Bruce Scott Dwyer asked:


The link between celiac disease and asthma has been as difficult to prove as finding the reason celiac disease exists. However some tangible evidence (statistical relationships) have been found.

The majority of articles suggest there is no link between celiac disease and asthma, while anecdotal evidence from celiacs suggests that their asthma increases dramatically after the ingestion of any gluten foods.

For instance, an article by Dr Pradeep Bhandari (Ref 1) says that “Celiac disease and Asthma tend to run in families and the tendency to get these diseases is inherited genetically. However, they are not inter-linked. The tendency to get celiac disease is inherited genetically. It mostly affects people of European descent. It is also more common in families with Diabetes or rheumatoid Arthritis. Something in the environment is necessary to trigger the celiac disease in those who are susceptible. Asthma tends to run in families. A person with a parent who has Asthma is three to six times more likely to develop Asthma than someone who doesn’t have a parent with Asthma. But no single gene is responsible for Asthma. Instead, you may inherit a general predisposition to Asthma” Ref 1

However a 2005 study was performed on a population of 86 persons residing in the Maltese Islands in the Mediterranean Sea does suggest some correlation:

MALTESE RESEARCH 2005 (Ref 2: Ellul P, Vassallo M, Montefort S)

“Patients previously diagnosed to have CD (based on serological tests and duodenal biopsy) and attending a medical out-patient clinic answered a questionnaire designed to determine whether they had previously been diagnosed to have asthma or allergic rhinitis.” Ref 2

“All 86 patients (age range 16-69 [median 43] years; 65 female) answered the questionnaire about CD and asthma. They constituted 21% of the 409 patients with CD in the Maltese islands included in a register kept for controlling free prescription of gluten-free foods.” Ref 2

Of 86 respondents, 24 (27.8%; 21 female) had asthma, including 22 with known asthma and 2 with previously undiagnosed asthma; the frequency of asthma in CD patients was higher than that reported in the general Maltese population (11.1%; p<0.00005).[7] In addition, four non-asthmatic patients (one smoker, two ex-smokers, one non-smoker) reported wheezing in the absence of respiratory tract infection in the past; they however had normal pulmonary function tests.

In 16 patients, asthma preceded CD by 3 months to 39 years (median 20 years). Among these patients, gluten-free diet had led to improvement in asthma in 6 patients, possible improvement in 2 patients, and no change in 8 patients. In the remaining 8 patients, asthma followed CD by 2 to 14 years (median 8). Thirty-one of 86 patients with CD and 11 of 24 patients with CD and asthma gave family history of asthma among first-degree relatives.

Eighty-two patients (62 female) answered the questionnaire about allergic rhinitis. Of these, 36 (44%) suffered from allergic rhinitis; this frequency was higher than that reported in the general Maltese population (32.3 %; p<0.05). They conclude that their findings suggest that asthma and allergic rhinitis are more common in CD patients than in the general population in Malta. In patients with atopic diseases, index of suspicion for CD should be high.

FINNISH study in 2001 (Ref 3: Journal of Allergy and Clinical Immunology)

This study tested the postulate of whether TH1 and TH2 cells could co-exist. A correlation between these would suggest a correlation between celiac disease and asthma.

“Background: Asthma is generally regarded as a disease with strong TH2-type cytokine expression, whereas in autoimmune disorders, such as celiac disease (CD), insulin-dependent diabetes mellitus (IDDM), and rheumatoid arthritis (RA), TH1-type expression is seen. According to the cross-regulatory properties of TH1 and TH2 cells, one would assume that these diseases exist in different patient populations.” Ref 3

“Objective: We sought to test the hypothesis that asthma could exist in children with TH1-type diseases, such as CD, IDDM, and RA. Methods: Comparison was made of the cumulative incidence of asthma in children with CD, IDDM, or RA by linking Finnish Medical Birth Register data on the whole 1987 birth cohort (n = 60,254 births) with the data of several national health registers to obtain information on the incidences of these diseases during the first 7 years of life.” Ref 3

“Results: The cumulative incidence of asthma in children with CD (24.6%) or RA (10.0%) was significantly higher than in children without CD (3.4%) or RA (3.4%; P < .001 and P = .016, respectively). Asthma tended to be more common in children with IDDM than in children without IDDM. Conclusion: These data indicate that the TH1 and TH2 diseases can coexist, indicating a common environmental denominator behind the disease processes.”

IMPLICATIONS

While these two studies do not show a causal relationship (proof that one disease causes another), they do suggest that there is a strong correlation between the diseases. That means that if you have celiac disease there is a greater likelihood that you will have asthma. The main ‘take home’ point from this is that for people who are celiac, or gluten intolerant, and have asthma, that the removal of gluten from their diet is likely to decreases the incidence and severity of their asthma.

 

Melanie Simcock asked:


Evenings are getting lighter – leaves on the trees are unfurling – the promise of summer is in the air!

Most of us look forward to the arrival of the warmer weather but for some unlucky people the season brings misery in the form of hay fever and seasonal allergic rhinitis often caused by pollens from trees and grass.

Proteins in the pollens irritate the delicate membranes of the nose and eyes causing inflammation. Symptoms include red, itchy, watery eyes and runny or congested nose.

Not all hay fever sufferers react to the same pollen therefore the timing of symptoms should be noted. Generally tree pollen is present from February to May with the peak time being in April. Grass pollens are prevalent in June and July and weed pollens (eg nettle) will be worse in July and August. Hay fever that begins in late summer and continues into the autumn may be a mould allergy. It is possible to have allergy testing to pinpoint which plant pollens you are sensitive to – consult your GP or nutritional therapist.

So what can be done to alleviate the symptoms? As always being forewarned is forearmed: some simple preparations now can reduce the severity of attacks later in the season.

If you are lucky enough to be able to buy honey produced locally, take a teaspoon every day. It has been suggested that ingestion of tiny molecules of pollen in local honey is believed to help build resistance to pollens when they appear in full force later in the season.

Amongst various natural remedies butterbur is a herb that has undergone scientific trials showing a substantial health benefit for relieving hay fever.

Butterbur (Petasites hybridus) has been shown to relax blood vessels and various smooth muscles in the body. It contains chemicals that are also known to reduce inflammation, as demonstrated in human studies. Some studies have also shown that butterbur extract performed as well as a common antihistamine drug taken by hay fever sufferers, but without causing drowsiness.

Bioflavanoids are plant compounds that have shown anti-allergic and anti-inflammatory activity. Along with Vitamin C, these supplements can help prevent the formation of histamine – the chemical that causes the common reactions of streaming, itchy eyes and runny nose. Foods rich in the bioflavanoid quercitin include onions, garlic, green tea, red wine and dark chocolate (70%+ cocoa solids). Vitamin C is found in broccoli, green peppers, citrus fruits, strawberries, kiwi, cabbage and cauliflower.

Plant sterols (phytosterols) are fats found naturally in plant foods. Phytosterols are highly versatile substances that have been shown to be useful in the management of several conditions include immune disorders. Phytosterols inhibit the release of prostaglandins (hormone-like substances) thus reducing the production of histamine and its attendant symptoms such as itchy eyes and sneezing. Plant sterols are present in all plant foods with soy and whole grains, particularly whole oats, being rich sources.

Omega 3 fatty acids found in flaxseeds and cold water fish such as salmon and mackerel, can affect chemical pathways in the body to help ease allergy symptoms and reduce inflammation.

Vitamin E taken during the pollen season alongside other anti-allergy treatments has been shown to reduce the severity of hay fever symptoms by 23%. Good sources of dietary Vitamin E include cold pressed wheatgerm and sunflower oils, hazelnuts, sweet potato, avocado and spinach.

A strong immune system is essential to help fight off allergic symptoms. The Vitamins A, C, D, E and minerals zinc and selenium are all antioxidant supplements that can help immune function.

Vitamin A is found in calves liver, egg yolk, watercress, squash and oily fish such as mackerel and herring. Likewise, top sources of Vitamin D include mackerel, herring, sardines, as well as eggs and cheddar cheese.

Zinc can be obtained from pumpkin seeds, wholemeal bread and red meats. Eating just four to five brazil nuts daily can provide your recommended intake of selenium but other sources include fresh tuna, sunflower seeds, wholemeal bread and cashew nuts.

There are other measures to help ward off the worst effects of pollen:

• A thin layer of petroleum jelly around and just inside the nostrils can trap minute pollen particles and prevent them from being inhaled and starting an allergic reaction.

• Steam inhalations help to reduce the “blocked nose” feeling.

• Most national weather forecasts now include a pollen count so take note and keep windows and doors shut to reduce the chances of pollens invading your house!

If you are taking any medication, always check with your GP or health practitioner before taking any herbal or vitamin supplements.