Can celiac go away?

Fat Celiac, you have gone crazy – celiac disease cannot go away. Maybe it can. Bear with me, read the whole article, read the supporting documentation, and then let’s have a conversation about it. You may reach a different conclusion than I did, but the science might indicate that people could return to a gluten containing diet under certain circumstances.

First, here are the articles this is based on. The first article is about children with celiac who over time their celiac goes into a latent or silent phase. Note here that latent and silent are different technically. The second article is about a woman who had been on a gluten free diet for 10 years with confirmed celiac disease via blood tests and Marsh 3 damage in her intestines returning to a gluten containing diet without issue after a desensitizing protocol.

Let’s talk about the second article first. There was a woman diagnosed with celiac disease with elevated AGA and EMA blood tests and Marsh 3 damage to her intestines. She was on a gluten free diet for 10 years. After the 10 year gluten free diet, all celiac blood panels were normal, normal intestine with no celiac damage, no wheat allergy, and all other blood tests showed no mineral or vitamin deficiencies.

Then they began to introduce gluten in small amounts daily. Now, 100 parts per million or 30mg of gluten daily over the course of four weeks is thought to induce changes in villous architecture for those with celiac disease. Over the course of 6 months they slowly increased the amount of gluten until they reached 9g daily. Nine grams of gluten daily is the average intake of people on a gluten containing diet. Endoscopies were performed at 1, 3, 6, 9, 12, and 15 months.

During the gluten introduction, all celiac panel tests were within normal ranges. There was normal villous architecture and normal intraepithelial lymphocytes at all endoscopic procedures. At 20 months, the patient is on a gluten filled diet with regular bread and pasta without incident. She has normal blood tests, no vitamin deficiencies, and normal villous architecture.

So, this person is cured. Why or how they don’t really know or understand and more people need to be tested in order for this therapy to be approved for general use. That is one person. Who knows if this will work for everyone. Let’s look at the kiddos.

The bottom line on the study is that about 20% of celiac patients diagnosed as children can have their celiac disease turn from active into a latent or silent phase. Active celiac disease is where ingestion of gluten causes symptoms and damage to the small intestine. Latent celiac disease is where ingestion of gluten does not cause symptoms or minor symptoms, low positive blood tests, and no damage to the small intestine. Silent celiac is where ingestion of gluten does not cause any symptoms but does damage to the small intestine. The difference between latent and silent celiac in this discussion is important, so keep that in mind as we keep going.

The study evaluated 61 patients diagnosed with celiac disease as children that had resumed a normal gluten containing diet. Of those, 48 had silent celiac (no symptoms, but villous atrohpy), 13 had latent celiac (slight symptoms, no villous atrophy, slightly positive blood tests), and 7 were controls. Silent patients had an increased risk of osteoporosis or osteopenia, so the gluten free diet continues to be recommended for them. Over time, 2 of the latent celiac patients had a relapse of symptoms and damage, so this latent phase may not be permanent.

Also, the patients with latent celiac disease and introduction of the gluten free diet was much younger. Latent celiac patients were diagnosed at approximately 14 months versus silent celiac patients diagnosed at approximately 40 months.

No significant difference was found in symptoms between the latent celiac patients and the control patients. Celiac specific blood tests were slightly positive in latent celiac patients more often than patients on a gluten free diet. Researchers could not pinpoint the moment the active celiac went into a latent phase because the time period between endoscopic studies was significant – anywhere between 3 to 21 years.

While these patients may not have active disease on a gluten containing diet, long term, careful monitoring is required to ensure the disease does not return to its active form.

Some children and one woman with confirmed celiac disease have returned to gluten containing diets without issues. What does all this mean? I’m not sure. I’m starting to thing this disease has waxing and waning phases and nobody understands how or why this happens. I’m still processing all of this, but it is certainly interesting.

After reading these, it may make you want to try to slowly reintroduce gluten. DO NOT REINTRODUCE GLUTEN without your doctor’s permission. At this point, there is not enough data to confirm that we could do this safely. At the same time, I see a lot of people that are really, really worried about cross contamination and I’m starting to wonder if we really need to worry that much. I’m still processing this information.

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