The Pastore Podcast

Dr. Pastore covers a well-known, yet not well-understood diagnostic marker of celiac disease - tissue transglutaminase (TTG). He covers the function TTG plays as an enzyme, how TTG affects gluten and shares vital information about various TTG blood tests (TTG IgA and TTG IgG) for those looking for a diagnosis, and for the diagnosed celiac wanting to monitor their progress.

Show notes:

https://drrobertpastore.com/podcasts/063-tissue-transglutaminase

May is Celiac Disease Awareness Month, and Dr. Pastore covers important and relevant information on all-things celiac disease including statistics, symptoms, the history of the disease and how to go about being diagnosed, as 83% of those with the disease are not.

Show notes:

https://drrobertpastore.com/podcasts/celiac-disease-awareness-month-2020

Dr. Pastore answers questions asked by Lexie's fitness training team around gut health, digestion, food intolerances, candida, h-pylori, probiotics, and gut microbiota.

Show notes:

https://drrobertpastore.com/podcasts

Dr. Pastore discusses the vital role sleep plays in immunity, how lack of sleep and poor quality sleep can lower your immune system, sleep duration guidelines for optimal health and steps you can take to improve your sleep.

What is "poor" sleep [1:00]

• Quality sleep for adults 7-9 continuous, uninterrupted hours of sleep per night
• • Likely not possible for parents, like Dr. Pastore
• Teenagers require 8-10 continuous, uninterrupted hours of sleep per night
• • 6.5 - 7 hours for teenagers can have same effect as being inebriated
• Sleep science still needs much more research
• • Those staying home & safe during COVID-19 can cause COVID-19 dreams
  • • Intense/horror dreams due to inability to normalize stress/anxiety during the day

Lack of quality sleep mentioned above is directly associated with higher likelihood of being sick after being exposed to a virus [3:55]

• Studies on common cold
• Lack of sleep or disrupted sleep increases risk of getting a virus

Lack of sleep impacted how fast you recover if you do get sick [4:40]

• Dr. Pastore treating patients & working with other doctors treating patients with COVID-19, those recovering slower & have the virus longer have worse sleep
• • 21 & 23 days of having the active COVID-19 infection
  • Seen faster COVID-19 recovery of 9 days with better, quality sleep

Quality sleep needs to be uninterrupted [7:05]

• Difficult for parents waking up for children
• 7-9 for adults, 8-10 hours for teenager straight

Long-term poor quality sleep increase risk of obesity & diseases that further the risk for infections [9:05]

• Medical fact: poor sleep causes cardiovascular disease, diabetes & obesity
• Cardiovascular disease, diabetes & obesity increase risk for infections such as COVID-19 or regular flu
• Inflammasome is byproduct of being overweight & obesity
• • Proinflammatory response that can lower immune system
• Quality sleep drastically improves fat loss progress
• Lack of sleep (as little as 2-3 nights in a row) - cells become temporarily insulin resistant which causes elevation in glucose, can lead to weight gain & fat storage
• • Chronic lack of sleep can make cells permanently insulin resistant
• Quality sleep improves cell-signalling communication between insulin receptor cells & GLUT receptors to let glucose into the cells

Poor sleep lowers your immune system, makes it longer to recover from a virus, increases risk of diseases that can further lower the immune system, and can worsen health if pre-existing disease exists [13:00]

• We're all biochemically & genetically unique
• Knowing genetics, medical history, biological markers, calcium score

Why does decreased sleep lower the immune system? [14:55]

• Sleep supports & enhances the initiation of an adaptive immune system response
• Adaptive immune system response process:
• • Trouble maker / invading antigen / virus invading body
  • Human immune system takes up antigen & appropriates it
  • Breaks apart the antigen & presents fragments of antigen to T Helper Cells
  • T Helper Cells signal cytokines Interleukin 12
  • Interleukin 12 calls in T-Helper Cell One Response, supports antigen specific T-Cells
  • T-Helper Cell 1 Response starts B-Cell production of antibodies to always be able to recognize the invading antigen / virus
  • If the invading antigen is presented in the body again, the body will attack it
• Produced in the lymph nodes
• Vaccines are a great example of adaptive immunity, producing herd immunity
• Sleep turns this response on, lack of sleep turns it off
• • Immune cannot identify the invading antigen
• Sleep deprived hepatitis A vaccine patients vs quality sleep hepatitis A vaccine patients
• • Poor sleep patients did not have amplified adaptive immune system response to vaccine
• Parents typically lose hundreds of hours of sleep

Prescription medications to improve sleep quality [21:05]

• Dr. James Maas, "Father of Sleep" & other sleep doctors confirm prescription sleep medications will not lead to a perfect night's sleep or "sleep saviours"
• Have seductive-type affects
• Can affect memory & perception of sleep quality
• Our Neurochemistry of Sleep Podcast
• • LINK
• Be aware of side effects
• • Rebound insomnia
  • Dizziness
  • Headaches
  • Difficult swallowing or breathing
  • Worsening depression & suciride ideation
• Study showed those with highest sleep medication prescriptions had highest risk of all-cause mortality
• Study showed increased risk of various cancers, increased risk of dementia
• Not getting into a deep sleep, interferes with glucose & cell receptor response

Could be underlying issue or health concern causing lack of sleep [24:20]

• • Chronic pain & arthritis
  • Breathing disorders
  • Dietary supplements & stimulants (caffeine) close to bed
  • Gastoresophorefluz disorder
  • Hypothyroidism, Graves Disease
  • Chronic back pain
  • Sinus disorder or allergies
• Medications can disrupt sleep
• • Birth control
  • Cold medicine
  • Asthma medication
  • High blood pressure medication
  • Depression
  • Thyroid medication
• Talk to your doctor to find the underlying cause
• Pharmacogenetics - PGX
• • Test genetics to determine drug response based on individual genetics
  • Medications aren't a one-size fits all
• Could be nutritional deficiency
• • Magnesium, Vitamin D
  • Request bloodwork from physician
  • 40% population at risk for low magnesium
• Undiagnosed sleep apnea
• • Temporarily stop breathing, adrenaline wakes you up

Lifestyle changes to implement to improve sleep [29:30]

• Address stress
• Get regular physical activity & exercise
• • Exercise helps lower stress
• Caffeine consumption
• • Genetic variations to process caffeine faster/slower
  • Avoid caffeine after 3-4PM
  • Green tea, diet cola, soft drinks with caffeine
• Exposure to artificial light
• • Disrupts normal neurological signalling for sleep, turns off melatonin production
  • Can upregulate alert/excitatory neurotransmitters to keep you awake
  • Blue light blocking glasses
  • Night mode on electronics reducing blue light
• Limit alcohol
• • Sedative effect - can help you fall asleep initially
  • Later in night, causes dopamine rush & interferes with adaptive immune response
  • More consistent alcohol consumption will continue to lower immune system nightly
• Limit or eliminate nicotine
• • Vaping, chewing tobacco
  • Nicotine neurotoxin, extremely addictive
  • Makes it difficult to fall asleep
• Sleep in a cool bedroom
• • Lower temperature helps with sleep

Melatonin for sleep [35:30]

• Melatonin is both a hormone and neurotransmitter
• Excreted from penial gland
• Exposure to natural light during day, as sun sets, darkness cues melatonin production
• Helps stimulate our sleep - high affinity melatonin receptors in SCN
• • MTA & MT1A, MT2 & MT2B receptors - absorbs melatonin & slows excitatory function to prepare for sleep
• Promotes sleep by stimulating acute inhibition of neurological firing of awake neurotransmitters in SCN
• Helps initiate sleep process, but won't benefit rest of sleep cycle
• Helps regulate circadian rhythm (sleep/wake cycles)
• Taking a "low" dose of 1mg of melatonin is still incredibly high compared to what the brain produces naturally
• • Can produce "hangover" in the morning
  • Fatigued, tired, brain fog, delayed responses
  • Suppressing dopamine responses
  • Receptors of SCN turned off way past sleep period
  • Up to 18 hours of hangover
  • Walking wounded: feel better at 8-10PM and take another dose
• High-dose (1mg+) melatonin should not be a nightly supplement for sleep

Effective natural products for sleep do exist [40:50]

• Dr. Pastore's poor sleep practicing as a doctor, then being a father
• Developed sleep supplement Power OFF for his own sleep issues as nothing else worked
• • https://poweronpoweroff.com/products/power-off
• We can provide you with the scientific paper Dr. Pastore wrote
• Help turn off excitatory neurotransmitters before bed to fall asleep
• Help stay asleep without waking up
• • Studies on theanine + 5 hydroxytryptophan shown to keep you asleep
• GABA to help you fall asleep
• • Most GABA can't cross blood-brain barrier
  • • Blood-brain barrier: only allows certain nutrients/neurotransmitters into the brain from the bloodstream to protect the brain
    • Dr. Pastore used his PhD in nanomedicine to make GABA pass the blood brain barrier
• Magnolia plant - honokiol
• • Studies show honokiol primes receptor for GABA uptake
• Combination of ingredients address mechanism of turning off cellular stress response constantly being fired by ephedrine (excitatory / awake neurotransmitter) at night
• • Requires sulphur enzyme system - enzyme phenalethol…..help :)
  • • Cysteine & dimer to create cystine

• Helps fall back asleep after interrupted sleep
• Won't prevent you from waking up if needed
• Formula evolves as new studies & research comes out

Antihistamines / Benadryl before bed [52:55]

• Dangerous for long-term health
• Harvard in 2005 urged doctors to advise patients to stop using antihistamines for sleep
• Antihistamines reduce acetylcholine, which over time increases risk of age-related mental decline
• • Disrupts memory, cognitive sharpness, more forgetful

Wrap-Up [55:15]

• Aim for 7-9 hours per night
• Work with physician to find underlying cause for lack of sleep
• Stay away from prescription sleep aids & over the counter sleep aids as much as possible
• Be mindful of melatonin
• [email protected] & https://poweronpoweroff.com/products/power-off
• www.drrobetpastore.com & @drrobetpastore

As covered in previous podcasts, celiac disease can have many symptoms beyond gastrointestinal issues and looking skinny/malnourished. In this episode, Dr. Pastore discusses a study that revealed two new acute, non-classic symptoms that could be the only sign of celiac disease - nausea and vomiting within 2-4 hours of eating. Both symptoms typically originate in the stomach, whereas classic celiac symptoms are caused due to damage of the small intestine. He covers what is causing these symptoms and what to do if you experience them.

Links mentioned:

Nausea & Vomiting after Gluten Exposure

https://celiac.org/glutenexposuremarkers/

Full vaccine study:

https://celiac.org/main/wp-content/uploads/2020/03/NexVax2-Study.pdf

Dr. Pastore shares the science and latest research behind coronavirus, how it differs from COVID-19 and what makes it so dangerous. As he is actively treating those with the virus, he covers the lesser-known symptoms, the genetic polymorphisms (gene errors) that put some more at risk than others beyond age and pre-existing medical conditions, the current status of treatment for COVID-19 and what you can do to keep you and those around you safe.

SHOW NOTES

Review of Dr. Pastore's qualifications [0:20]

• PhD Biomedical informatics, nanomedicine and clinical informatics from Rutgers University, School of Health Professions
• • Expertise is understanding biomedical sciences, human genetics & RNA mechanisms, disease processes & systems, nanomedicine, drug discovery
• Graduate degree in Human Nutrition, Certified Nutrition Specialist

All of the information today is backed by science [3:00]

What is the Coronavirus and what is COVID-19 and how does this compare to SARS [3:45]

• Coronavirus - simply type of virus, under microscope has pointed structure looks like it wears a crown
• • Been exposed to coronavirus for a long time - cold, mild upper respiratory tract infection where bodies fight back - no cure
  • 200+ different types
  • "Novel" coronavirus = newly identified coronavirus type, no resistance against it
• SARS 2003-2004 [6:20]
• • Severe acute respiratory syndrome, caused by a novel coronavirus at the time
  • Jumped from animal kingdom to humans, which is what is believed to have happened with the new 2019 coronavirus
• COVID-19 [7:05]
• • The upper respiratory infection some people develop after contracting the novel 2019 coronavirus (hence the name COVID-19)

• You can be exposed to the coronavirus, be a carrier of the coronavirus, potentially exhibiting zero symptoms ever, transmit the virus to someone else and they can develop COVID-19 symptoms [7:30]

• Coronavirus is spreading faster than SARS in 2003 [8:00]
• • Less severe of an illness in the majority of those infected when compared to SARS
• Those with strong immune systems may only ever feel incredibly mild cold/flu symptoms or nothing at all, yet are giving the coronavirus to others with weaker immune systems [9:40]
• • There are some individuals who do not feel sick, infect others, and then develop COVID-19 symptoms

What makes the coronavirus so dangerous? [10:50]

• Spreading faster than any other virus in history
• Those that have passed away from COVID-19 experienced a "cytokine storm" [11:30]
• • Mutli-factorial hyper-inflammatory process
  • Over-stimulates the immune system factors, causing the lungs to shut down the normal process of breathing
• Genetic polymorphism (genetic expression) in gene ACE2 can allow COVID-19 to get deeper into the lungs, greater chance of developing cytokine storm requiring hospitalization & ventilation [13:25]
• As of April 9, 2020, 25% of people walk around asymptomatic (constantly changing) [17:00]
• • was 17.3% March 20th, 2020
  • People need to behave like they have the infection

Less-known/more rare symptoms of the coronavirus beyond cough/fever/chills [18:00]

• 3% of carriers present with pink-eye, can be the only symptom
• Diarrhea & other gastrointestinal/digestive complaints can be your only symptoms, don't assume it's a stomach bug or bad food
• Loss of taste or smell
• Sudden confusion - potentially caused by reduced blood-oxygen levels

What causes the more common symptoms [22:05]

• Dry "barking" cough, fever, chills, body aches, headache, shortness of breath, congestion
• Virus interacting with immune system
• Virus is replicating within body [22:45]
• • Virus is RNA strands that fool your own cells into reproducing the virus (making your body "photocopy" the virus to take over more of your body) and then bust out of cells & take over nearby healthy cells
• Replication of virus + immune system response causes the common symptoms

Immediately notify your physician if these symptoms arise, get immediate medical help if you have trouble breathing or pale/bluish skin [24:30]

How long does it take to show symptoms? [25:15]

• 2-14 days from time of exposure, if at all
• Some reports of people being sick/developing symptoms beyond that
• Learning more about how long virus can survive.
• • can live 3 days on stainless steel, 24 hours on package delivered to your door [26:25]

Who's most at risk? [27:00]

• Those with pre-existing conditions like diabetes, heart disease, lung diseases
• Immuno-compromised individuals - HIV, autoimmune diseases, undiagnosed or newly diagnosed celiac disease patients that are sIgA deficient

Recovery [29:15]

• Some feel fine after 3 days, some passing away - why?
• • Genetic ACE2 polymorphism
  • • Some have the ACE2 polymorphism that better prevents the coronavirus from infecting the body
  • Pre-existing conditions, those with poor health
• Body produces surfactant chemical that makes lungs sponge-like [31:05]
• • Genetic polymorphism that lowers surfactant production, makes lungs less sponge-like and makes breathing more challenging with COVID-19

What can we do? [32:15]

• Pretend you have the coronavirus
• Social distancing - use technology to virtually connect with others
• REALLY wash your hands - scrub & sing "Happy Birthday" twice
• Hand sanitizer - minimum 60% alcohol
• • Other types are NOT designed to kill novel/new viruses
• Stay home as much as possible - 6 feet from others is not enough
• Wear a mask when going out
• • To protect others from you
• Don't touch your face before washing your hands
• • Study showed even trained, educated medical professionals touch their face 23 times per hour
• Clean & disinfect all surfaces that could have been exposed (groceries, counter where you rested groceries, car surfaces)
• • Alcohol-based surface cleaners need to have at least 70% alcohol
• Strip off & wash your clothing in hot water, warm shower with soap as soon possible
• • So far, we know virus can live on cloth for 3 days

How is COVID-19 treated? Current research shows…. [45:00]

• No FDA/CDC/WHO approved medical treatment
• Hospitals are practicing palliative care, symptom treatment
• Ongoing experimental medical trials around the world (approx. 60 so far)
• • NYU hyperbaric oxygen therapy - putting COVID-19 patients in more oxygen-rich environment, previously used to treat lung damage
• Repurposing FDA-approved drugs to treat COVID-19 [47:15]
• • Scientists are using drugs that have already been approved for other conditions and are currently being studied on effect to combat COVID-19 & slowing the spread within the body
  • Limits the virus spread so your own immune system can battle it
• DRUG TRIAL: Remdesivir
• • Believed to inhibit the action of RNA polymerase, intravenous delivery
  • Targets how coronavirus replicates
• DRUG TRIAL: Galidesivir
• • Viral RNA-polymerase binder, intravenous delivery
• DRUG TRIAL: Camostat
• • Transmembrane protease, serine 2 inhibitor
  • Blocks penetration of coronavirus to get into cell
• DRUG TRIAL: Favipiravir
• • Selective viral RNA-polymerase inhibitor, delivered orally
• Two HIV drugs being studied right now
• • DRUG TRIAL: Darunavir and Cobicistat, delivered orally
• DRUG TRIAL: Fingolimod
• • Sphingosine 1-phosphate receptor modulator, delivered orally
  • Class of drugs used as immunomodulators and are used in conditions such as multiple sclerosis.
  • Calms the immune system/cytokine storm to prevent it from attacking your own cells
• DRUG TRIAL: Plaquenil, better known as hydroxychloroquine
• • May inhibit the terminal glycosylation of ACE2 of this virus

These drugs SHOULD NOT be taken as a prophylactic / to "prevent" the coronavirus [51:00]

• All medications have side effects
• Pharmacogenetics - study of genetic reaction to drugs (99.999% accurate)
• • Based on an individual's genetics and polymorphisms, some may have opposite reaction and worsen health
  • Can not respond to a drug
• Won't be one specific drug to treat it
• Instead, a polypharmacy - multiple options to treat based on genetics and other pre-existing medical conditions

Testing accuracy & false negatives [57:25]

• NIH estimates weeks away from a finger-prick test with almost 100% coronavirus diagnosis accuracy
• Current testing of throat swabs 87.3% accurate, at best
• • 13 of every 100 people that have been tested are given a false negative and are out in public infecting others

Vaccination? [60:00]

• Over a year out, but trials are underway
• Using plasma of those that have recovered from the virus
• Cell-surface receptor to suppress cytokine storm (keep immune system calm to prevent degrading of lung function)
• When vaccine is available, celiacs should get tested to ensure vaccine is effective (often times they do not)

The future evolution of the coronavirus [63:20]

• Hard to determine next 6 months, constantly changing
• Hoping to flatten curve - signs are showing improvement
• • Less infected, more time to react
  • The faster everyone does their part, the faster the curve will flatten
• Drug trials to conclude in a few months - more answers to what drugs work for certain categories of people

Conclusion [66:30]

• Do your part - stay home
• www.drrrobertpastore.com
• @drrobertpastore

LINKS:

EPA Disinfectants for Use Against SARS-CoV-2

https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2

CDC Cleaning and Disinfection for Households

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cleaning-disinfection.html

[PART 2]

Dr. Pastore continues on the topic of brain health, and what celiacs & non-celiacs can do now to lower the risk of future neurological & cognitive health issues. He covers what medical tests to have done, recommended foods and supplements, as well as ways to cognitively challenge your brain.

• Recap of part 1, upcoming in episode [0:40]
• • Key action steps for celiac and non-celiac patients for brain health
  • Decrease in gray & white matter in the brain for those with celiac disease, even if following a strict gluten-free diet [1:35]
  • • Can lead to cognitive decline or mental illnesses
  • Celiac Disease & Mental Health (Part 1) podcast episode: https://podcasts.apple.com/us/podcast/on-mental-health-celiac-disease-part-1/id1455383694?i=1000468339779

• Why celiacs feel brain fog, forgetful or fatigued [2:30]
• • Multifactorial - many reasons for these symptoms based on structural gray/white matter changes in the brain celiacs have
  • Malabsorption of nutrients due to damaged villi, causing nutrient deficiency [4:15]

• Recommended test #1 for brain health and cognition: BrainSpan [4:40]
• • https://www.brainspan.com/home
  • • Can be ordered directly to your house & mailed back
  • Finger-prick blood test
  • Measuring Omega 3 fatty acid levels EPA/DHA
  • • Celiacs should use fish oil supplementation [6:30]
  • Brain health & cardiovascular diseases are connected [8:50]
  • • Plaquing of the arteries negatively affects brain health
    • High blood pressure presents with a higher risk of dementia
  • Analyze palmitic acid levels to help normalize insulin, leptin signalling, appetite cues, never feeling full [10:05]
  • Blood test is paired with brain games both developed by US military physician & used by physicians from Harvard. Sanjay Gupta, MD of CNN is an advisor [11:40]
  • • Measures memory, sustained attention, cognitive flexibility, and processing speed
  • Celiacs - speak to your physician about the test [13:00]
  • • Covered by Medicare in USA

• Recommended test #2 for brain health and cognition: Bloodwork for nutritional deficiencies [15:30]
• • Deficiencies for celiacs podcast episode
  • • https://podcasts.apple.com/us/podcast/on-nutritional-deficiencies-increased-infection-risk/id1455383694?i=1000454914981
  • Deficiencies for non-celiacs
  • • https://podcasts.apple.com/us/podcast/on-common-nutritional-deficiencies/id1455383694?i=1000445381290

• High blood sugar & insulin [16:45]
• • Previous podcast: Alzheimer's Type 3 diabetes
  • • https://podcasts.apple.com/us/podcast/on-alzheimers-disease-a-new-type-of-diabetes/id1455383694?i=1000448202120
    • Poor circulation can affect white & grey matter in the brain
  • Previous podcast on Blood Sugar & Insulin here:
  • • https://podcasts.apple.com/us/podcast/on-blood-sugar-insulin/id1455383694?i=1000438688442
  • Previous podcast on Triglycerides & Glycemic Index here:
  • • https://podcasts.apple.com/us/podcast/on-the-glycemic-index-triglycerides-and-cholesterol/id1455383694?i=1000440223375
  • Celiac disease is connected to Type 1 diabetes
  • Eat low-glycemic index carbohydrates
  • Identify if there is a risk factor for insulin resistance [18:45]
  • • Take fasting glucose & fasting triglycerides level from last bloodwork to predict risk of insulin resistance [20:05]
    • • Triglyceride-Glucose Index - https://jscalc.io/calc/4VDpIssERFymapm5 (calculator)
      • • Fasting Glucose * Fasting Triglycerides / 2
        • Index of 4.9+ have greater risk of insulin resistance

• Foods & Nutrients to consume daily for brain health [22:55]
• • Berries - blueberries, strawberries [23:20]
  • • Harvard study: 2 servings per week delayed memory decline by 2.5 years
  • Caffeine [24:40]
  • • John Hopkins: Caffeine equivalent to 1 cup of coffee, better memory recall the next day than placebo
    • Genetics affect reaction to caffeine [25:35]
    • • Previous podcast on caffeine genetics:
      • • https://podcasts.apple.com/us/podcast/on-functional-nutrigenomics/id1455383694?i=1000446534488
  • Omega 3 Fatty Acids [28:10]
  • • UCLA study: Walnut consumption improved cognitive test scores
    • • Rich is ALA, converted into EPA
    • Fish
    • • Can reduce beta amyloid plaque production, improving brain signalling
  • Choline [29:25]
  • • 92% people deficient in choline
    • ~400-550mg/day
    • Critical for white matter function & reducing inflammation
    • Found in beef liver, egg yolk, chicken breast, ground beef, cod, broccoli
    • Celiacs not absorbing food optimally
    • • Supplementation recommended
    • Power ON to improve cognitive function and cell integrity - https://poweronpoweroff.com/products/power-on

• Brain games to improve cognition [36:05]
• • AARP brain games, apps such as Lumosity

• Get adequate sleep [37:05]
• • Journal of Sleep - short sleep duration showed worse white matter markers in mid-life
  • Middle-aged celiacs with already lower white matter because of the disease especially need adequate sleep to lessen risk of cognitive decline, dementia, stroke
  • • Power OFF to help calm the mind & improve sleep quality
    • • https://poweronpoweroff.com/products/power-off

• Learn something new and complex [38:45]
• • Leads to rapid structural changes in white and grey matter
  • Must be complex - multiple steps to achieve success
  • Must be something entirely new to you - language, computer code, tactile skill, musical instrument, a new exercise with proper form

• Probiotics [40:40]
• • Journal of Nutrients April 2019 study showed
  • You must care for your gut microbiome
  • • Eating healthy, whole foods
    • Removing digestive irritants/intolerant foods
    • Consuming fiber (prebiotic)
    • Take a probiotic supplement *if* recommended by a physician
  • Gut & Mood are connected for cell communication and neurotransmitter production
  • • Podcast: LINK

• Episode recap [41:45]
• • We'll be back next week with a COVID19 episode

[PART 1] Dr. Pastore discusses the topic of mental health and celiac disease after the results of a brand new study that was released this week.

Sometimes, mental illnesses, ataxia, multiple sclerosis, personality disorders can be the only sign or symptom of celiac disease. These can also be comorbidities of celiac disease (simultaneous presence of multiple diseases or conditions).

Studies with MRIs have shown that both white and gray matter in the brain are negatively impacted for those with celiac disease, even if following a gluten-free diet and considered "healthy"

White matter consists of myelinated axons, which forms connections between brain cells.

Gray matter consists primarily of neuronal cell bodies in a a spherical structure that houses the neuron's nucleus. It also contains glial cells.

Celiac disease patients have an increased risk for brain disorders, but can be minimized if following a MILITANT gluten-free diet.

White matter disorders:

https://pubs.rsna.org/doi/full/10.1148/rg.2016160031

[BLOG] Celiac disease & nutritional deficiencies:

https://drrobertpastore.com/blog/2019-10-09-common-nutrient-deficiencies-in-the-newly-diagnosed-celiac-disease-patient/

[BLOG] How to get tested for celiac disease

https://drrobertpastore.com/blog/2019-08-26-what-do-you-do-if-you-think-you-may-have-celiac-disease/

[BLOG] Proper medical follow-up for celiacs

https://drrobertpastore.com/blog/2020-02-27-what-is-the-proper-medical-follow-up-for-a-celiac-patient/

Dr. Pastore discusses the dental defects he suffered with prior to his celiac diagnosis, and how gluten and oral health are connected.

Discussed:

- What causes dental enamel defects (DED) and demineralization

- How DED is associated with celiac disease

- One study found that 83% of celiac disease patients had some degree of DED

- How other oral health issues such as cavities and canker sores are connected to gluten

- How to treat DED and other oral issues for celiac disease patients

Dr. Pastore discusses Dermatitis Herpetiformis - an autoimmune condition with skin rashes that is caused by the consumption of gluten.

He covers who is most at risk, what this autoimmune condition is, how to get properly diagnosed and the celiac disease connection.

Discussed:

Dermatitis Herpetiformis (DH) is NOT the same as celiac disease. The majority of those with DH also have celiac disease, however there are people that only have DH and not celiac disease, and vice versa.

DH is an autoimmune reaction where antibodies (IgA) are formed after the consumption of gluten, which travels in bloodstream and are deposited in skin. This signals a reaction that creates itchy/blistering skin or bumps, resembles herpes-like lesions.

DH is misdiagnosed 95% of the time for eczema.

The prominent sign that it is DH and not eczema is that rashes will occur on both sides of body - typically around the knees, scalp, buttocks, elbows.

DH is diagnosed via skin biopsy, as 20% of patients have normal blood and intestine testing for celiac. Most have no gastrointestinal issues.

If you or a relative had Hashimoto's thyroiditis, Grave's disease, Celiac disease, type 1 diabetes, lupus, or Sjogren's syndrome and you have eczema-like rash, speak to your doctor about a skin biopsy.

Misdiagnosed DH patients that are prescribed Prednisone/topical corticosteroids creams can mask symptoms temporarily, then cause a rebound flare-up.

Consuming other food intolerances (besides gluten) can make DH worse.

A gluten free diet combined with the antibiotic dapsone (topical or orally) is the common treatment for DH. It can take up to 2 years for full skin recovery.

Iodine and Nonsteroidal anti-inflammatory drugs (NSAIDs) can also cause or worsen flares. Iodine is found in: cough medicine, iodized salt, shellfish, seaweed/kelp/nori, yogurt, milk, and iodine supplements.