CLEMENS HURLS A SPIT BALL?

Celiac disease sometimes comes up in the media in surprising, even shocking, ways. A recent example has to do with the animosity between sports trainer Brian McNamee and pitcher Roger Clemens, who has been implicated by McNamee as a steroid user.

As part of a campaign to defend himself and attack McNamee, Clemens—a notoriously aggressive pitcher—recently played a taped phone conversation between himself and McNamee in front of the media. I'm having trouble figuring out how this stunt could actually help Clemens, but maybe I'm distracted by the fact that the conversation includes references to the ill health of McNamee's son, who has apparently been diagnosed with celiac disease as well as diabetes. Regardless of the fact that New York is a state where medical confidentiality is supposed to be extremely protected, is it proper for Clemens to "out" McNamee's child in this manner? ESPN writer Shaun Assael doesn't seem to think so.

Also, in playing the tape, Fox Sports (and maybe other media outlets) saw fit to bleep some of the words, but went ahead with those related to the health disclosure. Is that right? I feel bad about posting the video here (the second part is here), but hopefully I'm not compounding any damage by bringing up the issue at this point.



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WHAT YOU NEED TO KNOW ABOUT CELIAC DISEASE AND THE GLUTEN-FREE DIET

Have you ever been to a medical panel discussion about celiac disease? Now, free on YouTube, you can see a comprehensive seminar on the basics of celiac disease and the gluten-free diet offered by the William K. Warren Medical Research Center for Celiac Disease at the University of California, San Diego.

Originally aired on November 29, 2007 by University of California Television (UCTV), the panel features director Martin Kagnoff ("What is Celiac Disease?"), gastroenterologist Gregory S. Harmon ("Do You Have Celiac Disease? Understanding Testing in Celiac Disease"), and nutritionist Susan J. Algert ("Mastering the 8 Principles of the Gluten-Free Diet"), plus a Q&A session.

One point that comes up in the program: Of the estimated 3-4 million people with celiac disease in the United States, only 40,000 have been diagnosed so far! Elsewhere, it's interesting to see how much faith Dr. Harmon has in the tTG for diagnostic testing, but I suspect the full panel of blood tests might still be worth giving just to get a good baseline and overview, especially in light of persistent questions regarding non-celiac gluten sensitivity. Dr. Harmon also mentions chronic borderline anemia as a red flag that can be investigated via tests for ferritin. Regarding the hot subject of whether one would take a pill (or just adhere to the diet), Dr. Kagnoff says that many gluten-free Netherlanders say they're very happy with the diet and wouldn't want to switch to a pill, though younger people and those new to the diet seem more enthusiastic about such medication.

Anyway, this is a very good and clear presentation. Instead of being broken up into several portions, it's offered in one big serving that's about as long as a feature film, so get out the popcorn and M&Ms and make yourself nice and cozy to watch it if you want to know what you need to know. After all, seeing the presentation via YouTube is a helluva lot cheaper than going back in time to see it live in San Diego! Plus, in this format, you have the power to pause the lectures to make sure you don't miss anything for whatever reasons.



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CELIAC SPRUE UNDER THE MICROSCOPE

Here's a quickie presentation on what happens to the small intestine when a person with celiac disease is not on a gluten-free diet. Click here for the Dr. Peter Green version. And here's a blues version.



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PS Best wishes for the L. Lodico Celiac Walk for Celiac Disease!

FIBROMYALGIA AND IBS: CELIAC DISEASE IN DISGUISE?

Could some people diagnosed with fibromyalgia actually be suffering from celiac disease? The National Fybromyalgia Association seems to think so. The May-August issue of its magazine Fibromyalgia Aware includes an overview of celiac disease written by Elaine Monarch of the Celiac Disease Foundation.

Available on PDF, the article--"Are You the One?"--cites nationally recognized research to establish how nearly 3 million Americans are estimated to have undiagnosed celiac disease, then states

A study by one nationwide celiac disease support group* indicated that among adults ultimately diagnosed with celiac disease, 9 percent were orginally diagnosed with fibromyalgia and 30 percent with IBS. Since many patients with CD have muscle aches, joint pains, GI symptoms, and fatigue, it is understandable that those people might get a label of fibromyalgia.

In addition to the tender points exam, the diagnosis of fibromyalgia is based on a number of symptoms that can be due to other conditions--celiac disease among them. This is further evidence that different so-called "silent" symptoms need to be taken seriously by physicians and thoroughly evaluated before a diagnosis of fibromyalgia (or IBS) is given.

People diagnosed with celiac disease typically experience greatly improved health when excluding wheat, barley, and rye from their diets. Diagnostic testing for celiac disease should, however, take place while one is still eating those foods.

* Cited in Dr. Peter Green's book Celiac Disease: A Hidden Epidemic.