Before Marsh III: Why the Early Stages of Celiac Disease Must be Taken Seriously

Michael Marsh, MD, DSc, FRCP

  • Understanding the stages of villous atrophy
  • Identifying celiac disease before it is full blown
  • Exploring the pathology of celiac disease
  • The causes of intestinal permeability
  • Genetics and celiac disease
  • Immune function of the intestinal mucosa

You spoke and we listened. We've added a spot for comments for those of you that aren't on Facebook.

Comments

comments

118 Comments

    Debbie Hobin

    Love listening to this information. We need a way to pause the lecture, and to see how much time has elapsed and how much time is remaining. (Or am I just not finding this on my screen?)

    Susan

    Thank you for allowing us to view these wonderful videos. My question is how long for the symptoms of malabsorption to resolve? My naturopathic physician has taken me off of wheat & gluten for 2 1/2 yrs (I have fibromyalgia, chronic fatigue, painful neuropathy, hypothyroid and exhausted adrenals) and taking probiotics and supplementing with minerals, B vitamins, Vit C 3,000 mg day, and andrenal support (Dr. Wilson). I’m still low in ferritin, iron and many of b-vit’s and I’m not absorbing fat soluble as in Vit A, Vit D (I take 5,000 day) and omega 3’s. I’m pretty sure it’s due to a malabsorption problem. Are their other steps I’m missing here? The worst part of this is the daily life with chronic fatigue and painful neuropathy in my legs & hands, arms. Any advice?

    Douglas T Kane, DC

    How wonderful it is to hear all this information from Dr. Marsh himself! Thank you so much for all you have done to help so many people. The countless hours in the lab have certainly been worth it! Bravo!!

    Shona Hewitt

    I was diagnosed with celiac disease nearly 4 years ago and recently with breast cancer. No celiac or cancer in my family and I wonder if there are any links at all. Enjoying the gluten summit and talks

    Di

    Great information, listening from Australia, thank you for the opportunity.

    Carol Skaggs

    I was diagnosed with h.pylori in June. It had since been eradicated by using 1st doxycycline and Flagyl in combination. I used it for 5 days and was having such dreadful anxiety and depression I couldn’t continue. Later I was switched to Levaquin and amoxicillin for 14 days. I was told to use Aciphex twice a day. After treatment an endoscopy was done and I was told its gone. I still have been having reflux was told I have gastritis. Still currently experiencing problems with my moods. Have been considering a gluten free diet. Is it possible I could have celiac disease and would the Dr have noticed when he performed my endoscopy?

    Patricia Grisham

    I was diagnosed with Celiac Sprue in December 2011. The tTg test was positive, endoscopy performed and biopsy came back positive. My physician says that a small amount of gluten would not hurt me, because my Celiac Disease was not severe. I had severe anemia before diagnosis, iron supplements didn’t raise my levels, then I had an iron transfusion and suffered a severe allergic reaction to the infusion. How do you find a physician that takes Celiac Disease seriously, instead of just taking your money for substandard care?

    Jo

    I would like to ask, does anyone know what digests gluten? Does anyone do stool analysis to find out if it comes out the same way it went in? And, if bread makes a person gain weight or their blood sugar rise from it, is that just from the starch part of it? One would assume that if you can’t digest it you would not be able to turn it into a fat making bomb for the belly.

    The celiac Cakery

    Excellent interview, it clarified a lot of things that have been floating around on the internet.

    Kay

    Very interesting and informative presentation.

    Ann

    Great talk. It was physically found in May 2013 that I have Celiac Diease with intestine being smoothe as silk. Have severe Osteoporosis, anemia, and severe blood clotting. Thank goodness for all of your help.

    Cathy Nissley

    BIG aha! moment for me. Everything makes sense to me. I’m eliminating gluten from my diet and I wish I had this information earlier in my life! Glad to see the increase in gluten-free products. This information is so important. Enjoying the summit!

    Lilylace

    Great info, sound is stalling a lot..Do beleive it is the toxins in and around us. How could it not be.

    Ren

    WRT to Lunvigsson longitudinal study with 72 % inc. mortality in the “just inflammation” group., Is it, that since there was “just inflammation” this group was not cautioned against consuming gluten so over time they would have continued to damage their system? Or was it that in spite of not consuming gluten and their inflammation never developing to something further, that they still suffered this huge surge in mortality? In other words, did the longitudinal study check their inflammation periodically through those 20 years and it never developed into something more?

    Tricia

    I so appreciate learning from Dr. Marsh. It is a privilege and an honor to listen to his wealth of knowledge. Thank you.

    Shirley Palmer

    Great presentation

    Petra C. H. Gampper

    11/11/13 Outstanding, indeed, including the presentation’s format, i.e. enabling us listeners to ‘read’ along Dr. Marsh’s and your conversation/explanations ~ I have enjoyed both your conversation on CD and gluten sensitivity issues ~ …refreshingly down to earth factual, honest and given with integrity. Thank you, I shall walk away from this with a lot of food for thought and application about this ‘jeweled’ information on the increasing gluten dilemma, also for me, with regard to the serious, still unlabeled, untested, unsafe genetically engineered crops, foods, and their hidden, related GMO/GE ingredients in U.S. foods, packaged or not..! Sincerely, Petra C. H. Gampper

    Holly DeCovny

    Interesting interview. With the possibility of inviting further auto immune complications, I’m skeptical about the English beer, unless it’s gluten free. I also am a firm believer that the best modern technology we have for an appetizing gluten free diet that rivals a wheat diet, is commonly referred to as the home kitchen!

      Dr. Tom

      Please see my answer re: celiacs and gluten-containing beer – important! All Right Folks, I have to intervene now. Dr. Marsh is truly the ‘Godfather of Celiac Diagnosis’ but he would be the first to tell you he is not an expert in WHICH foods work and do not work on a GFD. I have to urge caution before breaking a GFD with gluten-containing beer. If someone wants to do this, it’s early in the week, I’ll talk about this in detail at the end of this Summit, but I can not have people thinking I am endorsing gluten-containing beer. The only way to do this would be to do a panel looking at multiple peptides of gluten, confirm that there are no elevated antibodies to any of the peptides of gluten (whether in wheat, rye or barley). If all are negative, then doing a beer challenge will tell you if it’s ok for you. Read my paper on this topic of gluten challenges ‘Do I have to Re-introduce Gluten in Order to have an Accurate Gluten Sensitivity Test Done?’ Once again, NOT recommended to do, but if you are going to, this is the safest protocol. Take care of yourselves folks. Tom O’Bryan, DC, CCN, DACBN http://www.thedr.com/images/reintroducegluten.pdf

    Anna De Roos

    Why did the research stop at the immunological level??

    Iain macMillan

    Very informative and balanced interview, thanks for making it available around the world. Lynette, I did have some iPad issues got 2/3 of the interview, then it stopped loading. Going to try again, going by the comments I missed the part about beer being ok :-)

      Dr. Tom O'Bryan

      IMPORTANT!!! All Right Folks, I have to intervene now. Dr. Marsh is truly the ‘Godfather of Celiac Diagnosis’ but he would be the first to tell you he is not an expert in WHICH foods work and do not work for each individual on a GFD. I have to urge caution before even thinking about breaking a GFD with gluten-containing beer. I’ll talk about this in more detail at the end of The Summit, but PLEASE do NOT think I am endorsing gluten-containing beer for someone with a gluten related disorder. If you want to try beer, please first read the article about re-introducing gluten: http://www.thedr.com/images/reintroducegluten.pdf And please pay close attention to the words in red: THIS IS STRONGLY NOT RECOMMENDED. Once again, this is NOT recommended, but if you are going to, this is the safest protocol. Take care of yourselves! Tom O’Bryan, DC, CCN, DACBN

    xing ma

    The summit is free, how can I watch day one interview without pay ? please advice

    Dawn walker

    This is very interesting kind of confusing but I’ve been sick since I was 20 yrs old. I was tested at 38 and they didn’t test me for celiac but I decided to stop eating gluten. I feel so much better but still get episodes. My question is can my children get celiac disease from me and what can I do to cure it because I can’t have a life because I’m so scared I’m going to get sick so I don’t eat all day until I get home and I’ve been doing this for many years…

    Kristen

    Great interview! Thank you!

    Elke Mayer

    Listened to Dr. Marsh with great interest. I am looking forward to the other speakers. Excellent seminar : Thank you so much!!!

    santos

    Will this summits audio be available for download or purchase?

    Merle Darling, Brandon, Manitoba

    Wow. What a load to digest! I had forwarded The Gluten Summit invitation to my family so I’m hoping they were able to listen to your interview. My biggest challenge is the diet. Even though I was diagnosed in 1985, there is so much to learn. There are over a dozen of our family members diagnosed with Celiac Disease so a family meal get-together is always gluten-free. A gluten-free diet can be adhered to at home very easily. It is eating in restaurants that causes concern. I had asked a waitress about nachos, whether they are gluten-free. She replied that the actual nacho is gluten free but the restaurant places the nachos in the deep fryer that is also used for all other deep fried foods. So we can’t be too cautious. Grocery stores have come onboard with many many gluten free products. Thanks for giving me the opportunity to listen to your interviews.

    Manuela Malaguti Boyle

    Listening (from Brisbane, Australia) to this insightful interview. Truly enjoyed Dr. Marsh’s brilliant explanation on gluten. Interestingly, research has shown that Patients with celiac disease have a higher risk for several types of cancer, and their risk for non–Hodgkin’s lymphoma is 9 times that of the general population. The risk for cancer overall is reduced considerably with a gluten–free diet. However, the risk for non–Hodgkin’s lymphoma in these patients is still 6 times that of the general population. Patients with dermatitis herpetiformis, a condition often experienced by individuals with celiac disease, also more frequently develop lymphomas of both the B–cell and T–cell variety, although this risk is reduced by following a gluten–free diet.

    Paula

    I too, am having a problem with audio. There are long mute pauses every 20 – 30 seconds. Otherwise, I found this info just fascinating and I will apply it to my patients.

    Olena

    Thank you! I learned so much from this, and really appreciate all your work!

    Amber Littler

    Fantastic listening to Dr. Marsh. Thank you, Dr O’Bryan for organizing the summit!

      Dr. Tom O'Bryan

      Thank you for listening Amber! Please tell your friends and family about the Summit. The more who hear accurate information, the sooner our Doctors will have the ‘Big Picture’.

    Carlos Bucio Borja

    SALUD, Dr. Marsh… ;)

    Meg Fairfield

    These interviews are fantastic. Dr. O’Bryan has a rare gift for filtering technical information (both in the interview and on the accompanying slides) and bringing the best out in the guests. We need you in the autism community!

      Dr. Tom O'Bryan

      What a kind acknowledgement Meg. I am thrilled and honored to assist in bringing the best information to our listeners. Please tell your friends and family about The Summit. The more who hear accurate information, the sooner our Doctors will have the ‘Big Picture’.

    Vickie

    I firmly believe the chemicals ( yes I am talking about it … and the BIG companies that make the fertilizers …what have you) is making people sick. the chemicals used on the crops that are fed to the cows, pigs, animals …. and then animals are butchered for public to eat. Come on people WAKE UP …. there’s a lot of greed in these companies that are pushing farmers to use their products. Read the ingredients …. educate yourself …. even Kids are dealing with more food allergies than ever before. We need to go back to the old ways of farming our land and protect the soil.

    Hope

    Yay! Beer! That part of the interview made me very happy. Hales Cream Ale here I come!

    Angie Hammond

    Thank you so much for allowing us to hear this seminar. It shed light on many issues I’ve had. God Bless Dr. Marsh and all those who’ve made this presentation possible.

    Susan Shore

    Thank you, Dr. Marsh! Very helpful! Doctor found out that I was iron deficient in April this year. She ecommended a gluten-free diet. I started and lost 28.5 lbs in 3 months! (Jump start on weight loss came from removal of inflammed not working gall bladder, two weeks after I started gluten free.) Iron deficiency is improving. Cravings of sugar and carbohydrates quickly and dramatically subsided after years of binging and overeating! Freedom from fighting gluttony feels incredible! Blood tests negative before gluten free diet! Excited to hear more from the Gluten Summit!

    Jerri

    Appreciated the great depth of concern in so many directions. OUTSTANDING!

    Joan Hartwick

    Thank you so very much for this very, very interesting discussion about Celiac. I am enjoying it immensely, and without a definite diagnosis, I have been gluten free since 1988, when my then gastroenterologist suggested that I might perhaps be Celiac. At that time, he did not indicate any positive test for Celiac. I have 3 sons, the eldest is wheat intolerant by his blood work (eats whatever he likes!) the second son had the blood test, definitely Celiac and adheres very strictly to the diet, and the third son eats whatever he likes, but I strongly suspect he is Celiac. However it is their lives, they are all adults.

    Michelle Crone Naturopathy

    How fantastic to hear the wonderful Dr Marsh, so passionate about his work, and the gut health… We naturopaths are so far ahead of conventional medicine in terms of preventing and treating degenerative conditions of humanity…we need the awesome work of such people in order to keep working at preventing gut disorders. thankyou so much for your presentation from Australia!

    Sheila Wagner

    Never having had the opportunity to hear Dr. Marsh speak, this was a wonderful opportunity to hear his wisdom and truth about gluten and gut morphology…so enlightening and some historic words were said for sure! Thank you Tom for bringing Dr. Marsh to us!

      Dr. Tom O'Bryan

      You are very welcome Sheila. Thank you for listening and appreciating how unique and essential The Gluten Summit truly is. Please tell your friends and family about The Summit. The more who hear accurate information, the sooner our Doctors will have the ‘Big Picture’.

    Sarah

    Very good interview! I was hoping to hear Dr Marsh response to allowing a celiac or gluten sensitive person to eat fermented wheat grain products. Thousands and even hundreds of years ago, that was the only way to make bread, through the fermentation process. As the process of fermentation predigests protein and makes it into a digestible form. The mention he made about beer (a fermented wheat drink) being ok for celiacs to drink, supports my theory that a celiac or at least a gluten sensitive person can eat fermented bread, waffles, etc. that’s the way people have been eating it for thousands of years without problems.

      Dr. Tom

      Please see my answer re: celiacs and gluten-containing beer – important! All Right Folks, I have to intervene now. Dr. Marsh is truly the ‘Godfather of Celiac Diagnosis’ but he would be the first to tell you he is not an expert in WHICH foods work and do not work on a GFD. I have to urge caution before breaking a GFD with gluten-containing beer. If someone wants to do this, it’s early in the week, I’ll talk about this in detail at the end of this Summit, but I can not have people thinking I am endorsing gluten-containing beer. The only way to do this would be to do a panel looking at multiple peptides of gluten, confirm that there are no elevated antibodies to any of the peptides of gluten (whether in wheat, rye or barley). If all are negative, then doing a beer challenge will tell you if it’s ok for you. Read my paper on this topic of gluten challenges ‘Do I have to Re-introduce Gluten in Order to have an Accurate Gluten Sensitivity Test Done?’ Once again, NOT recommended to do, but if you are going to, this is the safest protocol. Take care of yourselves folks. Tom O’Bryan, DC, CCN, DACBN http://www.thedr.com/images/reintroducegluten.pdf

    Ali

    Thank you so much for this interview. I thought I was educated on this subject, but a whole new world of information has been opened up to me today. Many thanks.

    Betty

    I have been Gluten Free for several years and doing very well with the diet until about a year ago. I have the Celiac DH and have a rash on several areas of my body that will not go away. So what has happened to me? I am so careful and read every label on any food I eat to make sure I don’t get any gluten.

    Diane

    I have been gluten free for 8 years now. I would like to hear if there is any connection to Crohn’s disease which I was diagnosed with at 19 yrs. of age. I am 67 and developed gluten intolerant symptoms 8 years ago. Now, I react very violently to gluten. I only get gluten if there is cross contamination because I become violently ill, I cannot afford to cheat on this diet and don’t.

    Kathy Randolph

    Thank you, Dr. O’Bryan. So far the information from this Summit is incredibly invaluable. I cannot wait to hear what more you have in store for us. I suffered with “IBS” for over 25 years with no relief until I went to a naturopath who tested me using a stool and saliva tests. I had already been eating gluten free when I took the test, but found out I was intolerant to milk, soy, “equivocal” with eggs and my gluten was negative with a low number. I had been eating the SCD and couldn’t believe the difference it made. The only way I can explain it is I didn’t know how sick I was until I felt better! All my stick tests, blood tests have all come back negative. However, I realize I cannot have any grains whatsoever. I have a question that my gastroenterologist could not answer: Can one become more sensitive to gluten after a colonoscopy? That seemed to be the case for me. Thank you again for the insurmountable task of assembling these presenters for us. I cannot wait to hear more.

      Sybil Nassau

      Carol. spelt is in the same family as wheat, but a different form . It is NOT gluten free and usually cannot be tolerated by those who need a gluten-free diet.

    Carole

    I do not have celiac disease, but have taken an interest in this discussion as a follower of Suzy Cohen’s websites. Is it possible, I wonder, that more and more people have been developing this disease over the past 50 years or so because of eating “severely modified” wheat crops that did not exist back in those times? Would we all be better off if we ate bread made from Spelt flour, which was originally brought over to the UK by The Romans. It is very low in gluten I gather. Tragically, it is not widely grown by farmers here anymore because the yield is not as great as the more modern varieties of wheat. Dr O’Bryan and Dr Marsh I would love to know your thoughts on this – if non celiacs were to only eat this wheat, could it stop them from ever developing celiac disease? Thank you so much for your time and efforts on all of our behalfs.

    Suyay Torres

    I would like to know why Dr Marsh says that there is no problem with drinking beer. Isn´t it made of barley? Should celiac people consume products made of this cereal?

    Agnes

    Having problems accessing video on iPhone. Suggestions? Thanks!

    Lyn

    Thank you so much for this information! I wanted to ask if either of you are familiar with chronic mast cell activation? Thousands of us have been diagnosed with a newly recognized variant of mastocystosis, (but we have normal tryptase and do not meet the WHO criteria for mastocytosis), and have biologic markers of chronic mast cell activation. Dr Theo Theoharides of Tufts, Dr Lawrence Afrin of MUSC in Charleston, SC and Dr Mariana Castells of Brigham in Boston are at the front of this Mast Cell Activation Syndrome (MCAS) front. Dr Theo has performed mast cell research for decades and links mast cell to many of the current chronic conditions. Folks with MCAS often have elevated levels of histamine (N methyl histamine), prostaglandins (PGD2, PGF2), heparin, NSE, TNF, etc. and suspected elevated levels of many of the known 200 plus mast cell mediators that drive immune responses and chronic inflammation. Since many of us face daily anaphylaxis and massive intolerance to scores of foods, medications, and environmental triggers, I dream of the day when the dots are all connected and community based physicians understand all of these critical concepts. Many of us suspect the mast cell connection is a huge part of this inflammatory puzzle often seen in other chronic disorders and we often do better of a GF, Casein-Free diet. Do you have any initial thoughts on a potential mast cell connection? Please share this information with anyone you feel fit or reply for additional resources. Thank you so much for this information!

    Cathie

    I was waiting to hear why beer was ok when sensitivity occurs from other grains. Is it the fermentation process? I’m much better on a gluten free diet. Occasional lapses will result in loose stools. Thank you for the interview.

    MaryeW.

    Listening to Dr. Marsh~absolutely fascinating! As someone who suffers from a variety of autoimmune conditions (celiac’s being one of them) I gained a lot of new & valuable insight. Can’t wait to learn more throughout the week. Thanks so much Tom O’Bryan for your hard work & dedication in bringing this summit to us!

    Jazel

    Thank you so much for this most informative conversation. Dr Marsh is a wealth of information and should be listened to world wide. I wasn’t aware of the extent of the effects of gluten. I have FMS/CFS and other chronic illnesses. When I stay of gluten I am much better. Now I understand why. I live in Queensland Australia and it is wonderful to be able to hear this on the internet. Thank you Bill Gates, the internet has virtually saved my life, due to information available and talks from wonderful people like Dr Marsh. I feel honoured to be able to listen to him. After hearing Dr Marsh today I am definitely going totally gluten free. Thank you Dr Marsh for all your work and information. Jazel

    Clare Willis-Burton

    Fantastic information, I have been Gluten free for 6 months after being diagnosed negative for gluten sensitivity by my hospital consultantbut also having a very inflamed stomach on a gastrocopy exam and raised blood markers for inflamation. He poo pood my crazy new diet and food intolerence test I have had done by my chiropractor, which have changed my life, told me to take the antacids as perscribed and consider prozac instead. Thank you to Sean Croxton and Zoe Harccombe for this introduction to the Gluten Summit and for your hard work to get this to the general public

    Lyn

    Thanks for the information!

    Ann Medley

    Thanks so much for all the great info. I was diagnosed 2 years ago with non hodgkins lymphoma ( Waldenstrums Macrogloboenemia ) stage IV. Went thru chemo and on my advice of a naturapathic dr stopped eating gluten) I had also been diagnosed with 2 frozen shoulders ( autoimmune condition) I live in Cincinnati Ohio, which has a fair amount of pullution. My identical twin sister lives in Glen Arbor Michigan which is a much cleaner environment . She has a clean bill of health. If anyone would like to study us, feel free.

      jeanne

      Loved loved loved this discussion with Dr. Marsh and great questions from Dr. O’Byron! last comment i read stated that frozen shoulders are an autoimmune condition.I would like to know more about this, I have had two frozen shoulders – one pretesting days and one 8 yrs. on a gluten free diet!!

    C. Reichert, MD, PhD

    I am a medical doctor (pathologist) and scientist (biochemist) with non-celiac gluten sensitivity in myself and in members of my family. Ironically, I live in the heart of “the golden triangle” of wheat production in the middle of Montana. From my particular vantage point I would like to offer several observations which I hope may be helpful to others with gluten intolerance: 1) Wheat has become more antigenic through traditional methods of genetic selection. The higher the protein content the more money the wheat farmer is paid. The higher gluten content is sought by bakers because it gives “elasticity” to the dough. 2) There is currently an EPIDEMIC of gluten intolerance. When I started my pathology practice in the 1980’s, celiac disease was a rare phenomenon. Today small bowel biopsies are one of the most common specimens submitted in community practice, and many of these specimens show Marsh I features in patients with diarrhea and no other underlying causes. Lymphocytic colitis is also becoming more and more prevalent. When I recently stopped at a store that specializes in Italian foods, the proprietor responded to my question about gluten free options with the comment, “What’s with all you people….we never heard of gluten 20 years ago.” 3) I suspect that commonly used non steroidal anti-inflammatory drugs such as ibuprofen are contributing to the microscopic injury of the gut that allows “immunization” against gluten to take place. Folks with a genetic predisposition to gluten intolerance should be forewarned to avoid this category of pain relievers. My own sensitization took place more than 15 years ago after I took over-the-counter NSAIDS for several weeks following a minor injury. It is known that small bowel biopsies from patients with no symptoms who are taking NSAIDS may exhibit Marsh I features. I hope that my concern becomes the topic of much more research. 4) Gluten sensitivity should be considered a systemic rather than a gastrointestinal disorder. T lymphocytes circulate throughout the body. I presented with joint stiffness that completely resolved on a wheat-free food program. In addition to the rheumatologic and gastrointestinal manifestations, I have have also experienced respiratory symptoms (sneezing, nasal congestion, coughing) when I travel within 5 miles of a wheat field at harvest time. Recently I developed dermatologic complaints (periorbital erythema and burning) from some of the “higher quality” hair products, which I discovered contain “hydrolyzed wheat protein”. (The skin in this periorbital location is very thin, hence the appearance here rather than on the scalp). 5) Lactose intolerance frequently accompanies gluten sensitivity, and this has also happened to me. Since the enzyme lactase is located on the tips of the villi of the small bowel, it is not surprising that gluten-medicated injury to the small bowel also impairs the enzymatic breakdown of the disaccharide lactose. Of note, I can tolerate milk products that have been cultured, since in these products the bacteria have done the work of splitting the lactose molecule. Thus, I can readily digest good quality yogurts, cultured buttermilk and butter & most cheeses. If gluten sensitive patients are suffering bloating and stomach pain on a gluten-free food program, lactose may be the culprit. 6) Probiotics may be helpful in dampening immune hypervigilence in the intestines of patients with gluten sensitivity. I take a daily probiotics, and I rotate manufacturers and liquid and capsular forms. I also carry “Gluten-ease” and “Lactase” enzyme support with me for those occasions when I am dining out and may inadvertently consume wheat or lactose. These supplements are available in health food stores. 7) I have discovered that my wheat intolerance may be a “blessing in disguise”. Of necessity I have been introduced to a world of culinary alternatives and my sensitivity to gluten has helped me to avoid weight gain. I am appreciative of all the delicious gluten-free alternatives that are now available in stores and for restaurants that provide gluten-free options on their menus. I thank Dr. Marsh for the clarity and lifelong dedication that he has brought to this subject and Dr. O’Bryan for his brilliant and unprecedented idea of bringing this dialogue to a world audience. I look forward to listening to the rest of the program.

    Jo

    I’m now very curious about beer! Was Dr Marsh just saying that there is no eveidence that it contains gluten (but also no evidence that it doesn’t?) also what he did mean by English beer – something like bitter? I always imagined that would have the worst effect… Incidentally I’m drinking Corona beer without ill effects.

      Dr. Tom O'Bryan

      IMPORTANT!!! All Right Folks, I have to intervene now. Dr. Marsh is truly the ‘Godfather of Celiac Diagnosis’ but he would be the first to tell you he is not an expert in WHICH foods work and do not work for each individual on a GFD. I have to urge caution before even thinking about breaking a GFD with gluten-containing beer. I’ll talk about this in more detail at the end of The Summit, but PLEASE do NOT think I am endorsing gluten-containing beer for someone with a gluten related disorder. If you want to try beer, please first read the article about re-introducing gluten:http://www.thedr.com/images/reintroducegluten.pdf And please pay close attention to the words in red: THIS IS STRONGLY NOT RECOMMENDED. Once again, this is NOT recommended, but if you are going to, this is the safest protocol. Take care of yourselves! Tom O’Bryan, DC, CCN, DACBN

        Shirley JACOBSON

        I’m viewing interviews on an iMAC. It may be dependent on the version your operating system, but I’ve had no problem.

    Sherri

    Do the lectures play on a Mac? I can’t get any of the links to work.

    Joan

    When Dr. Marsh talked about being able to use the pathology from stillborn babies, it really hit “home” with me. I wish when my Gerri Ann, who was stillborn could have been helpful. I was diagnosed with Celiac very late in life due to elevated liver enzymes, now, I am having brain surgery, and not sure yet what that diagnosis will be from this lesion in my left temporal lobe. I have been gluten free for over two years now, my liver enzymes are almost completely normal, the AST is still slightly elevated. I have felt better and the arthritic pain that had started before being GF, only returns if I am unknowingly glutened. I am so happy to know this summit is here! Thank you to all who have made this possible.

    Eman Mirza

    Excellent! Very interesting. I find it very moving to listen to someone with so much experience!

    Tricia

    Please clarify if possible! I was diagnosed Celiac in June 2012 through blood tests and biopsy. Since then I have not knowingly ingested gluten, including through lipstick, makeup, etc. Three follow-up blood tests since then have showed no decrease in blood antigens (very frustrating), but a 2nd endoscopy last week indicated I had gone from total villus atrophy to no sign of villus injury. What does this mean – why the disparity between these two tests??

    Peggy Cyprowski

    DR.Marsh lecture is fifty years of research answered. I am gluten free. Many years of gastro complaints, covered up with medications complicated the issues. I am 81 yrs, became seriously ill two years ago; five doctors;overlooked yeast overgrowth; Candidiasis. I am four year undergraduate: Health Information. Many thanks and appreciation for your brilliant medical knowledge, Peggy Cyprowski

    Cynthia Longueville, BCN, NTP, CGP

    Thank you for including us non-physicians in this conversation. I watched the video yesterday and didn’t realized the extra foundation it provided until I woke up this morning. I feel like I can speak directly to the history of gluten issues and, although I know I haven’t really done so, feel like I know Dr. Marsh, and how much he’s put his heart and sole into his work and still wants everyone to know how gluten can and does affect us all. Thank you, again, Dr. Marsh and Dr. O’Bryan.

      Dr. Tom O'Bryan

      Thank you for listening Cynthia. Please tell your friends and family about The Summit. The more who hear accurate information, the sooner our Doctors will have the ‘Big Picture’.

    Bente

    A question ; My husband has a fairly big belly, but is not diagnosed with any digestion diseases. Could it be his belly has grown caused by gluten ??

    nancy birang

    what is the best test for people to do to identify a gluten problem?

    Susan

    This was very enlightening! Thank you!

    gil

    I”ved been treated for dermatitis herpetiformis since 1972 along with many other symptons. beer has always made me sick. I wouldn’t risk it. I wasn’t diagnosed with celiac until Jan 2012.

      Dr. Tom O'Bryan

      IMPORTANT!!! All Right Folks, I have to intervene now. Dr. Marsh is truly the ‘Godfather of Celiac Diagnosis’ but he would be the first to tell you he is not an expert in WHICH foods work and do not work for each individual on a GFD. I have to urge caution before even thinking about breaking a GFD with gluten-containing beer. I’ll talk about this in more detail at the end of The Summit, but PLEASE do NOT think I am endorsing gluten-containing beer for someone with a gluten related disorder. If you want to try beer, please first read the article about re-introducing gluten:http://www.thedr.com/images/reintroducegluten.pdf And please pay close attention to the words in red: THIS IS STRONGLY NOT RECOMMENDED. Once again, this is NOT recommended, but if you are going to, this is the safest protocol. Take care of yourselves! Tom O’Bryan, DC, CCN, DACBN

    Melanie

    I found his message scary as I think it drives me to having to look for a new doctor that is better educated, and not so into pharmaceuticals.

    Carol

    I have been following/reading comments about celiac and have had many symptoms. The one that stands out is I can’t seem to gain weight even though I eat all the time. My friends say I’m too skinny I am 5’2 and weight 110 lbs and can’t seem to gain. My massage therapist told me to watch this summit. What a wealth of info……. glad to see i’m not the only one

    Jamie

    I’m just curious – are all the speakers on this subject gluten-free?

    SC

    Caution is good regarding introducing or reintroducing beer as Dr. O’Bryan says. I can say from personal experience and that of my brother, we could always tolerate Guinness and other stouts but never lagers or light or dark ales (like German beer). Porters have also been digestible as well. An American beer maker (home-brewer) told me Guinness uses a different process, more like wine making. I don’t know if that’s true or not or if my tolerance of stouts is more related to the content of the beer itself. Note: some breweries offer a milk stout which may not be tolerated if you have issues with lactose. Always read the labels of course!

    Leslie F.

    Thank you very much Dr. Marsh, you managed to clarify many points I had questions on. I put myself on a gladin free diet more than 7 months ago with some good success on my own. I limit myself to the wide variety of different types of rice, rice flour, tapioca, tapicoa flour, sweet potatoes and some white potatoes plus occasionally a little non GMO white cornmeal. Mine is an inherited autoimmune problem from the female side of my Mothers side of the family that was from the area around county Cork in Ireland a 3 generations back.While I don’t know the specific gene. I was blood tested at 29 yrs. old after the birth of my 2nd daughter for SLE , She was born with Neonatal Lupus so that’s how I knew about the SLE. I wasn’t asymptomatic before that time. I had always had intermittent fevers and anemia, joint and connective tissue pain, migraines and Sicca symptoms, I do know I came up positive for anti-Rho SSA autoantibodies at 29 yrs.. I never knew if I was La , S or B. I am sensitive to transglutimate and have known that for a while. I knew that wheat made my SLE flair badly. Also many Gluten free baked goods made me flair . I have some symptoms of RA too plus Sjogrens dry eyes.I do now test ANA neg. But I tested positive at 29 yrs. I do feel like the gliadin free diet is helping. Three questions if you please 1. Am I safe to assume in my case that the giladin free diet is a life long deal in my case?( I actually do believe it is, but am I right..) 2. How does my auto- immune response in my gut, lower intestines, colon differ from a celiac? 3. I know I’m at a greater risk for lymphoma. Polymyalgia Rhumatica is also in the picture since two of my Great Aunts on my Mothers side had it as did my Grandmother( hers starting about age 58), but am I also at a greater risk of Barretts Esogophus is that related to weird T cell changes? I do have some symptoms of Barretts already. Trouble swallowing, lack of appetite and heartburn when I do eat and I have never suffered from heartburn in my life a little light on a very complex subject especially for a laywoman. Leslie F.

    Letitia

    I have a question from the first part where a patient carries the genetics for ceoliac disease and has many symptoms but is not positive for other tests should they be on a gluten free diet? If they go on the gluten free diet and every other symptoms goes away and they become “normal” what does that show?

    Michael Haley

    Why so many questions and comments about beer? It is rather easy to avoid and there are much better things to ferment other than wheat.

    Shannon

    On the slide titled “Work to Be Done” one of the bullet points is “We need to study the interaction between the genes and mucosa.” I agree with this point, but I would add that we also need to study the interaction between genes, mucosa, AND gut flora. The bacteria that comprise our gut flora have the power to turn human genes on and off. Here is a link to an article by Scientific American that discusses how gut flora can impact gene expression in different regions of the brain: http://www.scientificamerican.com/article.cfm?id=the-neuroscience-of-gut&page=2

    Pushpa

    It was great to hear Dr. Marsh!!

    Diane

    I was diagnosed with ulcerative colitis at 36, but had the symptoms for years before that. Then the surgery biopsies of my colon indicated Crohn’s colitis sixyears after diagnosis. I’ve never had a relapse of the IBD in 20 years, but have lots of the arthritis, had fibromyalgia, and some skin issues. When I cut back on gluten, I always felt better. Now my elderly sister has just been diagnosed with UC! I told her to avoid gluten, wondered what antibiotics she may have taken that might have been her tipping point, and realized that just last year she had shingles, a likely clue that her immune system was not up to its previous par. She gets good medication, but I wonder: is gluten as likely a trigger as any? There must be a tipping point for the disease process, in fact for all autoimmune disease processes. Do you think that gluten awareness and avoidance might also impact all the other autoimmune diseases? And since it appears in high-carb foods, do you reckon that the awareness of avoiding high carbs as a way to beat Type II diabetes may also impact coeliac disease?

    Roman

    Please reopen the day 1 videos!

    Mahasti

    Hello Dr.s I was diagnosed to have celiac marsh I and the doctor told me that I do not need to follow any diet and can have gluten in my diet. I would like to get sure if I do not really need to follow a gluten free diet, because later I read on the Internet that every type of celiac needs to avoid eating gluten. I would really appreciate your help. It would be very surprising to hear from experts. Thank you!

    Patty

    Dr. Tom, thank you so much for this session. It’s answered so many questions for me. My daughter’s recent blood screening came back positive, but the endoscopy/biopsy were negative. A follow up gene test showed DQ2.5. While my son does have celiac, the doctor said she could not say my daughter had celiac, although she expected it to develop. She also said she could not tell us that my daughter should start the gluten free diet at this point, and suggested returning in a year for another endoscope. Since there is stomach pain every time she eats gluten (which started this past summer), my daughter decided it was stupid to wait for damage to show on a test just to have to go gluten free to heal from it. You and Dr. Marsh were very informative and the support of our decision over her doctor’s suggestion to wait another year is greatly appreciated.

    Shirley

    Dr. Marsh when I learned about the Gluten Summit and that you were going to be one of the speakers I could hardly wait for the day to come when you would be speaking. Well lucky me you were on the first day of the summit. On June 16, 2013 i had a positive TTG and EMA. I also had H Pylori gastritis. The changes in the duodenum were Marsh 1-11. I do have the HLA-DQ2 gene. The results indicated possible early spruce. I went on a gluten free diet and have been feeling great. I was 71 years old at the time and now I will be 75 on March 26, 2014. I had no problem going free and after listening to you and all the speakers at this Summit I know I wise to never eat a slice of bread or any form of wheat since June 16, 2010. I have been doing a lot of research the last 3 1/2 years and could never understand what Marsh was all about. I know I had developed osteoporosis and couldn’t understand why because I had a Shiba Inu and always walked her 3 miles a day so I got plenty of exercise. I also took my vitamins and had a good diet. Never in my life did I drink any alcohol and did not smoke. I forgot to say the endoscopy showed my villa was slightly bent. My stomach had a generalized atrophic appearance with a marked diminished rural fold height. The endoscopy was negative. I always had wondered if I could have made a mistake by going gluten free. Then I know my body is healing so after listening to your most informative talk I no longer have to search for more answers. You answered all my questions. I now know all about the dangers of wheat and what it did to my body. You are definitely the Godfather of celiac disease. Thank you so much for your help. Just know I appreciate all the work and discoveries you have made to help me and others. .

    Kathy

    Dr Marsh the information you so generously and thoughtfully shared today has given me a much better understanding of many issues. You are brilliant! Heartfelt thank you for all the wonderful work you’ve done.

      Margaret

      Gluten grains are wheat and all grains in wheat family – triticale, spelt, kamut, farro, rye and barley. Oats are often contaminated from being processed with wheat but are generally considered to be non-gluten grain. So gluten-free oats which are uncontaminated oats are available in stores. Buckwheat is not related to wheat and does not contain gluten.

    Janet

    Please clarify: Regarding Oat, Rye, Barley, Buckwheat: Are these safe for a person who has gluten intolerance? Is their gluten the same as Wheat Gluten? As a BTO, safe to eat Rye?

      Margaret

      to Janet, I replied to Kathy by mistake. Gluten grains are wheat and all grains in wheat family – triticale, spelt, kamut, farro, rye and barley. Oats are often contaminated from being processed with wheat but are generally considered to be non-gluten grain. So gluten-free oats which are uncontaminated oats are available in stores. Buckwheat is not related to wheat and does not contain gluten.

    Carol Mielke

    This has been truly outstanding and I am glad to have been a part of learning the latest from the World renown Drs. who are all extremely educated. I like to keep up on the latest as my Grandchildren are now showing some different health issues which are being looked into. Thank you so much. Sincerely, Carol.P.S. One of the Dr.s said on his site that there is mold in coffee which surprised me . Could one of you e-mail me about that?

    Peter

    Thank you Dr Marsh for your talk and thank you Dr O’Bryan for arranging this amazing Gluten Summit which was so desperately needed. Here in the UK we are very much in the dark ages with regard to the whole issue of gluten sensitivity, auto-immune conditions and other systemic illness and medicine is very slow to change and take a more holistic view. I note that the question was posed about antibiotics and very disappointed that it was not acknowledged that prescription antibiotics have done a great deal of damage to the intestinal mucosa of thousands of people around the world. Once the intestinal mucosa and good gut flora are damaged leading to dysbiosis and intestinal permeability, gluten and many other foods cause immune reactions. It is a great shame this was not highlighted as one of the reasons why non-coeliac gluten sensitivity (NCGS) is dramatically on the increase. Increasing numbers of adults and children are suffering the effects of antibiotic treatments through maldigestion and gaining gluten sensitivity and immune reactions to other foodstuff as a result of indiscriminate use by doctors of antibiotics. Sadly the situation will get worse due to continuation of antibiotic therapies and antibiotics in farming but thankfully this Summit can teach a lot of people how best to heal themselves. There is a desperate need for change of attitude in the medical profession and the Summit is hopefully going to not only teach patients but a lot of doctors too, the right way to progress.

    Margaret

    Thanks Dr O’Bryan for this. We are of Chinese descent living in Singapore. Doctors here generally refuse to test for celiac or gluten sensitivity because “chinese rarely suffer from it”. It is interesting to read from the comments that some kids are discovered at 3 years of age. My daughter too, bloated up the day after she turned 3. After a year of seeing specialists, I finally put her on a gluten-free, dairy-free diet and she stopped bloating and gained weight. We took a panel of tests from Enterolabs but none of the doctors here recognise the tests and refuse to use it in their investigations. I have had her on a gluten, dairy, soy, egg-free diet plus daily probiotics for more than 3 years and she is thriving. But she does get regular “allergic-coughs” and I wonder what is behind it. Now that she has not had any gastro incidences for a long time, I am reintroducing soy sauce which is gluten contaminated and of course soy-based and she seems to be ok. No gut issues or pain but could the coughs be a symptom?

      Sybil Nassau

      There is no blood test for non-celiac gluten sensitivity, regardless of what you may read elsewhere. I am very sorry to read your history and that of your family members as you all may well have been classic celiac patients- lymphoma in untreated celiac can lead to a much greater chance of a digestive cancer and lymphomas, sorry to say.

    Margo

    Hi Dr. O’Bryan. So much information to digest…haha. I am really trying. I’m 76 years old and have been off gluten for about a year and a half. No test before going off, just tried removing it and two days later all my bathroom problems went away. Which, by the way, had been going on for several years after having had a rectal tumor and chemo and radiation and surgery and a J-pouch. I’m cancer free, 8 years now. Interesting, after listening to Dr. Marsh, my father, his brother and one sister all died of a Lymphoma, and I end up with a rectal carcinoma. I’m sure my local doctor wouldn’t do anything more now than do a blood test for gluten sensitivity and I really doubt if it would show anything since I don’t eat gluten. There was a lot of talk about bloating and pain, and I have none of that. I’m also on an organic veg diet, small amt of fruit, grass fed meat and pastured chicken and eggs, raw milk grass fed 60-day aged cheese. I’ve had 2 colonoscopies since surgery and nothing anywhere. I guess my question is: can a very slight amount of mucous coating possibly be seen with Celiac or NCGS? I can’t mention it at the local md office, they would just send me for another colonoscopy. There’s no where to go for help that I can afford.

    Lynda

    Enjoyed following along. Will pass notes to adult son with celiac disease, a beer drinker! After my decision to eat only organic, sprouted Flax bread/chips, Flaxseed milk, and Kalona whole milk occasionally, Chia Seeds, lentils/mung/black/ garbanzo/beans, along with Genesis Today Greens powder, my normal diet, when in season Is as Dr.Mercola discusses. I hope to seek total gluten-free foods, eliminate most sugars and salts, enjoying taste of foods as they were created. I am now age 70, with osteopenia in hios, osteoporosis in spine, but take care as best as I can, eating: baby cucumbers, brocolli, squashes, radishes, pecans, avocado, tomatoes, onions, celery, eggs, olivesand oil, buffalo, wild salmon, chicken, blueberries, kamut cereal, tumeric, himalyian sea salt, spring water in glass, carrots, yams, dark choc.,curry, basil, sprouts, pickles, grassfed beef, pumpkin, rice noodles, little else!

      Rachel

      @Lynda – Kamut contains gluten. Yes, it supposedly an ancient form of wheat and likely contains less gluten (or perhaps less harmful gluten) proteins, but I’d still avoid that if you’re wanting to be completely gluten-zero.

    Regina

    Thank you so much for opening my eyes. I love learning ,but, I’m also so frustrated. Sometimes I feel like my doctors think I am too dramatic. When I couldn’t stand taking over the counter stomach medication any longer, my doctor said “well, just stop eating different foods until you figure out which ones to avoid.” She pretty much left it at that. I new about possibly being lactose intolerant, so I stopped eating all dairy. I also read that wheat is not really good for us and can cause bloating and swelling. I stopped eating wheat, as well. I feel much better although not great. Four years ago I was diagnosed with Osteoporosis and bloodwork shows false positive for Rheumatoid Arthritis, Lupus, Lyme and hepatitis. My doctors are treating that as no big deal, as well. Should I be concerned?

    Robert W.Boxer,M.D.

    Great presentation by Dr. Marsh. In response to Arturo Riojas, I have measured zinc and copper in the blood of hundreds of patients, especially those with ADD or ADHD. Giving zinc can be very beneficial, especially if copper levels are elevated, since they compete with each other. However giving excessively high doses of zinc can lower copper to levels that can adversely affect the heart. It’s important to monitor levels of each, since copper is also an important catalyst for many enzymatic reactions.

    Robert W.Boxer,M.D.

    Recently retired after practicing allergy for over 51 years. I have seen numerous patients with inflammatory bowel syndromes who responded to identification of specific food allergies by carefull skin testing and ofter by looking at still controversial IgG blood tests, Food Intolerance Testing, and by IgE Rast Tests. I have also found desensitization to airborne inhalants such as pollens, molds, dust, dust mites, an animal danders to ocassionally be helpful. Treating Intestinal Yeast Overgrowth, although still controversial, may also be helpful. It is important to rule out intestinal infection by parasites and pathogenic bacteria. Probiotics and Prebiotics have also been useful.

    Doris Johnson

    Still learning……

    Wanda

    I’m behind on homework and have just now had the time to sit and listen to Dr. Marsh. All I can say is WOW! This was very informative. I learned so much. I’d love to have the time to go back and listen again because I’m certain there are things I missed. Thank you for this presentation!

    Darshi Shah

    The tests that you recommend… the array 3, array4, etc – can you be tested after a year of being gluten-free? Does GF eating mess the results up?

    Mindy

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    sharon

    I purchased the Autoimmune summit for 47 dollars can I get some kind of discount because of wanting to purchase the gluten summit.

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