism. She explains the connection between disorders of the blood and bones, offering insight around why men with both anemia and osteoporosis are also likely to have celiac disease.

Nadine discusses the danger in taking H2 blockers or proton pump inhibitors for GERD long-term, describing how those medications decrease the gastric acid necessary for breaking down food. She also addresses what you can do to identify any nutritional deficiencies in your blood and reminds us why celiac patients have difficulty absorbing the nutrients necessary to form red blood cells. Listen in to understand how the skin reflects what’s happening internally and learn how to prevent a number of blood disorders with a gluten-free diet!

What’s Discussed: 

The hematologic manifestations of celiac disease

  • Anemia secondary to malabsorption of iron, folate and vitamin B12
  • Thrombocytosis, thrombocytopenia, leukopenia, venous thromboembolism
  • Hyposplenism, IgA deficiency and increased risk of lymphoma

Why iron supplements didn’t solve Nadine’s anemia

  • Couldn’t absorb supplements due to undiagnosed celiac disease

The connection between anemia, osteoporosis and celiac disease

  • B12 forms red blood cells made in long bones

The danger of taking H2 blockers and PPIs long-term

  • Decreases levels of gastric acid necessary to liquify food
  • Leads to bacterial overgrowth, gastritis

How to uncover potential nutrient deficiencies in your blood

  • CBC with differential (breakdown of red blood cells)

The conclusions of the 2007 study in Blood

  • Anemia and hyposplenism are most common complications of celiac disease
  • Obtain small-bowel biopsy in all patients with iron-deficiency anemia

The fat-soluble vitamins

  • A, D, E and K
  • Deficiency in one indicates malabsorption, potential celiac disease

The connection between DH and celiac disease

  • Skin disorders begin in intestines

Resources:

‘Hematologic Manifestations of Celiac Disease’ in Blood

Celiac Disease and Your Spleen

Dr. Ben Lynch: Folic Acid vs. Folate

‘The Thrombophilic Network of Autoantibodies in Celiac Disease’ in BMC Medicine

‘Hematologic Manifestations of Celiac Disease’ in Celiac Disease— From Pathophysiology to Advanced Therapies

‘Sarcoidosis, Celiac Disease and Deep Venous Thrombosis: A Rare Association’ in Balkan Medical Journal

‘Celiac Disease Manifesting with Deep Venous Thrombosis: A Case Report’ in Govaresh

‘Deep Venous Thrombosis and Bilateral Pulmonary Embolism Revealing Silent Celiac Disease’ in Case Reports in Gastrointestinal Medicine

‘How Often Do Hematologists Consider Celiac Disease in Iron-Deficiency Anemia?’ in Clinical Advances in Hematology & Oncology

‘Deep Vein Thrombosis Associated with Celiac Disease’ in Bratislavske Lekarske Listy

‘Celiac Disease Presenting with Immune Thrombocytopenic Purpura’ in Case Reports in Hematology

‘Lower Extremity Deep Vein Thrombosis Associated with Gluten-Sensitivity Celiac Disease’ in Terapevticheskii Arkhiv

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

Apr 27, 2018

Your gastrointestinal tract is approximately 30 feet long, and it runs from your mouth all the way to the anus! We know that celiac disease can impact any part of the digestive tract. But there is another disease that wreaks havoc on the GI tract as well, a condition called eosinophilic esophagitis or EoE.

The Gluten Free RN is explaining the fundamentals of eosinophilic esophagitis, from its characteristic inflammation of the esophagus and elevated eosinophils in the blood to the common symptoms of vomiting and upper abdominal pain. She walks us through the treatment for EoE, an elimination diet or steroid therapy.

Nadine speaks to the research exploring a possible connection between eosinophilic esophagitis and celiac disease, citing a paper that found a higher prevalence of EoE in children with celiac disease than the general population as well as the case study of a woman with both celiac disease and elevated eosinophils in her blood. Listen in for the Gluten Free RN’s insight on the best EoE clinics and physicians in the country and learn why further study is needed around EoE and celiac disease!

What’s Discussed: 

The fundamentals of eosinophilic esophagitis

  • Allergic response to dietary antigens
  • Causes inflammation of esophagus, increased eosinophils in blood

The benefits of unsedated transnasal endoscopy for children with EoE

  • Monitors esophageal mucosa without sedation
  • Safer, faster and less costly

Some common symptoms of eosinophilic esophagitis

  • Vomiting, difficulty swallowing, food stuck in throat
  • Chest pain, heartburn, upper abdominal pain

The condition of achalasia

  • Muscles of esophagus don’t work appropriately
  • Causes spasms or constriction

The treatment for EoE

  • Elimination diet (remove wheat, eggs, milk, soy, shellfish and seafood, peanuts and tree nuts)
  • Topical or systemic steroids

The potential increased prevalence of EoE in children with celiac disease

  • 2015 paper found prevalence of 10.7% (much higher than general population)
  • Other research articles argue no increased prevalence of EoE in CD

The case study of a 30-year-old woman with celiac disease and elevated eosinophils

  • Presented with abdominal pain and distension, vomiting and frequent bowel movement
  • Treated with IV hydrocortisone, but developed steroid induced psychosis

Nadine’s insight on the best specialty clinics for EoE in the US

  • University of Colorado (Denver School of Medicine)
  • Pennsylvania

Dr. Glenn Furuta’s insight on the difficulty of diagnosing EoE

  • Relatively new disease, tendency to diagnose based on pathology report alone
  • Elevated eosinophils also found in GERD, inflammatory bowel disease and celiac disease

Special considerations for pediatric patients with EoE

  1. Consultation with dietician
  2. Limited exposure to corticosteroids
  3. Attention to development of feeding skills
  4. Potential psychosocial, behavioral problems

Resources:

‘Unsedated Transnasal Esophagoscopy for Monitoring Therapy in Pediatric Eosinophilic Esophagitis’ in Gastrointestinal Endoscopy

‘Eosinophilic Esophagitis Associated with Celiac Disease in Children’ in BMC Research Notes

‘Eosinophilic Gastrointestinal Disorder in Coeliac Disease: A Case Report and Review’ in Case Reports in Gastrointestinal Medicine

‘Eosinophilic Esophagitis in Children and Adults’ in Gastroenterology and Hepatology

‘The Association Between Celiac Disease and Eosinophilic Esophagitis in Children and Adults’ in BMC Gastroenterology

‘Eosinophils in Gastrointestinal Disorders’ in Immunology and Allergy Clinics of North America

‘2013 Update on Celiac Disease and Eosinophilic Esophagitis’ in Nutrients

‘Eosinophilic Esophagitis: New Insights in Pathogenesis and Therapy’  in the World Journal of Gastrointestinal Pharmacology and Therapeutics

‘Incidence and Prevalence of Eosinophilic Esophagitis in Children’ in the Journal of Pediatric Gastroenterology and Nutrition

‘Management of Eosinophilic Esophagitis and Celiac Disease’ in Current Opinion in Pharmacology

‘Increased Risk of Esophageal Eosinophilia and Eosinophilic Esophagitis in Patients with Active Celiac Disease on Biopsy’ in Clinical Gastroenterology and Hepatology

‘Individuals Affected by Eosinophilic Gastrointestinal Disorders Have Complex Unmet Needs and Frequently Experience Unique Barriers to Care’ in Clinics and Research in Hepatology and Gastroenterology

‘Eosinophilic Esophagitis and Celiac Disease: A True Association or Coincidence?’ in the Journal of Pediatric Gastroenterology and Nutrition

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

Apr 20, 2018

If you’re just getting used to eliminating gluten from your diet, it may feel like a burden to remove dairy as well—especially if you’re a fan of comfort foods like cheese and ice cream. Why exactly do many practitioners recommend a gluten- AND dairy-free diet to patients diagnosed with celiac disease and non-celiac gluten sensitivity?

The Gluten Free RN is walking us through the similarities between gliadin and casein, explaining how the proteins found in gluten, milk and cheese impact our brains. She discusses how Marsh 1 damage from celiac disease leads to an inability to break down the sugar in milk and why we crave the very foods that are making us sick.

Nadine shares the story of a young man with autism whose health improved once his family went gluten-free, describing the well-documented gut-brain connection and how the right high-fat diet can repair the neurological system. Listen in for the Gluten Free RN’s insight around dairy replacement options and get empowered to reclaim your health with a gluten- and diary-free diet!

What’s Discussed: 

The similarities between the gluten and casein proteins

  • Molecularly very similar, bodies read as toxins
  • Both capable of crossing blood-brain barrier

How the casein protein impacts the brain

  • Causes inflammation, hypoxia (decrease flow of oxygen)
  • Brain fog, anxiety, depression, irritability and fatigue

The effect of Marsh 1 damage due to celiac disease

  • Microvilli damaged or destroyed
  • Can’t produce enzymes that break down sugar in milk

How gluten and casein proteins act as exorphins

  • Bind with opium receptors in brain
  • Crave foods that make us sick

Nadine’s recommendations for dairy replacements

How a gluten-free diet helped a young man with autism

  • More interaction with family, fewer GI issues
  • High-fat diet repairs neurological system

The story of Dr. Terry Wahls

  • Diagnosed with MS, healed on gluten-free diet

Resources:

Aroy’d Coconut Milk

Kite Hill

NuCulture Foods

Mary’s Gone Crackers

Jilz Crackers

Dr. Terry Wahls’ TED Talk

The Wahls Protocol  by Dr. Terry Wahls

Dr. Terry Wahls’ Website

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

Apr 13, 2018

‘Globally, indigenous peoples suffer from poorer health, are more likely to experience disability and reduced quality of life, and ultimately die younger than their non-indigenous counterparts.’

A UN Report on the health of indigenous peoples points to a significant problem, but the question is WHY? Why are native populations more prone to autoimmune disorders and type 1 diabetes? Why do they have a higher incidence of alcoholism and drug addiction? And why the lower life expectancy?

The Gluten Free RN is exploring the role of food in health outcomes for indigenous populations around the world. She begins with an explanation of the dietary differences between hunter-gatherer and agricultural societies, discussing how native populations were exposed to the gluten in grains only when European conquerors came to occupy their lands.

Nadine shares her challenge in finding information about indigenous populations and celiac disease, explaining why further study is necessary. She speaks to the highly processed nature of the commodity foods provided to Native Americans in the US and the shortcomings of Canada’s Food Guide when it comes to the health of First Nations people. Listen in and learn the significance of educating indigenous populations around celiac disease and non-celiac gluten sensitivity, empowering those groups to make choices that will improve their health and quality of life!

What’s Discussed: 

The global indigenous population

  • 370M in 70-plus countries
  • Rich diversity of cultures

The health status of indigenous populations

  • Higher incidence of autoimmune disorders, T1D
  • Higher prevalence of addictive disorders, cardiovascular disease
  • Lower life expectancy, increased morbidity/mortality

Why indigenous populations have more health issues

  • Access to health care, isolation and lifestyle
  • Food (hunter-gatherer vs. agricultural society)

The lack of information around indigenous populations and celiac disease

  • Very few studies available

The impact of grains on the native population

  • Significant change in health care outcomes, quality of life

The prevalence of celiac disease in indigenous populations

  • At least 1%, likely 3% or higher
  • No way to know without mass screening

Why eating healthy is a challenge for the indigenous population

  • Food scarcity, desserts
  • Reliance on commodity foods provided by government

The conclusions of the Prairie Nymph blog on Canada’s Food Guide

  • Based on diet of European origins, doesn’t mention celiac disease
  • Ignores health benefits of traditional diet for First Nations people

Why it’s important to educate indigenous people around celiac disease

  • Empower to make food choices with better health outcomes

Resources:

Guns, Germs, and Steel: The Fates of Human Societies by Jaren M. Diamond

Dough Nation by Nadine Grzeskowiak

USDA Commodity Supplemental Food Program

‘Canada’s Food Guide and Native Women’ by Prairie Nymph

The Sioux Chef’s Indigenous Kitchen by Sean Sherman

American Indian and Alaska Native Health

‘Celiac Disease: A Disorder Emerging from Antiquity, Its Evolving Classification and Risk, and Potential New Treatment Paradigms’ in Gut Liver

‘Celiac Disease: A Life-Changing Diagnosis’ in Indian Country Today

‘Government Food Boxes? It’s Nothing New for Native Americans’ on WDET

UN Indigenous Peoples Fact Sheet

‘Many Native Americans Lack Access to Healthy Food, But There’s a Growing Movement to Change That’ in Grist

‘Characteristics and Factors Related to Quality of Life in Mexican Mestizo Patients with Celiac Disease’ in BMC Gastroenterology

Summary of Aboriginal and Torres Strait Islander Health

WHO Health of Indigenous Peoples

WHO Indigenous Peoples and Substance Abuse

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

Apr 6, 2018

‘It’s too hard.’ ‘It’s too expensive.’ ‘It’s time-consuming.’ ‘My family won’t support me.’

There are lots of excuses why you can’t go gluten-free or Paleo, but the Gluten Free RN argues that if it’s hard, you’re doing it wrong. And today, she’s prepared to explain how to easily go gluten-free or Paleo and either maintain or regain your health.

Nadine begins with a discussion of the connection between food and pain or discomfort. She explains how the processed, non-food that most people consume causes damage that prevents us from absorbing the nutrients our bodies need. She offers insight around where to go for gluten-free, organic food and how to jump-start a gluten-free or Paleo diet.

The Gluten Free RN provides tips on taking control of your food choices, trying new foods, and gluten-free cooking—minus the cheap fillers. She also outlines a shopping list for nutrient-dense foods that will heal your leaky gut and feed your neurologic system. Listen in and learn the easy way to go gluten-free or Paleo and optimize your health!

What’s Discussed: 

The value in recognizing how you feel

  • Shouldn’t have pain, discomfort daily
  • Underlying cause traced back to food

Nadine’s response to excuses for not going gluten-free

  • No more expensive, must buy food anyway
  • Food is medicine, good choices can improve health

How to avoid non-food with empty calories

  • Stay away from soda, sugary coffees
  • Pass up highly processed and fast non-food

The difference between organic and conventional food

  • Conventional food—herbicides, pesticides, genetically modified
  • Roundup causes leaky gut, even in absence of celiac disease

Nadine’s suggestions around where to go for gluten-free food

  • Grocery stores that cater to gluten-free population
  • Local food co-ops, farmers

Nadine’s advice for going gluten-free or Paleo

  • Try new foods in the produce section
  • Learn to pack simple breakfast, lunch and dinner
  • Consider putting in garden
  • Get re-educated, take control of food choices
  • Replace cutting boards, toasters, etc.

How to get started on a gluten-free or Paleo diet

Nadine’s shopping list for a gluten-free diet

  • Fruits and vegetables
  • Nuts and seeds
  • Meat, fish and eggs

Resources:

Whole Foods

Natural Grocers

Whole30

Midway Farms

Whole30 Cookbooks

Paleo Magazine

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

Mar 30, 2018

As stories about Russia continue to dominate the news cycle, you are probably familiar with the recent sanctions against the country, Vladimir Putin’s reelection, and even the expulsion of Russian diplomats from the EU and US. But what do you know about celiac disease in Russia?

The Gluten Free RN is taking a closer look at the limited information about celiac disease in Russia, giving us an overview of the country’s size and population and the likely number of celiac cases based on the global tendency. She discusses the thriving wheat production industry in Russia as well as the gluten-containing traditional Russian diet.

Nadine walks us through a presentation created by Dr. Elena Roslavtseva at the Scientific Center for Children’s Health in Moscow, sharing how the diagnoses of celiac disease changed from the 1970’s through the 2000’s, the inconsistencies with testing for celiac disease around the nation, and the challenges of maintaining a gluten-free diet in Russia. Listen in as the Gluten Free RN covers the Journal of Immunology Research’s overview of celiac disease in Russia, explaining why the reported frequency probably doesn’t reflect the true prevalence and the necessity of a mass screening.

What’s Discussed: 

General information about the country of Russia

  • Population of 144.3M
  • Dual nation state, 185 ethnic groups
  • Largest country by land mass

Russia’s thriving wheat production industry

  • Very high, exported to Middle East and Africa
  • Ban on genetically modified wheat

The first diagnoses of celiac disease in Russia

  • Late 1970’s—1980’s
  • Cases of severe malabsorption
  • No gluten-free foods available

How celiac diagnoses changed in the 2000’s

  • Diagnosed more often, well-known in most regions
  • Research done in many universities, med centers

The Eastern European countries that have done mass screenings

  • Romania, Slovakia, Slovenia, Estonia

Why the data around celiac disease in Russia is unreliable

  • Variation in how practitioners test for celiac disease
  • Belarus—HLA-typing not available in most cases
  • Latvia—mandatory screening for patients with IDDM and AIT

The problems associated with celiac disease in Russia

  • Unreliable data in absence of mass screening
  • Gluten-containing traditional Russian food

The overview presented in the Journal of Immunology Research

  • Diagnostic tools for celiac disease in Russia vary significantly
  • Reported frequency of 0.2-0.6%, but real rate unknown

Resources:

‘Coeliac Disease and Gluten Related Disorders in Russia and Former Soviet Republics’ by Dr. Elena Roslavtseva

‘Overview of Celiac Disease in Russia: Regional Data and Estimated Prevalence’ in the Journal of Immunology Research

‘Russia, Argentina and Canada Displace US, Europe in Global Wheat Trade’ in agriCENSUS

‘Russian Wheat Sales Expand Global Reach with Surge in Sudan’ in Bloomberg

‘Russia’s Wheat Industry: Implications for Australia’ from the Australian Export Grains Innovation Centre

‘Growing Importance of Russian Milling Wheat Worldwide’ from Solaris Commodities

‘How an Oil Giant (Russia) Came to Dominate Wheat’ in Bloomberg

‘Celiac Disease in Russia and the Former Soviet Republics’ in The Celiac Scene

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Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

Mar 23, 2018

When faced with new information, it’s important to consider the source. Stop for a moment and examine whether the material is coming from someone with YOUR best interests at heart. The Gluten Free RN has just returned from the Colombia University Celiac Disease Conference, and she is breaking down the information presented to determine what’s useful—and what might be tainted by the pharmaceutical or food industry agenda.

Nadine begins with a workshop led by General Mills that offered some questionable information about how grains are processed at their factories and a talk led by University of Chicago faculty on the topic of a gluten challenge. She also speaks to the differences between celiac management in the US and countries with universal healthcare like Italy and Australia.

Nadine covers new testing that detects gluten exposure in stool or urine and what that reveals about the systemic nature of gluten damage as well as her take on practitioners who perpetuate the myth that grains are necessary and nutritious. Listen in for the Gluten Free RN’s insight around pharmaceutical treatments for celiac disease and the danger in volunteering for studies backed by drug companies.

What’s Discussed:

The two programs available at Colombia’s 2018 conference

  • Clinical (nurses, RDs and laypeople)
  • International (doctors, scientists, industry and VC)

How celiac disease is managed in Italy

  • Presentation by Dr. Carolina Ciacci
  • Law mandates gluten-free options

Nadine’s frustration with the General Mills presentation

  • Major sponsor of conference
  • Claim to separate grains at factory

Nadine’s take on gluten-free Cheerios

  • Should be avoided, not truly gluten-free

Nadine’s confusion around Dr. Bana Jabri’s comments

  • Wouldn’t put ‘potential celiac patient’ on gluten-containing diet
  • Did not include patients with positive antibody test but negative biopsy

Why the biopsy for celiac disease is problematic

  • Only tests one foot into duodenum
  • GI tract is 30 feet in length

Nadine’s insight on a gluten-free challenge

  • No possible benefit for patient
  • Unnecessary, unethical

The systemic nature of gluten damage

  • New tests detect gluten exposure in stool, urine
  • Urine test indicates passage through every system

Nadine’s stance on pharmaceutical treatments for celiac disease

  • No pill or vaccine will treat or cure CD
  • Harmful to people in studies

The myth that grains are necessary and nutritious

  • Practitioners who perpetuate are ‘toeing company line’

Why it’s important to understand the source of your information

  • Should be untainted by pharmaceutical money, agenda

Australia’s requirements for gluten-free food

  • Standard of less than 3 ppm

Resources:

Celiac Symposium Program

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Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

Mar 9, 2018

To pierogi or not to pierogi…

If you have celiac disease, there is no question that you should avoid anything made with flour or grains, no matter how delicious the dish may be. Although the Gluten Free RN has fond memories of her Polish grandmothers making traditional pastries, she contends that you don’t have to eat customary Polish food to celebrate your Polish heritage.

In preparation for her upcoming trip to Warsaw in July, Nadine is taking a closer look at celiac disease in Poland. She discusses a 2009 study assessing the prevalence of celiac disease in Polish children, highlighting the asymptomatic and oligosymptomatic nature of the disease and explaining her own false negative test. Listen in for the Gluten Free RN’s insight around preparing for a trip to Poland, including research on the available gluten-free food and adult beverages!

What’s Discussed:

Why Nadine is concerned about her upcoming trip to Poland

  • Flour, grains used in cooking and baking

Nadine’s Polish heritage

  • Fond memories of grandmothers making pierogi, pastries

The 2009 study of celiac disease in Poland

  • Assessed prevalence in children, only screened for IgA EmA, IgG EmA
  • 3,235 children in Bydgoszcz tested, 25 identified (seven with Marsh III)
  • Predominantly asymptomatic or oligosymptomatic

Nadine’s genetic predisposition for celiac disease

  • HLA-DQ2.5 homozygous

How Nadine is preparing for travel in Poland

  • Aware of Polish translations for gluten-free, celiac (bezglutenowe, trzewny)
  • Take ‘rescue food’ for emergencies

The prevalence of celiac disease in Poland

  • 1:100 (matches worldwide estimate)

The gluten-free alcoholic beverages available in Poland

  • Potato vodka, honey mead

Nadine’s caution against eating bread in Europe

  • Wheat, grain causes damage regardless of location

The overlap between autoimmune and celiac disease

  • CD is grossly unrecognized, underdiagnosed

Nadine’s suggested diet for celiac patients

  • Meat, fish and eggs
  • Nuts and seeds
  • Fruits and vegetables 

Resources:

NIH Consensus Development Conference on Celiac Disease

‘Screening for Celiac Disease in Poland’ in the Medical Science Monitor

Gluten-Free Globetrotter Blog on Poland

Gluten-Free Travel in Poland—Coeliac Youth of Europe

Poland Travel Guide—Coeliac UK

‘Graves’ Disease, Celiac Disease and Liver Function Abnormalities in a Patient—Clinical Manifestation and Diagnostic Difficulties’ in ACTA Biochimica Polonica

‘Neuropsychiatric Symptoms and Celiac Disease’ in Neuropsychiatric Disease and Treatment

‘Evaluation of HLA-DQ2/DQ8 Genotype in Patients with Celiac Disease Hospitalised in 2012 at the Department of Paediatrics’ in Przeglad Gastroenterologiczny

For Visitors with Coeliac Disease—Polskie Stowarzyszenie Osob z Celiakia i na Diecie Bezglutenowej

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Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Mar 2, 2018

The Irish are known for being lucky… But does that luck hold out when it comes to celiac disease?

The prevalence of celiac disease among the Iris is 1:100, about the same as the rest of the world. And if you are a redhead of Irish descent, there is a good chance that you are an HLA-DQ2 or HLA-DQ8 gene carrier.

Today, the Gluten Free RN explores Irish ancestry and celiac disease, discussing how the Potato Famine led to a change in diet for much of the surviving population. She walks us through a paper published by Irish College of General Practitioners explaining the clinical presentations and complications of celiac disease.

Nadine shares her experience running the Dublin marathon and the health consequences she suffered after touring the Guinness brewery. Listen in to understand the work of the Coeliac Society of Ireland and learn about the trends in celiac disease among the Irish.

What’s Discussed: 

Why red hair is associated with celiac disease

  • Tend to be HLA-DQ2 and/or HLA-DQ8 gene carriers

The prevalence of celiac disease in Irish Setters

  • Do much better on a gluten-free/Paleo diet

The Irish Potato Famine

  • Potato-based diet, little access to grains
  • Famine from 1845-1849
  • One million died, many emigrated

The myth that celiac disease is more prevalent in Europe than the US

  • 30-50% of the population carries HLA-DQ2, HLA-DQ8 gene

The myth that women are more susceptible to celiac disease

  • Statistics don’t support this belief

The Irish College of General Practitioners paper on celiac disease

  • Clinical presentations, complications of celiac disease
  • Conditions associated with increased prevalence

The prevalence of celiac disease in Ireland

  • 1:100 (matches rest of world)

The appropriate testing for celiac disease and NCGS

  • Blood test for total IgA/IgG, DGP and AGA

Nadine’s experience running the Dublin marathon in 1998

  • Extreme edema in lower extremities

The information provided by the Coeliac Society of Ireland

  • Health ramifications of undiagnosed CD
  • Average duration from symptoms to diagnosis (nine months)

Resources:

‘Gluten-Sensitive Enteropathy in a Family of Irish Setters’ in The Canadian Veterinary Journal

‘Diagnosis and Management of Adult Coeliac Disease’ in ICGP

Coeliac Society of Ireland

‘Prevalence and Incidence of Celiac Disease in Edinburgh and the Lothian Region of Scotland’ in Gastroenterology

‘Prevalence and Diagnosis’ by the Coeliac Society of Ireland

‘Coeliac Disease in Europe’ in Alimentary Pharmacology & Therapeutics

‘Escalation in the Amount of Adults Diagnosed with Coeliac Disease’ in Lifestyle Health

‘Gluten-Free Foods’ by the Food Safety Authority of Ireland

‘How Irish Diets of the Past Affect the Present’ in The Irish Times

‘Changes in Presentation of Celiac Disease in Ireland from the 1960s to 2015’ in Clinical Gastroenterology and Hepatology

‘Coeliac Disease: A Personal Perspective’ in Irish Health

‘Coeliac Disease: More Common Than You Think in Irish Health

‘Pathology and Management of Coeliac Disease’ by the Dublin Academic Medical Centre & UCD

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Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Feb 23, 2018

It goes without saying that anyone who serves in the military needs to be healthy and strong—and that military leaders have an obligation to keep enlisted servicemen and women as safe and healthy as possible. So, it makes sense that people with food allergies (including celiac patients) are disqualified from military service, but it is less clear why celiac testing is not a part of the medical exam to qualify for enlistment.

Today, the Gluten Free RN addresses the issue of celiac disease in the military. She explains the challenges of preparing gluten-free food in a mess hall setting and describes the consequences for an active duty soldier who is found to have celiac disease.

Nadine shares a research study exploring celiac trends among active duty military as well as a case study around veterans and celiac disease. Listen in for insight on what’s behind the increased prevalence of celiac disease among military personnel and the confirmed association between celiac disease and other complex health issues.

What’s Discussed: 

Why celiac patients are disqualified from enlisting in any branch of service

  • Unable to provide safe food

What happens to military personnel who are found to have celiac disease

  • Will receive medical discharge

The US military policy around food allergies and intolerances

  • No accommodations made

Countries that allow celiac patients to serve

  • Israel, Finland and Scandinavia

The Mayo Clinic study of celiac trends among active duty military

  • Healthy worker population with medical diagnostic coding
  • Incidence of celiac disease increased five-fold from 1999-2008
  • Combination of increased suspicion and environmental factors

The challenge of preparing gluten-free food in a military setting

  • High risk of cross-contamination

A case study involving military veterans and celiac disease

  • Confirmed association between CD and other complex issues

The benefits of a gluten-free diet

  • Preventative for autoimmune disorders, nutritional deficiencies and cancer

Nadine’s argument for celiac testing prior to enlistment

  • Obligation to safety of servicemen/women

 

Resources:

Military Standards of Medical Fitness

‘The Incidence and Risk of Celiac Disease in a Healthy US Adult Population’ in the American Journal of Gastroenterology

‘Celiac Sprue Among US Military Veterans: Associated Disorders and Clinical Manifestations’  in Digestive Diseases and Sciences

‘Gluten-Free Soldier in Afghanistan’ in Gluten-Free Living

‘Medical Mix-Up Sidelines Army Sergeant’s Career’ in Military Times

Celiac Disease-Related Veterans Affairs Case

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Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Feb 9, 2018

We get vaccinated to protect ourselves, to gain an immunity to a particular disease. But in the case of hepatitis B, celiac patients may come to find out that we are NOT immune—despite having done the right thing in getting a hepatitis B vaccination.

 Today, the Gluten Free RN is walking us through the latest research around vaccination and celiac disease. She explores the fact that celiac patients are more likely to be non-responsive to HBV than the general population, explaining the fundamentals of hepatitis B and the two main theories as to why the vaccine doesn’t work for some celiac patients.

 Nadine shares her take on immunizations, explaining why she is a proponent of an alternate vaccination schedule for infants who may be immunocompromised. Listen in and learn how to determine whether you are truly immune to hepatitis B and protect yourself from potentially life-threatening disease!

What’s Discussed: 

The basics of hepatitis B (HBV)

  • Viral infection that attacks liver
  • Transmitted through blood, body fluids

The prevalence of hepatitis B

  • 257M people infected
  • 887K deaths in 2015

The 2013 Italian study around celiac disease and the hepatitis B vaccine

  • Number of non-responders to vaccine higher in CD patients
  • May be genetic OR caused by gluten intake during vaccination

Nadine’s experience with vaccination as a child

  • Contracted mumps despite MMR

Nadine’s take on vaccination

  • Advocates for immunization to prevent disease
  • Giving babies multiple vaccines at once may not be best

The conclusion of a 2017 Italian study

  • Administer booster shots of hepatitis B vaccine as needed
  • Evaluate response to vaccine in newly diagnosed celiac patients
  • Revaccinate one year after adoption of gluten-free diet

The value of a hepatitis B titer

  • Confirms whether really immune
  • If not, test for celiac disease

Resources:

‘Hepatitis B Vaccine in Celiac Disease: Yesterday, Today and Tomorrow in the World Journal of Gastroenterology

‘Vaccinations in Celiac Disease’ in the Journal of Pediatric Gastroenterology and Nutrition

‘Immune Response to Vaccines in Children with Celiac Disease’ in the World Journal of Gastroenterology

‘Immune Response to Hepatitis B Vaccine in Patients with Celiac Disease: A Systematic Review and Met-Analysis’ in Human Vaccines and Immunotherapeutics

‘Early Vaccinations are Not Risk Factors for Celiac Disease’ in Pediatrics

‘Gluten Intake Interferes with the Humoral Immune Response to Recombinant Hepatitis B Vaccine in Patients with Celiac Disease’ in Pediatrics

‘Effect of Pentavac and Measles-Mumps-Rubella (MMR) Vaccination on the Intestine’ in Gut

‘Normal of Defective Immune Response to Hepatitis B Vaccine in Patients with Diabetes and Celiac Disease’ in Human Vaccines and Immunotherapeutics

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Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Feb 2, 2018

When the Gluten Free RN went on a gluten-free diet 11 years ago, her thyroid settled down and the associated symptoms and disorders—Graves’ disease, weight gain and hair loss—resolved.

But when Nadine was inadvertently hit with gluten two years ago, several of those symptoms returned, along with a few new ones. She was losing hair and gaining water weight again. On top of that, her sinuses were congested. She developed asthma, a rash on her lower right leg and a scary case of pulmonary edema (excess fluid in the lungs).

Hindsight being 20/20, Nadine realizes that her recent diagnosis of hypothyroidism is associated with that accidental gluten ingestion. Further study made it clear that there is a potential connection between her thyroid problems and pulmonary edema, as the leaky gut that comes with celiac disease can cause fluid shifts into body tissues.

Today the Gluten Free RN explores the links among celiac disease, thyroid disorders and pulmonary edema. She explains the function of the endocrine system, the symptoms associated with hypothyroidism, and the diet she recommends for patients with thyroid issues. Listen in for Nadine’s insight around how gluten affects the thyroid gland and why the resulting low sodium levels might trigger edema in celiac patients.

What’s Discussed: 

The function of the endocrine system

  • Glands in body that make hormones

The connection between celiac disease and thyroid disorders

  • Thyroid especially vulnerable to gluten protein in wheat, barley, rye and oats

Nadine’s symptoms of hypothyroidism

  • Lower extremity edema
  • Congested sinuses
  • Hair falling out
  • Pulmonary edema
  • Asthma
  • Rash on leg

How damp rash lotion resolved Nadine’s symptoms

  • Prescribed by acupuncturist in Chiang Mai
  • Rash cleared, could breathe easy
  • Symptoms returned within four weeks of return to US

Nadine’s thyroid-stimulating hormone (TSH) levels

  • Within normal limits despite thyroid issues
  • Practitioner declined to order thyroid panel

The relationship between thyroid issues and edema

  • Sodium = major electrolyte, maintains body’s pH
  • Hypothyroidism means low sodium levels
  • Leaky gut of celiac disease leads to fluid shifts (edema)

The research around thyroid disorders and celiac disease in Current Allergy and Asthma Reports

  • Association between CD and thyroid disorders well documented
  • Increased prevalence of autoimmune thyroiditis and Graves’ disease in celiac populations

The diet Nadine recommends for celiac patients with potential thyroid issues

  • Gluten-free, dairy-free
  • Whole food, Paleo

Why patients with unexplained pulmonary edema should be tested for celiac disease AND thyroid disorders

  • Potential connection among all three

The symptoms associated with hypothyroidism

  • Puffy face, constipation, fatigue
  • Muscle weakness, aches and pains
  • Irregular, delayed menstrual periods
  • Hair loss, thinning hair
  • Slower heartrate, hypothermia
  • Depression, memory problems

Resources:

 

‘Pregnancy Complicated with Pulmonary Edema Due to Hyperthyroidism’ in the Journal of the Chinese Medical Association

‘Sleep Apnea, Hypothyroidism and Pulmonary Edema’ in CHEST Journal Letters to the Editor

‘Thyroid and Fluid Retention’ on the Wilson’s Syndrome Site

‘Acute Pulmonary Edema as a First Manifestation of Hyperthyroidism in a Pregnant Woman’ in Revista Medica de Chile

‘Hypothyroidism and Non-Cardiogenic Pulmonary Edema: Are We Missing Something Here?’ in Endocrinology, Diabetes & Metabolism Case Reports

‘Celiac Disease and Autoimmune Thyroid Disease’ in Clinical Medicine & Research

‘Celiac Disease and Autoimmunity: Review and Controversies’ in Current Allergy and Asthma Reports

‘An Unusual Cause of Flash Pulmonary Oedema’ in BMJ Case Reports

‘Challenges in the Management of a Patient with Myxoedema Coma in Ghana: A Case Report’ in Ghana Medical Journal

‘Hyponatremia and the Thyroid: Causality or Association?’ in the Journal of Clinical Medicine

‘Interactions Between Thyroid Disorders and Kidney Disease’ in the Indian Journal of Endocrinology and Metabolism

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Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Jan 26, 2018

An estimated 50% of Americans are on some type of psychotropic drug. Half of the US population!

What is causing such widespread prevalence of mental health disorders? Prescription anti-depressants and sedatives don’t solve the underlying problem…  So how do we get to the bottom of this? 

The Gluten Free RN contends that there may be a connection between mental health and undiagnosed celiac disease. Today she explains how several disorders (anxiety, depression and paranoia, among others) have been linked to gluten, discussing how a leaky blood-brain barrier can lead to hypoxia, an inflammation of the brain.

Nadine walks us through the best research in mental health disorders and gluten sensitivity, sharing two landmark studies that emphasize the gut/brain connection and characterize celiac disease as primarily a neurological disorder. Nadine offers her insight around working with schizophrenic patients and the increasing number of children suffering from anxiety. Listen in to understand how gluten impacts your mental health, and learn how to eliminate brain fog, get off prescription meds, and enjoy a higher quality of life!

What’s Discussed: 

The connection between gluten and hypoxia

  • Leaky blood-brain barrier leads to inflammation of brain, decreased oxygen flow

The shocking statistics around Americans and psychotropic drugs

  • Estimated 50% of US population on psychotropic medication

The potential relationship between mental health disorders and undiagnosed celiac disease

  • High instance of depression, anxiety, fatigue and paranoia
  • May have difficulty sleeping, headaches or seizure disorder
  • Nearly all experience brain fog

The health consequences of undiagnosed celiac disease

  • Malabsorption of nutrients
  • Damaged immune system
  • Neurological symptoms
  • Hormonal imbalance
  • Neurotransmitter disruption

The findings of the landmark Cooke study in 1966

  • Ten of 16 patients with celiac disease had severe progressive neuropathy
  • All 16 had severe malabsorption

The conclusion of an editorial published in Neurology, Neurosurgery & Psychiatry

  • Celiac disease, NCGS is primarily neurological

How a gluten-free diet can resolve gastrointestinal and psychiatric symptoms

  • Celiac disease can manifest as depression, anxiety or psychosis
  • Research published in International Journal of Celiac Disease demonstrates gut/brain connection

Nadine’s experience with schizophrenia patients

  • Majority are gene positive for HLA-DQ2, HLA-DQ8

The increasing number of children diagnosed with anxiety disorder

  • May be caused by undiagnosed sensitivity to gluten

The concept of food as medicine

  • Body may read gluten as toxic, must remove from diet

Resources:

‘Gluten Sensitivity as a Neurological Illness’ in the Journal of Neurology, Neurosurgery & Psychiatry

‘Psychiatric Complications of Celiac Disease’ in the International Journal of Celiac Disease

‘Genetic Hypothesis of Idiopathic Schizophrenia: Its Exorphin Connection’ in Schizophrenia Bulletin

‘Markers of Gluten Sensitivity and Celiac Disease in Bipolar Disorder’ in Bipolar Disorders

‘Neurologic and Psychiatric Manifestations of Celiac Disease and Gluten Sensitivity’ in Psychiatric Quarterly

‘Neuropsychiatric Symptoms and Celiac Disease’ in Neuropsychiatric Disease and Treatment

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Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Jan 19, 2018

Two and a half years ago, Nadine was inadvertently hit with gluten—three times in a row. In the past, it had taken about ten weeks for her symptoms to resolve after an accidental exposure, but this time they stuck around. It started with feeling cold. Then she began experiencing abdominal distention and pain.  Her dermatitis herpetiformis returned, she was plagued with sinus congestion, and she was gaining weight. Most concerning of all, she developed pulmonary edema, a condition caused by excess fluid in the lungs.

 Today, the Gluten Free RN is getting real, revealing the health struggles she has been dealing with since 2015. She explains the circumstances that led to her accidental gluten exposure and recounts the ten scary nights she spent in a recliner, forced to sit up in order to breathe.

 Nadine takes us along on her global search for the answers that began with a practitioner in Thailand and a tiny container of damp rash lotion, and ended with a diagnosis of myxedema from a naturopath here in the States. Nadine discusses how those three consecutive hits of gluten targeted her thyroid gland and how T3 is working to resolve her symptoms. Listen in and learn how the Gluten Free RN is reclaiming her Superwoman status and how you, too, can reach your full potential with good health and wellbeing!  

What’s Discussed: 

Maslow’s hierarchy of needs

  • Physiological, safety needs must be taken care of first
  • Difficult to achieve self-actualization with poor health

 Nadine’s health struggle the past 30 months

  • Inadvertently hit with gluten three times in a row
  • Symptoms persisted past usual ten weeks
  • Sinus congestion, DH, pulmonary edema and weight gain

 Nadine’s search for the underlying cause

  • Saw practitioner in Chiang Mai, damp rash lotion resolved symptoms
  • Naturopath in Oregon diagnosed myxedema (hypothyroidism)

 How Nadine is reclaiming her health

  • Taking T3 to resolve symptoms

 How a damaged thyroid gland impacted Nadine

  • Affected sleep, ability to do challenging physical activity

 The importance of support in getting your health back

  • Need relationships to support choices

Resources:

Whole30

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Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Jan 12, 2018

Celiac disease is messy. It can develop at any age, in any ethnicity, in both men and women, with any symptom or no symptom at all. Every patient is different, and each one presents differently. There is nothing cut and dried about celiac disease, except that a 100% gluten-free diet is necessary for healing.

Nurses are in a unique position to make sense of this chaos and advocate for patients, recognizing possible celiac disease and non-celiac gluten sensitivity and recommending appropriate testing when necessary. Today, the Gluten Free RN covers the basics of celiac disease for nurses, explaining the frequency with which the disorder is misdiagnosed or goes undiagnosed for years.  She walks us through the testing required for a diagnosis of celiac disease proper, who should undergo testing, and why one negative test doesn’t rule out the disease.

Nadine speaks to the 300-plus signs of celiac disease, reviewing the most common symptoms and the overlap between celiac disease and autoimmune disorders like type 1 diabetes. She also shares the discouraging statistics around the impact of undiagnosed celiac disease on fetal development and maternal health. Listen in to understand why Nadine encourages fellow nurses include celiac disease as part of their differential diagnosis, providing gluten-sensitive patients with a safe, gluten-free environment and a higher quality of life!

What’s Discussed: 

The frequency with which celiac disease is misdiagnosed or goes undiagnosed

  • 94% of people with celiac disease are undiagnosed
  • Current estimate is 3% of US population
  • Takes average of 9-15 years for diagnosis

 The challenges around getting a diagnosis of celiac disease proper

  • Requires genetic test, celiac antibody test and documented villous atrophy
  • Celiac antibody test = 70% false negative in US

 The chronic nature of celiac disease

  • Patients must go 100% gluten-free for life

 The 300-plus signs and symptoms of celiac disease

  • Primarily a neurological disorder

 Why celiac patients must be tested for potential nutritional deficiencies

  • May need B12, Mg RBC, D3, Zn or I supplements

 The detrimental impact of undiagnosed celiac disease on fetal development, maternal health

  • 800-900% increase in miscarriage
  • Increased risk of stillbirth, premature birth and neural defects

 Where gluten is hiding

  • Medications, personal care products and food items

 Who should be tested for celiac disease

  • Patients with mental health issues, developmental delays
  • Anyone with an autoimmune disorder (e.g.: type 1 diabetes)
  • Family members of celiac patients

 Why one negative test doesn’t rule out celiac disease

  • Can seroconvert at any time

 How a gluten-free diet can benefit children with stunted growth

  • Growth resumes if diagnosed before epiphyseal plates seal

Resources:

Celiac Disease and Non-Celiac Gluten Sensitivity for Nurses

Recommended Labs

Recognizing Celiac Disease: Signs, Symptoms, Associated Disorders & Complications by Cleo J. Libonati

Gluten Free Works

PubMed

Cyrex Labs

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Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Jan 5, 2018

As we ring in the New Year, many of us take the time to jot down our aspirations for the next twelve months. What are your hopes and dreams for 2018? Health and happiness? An opportunity to travel? Stronger relationships?

 Whether you have big plans to hike the Grand Canyon this year, or you simply resolve to get a little more sleep, it’s likely that aspects of health and wellness are a big part of your vision for 2018. The Gluten Free RN wants you to be happy and healthy in the coming year, and today she is sharing her hopes and wishes around celiac disease for 2018.

 Nadine offers insight on taking control of what you can, including the food you eat. She shares her wish for widespread access to high-quality food and nutritional information that is NOT influenced by corporations. She explains the need for universal healthcare, better comprehensive testing for celiac disease (performed annually), and appropriate follow-up care for patients with a celiac diagnosis. Listen in to understand why Nadine advocates for a global celiac education campaign and learn how to evaluate new information about the disease with a critical ear. Let’s get happy and healthy in 2018 so that we can pursue all of our hopes and dreams!

What’s Discussed: 

Nadine’s wish for health, happiness and wellness

  • Reevaluate your choices and control what you can (sleep, food, activities)

 Why Nadine advocates for universal healthcare

  • Everyone deserves access to high-quality healthcare without financial strain

 The need for better comprehensive testing

  • Healthcare providers should be educated in ordering, interpreting labs

 Nadine’s hope for worldwide knowledge of celiac disease

  • Patients in US not diagnosed correctly for 70 years
  • Consider mini-mass screening of patients/family

 The importance of accurate media coverage

  • Stories not influenced by sponsors, pharmaceuticals, etc.

 Why friends and family should be tested every year

  • Early diagnosis important
  • Can be ruled in, not ruled out

 The value of nutritional information not influenced by food companies

  • Understand where food comes from, how processed

 Nadine’s aspiration for universal access to high-quality food

  • Organic, whole foods with minimal processing
  • Provides fuel today, building blocks of healing

 The need for appropriate follow-up care

  • Labs to address nutritional deficiencies, associated issues

 Nadine’s insight around celiac education

  • Seek information, evaluate with critical ear

 

Resources:

Rotten Documentary Trailer

Whole30

Nadine’s Recommended Labs

Columbia University Celiac Disease Center

PALEOf(x)

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Dec 15, 2017

In 11 years as the Gluten Free RN, Nadine has done an incredible amount of research on celiac disease and delivered more than 2,000 lectures. No question she is frustrated to see misinformation continue to make its way onto celiac support sites and Facebook groups. How does the average person sift through all the material that’s out there—material that may be influenced by corporations and pharmaceutical companies with a vested interest in the way celiac disease is perceived—to get to the most accurate information?

Just in time for the holidays, the Gluten Free RN is sharing her wish list around the direction of celiac disease and non-celiac gluten sensitivity in the next ten years. She discusses the need for a global mass screening, explaining how celiac disease meets the World Health Organization’s criteria. She covers the reasons why pharmaceutical companies have no place in celiac research as well as the bad publicity the gluten-free community receives in the media.

Nadine speaks to the grievous lack of education about celiac disease among healthcare providers and shares her hope for a cultural shift to support people on a gluten-free diet, explaining the role nurses can play in ending the needless suffering. She talks about why a gluten-free diet is NOT dangerous and how to make the best food choices based on your lifestyle and current situation. Listen in and get empowered to accept responsibility for your health!

What’s Discussed: 

The need for a global mass screening

  • Celiac disease meets WHO criteria
  • 30-50% of population carries gene

Why pharmaceutical companies should not be involved in celiac research

  • Diet change resolves symptoms
  • Pharmaceutical involvement gives false hope for cure

The misinformation about celiac disease in the media

  • Misrepresentation in recent episode of Freakonomics Radio

The need to educate healthcare providers around celiac disease

Nadine’s call for support of people on a gluten-free diet

  • Don’t assume intentionally being difficult

The unique position of nurses to use their influence

  • Prevent needless suffering with understanding of celiac disease

Why you must accept responsibility for your own health

  • Take advantage of available resources
  • Find practitioners open to other modalities

How to avoid processed foods

  • Focus on raw, whole foods
  • Choose fresh fruits, vegetables
  • Don’t fall victim to convenience marketing
  • Use community, intuition to make decisions

Why a gluten-free diet is NOT dangerous

  • Nadine restored her health by eliminating grains
  • Unethical to suggest that celiac patient go off gluten-free diet

Resources:

Freakonomics Radio: The Demonization of Gluten

2004 NIH Consensus Statement on Celiac Disease

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Dec 8, 2017

You know that vitamin C is good for you. It is necessary for the growth, development and repair of all your body tissues, and it plays a role in the healthy functioning of your immune system. But evidence shows that the RDA—90mg for men and 75mg for women—may be woefully inadequate. And if you are suffering from certain types of cancer or sepsis, vitamin C may be the key to recovery.

 The Gluten Free RN is joined by vitamin C researcher Alex Michaels from the Linus Pauling Institute at Oregon State University to discuss the latest developments in vitamin C, explaining how intravenous vitamin C works to kill certain cancer cells and reverses the organ failure associated with sepsis. He also covers the difference between vitamin C inadequacy and vitamin C deficiency and the debilitating symptoms of scurvy.

 Nadine and Alex speak to the best food sources of vitamin C and how it impacts other vitamins and minerals like iron and copper. Alex offers his advice around how much vitamin C you should get on a daily basis and explains why synthetic and natural vitamin C are identical. Learn about the LPI mission to determine the optimal ranges of micronutrients and phytochemicals you should be getting on a daily basis and how you can benefit from their research!

What’s Discussed:

Micronutrients vs. macronutrients

  • Micronutrients are vitamins, essential minerals needed in small amounts (milligrams or micrograms/day)
  • Macronutrients include fats, carbs and proteins (grams/day)
  • Phytochemicals come from plants, affect health but not essential nutrients

 The difference between intravenous and oral vitamin C

  • Intravenous bypasses GI system, high concentration in bloodstream (up to 100 grams)
  • Body can only absorb certain amount of oral vitamin C, inflammation may prevent absorption

 Vitamin C’s resurgence as a cancer therapy

  • High levels of intravenous vitamin C can covert oxygen to hydrogen peroxide
  • Hydrogen peroxide floods and kills some cancer cells (e.g.: pancreatic tumors)

 Vitamin C’s role in the treatment of sepsis

  • Reverses organ failure, decreases inflammation
  • May restore vitamin C to normal levels, protect from negative effects of iron

 The availability of intravenous vitamin C

  • Difficult to obtain, naturopaths usually have dedicated supplier
  • More readily available in Australia, New Zealand

 The fundamentals of scurvy

  • Defined as deficiency in vitamin C
  • Symptoms include bleeding gums, corkscrew hair growth, open wounds, malaise and low energy
  • Very rare in western world, would have to go without any fruits or vegetables for months
  • May have vitamin C inadequacy without any outward signs of problem

 The best food sources of vitamin C

  • Chili peppers
  • Tropical fruits (papayas, Kakadu plum, camu camu)

 Factors that are known to denigrate vitamin C

  • Heat, light and air
  • Mechanical disruption (i.e.: juicer)
  • Basic pH (anything above 7)
  • Enzymatic factors
  • Iron, copper

 How vitamin C impacts other vitamins and minerals

  • Enhances iron absorption, some must be careful of iron overload
  • Synthetic vitamin C may deplete copper concentration

 Alex’s take on the appropriate daily intake of vitamin C

  • 400 mg/day recommended
  • RDA much too low

Resources:

Linus Pauling Institute

Micronutrient Information Center

LPI on Facebook

LPI on Twitter

LPI on LinkedIn

LPI on Pinterest

Biochemical, Physiological, and Molecular Aspects of Human Nutrition by Martha H. Stipanuk PhD and Marie A. Caudill

Cancer and Vitamin C by Ewan Cameron and Linus Pauling

Dr. Paul Marik on NPR

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Dec 1, 2017

How do you successfully transition to and maintain a 100% gluten-free diet for the rest of your life? The prospect of eliminating wheat, barley and rye from your diet may seem daunting, but it is possible to go gluten free for good—for the good of your family and your health!

The Gluten Free RN explains the addictive nature of gluten and what to expect during the detox process as you begin your gluten-free journey. She offers valuable advice around how to choose the best quality food products while avoiding potential sources of cross-contamination.

Nadine discusses the need for supplements that will help you heal faster and more completely, speaking to the vitamin levels you should monitor along the way. Listen and learn her best tips for navigating the grocery store and maintaining a positive attitude throughout the process of going gluten-free—for GOOD!

What’s Discussed: 

The addictive nature of gluten

  • Gliadin, gluten proteins bind to opioid receptors
  • Wheat, barley and rye are cheap and readily available

 What to expect during the detox process

  • Different for everyone
  • Consider elimination diet to reboot system
  • May feel worse before feel better
  • Headaches, low energy and feeling hungry are common

 Why you shouldn’t cheat on a gluten-free diet

  • Same autoimmune response, even if symptom-free

 Potential sources of cross-contamination

  • Processed foods
  • Unwashed fresh fruits, vegetables
  • Bulk bins
  • Restaurants
  • Own home (i.e.: cutting boards, hands, pets, utensils, appliances, etc.)

 Nadine’s rules around choosing quality food products

  • Five ingredients or less
  • Picture every ingredient
  • Certified gluten-free
  • 100% grain-free

 Why there is no such thing as cheap food

  • Pay for quick-fixes to treat symptoms

 The necessity of additional vitamins, supplements

  • Helps heal faster, more completely
  • Use multivitamin, fish oil, pre- and probiotics
  • Check levels of D3, Zinc, B6 and B12
  • Liquid, chewables and capsules are easier to break down

 Nadine’s advice around navigating the grocery store

  • Plan menus in advance
  • Bring list of safe foods
  • Read labels carefully
  • Consider local co-ops, natural grocers and farmers markets

 Nadine’s best tips for going gluten-free

  • Concentrate on what you can eat
  • Accept more cooking, baking and meal planning
  • Find support group
  • Stay current on research, food labeling
  • Practice mindfulness, maintain positive attitude

 Resources:

 

Whole30

Country Life Vitamins

Robb Wolf’s Paleo Food Matrix

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Nov 24, 2017

‘When in doubt, go without.’

The problem with processed food is that you simply can’t be sure that it is gluten-free. The risk of cross-contamination is high, and no one at the big corporations is accountable for your health. Not to mention the fact that processed foods have been irradiated to make them shelf-stable, effectively killing any probiotics. Even certified gluten-free products are often low in nutrients, high in calories—and expensive!

So what should you eat? The Gluten Free RN is on the case with her best suggestions around finding organic, whole foods that contain the healthy fat you need to heal. She explains her revised, gluten-free version of the food pyramid and discusses how these nutrient-dense foods support the healing process.

Nadine provides a list of the best nutrient-dense foods, offering the benefits of each. She also speaks to the most appropriate vitamins and supplements available to solve your nutrient deficiencies. You are what you eat, so make sure you are filling your tank with nutrient-dense foods that will improve your health and quality of life!

What’s Discussed: 

How nutrient dense foods support healing

  • Regenerate villi
  • Reduce inflammation of intestines
  • Heal immune system

Why Nadine recommends staying away from gluten-free junk foods

  • Low in nutrients, high in calories
  • Risk of cross-contamination (processed in facilities with wheat products)

The best sources of nutrient-dense foods

  • Whole foods, organic
  • Farmers market (few/no fertilizers)

Why shelf-stable products lack nutrients

  • Food dead from irradiation, no live probiotics

The risk of contamination in processed foods

  • No one accountable at big corporation
  • ‘When in doubt, go without’

Nadine’s revised food pyramid

  • Fruits and vegetables at base
  • Meat, fish and eggs
  • Nuts, seeds and berries

The importance of eating healthy fats

  • Heals intestines
  • Absorb fat-soluble vitamins (A, D, E and K)
  • Fix deficiencies
  • Healthy brain cells, nervous system
  • Balance hormones

Nadine’s recommendations around the best nutrient-dense foods

  • Sweet potatoes
  • Leafy greens (e.g.: kale, collard greens)
  • Berries
  • Coconuts
  • Black molasses
  • Avocados
  • Pumpkin, chia seeds
  • Meat and fish
  • High-quality eggs
  • Licorice root, peppermint tea
  • Cinnamon

Nadine’s vegetable challenge

  • Expand your vegetable repertoire
  • Try one new veggie per week

Nadine’s suggestions around additional vitamins, supplements

  • Good quality multivitamin
  • Fish oil (i.e.: Nordic Naturals)
  • Pre/probiotics
  • Vitamin D

How to avoid cross-contamination

  • Avoid bulk food bins
  • Wash produce

Resources:

Midway Farms on Facebook

Nordic Naturals

Country Life Vitamins

Bluebonnet Nutrition

Pure Encapsulations

National Nurses in Business Association

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

Nov 17, 2017

With the approach of the holidays, you may be nervous about navigating family and workplace gatherings—especially if you are newly diagnosed with celiac disease. How do you explain your dietary restrictions and keep yourself safe, eating well without getting ‘glutened’?

Today the Gluten Free RN shares her best advice around managing the holidays with celiac disease. She offers ten key tenants to help you enjoy the holiday season and mitigate stress, without feeling like you’re missing out. She shares some things you need to avoid, including unsafe situations, people who make you miserable, and cheating on your gluten-free diet! But she also discusses strategies you can implement to make the season bright, such as creating new traditions, getting creative in the kitchen, and finding your tribe—the people who will support you in your gluten-free journey.

Nadine also gives tips around where to go for gluten-free ingredients and holiday recipes, and how to develop a backup plan so you won’t go hungry if the food you encounter is questionable. You are likely to encounter well-intentioned friends and family members who have no idea how to feed you safely at holiday parties. Listen in and learn how to be clear about your dietary needs and take control of your health without isolating yourself from loved ones during this most wonderful time of the year!

What’s Discussed: 

#1 Don’t eat anything contaminated with wheat

  • Cannot eat center of pie, any part of turkey with bread stuffing

#2 Beware of good-intentioned people

  • Don’t eat anything questionable
  • Bring a snack with you just in case

#3 Be prepared to establish new traditions

  • Get creative in kitchen

#4 Don’t isolate yourself

  • Find support group, create your own

#5 Gather recipes early

#6 Order ingredients in advance

  • Consider organic, free range turkey

#7 Don’t invite people who make you miserable

  • Set clear boundaries (no complaints, ridicule)

#8 Eat before you go or take your own plate

  • ‘Desperate people make desperate decisions’
  • Take a dish to share, take your portion first

#9 Don’t be a victim

  • Be clear about your needs

#10 Find your people

  • Those who truly love you don’t want you to be sick

Resources:

Nima Sensor

EZ Gluten Test Strips

Paleo Magazine

Paleo Principles: The Science Behind the Paleo Template, Step-by-Step Guides, Meal Plans, and 200+ Healthy & Delicious Recipes for Real Life by Sarah Ballantyne

Sarah Ballantyne on Instagram

Glutenpro

EnteroLab

Connect with Nadine:

Instagram

Facebook

Contact via Email

‘Your Skin on Gluten’ on YouTube

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

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