Iughetti et al studied 130 patients (59 males, age 5.67 ± 3.6 years, height 0.32 ± 1.25 SDS) who had been diagnosed with celiac disease (CD) based on the presence of antigliadin, antiendomysial, and antitransglutaminase antibodies, as well as endoscopic biopsies of the distal duodenal mucosa. These children had a poor clinical response to a gluten-free diet (GFD) and a growth hormone deficiency (GHD); they presented to the pediatric clinic at the University of Modena and Reggio Emilia, Italy between 1999 and 2004. Their growth velocity was determined yearly and serum endomysial antibodies were measured after at least 12 months on a GFD. Those children showing no catch-up growth on a GFD were evaluated to exclude possible GHD. Studies included measurement of basal serum GH, insulin-like growth factor (IGF)-I, IGF binding protein (IGFBP)-3, free T3 , free T4 , TSH, prolactin, cortisol, ACTH, LH, FSH, estradiol or testosterone, and repeat studies for antibodies. In addition, antipituitary and antihypothalamus antibodies were measured. On different days, arginine and L-dopa GH stimulation tests were performed in all 7 of the children identified as having poor catch-up growth. Bone age was determined as well. A diagnosis of GHD was based on short stature, decreased growth velocity, delayed skeletal maturation, and blunted GH response (<10 µg/L) to the 2 pharmacological tests. Antipituitary antibodies were detected by an immunofluorescent method that had been previously described. MRIs were performed in these 7 patients.

Five of the 7 patients showed a blunted GH response to the different stimuli and met the criteria for GHD. Four of the 5 had high titers of antipituitary antibodies, 2 were additionally positive for antihypothalamus antibodies. Antipituitary antibodies were also positive in low titers in 3 out of 25 (12%) children with CD only, and in 2 out of 58 (3.4%) control children. None of the 7 children had any pituitary abnormalities on MRI.

The authors stated that in the past an insufficient GH response to hypoglycemia had been reported in children with CD, which subsequently improved with a GFD. The hypothesis that autoimmunity could involve the pituitary gland was reported about 40 years ago; however, the nature and significance of antipituitary antibodies in GHD patients is still being discussed. The authors stated, however, that high titers of antipituitary antibodies could explain some cases of apparent idiopathic GDH. In patients with multiple autoimmune abnormalities, such as the children with CD, these antibodies may explain their GHD.

Iughetti L, De Bellis A, Predieri B, et al. Growth hormone impaired secretion and antipituitary antibodies in patients with celiac disease and poor catch-up growth after a long gluten-free diet period: a causal association? Eur J Pediatr. 2006;165:897-903.

ollie wrote:Craig, thanks for pulling this together. My girlfriend has celiac disease and will no doubt find the information useful.

Rab wrote:To add. Sainsburrys do a decent "free from" range inc gluten free oats

ollie wrote:I think most people are better off without bread - just not everyone chooses to pay attention to it.

I didn't know about enriched vs un-enriched rice Det. What's the difference exactly?

It's only when you have to be aware of gluten that you realise how many products are 'contaminated' with or contain it that you wouldn't expect. Eating out is nearly always a risk, too.

julesm wrote:i dont know if this is snake-oil supplementation?
worthy of a mention though:

enzymedica- glutenease
http://www.enzymedica.com/products/GlutenEase" onclick="window.open(this.href);return false;

A food-grade enzyme preparation with modest gluten detoxification properties.

Ehren J, Morón B, Martin E, Bethune MT, Gray GM, Khosla C.

Department of Chemical Engineering, Stanford University, Stanford, CA, USA.
Abstract

BACKGROUND AND AIMS: Celiac sprue is a life-long disease characterized by an intestinal inflammatory response to dietary gluten. A gluten-free diet is an effective treatment for most patients, but accidental ingestion of gluten is common, leading to incomplete recovery or relapse. Food-grade proteases capable of detoxifying moderate quantities of dietary gluten could mitigate this problem. METHODS: We evaluated the gluten detoxification properties of two food-grade enzymes, aspergillopepsin (ASP) from Aspergillus niger and dipeptidyl peptidase IV (DPPIV) from Aspergillus oryzae. The ability of each enzyme to hydrolyze gluten was tested against synthetic gluten peptides, a recombinant gluten protein, and simulated gastric digests of whole gluten and whole-wheat bread. Reaction products were analyzed by mass spectrometry, HPLC, ELISA with a monoclonal antibody that recognizes an immunodominant gluten epitope, and a T cell proliferation assay. RESULTS: ASP markedly enhanced gluten digestion relative to pepsin, and cleaved recombinant alpha2-gliadin at multiple sites in a non-specific manner. When used alone, neither ASP nor DPPIV efficiently cleaved synthetic immunotoxic gluten peptides. This lack of specificity for gluten was especially evident in the presence of casein, a competing dietary protein. However, supplementation of ASP with DPPIV enabled detoxification of moderate amounts of gluten in the presence of excess casein and in whole-wheat bread. ASP was also effective at enhancing the gluten-detoxifying efficacy of cysteine endoprotease EP-B2 under simulated gastric conditions. CONCLUSIONS: Clinical studies are warranted to evaluate whether a fixed dose ratio combination of ASP and DPPIV can provide near-term relief for celiac patients suffering from inadvertent gluten exposure. Due to its markedly greater hydrolytic activity against gluten than endogenous pepsin, food-grade ASP may also augment the activity of therapeutically relevant doses of glutenases such as EP-B2 and certain prolyl endopeptidases.

A food-grade enzyme preparation with modest gluten detoxification properties

When used alone, neither ASP nor DPPIV efficiently cleaved synthetic immunotoxic gluten peptides

Rab wrote:Have to say i really enjoy the gluten free oats. they go nice and fluffy and dont have a bitter taste from them

Pretty expensive though so i dont see them being long term which is a shame

Rab wrote:Asda are now selling gluten free oats. slightly cheaper and slightly more than sainsburys. Do yourself a favour though and save yourself £2.79 and dont buy them. Fcuking rotten. chowing my way through a bowl right ow. Im depleted and sarving and it still tastes like shit. actually considering ditching it and having a few plain rice cakes instead its that bad

Rab wrote:Asda are now selling gluten free oats. slightly cheaper and slightly more than sainsburys. Do yourself a favour though and save yourself £2.79 and dont buy them. Fcuking rotten. chowing my way through a bowl right ow. Im depleted and sarving and it still tastes like shit. actually considering ditching it and having a few plain rice cakes instead its that bad