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Nutritionist appointment 1 for coeliac and food allergy
Published 19 April, 2007
TweetIf you've been reading Gluten Free Food Freak for a while, you'll know I have other food allergies. Because of this, and because of my increasing sensitivity to gluten, I decided to consult a nutritionist.
I was recommended a nutritionist who specialises in the immune system and had my first phone consultation with him the other day. I'm going to post here the notes I made in case they're helpful. Bear in mind I was scribbling as we talked, so some of the notes might be a bit rough (or possibly wrong!)
I had already provided my nutritionist with a full background of my situation (some of which you can read here), my food diary, details of the supplements I am taking, in addition to his own comprehensive questionnaire.
My nutritionist notes
- There are many forms of gluten, some worse for coeliacs, some not so bad
- The adaptive immune system can start to cross-react with other proteins than gluten
- In the stomach there is very little contact with the immune system
- The intestine carries 70%-80% of the immune system
- The intestine wall provides a very thin barrier between 'you' and 'not you', that is between you and what you consume. This barrier is a little thicker than a piece of paper. (!)
- On the inside of the intestine is a 'paste' that is made of, partly at least, beneficial bacteria
- Specialised immune cells check the stuff in your gut before allowing it through.
- A gut that is damaged by the coeliac disease immune response resorts to a less specialised form of defence and so can react over-aggressively to both gluten and non-gluten proteins
- The immune system communicates with the brain during these reactions using messenger molecules called cytokines.
- This causes the brain to develop the 'sickness response' within the body. The sickness response can create all sorts of seemingly unrelated symptoms including depression, lack of sociability, lowered sex drive.
- Tiredness during an immune response is partly due to energy going to production of antibodies instead of to ATP (the body's energy source)
- Coeliac disease causes villous atrophy - poor absorption, poor bacterial adhesion, low levels of paste, and foreign antigens get no filtering
- Coeliac disease is generally seen as TH1 based, but TH2 is also involved
- TH2 cells are regulatory T-cells, helping modulate and damp down immune responses
- Regulatory T-cells are converted from T-cells when they come into contact with gut bacteria
- Patients with coeliac disease initially have lots of regulatory T cells but then as damage continues, levels of regulatory T cells drop and immune control is damaged - hence the over-reaction to tiny amounts of gluten and other allergic proteins
- The aim of the treatment is to re-populate the gut with bacteria to improve the levels of paste and help regulatory T-cells increase, so returning proportionality to the immune response
- The outcome we're looking for is that I feel more robust and see a reduction in symptoms such as eczema, tiredness etc.
- Immune response is also tied to bone repair, which may be contributing to my osteopoenia. A good result should also improve bone density.
- I'm to take a secretory IgA test (SIgA) and a stomach acid test to check the level of hydrochloric acid in my stomach (HCL). This involves swallowing a capsule and a string. I'm off to do that now - wish me luck.
