I’ll be curious to see how many people skip over reading this week’s email because they see “Celiac disease” (CD) and think, nah, not me (or, I would rather bury my head in the sand than consider getting tested for that).

BUT please consider reading some of these quick facts before you go (it may just change your mind):

• Delays in the diagnosis of celiac disease remain unacceptably long. The average age at diagnosis is 45 years, with an average diagnostic delay of 12 years (as in, from the time the symptoms start…it takes 12 years to get a diagnosis…!!!). This I find mind-boggling because the first step screening test is basic blood work.
• In Canada, it is estimated that nearly 1.0% of the population (or 1 in 114 Canadians) are affected by celiac disease, although nearly 90% of celiac disease cases remain undiagnosed. 
• If you have a 1st degree relative with Celiac disease, the risk for developing the condition is between 8-15%, and 5% if one of your second-degree relatives is affected.

Now, if you care to read on, here are the quick & dirty facts on Celiac.

What is Celiac disease? No, it’s not an allergy

Celiac disease is an autoimmune disease; it is not a form of food allergy. In celiac disease, the immune system reacts against gluten, a protein found in wheat, causing damage to villi (small finger-like structures) that make up the lining of your small intestine. This damage prevents nutrients from being properly absorbed.

Celiac or gluten sensitivity? 

This is important to understand. I see many patients who think it’s Celiac or nothing: as in, if they’ve had Celiac disease ruled out, they are a-ok with gluten or wheat. This isn’t necessarily true. While Celiac disease is on a completely different level than non-celiac gluten sensitivity (NCGS) or non-celiac gluten enteropathy – both can cause distressing symptoms.

(Quick aside: The reasons someone may react to gluten (or other wheat proteins) are many and go beyond simple immune activation, e.g. glyphosate herbicide exposure, the hybridization of wheat, lack of gluten digesting bacteria in your microbiome, inadequate digestive enzymes, etc).

I was prompted to write about this topic this week because I’ve had a slew of adult patients diagnosed with Celiac disease recently and given my practice is focused in digestive, hormone, autoimmune, and mental health, I have this educational convo on. the. regular.

One of my patients recently diagnosed with Celiac disease said no one else in her family will go get screened for it. I get it, it carries a burden – financially, socially, logistically, emotionally – not to mention its comorbidities…about 30% of adults with celiac disease have one or more additional autoimmune disorders, compared to about 3% in the general population. But for this patient, now in her 50s, she sure wishes she’d have had this information earlier in life: it may have played a role in her history of unexplained infertility, as well as two autoimmune skin disorders and the softening of her bones.

So, the main point of sending this info out is:

• If you have a relative with Celiac disease and you haven’t been checked (even if you don’t think you have the symptoms), consider getting tested.
• If you have IBS but you’ve never been tested, Celiac disease should have been ruled out when making this diagnosis. Caveat: if you are eating a gluten-free diet, the test isn’t worth performing as you could expect to get a false negative.
• There are certain medical conditions or symptoms where Celiac disease should automatically be checked for (I think I will have to write a future blog with more on this…stay tuned).

Over the years I’ve developed a framework for assessing & treating the gut. Recently I decided I want to try and make this more accessible from home, not just when you’re in my office chair (or across the screen!). So I’m making a Gut program and if you want to know when it’s finished, put your name down here.