I don’t know about you but I am so disappointed with my endocrinologist telling me each time that there is no way to lessen my symptoms because there is no cure for Hashimoto’s, an  autoimmune thyroiditis.

Problem-Solution

This chronic disease causes inflammation of the thyroid gland and slowly destroys it. This is why the thyroid cannot produce hormones anymore. Instead, the patient needs to take synthetic T4 thyroid hormone for the entire life.

So simple ?

It seems logical and easy but it just doesn’t work. Most of the patients complain about their symptoms and additional symptoms appearing as a side-effects of taking the synthetic pills for a long time. Unfortunately, nothing changes about the therapy. The medical world doesn’t go forward fast enough.

• The antibodies in a Celiac’s intestine disappear once gluten is removed from the diet. However, the antibodies attacking the thyroid gland don’t disappear when one takes synthetic hormones. Most of doctors do not know how to get rid of the antibodies attacking thyroid. The prescribed hormones are supposed to eliminate the consequences of the lack of the thyroid gland. Nothing else.
• Another issue is that the synthetic thyroid hormones are not well absorbed by Hashimoto’s patients.

Some reasons of bad absorption 

• Reduced absorption in the intestines due to the lack of intestinal villi – celiac disease;
• Inflammation/Antibodies’attack in the intestines – if the pill contains lactose/casein or gluten (in case a patient is intolerant to it);
• Allergic reaction to other ingredients in the pill;
• Consuming dairy (especially in the morning) – reduces absorption process;

What else you can do

Many patients try to find help beyond the endocrinologists, most of whom openly admit to have no clue how to help us. Here, especially the alternative medicine, new lifestyles and new diets come forward.

How patients fight with Hashimoto’s

• Hormones
  • Some people feel better after taking the natural desiccated pig’s thyroid gland;
  • Many patients claim to feel better after taking a combination of synthetic T4 and T3 thyroid hormones;
  • Exceptions feel better after taking the synthetic T3 hormone only;
  • Others feel better when taking the hormones in the evening rather (2 hours after the last meal) than in the morning;
  • Balancing female hormones might be very important too;

• Supplements
  • The crucial minerals for good thyroid functioning are: selenium (which proves to reduce the antibodies), zinc, iron, magnesium (and possibly iodine (still controversial)– although some opinions are that as long as your thyroid is still active you shouldn’t supplement iodine);
  • Vitamins supplements – especially vitamin D;
  • Omega 3 supplement;
  • Good quality multivitamin might be helpful as well;
  • Probiotics;

• Diet
  • Gluten free diet (many Hashimoto’s patients have celiac disease);
  • Paleo Autoimmune Protocol (it proved to be successful at many patients);
  • Removing hormones containing foods like conventional meat (especially fat pieces as fat is the storage of these compounds), soy (phytoestrogen), tap water (showed presence of high level of female hormones; the hormones are not filtered from the water);
  • Diet rich in healthy fats (fish, olive oil, avocado, eggs), proteins and carbohydrates from root vegetables (beets, carrots, sweet potatoes)
  • Organic food – fruits and vegetables clean from synthetic pesticides (among other proves: recently on TV you could see a documentary about children born in Argentina near the fields sprayed with synthetic pesticides – they were born with serious health problems);
  • Including see foods in the diet – they are a good source of natural selenium and omega 3 fatty acids (despite Mercury – it’s healthier to eat fish than not to eat it);
  • Limiting processed foods and highly refined food ingredients (containing residues of solvents);
  • Supporting the good micro flora in your guts with probiotics and prebiotics (kimchi, kombucha tea, sauerkraut, supplements);
  • None or reduced caffeine intake – some level of adrenal fatigue  is very common at Hashimoto’s patients;
  • Limiting refined sugar intake might help balancing hormones together with the blood sugar level;
  • Overall anti-inflammatory diet;
  • Poor digestion and low stomach acid is very common at Hashimoto’s patients. Eating slow and chewing well might be helpful here. Other option is supplementing digestive enzymes;

• Limiting toxins
  • Detox from toxins – for example steam sauna, consuming organic food;
  • Using good quality product for personal care like e.g. shower gel or deodorant (without parabens, aluminum, formaldehyde, petrochemicals);
  • Spend more free time in nature rather than city;
  • Limit using plastic food containers and bottles;
  • Limit using synthetic fragrance and air fresheners;
  • Make sure you don’t suffer from infections. Literature lists Pylori,Yersinia, Epstein-Barr & Lyme disease as most common infections occuring at Hashimoto’s patients;

• Change your lifestyle
  • Reduce daily stress (sometimes it even means to change a job);
  • Introduce mild physical activities like walking, yoga and avoid excessive sports and long lasting stagnation;
  • Think positive;
  • Organize;
  • Plan and prepare;
  • Practice gratitude;
  • Laugh and have fun;
  • Appreciate life with all its small and big things;
  • Make time for your hobby and find new ones;
  • Meditate;
  • Cuddle with your loved ones and/or with your pet :)
  • No pet? Get one!
  • Exercise your brain, challenge it – or just do sudoku ;-)
  • Be creative;
  • Don’t forget to get some fresh air and sun (if possible);
  • Eat regularly;
  • Don’t skip meals;
  • Look for the good side of everything;
  • Do whatever relaxes you every day!

According to my research, these are the things that helped other people with Hashimoto’s. I just started with bio-selenium supplement and I am curious if it is going to help against the thyroglobulin antibodies (currently 1000-2000  IU/mL).

Thank you for reading,

Kati xxx

The adrenals participate in keeping a right balance between DHEA (DHEA is a natural steroid and precursor hormone produced by the adrenal glands), estrogen, testosterone and progesterone. This is necessary in order to avoid PMS and infertility. Besides, these hormones participate in regulating blood pressure, blood glucose level and in preventing dehydration.

When the adrenals are exhausted (e.g. when one is gluten intolerant), they can’t function optimally. They simply have to choose between producing sex hormones and supporting the basic body functions.

Common Causes of Adrenal Stress

• Anger
• Fear
• Worry
• Anxiety
• Depression
• Guilt
• Overwork
• Physical or mental strain
• Excessive exercise
• Sleep deprivation
• Light-cycle disruption
• Going to sleep late
• Surgery
• Trauma
• Injury
• Chronic inflammation
• Chronic infection
• Chronic pain
• Temperature extremes
• Toxic exposure
• Malabsorption
• Maldigestion
• Chronic illness
• Chronic-severe allergies (or celiac disease)
• Hypoglycemia
• Nutritional deficiencies

Associated Symptoms and Consequences of Impaired Adrenals

• Low body temperature
• Weakness
• Unexplained hair loss
• Nervousness
• Difficulty building muscle
• Irritability
• Mental depression
• Difficulty gaining weight
• Apprehension
• Hypoglycemia
• Inability to concentrate
• Excessive hunger
• Tendency towards inflammation
• Moments of confusion
• Indigestion
• Poor memory
• Feelings of frustration
• Alternating diarrhea and constipation
• Osteoporosis
• Auto-immune hepatitis
• Auto-immune diseases
• Lightheadedness
• Palpitations
• Dizziness that occurs upon standing
• Poor resistance to infections
• Low blood pressure
• Insomnia
• Food allergies
• PMS
• Craving for sweets
• Dry and thin skin
• Headaches
• Scanty perspiration
• Alcohol intolerance

Balancing Your Meals for Blood Sugar Control

To sustain good adrenal function it is important to control the blood sugar level by:

• Eating small meals or snacks every 3-4 hours
• Eating within the first hour after waking up
• Eating small snacks before going to sleep
• Eating before feeling hungry to avoid low blood sugar (hypoglycemia = stress on the adrenal glands).

Based on:

• ‘Adrenal Fatigue: The 21st Century Stress Syndrome’ by James Wilson and Jonathan V. Wright
• ‘The Gluten Effect’ by Vikki Petersen and Richard Petersen

Previous research showed that taking an acidic substance (like hydrochloric acid) at the same time as the levothyroxine improved the drug absorption to the bloodstream. That inspired the latest research to investigate the effect of ascorbic acid on decomposition and absorption of the levothyroxine.

It was found that vitamin C improves the oral absorption of the levothyroxine (ref). The results showed that the presence of vitamin C improves the drug absorption. In consequence, the serum concentration of T4 and T3 improves and the serum TSH decreases and normalizes.

However, the patience who participated in this study did not have a celiac disease. Meaning, the damage to the intestines at celiacs (especially in the beginning of the gluten free diet when the intestine is not yet healed) is expected to play a role in malabsorption of the levothyroxine.

The treatment of Hashimoto’s should actually be focused on treating the immune system. Such an overactive immune system that attacks the body’s cells needs to be calmed down. This is important. Some try to improve their health by using ‘superfoods’ but it seems that not everybody understands that ‘superfoods’ are highly functional ingredients. They can stimulate human organism and be beneficial to health but they can also be harmful when used incorrectly, especially for those who already developed some disease(s). Before using ‘superfoods’ it is good to research if the particular ingredient benefits our individual condition.

Literature shows that if the treatment of Hashimoto’s doesn’t direct the immune system but instead only suppresses the symptoms of Hashimoto’s, the immune system will attack other body tissues. The immune system is programmed to protect us. When it sees a threat it attacks. What triggers the imbalanced reaction of the immune system (and an auto attack) is still not fully understood. Recent studies suggest that the ‘leaky gut’ can be one of the reasons. It seems that once such an auto-attack is activated it cannot be stopped. It can however be reduced.

How to soothe the autoimmune reaction

Our immune system has two main arms: Th1 and Th2.
Th1 is responsible for the production of NK cells (natural killer) and T cells (lymphocytes = white blood cells), which are responsible for ‘killing the intruders’, whereas Th2 is responsible for the production of B lymphocytes, which point out the cell that must be destroyed.

Usually, one of the arms is more active than another and a suitable treatment should be adjusted accordingly. To define this, usually the level of cytokines is tested. Cytokines are small proteins used in cells communication, also in communication between the lymphocytes Th (helpers) and the immune system.
Cytokines are a bit like hormones. Too high level of cytokines Th1 or Th2 blocks thyroid receptors and does not allow hormones to enter the cells. This blockage leads to hypothyroidism.

How do we know which cytokines dominate (Th1 or Th2)

Cytokines of Th1:

• IL-2
• IL-12
• TNF alpha
• Interferon

Cytokines of Th2:

• IL-4
• IL-10
• IL-13

Balancing Th1 and Th2

Balance between Th1 and Th2 is essential to improve functioning of thyroid in Hashimoto’s patients. It requires adaptation of a new diet and lifestyle, aimed at calming the immune system.

It is necessary to support and balance the lymphocytes T (regulatory). What helps:

• Vitamine D (the highest safe level)
• EPA/DHA (Omega3)
• Glutathione (ref)

Besides, the weaker arm of the immune system should be stimulated.

Stymulation of Th1 (when Th2 dominates)

• Astragalus
• Echinacea
• Mushrooms’s Beta-glucan
• Mashroom Maitake
• Liquorice
• Melissa

Stymulation of Th2 (when Th1 dominates)

• Caffeine
• Green tea
• Grape seed extract
• Pine bark extract
• Willow bark extract
• Lycopene
• Resveratrol
• Pycnogenol

Modulation of Th1 and Th2

• Probiotics
• Vitamine A
• Vitamine E
• Colostrum

Lowering IL-1*, activation of Th1 and Th2

• Boswellia
• Pancreas enzymes
• Turmeric (Kurkuma)

*IL-1 = cytokines, which play a central role in the regulation of immune and inflammatory responses.

It sounds straightforward. But it seems that it is not that easy to test which arm of the immune system is weaker. Perhaps this is also a reason why it is not commonly practiced (it sounds pricey too). This is why, paying an attention to the body responses is very important. For example, how a person reacts to the stimulants associated with the particular arm, Th1 or Th2.

Also, it seems that in some cases, both arms Th1 and Th2 are equally dominant but the level of the lymphocytes T is low. That means that some antigen is stimulating the immune system. An antigen can be a fungus, virus, heavy metal, pesticides or gluten.

Figures 1-5

[See image gallery at glutenfreelady.nl]

Source: Tluste Zycie (Highly recommended if you can read Polish)

Literature shows that although Hashimoto’s is the most common form of hypothyroidism, it is still often misdiagnosed. The doctors conclude hypothyroidism based on increased level of the hormone TSH in blood and subscribe synthetic thyroid hormone T4. Often, they don’t bother to test the TPO and TG antibodies. Even if they do test the antibodies, the treatment doesn’t change. The cause of our condition is never investigated by the conventional doctors.

But a gland does not just stop functioning properly without any reason. It is a secondary condition. A human body consists of many organs that cooperate and communicate together. Each organ relies on other organs and their performance.  These are strongly affected by our diet, lifestyle, stress level etc.

What causes the low performance of the thyroid?

• A diet of too little calories
• Too intense training
• Not enough of carbohydrates in a diet
• Weaker performance of hypothalamus
• High level of estrogen
• High level of prolactin
• Low level of progesterone
• High level of testosterone at women
• Malnutrition
• Problems with digestion
• Chronic infections
• Diet rich in foods that cause inflammation like gluten, sugar, dairy, alcohol, coffee
• Stress
• High level of homocysteine
• Toxins
• Anemia
• Lack of Hydrochloric acid
• Instable glucose level in blood

The factors listed above influence the thyroid health directly or indirectly. Using a synthetic hormone to fix it might reduce some of the symptoms temporarily but after a couple of weeks the symptoms come back. Inhibition of one symptom does not solve the cause of the problem. In contrary, it leads to further imbalances like:

• If you already have high testosterone, and you start using the synthetic T4 hormone and the contraceptive pill, it results in too high level of estrogen.
• If you have a problem with digestion and thyroid, and you start using the synthetic T4 hormone, you are not improving the absorption of the nutrients nor the intestinal bacterial flora risking impaired conversion of T4 to T3.

Besides, lab results do not show what is really happening on the cellular level. Your TSH, T4 and T3 levels might be ideal while you still experience all the symptoms of Hashimoto’s.

The key to recovery is a good doctor ‘detective’, who looks into the level of TPO and TG antibodies and does not base the entire treatment on level of the TSH just to prescribe ‘suitable’ dose of levothyroxine.

Main source: Tluste Zycie (Highly recommended in you can read Polish)

In the Netherlands if you have celiac disease and Hashimoto’s you will regularly visit two different doctors. Your Hashimoto’s will be controlled by Internist (in Dutch also ‘Internist’) and the celiac will be under supervision of so called ‘Stomach – Intestine – Liver’ specialist (in Dutch ‘Maag- Darm- Lever’, MDL-arts).

Since a lot of the symptoms of Hashimoto’s and celiac are very similar, it took years before my celiac was diagnosed. It happened by a coincident after my Internist diagnosed me with the iron-deficiency anemia. Surprised by the low level of iron, she decided to screen my blood on celiac disease. First, I thought it was exaggeration; I had no suspicions of having celiac. When the results arrived and I received the phone call with the news, I could not believe and decided to run the test again in Poland (my home country). Well, it was positive for the second time.

Symptoms of Hashimoto’s

Most common

• Fatigue (99%)
• Dry, coarse skin (97%)
• Lethargy (91%)
• Eyelid edema (90%)
• Cold intolerance (89%)
• Decreased sweating (89%)
• Pallor of skin (67%)
• Cognitive changes like memory impairment (66%)
• Constipation (61%)
• Weight gain (59%)
• Loss of hair (57%)
• Peripheral (55%)
• Hoarseness (52%)
• Heavy (menorrhagia) or irregular menstrual periods (32%)

Other

• Muscle pain
• Stiff and tender joints, particularly in the hands, feet and knees
• Dry, thinning hair
• Yellowish skin due to inability to convert  beta carotene into vitamin A
• White discoloration of skin especially on upper arms
• Impaired fertility
• Problems getting pregnant
• Giving birth to a baby with birth defects
• Miscarriage
• Decreased libido
• Slowed heart rate
• High cholesterol
• Heart problems
• Shortness of breath
• Recurrent hypoglycemia
• Fluid retention (oedema)
• Swelling of the legs
• Puffy face
• Decreased sense of taste and smell
• Unnatural sleepiness
• Decreased concentration
• Slow though process
• Sluggish reflexes
• Diminish cognition
• Slow motor function
• Drowsiness
• Irritability
• Moodiness

Why some people have more symptoms than others? Check this video to find out the answer.

The thyroid gland makes two thyroid hormones, triiodothyronine (T3) and thyroxine (T4). A nice video’s explaining the thyroid hormones production (video 1) and common thyroid problems (video 2).

Two brain structures (the pituitary gland (fig 2) and the hypothalamus) regulate the thyroid hormones as follows (video 3):

• The hypothalamus prompts the pituitary gland to make a thyroid-stimulating hormone (TSH).
• The pituitary gland checks the amount of T4 and T3 in the blood and releases TSH. If the T4 and T3 levels need to be increased.
• The thyroid gland secretes the needed T4 and T3. The more TSH the thyroid receives, the more T4 and T3 it secretes.
• The pituitary gland may stimulate the thyroid gland to make T4 and T3 but, in the case of Hashimoto’s disease, the thyroid gland can’t deliver them.
• The immune system creates antibodies that attack thyroid tissue. The thyroid gland becomes inflamed and thyroid cells become permanently damaged (can’t make T4 nor T3).
• In response, the pituitary gland secretes more thyroid-secreting hormone (TSH).
• Then the thyroid may enlarge (goitre).

[See image gallery at glutenfreelady.nl]

Hashimoto’s disease is an autoimmune disorder, meaning the body’s immune system attacks its own healthy tissues. The immune system makes antibodies that attack cells in the thyroid and restrict the ability to produce thyroid hormones. Large numbers of white blood cells called lymphocytes accumulate in the thyroid. Lymphocytes make the antibodies that initiate the autoimmune process. Over time, thyroid damage can cause thyroid hormone levels to be too low. This is called an underactive thyroid or hypothyroidism. An underactive thyroid causes every function of the body to slow down, such as heart rate, brain function, and the rate your body turns food into energy.

Consequences of having Hashimoto’s

• abnormal calcium metabolism
• chronic constipation (risk of infection)
• reduced efficiency of the liver and gall bladder (also kidney)
• reduced production of growth hormone
• reduced metabolism and weight gain
• glucose metabolism disorder (slowly enters the cells having symptoms such as “brain fog” and causing hypoglycemia)
• elevated levels of cholesterol and triglycerides
• problems with correct functioning of the brain (mood swings, depression)
• abnormal metabolism of estrogen (this may lead to breast cancer, ovarian cysts)
• disturbed metabolism of adrenal hormones
• deficiency of progesterone and stopping ovulation
• anemia
• increased levels of homocysteine ​​and heart disease risk
• reduced body detox (thyroid hormones affect the phase II of the detox in the liver)
• reduced production of hydrochloric acid and impaired metabolism of proteins

When I was diagnosed with celiac disease I wanted to know what exactly is happening inside of my body when I eat gluten and why is it so bad to me.

Every time gluten reaches my intestines, the enzyme produced in the intestinal wall called tissue transglutaminase (tTG) breaks down gluten into individual elements: gliadin and glutenin. The part of the immune system located in the gut, which is the gut associated lymphoid tissue (GALT), reviews everything that enters the digestive system for the possibly harmful substances. The GALT of people with celiac disease recognizes gliadin as a dangerous substance and produces antibodies to attack it. These antibodies, however, do attack not only the gliadin, but also the tTG that broke down the gluten in the first place. The tTG enzyme has another important role, it is responsible for holding together the intestinal microvilli.

Hence, when the antibodies attack the tTG, the microvilli can degenerate and disappear. Normally, the intestinal microvilli increase the surface area of the intestine and absorb nutrients. The lack of the villi, which assists the celiac disease, results in a ‘leaky gut’. In order to absorb nutrients, our gut is permeable to tiny molecules. Regulating that permeability is the basic function of the cells that line the intestinal wall. In celiac people, gluten can cause the gut cells to release zonulin, a protein that can break the tight junctions (TJs) apart. Disruption of the TJs leads to intestinal hyper permeability (the so-called ‘leaky gut’) (ref). That means that toxins, microbes and undigested food particles, among others, leak through the intestines and travel with the bloodstream. One of the things allowed to escape are the antibodies that the body produced to attack the gliadin. These antibodies confuse tTG with gliadin but also attack other organs. This is why having a celiac disease increases the risk of developing another autoimmune disease like (in my case) Hashimoto’s. Mechanism  of the disease

Gastrointestinal symptoms:
(mostly due to fat malabsorption)

• Diarrhea
• Stomach crumps
• Constipation
• Vomiting
• Acid reflux
• Abdominal bloating and pain
• Nausea
• Irritable bowel
• Indigestion
• Sticky, greasy stools
• Loose stools
• Poor absorption of nutrients, medicines and supplements
• Hemorrhoids
• Cancers of the intestine (rare cases)

(due to carbohydrate malabsorption caused by a lack of the lactase enzyme located on a surface of the villi)

• Lactose intolerance
• Abdominal distention
• Excessive flatulence

Other symptoms resulted from poor absorption of nutrients:

• Fatigue
• Energy loss
• Excessive sleeping
• Irritable and fussy behavior
• High cholesterol
• Hair loss
• Easily bruising
• Fluid retention and joint swellings
• Itchy skin with a rash (dermatitis herpetiformis)
• Nosebleeds
• Arthritis
• Anemia
• Osteoporosis (fig 1)
• Epilepsy
• Hypothyroidism
• Rheumatism

Fig 1. Bone structure – healthy and with osteoporosis.

[See image gallery at glutenfreelady.nl]

Oral symptoms:

• Gum disease
• Swollen gums
• Bad breath
• Tooth enamel erosion
• Tooth cracking
• Mouth infections
• Mouth ulcers
• Cavities

Female-specific symptoms:

• Irregular menstruation
• Heavy, painful menstruation
• Hormonal level swings
• Breast tenderness
• Early menopause
• Swollen bladder
• Bludder infections
• Infertility
• Reduced fertility
• Miscarriages

Neurological symptoms:
(Peripheral neuropathy – nerve damage:  motor nerves, sensory nerves, and autonomic nerves) 

• Tingling or numbness in the hands or feet
• Ataxia
• Muscle cramps (legs, back)/pains
• Muscle twitching
• Muscle weakness
• Abnormal blood pressure or heart rate
• Lowered body temperature
• Reduced ability to sweat normally
• Poor balance
• Sudden feelings of fear or anxiousness
• Dizziness
• Changes in vision
• Migraines (chronic headaches)
• ADHD

Weight related symptoms:

• Decreased or increased appetite
• Constant hunger
• Overweight or weight loss
• Poor growth / underweight (especially children)

Psychological symptoms:

• Depression
• Difficulty to concentrate
• Memory loss
• Foggy mind
• Learning disabilities
• Moodiness
• Mood swings
• Tearfulness
• Irritability
• Irrational anger
• Isolation
• Lost interest in activities
• Sleeping issues

Common nutrient deficiencies:
Minerals:

• Calcium
• Copper
• Iron
• Magnesium
• Phosphorus
• Potassium
• Selenium
• Zinc

Vitamins:

• Vitamin A (retinol, retinal, and retinoic acid)
• Vitamin D (calciferol)
• Vitamin E (alpha-tocopherol)
• Vitamin K (phylloquinone, menadione)
• Vitamin C (ascorbic acid)
• Vitamin B₁ (thiamine)
• Vitamin B₂ (riboflavin)
• Vitamin B₃ (niacin or niacinamide)
• Vitamin B₆ (pyridoxine, pyridoxal, or pyridoxamine, or pyridoxine hydrochloride)
• Vitamin B₉ (folic acid)
• Vitamin B₁₂ (cobalamins)

Eliminated gluten from the kitchen:

• All food products from the kitchen shelves – even if originally it contained no gluten it  probably became polluted upon using
• All food products from the fridge
• Jams and other products in open jars/tins – most likely polluted with a knife having bread crumbles on it
• Wooden kitchen accessories like cutting boards and wooden spatulas
• Colander
• My old bread box
• Old frying pans that were not easy to clean anymore
• Baking forms/molds
• Old toaster

Cleaned really well:

• All kitchen surfaces
• Kitchen shelves
• Oven
• Fridge
• Plates, cutlery and pots
• Cloth kitchen towels
• Dining table and mats

Bought new:

• Cutting boards
• Spatulas
• Baking forms
• Bread baking machine – with a fast gluten free program
• Bread box and bags with a seal to keep bread in it
• Frying pans

Removed all the gluten containing medicines and supplements from the medicine cabinet.

Learnt how to distinguish hazardous and gluten free products (how to read the label’s and recognize gluten free logo’s) 

Checked gluten free department in every store in a neighborhood

Checked online shops for gluten free products

Started baking gluten free bread, cookies, cakes etc. using gluten free ingredients (my recipes)

Filled my kitchen shelves, fridge and freezer with naturally gluten free foods 

Visited a dietitian and learnt following:

• The celiac symptoms can occur already after consumption of 10 milligrams of gluten, (otherwise known as a bread crumb) and this is why the contamination has to be avoided by any means
• Web shops with gluten free products
• Handy recipes
• Handy links to find the safe food, e.g. Livaad.nl
• About ‘De Nederlandse Coeliakie Vereniging’
• About tax compensation (ref)
• Overall tips regarding how to stay gluten free

Subscribed to the Dutch Celiac Association ‘De Nederlandse Coeliakie Vereniging’ 

• Membership card
• Discount when shopping for gluten free foods at certain shops (e.g. webshop, EcoPlaza)
• Welcome packet from DNCV
• Welcome packet from Schar
• Brochures with information’s
• Invitations to organized by DNCV events like baking workshops, gluten free markets, symposium’s etc.
• Mails informing about new gluten free products available on a Dutch market
• Other

Found blogs / websites written by other celiacs/doctors/ scientist for ideas and inspiration, knowledge but also support!

* After my diagnosis I found a following post by Gluten free Goddess ‘here’ . Check it out! 

What is Celiac Sprue

Celiac disease (coeliac; or in Dutch ‘coeliaki’) is an autoimmune disorder, a condition in which the body’s immune system attacks its own cells and tissues. All it takes to develop the celiac is to be genetically predisposed. In the Netherlands the celiac disease seems to affect already 1 in 100-150 persons.

The disease can activate regardless the age and it is a chronic condition. The only known effective treatment in celiac disease is a lifelong gluten free diet  (gluten  free diet basics). The exact triggers to develop celiac are still unknown, but experts believe that times of extreme emotional or physical stress, health issues, and too high gluten levels in the modern diet or other environmental factors (like pesticides or heavy metals) can set the stage.

Fig 1-4

[See image gallery at glutenfreelady.nl]

The main characteristic of the celiac disease is an abnormality in the lining of the small intestine (fig 1) – the part of digestive tract connecting the stomach with the large intestine. Normally, the lining of the small intestine consists of tiny finger-like tissues called villi (fig 2). Consumption of gluten, though, leads to a reaction in the small intestine upon which the immune system causes inflammation and damages the intestinal villi (fig 3). We have villi to increase the surface area of the intestine. Besides, the villi contain specialized cells that transport substances into the bloodstream. In other words, we need villi to absorb nutrients from our food; otherwise nutrients just pass through the digestive track and we develop malnutrition. The vitamins and minerals normally absorbed in the small intestine are necessary for many important body functions (fig 4) and their lack causes other serious conditions like e.g. osteoporosis, rickets, neuropathy, diabetes (ref), depression, infertility, anemia or even lymphoma.

But that is not all. The vitamin D3 and the incredibly important brain hormone (neurotransmitter) Serotonin are produced in the intestinal villi. Serotonin is responsible for well-being and happiness. Approximately 90% of the serotonin is located in the intestinal tract, where it is used to regulate intestinal movements. Besides, Serotonin regulate mood, appetite, and sleep. It also has some cognitive functions, like our memory and learning ability. Vitamin D, which is normally produced in healthy intestine, is required for healthy bones. Lack of this vitamin is linked to depression, joints pain, muscle pain, chronic fatigue but also cancer! Each person diagnosed with cancer has extremely low vitamin D level.

Common nutrient deficiencies 
Minerals

• Calcium
• Copper
• Iron
• Magnesium
• Phosphorus
• Potassium
• Selenium
• Zinc

Vitamins

• Vitamin A (retinol, retinal, and retinoic acid)
• Vitamin D (calciferol)
• Vitamin E (alpha-tocopherol)
• Vitamin K (phylloquinone, menadione)
• Vitamin C (ascorbic acid)
• Vitamin B1 (thiamine)
• Vitamin B2 (riboflavin)
• Vitamin B3 (niacin or niacinamide)
• Vitamin B6 (pyridoxine, pyridoxal, or pyridoxamine, or pyridoxine hydrochloride)
• Vitamin B9 (folic acid)
• Vitamin B12 (cobalamins)