On the plane yesterday I watched The Celiac Project – a documentary about celiac disease. It was one of the things that arrived in my care package from the University of Chicago Celiac Disease Center.

There were a couple of key learnings for me in the video. The first was to really internalize what it meant to have an auto-immune disease. It isn’t so much the gluten that is the problem – it can cause some short term discomfort – rather it is the anti-bodies that the body produces in response to the gluten. This is why it is an auto-immune disease and not an allergy. The body produces antibody that in turn make you sick. These anti-bodies are the source of long term health problems (I need to do more official research on these long-term problems). Some of the long term problems include: osteoporosis, stomach cancer, lymphoma, other autoimmune diseases).

This is why “cheating” or eating gluten occasionally is a problem. It can take months (over a year) for your antibodies to drop. Eating gluten weekly means that your antibodies never get a chance to go down. As per my last post, it only takes 1/8 of a tea spoon of flour to feed the antibodies. The Anti-tissue Transglutaminase Antibody; tTG; tTGA blood test is used to first screen for celiac disease (it is a simple blood test) and then again to monitor adherence to a gluten free diet.

I hate the word adherence or compliance, as in both cases it sounds like the patient is intentionally doing something wrong. In some cases, that is the truth. They are cheating by intentionally ingesting gluten now and then (take a celiac holiday). But in other cases, they are getting gluten in their diets accidentally. They don’t know the source of gluten.

Another interesting comment in the video was that a “gluten free diet wasn’t healthy for those without celiac”. This is an interesting statement. In part this is because a lot of gluten-free alternatives are loaded with sugar and fat. But if you are eating mostly naturally gluten free meals, than I do not understand the comment about the items being unhealthy. It is an area where I struggle – what does health mean for me? How is my healthy meal different form a healthy meal for my husband who does not have celiac disease?